Edgardo Perez

• Doctor of Medicine
• psychiatrist at Niagara Health System

The authors examined the prevalence and predictors of sexual dysfunction in a sample of 3,717 psychiatric inpatients assessed with the Minimum Data Set-Mental Health Version 1 (MDS-MH 1.0). Sexual dysfunction was found to be less prevalent in inpatient psychiatry (17%) than is typically reported in community settings. Severe depression symptoms, us...

An important challenge facing behavioral health services is the lack of good quality, clinically relevant data at the individual level. The article describes a multinational research effort to develop a comprehensive, multidisciplinary mental health assessment system for use with adults in facilities providing acute, long-stay, forensic, and geriat...

This report discusses the process used by the Healthcare Quality Certification Board to internationalize its certification program. With some modifications this methodology can be utilized to define the role of any healthcare professional and to legitimize, create or restructure a certification program that assesses competency in a particular healt...

There is a growing need for an integrated health information system to be used in community, institutional and hospital based settings. For example, changes in the structure, process and venues of service delivery mean that individuals with similar needs may be cared for in a variety of different settings. Moreover, as people make transitions from...

The effects of light therapy on food intake and affective symptoms of bulimia nervosa (BN) were examined in a double-blind study. Eighteen women who met DSM-III-R criteria for BN were randomly assigned to receive either 2500 lux of bright light (experimental condition) or < 500 lux of dim light (placebo condition) daily in the early evening for a 1...

Prognostic indicators of short-term outcome were identified in 69 women with the DSM-III-R diagnosis of bulimia nervosa who participated in a weekly 10-session structured cognitive-behavioral outpatient group program. Prior to treatment, all subjects completed the computerized Diagnostic Interview Schedule (DIS), the Moos Family Environment Scale (...

Sessional funding is a mechanism that originated in the 1960s in Ontario, Canada, to pay for indirect psychiatric services provided in the general hospital system and through community mental health programs. This article describes the sessional funding system and the problems that developed in the allocation of sessional hours and accountability f...

Stress has been implicated as a major confounding factor in the interpretation of Dexamethasone Suppression Test (DST) results. This study was designed to examine the effects of stress on DST results. Fifty patients with high levels of acute, chronic, and environmental stress participated in the study. Each patient was given a comprehensive psychia...

The aim of this research was to determine whether a seasonal pattern to symptoms of bulimia nervosa could be identified. In study 1, seasonal patterns of binge-purge frequency and mood were compared between 31 patients with bulimia nervosa and 31 age-matched normal comparison subjects, using a modified (to include binge and purge items) version of...

The authors of this study examine the demographic and clinical characteristics of hospitalized long-term active psychiatric patients in a metropolitan Canadian region. Their characteristics are compared to other hospitalized patients. Problems inherent in using a cross sectional methodology are reviewed. It was expected that this study's findings w...

The purpose of this study was to identify variables useful for predicting a positive response to the tricyclic antidepressant desipramine, amongst bulimic subjects. Using a randomized double-blind cross-over design, 24 normal weight bulimics completed a 15-week protocol in which they received either desipramine (150 mg/day)for six weeks, no drug fo...

Desipramine and fenfluramine were administered to bulimic patients in a 15-week study of double-blind, placebo-controlled, crossover design. The 22 patients in the study met DSM-III criteria for bulimia and were of normal weight. Twelve subjects were randomly allocated to the fenfluramine group, and 10 subjects received desipramine. Half the subjec...

The National Institute of Mental Health (NIMH) Diagnostic Interview Schedule (DIS) is a highly structured interview designed to be administered by lay interviewers and to yield psychiatric diagnoses. While the DIS has been used widely in large research centers, its use has been limited due to its complexity and need for extensive training to admini...

This study was designed to assess the extent to which DST nonsuppression in bulimic women could be predicted by the incidence of major depression in the patient and her family and by other factors known to affect DST results, such as suboptimal weight. The DST was administered to 33 women who met DSM-III criteria for bulimia. Subjects were given a...

The purpose of this study was to evaluate the effect of desipramine, a tricyclic antidepressant with relatively specific noradrenergic effects, on bulimic behaviour, eating attitudes, and mood. Using a double-blind crossover design, 47 normal weight bulimics were randomly assigned to receive either desipramine (150 mg/day) for six weeks, no drug fo...

