Menninger Clinic Research Articles

Duration of psychosis and outcome in first-episode schizophrenia.

This study was undertaken to assess the potential effect of duration of untreated illness on outcome in a group of first-episode schizophrenic patients. Seventy patients with schizophrenia diagnosed according to the Research Diagnostic Criteria entered the study and were followed for up to 3 years. All patients received standardized treatment and uniform assessments both during the acute phase of their illness and throughout the follow-up period. Outcome was measured in terms of time to remission of acute psychotic symptoms as well as degree of symptom remission. The mean duration of psychotic symptoms before initial treatment was 52 weeks, preceded by a substantial prepsychotic period. According to survival analysis, duration of illness before treatment was found to be significantly associated with time to remission as well as with level of remission. The effect of duration of illness on outcome remained significant when diagnosis and gender variables, themselves associated with outcome, were controlled in a regression analysis. Duration of illness was not correlated with age at onset, mode of onset, premorbid adjustment, or severity of illness at entry into the study. Duration of psychosis before treatment may be an important predictor of outcome in first-episode schizophrenia. Acute psychotic symptoms could reflect an active morbid process which, if not ameliorated by neuroleptic drug treatment, may result in lasting morbidity. Further implications of these findings are discussed.

Anxiety Disorders and Parkinson's Disease

Back to table of contents Previous article Next article ArticleNo AccessAnxiety Disorders and Parkinson's DiseaseLUIS M. IRUELA, VICENTE IBANEZ-ROJO, INMACULADA PALANCA, and LUIS CABALLEROLUIS M. IRUELASearch for more papers by this author, VICENTE IBANEZ-ROJOSearch for more papers by this author, INMACULADA PALANCASearch for more papers by this author, and LUIS CABALLEROSearch for more papers by this authorPublished Online:1 Apr 2006https://doi.org/10.1176/ajp.149.5.719-cAboutSectionsPDF/EPUB ToolsAdd to favoritesDownload CitationsTrack Citations ShareShare onFacebookTwitterLinked InEmail "Anxiety Disorders and Parkinson's Disease." American Journal of Psychiatry, 149(5), pp. 719-c–720 Access content To read the fulltext, please use one of the options below to sign in or purchase access. Personal login Institutional Login Sign in via OpenAthens Purchase Save for later Item saved, go to cart PPV Articles - American Journal of Psychiatry $35.00 Add to cart PPV Articles - American Journal of Psychiatry Checkout Please login/register if you wish to pair your device and check access availability. Not a subscriber? Subscribe Now / Learn More PsychiatryOnline subscription options offer access to the DSM-5 library, books, journals, CME, and patient resources. This all-in-one virtual library provides psychiatrists and mental health professionals with key resources for diagnosis, treatment, research, and professional development. Need more help? PsychiatryOnline Customer Service may be reached by emailing [email protected] or by calling 800-368-5777 (in the U.S.) or 703-907-7322 (outside the U.S.). FiguresReferencesCited byDetailsCited byEfficacy of Acupuncture for Parkinson’s Disease Anxiety: Two-Stage Protocol for a Randomized Controlled Clinical TrialEvidence-Based Complementary and Alternative Medicine, Vol. 2022Anxiety: An ignored aspect of Parkinson’s disease lacking attentionBiomedicine & Pharmacotherapy, Vol. 131Bulletin of the Menninger Clinic, Vol. 81, No. 1, Vol. 83Current Psychiatry Reports, Vol. 5, No. 1Neuropsychiatric Aspects of Parkinson’s DiseasePsychosomatics, Vol. 41, No. 1International Review of Psychiatry, Vol. 12, No. 4Biological Psychiatry, Vol. 34, No. 7 Volume 149Issue 5 May 1992Pages 719-c-720 Metrics PDF download History Published online 1 April 2006 Published in print 1 May 1992

An outcome study of psychotherapy for patients with borderline personality disorder.

