Vietnam veterans in the general hospital.

Posttraumatic stress disorder is now well known to occur among Vietnam combat veterans. The interest in this diagnosis may have caused an unintentional neglect of veterans with problems that do not meet the strict criteria of DSM-III for this disorder. The authors studied 300 Vietnam veterans admitted to a general hospital to determine their level of symptomatology and to gather data on this previously unstudied group. More than 75 percent of the sample were medical-surgical patients; about 50 percent had high levels of depression and symptoms of posttraumatic stress disorder, or both. Combat veterans were considerably more symptomatic; more than 50 percent of the patients with the highest levels of combat activity were on nonpsychiatric wards. The authors suggest the need to identify Vietnam veterans on medical and surgical wards. Reluctance to talk about war experiences makes Vietnam veterans a group likely to be overlooked.

Hypnosis compared to relaxation in the outpatient management of chronic low back pain.

Chronic low back pain (CLBP) presents a problem of massive dimensions. While inpatient approaches have been evaluated, outpatient treatment programs have received relatively little examination. Hypnosis and relaxation are two powerful techniques amenable to outpatient use. Seventeen outpatient subjects suffering from CLBP were assigned to either Self-Hypnosis (n = 9) or Relaxation (n = 8) treatments. Following pretreatment assessment, all subjects attended a single placebo session in which they received minimal EMG feedback. One week later the subjects began eight individual weekly treatment sessions. Subjects were assessed on a number of dependent variables at pretreatment, following the placebo phase, one week after the completion of treatment, and three months after treatment ended. Subjects in both groups showed significant decrements in such measures as average pain rating, pain as measured by derivations from the McGill Pain Questionnaire, level of depression, and length of pain analog line. Self-Hypnosis subjects reported less time to sleep onset, and physicians rated their use of medication as less problematic after treatment. While both treatments were effective, neither proved superior to the other. The placebo treatment produced nonsignificant improvement.

Psychiatric residents' attitudes toward teaching.

The authors surveyed psychiatry residents in academic training programs to determine the amount of time they spent in teaching activities and to assess their attitudes toward teaching. They found that most residents spent from 1 to 2 hours per day teaching and felt they should do more. They tended to see themselves as capable teachers, and they valued traditional medical skills. They did not seem to value the use of audiovisual materials, written handouts, or self-instructional materials. Most of the residents had received no formal instruction designed to make them better teacher or direct feedback from faculty supervisors about their teaching skills.

Hemodialysis and schizophrenia: a double-blind study.

Partial or total remission of schizophrenic symptoms after exchange transfusion or hemodialysis have been reported in the literature. Although the results of these reports are encouraging, they have not been confirmed by controlled studies. We have conducted a double-blind placebo-controlled study to evaluate the effect of hemodialysis on chronic schizophrenia. Our data seem to indicate that some schizophrenic symptoms improve after hemodialyses.

Effect of hemodialysis on hallucinations.

A patient with chronic schizophrenia had two hemodialyses and two sham dialyses in a single-blind design. There was no change in the patient's affect after either procedure, but her auditory hallucinations disappeared after both hemodialysis and sham dialysis, with hemodialysis inducing a much longer partial remission.