Psychometric properties of the Fletcher Recovery Housing Alliance Measure (FRHAM-12).

Recovery Housing (RH), an important resource for substance use disorder (SUD) recovery, centers on shared lived experience. Program evaluation considers the contribution of environmental factors to outcomes, yet most research on outcomes has focused on patient factors and fidelity to protocols. Investigations of process measures reflecting the dynamic interplay between patient factors and the treatment program are limited.

Patient complexity, depression, and quality of life in patients with epilepsy at an epilepsy center in Japan.

Objective: The relationship between care complexity and quality of life among patients with epilepsy has not been assessed, especially in Japan. The aim of this study is to test the hypothesis that care complexity is associated with health-related quality of life (HRQOL) and mood disturbance.

Method: This was an observational cross-sectional study.

The relationship between the INTERMED patient complexity instrument and Level of Care Utilisation System (LOCUS).

Objective: To investigate the concurrent and criterion validity of two independently developed measurement instruments, INTERMED and LOCUS, designed to improve the treatment and clinical management of patients with complex symptom manifestations.

Methods: Participants (N = 66) were selected from hospital records based on the complexity of presenting symptoms, with tripartite diagnoses across biological, psychiatric and addiction domains. Biopsychosocial information from hospital records were submitted to INTERMED and LOCUS grids.

Childhood Enuresis: Current Diagnostic Formulations, Salient Findings, and Effective Treatment Modalities.

Enuresis constitutes a frequently encountered problem area for children that may adversely affect social and emotional adjustment. This type of incontinence has been of concern to the human family for centuries. A brief history of enuresis is presented followed by current conceptualizations, diagnostic criteria, prevalence rates and psychiatric comorbidities.

Depression and Liver Transplant Survival.

Background: Patients who underwent liver transplantation and experienced clinical depression have heretofore evinced lower survival rates when compared to nondepressed counterparts.

Objective: To investigate the hypothesis that transplant patients who seek and obtain medical treatment for depression would circumvent the prior reduced survival findings.

Methods: A total of 765 patients with liver transplants were scrutinized for complications following transplantation.

Confirmatory Factor Analysis of the Delirium Rating Scale Revised-98 (DRS-R98).

Principal components analysis applied to the Delirium Rating Scale-Revised-98 contributes to understanding the delirium construct. Using a multisite pooled international delirium database, the authors applied confirmatory factor analysis to Delirium Rating Scale-Revised-98 scores from 859 adult patients evaluated by delirium experts (delirium, N=516; nondelirium, N=343). Confirmatory factor analysis found all diagnostic features and core symptoms (cognitive, language, thought process, sleep-wake cycle, motor retardation), except motor agitation, loaded onto factor 1.

Using the INTERMED complexity instrument for a retrospective analysis of patients presenting with medical illness, substance use disorder, and other psychiatric illnesses.

Background: The financial and treatment challenges of complex patients must be addressed with adequate assessment and evaluation. The INTERMED complexity instrument (INTERMED) has been developed for this purpose, but to date has not been used retrospectively. The current study represents a retrospective validity investigation of INTERMED with patients with substance use disorder comorbid with other psychiatric and medical conditions (triple diagnoses).

Treatment of delirium with risperidone in cancer patients.

Aim: Antipsychotic medications have frequently been regarded as the treatment of choice for delirium. This study examined the clinical efficacy of risperidone for the treatment of delirium in cancer patients, combined with a repeated assessment of underlying medical severity levels.

Methods: The study included consecutive referrals of 29 delirious cancer patients (mean age, 68.

Coefficient alpha and interculture test selection.

The internal consistency reliability of a measure can be a focal point in an evaluation of the potential adequacy of an instrument for adaptation to another cultural setting. Cronbach's alpha (α) coefficient is often used as the statistical index for such a determination. However, alpha presumes a tau-equivalent test and may constitute an inaccurate population estimate for multidimensional tests.

Functional neuro-imaging and post-traumatic olfactory impairment.

Objective: To evaluate via a research literature survey the anterior neurological significance of decreased olfactory functioning following traumatic brain injuries.

Materials And Methods: A computer literature review was performed to locate all functional neuro-imaging studies on patients with post-traumatic anosmia and other olfactory deficits.

Results: A convergence of findings from nine functional neuro-imaging studies indicating evidence for reduced metabolic activity at rest or relative hypo-perfusion during olfactory activations.

