Effectiveness of a psychiatric pain clinic.

Medical charts were reviewed for 101 consecutive outpatients seen between January 1, 1993 and July 1, 1996 at a unidisciplinary, psychiatric pain clinic, which exists within a hospital-based, university-run, outpatient service with primary and specialty care clinics. Mean duration of pain was 7 years. Multiple sites of pain were present in 69% of patients. Eighty-eight percent fulfilled DSM-IV criteria for pain disorder. The patients had significantly fewer medical visits and diagnostic tests 6 months after attending the pain clinic, compared with 6 months before (P < 0.0001). Interventions frequently included detoxification and reduction and substitution of medication, and always included psychotherapeutic approaches, particularly support and suggestions.     

Development and function of a psychiatric liaison clinic

The author explains the rationale behind the formation of an outpatient psychiatric liaison clinic at Boston City Hospital, describes the services provided there, and reviews the clinic's first year of operation. The clinic is an outgrowth of a consultation-liaison service and it integrates consultation and liaison functions within a clinic setting. It provides diagnostic evaluation and treatment of a wide range of psychosomatic disorders within the context of active liaison with the medical staff, and adds an important dimension to the research and educational needs of the traditional consultation-liaison service.     

Indications for psychotherapy in a psychiatric clinic population. A survey.

As a part of a larger project of trying to differentiate the therapies for inpatients in a psychiatric clinic, we have made a half year's survey of the patients' needs for short-term dynamic psychotherapy. Our findings point to less than 10% of the inpatients being able to profit from this kind of therapy. These findings and their implications are discussed briefly.     

The prevalence of psychiatric disorder among female new referrals to a migraine clinic

In a consecutive series of 46 female new referrals to a migraine clinic, 17 patients (37%) complained of increased irritability and/or depression in association with more than 50% of their migraine attacks. This was not related to the attack frequency or duration. Sixteen patients (33%) met DSM-III criteria for a current diagnosis of an affective syndrome and when present this was significantly associated with these complaints.     

Management of pain in pain clinic (review of 1348 cases)

Our series have shown that psychotherapy and physiotherapy when incorporated with specific therapy, produced a much better relief from pain and that the functional return of ability of the affected part was quicker.     

Effectiveness of telemedicine in the outpatient pulmonary clinic.

BACKGROUND: Over the past several years, there has been a resurgence of interest in telemedicine. Despite this renewed interest, some health care providers remain skeptical regarding the effectiveness of telemedicine for the delivery of health care. OBJECTIVE: The objective of this prospective, crossover study was to determine if there was any difference between care delivered using video conferencing-based telemedicine technology and that given by a traditional face-to-face encounter in a pulmonary medicine clinic. METHODS: Two pulmonologists sequentially examined 40 individuals via video conferencing-based telemedicine technology and by the traditional face-to-face method. Two additional pulmonologists, in a blinded fashion, compared the results for consistency in the history, examination with focus on auscultation of the lungs, diagnostic impression, and evaluation and treatment plans. RESULTS: Evaluation of patients by telemedicine was as effective as the traditional mode. The telemedicine physician and the physician examining the patient in the traditional manner were able to elicit the same key complaints and hear the same adventitious sounds on auscultation of the lungs. CONCLUSION: Telemedicine can enable the provision of high-quality care in a pulmonary clinic setting.     

Indications for psychotherapy in a psychiatric clinic population. Reliability and validity of evaluations.

A half-year survey was made on an in-patient clinic population as to a specific kind of short-term dynamic psychotherapy. The reliability and validity of the evaluations are discussed. It was found that a moderate accordance in evaluations could be found between the evaluators, with a high degree of reliability.     

The comparative effectiveness of community clinic and psychiatric hospital treatment.

Explored in this study are the pre- and posttreatment differences in clients going to clinics and patients going to hospitals for treatment. As expected, clients were found to be better adjusted initially than their hospitalized counterparts, and both groups showed more improvement in symptoms than in their instrumental role functioning. Unexpected was the finding that hospitalized patients (especially females) showed more improvement than clinic clients, when the pretreatment adjustment differences between groups were controlled. This study supports a growing body of evidence indicating that hospital-based treatment is not necessarily less effective than treatment in the community.     

Patients visiting the complementary medicine clinic for pain: a cross sectional study

Background  

Pain is one of the most common reasons for seeking medical care. The purpose of this study was to characterize patients visiting the complementary medicine clinic for a pain complaint.     

Screening of lower back pain, low back pain clinic. The clinical experience

Acute low back pain is a common complaint with high prevalence in society. Orthopaedic and specialist spinal services may be overwhelmed by large numbers of patients with low back pain who do not require investigation or surgical intervention. This phenomenon has led to the establishment of back pain screening clinics as a system of triage for those with acute low back pain. In March 2001, a back pain screening clinic was established in the Adelaide and Meath Hospitals incorporating the National Children's hospital. Six hundred and sixty-five patients were seen in the first year of this clinic. Of these, only ninety-six required referral to the orthopaedic spinal clinic. Just twenty-nine of these patients required surgical intervention. The introduction of this service resulted in a reduction in the waiting periods for the specialised spine clinic. We conclude that back pain screening clinics result in a clinical and economical improvement in the care of those suffering from acute low back pain. This is achieved by the systematic and efficient assessment, treatment and referral of patients afflicted with acute low back pain.     

The application of computerized content analysis of speech to the diagnostic process in a psychiatric outpatient clinic

Twenty-five new psychiatric outpatient were clinically evaluated and were routinely administered a brief psychological screening battery which included measures of symptoms, personality, and cognitive function. Included in this assessment procedure were the Gottschalk–Gleser Content Analysis Scales on which scores were derived from five-minute speech samples by means of an artificial intelligence-based computer program. Intercorrelations of these content analysis measures with scores obtained from the MMPI-2, SCL90, and other measures confirmed previously published construct validation findings. The use of this computerized content analysis procedure for initial, rapid diagnostic neuropsychiatric appraisal is supported by this research. © 1997 John Wiley & Sons, Inc. J Clin Psychol 53 : 427–441, 1997.