Search PubMed⌕ Search

Biomedical subjects

A Mann

Publications and source records attributed to A Mann.

At least 109 records · Page 6Linked to original sources
PubMed1996

Psychiatric and alcohol disorders as risk factors for drug abuse. A case-control study among adults in Rio de Janeiro, Brazil.

This study tested the hypothesis that a history of psychiatric and alcohol disorders would affect the risk of developing drug abuse or dependence later in life. This case-control study selected cases and controls using the "snowball" technique in order to obtain cases from this "hidden" population and to match sex, age and friendship. Information was gathered using the Composite International Diagnostic Interview (CIDI), and computer diagnoses were generated according to the DSM-III-R criteria. The study included 370 subjects. Results of the conditional logistic regression analysis showed that having a history of alcohol dependence was independently associated with an increased risk of drug abuse/dependence (OR = 2.6, 95% CI 1.1-6.0) and that this risk was even higher for those whose alcohol dependence occurred in combination with another psychiatric disorder (OR = 4.6, 95% CI 2.1-10.0). An increased risk of drug abuse/dependence was also found for those who were aged 12 years or under when their first psychiatric disorder was manifested (OR = 2.2, 95% CI 1.3-3.7) and among those with two or more psychiatric disorders (OR = 2.5, 95% CI 1.5-4.1). These findings suggest that programmes directed towards the treatment and prevention of drug abuse must be prepared to address psychiatric and alcohol disorders in childhood and adolescence.

Adolescent↗
PubMed1996

A comparison of DSM-III-R and ICD-10 personality disorder criteria in an out-patient population.

This study reports the results of a comparison of DSM-III-R and ICD-10 personality disorder criteria by application of both sets of criteria to the same group of patients. Despite the clinical relevance of these disorders and the need for reliable diagnostic criteria, such a comparison has not previously been reported. DSM-III-R and ICD-10 have converged in their classification of personality disorders, but some important differences between the two systems remain. Personality disorder diagnoses from both systems were obtained in 52 out-patients, using the Standardized Assessment of Personality (SAP), a brief, informant-based interview which yields diagnoses in both DSM-III-R and ICD-10. For individual personality disorder diagnoses, agreement between systems was limited. Thirty-four subjects received a personality disorder diagnosis that had an equivalent form in both systems, but only 10 subjects (29%) received the same primary diagnosis in each system. There was a difference in rate of diagnosis, with ICD-10 making significantly more personality disorder diagnoses. The lower diagnostic threshold of the ICD-10 contributed most of this effect. Further modifications in ICD-10 Diagnostic Criteria for Research (DCR) and DSM-IV to the personality disorder category have been considered. The omission in DSM-IV of three categories unique to that system and the raising of the threshold in ICD-10 DCR, do seem to have been helpful in promoting convergence.

Adolescent↗
PubMed1996

A longitudinal study of factors predicting change in cognitive test scores over time, in an older hypertensive population.

This study aims to describe factors associated with cognitive decline among 2584 subjects, aged 65-74, who were followed up for 54 months in the Medical Research Council Elderly Hypertension Trial (1982-1989). The subjects completed a cognitive test, the Paired Associate Learning Test (PALT), five times over this period. Decline on the PALT was associated with advanced age, male sex, rural residence, depression and low intelligence. These effects were modified by gender and level of pre-morbid intelligence. Advanced age, rural residence and number of cigarettes smoked daily were only associated with PALT decline among women of below median intelligence. The association between depression and PALT decline was only apparent in women of below median intelligence and men of above median intelligence. While these findings are consistent with other research into cognitive decline, they differ in some ways from reported risk factors for dementia, suggesting aetiological separateness. That women were more vulnerable than men to the effects of age and smoking raises the question of the impact on cognition of accelerated atherosclerosis after the menopause.

Aged↗
PubMed1996

Psychosocial risk factors for chronic fatigue and chronic fatigue syndrome following presumed viral illness: a case-control study.

This study investigated psychosocial morbidity, coping styles and health locus of control in 64 cases with and without chronic fatigue identified from a cohort of primary care patients recruited 6 months previously with a presumed, clinically diagnosed viral illness. A significant association between chronic fatigue and psychosocial morbidity, somatic symptoms and escape-avoidance coping styles was shown. Chronic fatigue cases were significantly more likely to have a past psychiatric history and a current psychiatric diagnosis based on a standardized clinical interview. Twenty-three of the cases fulfilled criteria for chronic fatigue syndrome (CFS). Such cases were significantly more fatigued than those not fulfilling criteria, but had little excess psychiatric disorder. A principal components analysis provided some evidence for chronic fatigue being separable from general psychosocial morbidity but not from the tendency to have other somatic complaints. Past psychiatric history and psychological distress at the time of the viral illness were risk factors for psychiatric 'caseness' 6 months later, while presence of fatigue, psychologising attributional style and sick certification were significant risk factors for CFS. These findings extend a previous questionnaire study of predictors of chronic 'post-viral' fatigue.

