Assessment in undergraduate psychiatric education

An assessment of medical students' psychiatric performance demonstrated no association between the ability to rate psychopathology or to observe interview behaviour and traditional written methods of academic achievement. This is in accordance with those few studies which have addressed this issue and indicates that there may well be at least three independent skills involved in clinical decision-making: the ability to engage in interpersonal interaction and elicit information; and the ability to acquire and use academic knowledge. This is consistent with work suggesting that maturational and learning processes influence clinical reasoning, and demonstrates that each component should be addressed in assessing students in psychiatry.     

帕罗西汀治疗广泛焦虑症的疗效分析

目的 观察帕罗西汀对广泛焦虑症的临床疗效和副反应。方法 对60例临床诊断为广泛焦虑症的住院病人服用帕罗西汀治疗4周。采用汉密尔顿焦虑量表(HAMA)评价其疗效，不良反应症状量表(TESS)评价其副反应。结果 帕罗西汀治疗广泛焦虑症的有效率为86．7％，痊愈率为63．3％，副反应较轻。结论 帕罗西汀对广泛焦虑症治疗安全而有效，尤其适用于老年人。     

Nocturnal penile tumescence as a biologic marker in assessing erectile dysfunction

Recent findings challenge the belief that most cases of impotence are psychogenic. Research indicates that nocturnal penile tumescence (NPT) can be viewed as a biologic marker for physiologic erectile capacity. Thus, the test can help to distinguish between physicogenic and psychogenic impotence. To determine proximal causes of erectile failure, other evaluations are easily performed during NPT monitoring.     

HLA antigens in affective disorders and schizophrenia

The distribution of HLA antigen frequencies has been studied in patients with affective disorders. There were no significant differences between bipolar patients, unipolar patients, or controls. Preliminary data on HLA antigen distribution in schizophrenic patients are reported. Our negative results in affective disorders are discussed in relation to HLA studies reported from other laboratories, with special reference to some potential methodological problems.     

The biopsychosocial approach: Clinical examples from a consultation-liaison service

In this second of three articles exploring Engel's biopsychosocial model, five case histories illustrate how psychological factors, sometimes related to organic trauma or illness, may precipitate psychiatric conditions. The patients’ disorders, and their management by a consultation-liaison team, demonstrate the interaction of biologic, psychological, and social systems in assessment and treatment of disease.     

Effects of female sterilization: one year follow-up in a prospective controlled study of psychological and psychiatric outcome

A prospective controlled study of the psychological effects of elective interval and postpartum tubal sterilization was carried out on a selected sample of women. Subjects were interviewed pre-operatively (n = 138) and one year post-operatively (n = 116; 83%), using standardized instruments and procedures, including the Present State Examination. No differences within or between sterilization and control groups were found over the follow-up year in the prevalence of psychiatric morbidity, which was no higher than would be expected in a general population sample. Beneficial effects of sterilization were reported on a number of psychosexual variables. Adverse effects such as regret or deterioration in marital relationship were rare, but were more likely to occur in postpartum subjects, among whom abdominal pain was also reported more commonly at one year follow-up than pre-operatively. The relevance of "normal" postnatal events and of the role of pre-operative counselling are considered in relation to these findings. Less favourable outcome at one year follow-up was commonly associated with higher PSE scores pre-operatively.     

ER "capture" of the skid-row alcoholic

In response to the spiraling anger and frustration voiced by the emergency room (ER) medical staff and the observed negative interactions between the alcohol-dependent patient and the ER staff, the author completed a 6-month retrospective review of all patients evaluated by the ER service with a complaint of alcohol abuse, chronic alcoholism, or requesting detoxification. As a result of that study, an ER-based comprehensive approach to the management of this population was proposed. Utilizing an existing Connecticut state statute, a specific approach to manage the skid-row alcoholic arriving repeatedly in the ER was developed. I report on this ER-based model and an approach to "capturing" the skid-row alcoholic.     

精神科医院感染的临床调查

目的了解我院精神科医院感染发病率,分析发生医院感染相关因素,减少医院感染的发生。方法采用回顾性调查分析,对我院精神科2000年1月~2004年12月的住院病历进行分析,计量资料进行均数计算,计数资料用χ2检验。结果9 089例精神科住院患者发生医院感染313例次,医院感染率为3.44%,总感染率呈逐年下降趋势(P<0.05);感染部位以上呼吸道(34.82%)、胃肠道(20.45%)、泌尿道(18.53%)为主;女病区医院感染率(3.83%)高于男病区医院感染率(3.07%)P<0.05;重管室医院感染构成比(57.51%)高于康复室医院感染构成比(42.49%)P<0.05。结论根据精神科医院感染的特点,必须加强医生、护士的防护意识和医院感染的重点监控,减少医院感染的发生。