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Rumination in patients with eating disorders
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Ciraulo, DA; Sands, BF; Shader, RI
doi: N/Apmid: 2904227
The authors critically reviewed the literature on benzodiazepine use among alcoholics, psychiatric patients, and the general population to determine whether alcoholics have a greater liability for benzodiazepine abuse. Data suggest that the prevalence of benzodiazepine use among alcoholics is greater than in the general population but comparable to the prevalence in psychiatric patients. The liability for abuse may also be greater for alcoholics, but the substantial methodologic deficiencies of existing studies preclude such a conclusion. Given the frequency of anxiety disorders and benzodiazepine use among alcoholics, their potential for benzodiazepine abuse is an important issue. The authors discuss clinical
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doi: N/Apmid: 3057925
Over the past 15 years the health maintenance organization (HMO) movement has abandoned its social objectives in favor of economic ones. The early emphasis on making equitable and affordable health care available to populations has been superseded by concerns about profitability, market share, and consumer appeal. Psychiatric services, which came late in the HMO movement, were characterized by common values and priorities in the closed-panel HMOs of the 1970s. Trends toward independent practice associations (IPAs) and other open-panel systems, rising expectations, and the monetarization of health care are forcing prepaid psychiatrists to
doi: N/Apmid: 3057921
As soon as there is reasonable evidence for the diagnosis of Alzheimer's disease (primary progressive degenerative dementia), the physician should urge legal and financial counseling of the patient and the family in planning for the patient's long-term care. The general purposes and the process of such counseling are described as a guide for physicians who care for these patients and their families. The issues of informed consent, competency, powers of attorney, guardianship, inter vivos trusts, wills, and living wills are discussed. Timely planning eases the burden on the family and assists the physician in the patient's care during the later
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