Adaptation, Psychological↗
PubMed1996

Effect of early life experiences and personality on the reporting of psychosocial distress in general practice. A preliminary investigation.

BACKGROUND: About 25% of primary care attenders are 'somatic presenters'; individuals consulting for physically-attributed somatic symptoms in the presence of psychiatric morbidity. We tested the hypothesis that somatic presenters differed from psychological presenters on measures of personality ad childhood experience. METHOD: Case-control study of 'psychological presenter' and 'somatic presenters'. RESULTS: Psychological presenter reported significantly greater insecurity in intimate relationships, and recalled their fathers as significantly less caring and more over-protective, than somatic presenters. These difference remained after adjusting for differences in the severity and duration of psychiatric symptoms. CONCLUSIONS: Personality and childhood experiences may be associated with specific types of adult illness behaviour, independent of associations with the prevalence of psychiatric disorder.

Adolescent↗
PubMed1995

The dopamine D3 receptor and schizophrenia: pharmacological, anatomical and genetic approaches.

Antipsychotic drug therapy mainly rests on the use of antagonists of dopamine D2-like (D2, D3 and D4) receptors, for which all clinically active compounds have high affinity. The D3 receptor has a restricted expression in brain limbic areas, associated with cognitive functions and motivated behavior. D3 selective agonists and antagonists reveal an inhibitory role on motor behaviors for the D3 receptor, opposite to that of the D2 receptor. An opposing role for D2 and D3 receptors is also suggested by the contrasted effects of D2/D3 antagonists on neurotensin expression in discrete subdivisions of nucleus accumbens, where D2 and D3 receptors are selectively expressed. Tolerance to the motor but not to the therapeutic effects of neuroleptics is observed after repeated administration, which upregulates the D2, but not the D3 receptor in animals. In genetic association studies, an excess of homozygosity for both alleles of the BalI polymorphism at the D3 receptor gene was found in schizophrenic patients, suggesting that this gene may have subtle influence on the liability to develop schizophrenia. These results suggest the D3 receptor as an important target for antipsychotic drug action, and D3 receptor selective antagonists as promising therapeutic agents.

Animals↗
PubMed1995

The phenomenology and explanatory models of common mental disorder: a study in primary care in Harare, Zimbabwe.

In order to describe the explanatory models and the etic and emic phenomena of common mental disorder in Harare, Zimbabwe, 110 subjects were selected by general nurses in three clinics and by four traditional healers from their current clients. The subjects were interviewed using the Explanatory Model Interview and the Revised Clinical Interview Schedule. Mental disorder most commonly presented with somatic symptoms, but few patients denied that their mind or soul was the source of illness. Spiritual factors were frequently cited as causes of mental illness. Subjects who were selected by traditional healer, reported a greater duration of illness and were more likely to provide a spiritual explanation for their illness. The majority of subjects were classified as 'cases' by the etic criteria of the CISR. Most patients, however, showed a mixture of psychiatric symptoms that did not fall clearly into a single diagnostic group. Patients from a subgroup with a spiritual model of illness were less likely to conform to etic criteria of 'caseness' and they may represent a unique category of psychological distress in Zimbabwe. A wide variety of emic phenomena were elicited that have been incorporated in an indigenous measure of non-psychotic mental disorder. Kufungisisa, or thinking too much, seemed to be the Shona term closest to the Euro-American concept of neurotic illness.

Adolescent↗
PubMed1995

The Gospel Oak Study stage IV: the clinical relevance of subjective memory impairment in older people.

The prevalence rate of subjective memory impairment (SMI) and its value as a predictor of future depression or dementia was studied in a community sample of elderly residents in one electoral ward using the short-CARE. SMI was found to be common, occurring in 25% of subjects. Subjects with SMI were more likely to be suffering from either dementia or depression than those without the complaint, although 60% of subjects with SMI did not have evidence of either disorder. When followed up over a 2-year period, subjects with SMI were found to be at four-fold greater risk of developing future dementia and two-fold greater risk of developing a depression compared with those without SMI. The SMI scale was not found to be useful as a population screen for dementia or depression, although two of the nine items might have value as screening questions in clinical circumstances to determine those with memory complaints at risk for dementia.

Aged↗