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Biomedical subjects

D F Klein

Publications and source records attributed to D F Klein.

At least 307 records · Page 17Linked to original sources
PubMed1976

Prophylaxis of affective disorders. Current status of knowledge.

A review of all properly controlled studies clearly indicates that lithium carbonate is prophylactic for mania in bipolar patients; it is suggestive of prophylaxis for depression in both bipolar and unipolar patients. Studies are outlined that would clarify lithium carbonate's prophylactic effect for depression in these two patient groups. Continuation therapy with antidepressants reduces incidences of recurrence in unipolar depressives. The only controlled study indicates that tricyclic antidepressants may have prophylactic effect in unipolar patients. This finding needs confirmation. Data are insufficient for conclusions on prophylactic treatment for schizoaffective disorders.

Antidepressive Agents↗
PubMed1976

Methylphenidate effects in learning disabilities. Psychometric changes.

Sixty-one children of average intelligence with appreciable learning lags, but no behaviour disorders, received placedo or methylphenidate hydrochloride for a 12-week period. Methylphenidate was instrumental in improving performance on many psychological tests, but did not affect performance on standardized achievement tests. None of the patient characteristics investigated was stringly predictive of drug effect. Methylphenidate seems to have a specific effect on visualmotor processes, which in turn positively affect performance tasks, but not verbal tasks. Under the conditions of this study, methylphenidate treatment alone did not emerge as a useful agent for the amelioration of reading performance, although the data provide evidence for stimulation effects on children's cognitive functions.

Adolescent↗
PubMed1976

Electroencephalographic correlates of oral contraceptive use in psychiatric patients.

Previous studies have pointed to wake electroencephalographic changes associated with oral contraceptives. This investigation sought to determine if sleep EEG activation would show additional EEG-oral contraceptive relationships not previously suspected. With blind procedures, oral contraceptive and EEG data were collected on 110 adult women. Three age-equated comparison groups were formed: (1) never used pill (control); (2) previously used pill without side effects (asymptomatic); and (3) previously used pill with side effects (symptomatic). Analyses indicated a significant statistical relationship between paroxysmal EEGs and symptomatic pill use. No difference in paroxysmal EEG incidence existed between control and asymptomatic pill use groups. Among prior pill users, women with paroxysmal EEGs reported almost twice the side effect incidence (81.3%) as did women with normal EEGs (42.1%).

Contraceptives, Oral↗
PubMed1976

Neurologic soft signs in schizophrenia and character disorders. Organicity in schizophrenia with premorbid asociality and emotionally unstable character disorders.

Previous studies indicated that for two subgroups of patients, schizophrenics with premorbid asociality (SPA) and individuals with emotionally unstable character disorders (EUCD), central nervous system damage may have etiologic significance. It was hypothesized that these two patient groups would also have an increased number of neurologic soft signs. The relationship of neurologic examination, tests of auditory-visual integration, and intelligence quotient, and diagnoses was studied for 350 patients. Tests of reliability and persistence for all observed signs were performed. The EUCD and SPA groups had increased evidence of neurologic soft signs. Differences in patterns of IQ scores also suggest that different forms of brain damage may be present in these two groups. When the two groups were removed from the larger patient sample, those patients with other types of schizophrenia and character disorder did not exhibit evidence of neurologic impairment. This study of neurologic soft signs adds to the validity of considering SPA and EUCD as separate diagnostic entities.

Central Nervous System Diseases↗
PubMed1976

Comparative effects of methylphenidate and thioridazine in hyperkinetic children. I. Clinical results.

The effects of three pharmacological treatments, methylphenidate hydrochloride, thioridazine hydrochloride, a methylphenidate/thioridazine combination, and placebo were studied in outpatient hyperkinetic children rated hyperactive both in school and at home or clinic. Active treatment lasted 12 weeks; placebo lasted four weeks. Significant clinical improvement was obtained in a variety of settings--all treatments were superior to placebo on ratings filled out by parents, teachers, and clinic staff. Though initially the combination of methylphenidate and thioridazine tended to produce greater clinical improvement, it was not superior to methylphenidate alone after 12 weeks of treatment. Methylphenidate alone and the methylphenidate/thioridazine combination were more effective than thioridazine alone. The salient side effects with methylphenidate treatment were decrease in appetite, difficulty in falling asleep, and increased mood sensitivity. In contrast, thioridazine administration was associated with appetite increase and enuresis.

Administration, Oral↗
PubMed1976

Clinical effectiveness of "short" vs "long" psychiatric hospitalization. I. Inpatient results.

To evaluate the clinical effectiveness of short-term (three month maximum length of stay) and long-term (discharge based on clinical judgement) hospitalization, the inhospital course of 68 "short-" and 58 "long-term" psychiatric patients was studied. The results indicate that patients assigned without bias to short-term patterns, however, indicated that these results could be entirely accounted for by the significantly greater use of group therapy as an additional treatment modality in the short-term units. The need for a more systematic exploration of the effect of restricted hospital stay on the treatment patterns of the clinician and the effect of these differential treatment patterns on inhospital improvement is emphasized. The necessity for follow-up data to gain a complete picture of these treatment contrasts is clear.

