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Biomedical subjects

D V Sheehan

Publications and source records attributed to D V Sheehan.

84 records · Page 5Linked to original sources
PubMedDate not supplied

Benzodiazepines in panic disorder and agoraphobia.

Benzodiazepines, particularly alprazolam, are quickly becoming the drugs of first choice in the treatment of many cases of panic and agoraphobia. The reason for this choice is that these drugs are safer to use, quicker in onset of action, easier for the physician to prescribe and more pleasant for the patient to take than the alternatives. Although the treatment of panic disorder and agoraphobia has been best studied with the benzodiazepine alprazolam, it now appears likely that other benzodiazepines, for example diazepam, lorazepam and chlorazepam, may also be effective when correctly used. There is no reason at this point to believe that any of the benzodiazepines are unique in this regard. Future research will undoubtedly clarify this observation. In the meantime, it is hoped that some of the guidelines in this paper will help the practicing clinician in the management of his patient with this disabling and neglected disease.

Agoraphobia↗
PubMedDate not supplied

Psychosocial predictors of accident/error rates in nursing studies: a prospective study.

A prospective study of accident/error rates was carried out on thirty-one nursing students. Recent life changes and stresses, social support available to cope with this stress, depression, illness rate, and coping skills were measured at baseline. Five weeks later students recorded accidents suffered and errors made over a week long period. The number of life changes in the previous two years made over a week long period. The number of life changes in the previous two years and the amount of adjustment required to cope with these changes, together with the social support available to help cope with these events were the most powerful predictors of accident/error rate. Together they accounted for 70 per cent of the variance. Multiple regression equations for the outcome variables were calculated to study the best linear predictor combination. Depression and coping skills had poor predictor power. The implications of the findings for health care personnel are discussed. Steps to lower the accident/error rate in those at risk are outlined.

Accident Proneness↗
PubMedDate not supplied

The relationship between response qualities of life change events and future illness rates.

A prospective study over three months explored whether measures of response "qualities" of life change events (e.g., whether the event was positive or negative in its subjective impact) enhance the ability of a simple counting of recent life change events to predict near future illness rates. Thirty-four nursing students were studied. Results confirm previous reports that future illness rates increase positively and significantly in direct relationship to the accumulation of recent past life change events. A simple count of the number of untimely or unexpected life stresses (31% of total life changes) or a simple count of the number of negative life events (53.8%) were as potent predictors as the total count of recent life changes. The total number of times each event occurred did not add to the predictive power of a count of the number of events experienced. Anticipated life events were poor predictors of future illness rates. The subjective life change unit scaling system (SLCU) did not add to the predictive power of a simple count of the number of events. Social support availability did not significantly lower illness rates.

Adaptation, Psychological↗
PubMedDate not supplied

The classification of phobic disorders.

The history of classification of phobic disorders is reviewed. Problems in the ability of current classification schemes to predict, control and describe the relationship between the symptoms and other phenomena are outlined. A new classification of phobic disorders is proposed based on the presence or absence of an endogenous anxiety syndrome with the phobias. The two categories of phobic disorder have a different clinical presentation and course, a different mean age of onset, distribution of age of onset, sex distribution, response to treatment modalities, GSR testing and habituation response. Empirical evidence supporting this proposal is cited. This classification has heuristic merit in guiding research efforts and discussions and in directing the clinician to a simple and practical solution of his patient's phobic disorder.

Anxiety Disorders↗
PubMedDate not supplied

Monoamine oxidase inhibitors: prescription and patient management.

The historical roots of the current avoidance of MAOIs are reviewed. A practical approach to the careful prescription of MAOIs is outlined. Medical contraindications, side effects and their management and drug and food interactions with MAOIs are discussed. With careful patient selection, adequate caution by the physican, and appropriate preparation of the patient, MAOIs are often uniquely effective (as in endogenous anxiety) and have an acceptably low potential for serious toxicity.

Anxiety Disorders↗
PubMedDate not supplied

Vasopressin response to lactate infusion in normals and patients with panic disorder.

Infusions of sodium lactate evoke panic symptoms in patients with panic disorder but not in normal subjects. Although plasma vasopressin (AVP) is known to rise in response to other forms of stress, its response during this maneuver has not previously been reported. We measured plasma AVP in double-blind infusions of sodium lactate in 5 normal subjects, 6 patients with panic disorder, and, again in 4 patients after chronic alprazolam. In all groups administered lactate, AVP rose significantly above baseline values (p less than 0.05) though no change was seen in a control group of patients during D5NS infusion. No difference in AVP response to lactate was apparent between untreated patients (who experienced panic) and normals or chronically treated patients (who had minimal symptoms). Thus, the presence of panic symptoms induced by lactate is insufficient to provoke an abnormal pattern of AVP release.

Adult↗