Chief Of Service Research Articles

Positive Psychiatry Portrayals A Rarity in Hollywood

Back to table of contents Previous article Next article Professional NewsFull AccessPositive Psychiatry Portrayals A Rarity in HollywoodChristine LehmannChristine LehmannSearch for more papers by this authorPublished Online:2 Aug 2002https://doi.org/10.1176/pn.37.15.0010Maj. Steven Pflanz: “Psychotherapy appeals to filmmakers because it deals with powerful human emotions, and art at its core is about human emotions.”Hollywood continues to be fascinated with psychiatric themes. At least 10 movies that featured different kinds of relationships between therapists and patients were box-office hits in the 1990s, said Maj. Steven Pflanz, a psychiatrist who led a workshop on psychiatry and film at APA’s 2002 annual meeting in May in Philadelphia.Among these films were “Good Will Hunting,” “Analyze This,” “As Good as It Gets,” “Don Juan DeMarco,” and “Grosse Pointe Blank.”“Psychotherapy appeals to filmmakers because it deals with powerful human emotions, and art is really about human emotions at its core,” said Pflanz, who has presented numerous workshops at previous annual meetings.Pflanz is chief of mental health services and deputy squadron commander of the 90th Medical Operations Squadron at F.E. Warren Air Force Base in Cheyenne, Wyo.But when does artistic license cross the line and become an irresponsible misrepresentation? The answer is not always clear.For example, in the 1997 movie “Good Will Hunting,” Robin Williams plays psychotherapist Shawn McGuire, who helps Will Hunting, a troubled math genius, come to terms with his abusive past. Pflanz and others at the workshop characterized the therapeutic relationship as a positive one that “transformed the patient and therapist.”However, the movie also includes a scene early in Will’s therapy in which he insults McGuire’s wife. McGuire responds by pushing Will against the wall and threatening to hit him if he ever again insults his wife, who is deceased. Later in the film, there are scenes of McGuire hugging Will and visiting each other at home.“We are supposed to be the agency of compassion,” said one psychiatrist who attended the session. “People seeing a therapist assault a patient might wonder if that would happen in therapy and feel unsafe.”Another audience member said, “Hugging a patient and visiting the patient in his home is clearly a line that many therapists would not cross.”In the 1999 movie “Analyze This,” Robert de Niro plays a Mafia boss who consults a psychiatrist, played by Billy Crystal, to help him deal with his emotional problems. To avoid being “whacked by the mob” for revealing secrets to a psychiatrist, de Niro insists on clandestine meetings with the psychiatrist, including impromptu visits while the psychiatrist is on vacation and at the psychiatrist’s home after breaking in.Crystal’s character “seemed weak and intimidated by de Niro,” commented an audience member. “There were numerous violations of professional boundaries,” said another.By contrast, the 1997 film “As Good as It Gets” got high marks from the workshop audience for depicting the psychiatrist in the movie as a professional who set boundaries with patients and providing a more realistic portrayal of how psychiatry is practiced.In one scene, for example, Melvin Udall, played by Jack Nicholson, barges into the psychiatrist’s office without an appointment and clearly expects to be seen immediately. The psychiatrist patiently but firmly explains to Udall that he will not make an exception for him and instead schedules an appointment.Hollywood movies tend to portray women therapists in more compromising roles than men, said Pflanz. As of 1989, there were twice as many films portraying unethical sexual behavior by women therapists as male therapists, according to the 1999 book Psychiatry and the Cinema by Gabbard and Gabbard (American Psychiatric Press Inc., 1999).That pattern continued in the 1990s with such movies as “The Prince of Tides.” Barbra Streisand plays a psychiatrist who becomes romantically involved with the brother of a suicidal patient. The brother is played by Nick Nolte.Portrayals of psychotherapists as dark characters who murder their patients in movies such as “Dressed to Kill” and “Whispers in the Dark” are examples of art misrepresenting psychotherapy, said Pflanz.“We should let producers know when they portray the profession in a responsible manner and when they don’t. We should also educate them about the profession so they have a better understanding of psychotherapy,” said Pflanz. ▪ ISSUES NewArchived

