George L. Adams

Pharmacotherapy of the chronic patient: Gender and diagnostic factors

Clinical data from 1752 patients in five, ambulatory community mental health centers were used to test hypotheses about the diagnosis and psychopharmacotherapy of chronic patients. Analysis focused upon the interrelationships among gender, diagnosis, and the number of medications and dosages prescribed. Men and women differed in their age distributions and in the diagnoses received. Women were more often diagnosed with affective disorders than were men. There were also notable interaction effects with ethnicity. There was little evidence of differential drug prescribing practices, although women were somewhat more likely than men to be prescribed anti-psychotics and anti-depressants in the absence of an appropriate diagnosis.

Mental Health, the Poor, and the Promised Land—The Houston Consortium Training Program

The title of this paper reflects the contradictory implicit premises and real difficulties that confront health and mental health professionals in their efforts to redress past shortcomings, meet current challenges, and set realistic goals for the provision of comprehensive care to the poorer segments of United States society. Born out of the optimism of the early 1960s, the community mental health

Attitudes in the development of public sector clinicians.

Attitudes have been a neglėcted variable in the development of public sector clinicians. Clinicians of differing disciplines may commonly possess attitudes which would affect their role in the public sector. The Houston Consortium assessed some of these attitudes in their students and faculty. The results may have heuristic implications for improving mental health care.

Mental health in primary care training and practice: an innovative approach.

The need to augment the number of primary care physicians throughout the nation has been well documented. Moreover, there is increasing recognition of the importance of mental health in primary care practice. The authors present a working definition of primary care practice, discuss the role of mental health in primary care, and describe an innovative program developed in Houston which integrates primary care mental health training into the education of primary care physicians and mental health professionals.

Culture, Primary Care, and Community Mental Health

underscores the fact that sociocultural pluralism will continue to be a significant aspect of American life (Dashejsky, 1976; Marden & Meyer, 1968). Concomitantly, the last two decades have witnessed, in the parallel development of the primary -care and community mental health movements, an impetus toward making services more accessible and culturally relevant to previously underserved segments of the population (Girodano ,1976; Musto ,1977; National Health Council, 1975). Issues of ethnic diversity have become the focus of considerable attention in community mental health (Giordano, 1973; Giordano & Giordano, 1976), and the Presidents Commission on Mental Health (1978) asserted that such factors should be regarded as

Pharmacotherapy in the Public Sector Care of Hispanics

It is believed that the unique characteristics of Hispanics, rooted in their cultural heritage, play a major role in their utilization of mental health services and response to pharmacotherapeutic treatment (1,2). Moreover, it is believed that the Hispanic patient seen in the public sector typically suffers from a major psychiatric disorder. Epidemiological studies have suggested that the poor, including Hispanics, are more often labeled as being severely mentally disordered, and that the Hispanic population suffers a higher incidence of major psychiatric disorder than the general population (3,4). Some studies report that there are more Hispanics who have functionally impairing symptomatology compared to other persons who are mentally ill (4,5). Still other research has shown that low income, poorly educated patients, Hispanics included, are accepted less often into psychotherapy (7). Furthermore, low income groups generally receive less physician time than more affluent groups (8), and are more likely to be on chemotherapy (7). Thus the public sector mental health care network is most often the primary point of access for Hispanics who require mental health services in the United States, and pharmacotherapy is considered to be an integral part of the treatment plan for the Hispanic patient.

The Couvade Syndrome: Its Psychophysiological, Neurotic, and Psychotic Manifestations

The psychosomatic and other emotional problems of fatherhood are probably more frequent than the relatively small number of publications on the subject would indicate. Couvade is the name given a process or custom in which a husband develops symptoms of pregnancy during his wife’s parturient and puerperal periods. Much neglected in the psychiatric literature, most references to couvade are limited to the psychophysiological reactions seen in expectant fathers. The purpose of this paper is to explore the complexities of couvade and to demonstrate its occurrence not only as a psychophysiologic reaction but as a neurotic and psychotic disorder as well.