Nanette Gartrell

Psychiatric symptoms in medical students

Abstract The current study examined the presence of psychiatric symptomatology in a sample of medical students. Results demonstrated that while medical students evidenced levels of symptomatology that were considerably lower than those previously reported in outpatient psychiatric samples, they evidenced considerably higher symptom levels than those previously reported in a general population survey. Compared to the general population, medical students showed a mild elevation in somatic symptoms, a moderate elevation in anxiety and depressive symptoms, and a substantial elevation in obsessive-compulsive symptomatology and in interpersonal sensitivity. The marked elevations in obsessive-compulsive symptomatology and in interpersonal sensitivity may reflect, in part, a sensitization to excessive performance demands that is manifested by anxiety-induced cognitive inefficiencies such as indecisiveness, blocking, or memory impairment and by excess sensitivity to the evaluative opinions of other individuals. In comparing students from the four classes, there was no significant relationship between the year in school and symptom level. In examining sex differences, women reported a significantly higher level of total symptomatology and higher symptom levels on four of the five subscales examined. The largest sex differences were observed in the symptom areas of depression and interpersonal sensitivity.

REPORTING PRACTICES OF PSYCHIATRISTS WHO KNEW OF SEXUAL MISCONDUCT BY COLLEAGUES

Of 1423 psychiatrists responding to a national survey, 65% reported treating patients who had been sexually involved with previous therapists. Respondents saw these prior involvements as harmful in 87% of cases but reported the sexual abuse in only 8% of cases. The majority, however, favored mandatory reporting of such incidents. The problem of underreporting and the need for effective management of sexual abuse cases are discussed.

Sex differences in the naming of children's genitalia

Childrens knowledge of human genital anatomy was examined retrospectively. Of the 223 adults who responded to a questionnaire on this subject, 39.8% of males and 29% of females learned correct anatomical names for male genitalia as children. In contrast, only 6.1% of females and 17.7% of males learned correct names for female genitalia. Most respondents learned either euphemisms or no names for female genitalia as children. Whereas male respondents acquired a complete vocabulary for male genitalia by a mean age of 11.5 years, female respondents did not complete their anatomical vocabulary for female genitalia until a mean age of 15.6 years. The importance of recognizing that children have erotic experiences and that they need a vocabulary for describing their feelings is discussed.

Gay Patients in the Medical Setting

Approximately 20 million people in this country are predominantly homosexual for some part of their lives.1,2 An even larger number engage in homosexual activity from time to time. Although the average physician may not be aware of the sexual orientation of most patients, he can expect that about 5%–10% of patients are homosexual. This chapter examines the special needs and problems of the gay patient in seeking health care from non-gay physicians.