Recent advances in psychiatric research methodology promise major progress. Simultaneously, however, mounting concerns about ethnics of human experimentation have resulted in increased scrutiny and regulation that threaten scientific productivity. Virtually no systematic data have been gathered about the effects of research participation on treatment outcome or patient satisfaction. In this study 56 hospitalized depressed patients, who had agreed to participate in psychobiological research protocols, were then randomly assigned to treatment on a research unit or on standard adult inpatient (nonresearch) units. Research participants received more diagnosis-related somatic treatments, had a longer mean length of stay, and experienced trends toward greater symptom reduction and better consumer satisfaction. We conclude that research participation may be helpful to patients but that more systematic study is needed to help to resolve ethical questions and to assist risk-benefit evaluations.
"Consistent with this trend, some researchers have solicited opinions from patients about their perceptions of research participation (Vogel-Scibilia, 1999). Seeking patients' views regarding their experience in research projects allows investigators to identify areas of research that are important to patients, to question how patients' experiences may affect research outcomes (Mason et al., 1998), to develop more effective recruitment and retention strategies (Mezey, 1999), and to identify unintended costs and benefits of research participation (Kocsis et al., 1981). However, nearly all of the published research conducted with individuals diagnosed with a SPMI have focused on drug trials. "
[Show abstract][Hide abstract] ABSTRACT: We conducted exit interviews with 45 outpatients with severe and persistent mental illness (SPMI) who had participated in a randomized clinical trial. The interviews followed a semistructured format and were audiotaped for later transcription and rating by two independent raters. Content analyses of the interviews revealed that most participants evaluated their experiences quite favorably. For example, most noted that the assessment process was thought-provoking and motivational and that the intervention groups led to increased self-confidence and new friendships. Although a few participants noted that the assessment contained sensitive material, all appreciated the frequent reminders that information disclosed was strictly confidential. These results indicate that persons living with a SPMI often enjoy participating in behavioral research, which can yield immediate benefits to patient-participants. Exit interview research such as this can help investigators to understand reasons for consent and participation, to identify needs for protocol modifications, and to facilitate the integration of evidence-based interventions into the mental health care systems.
"If such risks exist, the thoughtful care of patients in research settings can greatly decrease them. In fact, evidence suggests that research patients are no more likely to suffer adverse consequences , and at times receive greater benefits, than those treated in normal clinical settings (Cardon et al. 1976; Carroll et al. 1980; Kocsis et al. 1981; Macklin 1981; Kalman et al. 1982; McCrae 1982; Giller and Strauss 1984). The purpose of this article, however, is to examine whether discontinuation of antipsychotic medications for research purposes might increase the longterm morbidity of schizophrenia. "
[Show abstract][Hide abstract] ABSTRACT: This article, and the accompanying one by Dr. Carpenter, discuss the benefits and risks associated with taking patients with schizophrenia off medications for research purposes. This article reviews the concept that at least some forms of schizophrenia are progressive. Evidence for this view is provided by studies examining the impact of early intervention with antipsychotic medications on the long-term morbidity of schizophrenia, as well as the few studies examining the long-term risks of discontinuing antipsychotic medications in patients with schizophrenia. While there is evidence that early intervention improves the long-term course of the illness, it is not known whether withdrawal of antipsychotic medications increases long-term morbidity. This is an area where further information is needed for clinical practice and research.
[Show abstract][Hide abstract] ABSTRACT: A deficiency in general medical care for terminally ill patients is recognized. A hospice care-providing team has been formed to obviate this urgent problem. Logistics dictate that hospice care can be implemented most effectively in the home environment. Home hospice care is therefore promoted as the ideal situation for most terminally ill patients.
South African medical journal = Suid-Afrikaanse tydskrif vir geneeskunde 04/1983; 63(13):487-8. · 1.63 Impact Factor
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