H. Mitchell Perry, Jr, MD

One of the leading workers in the hypertension field since the early days of the development of antihypertensive therapeutic agents was H. Mitchell Perry, Jr, MD. Not only was he totally committed to new therapeutic advances, but his investigative activities were also focused in the laboratory where he was deeply immersed in identifying the role of environmental substances that may participate in the pathogenesis of hypertension. In these studies he was a world authority on the role of such specific metallic ions as cadmium and lead. “Mitch” Perry, as he was referred to by his many friends, spent his entire professional career in St. Louis at Washington University. Thus, after completing his undergraduate education at Swarthmore College, he entered that university, completing his medical education within 3 years. Then, following his training in internal medicine at Barnes Hospital and a stint in the US Army in Frankfurt, …

Colleges Use Aggressive Outreach To Prevent, Identify MH Problems

Colleges Use Aggressive Outreach To Prevent, Identify MH Problems

Current Initiatives at the National Cancer Institute

Click to increase image sizeClick to decrease image size Additional informationNotes on contributorsMargo MichaelsAll authors are affiliated with the National Cancer Institute, National Institutes of Health, in Bethesda, Md. Margo Michaels, M.P.H., is an education program specialist in the Public and Survivor Education Section, Office of Education and Special Initiatives. Andrea M. Denicoff R.N., M.S., C.A.N.P., is a clinical trials specialist in the Office of Education and Special Initiatives. Mary Anne Bright R.N., M.N., is the acting chief of the Cancer Information Service. Jeffrey Abrams, M.D., is a senior investigator in the Cancer Therapy Evaluation Program. Detra K. Robinson, M.A., is a project manager with Westat, Inc., in Rockville, Md.Andrea M. DenicoffAll authors are affiliated with the National Cancer Institute, National Institutes of Health, in Bethesda, Md. Margo Michaels, M.P.H., is an education program specialist in the Public and Survivor Education Section, Office of Education and Special Initiatives. Andrea M. Denicoff R.N., M.S., C.A.N.P., is a clinical trials specialist in the Office of Education and Special Initiatives. Mary Anne Bright R.N., M.N., is the acting chief of the Cancer Information Service. Jeffrey Abrams, M.D., is a senior investigator in the Cancer Therapy Evaluation Program. Detra K. Robinson, M.A., is a project manager with Westat, Inc., in Rockville, Md.Mary Anne BrightAll authors are affiliated with the National Cancer Institute, National Institutes of Health, in Bethesda, Md. Margo Michaels, M.P.H., is an education program specialist in the Public and Survivor Education Section, Office of Education and Special Initiatives. Andrea M. Denicoff R.N., M.S., C.A.N.P., is a clinical trials specialist in the Office of Education and Special Initiatives. Mary Anne Bright R.N., M.N., is the acting chief of the Cancer Information Service. Jeffrey Abrams, M.D., is a senior investigator in the Cancer Therapy Evaluation Program. Detra K. Robinson, M.A., is a project manager with Westat, Inc., in Rockville, Md.Jeffrey AbramsAll authors are affiliated with the National Cancer Institute, National Institutes of Health, in Bethesda, Md. Margo Michaels, M.P.H., is an education program specialist in the Public and Survivor Education Section, Office of Education and Special Initiatives. Andrea M. Denicoff R.N., M.S., C.A.N.P., is a clinical trials specialist in the Office of Education and Special Initiatives. Mary Anne Bright R.N., M.N., is the acting chief of the Cancer Information Service. Jeffrey Abrams, M.D., is a senior investigator in the Cancer Therapy Evaluation Program. Detra K. Robinson, M.A., is a project manager with Westat, Inc., in Rockville, Md.Detra K. RobinsonAll authors are affiliated with the National Cancer Institute, National Institutes of Health, in Bethesda, Md. Margo Michaels, M.P.H., is an education program specialist in the Public and Survivor Education Section, Office of Education and Special Initiatives. Andrea M. Denicoff R.N., M.S., C.A.N.P., is a clinical trials specialist in the Office of Education and Special Initiatives. Mary Anne Bright R.N., M.N., is the acting chief of the Cancer Information Service. Jeffrey Abrams, M.D., is a senior investigator in the Cancer Therapy Evaluation Program. Detra K. Robinson, M.A., is a project manager with Westat, Inc., in Rockville, Md.