Early-onset Major Depressive Disorder in men is associated with childlessness.

Methods: The self-reported number of children was compared for men and women from the National Epidemiologic Survey of Alcoholism and Related Conditions Survey (NESARC). Subjects with a diagnosis of major depressive disorder or bipolar disorder were compared to those without an axis I disorder. The effect of age, gender, marriage and diagnostic status on number of children was completed using multivariate analyses.

Psychiatric consultation and substance use disorders.

Background: A substantial number of patients in general hospitals will evince substance abuse problems but a majority is unlikely to be adequately identified in the referral-consultation process. This failure may preclude patients from receiving effective interventions for substance use disorders.

Objectives: 1.

More on Darwin's illness: comment on the final diagnosis of Charles Darwin.

Without the possibility of confirmatory exhumation, diagnostic inferences about Darwin's illness must remain speculative. A diagnosis of Darwin's aggregate symptoms must account for not only gastrointestinal distress but also his predominant and excessive retching and the conglomerate of other heterogeneous symptoms. We opine that Crohn's disease, posited as the 'final diagnosis', is not sufficient for subsuming his pleiomorphic symptomatology.

Review of two years of experiences with SPECT among psychiatric patients in a rural hospital setting.

We summarize single proton emission computed tomography (SPECT) findings from 63 psychiatric patients in a small rural hospital in western Minnesota. SPECT scans were ordered only for patients in whom documentation of hypoperfusion and functional deficits might be helpful in clarifying diagnoses and treatment planning. The patients referred for SPECT scans had histories of traumatic brain injuries, atypical psychiatric symptom presentations, or conditions that were refractory to standard treatments.

Misdiagnosed delirium in patient referrals to a university-based hospital psychiatry department.

The authors examined the factors associated with referral errors in which the presence of delirium was ostensibly not recognized by medical staff personnel. Medical records of 541 university-hospital patients consecutively referred for psychiatric consultation were scrutinized for extant delirium. The data indicated that a greater likelihood of a missed diagnosis was associated with younger age; referrals outside of family practice service; orientation as to person, place, and time; and a history of bipolar affective disorder or psychosis.

A comparison of psychiatric consultation liaison services between hospitals in the United States and Japan.

The authors investigated psychiatric consultation in two hospitals, one in the United States, the other in Japan. They examined similarities and differences, and drew inferences on possible cross-cultural values and/or temporary cultural conditions. As compared with the Japanese consultation patients, the Americans had more mood disorders, including anxiety and chemical-dependency problems, in respective diagnostic classifications.

Delirium: patient characteristics that predict a missed diagnosis at psychiatric consultation.

Objective: This study evaluates patient characteristics that might predict a missed diagnosis of delirium prior to being seen by a psychiatric consultant.

Method: Study participants were assessed using quantitative standardized scales of cognitive function, delirium and physical impairment.

Results: Referring service personnel missed the diagnosis of delirium in 46% of psychiatric consultations.

T-cell clonality analysis in biopsy specimens from two different skin sites shows high specificity in the diagnosis of patients with suggested mycosis fungoides.

Background: The diagnosis of mycosis fungoides (MF) is often difficult because of significant clinical and histopathologic overlap with inflammatory dermatoses. T-cell receptor (TCR)gamma chain rearrangement by polymerase chain reaction (PCR) (TCR-PCR) is a helpful adjuvant tool in this setting, but several of the inflammatory dermatoses in the differential diagnosis of MF may contain a clonal T-cell proliferation.

Objective: We examined whether analysis for T-cell clonality and comparison of the clones with the standardized BIOMED-2 PCR multiplex primers for the TCRgamma chain from two anatomically distinct skin sites improves diagnostic accuracy.

Psychosis or temporal lobotomy: SPECT findings in a paraplegic patient with chronic mental illness.

Objective: To ascertain if single proton emission computerized tomography (SPECT) imaging involving a patient with a history of head trauma, paraplegia, and chronic mental illness, would provide useful information regarding diagnosis and treatment.

Method: A case report.

Results: SPECT data indicated a convexity of the temporal lobe; it was significantly crumpled inward in the location of the traumatic blow suffered 18 years earlier.

Histopathologic spectrum of erythema nodosum.

Erythema nodosum (EN) is the most common panniculitis and histologically represents the prototype of a septal panniculitis. However, the histologic findings can be quite variable. We describe four patients with EN who each underwent two consecutive biopsies.