James R. Hillard

Psychiatric disorders of abused women at a shelter.

Thirty physically abused women were randomly selected from the population of a local womens shelter and evaluated by psychiatric interview and psychiatric rating scales. High prevalences of major depression disorder (37%) and PTSD (47%) were determined. Furthermore, these disorders were found to be positively associated. These results suggest the need for immediate availability of psychiatric services at such shelters along with further study of their populations and possible intervention strategies.

Knowledge and Attitudes of University Health Service Clients about Genital Herpes: Implications for Patient Education and Counseling.

Abstract Genital herpes virus infection is an important target for health education efforts because of its apparently rising incidence in the college student population and because it can have potentially serious psychological as well as medical consequences. In order to better understand the health education and counseling needs of students, the present study surveyed knowledge and attitudes about genital herpes of 190 university students using a gynecology clinic and of 161 students using a general medical clinic. The students were found to have a high degree of familiarity with the disease, its cause, and mode of transmission, but tended to view the consequences of the disease as more severe than is actually warranted by the common medical complications. There was some degree of misinformation about prevention and treatment of the disease and some negative attitudes about patients suffering from it, but the survey respondents endorsed a high level of responsible behavior with regard to the disease and ...

Residency training in emergency psychiatry : changes between 1980 and 1990.

Independent random samples of residency training programs were surveyed in 1980 and in 1990 about their emergency psychiatry training. A larger percentage of the programs required daytime emergency service duty in 1990 (80%), compared with 1980 data (50%), and a larger percentage offered a daytime block training rotation, defined as at least 5 days a week of emergency psychiatry for at least 4 weeks (48%), compared with 23% in 1980. Each sample reported that the most important topics in emergency psychiatry were being taught. In 1990, two trends were noted: 1) more faculty psychiatrist time allocated to the emergency service, and 2) more emergency patient visits per shift. In 1990, the residents said they felt more stressed by the heavy patient load and lack of disposition facilities than in 1980, but less stressed by the lack of faculty interest and backup. Based on the data, the interpretation was made that emergency psychiatry training had improved over this period; however, it was indicated that further improvement was also needed.

Prevalence of eating disorders in the psychiatric emergency room.

A random sample of 143 patients from a centralized psychiatric emergency service with a catchment area of one million people was studied. A two-stage interview was conducted for diagnosis of DSM-III-R eating disorders. Of those reporting active bingeing, 14.5% were men, and 22.4% were women. No cases of anorexia nervosa were discovered. Bulimia nervosa was diagnosed in 3.0% of the women and 2.6% of the men. Race and marital status were unrelated to bingeing or to any eating disorder diagnosis. Many patients never had discussed their eating behaviors before with a therapist.

Underdiagnosis using SCIDR in the homeless mentally ill

There are a growing number of studies attempting to diagnose the degree and extent of mental illness among the homeless. Increasingly, these studies are relying on structured diagnostic interviews such as the structured clinical interview for DSM III R diagnosis (SCIDR). This study examines the sensitivity of the SCID in diagnosing major mental illness among the homeless. Comparing SCID interviews with hospital chart diagnosis of twenty-three homeless individuals, the study found that whereas the positive predictive value of the SCID is high in that it accurately predicts a positive diagnosis, its negative predictive power is quite low. A negative SCID diagnosis does not accurately reflect a negative history of mental illness. The study indicates that single point interviews cannot be relied upon to accurately diagnose past history and, therefore, future need for treatment.