Abstract:
BACKGROUND:Psychiatric consultations involving the evaluation of patients' medical decision-making capacity often seem to have little to do with truly compromised patient autonomy. OBJECTIVE:The authors seek to examine hidden ethical dilemmas that lead to capacity evaluation requests. METHOD:The authors utilize the "principlism" approach to biomedical ethics to illustrate some common moral issues in patient care that are poorly captured by the "autonomy-versus-paternalism" paradigm. RESULTS:Patient autonomy sometimes comes into conflict with ethical imperatives to do "good," to avoid harm, and to deliver care fairly, as well as with the autonomy of others. Consultation psychiatrists are well positioned to unearth these dilemmas and begin to address them. DISCUSSION:Effective engagement of everyday ethics in clinical medicine is hindered by reflexive resort to capacity evaluations when moral problems arise. Greater attention to matters of values, aggressive urges, and obligations to others can enhance the negotiation of routine ethical dilemmas.
journal_name
Psychosomaticsjournal_title
Psychosomaticsauthors
Kontos N,Freudenreich O,Querques Jdoi
10.1016/j.psym.2012.06.003subject
Has Abstractpub_date
2013-03-01 00:00:00pages
103-10issue
2eissn
0033-3182issn
1545-7206pii
S0033-3182(12)00111-9journal_volume
54pub_type
杂志文章相关文献
PSYCHOSOMATICS文献大全abstract::The authors assessed, in an adolescent population sample, the internal consistency, test-retest stability, and factor structure of the Toronto Alexithymia Scale (TAS-20) and established the frequency of alexithymia in this age-group. Pupils (N=882; age-groups: 14-, 15-, and 16-year-olds) from two secondary schools com...
journal_title:Psychosomatics
pub_type: 杂志文章
doi:10.1176/appi.psy.48.2.154
更新日期:2007-03-01 00:00:00
abstract:BACKGROUND:Falls and delirium in general-hospital inpatients are related to increases in morbidity, mortality, and healthcare costs. Patients fall despite safeguards and programs to reduce falling. OBJECTIVE:The authors sought to determine the prevalence of diagnosed and undiagnosed delirium in patients who fell durin...
journal_title:Psychosomatics
pub_type: 杂志文章
doi:10.1176/appi.psy.50.3.218
更新日期:2009-05-01 00:00:00
abstract:BACKGROUND:Research has shown that Intensive Short-Term Dynamic Psychotherapy (ISTDP) can effectively decrease pain intensity and improve quality of life in patients with medically unexplained pain. OBJECTIVE:Understanding that not all patients with medically unexplained pain have access to in-person ISTDP, this study...
journal_title:Psychosomatics
pub_type: 杂志文章,随机对照试验
doi:10.1016/j.psym.2016.01.001
更新日期:2016-05-01 00:00:00
abstract:BACKGROUND:Late-life somatic symptom disorder (SSD) is characterized by various aging-associated factors, such as a functional decline, psychosocial problems, and cognitive dysfunction. However, the details of the cognitive dysfunction that occur in late-life SSD are still unknown. OBJECTIVE:The aims of this study wer...
journal_title:Psychosomatics
pub_type: 杂志文章
doi:10.1016/j.psym.2014.10.004
更新日期:2015-09-01 00:00:00
abstract::In the treatment of psychiatric patients with complicating medical illness, clinicians may encounter patients who cannot take oral medications. This review will acquaint the practicing clinical psychiatrist with psychotropic medications available by nonenteral routes of administration. A computerized MEDLINE search wa...
journal_title:Psychosomatics
pub_type: 杂志文章,评审
doi:10.1016/S0033-3182(99)71234-X
更新日期:1999-05-01 00:00:00
abstract::Authors evaluated the sensitivity and specificity of DSM-IV and ICD-10 criteria and the cutoff value of the Memorial Delirium Assessment Scale (MDAS) in diagnosing postoperative delirium in 260 cardiac surgery patients. Incidence of delirium diagnosed on the basis of DSM-IV and ICD-10 criteria, and with the use of the...
journal_title:Psychosomatics
pub_type: 杂志文章
doi:10.1176/appi.psy.49.1.73
更新日期:2008-01-01 00:00:00
abstract::This article reviews the effects of psychotropic medications on the eye. Although some of these effects have been known for years, they have been largely ignored by psychiatrists. The ophthalmologic effects of antidepressants, neuroleptics, benzodiazepines, carbamazepine, and lithium in therapeutic doses and overdose ...
journal_title:Psychosomatics
pub_type: 杂志文章,评审
doi:10.1016/S0033-3182(92)71965-3
更新日期:1992-07-01 00:00:00
abstract::Trichophagia secondary to trichotillomania can be a potentially life-threatening condition if left untreated. This report documents the unique case of a 16-year-old girl whose untreated trichotillomania led to a trichobezoar requiring surgical intervention and follow-up psychiatric treatment. Challenges in the identif...