Amassing Power: J. B. Duke and the Saguenay River, 1897-1927

The damming of the Saguenay brought industrialisation on a grand scale to rural Quebec in the form of newsprint and aluminum manufacture. Tapping into rich and diverse sources in Canada, the United States, and Europe, Massell provides an interdisciplinary, cross-border study of American capital and Canadian resources. He shows us how ever-larger amounts of capital yielded increasingly massive and sophisticated applications of hydroelectric technology. Grand industrial plans, in turn, encroached upon provincial water rights and farmers' lands, which drew the attention of the state. He examines the protracted power struggle between public and private interests - between American capitalists and the nascent bureaucracy of the province of Quebec - and describes the origins and evolution of the events that led to state control over hydraulic resources in the province. In doing so he provides vivid portraits of Duke and of Quebec politicians of the period and gives a dramatic account of the protracted battle of wits between Duke's chief engineer, William States Lee, and Quebec's chief of Hydraulic Service, Arthur Amos. Amassing Power speaks to the integration of North American economies, vividly illustrating the process by which American capital drew Canada's resource-rich North into the economic orbit of the United States.

Principles of privileging and credentialing for endoscopy and colonoscopy

Privileging or credentialing for the performance of esophagogastroduodenoscopy (EGD) and colonoscopy should be based on prior demonstration of proficiency in the performance of these procedures. Proficiency should be substantiated by documentation provided by the applicant from Residency Program Directors, Chiefs of Service, or other members of the teaching faculty who have directly observed the applicant performing endoscopy. Individuals applying for privileges for EGD and colonoscopy should have demonstrated satisfactory completion of an Accreditation Council for Graduate Medical Education-accredited training program in adult or pediatric gastroenterology, general surgery, colorectal surgery, or pediatric surgery. Attestation to competency in the performance of these techniques should therefore be provided by the Program Director and, if deemed necessary, by the Credentialing or Privileging Committee at the institution at which these privileges are being sought or by other teaching faculty from the applicant’s residency program. In the case of applicants who already have privileges to perform these procedures and are applying for similar privileges at another facility or for renewal of privileges at the same facility, attestation of competency should be provided by the applicant’s Chief of Service. Maintenance of continued competency is the responsibility of the respective Credentialing or Privileging Committee and should be based on ongoing review of the applicant’s performance by their Chief of Service. These credentialing guidelines are intended to apply to any site at which EGD and colonoscopy are practiced. These guidelines should supplement previously published guidelines by A.S.G.E., A.S.C.R.S., and S.A.G.E.S. More comprehensive discussions of issues surrounding the granting of privileges for gastrointestinal endoscopy are available on the societies’ websites, i.e., www.asge.org, www.sages.org, and www.fascrs.org.

