Biomedical subjects
Publications and source records attributed to A Roy.
Twenty-two inpatients with a discharge diagnosis of hysterical seizures were compared with 22 matched inpatients with a discharge diagnosis of epileptic seizures. There were significant differences between the groups in respect to family and personal history of psychiatric disorder, attempted suicide, sexual maladjustment, and a current affective syndrome.
Emergency department records and patient charts do not provide enough or sufficiently detailed data for audit of quality of care in a high volume emergency department. As a solution, at the Department of Emergency Medicine, University of Southern California School of Medicine, three emergency medical technicians--hospital-based paramedics--were trained as observers of patient process and treatment. In addition to basic identification information, the form completed by observers listed 21 procedural steps and process data such as sequence, time for completion, type of personnel performing, necessary equipment and supplies, and space for comments. Direct observation of patient process was carried out in 442 patients, a total of 3,882 procedures was observed and recorded. The direct observation is perhaps the most accurate method of data collection for auditing purposes because it reflects actual events. This data was used by the Research Peer Review Committee to help rate the quality of patient treatment process.
The classification of depression remains controversial (Kendell, 1976). Overall et al. (1966) used the Brief Psychiatric Rating Scale (PBRS), a computer classification procedure and derived three depressed groups: anxious, hostile and retarded depressives. Paykel (1971, 1972) reported four groups derived from a multivariate cluster analysis: psychotic depressives and '...three groups, anxious, hostile and young depressives with personality disorder, from the diversity of patients subsumed under neurotic depression'. Amongst 85 women treated with amitriptyline 'this typology predicted outcome significantly'. This paper presents the results of a cluster analysis of a group of 60 female out-patient neurotic depressives.
In a matched retrospective study, 31 patients with hysterical neurosis were compared with 31 with depressive neurosis. There were no significant differences between the groups for siblings' position, medical work, brain disease, poor marriage, frigidity, or family history of psychiatric disorder. Significantly more of the hysterics had a preceding head injury and 29% had a past history of hysteria. By the time of the study 48% had been treated for depression.
Forty-two epileptics were given a psychiatric interview and completed five questionnaires. Current affective symptoms were significantly associated with a past history of neurotic disorder but not with temporal lobe epilepsy.
Osteoid osteoma in cancellous bone lacks the usual osteoblastic reaction that accompanies the classical cortical or juxtacortical osteoid osteoma. Familiarity with this type of presentation should instigate the appropriate diagnostic steps, including nuclear medicine studies using pin-hole collimation, and thin tomographic cuts.
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A controlled study of self-mutilators found them to be significantly more introverted, neurotic and hostile. They report excessive physical punishment in childhood, sado-masochistic fantasies and more suicidal attempts.
A matched controlled study of 84 depressed women confirms the findings of Browm et al, that loss of mother before 11, three or more children at home under 14 years of age, lack of a confiding marital relationship and lack of employment may be vulnerability factors predisposing to depression in working-class women.
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Ten married women with cataplexy were found to be rarely orgasmic. Cataplexy is characterized by recurrent episodes of short-lived generalized muscle paralysis. It is precipitated by arousing emotional precipitants such as laughter, fear, and anger. Patients learn to avoid situations exposing them to these precipitants. It is suggested that anorgasmia is a consequence of this general tendency to avoid arousal.
A quality care evaluation system was designed to serve as a framework for on-going research in the area of quality assurance in emergency medicine. It included a set of basic evaluation tools, such as direct observation of patient care, record review and analysis, and patient follow-up interview for outcome. These tools are used in an attempt to quantify relationships between quality care and patient outcome.
Seventeen patients with hysterical fits, previously diagnosed and treated by neurologists as epileptics, were distinguished from a matched control group of 17 epileptics by 5 factors: a family history and personal history of psychiatric disorder, attempted suicide, sexual maladjustment, and a current affective syndrome.
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In a study of male addicts attending a London drug dependence unit, it was found that convicted addicts tended to score more highly on measures of hostility than non-convicted subjects. The differences in hostility between the convicted and non-convicted groups were most clearly seen on the violent crimes variable, although addicts convicted of drug-possession and of non-drug crimes were also more hostile than non-convicted subjects. It is suggested that hostility acts as a personality factor which predisposes the individual towards criminal behaviour, and that the more hostile subjects may also be more likely to be apprehended and convicted.
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