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Biomedical subjects

A Sims

Publications and source records attributed to A Sims.

At least 37 records · Page 2Linked to original sources
PubMed1988

Epidemiological survey of the "natural" mortality in psychiatry.

The authors reviewed articles published from 1838 dealing with excess of "natural" mortality in psychiatric "in-" and "out" patients. The high natural mortality rate has always existed and is still observed today despite the quality of somatic care. The excess is observed in every country, ethnic group, sex, age or site of treatment but does not seem to be associated with specific organic pathology. The risk of "natural" mortality (suicide and accidents excluded) remains 2 to 5 times greater than in normals. Hypotheses concerning the phenomenon are reviewed or suggested.

Adult↗
PubMed1986

Perspectives in the study of neuroses in contemporary psychiatric practice.

Although DSM III has removed the category of neurosis, the implied fragmentation of the generic concept has been regretted by some investigators. Since its introduction in 1769, when the term was used to denote conditions which had a hysterical and hypochondriacal character, the technical use of the term has undergone revisions and reinterpretations which at one extreme have been embedded in psychoanalytic theory, and at the other have resulted in the replacement of the single concept by a proliferation of operationally defined syndromes. The present paper discusses some of the nosological problems implicit in recent trends. Whereas depression appears in 10 ICD9 categories does the psychiatric/neurotic dichotomy in relation to depression still have meaning in the absence of the generic term 'neurotic'? The hierarchical principle is widely accepted as a basis for classification, and yet the hierarchically minor syndromes may be a source of major distress. The paper reviews epidemiological studies of prognosis and follow-up of neuroses, and shows a significant excess of mortality, which is both behavioural and organic in origin. One important difficulty with the loss of the generic term is the potential loss of generic research where, for example, evaluation of treatment of panic disorder is considered distinct from other types of anxiety and phobia. The paper argues for the practical and theoretical benefits of retaining an umbrella term such as 'neuroses'.

Depressive Disorder↗
PubMed1984

Neurosis and mortality: investigating an association.

Neurosis is not a cause of death, but at follow-up neurotic patients are found to experience increased premature mortality. Suicide and accidental death are considerably increased in this group. There is also an excess of deaths from natural causes; amongst hypotheses to account for this there is some evidence to incriminate arteriosclerosis, and increased toxicity from cigarette smoke may be a factor. The increased mortality is not explained by confusion over the term depression. Those neurotic patients who subsequently die are more likely to have suffered from a more severe degree of neurosis at the time of initial treatment.

Accidents↗
PubMed1984

Co-existence of the Capgras and Ekbom syndromes.

A case is described in which a diagnosis of paranoid schizophrenia was made using the criteria of Schneiderian first-rank symptoms. The patient showed the Capgras syndrome, with delusional misidentification of her son and other people in her environment, and also Ekbom's syndrome, with the delusion that she was infested with parasitic worms which migrated between various parts of her body. In this case, the two syndromes are descriptions of a specific delusional content, and occur as part of the psychopathology within a schizophrenic disorder, rather than as distinct disease entities.

Capgras Syndrome↗
PubMed1981

Smoking profiles of patients admitted for neurosis.

A detailed record of the smoking habits of 83 patients treated in hospital for neurosis was compared with national statistics derived from the General Household Survey and Statistics of Smoking in the United Kingdom, and with a control group of patients admitted for treatment of varicose veins. Neurotic patients were more likely to be smokers. They started to smoke at a younger age, smoked more cigarettes and were more likely to inhale deeply. It is concluded that neurotic patients have a greater exposure to the potentially toxic effects of cigarette smoking than non-neurotic individuals.

Adolescent↗
PubMed1978

Hypotheses linking neuroses with premature mortality.

The death risk for psychiatric patients has decreased over the last 30 years but still remains higher than that of the general population. The death risk for patients with a diagnosis of neurosis is higher than that for the general population. Previous studies are enlisted to investigate this mortality for socio-economic characteristics, alcohol and drug abuse, psychopathy and accident proneness. Possible psychosomatic aetiology of disease and subsequent death is examined. Psychological theories for premature death are discussed and some recommendations made for future areas of enquiry.

Accident Proneness↗
PubMed1978

Ganser syndrome: the aetiological argument.

In this case history, which shows the clinical features of the Ganser syndrome, there was abundant evidence to support both an organic and an hysterical aetiology. The aetiological dilemma is discussed, and the case illustrates some of the problems of nosology, clinical presentation, and psychopathology that this syndrome raises.

Adult↗
PubMed1978

Problems associated with the analysis and interpretation of saliva lithium.

The correlation between serum and saliva lithium levels in patients undergoing lithium prophylaxis therapy is discussed. Although a high correlation can be obtained, there is an unacceptably high individual variation of paired results. Two strategies were used in an attempt to improve the reliability of saliva as a predictor of serum levels. A naturally occurring marker in saliva and serum was used. This showed high correlation but still did not prevent large sporadic differences. Serially paired results in individual patients also showed occasional excessive variation. Although saliva lithium has been used for monitoring when serum assessment is impracticable, it is considered that it is, as yet, an unreliable technique.

Humans↗
PubMed1978

The pattern of mortality in severe neuroses.

Is there an increased relative risk of death in severe neurosis? 1,482 patients from three psychiatric units in different hospitals in Birmingham were followed-up after a mean of 10.9 years. 91 per cent of the sample were traced and 139 patients were found to have died; a highly significant increased mortality for both sexes for all causes of death. Although suicide and accidents contributed disproportionately, particularly in early follow-up, there was still a markedly increased mortality from the combined categories of nervous respiratory and cardiovascular disease, more evenly distributed in time.

Accidents↗