Journeys Beyond the Horizon

Jules M Rothstein, clinician, researcher, educator, author, and speaker, entered into the field of physical therapy in 1975 following graduation from the Department of Physical Therapy at New York University. He completed his Master of Arts Degree in Kinesiology in 1979 and his Doctor of Philosophy in Physical Therapy in 1983, also at New York University. During his training, he worked as Staff Physical Therapist at Peninsula Hospital Center in Queens, as Research Fellow with the Arthritis Foundation, and in private practice in Cedarhurst, New York. From 1977 to 1980, Dr Rothstein was Adjunct Instructor in the Department of Physical Therapy at New York University. From 1980 to 1983, he was Instructor and Coordinator of Clinical Research and Training Programs at Washington University School of Medicine, and from 1984 to 1990, he was Associate Professor at the Medical College of Virginia. A tenured professor at the University of Illinois at Chicago since 1990, Dr Rothstein also served as Head of the Department of Physical Therapy at the University of Illinois at Chicago and as Chief of Physical Therapy Services at the University of Illinois Hospital in Chicago until 1999. During that period, the department obtained more than $6 million in research funding and received APTA's 1997 Minority Initiative Award for consistently recruiting and maintaining ethnic and racial diversity among its students. He continues to serve as Professor in the Department of Physical Therapy and remains active in all areas of physical therapy, practice, research, and service. Dr Rothstein's expertise in measurement and research design has been used by many professionals—across disciplines—in the allied health community. He is in great demand as an invited guest speaker, having given professional presentations and keynote speeches on the topic of rehabilitation sciences at numerous national and international forums, including Sweden, Denmark, Iceland, Japan, and Saudi Arabia. He has also served as a consultant and visiting professor in South Africa, the Netherlands, and Poland. Dr Rothstein has made extensive contributions to the physical therapy profession's body of knowledge, including the publication of more than 60 refereed articles and abstracts. In 1985, he edited the text Measurement in Physical Therapy. He chaired the APTA Task Force on Standards for Measurement in Physical Therapy that produced the first APTA Standards for Tests and Measurements in Physical Therapy Practice in 1993. As part of that task force, he co-authored the Primer on Measurement: An Introductory Guide to Measurements Issues. Since 1989, Dr Rothstein has served as Editor of Physical Therapy and has been appointed to that position for three 5-year terms by the APTA Board of Directors. Dr Rothstein is a Catherine Worthingham Fellow of the American Physical Therapy Association. He is the recipient of numerous awards, including the Golden Pen Award, the Outstanding Service Award for Research, the Outstanding Service Award for Continuing Education, and the Outstanding Therapist Award in the State of Illinois. [Rothstein JM. Thirty-Second Mary McMillan Lecture: Journeys beyond the horizon. Phys Ther. 2001;81:1817–1829.]

T Jacob John—taking India forward in infectious disease control

T Jacob John qualified as a clinical paediatrician in 1961. In the years to follow he branched out into virology and microbiology in the UK and the USA before bringing his skills and knowledge back to India in 1966 and continuing his studies at the Christian Medical College (CMC), Vellore. From 1970 to1995, he was the chief of clinical virology services at the CMC. In that time he also spent 10 years as the chief of the National HIV/AIDS Reference Centre, 15 years as chief of centre of Advanced Research in Virology, and 8 years as head of clinical microbiology.

Vida y obra del doctor Jaume Peyrí i Rocamora (1877-1950)

Jaume Peyrí (Reus, 1877; Barcelona, 1950), was the first professor of Dermatology and Syphilography of the University of Barcelona and the second in Spain. Simultaneously he was the Chief of the Dermatologic Service in the Clinic Hospital, between 1915 and 1947, with a brief parenthesis during the Civil War. His multiple medical contributions —12 books and 200 articles— and his great activity —he trained more than 5.000 pupils and attended more than 70.000 patients— reflect his educational vocation, his inteligence and working capacity. His international projection was posible because of his eminent speaking of several languages, that let him have notorious positions in international dermatologic societies.Humanist and with a wide culture, he made interesting aportations not only to the history of medicine and Dermatology, but to philosophy, literature, theater, art and politics. Catalan nationalist and republican, he always protected the catalan language as a scientific one, but never mixed up in politics. He belonged to numerous scientific and cultural associations, having responsible positions. He was the president of the Royal Academy of Medicine of Barcelona, the Medical-Pharmaceutical Institute of Catalunya, the Catalan Society of Dermatology and the Catalan Section of the Spanish Academy of Dermatologists.

