Biomedical subjects

C J Lamarre

Publications and source records attributed to C J Lamarre.

7 recordsLinked to original sources

PubMed1992

Pharmacologic management of refractory depression.

OBJECTIVE: To review published clinical trials of the pharmacologic management of refractory depression. DATA SOURCES: MEDLINE was searched for relevant articles published from 1983 to 1990. The bibliographies of review articles were searched for additional references. Studies of nonpharmacologic treatments, such as electroconvulsive therapy, were not included. STUDY SELECTION: Eleven studies were found that did not contain obvious digressions from several methodologic assessment criteria (adapted from the McMaster guidelines for the evaluation of clinical trials). Further scrutiny by a nonblind reviewer resulted in the selection of four reports that were considered acceptable. An assessment by a second reviewer, blind as to author, results and journal name, confirmed this judgement. DATA EXTRACTION: Data describing response to the treatments were extracted by a single (nonblind) reviewer. Post-hoc power estimates and 95% confidence intervals were calculated whenever possible. DATA SYNTHESIS: The efficacy of augmenting an antidepressant regimen with lithium carbonate, triiodothyronine or reserpine was not supported by findings from the clinical trials reviewed. However, many trials with negative results lacked adequate statistical power to exclude the possibility of the drug's efficacy. The use of a monoamine oxidase inhibitor was supported by the one study that met the review's methodologic criteria. However, this study was not conducted under double-blind conditions. CONCLUSION: The generally recommended strategies for the pharmacologic treatment of refractory depression are not supported by methodologically sound studies.

Antidepressive Agents↗

PubMed1992

Can drug-induced depressions be identified by their clinical features?

Drug-induced depression is classified by the DSM-III-R as an organic mood syndrome of the depressed type. Because drugs have specific pharmacological effects and mechanisms of action, depressive syndromes induced by specific drugs may have characteristic clinical features. An awareness of such features would be valuable for clinical purposes. This review is an attempt to summarize the information on clinical features of drug-induced depressions. The review determined that no unique clinical features have been identified for depressive syndromes associated with most drugs. However, the literature did suggest that depressions associated with oral contraceptive agents may differ significantly from non organic major depressive episodes.

Adrenergic beta-Antagonists↗

PubMed1991

Evaluation of the Modified Mini-Mental State Examination in a general psychiatric population.

Studies of clinical cognitive screening tests began in the 1960s, and ten instruments have been reported in the English literature. In this study, we have compared the widely used Mini-Mental State Examination developed by Folstein with a reportedly enhanced version, the Modified Mini-Mental State Examination devised by Teng, using a sample of 250 patients (inpatients, outpatients, emergency). We have come to the conclusion that the modifications brought about by Teng result in a minor improvement of the validity of the Mini-Mental State Examination in a psychiatric patients in a general hospital.

Emergency Services, Psychiatric↗

PubMed1989

Dysgraphia.

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Agraphia↗

PubMed1989

The face-hand test: a useful addition to the psychiatric physical examination.

The Face-Hand Test is a quick and simple neurological test which can be used to detect organic mental disorders. It is based on the principle that when light touch stimuli are simultaneously applied to the cheek and the hand, patients with organic mental disorders frequently report only the face stimulus. In other words, the hand stimulus is frequently extinguished. The test is conducted with the patient's eyes closed. For clinical purposes, ten consecutive face-hand (e.g., left cheek, right hand) combinations are applied and one point is awarded for each time the patient correctly localizes both stimuli. A score of six or less is considered a positive test. In this study, the Face-Hand Test was performed, by a blind tester, to eighty five admissions to psychiatric inpatient units at the Calgary General Hospital. Subsequently, a chart review was done, by a reviewer unaware of the test scores, and the presence or absence of an organic mental disorder was ascertained. In this sample, the sensitivity of the test for the detection of organic disorders was 87% and the specificity was 84%. The negative predictive value of the test was 97%, indicating that the test may be quite useful for the purpose of ruling out organic mental disorders among psychiatric admissions.

Humans↗

PubMed1988

Psychiatric consultation in a general hospital.

The psychiatrist's role in the therapeutic management of a wide range of hospitalized persons is now recognized. This study investigated the extent and the pattern of consultations among the medical specialties (medicine, surgery, obstetrics/gynecology, family practice, pediatrics and psychiatry) in a large teaching hospital over a one year period. Among the specialties consultations were requested most often from within the same specialty; for example, medicine sought 64.4% consults from medicine. The proportion of patients with an associated psychiatric diagnosis in each of the specialties ranged from 2 to 21%. Psychiatric consultations on these patients ranged from 5 to 13 per hundred (medicine = 12, surgery = 8.9, family practice = 13.2 and pediatrics = 5). Consultations rates reported in previous studies were also reviewed. Factors that may contribute to the generally low rate of psychiatric consultation and the implications for providing better care are then discussed.

Alberta↗

PubMed1986

Parasuicides in a general hospital psychiatric unit: their demographic and clinical characteristics.

This study presents a profile of 89 patients admitted to the psychiatric unit of a general hospital for a deliberate but not fatal self-inflicted injury. The role of selected demographic clinical and psychosocial characteristics in the hospital admission of these parasuicide patients and their use of available services during the acute phase of their period of distress are discussed.

Adolescent↗