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Biomedical subjects

C J Main

Publications and source records attributed to C J Main.

48 records · Page 3Linked to original sources
PubMed1986

Applied relaxation training for generalised anxiety and panic attacks: the efficacy of a learnt coping strategy on subjective reports.

The results of applied relaxation training in patients with generalised anxiety and panic attacks are reported. ART was taught during one session, by means of participant demonstration, written instructions, taped instructions, or a combination of all three, with instructions to practice at home. All four methods proved superior to a waiting list control, but there were no differences between the treatment groups. There was some evidence for the non-specific effect of expectancy, but this did not completely explain the treatment effect.

Adaptation, Psychological↗
PubMed1985

Psychological assessment in general orthopaedic practice.

The importance of psychologic distress and illness behavior is well recognized in low-back pain but has rarely been studied in other orthopedic conditions. Psychologic and clinical assessment of 100 patients undergoing elective surgery for minor leg conditions or joint replacement for osteoarthritis or rheumatoid arthritis showed surprisingly little psychologic distress or illness behavior, particularly when compared with 235 patients with low-back pain. The most striking finding was that in low-back pain there was a close relation between psychologic disturbance and failed surgery, but the nonspinal patients showed a complete absence of such a relation. This type of psychologic assessment is neither necessary nor helpful in the routine management of most clearly defined, nonspinal, correctly managed orthopedic conditions.

Adult↗
PubMed1984

Symptoms and signs: physical disease or illness behaviour?

The amount of treatment received by 380 patients with backache was found to have been influenced more by their distress and illness behaviour than by the actual physical disease. Patients showing a large amount of inappropriate illness behaviour had received significantly more treatment (p less than 0.001). The symptoms and signs of illness behaviour need to be clearly distinguished from those of physical disease, and better assessment of illness behaviour is essential if everyday clinical practice is to fulfil the ideal of treating patients as well as diseases.

Adult↗
PubMed1984

Chronic low-back pain, psychologic distress, and illness behavior.

The authors have calculated the mathematic relationship between measured elements of illness behavior in chronic low-back pain. Objective physical impairment accounts for about one-half the total disability that also is affected by psychologic reactions. The most important psychologic disturbance in low-back pain is emotional distress, measured on questionnaires as increased bodily awareness and depression and presenting clinically as inappropriate descriptions of symptoms and inappropriate responses to physical examination. Simple methods for the assessment of distress and illness behavior in chronic low-back pain are developed and described.

Adult↗
PubMed1983

The Modified Somatic Perception Questionnaire (MSPQ).

The development of a new scale to measure somatic and autonomic perception, the Modified Somatic Perception Questionnaire or MSPQ is described. It has been derived specifically for use with chronic backache patients, although its utility with other chronic pain problems is currently under investigation. Following pilot studies on anxious patients and normal controls a pool of items was subjected to reliability checks and parallel-form analysis. The final 13 item scale was derived from a pilot study of 102 chronic backache patients and its construct validity confirmed on a further study of 200 backache patients. Sex differences in the use of the scale were integrated into the final version. The scale was compared with the Zung Depression Inventory and the first three clinical scales of the M.M.P.I. Individual items were compared with clinical symptomatology rated independently by an orthopaedic surgeon. In a small experimental study the MSPQ was compared with electromyographic readings from the erector spinae muscles and biceps, with the rating of pain using the McGill Pain Questionnaire, and with experimental ischaemic pain using the submaximum effort tourniquet test. In other studies the scale has been shown to be of importance in the understanding of functional disability. Its predictive validity in response to treatment is currently under investigation in studies of spinal fusion, chemonucleosis and multidisciplinary pain programmes. The simple 13 item four-point self-report scale is easy to administer, has high patient compliance and, in conjunction with measures of depressive symptomatology and inappropriate signs and symptoms would seem to be of considerable promise in the understanding of the sequelae of backache and much more sensitive than traditional measures of personality structure.

Anxiety↗
PubMed1982

Normality and reliability in the clinical assessment of backache.

Backache is common yet its routine medical assessment is imprecise, unreliable, and poorly interpreted. Reproducibility studies on 475 patients improved the reliability of clinical interview and examination in backache, while studies of 335 normal subjects defined the limits of normality. Assessment of nerve function was found to be reliable but assessment of the back itself had to be considerably modified and examination improved by incorporating actual measurements. The validity and clinical utility of the information were analysed to determine the minimum amount of information which should be collected to permit clear diagnosis and management.