This study evaluated the effectiveness of well-defined outpatient psychotherapy for patients with borderline personality disorder. Thirty patients with borderline personality disorder diagnosed according to the DSM-III criteria were given twice weekly outpatient psychotherapy for 12 months by trainee therapists who were closely supervised. The treatment approach was based on a psychology of self (this term being used in its broad sense), and strong efforts were made to ensure that all therapists adhered to the treatment model. Outcome measures included frequency of use of drugs (both prescribed and illegal), number of visits to medical professionals, number of episodes of violence and self-harm, time away from work, number of hospital admissions, time spent as an inpatient, score on a self-report index of symptoms, and number of DSM-III criteria (weighted for frequency, severity, and duration) fulfilled. The subjects showed statistically significant improvement from the initial assessment to the end of the year of follow-up on every measure. Moreover, 30% of the subjects no longer fulfilled the DSM-III criteria for borderline personality disorder. This improvement had persisted 1 year after the cessation of therapy. The results suggest that a specific form of psychotherapy is of benefit for patients with borderline personality disorder.

Dr. Volkow and Associates Reply

Dr. Volkow and Associates Reply

Dr. Goldstein Replies

Back to table of contents Previous article Next article ArticleNo AccessDr. Goldstein RepliesWILLIAM N. GOLDSTEINWILLIAM N. GOLDSTEINSearch for more papers by this authorPublished Online:1 Apr 2006https://doi.org/10.1176/ajp.148.10.1409-aAboutSectionsPDF/EPUB ToolsAdd to favoritesDownload CitationsTrack Citations ShareShare onFacebookTwitterLinked InEmail "Dr. Goldstein Replies." American Journal of Psychiatry, 148(10), pp. 1409-a–1410 Access content To read the fulltext, please use one of the options below to sign in or purchase access. Personal login Institutional Login Sign in via OpenAthens Purchase Save for later Item saved, go to cart PPV Articles - American Journal of Psychiatry $35.00 Add to cart PPV Articles - American Journal of Psychiatry Checkout Please login/register if you wish to pair your device and check access availability. Not a subscriber? Subscribe Now / Learn More PsychiatryOnline subscription options offer access to the DSM-5 library, books, journals, CME, and patient resources. This all-in-one virtual library provides psychiatrists and mental health professionals with key resources for diagnosis, treatment, research, and professional development. Need more help? PsychiatryOnline Customer Service may be reached by emailing [email protected] or by calling 800-368-5777 (in the U.S.) or 703-907-7322 (outside the U.S.). FiguresReferencesCited byDetailsCited byThe Insidious Dance of Love & Hate: An Examination of Envy and Greed in the Stalker-Victim Dynamic Part Two: Clinical Application16 February 2022 | Psychodynamic Practice, Vol. 28, No. 2Journal of the American Psychoanalytic Association, Vol. 67, No. 4Girls in Gangs: Exploring Risk in a British Youth Context21 March 2018 | Crime & Delinquency, Vol. 64, No. 13Transactional Analysis Journal, Vol. 36, No. 3Acta Psychiatrica Scandinavica, Vol. 112, No. 3Culture, Politics and Group Therapy: Identification and Voyeurism30 June 2016 | Group Analysis, Vol. 34, No. 4Bulletin of the Menninger Clinic, Vol. 65, No. 4Tijdschrift voor Psychotherapie, Vol. 25, No. 4A Little Cream and Sugar: Psychotherapy With a Borderline PatientJoan Wheelis, M.D., and John G. Gunderson, M.D.1 January 1998 | American Journal of Psychiatry, Vol. 155, No. 1Journal of Couples Therapy, Vol. 7, No. 2-3Supportive Care in Cancer, Vol. 4, No. 1Psychoanalytic Inquiry, Vol. 16, No. 1Journal of the American Academy of Psychoanalysis, Vol. 24, No. 3Mother-Child Interaction and Borderline Personality DisorderRICHARD BALON1 April 2006 | American Journal of Psychiatry, Vol. 152, No. 3Sexual harassment1 April 2006 | American Journal of Psychiatry, Vol. 152, No. 3Sexual harassment1 April 2006 | American Journal of Psychiatry, Vol. 152, No. 3Sexual harassment1 April 2006 | American Journal of Psychiatry, Vol. 152, No. 3Mother-child interaction and borderline personality disorder23 January 2015 | American Journal of Psychiatry, Vol. 152, No. 3New Directions for Mental Health Services, Vol. 1995, No. 1Contemporary Psychoanalysis, Vol. 31, No. 3Contemporary Psychoanalysis, Vol. 30, No. 3Contemporary Psychoanalysis, Vol. 30, No. 3The Historical Method in Psychiatric Research26 June 2016 | Australian & New Zealand Journal of Psychiatry, Vol. 27, No. 4Journal of Clinical Psychology, Vol. 48, No. 4Academic Psychiatry, Vol. 16, No. 2Journal of Social Work Practice, Vol. 6, No. 1Acta Psychiatrica Scandinavica, Vol. 85, No. 6Risks of Restraints Versus Psychotropic Medication for Pregnant PatientsVALERIE D. RASKIN, NEHAMA DRESNER, and LAURA J. MILLER1 April 2006 | American Journal of Psychiatry, Vol. 148, No. 12Further Comments on Projective IdentificationJAMES S. GROTSTEIN1 April 2006 | American Journal of Psychiatry, Vol. 148, No. 12Further Comments on Projective IdentificationJ. REID MELOY1 April 2006 | American Journal of Psychiatry, Vol. 148, No. 12Risks of restraints versus psychotropic medication for pregnant patients23 January 2015 | American Journal of Psychiatry, Vol. 148, No. 12Further comments on projective identification23 January 2015 | American Journal of Psychiatry, Vol. 148, No. 12Comments on projective identification1 April 2006 | American Journal of Psychiatry, Vol. 148, No. 10Comments on Projective IdentificationVICTOR SCHWARTZ1 April 2006 | American Journal of Psychiatry, Vol. 148, No. 10Comments on Projective IdentificationLEONARD M. GOLD1 April 2006 | American Journal of Psychiatry, Vol. 148, No. 10 Volume 148Issue 10 October 1991Pages 1409-a-1410 Metrics PDF download History Published online 1 April 2006 Published in print 1 October 1991

