The education of the psychiatrist as a physician.

Reasoning that the psychiatrist should function as both a medical specialist and a general physician, the author considers the legal, competency, and tranference issues this approach brings up. He then describes what has been done to implement a medical approach for faculty and residents in a psychiatric training program. The program includes seminars on the psychiatrist as a physician, a comprehensive rotation in neurology, and the application of basic medical skills on inpatient units.

The hypertensive psychiatric patient: pharmacologic problems.

Psychiatric symptoms secondary to antihypertensive drugs and adverse drug interactions between antihypertensive and psychotropic drugs are described. Recommendations are made concerning the drug therapy of the hypertensive psychiatric patient.

Hyponatremia due to psychotropic drugs.

The syndrome of hyponatremia in psychiatric patients is described, and cases associated with psychotropic drug treatment are reviewed. The causative role of the drug should be documented by rechallenge or a water loading test. In some instances it is possible to continue psychotropic treatment by restricting fluids or administering demeclocycline.

Psychotropic drug prescribing in a family medicine residency program.

The records of 201 patients in a family medicine training clinic were examined for frequency of prescription of psychotropic drugs. It was found that 11.5 percent (23/201 patients) had received a psychotropic drug over an average clinic visit time of 2 1/2 years. Patients were primarily female (2:1), with the socioeconomic status skewed towards the lower end, and with patient age ranging from 18 to 87 years. It was found that most psychotropic drugs were prescribed for short periods of time, with the prescriptions ranging from 1 month to 4 1/2 years. That only 11.5 percent of patients received a psychotropic drug was lower than expected. The clinic's conceptualization of the role of psychotropic drugs, the different approach utilized in data collection, or characteristics of the "training" setting, may account for these phenomena.

Faculty members' evaluations of sabbaticals.

Seventy medical school faculty members at seven institutions who had taken a sabbatical leave were interviewed about their sabbatical experiences, and 15 who were eligible but had not taken a sabbatical were asked their reasons for abstaining. Nineteen of 35 medical schools solicited also provided information about sabbaticals. The sabbatical experience was viewed very favorably by 80 percent of the participants; and three out of four were judged by the authors of the present paper as having accomplished something substantial, such as writing research papers or books or reorganizing teaching programs, following the sabbaticals. Presabbatical planning was emphasized by the respondents as the key to a satisfying sabbatical. Postsabbatical depression was common but not severe. At the 19 responding schools, sabbaticals were taken by an average of less than one-sixth of the eligible faculty members. Faculty members who had not taken sabbaticals gave a variety of reasons for the modest level of participation. Responses of the faculty members who had taken sabbaticals indicated that most medical school administrations did not capitalize on the opportunity to make the results of sabbaticals of maximum value to their institutions.