Mollie C. Grob

Alcohol, Drugs, and Psychiatric Disorders A Current View of Hospitalized Adolescents

This study investigated the type, frequency, and chronicity of alcohol and drug use, impact of such use on functioning, and concomitant psychiatric diagnoses, symptomatology, and behavioral problems among adolescent psychiatric inpatients. The sample consisted of 29 males and 19 females under 20 years of age consecutively admitted to a psychiatric hospitaL Self-report and clinical measures were used to assess substance use and other psychiatric symptoms and problems. Results suggested that approximately 50% of the sample had problems with alcohol or drugs. Those with substance abuse problems reported more difficulty with interpersonal relationships, daily living skills, depression/anxiety, anud impulsivity than did those without substance abuse problems. Other symptoms and problems preceded alcohol and drug use. The findings are consistent with those of several other studies and support the need for identification and appropriate treatment for the substance abuse as well as for other psychiatric symptoms and problems.

The role of the high school professional in identifying and managing adolescent suicidal behavior

The ongoing contact of adolescents with high school staff may provide an opportunity for the early identification and effective management of suicidal behavior. In this study, the knowledge, attitude, and experience of 80 high school professionals regarding adolescent suicide were assessed through semistructured personal interviews. Respondents identified more than 30 signs of potential vulnerability — manifestations of depression, verbal and written cues, isolation, and self-destructive behaviors. Among predisposing factors, those related to alienation within the family were most prominent. Other important risk factors were low self-esteem, difficulty in peer relationships, and economic or ethnic differences from other students. When suicidal behaviors occurred, respondents saw students and staff as attempting to be helpful; families were more often viewed as defensive.

Medical care in a geriatric psychiatry unit: impact on psychiatric outcome.

The medical care of 49 randomly selected patients admitted to a geriatric psychiatry evaluation unit was assessed to determine the impact on psychiatric care and outcome. Medical factors were identified as directly causing psychiatric symptoms in 12 of the 49 cases, whereas psychiatric decompensation was precipitated by medical illness in 25. Previously undiagnosed significant medical problems were found in ten patients. In 25 cases concomitant medical illness had a major effect on psychiatric treatment, and in 23 the course of the medical illness affected psychiatric outcome. Seventy‐nine per cent of the patients had at least moderately improved at the time of discharge, and most were able to return to their homes. Improvement in medical condition was correlated significantly with psychiatric improvement. Implications for the care of geriatric psychiatry patients are discussed.

Validity of record ratings of the Global Assessment Scale

The Global Assessment Scale (GAS) is a comprehensive rating of psychiatric status that is usually based on face-to-face interviews. Validity has not been established for the use of the GAS when it is based on secondary sources of information about the patient, source of patient information, although secondary sources have been used for this purpose. The current study examined agreement between GAS ratings based on medical records and ratings based on face-to-face interviews. Results showed moderate agreement between the two sets of ratings, with the intraclass correlation-coefficient (ICC) equaling .62. Record-based (R)-GAS ratings were upwardly biased and were restricted in range when compared with interview-based (I)-GAS ratings. A case-by-case analysis showed that the disagreement could be accounted for by inconsistent documentation of the degree of functional impairment in the most severely disturbed patients. We conclude the following: If R-GAS ratings are used, designs should be modified to adjust for probable overestimated functioning of the most severely disturbed patients.

A follow-up study of Berkeley House--a psychiatric halfway house.

IT is well documented that community residential care for the mentally ill is JL rapidly expanding. The number of halfway houses in the United States has grown from 7 in 1960 (14) to 209 in 1973 (10). In spite of considerable literature emerging describing these programmes, there is relatively little in the way of followup evaluation. Including several departure studies in Glasscote, Gudeman, Elpers (5), there are approximately twenty-eight published evaluative reports on halfway house programmes (11). Of these, however, the vast majority are departure studiesgiving the vocational, domiciliary, and clinical status of the residents at the time they leave the community residence. Only five studies were found to be true follow-up studies seeking to determine the status of the ex-resident some interval after leaving the halfway house (7,16,15,9,4). There are several problems that one must address in approaching these evaluations. Controlled studies would be ideal; however, it would be unrealistic and impractical to attempt them for any extended duration in an ongoing clinical programme. The populations served by the community residence are so variable

Adolescent patients in transition : impact and outcome of psychiatric hospitalization

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How Families View Psychiatric Hospitalization for Their Adolescents: a Follow-Up Study

~’HIS is a preliminary report on some results of a continuing follow-up study 1 of 67 of the 97 adolescent patients treated at McLean Hospital between September 1961 and May 1963. The sample includes all adolescents, aged 13 to 19 years, who were hospitalized for three months or more. Thirty patients whose length of stay was under three months were eliminated from the study. The focus of this paper, and a major objective of the study, is an investigation and documentation of family reactions to the hospitalization experience. Other analyses of the follow-up data are projected. In the last decade, the number of adolescent admissions to mental hospitals throughout the country has increased greatly. According to Hansen (1969)1, In recent years the out-of-joint nature of our society apparently makes it difficulty for many adolescents to grow up without displaying