What???s a Trauma Surgeon Worth? A Salary Survey of the Eastern Association for the Surgery of Trauma

Professional compensation is an important consideration for all physicians. Few objective data specific to trauma surgery are available to those seeking employment or contract renegotiation in the United States. National benchmark salary data should assist trauma surgeons in securing fair and equitable compensation. The purpose of this study was to survey trauma surgeons who are members of the Eastern Association for the Surgery of Trauma regarding current salary levels, benefits, contract arrangements, practice descriptors, and opinions on professional reimbursement. Anonymous self-report questionnaires were mailed to active members of the Eastern Association for the Surgery of Trauma. Only general surgeons practicing in the United States were included. Data were maintained in a confidential database. Of 385 surveys mailed, 207 (53.7%) were returned. There were 172 usable questionnaires, for an overall response rate of 44.6%. Nearly 93% of respondents worked in states east of the Mississippi River. Mean age was 42.4 years (range, 33-50 years) and 94.7% were male. Over 66% of the surgeons were fellowship trained in trauma, and 44% were chiefs of trauma services. The mean years of experience was 8.8 years (range, 1-17 years). Most respondents worked at teaching institutions (88%) and Level I centers (66%). The mean annual compensation was $229,142+/-$78,045 (range, $90,000-$528,000). These salaries were comparable to ranges from academic surveys of general surgeons. Few surgeons had professional guidance negotiating their compensation. Survey respondents were aware of few objective data specific to trauma surgery. This preliminary survey provides a unique benchmark for trauma surgeon salaries. Trauma surgeons should benefit from a more informed and structured approach to salary negotiations. Detailed trauma surgeon-specific data obtained periodically are essential to ensuring fair and equitable compensation in this specialty.

Morning report: focus and methods over the past three decades.

Residents rank morning report as the most important educational activity of their residency training. Although there is a lack of documented evidence as to the educational value of morning report, the practice is ubiquitous across almost all primary care residency programs in North America. The ever-changing practice of medicine and ongoing demands for evidence in medical education force us to examine essential aspects of morning report in order to base future decisions about morning report on sound educational evidence. Thus, a systematic review of the published literature on morning report was done in order to identify the various purposes and modalities of morning report, to find evidence in support of its educational value, and to discuss possible future directions for research on morning report. The term ‘‘morning report’’ is used to describe case-based conferences where residents, attending physicians, and others meet to present and discuss clinical cases. The term includes resident reports, morning or housestaff conferences, and morning sessions but excludes work rounds or teaching rounds. In a typical morning report, the team on duty during the night presents recently admitted patients, followed by a general discussion of the cases and related topics.

Investment in a rural residency program: a case study.

Rural hospitals have used numerous strategies over the past several decades to recruit and retain physicians. These have included providing physicians economic incentives, immigration status, professional and technical support and establishing rural training tracks (RTT) in family practice residency programs. This paper presents the experience of an isolated rural region in southwestern New York state that has employed each of these strategies in the past decade. Success as measured by the change in size of the medical staff, hospital operating margins, admissions and employment occurred only after the emphasis changed from meeting hospital needs to physician needs. Pivotal to this strategy was the nurturing and development of an RTT. Investment in the residency program required strong leadership to ensure the political, financial and operational commitment of its affiliated hospital. In addition, the RTT required an affiliation with a financially viable, full-service hospital, a strong on-site chief of service, family physicians who performed cesarean sections, midlevel providers and practitioners dedicated to the mission of teaching.

Acog’s 1999 VBAC guidelines: a survey of western massachusetts obstetric services

Objective: ACOG Practice Bulletins provide management standards for obstetric and gynecologic services. The recent ACOG guidelines for vaginal birth after cesarean (VBAC) (Number 5, July 1999) are controversial concerning hospital VBAC policy. We surveyed all western Massachusetts obstetric services regarding their VBAC policy.Methods: A survey regarding procedure rates and VBAC policy was presented to chiefs of western Massachusetts obstetric services and the data summarized.Results: All services completed the survey. Of the approximately 8,000 annual deliveries performed in western Massachusetts, 18.5% are cesarean. From 1994, all services reported a decline in overall cesarean rate and an increase in VBAC rate. All institutions reported an unchanged primary cesarean rate, except for the only level 3 center surveyed, where it rose slightly. Regarding recent ACOG VBAC guidelines, five of six services were aware of the new guidelines. Fifty percent describe “immediately available” as cesarean delivery initiated within 30 minutes and 50% as within 15 minutes. Sixty-seven percent describe “physician availability for cesarean delivery” as anesthesia coverage in-hospital and 33% as anesthesia coverage on labor and delivery. The only service mandating an obstetrician’s attending presence during VBAC trials is the tertiary care center due to residency training. Five of six services have anesthesia availability in hospital, but not specific to labor and delivery.Conclusions: The recent ACOG VBAC guidelines were inconsistently interpreted among the services surveyed. At these institutions, declines in cesarean deliveries are due to the increase in VBAC trials. While failure to incorporate guidelines could increase liability for institutions, strict implementation may discourage VBAC trials and increase cesarean deliveries by as much as 50%. In our opinion, closer review of data regarding VBAC complication rates is necessary to develop workable guidelines applicable to institutions of all levels.

