Faculty Bibliography

A survey of psychiatric inpatient, outpatients, and consultation services of a large general hospital showed a high incidence of undiagnosed physical illnesses in psychiatric patients. The finding is consistent with that of other researchers and highlights the need for a comprehensive medical examination of all psychiatric patients. The authors discuss the clinical diagnostic interface between physical and psychiatric disorders, as well as medical complications of psychiatric treatment and the reaction of psychiatric patients to physical illness. One recommendation for improving the delivery of medical care to this population is to equip psychiatric services to give complete medical work-ups as part of the standard psychiatric evaluation of entering patients

An increasing number of young, childless women currently seek tubal ligation for fertility control. They state that they have no maternal aspirations and that available contraceptive methods are not safe enough. This aspect of voluntary sterilization has received little attention by psychiatrists in the past. This paper presents a psychological picture of seven women with a particular focus on some psychodynamic considerations underlying their wish to remain childless and the role of the psychiatrist in the decision-making process for this procedure

The authors observed the management of 35 manic patients admitted to a 32-bed general hospital unit that emphasized milieu treatment. They concluded that the principles of treatment derived from the therapeutic community model--democratization and permissiveness--are generally incompatible with the effective treatment of manic patients, who can be a strong disruptive force on the patient and staff community. The authors describe approaches to managing manic patients in four phases--preadmission evaluation, and the postadmission, middle, and termination phases of inpatient treatment. They stress that milieu modifications are necessary to meet individual treatment needs