The authors review includes: the historical background, standards, functional issues, efficacy and alternative models of care of partial hospitalization programs in North America. The emphasis is placed on those issues which are of relevance when planning alternative programs to inpatient hospitalization.

The authors of this study examine the demographic and clinical characteristics of repeated users of psychiatric emergency room services in a general hospital. 37.8% of all the patients (913) seen during one year had one or more visits to the emergency room in the six months preceding the index emergency room consultation. Repeaters were more likely...

The authors compared the demographic and clinical characteristics and treatment recommendations for elderly (greater than or equal to 60 years) and younger patients (17 to 59 years) seen for an emergency psychiatric consultation in a teaching general hospital. Findings revealed 11 distinctive characteristics that differentiated elderly from younger...

Given the high drop-out rates frequently noted in drug trials with bulimic subjects, we have attempted to correlate drop-out status with a greater level of psychopathology as measured by a thorough standardized psychological assessment battery (NIMH-DIS, EDI, POMS and SCL-90). Despite a trend toward higher scores on the Paranoid Ideation Subscale o...

To investigate the extent to which psychosocial aspects of medical practice are currently taught in Canadian medical schools, a brief questionnaire was distributed to the 16 directors of psychiatric undergraduate education. Twelve of the fourteen departments that replied offered some theoretical and clinical teaching on this subject, amounting on t...

Emergency physicians have a significant responsibility in the recognition, management and prevention of suicide behavior. A comprehensive clinical assessment should include a systematic review of high risk factors. Five important aspects associated with high risk factors are reviewed in this paper: the patient's suicidal intention; the lethality of...

Emergency physicians have a significant responsibility in recognizing, managing and preventing suicidal behavior. This paper proposes a theoretical model for disposition of patients with suicidal ideas and behavior. This model is based on five well documented predictors of suicide: intention and lethality of the suicide attempt, psychiatric diagnos...

Factors affecting compliance to referrals in the psychiatric emergency room (ER) were studied in a sample of 468 patients referred for ambulatory care. Compliance was defined as attendance at the first appointment. The overall compliance rate was 59%. Compliance rates were higher among those patients who were receiving psychiatric treatment (active...

The elderly (65 years or older) constitute approximately 25% of the patients referred for psychiatric consultations in general hospitals. The authors compared the clinical characteristics of and treatment recommendations for elderly and younger (less than 65 years) patients. Our findings revealed fourteen distinctive characteristics which different...

Describes the findings of a 20-yr computerized literature review of compliance with referrals from adult psychiatric emergency wards to outpatient services. Compliance in most of the studies was defined as attendance at the 1st appointment in the facility to which the patient was referred. Results show that compliance rates ranged from 28 to 64%. F...

Delirium is the organic mental disorder most often encountered by psychiatrists and other physicians. Early recognition and management of patients with this condition is critical. Its presence in medically ill patients is highly correlated with an increased mortality rate. In a study of patients who were referred for psychiatric consultation in a g...

The authors reviewed 255 psychiatric consultations in a Canadian teaching general hospital over a one-year period. The majority of the patients were referred from the medical and surgical services. The three most commonly stated reasons for referral were either parasuicidal behavior, depression, or psychological conflicts affecting physical illness...

Canadian Psychiatry Residency programs were surveyed through questionnaires to determine the status of Consultation Liaison Training (CLT) for the year 1979/80. Virtually all the programs offered CLT as lecture/seminars and clinical postings. The majority of residents who received CLT were in their first and second years, with the average trainee s...

Data was analyzed from 815 completed questionnaires by 530 physicians, 122 residents and 163 medical students to identify the attitude of physicians about death and dying. The following four areas were surveyed: 1) the physician's attitude toward terminally ill patients and relatives; 2) toward his own or a relative's terminal illness; 3) the major...

The aim of this specific study was to investigate the attitudes of psychiatrists and psychiatric residents in order to help in the setting of an adequate training program at the various levels of medical education. This study seems to reflect for the psychiatrist a profile of attitudes towards the terminally ill patient similar to the one of the me...