Clinicians' judgment of mental mealth: An international validation of HSRS

The Health-Sickness Rating Scale (HSRS), originally developed at the Menninger Foundation, was translated into French and Swedish and sent out to a relatively large group of clinicians in each of the two countries, and to a group of judges in the USA. Ratings of the 34 specimen cases were made blindly by 21 US, 62 French, and 21 Swedish clinicians for each of the seven subscales and the global rating scale of HSRS. The consistency among the judgments within each country was found to be very high (.81, .77, and .78 respectively). The consistency among the three national averages and the original Menninger judgments was found to be extremely high (.96) for the global rating. The results were interpreted to encourage further inquiries into the measurement properties and usefulness of the scale. The usefulness of HSRS as an international thermometer of mental health is strongly supported.

Menninger: The Family and the Clinic

Seldom do you travel to the funeral of a friend and mentor reading his biography. Even less commonly do you go with the information that, after reading his biography, your friend said, My heart is broken, became depressed and entered a hospital, and died of carcinoma, if not a broken heart. Lawrence Friedman's detailed account of a remarkable period of development in medical-psychiatric history, which coalesced about the Menninger family, is based on the prolific writings of the family members, the extensive archives maintained by the Menninger Clinic, private papers, and extensive personal interviews. Friedman was given an absolutely clear, unfettered shot at writing the definitive history of the Menninger Clinic, and he melded his study of the interviews and documents into a book that was published without benefit of prior review by any of the significant characters. As the author remarks early on, It is not entirely clear why

Anxiety Disorders: Contemporary Treatment Approaches—Bulletin of the Menninger Clinic, volume 54, number 2, Spring 1990

<b>Anxiety Disorders: Contemporary Treatment Approaches</b>—Bulletin of the Menninger Clinic, volume 54, number 2, Spring 1990

Controlled comparison of buspirone and clomipramine in obsessive- compulsive disorder

Eighteen outpatients with obsessive-compulsive disorder were treated with either buspirone, a partial serotonin agonist, or clomipramine, a serotonin uptake inhibitor, in a double-blind, random-assignment study. Both drugs led to statistically significant and similar improvements in scores on the Yale-Brown Obsessive-Compulsive Rating Scale and other obsessive-compulsive and depression scales. This preliminary result warrants further exploration with a larger sample and other serotonergic agents.