Thirty-sixth Annual Meeting January 31–February 2, 2000 Greater Fort Lauderdale/Broward County Convention Center, Fort Lauderdale, Florida

Thirty-sixth Annual Meeting January 31–February 2, 2000 Greater Fort Lauderdale/Broward County Convention Center, Fort Lauderdale, Florida

Editorial Comment

Editorial Comment

Metal mania: fact or fiction?

In 1960, when I was a second-year resident in orthopaedic surgery, I was sent to Gillette Children's Hospital in St. Paul, Minnesota, for a six-month rotation in children's orthopaedics. Dr. John Moe was the Chief of Staff and also the Chief of the Spine Service. About eight weeks after I began my rotation, I had the opportunity to scrub in on an operation on the first patient with idiopathic scoliosis at Gillette Children's Hospital to be managed with Harrington instrumentation. The operative team consisted of Dr. Paul Harrington, Dr. John Moe, Dr. Walter Blount, Dr. Verne Nickel, Dr. William Bickel (the Chief of Scoliosis Surgery at the Mayo Clinic), and me. The operation was performed by Dr. Harrington, and a beautiful correction was safely achieved. From that moment onward, Harrington instrumentation with a Moe facet arthrodesis became the standard of care for scoliotic patients at Gillette. We quickly learned that, in a well fitted Risser localizer cast, scoliotic patients who were managed with this instrumentation could walk immediately, a far cry from the six months in bed that had been the norm previously. Instrumentation for scoliosis has advanced to the point that most patients do not need a brace or a cast; they now leave the hospital in five days and return to school in two weeks. All of this marvelous advance in patient care was achieved without a single prospective, randomized, controlled clinical study. At the same time, however, I have seen surgeons who are so enamored of the new implant technology that they have forgotten the basic purpose of the operation, which is to achieve solid fusion. Another dramatic evolution in orthopaedic …

Uniting La Frontera: The Ongoing Efforts to Establish a Transboundary Park

Click to increase image sizeClick to decrease image size Additional informationNotes on contributorsValerie J. NaylorJosé A. Cisneros is the superintendent and Valerie J. Naylor is the chief of Interpretation and Visitor Services at Big Bend National Park and Rio Grande Wild and Scenic River. The authors may be reached at P.O. Box 129, Big Bend National Park, Texas, 79834 (e-mail: Jose_Cisneros@nps.gov and Valerie_Naylor@nps.gov).

Halsted is dead: Time for change in graduate surgical education

More than 100 years ago William Stewart Halsted established a graduate training program for surgeons, based on the German system, at the Johns Hopkins Hospital. When the American Board of Surgery was organized in 1937, the Halsted triad of educational principles, namely knowledge of the basic sciences, research, and graduated patient responsibility for the resident, were the goals of the founders. The pyramidal structure of the Halsted system—that is, indefinite length, vigorous competition for advancement leaving only one resident at the pinnacle, and one chief of service—was never widely used. Almost all programs in the years after World War II adopted the rectangular structure established by Churchill at the Massachusetts General Hospital. Halsted's principles of education have been retained and are still the essential requirements of residency training programs. Unfortunately, the most important element of the triad, graduated responsibility for patient care leading to the role of the resident as the surgeon, can no longer be offered to residents due to social and economic changes in medical care. Thus, the heart and soul of the Halsted system of graduate surgical education has been lost. A drastic change is needed. Halsted is dead.