Adult↗
PubMed1981

Low blood pressure in psychiatric inpatients.

Blood pressure recordings in 116 female psychiatric inpatients were analysed. Sixty-nine women had schizophrenia, the remainder a variety of psychiatric conditions. All had been in hospital continuously for more than one year, the average for 19 years continuously. An average of seven recordings of blood pressure per patient had been made during that time. The latest of these compared well with measurements made independently using a sphygmomanometer free from observer bias. On admission to hospital the blood pressure of these patients was close to that of two normal populations. Thereafter it failed to rise at the normal rate and after an average of 19 years, in the women having measurements made by special sphygmomanometer, systolic pressure was 28 mmHg lower than controls of the same age while diastolic pressure was 12.8 mmHg lower. Lower than control blood pressure was apparent in schizophrenic and non-schizophrenic women and in women taking no drugs, phenothiazines, and other drugs. Weight loss is an unlikely explanation: the mean weight of these women was 61.5 kg compared with 64.1 kg in a local control population of the same age. Some factor related to prolonged isolation in hospital seems more important.

Adult↗
PubMed1981

Identification of features associated with flying phobia in aircrew.

The psychological and physiological features of 20 aircrew consecutively referred for treatment of anxiety symptoms when flying were compared with a matched control group of uncomplaining aircrew. There were no significant differences between the two groups on psychometric tests of personality, though there were differences in skin conductance; the phobics had a higher rate of spontaneous fluctuation, and habituated less to a repeated auditory tone. More of the phobic group worried about their wives and acknowledged childhood and other adulthood phobias; more had a family history of an episode perhaps best described as flying trauma. Many were on an overseas posting when symptoms presented. These few features could correctly classify 85 per cent of the subjects into the phobic or control group. This type of phobic aircrew index' now requires to be validated prospectively for its predictive value.

Adult↗
PubMed1978

Token economy, pimozide and chronic schizophrenia.

Response to a token economy was assessed in male chronic schizophrenic in-patients who were given, in a double-blind cross-over trial, pimozide (up to 20 mg daily) or chlorpromazine )up to 1,000 mg daily), each for three months. After six months there was little change in the patients' mental state, but general ward behaviour and token-rewarded "target" behaviours improved significantly. There were no statistically significant between-drug differences, but the trend was that general ward behaviour, but not token-rewarded behaviour, improved more on pimozide. The patients who showed initiative and cooperated best with staff were those whose token-rewarded behaviour was most satisfactory.

Behavior Therapy↗
PubMedDate not supplied

Comparison of physical treatments versus a brief pain-management programme for back pain in primary care: a randomised clinical trial in physiotherapy practice.

BACKGROUND: Recommendations for the management of low back pain in primary care emphasise the importance of recognising and addressing psychosocial factors at an early stage. We compared the effectiveness of a brief pain-management programme with physiotherapy incorporating manual therapy for the reduction of disability at 12 months in patients consulting primary care with subacute low back pain. METHODS: For this pragmatic, multicentre, randomised clinical trial, eligible participants consulted primary care with non-specific low back pain of less than 12 weeks' duration. They were randomly assigned either a programme of pain management (n=201) or manual therapy (n=201). The primary outcome was change in the score on the Roland and Morris disability questionnaire at 12 months. Analysis was by intention to treat. FINDINGS: Of 544 patients assessed for eligibility, 402 were recruited (mean age 40.6 years) and 329 (82%) reached 12-month follow-up. Mean disability scores were 13.8 (SD 4.8) for the pain-management group and 13.3 (4.9) for the manual-therapy group. The mean decreases in disability scores were 8.8 (6.4) and 8.8 (6.1) at 12 months (difference 0 [95% CI -1.3 to 1.4], p=0.99), and median numbers of physiotherapy visits per patient were three (IQR one to five) and four (two to five), respectively (p=0.001). One adverse reaction (an exacerbation of pain after the initial assessment) was recorded. INTERPRETATION: Brief pain management techniques delivered by appropriately trained clinicians offer an alternative to physiotherapy incorporating manual therapy and could provide a more efficient first-line approach for management of non-specific subacute low back pain in primary care.

Acute Disease↗