Characteristics of readmitted psychiatric inpatients

This study examined sociodemographic, diagnostic, psychological, and episode-based variables in a sample of 130 psychiatric patients admitted to treatment at least twice in a 6-yr. period. Short length of initial hospitalization (r = -.30, p < .01) and younger age on initial admission (r = -.20, p < .05) were significantly correlated with frequent hospital admissions. Scores on four of the subscales of the WAIS-R were significantly correlated with readmission, confirming that patients who have fewer cognitive resources are at risk of frequent admissions. A multiple regression analysis combining variables to predict readmission accounted for only 12% of the common variance (r128 = .34, p < .01), however, indicating that a prediction equation with these variables has limited clinical utility.     

MMPI predictors of mania among psychiatric inpatients

MMPI data from 64 patients with a diagnosis of manic-depressive illness, manic type, were compared with MMPI data from patients in two comparison groups--64 patients with a psychotic diagnosis other than manic-depressive illness, and 64 patients with a variety of psychiatric diagnoses. Manic patients had higher Ma scale scores for MMPI scales that assess personal distress and interpersonal difficulties (e.g., D and Si). Discriminant analysis, with the Ma, D, and Si scales as predictors, correctly classified as manic or not manic 82.5% of the patients in the derivation sample and 74.2% of the patients in the cross-validation sample. Two high-point pairs, Sc-Ma/Ma-Sc and Pa-Ma/Ma-Pa, occurred in the MMPI profiles of almost half of the manic patients but were rarely found among the profiles of other patients. The results of this study support the use of the MMPI in identifying manic patients, particularly when discriminating between mania and other types of psychosis.     

The efficacy of rational-emotive group therapy in psychiatric inpatients

The impact of rational-emotive theory and therapy upon the practice of clinical psychology has been profound, and many purportedly objective experimental tests of its efficacy as a mode of treatment have been reported. Yet the great majority of these reports have failed to utilize actual clinical populations. This study evaluated rational-emotive group therapy with psychiatric inpatients. Results supported the claim that irrational beliefs are related to emotional disturbance. It was also shown that patients undergoing rational-emotive group therapy changed their self-reported irrational beliefs more than did a control group. Finally, there was a trend for the experimental subjects to be more likely to have been discharged from the hospital during the 90-day follow-up period than were control subjects. However, this study failed to demonstrate that change in irrational beliefs was related to improvement in psychiatric symptoms or rates of discharge from the hospital. Some of the difficulties in conducting treatment evaluation research in a psychiatric hospital setting are discussed with respect to these results.     

Locus of control and achievement in child psychiatric inpatients

The relationship between the Nowicki-Strickland Locus of Control Scale for Children (Nowicki & Strickland, 1973) and academic achievement was examined in a sample of 66 child psychiatric inpatients. Previous studies had suggested that this measure correlated with achievement in normal samples (Nowicki & Strickland, 1973) but not in populations of male juvenile offenders (Little & Kendall, 1978). The product-moment correlation between the Nowicki-Strickland Scale and the Peabody Individual Achievement Test was significant. However, when the effect of IQ was controlled for in a partial correlation, there was no significant correlation. Discussion focuses on the relationship between these results and other findings in the area of locus of control, intelligence, and achievement.     

Normal range MMPI-A profiles among psychiatric inpatients

The present study examined the base rates of normal range Minnesota Multiphasic Personality Inventory-Adolescent (MMPI-A) profiles in an inpatient sample and examined the differences between adolescents with apparently valid normal range profiles (all clinical scale T-scores < 60) and those with elevated profiles on prior interventions, reported internalizing and externalizing symptoms, and MMPI-A validity scale scores and other indexes of underreporting. Normal range profiles cannot be adequately explained by a less pathological history prior to hospitalization or by defensiveness. Thirty percent of male and 25% of female adolescents produced valid MMPI-A profiles in which none of the clinical scales were elevated. Both male and female adolescents with normal range profiles were generally less likely to report internalizing symptoms than those with elevated profiles, but both groups report externalizing symptoms. Neither the standard MMPI-A validity scales nor additional validity scales discriminated between profile groups. Clinicians should not assume that normal range profiles indicate an absence of problems.     

Substance use among Iranian psychiatric inpatients.

