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Biomedical subjects

G Beaumont

Publications and source records attributed to G Beaumont.

At least 19 recordsLinked to original sources
PubMed1992

The SmithKline Beecham 'quality of life' scale: a validation and reliability study in patients with affective disorder.

The rationale for the development of Repertory-Grid based quality of life assessment (QOL) is described. The emergent scale, the SmithKline Beecham Quality of Life Scale (SBQOL) utilizes 23 predetermined constructs and three fixed elements: self now, ideal self and sick self. Inclusion of the latter two elements provides a personal frame of reference for the individual and recognizes the highly idiosyncratic and subjective nature of the experience which constitutes quality of life. A study of the validity and reliability of the SBQOL was conducted in 129 patients presenting to their GP with either major depression or generalized anxiety disorder, as defined by DSM III R. Patients were treated at the discretion of their GP and followed over a period of 12 weeks with assessments of treatment efficacy being performed at 6 weeks and 12 weeks in parallel with administration of the SBQOL. The results from co-administration of standard efficacy measures such as the Hamilton Depression Rating Scale (HAMD) and Hamilton Anxiety Scale (HAMA) with the SBQOL, provided good evidence of construct validity. Evidence in support of the concurrent validity of the SBQOL was provided by co-administration of the Sickness Impact Profile and General Health Questionnaire (external criteria) with the SBQOL scale. Test-retest reliability and internal consistency were high. No obvious advantage was conferred by the use of principal components analysis from the Flexigrid software package in contrast to a simple arithmetical procedure for computing interelement distances. It is concluded that the SBQOL provides a valid, reliable and practicable approach to the assessment of quality of life in patients with affective disorder.

Adolescent↗
PubMed1992

Patients at risk of suicide and overdose.

Suicide is a complex and confusing subject. Although social factors may be important a clear relationship has been established between suicide and some medical conditions, notably depression, schizophrenia and alcohol dependence. Primary care physicians are in the "front line" as far as the recognition of suicidal risk is concerned. There is good evidence that many individuals who commit suicide have had recent contact with medical services. Those who have attempted suicide are at a much greater risk of subsequently completing the act than the general population. Poisoning by solids or liquids is a common method of committing suicide. Prescribed medication is often used. Antidepressants vary considerably in their toxicity in overdosage. Newer compounds, including moclobemide appear to be safer than older ones. There is some evidence that suicide rates can be influenced by changing the availability of lethal substances and methods. It is suggested the prescription of toxic antidepressants should be restricted or avoided in patients in whom the risk of suicide is high.

Adult↗
PubMed1990

Mequitazine in the treatment of hayfever.

A single-blind, multicentre, comparative clinical trial was performed in 59 hayfever sufferers to compare the efficacy of mequitazine 5 mg bd and terfenadine 60 mg bd over a period of 14 days. Clinical assessments of nasal and ocular symptoms were made on admission to the trial and after seven and 14 days treatment by both physicians and patients. Critical flicker fusion threshold was measured at each assessment. A global assessment of efficacy was determined by both the doctor and patient at the end of treatment. Patients also completed a daily diary card. Thirty patients on mequitazine and 22 on terfenadine completed the trial. There were seven dropouts (five on terfenadine and two on mequitazine). Both treatments were equally effective in reducing the severity of symptoms over the 14 days of treatment. The overall assessment at the end of treatment showed no important significant differences between the two drugs. According to the physicians, 60 per cent of the mequitazine-treated patients and 63 per cent of the terfenadine-treated patients had an excellent or good response. Patients assessed their response as excellent or good in 56 and 62 per cent of cases respectively. Neither drug significantly impaired performance.

Adolescent↗
PubMed1990

A multi-centre open study in general practice to evaluate the efficacy and acceptability of zopiclone 7.5 mg nocte in patients requiring the prescription of an hypnotic.

