PSYCHODRAMA AS A TREATMENT FOR HOSPITALIZED PATIENTS: A CONTROLLED STUDYSLAWSON, PAUL FREDRIC
doi: 10.1176/appi.ajp.122.5.530pmid: 4378658
PAUL FREDRIC SLAWSON M.D. 1 1 Assistant Professor (in residence) in the Department of Psychiatry, School of Medicine, University of California at Los Angeles Twenty-seven hospitalized adult psychiatric patients participated in twice-weekly psychodrama sessions. They were matched on the basis of three variables (age, sex, MMPI profile) to controls drawn from the psychiatric hospital population. Both experimental and control patients were given a general personality inventory (MMPI) on admission and were retested at discharge. Such testing failed to distinguish between the psychodrama and control groups. These findings are discussed in the context of the available literature.
THE 15-MINUTE HOUR: BRIEF THERAPY IN A MILITARY SETTINGBARTEN, HARVEY H.
doi: 10.1176/appi.ajp.122.5.565pmid: 5835829
HARVEY H. BARTEN M.D. 1 1 Chief, Psychiatry, at the 36th Tactical Hospital, Bitburg Air Force Base, APO 132, New York, N. Y. The usefulness of very brief psychiatric appointments in treating many different kinds of patients is reported. It is suggested that the 15-minute interview is entirely sufficient for many patients who are relatively poor candidates for exploratory psychotherapy. Moreover, it is also an acceptable though limited alternative for some of the patients who ideally would receive more lengthy treatment. A few mornings of 15-minute appointments enable the psychiatrist to expand his practice considerably, while still preserving the great majority of his time for other, more exhaustive psychotherapeutic techniques.
THE CATECHOLAMINE HYPOTHESIS OF AFFECTIVE DISORDERS: A REVIEW OF SUPPORTING EVIDENCESCHILDKRAUT, JOSEPH J.
doi: 10.1176/appi.ajp.122.5.509pmid: 5319766
JOSEPH J. SCHILDKRAUT M.D. 1 1 Clinical Associate, Section on Psychiatry, Laboratory of Clinical Science, National Institute of Mental Health, Bethesda, Md. The "catecholamine hypothesis of affective disorders" proposes that some, if not all, depressions are associated with an absolute or relative decrease in catecholamines, particularly norepinephrine, available at central adrenergic receptor sites. Elation, conversely, may be associated with an excess of such amines. Evidence supporting this hypothesis was reviewed. Data from pharmacological studies, mainly in animals, suggest that the actions of both major classes of antidepressant drugs are mediated through the catecholamines. The monoamine oxidase inhibitors increase brain concentrations of norepinephrine while imipramine-like agents potentiate the physiological effects of norepinephrine. Reserpine, a drug which can cause clinical depression, depletes catecholamines, but other amines may also be involved in its mechanism of action. A rigorous extrapolation from pharmacological studies to pathophysiology clearly cannot be made. Clinical studies relevant to the catecholamime hypothesis are limited and the findings are inconclusive. It is not possible, therefore, to confirm definitively or to reject the catecholamine hypothesis on the basis of data currently available. In our present state of knowledge, however, the catecholamine hypothesis is of considerable heuristic value, providing the investigator and the clinician with a frame of reference integrating much of our experience with those pharmacological agents which produce alterations in human affective states.
"TANDEM" TEACHING TO NONPSYCHIATRIST PHYSICIANSNICHOLAS, JAMES B.; RANSOHOFF, WILLIAM
doi: 10.1176/appi.ajp.122.5.489pmid: 5835818
JAMES B. NICHOLAS M.D. 1 , and WILLIAM RANSOHOFF M.D. 1 1 Department of Psychiatry and Dr. Ransohoff with the Department of Internal Medicine, University of Cincinnati College of Medicine The "tandem" pair in our teaching of physicians in other specialties consists of a psychiatrist and a physician in the same specialty as the trainees. Both members of the tandem pair attend each session and are simultaneously responsible for the operation of the teaching vehicle, whether it is a conference, ward rounds or a lecture-demonstration. Some factors interfering with cooperative leadership, and ways of dealing with these factors, are discussed. The goals of our program are outlined. We believe this method has particular value for training nonpsychiatrist physicians because it furnishes the trainee with a useful model in his own specialty with whom he can identify. The paper closes with a brief comment about the research value of such a teaching method.