This study evaluated substance use among a sample of 205 psychiatric inpatients (70 women and 135 men) chosen randomly. The subjects (who had schizophrenia or mood disorders) were evaluated on a confidential questionnaire by interview. Their mean age was 35 yr. (SD= 10.4, range 16 to 69). Of these participants, 76% of the 135 men and 34% of the 70 women admitted use of substances: cigarettes (74% of men, 31.4% of women), opiates (31.9% of men, 4.3% of women), alcohol (23.7% of men, 4.3% of women), hashish (8.9% of men, no women), marijuana (3.7% of men, no women), and cocaine or LSD by none. Only 27% of the women and 63% of the men reported still using substances regularly; some reported using more than one substance. Of the current users, 61.8% of the schizophrenics, 20% of unipolar depressed, and 37.5% of bipolar patients reported current use. The reasons for substance use in order of frequencies of mention were release of tension, seeking pleasure, and need (to avoid withdrawal symptoms) by men and habit, seeking pleasure, and need by women.     

Replicating the five factor model of personality in a psychiatric sample

In this study we examined whether the factor structure and traits of the five-factor model of personality (FFM), derived from non-clinical samples, could be replicated in a sample of psychiatric patients. The revised NEO Personality Inventory (NEO PI-R) was administered to a study group of psychiatric patients (n=176). The test scores from these patients were intercorrelated, factor analyzed and the obtained factor structure was then compared to the factor structure of the normative data from the NEO PI-R. The factor structure from the psychiatric study group and that from the normative sample were virtually identical, with all five factors showing significant congruence. These results argue favorably for the clinical applicability of the FFM with psychiatric patients.     

Sex differences in mortality rates among long-stay psychiatric inpatients

Study of the sex ratio of mortality rates among three categories of long-term psychiatric inpatients suggests a trend toward equalization of death rates between the sexes by specific cause of death, given the constant inpatient environment. The most dramatic example of this equalization was the virtual parity of death rates for ischemic heart disease among younger schizophrenic patients of both sexes in contrast to a three- to fourfold male excess in the general population. An exception to this equalization was seen for neoplasm deaths, which showed a female excess in all three patient groups in contrast to the male excess seen in the general population. Further study of chronically hospitalized psychiatric patients seems indicated to delineate patterns of death associated with biologic variation in a relatively constant environment.     

The Rorschach Comprehensive System Egocentricity Index in psychiatric inpatients

This paper reports an exploratory study of potential correlates of Exner's Rorschach Egocentricity Index, a measure of self-focusing, in a sample of 70 psychiatric inpatients. We examined the relationship of the Index of the MMPI Ego Strength scale and to other MMPI and Exner Comprehensive System Rorschach variables, using Pearson Product-Moment correlations with partialling of the number of Rorschach responses. There were seven meaningful significant correlations between the Index and Rorschach variables: M, FM, X +%, F +%, Lambda, D, and A%. The Index-MMPI correlations were not significant. Sex differences and differences between these intercorrelations and some reported by Exner (1983) are discussed.     

Complementary and alternative medicine use by psychiatric inpatients

82 psychiatric inpatients hospitalized for acute care were interviewed about their use of complementary and alternative medicine (CAM) modalities. The clinical diagnoses of respondents included Depressive Disorder (61%), Substance Abuse (26%), Schizophrenia (9%), and Anxiety Disorders (5%). Analysis indicated that 63% used at least one CAM modality within the previous 12 mo. The most frequently used modality was herbal therapies (44%), followed by mind-body therapies such as relaxation or mental imagery, hypnosis, meditation, biofeedback (30%), and spiritual healing by another (30%). Physical modalities such as massage, chiropractic treatment, acupuncture, and yoga were used by 21% of respondents. CAM therapies were used for a variety of reasons ranging from treatment of anxiety and depression to weight loss. However, most respondents indicated they did not discuss such use with their psychiatrist or psychotherapist.     

The Last-Weiss Rorschach Ego-Strength Scale as a prognostic measure for psychiatric inpatients

This study tested the hypothesis that the Last-Weiss (Last & Weiss, 1976) Rorschach Ego-Strength Scale would predict outcome among a representative sample of first-lifetime psychiatric admissions. One hundred seventeen patients were assessed with structured symptom, psychiatric history, and social data interviews at hospital admission, and 2-year follow-up. Outcome measures included a multidimensional variable involving rehospitalization time, social and work functioning, and recent symptom level and symptom measures. Unexpectedly, the Last-Weiss Sum E variable correlated significantly with negative multidimensional outcome, a result that was strengthened when any possibly confounding effects of social class, IQ, and number of Rorschach responses were partialled out. It was found that Sum E's predictive value for poorer outcome was due to the space response (S+) component of the ego-strength variable. Possible explanations of the findings and implications for the previously validated Klopfer's Rorschach Prognostic Rating Scale are discussed.