journal_title:Psychosomatics
pub_type: 杂志文章
doi:10.1176/appi.psy.46.4.362
更新日期:2005-07-01 00:00:00
abstract:BACKGROUND:Comorbidity between vestibular and psychiatric disorders in predisposed individuals is underestimated, untreated, and may result in chronicization and poor quality of life. There are few studies concerning the type and the prevalence of psychiatric-psychosomatic distress in patients with benign paroxysmal po...
journal_title:Psychosomatics
pub_type: 杂志文章
doi:10.1016/j.psym.2013.02.005
更新日期:2014-05-01 00:00:00
abstract::The purpose of this study was to determine the utilization of medical specialists by anxiety disorder patients. The setting was a university's clinical outpatient drug trails for anxiety disorders. The participants were subjects identified by advertisement and diagnosed by psychiatric interviews and, in some instances...
journal_title:Psychosomatics
pub_type: 杂志文章
doi:10.1016/S0033-3182(97)71478-6
更新日期:1997-03-01 00:00:00
abstract:BACKGROUND:Electroconvulsive therapy (ECT) can be life-saving in treating depression, even for high-risk cardiac patients. A 56-year-old man with type 2 diabetes and dilated cardiomyopathy, using both a defibrillator and an experimental cardiac contractility modulator, had had episodes of severe depression superimposed...
journal_title:Psychosomatics
pub_type: 杂志文章
doi:10.1176/appi.psy.49.4.341
更新日期:2008-07-01 00:00:00
abstract::This article characterizes the academic, administrative, clinical service, and fiscal characteristics of departments of psychiatry in traditional children's hospitals to determine the characteristics of fiscally successful programs. A survey of chairs of psychiatry from short-term general children's hospitals was cond...
journal_title:Psychosomatics
pub_type: 杂志文章
doi:10.1176/appi.psy.41.2.128
更新日期:2000-03-01 00:00:00
abstract:BACKGROUND:Depression in patients with diabetes is associated with poorer adherence and worse health outcomes, however treating depression may help improve these outcomes. OBJECTIVE:The present systematic review identified published papers to evaluate treatments for depression in patients with diabetes. RESULTS:Seven...
journal_title:Psychosomatics
pub_type: 杂志文章,评审
doi:10.1016/j.psym.2010.11.007
更新日期:2011-01-01 00:00:00
abstract:BACKGROUND:Olfactory reference syndrome (ORS) is an underrecognized, understudied, and often severe psychiatric disorder characterized by a prominent and distressing or impairing preoccupation with a false belief of emitting an offensive body odor. As this condition has only recently been recognized in the Internationa...
journal_title:Psychosomatics
pub_type: 杂志文章
doi:10.1016/j.psym.2019.12.009
更新日期:2020-01-01 00:00:00
abstract:BACKGROUND:Although anesthetics have been used for more than a century, their mechanisms of action remain poorly understood. Given that a number of intraoperative and postoperative neuropsychiatric syndromes have been linked to the use of anesthetics, practitioners should familiarize themselves with these conditions. ...
journal_title:Psychosomatics
pub_type: 杂志文章,评审
doi:10.1016/j.psym.2013.06.020
更新日期:2014-01-01 00:00:00
abstract::The authors examined the psychological factors associated with self-excoriative behavior among 56 women (mean +/- SE age: 24.0 +/- 1.0 years) with mild-to-moderate facial acne vulgaris. Ratings associated with poor self-concept, such as perfectionistic and compulsive personality traits, correlated more strongly with s...
journal_title:Psychosomatics
pub_type: 杂志文章
doi:10.1016/S0033-3182(96)71578-5
更新日期:1996-03-01 00:00:00
abstract::Injuries from blows to the head often are manifested only as subjective complaints. Postconcussional syndrome thus can be feigned for financial or psychological gain. The authors review the pathology of brain trauma, symptoms of postconcussional syndrome, and criteria for diagnosis. In addition to somatic deficits, ps...
journal_title:Psychosomatics
pub_type: 杂志文章,评审
doi:10.1176/appi.psy.46.3.195
更新日期:2005-05-01 00:00:00
abstract:BACKGROUND:Although the hepatitis C virus (HCV) alone increases the risk of cirrhosis, alcohol use is thought to act synergistically with HCV to significantly hasten the development of fibrosis. OBJECTIVE:The authors assessed the impact of brief medical counseling or integrated-care approaches to lessen or eliminate a...
journal_title:Psychosomatics
pub_type: 杂志文章
doi:10.1176/appi.psy.51.2.149
更新日期:2010-03-01 00:00:00
abstract::Conflicts among consultants are frequent in general hospitals. Unfortunately, such disputes are rarely resolved to the satisfaction of all concerned. The authors discuss the conflicts that may arise among consultants and review techniques that can lead to more effective collaboration. Authors review the literature on ...
