A bibliography of mental patients' autobiographies: an update and classification system.

OBJECTIVE: This article brings to the present earlier bibliographies of books written by former mental patients. These books provide an inside view of mental disorder that can be useful in teaching, public education, theory, and research, and they have played a catalyzing role in mental health reform and in theory development. METHOD: The authors list seven anthologies and 48 autobiographies of former patients published since 1980 and introduce a classification system intended to increase the research value of this important archive. RESULTS: Recent books of this genre show more individuals with a mood disorder and more therapists and more women as authors. CONCLUSIONS: The research potential of these books suggests the value of an electronic database for classifying and retrieving the information they contain.

A case of a chemically dependent patient with a thalamic pain syndrome treated with amitriptyline.

A fifty year old white male with a right sided thalamic pain syndrome became alcohol and benzodiazepine dependent in an attempt to alleviate the pain. He entered an inpatient alcohol and drug treatment facility where, in an attempt to treat this pain, he was placed on low dose amitriptyline. Comparison of results on a symptoms checklist (SCL-90-R) completed at amitriptyline dosages of 30 mg. and 50 mg. showed a statistically significant difference in the somatization scale (p = .029). The low dose of amitriptyline used, its low blood level, and the early onset of effect make it unlikely that its antidepressant action was a significant factor in this patient's pain relief. This is, perhaps, the first described case where low dose amitriptyline has been shown to relieve the thalamic pain syndrome in a chemically dependent person.

The use of bromocriptine for the treatment of attention deficit disorder in two chemically dependent patients.

The dually diagnosed patient with attention deficit disorder, residual type (ADD-RT) may be especially prone to cocaine abuse, because ADD includes dopamine deficiencies and cocaine is a dopamine agonist. It is hypothesized that bromocriptine, a dopamine agonist, will reduce a patient's craving for cocaine and simultaneously address the patient's ADD-RT symptoms. A single-organism, double-blind research design is used to evaluate the efficacy of bromocriptine, as measured by scale 9 of the MMPI, the digit span and digit symbol tests of the Wechsler Intelligence Scale-Revised, and the signaling to numbers test. Statistical analysis of the results revealed an equivocal response to bromocriptine.

The use of laboratory intervention to stem the flow of fresh-frozen plasma.

Four methods of laboratory intervention were tested by the hospital blood bank in an effort to modify the use of fresh-frozen plasma (FFP). Over a one-year period, a utilization audit was serially initiated with feedback to physicians, a recurrent educational program was introduced for housestaff delineating guidelines for FFP use, a form was introduced requiring justification for FFP orders, and a policy was established requiring pathologist approval of FFP in patients with normal or no coagulation studies. Overall, in comparing the period following all forms of intervention (February 1986-October 1986) to the baseline period prior to any form of intervention (July 1984-March 1985), FFP use dropped 52% in the face of a 17% increase in red blood cell use. It was concluded that blood bankers can dramatically alter the use of this product using established methods for modifying physician ordering behavior.