Another Swing of the Pendulum

To the Editor—The review of the book “From Senility to Alzheimer's Disease: The Rise of the Alzheimer's Disease Movement”1 points out the danger of the pendulum swinging too far. In the case of Alzheimer's disease, this has led to neglect of the role of impaired brain circulation despite the fact that Alzheimer's 1906 paper,2 upon which the movement is based, notes that his patient, although only 51 years old, had arteriosclerosis of the radial and larger cerebral arteries. It is very possible she might also have had carotid artery stenosis or a disturbance in the distal circulation that could cause dementia,3 and that she might have responded to anticoagulant therapy had it been available at that time. Many of the dementia patients I have treated with anticoagulant therapy have responded very well4,5; one was later proven at autopsy to have Alzheimer's disease. Further confirmation of the importance of the circulation in dementia is the article in the same journal by U'Ren et al6 showing that “mental efficiency is frequently impaired in older patients with diabetes”; Knisely7 has shown that diabetes causes “blood sludging,” which can block the capillaries in the brain, and that this sludging can be cleared with anticoagulant therapy. I have noticed that patients with dementia who also have diabetes often respond much more quickly to anticoagulant therapy, presumably because there is more blood sludging that is reversible. In view of these observations it seems wise to offer dementia patients a trial of anticoagulant therapy before giving them up as hopeless, and this should be a part of “informed consent” to satisfy legal requirements.8 We must remember that, although the pendulum has swung toward Alzheimer's disease and away from arteriosclerosis as a contributory factor, the true cause has not yet been found, and a literature search by the Menninger Clinic has revealed no negative reports on the use of anticoagulant therapy for dementia.

Do clinicians agree about who needs extended psychiatric hospitalization?

This report examines the level of agreement among 194 staff members of The Menninger Clinic and Harding Hospital about the optimal length of stay for 71 types of patients selected on the basis of hypothesized suitability for various lengths of hospitalization. There were differences of opinion associated with hospital affiliation and professional discipline, but there was sufficient consensus to enable the development of comprehensive criteria for predicting required length of hospitalization. The validity of these criteria will be tested in a future treatment outcome study.

Hospitalization in the Psychiatric Treatment of Children and Adolescents—winter 1990 issue of theBulletin of the Menninger Clinic

<b>Hospitalization in the Psychiatric Treatment of Children and Adolescents</b>—winter 1990 issue of the<i>Bulletin of the Menninger Clinic</i>

Correction

Back to table of contents Previous article ArticleNo AccessCorrectionPublished Online:1 Apr 2006https://doi.org/10.1176/ajp.147.6.822-aAboutSectionsView articleAbstractPDF/EPUB ToolsAdd to favoritesDownload CitationsTrack Citations ShareShare onFacebookTwitterLinked InEmail View articleAbstractIn the review by Leston Havens, M.D., and Meredith Fields, M.D., of the book Schizophrenia: Treatment, Process, Outcome, by Thomas H.McGlashan, M.D., and Christopher J. Keats, M.D. (February 1990 issue, p. 248), the second paragraph should read,When this book is read together with Robert Wallerstein's review (1) of the Menninger Clinic borderline study, one conclusion stands out: supportive and managerial psychotherapies seem more important than interpretations or clarifications. Access content To read the fulltext, please use one of the options below to sign in or purchase access. Personal login Institutional Login Sign in via OpenAthens Purchase Save for later Item saved, go to cart PPV Articles - American Journal of Psychiatry $35.00 Add to cart PPV Articles - American Journal of Psychiatry Checkout Please login/register if you wish to pair your device and check access availability. Not a subscriber? Subscribe Now / Learn More PsychiatryOnline subscription options offer access to the DSM-5 library, books, journals, CME, and patient resources. This all-in-one virtual library provides psychiatrists and mental health professionals with key resources for diagnosis, treatment, research, and professional development. Need more help? PsychiatryOnline Customer Service may be reached by emailing [email protected] or by calling 800-368-5777 (in the U.S.) or 703-907-7322 (outside the U.S.). FiguresReferencesCited byDetailsCited byNone Volume 147Issue 6 June 1990Pages 822-a-822 Metrics PDF download History Published online 1 April 2006 Published in print 1 June 1990

Dr. Herman and Associates Reply

Dr. Herman and Associates Reply

Followup in psychoanalysis: clinical and research values.