journal_title:Psychosomatics
pub_type: 杂志文章
doi:10.1176/appi.psy.49.1.8
更新日期:2008-01-01 00:00:00
abstract::In Part 1 of this 2-part series, the epidemiology of psychiatric disorders in primary care settings was reviewed as well as evidence that indicates that these conditions often go underrecognized and undertreated by primary care physicians. Educational studies to improve the psychiatric skills of primary care physician...
journal_title:Psychosomatics
pub_type: 杂志文章,评审
doi:10.1016/S0033-3182(97)71497-X
更新日期:1997-01-01 00:00:00
abstract::Antihistamines and their drug-drug interactions are reviewed in depth. The metabolism of "classic" or sedating antihistamines is coming to light through in vivo and in vitro studies. The polymorphic CYP 2D6 metabolic enzyme appears to be potently inhibited by many of these over-the-counter medications. The history of ...
journal_title:Psychosomatics
pub_type: 杂志文章,评审
doi:10.1176/appi.psy.44.5.430
更新日期:2003-09-01 00:00:00
abstract::Severe personality disorder has been proposed as a contraindication for liver transplantation. Seventy-three subjects with alcoholic-related liver disease were evaluated for personality disorder and followed for 6 months. The subjects with severe personality disorder had higher rates of divorce, higher rates of comorb...
journal_title:Psychosomatics
pub_type: 杂志文章
doi:10.1016/S0033-3182(98)71282-4
更新日期:1998-11-01 00:00:00
abstract:BACKGROUND:Adolf Meyer, the first Professor of Psychiatry at Johns Hopkins, and Chief of the Phipps Clinic, brought a bevy of new ideas to clinical practice and to medical education. He used the word "psychobiology," which helped to establish psychosomatic medicine and formed the basis for Engel's "biopsychosocial" con...
journal_title:Psychosomatics
pub_type: 传,历史文章,杂志文章
doi:10.1016/j.psym.2012.10.007
更新日期:2013-03-01 00:00:00
abstract:BACKGROUND:The loss of a baby causes severe short- and long-term distress to parents and their marital relationship, but little is known about how this distress is shared between spouses. The authors hypothesized that the grief-related concordance within a couple 2 to 6 years after the loss of a premature baby could be...
journal_title:Psychosomatics
pub_type: 杂志文章
doi:10.1176/appi.psy.50.2.123
更新日期:2009-03-01 00:00:00
abstract::The eating disorders anorexia nervosa and bulimia nervosa have been reported to occur in Type I diabetes mellitus. Although prevalence estimates vary, the most rigorous studies yield rates similar to the population at large. Intentional insulin omission is more common, especially in young diabetic women, and at times ...
journal_title:Psychosomatics
pub_type: 杂志文章,评审
doi:10.1016/S0033-3182(98)71340-4
更新日期:1998-05-01 00:00:00
abstract:BACKGROUND:Mental illness is associated with an increased risk for medical hospitalizations. OBJECTIVE:This study investigates the degree to which nonpsychiatric factors account for these hospitalizations. METHODS:Using National Veterans Health Administration (VHA) fiscal year 2012 data for 2 million veterans under t...
journal_title:Psychosomatics
pub_type: 杂志文章
doi:10.1016/j.psym.2019.04.005
更新日期:2019-01-01 00:00:00
abstract:BACKGROUND:Some studies suggest intensive psychiatric consultation services facilitate medical care and reduce length of stay (LOS) in general hospitals. OBJECTIVE:To compare LOS between a consultation-as-usual model and a proactive consultation model involving review of all admissions, rapid consultation, and close f...
journal_title:Psychosomatics
pub_type: 临床试验,杂志文章
doi:10.1016/j.psym.2011.06.002
更新日期:2011-11-01 00:00:00
abstract::Psychotropic drugs are frequently used in both psychiatric and general medical practice. Familiarity with common side effects and their management may assist psychiatrists in the selection of agents to suit individual patient needs. The authors describe the morphologic features and pathologic basis of cutaneous reacti...
journal_title:Psychosomatics
pub_type: 杂志文章,评审
doi:10.1016/S0033-3182(97)71418-X
更新日期:1997-09-01 00:00:00
abstract::The authors examine the relationship of the Toronto Alexithymia Scale (TAS) to sociodemographic characteristics, medical history, symptomatology, and illness cognition in a sample of 244 family medicine patients. The TAS had moderate internal reliability. In multiple regression analysis, the TAS was related to age, ed...
journal_title:Psychosomatics
pub_type: 杂志文章
doi:10.1016/S0033-3182(93)71926-X
更新日期:1993-01-01 00:00:00
abstract:BACKGROUND:Psychosocial assessment is an essential component of the pretransplant evaluation. Many individuals have significant psychosocial problems, and they are either denied for transplantation or deferred from listing and transplant until the psychosocial issues are addressed. OBJECTIVE:The primary aim of this st...
journal_title:Psychosomatics
pub_type: 杂志文章
doi:10.1016/j.psym.2018.06.003
更新日期:2019-01-01 00:00:00