Purpose: The purpose of this study was to determine the impact on resource use of providing case managers with information on the potential for patients to benefit from home care services. Design and Methods: Twenty-four case managers working in the Arizona Long Term Care System (ALTCS) were randomized into treatment and control groups. Members of…

This paper illustrates one kind of "impasse" in psychoanalytic psychotherapy described by Rosenfeld (1987 [1995]. Clinical illustrations from the experiences of two adolescent patients are given. The author emphasises that perversion reinforced the confusion these patients felt in the transference and in their lives outside treatment. An internal…

Objective: Psychosomatic medicine, also known as consultation-liaison psychiatry, received approval as a subspecialty field of psychiatry by the American Board of Medical Specialties in the spring of 2003. This represents a crucial step in the development of the field of psychosomatic medicine and recognition by leaders in the fields of medicine…

Objective: This report describes an educational intervention designed to improve psychiatry residents' inpatient charting skills. Methods: The residency training committee formed a multidisciplinary team to study the problem by using quality improvement principles. The team hypothesized that residents' charting would improve with education about…

Objectives: The aims of the pilot study presented here were to determine whether low income women were receiving compendious breastfeeding advice from their attending physicians. Design: This study assessed low income women's reports of physician breastfeeding advice using a newly designed Likert scaled survey based on the American Surgeon…

Obsessive-compulsive symptoms are a common feature of schizophrenia, and high rates of obsessive-compulsive disorder (OCD) have been reported in schizophrenic patients. Effective pharmacotherapeutic options are available for both OCD and schizophrenia, and for some patients combining medications targeted at both conditions may be a helpful…

In this article, we describe a cognitive behavioral treatment approach to cases of obsessive-compulsive disorder (OCD) that have not responded to standard outpatient evidence-based treatment. The approach begins with an assessment of the reasons why patients have not responded to treatment, which can be grouped into two categories: (a)…

Objective: Both the National Institute of Mental Health and the American Psychological Association have called upon psychodynamic practitioners to start demonstrating their outcomes. This effectiveness study attempted to begin to answer these calls. Method: The study was a secondary analysis of data from a multidisciplinary, psychodynamic mental…

The extent and course of psychological distress were examined in a representative sample of patients attending a primary health care practice in metropolitan Adelaide where general practitioner (GP) and clinical psychologist services are co-located. Scores for psychological distress were similar to national norms. Approximately one in six patients…

Cancer treatment outcomes have improved over the past 20 years, but treatment decision making in this context remains complex. There are often a number of reasonable treatment alternatives, including no treatment in some circumstances. Patients and doctors often have to weigh up uncertain benefits against uncertain costs. Shared decision making…

Genital human papillomavirus (HPV) is the most prevalent and widespread sexually transmitted disease and is responsible for almost all cases of cervical cancer worldwide. However, HPV has received little public health attention, is not a reportable STD, and often is absent from the repertoire of STDs. In addition, there is pervasive misinformation…

This study examined how Parkinson's disease patients cope with disease-related stressors over time. Of interest was whether patterns of coping would support a dispositional model of coping (i.e., stability) or a contextual model of coping (i.e., change). The influence of stability and change in coping on mental and physical health outcomes was…

In the delivery of clinical services, outcomes monitoring (i.e., repeated assessments of a patient's response to treatment) can be used to support clinical decision making (i.e., recurrent revisions of outcome expectations on the basis of that response). Outcomes monitoring can be particularly useful in the context of established practice research…

Context: Physician assistants (PAs) and nurse practitioners (NPs) have licensure to practice in all states and they have prescriptive authority in 47 and 40 states, respectively. However, there have been no published studies from a national standpoint comparing urban and rural settings. Purpose: The objective of this study was to describe the…

This randomized trial is a first evaluation of a brief psychotherapeutic intervention for primary care patients. Sixty-two participants were randomly assigned to the intervention or to treatment as usual. As compared with treatment as usual, the intervention led to significant reductions in symptoms of anxiety and depression. The reduction was…