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Biomedical subjects

G E Murphy

Publications and source records attributed to G E Murphy.

At least 37 records · Page 2Linked to original sources
PubMed1986

Long-term gonioscopy follow-up of eyes with posterior chamber lens implants and no iridectomy.

One hundred eyes which had undergone extracapsular cataract extraction with no iridectomy followed by insertion of a posterior chamber lens were examined gonioscopically 1 to 4.7 years postoperatively to determine the prevalence of asymptomatic angle closure from pupillary block. Since no peripheral anterior synechiae (PAS) characteristic of pupillary block were found, there seems to be little risk that these eyes will develop angle-closure glaucoma. During the study small PAS were noted adjacent to many haptics implanted in the ciliary sulcus.

Cataract Extraction↗
PubMed1984

Cognitive therapy and pharmacotherapy. Singly and together in the treatment of depression.

Eight-seven moderately to severely depressed psychiatric outpatients were randomly assigned to 12 weeks of cognitive therapy (CT) (n = 24), pharmacotherapy (n = 24), CT plus pharmacotherapy (n = 22), or CT plus active placebo (n = 17). Seventy patients completed the treatment protocol. Seventeen dropped out before the end of the treatment period. Patients who completed treatment showed significant improvement in mean scores on two common measures of severity of depression (the Beck Depression Inventory and the Hamilton Rating Scale for Depression) between evaluation and termination. Improvement did not differ as a function of the different treatment modalities. Inclusion of dropout patients' end-point scores did not alter these results. Treatment gains in all groups were maintained at one-month follow-up assessment. A portion of this study replicated an earlier study. While the results were not identical, they indicated that either CT or antidepressant drug treatment can be effective in treating outpatients with primary, nonbipolar depression of moderate or greater severity. Combining treatments did not lead either to additive effects or negative interactions.

Adult↗
PubMed1984

The process of change in cognitive therapy and pharmacotherapy for depression. Changes in mood and cognition.

Twenty-eight moderately depressed outpatients were randomly assigned to 12 weeks of cognitive therapy (N = 14) or pharmacotherapy (N = 14). Significant changes in mood, cognitive processes, and content were similar to those found in previous studies demonstrating effectiveness of cognitive therapy. Patients treated with medication, however, demonstrated nearly identical change on all measures, including cognitive measures, despite the absence of direct focus on cognitive activity. Further analyses disclosed that cognitive change may be an important feature of overall clinical improvement, as patients whose conditions did not improve (regardless of treatment modality) showed significantly less change on cognitive measures. These findings suggest that cognitive change may be more accurately seen as a part of improvement rather than the primary cause of improvement. This suggests a more complex conceptualization of the role of cognitions in the change secured by cognitive therapy.

Adult↗
PubMed1984

Patient attrition in a comparative outcome study of depression. A follow-up report.

Eighty-seven moderately to severely depressed psychiatric outpatients were randomly assigned to 12 weeks of cognitive therapy (n = 24), pharmacotherapy (n = 24), cognitive therapy plus pharmacotherapy (n = 22) or cognitive therapy plus active placebo (n = 17). Seventy patients completed the treatment protocol; 17 dropped out before the end of the treatment period. Completers and dropouts did not differ at pretreatment on demographic variables, measures of depression, cognitive functioning or social adjustment. Sixteen of the 17 patients who dropped out were followed up and interviewed to assess their clinical status and reasons for discontinuing treatment. Neither group remained depressed at follow-up. Practical matters and issues related to the type of treatment received seemed to contribute most to patients' decision to drop out. Patients assigned to the combination therapies were more likely to complete the research protocol than those assigned to single treatment modalities. These findings are discussed in terms of their implications for clinical practice and outcome research.

Adolescent↗
PubMed1984

The prediction of suicide: why is it so difficult?

Methods for selecting those persons in a clinical population who will later commit suicide inevitably include large numbers of false positives--persons with similar characteristics who will not take their lives. This is true because of the absence of unique predictors and the statistical properties of infrequent events. At a clinical level, the focus is on risk detection rather than on specific behavior prediction. Since suicide is intimately related to certain psychiatric illnesses, effective treatment of those illnesses can prevent suicides. This must already be taking place. Prevention, however, generates no data. If suicide is difficult to predict, its prevention is even more difficult to detect.

Diagnosis, Computer-Assisted↗
PubMed1984

A case of large postenucleation orbital cyst.

