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Biomedical subjects

A H Crisp

Publications and source records attributed to A H Crisp.

At least 91 records · Page 5Linked to original sources
PubMed1981

Laterality of migraine and reported affect. The relevance of an hypothesis concerning the nature of migraine.

The few right-handed female subjects with exclusively left-sided classical migraine drawn from an epidemiological study have been found to be characterized by very low levels of anxiety and depression. This finding is examined in relation to the theory that migraine is a cerebral hemisphere response, ultimately vascular, to 'information overload' and that such specificity may be an indication of relatively high and selective hemisphere capacity and activity, left-sided in the above instance. There is also experimental evidence from elsewhere that unfettered or predominant left hemisphere activity is associated with reduction in depressive affect in normal subjects. This, then may be the basis of the present finding.

Adult↗
PubMed1981

Schizophrenia and anorexia nervosa.

The clinical features in six patients who developed schizophrenia or schizophrenic form illnesses in the context of their anorexia nervosa were described. The patients appeared to have retained their anorectic psychopathology even in their psychosis.

Adolescent↗
PubMed1981

Therapeutic outcome in anorexia nervosa.

There are no controlled studies of the outcome of treatment for anorexia nervosa. An early study showed that biologically recovered anorectics were, as a group, socially phobic four years following the completion of treatment. This position is more sophisticated and mature than that at the time of their original anorexia and one shared by many "normal" people. A recent study evaluated treatment in terms of strict criteria for good outcome: all the patients had been severely ill with anorexia nervosa when first seen. Four to seven years later, 84% were holding a body weight above the pubertal threshold but of these, 2% were obese and 18% were well below average adult weight. Sixty-four percent, therefore, were sustaining a normal and stable body weight and the majority of these had regular menses. Quite a number were preoccupied with body shape, but their psychosocial adjustment was reasonable. In contrast, 14% had remained severely ill and only 2% had died. These findings suggest that treatment aims at altering the long term cause of the disorder for the better is probably effective in (a) helping about 20 to 30% of the population to recover who would not otherwise have done so; and (b) in preventing some deaths.

Adolescent↗
PubMed1981

Anorexia nervosa at normal body weight!--The abnormal normal weight control syndrome.

Disgust with "fatness" and a consequent preoccupation with body weight, coupled with an inability to reduce it to or sustain it at the desired low level, characterizes the abnormal normal weight control syndrome. Individuals remain sexually active in a biological sense and often also socially. Indeed their sexual behaviour may be as impulse ridden as is their eating behaviour, which often comprises phases of massive bingeing coupled with vomiting and/or purgation. The syndrome is unlike frank anorexia nervosa in that the latter involves a regression to a position of phobic avoidance of normal body weight and consequent low body weight control with inhibition of both biological and social sexual activity. In abnormal normal weight control there is a strong and sometimes desperate hedonistic and extrovert element that will often not be denied so long as body weight does not get too low. Individuals nevertheless feel desperately "out of control" and insecure beneath their bravura. The syndrome is much more common in females than in males. There is a clinical overlap with anorexia nervosa and obesity in many cases as the disorder evolves. Depression, stealing, drug dependence (including alcohol) and acute self-poisoning and self-mutilation are common complications. Clinic cases probably only represent the tip of the iceberg of the much more widespread morbidity within the general population. Like anorexia nervosa and for the same reasons the disorder is probably more common than it used to be.

Adolescent↗
PubMed1980

The Crown-Crisp Experiential Index (CCEI) profile in Anorexia Nervosa.

Patients with anorexia nervosa show a decrease in psychoneurotic symptomatology as measured by the Crown-Crisp Experiential Index (CCEI) as their clinical status improves. Those who remain ill continue to display a moderate degree of varied psychopathology 4 to 8 years after their presentation. Vomiters and those with anxiety on eating with others can be distinguished on the CCEI from those without such features. Lower anxiety, phobia, obsessional and somatic scores at presentation are predictive of good outcome in terms of weight and menstrual function 4 to 8 years later.

Anorexia Nervosa↗
PubMed1980

Sleep, activity, nutrition and mood.

For the past fifteen years we have been studying aspects of relationships between sleep, activity, nutrition and mood. This paper comprises a brief statement of some of this research and our views to date.

Adolescent↗
PubMed1980

Hunger, food intake and weight: the impact of clomipramine on a refeeding anorexia nervosa population.

This double-blind controlled study examines the impact of clomipramine when taken by an anorexia nervosa population, refeeding in hospital, over and above that generated by the established treatment programme. Of the 16 patients studied, all reached their target weights including three who asked to leave the study. Clomipramine was significantly associated with increased hunger, appetite and energy intake. It tended, though, to be associated with a reduced rate of weight gain, possibly because activity was increased. Patients receiving clomipramine were more stable in their eating habits and maintained body weight better than those on placebo after leaving the trial. These findings indicate the sensitivity of the hypothalamus to changes in body weight. Clomipramine, which is known to act at a hypothalamic level, seems to influence hunger, appetite and dietary intake according to the body weight of the patient. The threshold weights which have been shown to trigger hypothalamic sexual responses, may also influence hunger, appetite, motility and voluntary energy intake.

Anorexia Nervosa↗
PubMed1979

Outcome of anorexia nervosa.

100 females with anorexia nervosa were followed up 4-8 years after first presentation. All but 12 had had refeeding and/or psychotherapy. 48 had a good outcome (weight at least near normal, regular menstruation, largely satisfactory mental state and psychosexual and psychosocial adjustments) but outcome was intermediate in 30, and poor in 20 patients. 2 had died. Poor outcome could be positively associated with clinical data such as longer duration of illness, older age of onset and presentation, lower weight during illness and at presentation, presence of symptoms such as bulimia, vomiting, and anxiety when eating with others, poor childhood social adjustment, and poor parental relationships.

Adaptation, Physiological↗
PubMed1979

Weight and skeletal maturation - a study of radiological and chronological age in an anorexia nervosa population.

The carpal bones of 18 anorexia nervosa patients were radiographed and the X-ray age assessed by 2 different standard methods. The study demonstrates that skeletal development in anorexia nervosa patients is delayed such that there is no association between radiological assessment of age and chronological age. It is strongly suggested that bony development actually ceases when body weight falls sufficiently to stop menstruation. There was a highly significant (P = 0.001) linear relationship between radiological age and the sum of the age of onset of the illness plus any period(s) of re-feeding. Weight gain seems to re-kindle the bone maturing mechanisms: the role of weight thresholds and associated hormone activity being discussed. The findings of this study strongly support the existing evidence that the anorexia nervosa patient is biologically and psychologically immature.

Adolescent↗
PubMed1979

Comparisons of weight concepts in groups of neurotic, normal and anorexic females.

A group of normal women and a group of women in hospital for treatment of a neurosis but without a disorder of eating were compared with a group of anorexic patients in terms of their attitudes to weight. All subjects completed a rank order form of repertory grid. Differences in construct patterning between the anorexic patients and the other female groups could not be accounted for by social class, age or neurotic disorder. The most psychologically significant finding was a positive correlation between the constructs self at normal weight and ideal weight instead of a negative correlation which clinical experience would lead one to expect. Four explanations are proposed to account for this finding.

Adult↗