Shahe S. Kazarian

Predictive validity of the level of expressed emotion (LEE) scale: Readmission follow‐up data for 1, 2, and 5‐year periods

The predictive validity of the Level of Expressed Emotion (LEE) Scale in a group of schizophrenic patients was examined. Forty-six patients with DSM-III diagnoses of schizophrenic disorders were administered the perceived expressed emotion measure (LEE) and followed up for a 5-year period. Patients ratings of their social environments were related to rehospitalization 1 year, 2 years (p < .02) and 5 years (p < .01) after initial assessment. These results supported the utility of the LEE in identifying schizophrenic patients at high risk for rehospitalization.

Inter-rater Reliability of Twelve Diagnostic Systems of Schizophrenia

The present and past symptomatology of 31 chronic schizophrenics was rated by four independent judges, two experienced clinical psychiatrists and two psychiatric residents, in a context more representative of actual clinical practice than most research studies. Ratings were made on 64 symptoms derived from 12 diagnostic systems, based on either live or videotaped interviews for present symptomatology and case records for past symptomatology. Inter-rater reliabilities were higher for present than for past symptoms, and in general did not approach those reported for highly trained raters. There were no differences between live and videotaped interviews. Diagnostic systems differed widely in rater agreement. The most consistent across both past and present symptomatology were the systems of Langfeldt, Schneider, and DSM-III, for which the level of reliability was consistent with other studies.

Perceived interpersonal attitudes and psychiatric complaints in patients with essential hypertension

The association between perceived interpersonal attitudes and psychiatric complaints in a group of hypertensives (N = 37) was evaluated. The Influential Relationships Questionnaire (IRQ), which measures perceived care, overprotection, and criticism, was administered to all patients. Hypertensives with psychiatric complaints (n = 14) were not different in terms of age, gender, obesity, smoking, alcohol intake, occupational stress, drug treatment, and baseline systolic and diastolic blood pressures compared to hypertensives without psychiatric complaints. They were, however, different in perceiving their social environment. Hypertensives with psychiatric complaints perceived their social environment as less caring, more overprotective, and more critical. Finally, patients without psychiatric complaints showed better outcome in terms of baseline vs. follow-up measures of systolic and diastolic blood pressures than did patients without psychiatric complaints.

Influential Relationships Questionnaire: Data from a Nonclinical Population

The Influential Relationships Questionnaire, a state measure of the perceived characteristics of care, overprotection, and criticism of significant others, was administered to 99 staff of a provincial psychiatric hospital. The relationship of scores to sex, marital status, and amount of weekly contact with two most influential people was examined. Analysis indicated that scores are independent of sex, marital status, and amount of weekly contact for the most influential person. The implication of normative data in relation to perceived attitudes and psychopathology is discussed.

Psychiatric Assessment of Patients with Life-Threatening Cardiac Arrhythmias

Objective: This article describes the development of a protocol specifically designed for the psychiatric assessment of patients with life-threatening ventricular arrhythmias. Method: Psychiatric assessment occurs in the context of a team approach in which the cardiologist has a pivotal role. Initial findings and one-year follow-up data on the first twenty-five patients evaluated psychiatrically are presented. Results: Findings tend to confirm that psychiatric complaints are common on initial assessment and suggest that patients with life-threatening ventricular arrhythmias who do not use the psychological mechanism of denial and volunteer psychological complaints may constitute a subgroup of patients who would be more amenable to psychiatric intervention compared to those denying psychological complaints at initial psychiatric interview. Conclusion: Psychiatrists and associated professionals should become more involved with patients with life-threatening cardiac arrhythmias.

Evaluation of two relaxation training programs under medication and no-medication conditions

This study evaluated two taped relaxation training programs with 39 psychiatric inpatients, half of whom received minor tranquilizers in conjunction with relaxation training. It appeared that the procedurally enhanced relaxation program was able to produce slightly more therapeutic effects than the standard training program. Significant differences were found between the medicated and the unmedicated groups by multivariate analysis of variance on multiple measures, including heart rate and frontalis EMG. Procedural clarity in relaxation treatment research and the importance of considering contextual factors in the treatment setting are stressed.

Psychiatric Treatment Strategies for Patients at Risk of Dying Suddenly

This paper outlines the development of psychiatric treatment approaches to certain patients with life-threatening ventricular arrhythmias which may affect outcome, both psychological and, at times, medical. Three cases sketches which illustrate psychiatric management strategies are presented. One case history indicates how lack of adherence to such treatment contributed to a negative outcome. Emphasis is placed on an integrated approach to psychiatric treatment which is individualized for each patient. The importance of close liaison with cardiologist, selective psychotherapy, stress management skills and family involvement is highlighted.