RESUMO
The authors describe a prepaid mental health service program in which outpatients referrals were 34.7 per 1,000 members per month, the hospital admission rate was .80 admissions per 1,000 members per year, and the average length of hospital stay was 5.03 days. They offer several explanations for their finding that the costs for mental health services in this program appear lower than those in fee-for-service programs.
Assuntos
Sistemas Pré-Pagos de Saúde , Serviços de Saúde Mental/organização & administração , Assistência Ambulatorial , Arizona , Honorários e Preços , Hospitalização , Humanos , Transtornos Mentais/diagnóstico , Transtornos Mentais/terapia , Serviços de Saúde Mental/estatística & dados numéricos , Psiquiatria , Psicoterapia , Encaminhamento e ConsultaRESUMO
The author examined the incidence and severity of extrapyramidal symptoms (EPS) in 19 male psychotic outpatients receiving fluphenazine decanoate. Ten patients developed an EPS; only 3 had symptoms of the highest severity. The data suggest that neither prophylactic nor long-term use of antiparkinsonian agents is necessary for most patients receiving fluphenazine decanoate. On the basis of a comparison to a study of fluphenazine enanthate patients, the author concludes that fluphenazine decanoate is the drug of choice in terms of incidence and severity of EPS.
Assuntos
Antiparkinsonianos/administração & dosagem , Doenças dos Gânglios da Base/induzido quimicamente , Flufenazina/efeitos adversos , Adulto , Antiparkinsonianos/uso terapêutico , Doenças dos Gânglios da Base/tratamento farmacológico , Doenças dos Gânglios da Base/prevenção & controle , Decanoatos/efeitos adversos , Transtorno Depressivo Maior/tratamento farmacológico , Heptanoatos/efeitos adversos , Humanos , Masculino , Pessoa de Meia-Idade , Esquizofrenia/tratamento farmacológicoRESUMO
A review of both past and present psychiatric literature reveals that the concept of hypochondriasis is inexact and confusing. In an attempt to make hypochondriasis a meaningful and useful concept for practicing clinicans, a functional classification is presented that views hypochondriasis from four aspects--(1) as a "warning signal," (2) as a symptom of psychosis, (3) as a symptom of depressive illness, and (4) as a syndrome labelled "true hypochondriasis." Each of these aspects is discussed, with emphasis placed on specific and practical recommendations for treatment.
