The chronically mentally ill, residency training, and psychiatry

Article Abstract:

The plight of the chronically mentally ill in our society has in many ways remained the same as it was in medieval times. The inherent differences in treating chronic mental illness as compared with chronic physical conditions make rehabilitative programs much more complex. Overlapping areas of concern which affect the chronically mentally impaired such as homelessness, drug abuse, vocational and socialization problems, and the long-term nature of the care that is needed by these individuals make effective programs for treatment prohibitively expensive. Society has not yet addressed the needs of this segment of the population and seems to be unwilling to commit the necessary resources to provide anything more than minimal support. There exists a tendency to deny the suffering of many who are chronically impaired by asserting that society is protecting the civil rights of those who are merely choosing an alternative lifestyle when, in fact, they are ill and unable to properly care for themselves. A recent report by Larry R. Faulkner and others, in the Oct 1989 issue of the American Jrl of Psychiatry, discusses the complexity of addressing the needs of the chronically mentally ill. Although no immediate or tangible solutions are offered, the report helps psychiatrists understand the needs of chronically mentally ill patients, a population not typically encountered in the course of residency training. The social awareness that can be gained by the psychiatric resident from exposure to chronic patients is invaluable. Science and social awareness should not function separately but should complement each other. Psychiatry alone cannot effectively address these problems of chronic patients and any effort for improvement must come as a joint venture between the medical community and the public sector. It is clear that not enough is being done for the chronic mental patient and several systems must be willing to work in conjunction with each other to improve and extend existing social support systems.

Health aspects, Psychiatric services, Mental health services, Ethical aspects, Chronically ill, Social psychiatry, editorial, Faulkner, Larry R.

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Psychiatric syndromes in adolescent substance abusers

Article Abstract:

There is little available information concerning the prevalence of psychiatric syndromes among adolescent patients who are addicted to drugs or alcohol. In order to isolate correlations between substance abuse patterns and specific adolescent psychiatric syndromes, 57 adolescents who had been referred for inpatient treatment of substance abuse were evaluated for the presence of psychiatric disorders. Half of the patients were seriously depressed, and 20 still met the criteria for major depressive episode at the end of the third week of hospitalization. Conduct disorder and the combination of attention deficit, hyperactivity and impulsiveness were the next most prevalent diagnoses. The incidence of phobias, or irrational fears, was surprisingly low.

Demographic aspects, Depression, Mental, Depression (Mood disorder), Drug abuse, Alcoholics

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Comorbidity of substance abuse and other psychiatric disorders in adolescents

Article Abstract:

Psychiatric disorders among adolescents are frequently compounded by substance abuse. Research indicates that drug and alcohol abuse are often involved in causing psychopathologies, and that the outcomes of these disorders are affected by the substance abuse. Disorders commonly associated with substance abuse include affective disorders (e.g., depression), antisocial behavior, hyperactivity, and anxiety. At the same time, the presence of psychiatric problems often makes adolescents more likely to abuse drugs or alcohol. Although the interdependence of substance abuse and psychiatric disorders in teenagers is well known, further research is required to establish genetic bases and the implications for clinical therapy.

Alcohol and youth, Juvenile drinking, Drugs and youth, Juvenile drug abuse

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