Adolescent↗
PubMed1976

Relative efficacy of methylphenidate and behavior modification in hyperkinetic children: an interim report.

Children reported to be hyperactive in school and with behavior difficulties at home were randomly assigned to methylphenidate, behavior therapy and placebo, or behavior therapy with methylphenidate for an 8-week period. Rating scales were obtained from teachers and parents. Independent blind observers rated childrens' classroom bheavior on a weekly basis. A behavior therapy program was implemented in the home and at school. Methylphenidate dosage was individualized. Ratings of behavior deviance were significantly reduced by all treatments. However, a significant advantage for the groups receiving methylphenidate was found over the group receiving behavior therapy and placebo. No significant differences between methylphenidate alone and methylphenidate combined with behavior therapy were obtained. Global ratings of improvement done by teachers favored the combined treatment of behavior therapy and methylphenidate over behavior therapy and placebo. No differences among treatments were found in the mothers' global ratings of improvement. The results indicate that though all three treatments were effective, methylphenidate was significantly superior to behavior therapy alone.

Attention↗
PubMed1976

Evaluating outcome criteria used in methadone maintenance programs.

This report reviews the results of several large methadone maintenance programs and analyzes the outcome measures used. Criteria measures were often vague and sometimes not defined. Many studies base their findings on unverified patient self-report because costs for more reliable and systematic data collection are prohibitive. Available data does not allow for resolution of the pro- or antimethadone maintenance views for treatment of heroin addiction.

Ambulatory Care↗
PubMed1976

Analogy tests and psychopathology at follow-up after open heart surgery.

A study of 100 coronary bypass and cardiac valvular surgery patients investigated whether preoperative brain damage, as measured by the Conceptual Level Analogy Test (CLAT), is a major risk factor for postoperative psychiatric symptoms and mortality. Three cognitive psychological tests, including the CLAT, and psychatric interviews were given preoperatively, postoperatively, and at 18-month follow-up. Surgical outcome was specified as: Catastrophic Outcome (death or severe stroke), Psychiatric Complications, or Good Outcome (survival with no psychiatric complications). Inhospital outcome related significantly to analogy test scores, as did both surgical procedure and diagnosis of rheumatic heart disease. However, long-term outcome was unrelated to medical diagnosis and only weakly related to surgical procedure, but highly significantly related to preoperative analogy scores. The CLAT was a more consistent predictor of both short- and long-term outcome than any of the other ten variables considered (medical and surgical variables, inhospital outcome, demographic measures, other psychological tests).

Brain↗
PubMed1976

Diagnostic implications of the B-mitten EEG pattern: relationship to primary and secondary affective dysregulation.

Previous studies indicate that the B-Mitten EEG pattern is specific to psychiatric dysfunction and rarely encountered among normal control subjects. Our previous investigations have demonstrated a significant relationship between mittens and reactive as opposed to process schizophrenic disease. Re-analyses of mitten incidence in schizophrenics and nonschizophrenics suggests needed modification of our earlier B-Mitten-schizophrenia formulation. Present considerations indicate that the B-Mitten-reactive schizophrenia association is not primary but rather that the differential process-reactive schizophrenia mitten incidence may be a secondary epiphenomenon reflecting a more fundamental underlying process. Analyses are presented suggesting that the mitten dysrhythmia relates positively to dysphoric affective dysregulation in a manner which cuts across broad diagnostic boundaries. That the mitten pattern possibly suggests as yet unclarified subcortical dysfunction associated with symptoms of affective disturbance is a tentative hypothesis offered for consideration.

Adult↗
PubMed1975

A study of abrupt lithium withdrawal.

Twelve patients were abruptly switched from lithium to placebo as part of a double-blind cross-over study. In contrast to other drugs effective in mood disorders, lithium produced no withdrawal syndrome.

Adolescent↗
PubMed1975

Very high dosage vs standard dosage fluphenazine in schizophrenia. A double-blind study of nonchronic treatment-refractory patients.

Previous work with chronic schizophrenic patients and a pilot study with nonchronic treatment-refractory schizophrenic patients indicated that very high doses of fluphenazine hydrochloride (1,200 mg/day) have a greater antipsychotic effect than do standard doses. Increased side-effects were not reported. In a double-blind six-week random assignment study, 18 nonchronic treatment-refractory patients received the very high dose and 13 the standard dose. The standard-dose treated patients had greater improvement on a variety of measures. Analysis of Inpatient Multidimensional Psychiatric Scale scores indicate that some patients taking very high doses had akinesia, and extrapyramidal side-effect that in part accounted for their inferior response.

Adolescent↗