This was an open study of the efficacy and acceptability of zopiclone 7.5 mg nocte as a somnifacient. The study population comprised 108 insomniac patients (70 female, 38 male) aged 22-74 years who received zopiclone 7.5 mg for 7 consecutive nights. Based on subjective sleep assessments, zopiclone reduced the patients' difficulty in falling asleep, increased the number of hours slept and decreased the number of nocturnal awakenings (p less than 0.001). The majority of patients reported sleeping well or very well. The quality of sleep improved (p less than 0.0001), and the incidence of waking earlier than desired decreased (p less than 0.001), with respect to baseline, after receiving zopiclone. Physicians rated efficacy as good or very good in the majority of patients. Zopiclone was efficacious both in patients who had not previously received hypnotic therapy (n = 37) and in patients who transferred directly to zopiclone from a benzodiazepine hypnotic (n = 26). Whilst receiving zopiclone, patients reported feeling better in the morning than they did prior to treatment (p less than 0.004); 78% expressing satisfaction with zopiclone as an hypnotic. Physicians reported zopiclone treatment to be without side-effects in the majority of patients. In conclusion, zopiclone appears to be an effective and well-tolerated hypnotic that may play a role in the treatment of insomnia in the general population.

Adult↗
PubMed1990

The management of anxiety in general practice.

This paper attempts to summarize a personal approach to the management of anxiety and to some of the problems that have been recently encountered in respect of public attitudes to benzodiazepines. In the management of anxiety 'psychological' approaches should be sought where possible. There are, however, occasions, both in connection with normal and abnormal anxiety, when drug therapy is appropriate or where perhaps a combination of 'psychological' and pharmacological methods represents the most expedient course of action. Prescribers need an 'armamentarium' of drugs, since no one type of anxiolytic meets all our needs. The paper suggests limited use of benzodiazepine, beta blockers, low dose neuroleptics, some newer anxiolytic agents and certain specific drugs. The general practitioner needs to tailor his choice to the needs and attributes of particular patients.

Anxiety Disorders↗
PubMed1989

The toxicity of antidepressants.

Considerable attention has been paid, both by regulatory authorities and clinicians, to the side-effects of antidepressants, but despite the known high suicide risk in depression, toxicity in overdosage has been largely ignored. On the basis of the evidence currently available, 'older' antidepressants appear to be more toxic than 'newer' agents. A case can be made for limiting the use of some of the older tricyclic antidepressants, especially in patients who remain in the community, when continuous supervision is lacking, in favour of newer, safer drugs.

Antidepressive Agents↗
PubMed1989

Suicide and antidepressant overdosage in general practice.

Depression is a very common condition, and most depressed patients in many countries are treated by their General Practitioners. It is a frequent cause of suicide - one of the major causes of death in young adults - and is the disorder most commonly associated with deliberate self-poisoning, a large percentage of suicides being due to poisoning with drugs that are only available on prescription. Self-poisoning with older tricyclic antidepressants (TCAs) poses major clinical management problems, since the majority of patients who overdose with these agents do not reach hospital alive. Though there is no convincing evidence that any one antidepressant is more effective than others or more rapid in onset of therapeutic action, antidepressants do differ substantially in their side-effect profiles and in their toxicity in overdosage, those introduced before 1970 being relatively more toxic. Since suicide rates have been reduced by limiting the availability of toxic substances such as barbiturates and harmful domestic gas, restricting the use of older antidepressant in favour of newer, safer compounds for depressed patients being treated in general practice would also seem to be advisable.

Antidepressive Agents↗
PubMed1984

Trazodone and mianserin in general practice.

In a double-blind, noncrossover study, general practice patients suffering from depression were treated with either trazodone (100-200 mg, nocte ) or mianserin (60-120 mg, nocte ) for 6 weeks. For entry into the study, a minimum score of 14 on the 17-point Hamilton Depression Rating Scale ( HDRS ) was necessary. By random allocation, 125 patients (61 on trazodone and 64 on mianserin) entered the study. Altogether there were 43 withdrawals, of whom 31 (72%) had received mianserin. At least one of the reasons for 22 withdrawals from the mianserin group was an unacceptable side effect, frequently being daytime drowsiness. In contrast, only 5 of the trazodone group withdrew because of side effects. These differences in the withdrawal rates for those patients entering the study were statistically significant (p less than 0.001). A total of 82 patients completed treatment and entered the analysis for efficacy; 49 on trazodone and 33 on mianserin. Results show that both treatments were equally effective in reducing symptoms of depression and anxiety. Thus, the mean HDRS score was 21.3 and 21.5 for trazodone and mianserin, respectively, at the start of treatment which decreased to 6.2 and 5.9, respectively, at the end of 6 weeks. The mean Zung self-rating anxiety scores for trazodone and mianserin were 45.6 and 44.4 at the start of treatment and 33.6 and 31.1 at the end of the study. The results suggest that, on the basis of fewer significant side effects, trazodone is more acceptable to mianserin in treating depression, with or without anxiety, in general practice patients.

Adult↗