Psychoanalysis has never developed a tradition of systematic followup study to evaluate outcome and to improve technique and theory for a variety of reasons, partly theoretical, stemming from the conception of the unfolding transference neurosis and its analytic resolution as the precondition for cure, and partly historical, having to do with the happenstance of its development as a private practice-based discipline and training outside of the academic setting. Freud, however, was never bound by such strictures and published whatever post-treatment data he acquired on all his best-known case histories. But following Freud most analysts, with some notable exceptions, eschewed followup activity as unanalytic. It is this tradition that more recent studies like those of Pfeffer in New York and the Psychotherapy Research Project of The Menninger Foundation in Topeka have squarely challenged. Data are presented from the Menninger project dealing specifically with the impact of routine planned followup on issues of treatment termination and resolution and on the nature of the post-treatment period. The degree and kind of patient cooperation with the followup inquiry, the impact of followup on treatment termination and resolution (both impeding and facilitating), and the role of followup intervention in relation to return to formal post-treatment therapy (or consolidating against it), are all discussed.

Indications for extended psychiatric hospitalization: A study of clinical opinion

The authors previously developed a conceptual model of factors bearing on length of stay from clinicians' vignettes describing patients considered ideal candidates for various lengths of stay. The previous study was conducted at The Menninger Clinic, the present study at Harding Hospital. The two hospitals provide a worthwhile contrast because Menninger specializes in long-term (LT) stays (averaging 1 year) and Harding in intermediate-term (IT) stays (averaging 2 to 3 months). The Harding findings generally replicated and complemented the Menninger results, and the authors used the combined data to generate a hypothesized set of general indications for various lengths of stay in these private psychiatric hospitals.

Observing The Erotic Imagination

Stoller is not just a scientist but a lover of words and language. In this book, his text is as playful, charming, and serious as his topic. The mix, a scientific and aesthetic exploration of the erotic imagination, is almost as irresistible as one's own erotic daydreams. Observing the Erotic Imagination is for all professional and private students of the erotic.-Dr. Ethel Person This book is a delight...He offers a model clinical illustration, brilliant and full of presence. Indeed, entire book is a model of clear, elegant conversational prose.-Jerome B. Katz, M.D., Bulletin of the Menninger Clinic Stoller presents new thoughts on his most provocative theory of the relationship between erotic excitement and fantasy of revenge and hostility.-Anke A. Ehrhardt, Ph.D. and Evan J. Elkin, Journal of the American Academy of Child and Adolescent Stoller's account is comprehensive and levelheaded.-Psychological Reports

Behavioral aspects of panic disorder

The behavioral approach to panic disorder distinguishes between agoraphobia and nonsituational panic and emphasizes the handicap to the patient caused by avoidance of agoraphobic situations. Agoraphobia is a more viable label than panic disorder. Behavioral treatment consists of delineating the patient's agoraphobic avoidance and panic profile and developing a self-exposure program to produce habituation. Systematic exposure to agoraphobic situations is usually of durable efficacy, and the treatment requires little time from clinicians. Antidepressant drugs, which do not interfere with exposure, are a useful addition when dysphoria is present, but they can have troublesome side effects.

Military Psychiatry: Learning From Experience—edited by W. Walter Menninger, M.D.; Menninger Foundation, 1987, 132 pages, paperbound. Available from the Division of Scientific Publications, Menninger Foundation, Box 829, Topeka, Kansas 66601, for $9.95

<b>Military Psychiatry: Learning From Experience</b>—edited by W. Walter Menninger, M.D.; Menninger Foundation, 1987, 132 pages, paperbound. Available from the Division of Scientific Publications, Menninger Foundation, Box 829, Topeka, Kansas 66601, for $9.95

Past sexual victimization by females of male patients in an adolescent medicine clinic population.

In an adolescent medicine clinic with more than 1,000 patients during 1982-1984, 11 male adolescents reported a history of sexual molestation by females. This molestation had commonly involved acquaintances and was unlikely to have been accompanied by threats of violence or physical coercion. One-fourth of the victims of both male and female molesters described themselves as sexually dysfunctional, and eight of the victims of male molesters identified themselves as homosexual. Both groups experienced the molestation as highly traumatic.