Biographical Sketches of the First Editorial Board and Those Who Have Edited Pediatrics

The first editorial board included nationally known pediatricians, many of them pediatric department chairmen. Most were involved in research activities that enabled them to critically review articles in their particular field of interest, but because of their knowledge and experience as clinicians, they also were able to evaluate articles in general pediatrics. Interestingly, several of these early leaders recognized the importance of psychosocial issues in the health care of children, leading to studies on early childhood development and behavior that evolved into a discipline that is an important part of pediatric practice today. What follows are short biographical sketches of the members who were appointed to the first editorial board in 1948. All but two were recipients of the annual John Howland Award, the most prestigious honor awarded by the American Pediatric Society (APS). This impressive list gave the journal immediate credibility and established it as the leading pediatric journal in the country. ### Anderson Aldrich Dr Aldrich was a member of the editorial board from 1948 until his death the following year. He was director of the Rochester, MN, Child Health Institute, a community project that was established to study growth and development of infants and children living in a normal environment over an extended period. Dr Aldrich also was noted for his studies of the psychosocial aspects of the practice of pediatrics. ### Allan M. Butler Dr Butler was a member of the editorial board from 1948 to 1952, during his 30-year tenure as a faculty member at Harvard University Medical School, chief of Children's Services at Massachusetts General Hospital and consultant to National Institutes of Health. His professional interests were broad: biological chemistry, parenteral fluids, renal disease, hypertension, community pediatrics, nephrology, and perinatal pediatrics. After his retirement from Harvard University in 1960, he directed the Health Insurance Plan for the United Auto Workers and …

The Principles and Practice of Addictions in Psychiatry

Back to table of contents Previous article Next article Book ReviewFull AccessThe Principles and Practice of Addictions in PsychiatryPatricia Isbell Ordorica,, M.D.Patricia Isbell Ordorica,Search for more papers by this author, M.D.Published Online:1 Jun 1998https://doi.org/10.1176/ps.49.6.846AboutSectionsView EPUB ToolsAdd to favoritesDownload CitationsTrack Citations ShareShare onFacebookTwitterLinked InEmail This textbook offers an essential focus on the diagnosis and treatment of addictive disorders as complex biopsychosocial disorders. Dr. Miller brings years of experience in the field as both a clinician and an educator to editing a textbook that addresses the complex interactions between addictive and other psychiatric disorders. The book's six major sections are on Etiology, Neurobiology, Diagnosis, Treatment Approach, Treatment Process, and Pharmacological Treatments. Many of the chapters are written by known experts in the field.In the etiology section, Jeffrey Goldsmith's chapter on an integrated psychology for addiction psychiatry provides a comprehensive overview of theories on the psychology of addictions, particularly relevant for trainees of all mental health disciplines. The neurobiology section, although relatively brief, is well written and offers a good foundation for understanding mechanisms involved in the addiction process. In the diagnosis section, Robert Anthenelli provides an excellent chapter on guidelines for assessing and diagnosing patients with substance use and other concurrent psychiatric disorders. This chapter is also especially well suited for trainees and for primary care clinicians.Clinicians in the field will find the section on treatment approach useful, with its topics ranging from managed care to special issues in the treatment of women and adolescents to Drake and Noordsy's case management strategies for patients with severe mental disorders and substance use disorders. The section on treatment process offers several excellent chapters that both trainees and experienced clinicians may find illuminating. The chapters in the final section, on pharmacologic treatments, are of evenly high quality. A weakness of this section is the absence of a discussion of the pharmacological treatment of nicotine dependence.Dr. Miller should be congratulated for attempting to offer an integrative approach to the diagnosis and treatment of these biopsychosocial disorders. Overall, he succeeds.Dr. Ordorica is chief of the psychiatry service at the James A. Haley Veterans Affairs Medical Center in Tampa, Florida.edited by Norman S. Miller, M.D.; Philadelphia, W. B. Saunders Company, 1997, 589 pages, $70 FiguresReferencesCited byDetailsCited ByNone Volume 49Issue 6 June 1998Pages 846-846 Metrics History Published online 1 June 1998 Published in print 1 June 1998