Giant postenucleation cyst of the orbit is a rare complication of enucleation that may be confused with recurrence of an orbital malignancy or other problem if the ophthalmic surgeon is not familiar with this entity. Despite its rarity (the case reported here is only the tenth found in the world literature), this entity is easily recognized by its characteristic clinical presentation. The presenting clinical findings and management of this case are described in detail and other reported cases reviewed briefly.

Cysts↗
PubMed1983

Problems in studying suicide.

Suicide is distinct from suicide attempt, in terms of male predominance (2:1), presence of serious psychiatric morbidity, and in the choice of rapidly effective means which will not be interrupted. However 1 per cent per year, and 10 per cent overall, of those attempting will progress to completed suicide. Communication of intent is the most significant and frequent danger signal of suicide, and the attempt may be such a communication. Useful prognostic features of the attempt are the medical seriousness of the act (overdose accounts for 90 per cent of attempts, and only 25 per cent of suicides), and the psychiatric seriousness of the patient's mental state. Suicide in the absence of psychiatric illness is rare. Depression is the most common associated illness, and whereas the distinction between major and minor is probably not prognostically significant, the presence of current depression is. The lifetime risk of suicide in depressive illness is 15 per cent. The second largest contributor is alcoholism, in particular alcoholics who have experienced loss of a close personal relationship. Other significant psychiatric diagnoses include schizophrenia, organic brain syndrome and personality disorder. Suicide rates differ internationally, but the identification of significant socio-cultural risk factors is hampered by the official differences in ascertainment which exist. Although suicide rates increase with each decade of life, there has been a steady recent rise in suicide rates in many countries, which has been occurring disproportionately among the group aged 15-34.

Alcoholism↗
PubMed1983

Limitations of blue field entoptoscopy in evaluating macular function.

Evaluation of macular function in cataract patients using blue field entoptoscopy (BFE) has been reported as useful in all cases by some authors; another found it useful only in patients with moderate visual acuity loss due to cataract. This paper reports findings in 101 cataractous eyes evaluated consecutively with BFE. A strong correlation was found between cataract type and percentage of false negatives, but the correlation between the preoperative acuity level and percentage of false negatives was poor. BFE was also poor in detecting moderate macular dysfunction (20/60-20/80). Four cases with profound visual acuity loss due to macular holes had normal perception of BFE.

Cataract↗
PubMed1982

The clinical management of hysteria.

Hysteria, as classically defined (before Freud), is a chronic polysymptomatic illness chiefly affecting women. A dramatic and complicated medical history is the rule. Although the etiology of this condition remains unclear, its implications for physicians are different from those of other illnesses. Clinical management is generally difficult and often unsatisfactory. As with other diseases, diagnosis precedes and directs treatment. This article discusses the basis on which a reliable diagnosis of hysteria can be made, and offers guidelines for conservative management, based on the clinical literature and the author's experience.

Adolescent↗
PubMed1982

Family history of suicidal behavior among suicide attempters.

Efforts to predict suicide and attempted suicide are hampered by their relative rarity on the one hand and the inadequate specificity of clinical characteristics and relevant antecedent events on the other; that is, these features are found widely among the nonsuicidal as well. In an effort to further understand these phenomena, the authors studied family history of suicidal behaviors (suicide, attempted suicide, and suicide threats) in 127 patients hospitalized following a suicide attempt. Patients with personality disorders (antisocial personality disorder, alcoholism, somatization disorder, and narcotic addiction), comprising 45 per cent of the sample, frequently reported a family history of these behaviors, most notably attempted suicide. Patients with primary affective disorder reported a family history of suicidal behaviors somewhat less often. The diagnoses grouped here as personality disorders (excepting alcoholism) contribute little to the suicide rate, while primary affective disorder contributes substantially. Although further data are needed, it is suggested that a family history of suicidal behavior in primary affective disorder should alert the clinician to heightened suicide risk, while a similar history in nonalcoholics with other psychiatric diagnoses is not particularly significant.

Adolescent↗
PubMed1982

Office slit lamp discissions in artiphakic eyes.

What is believed to be the first reported series of discissions in artiphakic eyes done in the office with a standard examination slit lamp is reported. Adequate optical openings were obtained in 22 of 24 eyes. No major complications such as vitreous wick, endophthalmitis, epithelial implantation, or lens dislocation occurred in this small series. It is felt to be a safe, inexpensive alternative to operating room discissions.

Ambulatory Surgical Procedures↗