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Biomedical subjects

A K Shapiro

Publications and source records attributed to A K Shapiro.

66 records · Page 4Linked to original sources
PubMedDate not supplied

Evaluation of the reported association of obsessive-compulsive symptoms or disorder with Tourette's disorder.

This review evaluates the evidence reporting an association of obsessive-compulsive symptoms (OCS) and obsessive-compulsive disorder (OCD) with Tourette's syndrome or disorder (TS). Published reports in the literature describing a relationship between OCS-OCD and TS provided the data for the review. The methodological adequacy of the studies are discussed and rated on five criteria: adequacy of the experimental sample, presence and adequacy of the control sample, whether tics are defined as OCS-OCD, whether blind procedures are used to diagnose OCS-OCD in subjects and controls, and evidence for the reliability and validity of OCS-OCD measures. Although there are considerable clinical indications suggesting an association of OCS-OCD with TS and chronic motor tic disorder (CMT), and a possible overlap between OSC-OCD and TS, our evaluation of the evidence does not provide adequate support for an association between these disorders. To meaningfully evaluate the possible relationship between OCS-OCD and TS requires development of specific criteria for classification of OCS-OCD-TS symptoms, use of adequate experimental and control samples, blind evaluation, reliable and valid measures of OCS-OCD-TS, and appropriate statistical analysis. If such studies are performed, it is possible that the strong relationship reported between OCS-OCD and TS is more likely to be artifact than fact, and recent bandwagon effect rather than the latest breakthrough.

Diagnosis, Differential↗
PubMedDate not supplied

Diazepam: how much better than placebo?

In a six week, double-blind, predictive, clinical study 224 neurotic and anxious outpatients were randomly assigned to treatment with diazepam (Valium) of placebo and weekly brief psychotherapy administered by experienced psychiatrists. Although diazepam was significantly more effective than placebo for the first week of treatment, it accounted for only 1-4% of the outcome variance, while nonspecific variables contributed 11-22%. After the first revisit and at endpoint, only nonspecific variables accounted for outcome variance ranging from 20 to 26% over the four outcome measures. According to physicians' global and scaled ratings of improvement, diazepam had a treatment advantage (p less than 0.01-0.05) over placebo at the end of the first week of treatment for both the total and completed samples, but not thereafter. According to patients' global ratings of improvement, diazepam was moderately superior (p less than 0.05) to placebo for the total sample only at the end of the first week of treatment and modestly better (p less than 0.10) than placebo for the completed sample on a highly reliable measure of reported anxiety at the same time point. However, patient ratings did not indicate an advantage for diazepam at any of the six points of observation on global ratings of improvement for the completed sample and on reported anxiety for the total sample.

Adult↗