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Biomedical subjects

G J Tucker

Publications and source records attributed to G J Tucker.

At least 19 recordsLinked to original sources
PubMed1991

DSM-IV: proposals for revision of diagnostic criteria for delirium. APA Work Group on Organic Disorders of the DSM-IV Task Force and Major Contributors.

This paper reviews the historical development of the American Psychiatric Association's Diagnostic and Statistical Manual. It presents some of the issues that the clinician has found difficult in applying DSM-III and DSM-III-R criteria for delirium. In addition it introduces some options for DSM-IV criteria for delirium based on several empirical studies. These options should be studied and debated carefully over the next year because in part, they represent radical departures from existing diagnostic criteria for delirium.

Aged↗
PubMed1991

Reliability of the Part II Board Certification Examination in Psychiatry: interexaminer consistency.

OBJECTIVE: The aim of the study was to examine the reliability (interexaminer consistency) of the American Board of Psychiatry and Neurology (ABPN) Part II (oral) examination in psychiatry. METHOD: Grades were assigned independently by two examiners who observed the same examination in a 1-year cycle (1,422 candidates, two examinations each). The consistency between these pairs of grades (pass, condition, fail) was analyzed using a weighted kappa statistic. RESULTS: There was perfect agreement between examiners in 67% of examinations, minor disagreement in 26%, and major disagreement in 7% (weighted kappa = 0.54-0.56). CONCLUSIONS: The Part II ABPN examination demonstrates fair to good reliability as measured by interexaminer consistency. Development of more explicit grading criteria should further improve examiner agreement in future examinations.

Educational Measurement↗
PubMed1988

Somatization, paranoia, and language.

Somatization and paranoia are circumscribed distortions of reality that are impervious to the normative process of consensual validation. These distortions are often postulated as a means of bolstering lowered self-esteem. We used computerized content analysis of the free speech of patients with these disorders in order to identify and compare dimensions of self-concept reflected in their lexical choices. Interestingly, patients with these disorders differed in the themes prominent in their speech. The higher frequency categories used by the somatization disorder group conveyed an overwhelming sense of negativism, distress, and a preoccupation with an uncertain self-identity. In contrast, the categories used by the paranoid patients portrayed an artificially positive, grandiose self-image and a defensive abstractness. Our exploratory analysis suggests that circumscribed distortions of reality in somatization and paranoid disorders are not associated with the same common defensive style attempting to bolster self-esteem.

Adult↗
PubMed1988

Neurology and psychiatry.

There has been a long historical relationship between neurology and psychiatry. This relationship has been nurtured by the common interest in the central nervous system and disturbed behavior associated with dysfunctions of the nervous system. This paper reviews the formal relationships between neurology and psychiatry and particularly looks at the behavioral aspects of neurological disease. For the past 10 years, both from a clinical and a theoretical viewpoint, the importance of understanding central nervous system functioning and dysfunctioning has become increasingly apparent to psychiatrists.

Humans↗
PubMed1988

The language of altered states.

To compare the subjective experience of different forms of altered states of consciousness, computerized content analysis was applied to 66 autobiographical accounts of schizophrenia, hallucinogenic drug states, or mystical ecstasy and to 28 autobiographical control accounts of important personal experiences. The patterns of lexical choice used by the four groups were significantly different in word frequencies from 49 of 83 lexical categories measured. When data from the 13 most statistically significant categories were used in discriminant and classification analyses, 84% of the samples were correctly identified by their word frequencies. These findings suggest that the subjective experiences of schizophrenia, hallucinogenic drug-induced states, and mystical ecstasy are more different from one another than alike.

Analysis of Variance↗
PubMed1988

Diagnostic classification through content analysis of patients' speech.

Speech samples from 71 patients in four diagnostic groups were analyzed by two quantitative methods of speech content analysis, the results of which were entered into a discriminant analysis to test whether patients could be accurately classified back into their appropriate diagnostic groups. These classifications were compared with classifications made by two psychiatrists, blind to the patients' diagnoses, who read transcripts of the speech samples. The results suggest that data from the systematic quantification of lexical choice can be used to classify patients into their respective diagnostic groups and that this classification compares favorably with that done by psychiatric raters.

Computers↗
PubMed1988

Modern perspectives on epilepsy in relation to psychiatry: classification and evaluation.

This paper begins a two-part series on current psychiatric aspects of epilepsy. Part I focuses on the current classification of epileptic seizures; the possible relationships of epilepsy, especially temporal lobe epilepsy, with psychopathology; and the difficulties of evaluating epileptic conditions through electroencephalography. Part II, to be published in the April issue, will cover the management of epilepsy that is accompanied by behavior disturbance.

Electroencephalography↗
PubMed1988

Modern perspectives on epilepsy in relation to psychiatry: behavioral disturbances of epilepsy.

In this paper, the second of a two-part series on current psychiatric aspects of epilepsy, the authors consider the classification and management of the various kinds of psychoses and other behavior disturbances associated with some cases of epilepsy. After discussing the common aspects of epilepsy and schizophrenia, they describe attempts to categorize epileptic psychoses, focusing on a classification of ten kinds of psychoses that they believe has broadest application. They present guidelines for psychopharmacological management of epilepsy accompanied by behavior disturbance, with emphasis on anticonvulsant monotherapy, and they discuss possibly related seizure disorders and possible etiologies of behavioral symptoms of epilepsy.

Anticonvulsants↗
PubMed1988

Fundamentals of carbamazepine use in neuropsychiatry.

Carbamazepine, mainly used as an anticonvulsant but also used for trigeminal neuralgias and other neuralgic pains, is now being used experimentally for affective disorders, nonresponsive psychoses, and dyscontrol. However, carbamazepine dosage must be carefully monitored because low initial doses are equivalent to higher later doses, and the drug's addition to a regimen of other drugs may increase carbamazepine's serum levels. Given alone to a pharmacologically naive inpatient, initial dosage of carbamazepine 200 mg/day can be increased by 100 mg every day or every second day; an outpatient can have the dosage increased by 100 mg every third day. Serum levels and side effects should be monitored. White cell counts usually decrease about 25%, but the decrease is not clinically related to the very rare occurrence of agranulocytosis. A side effect of concern is hepatic toxicity, but few such cases have been reported. The most common side effect is allergic rash, which occurs in about 5% of all patients receiving carbamazepine; antihistamines sometimes bring about a remission of the rash. Generic carbamazepine may cause more problems than Tegretol.

Carbamazepine↗
PubMed1986

"Rational" hospital psychiatry.

When, in 1974, the authors chose to describe their approach to hospital psychiatry as "rational", they were departing from the prevailing psychiatric belief that treatment should be based on theories of behavior. Instead, the authors advocated that rational treatments should be based on empirical findings and on pragmatic considerations, a view which a decade later has found its way into mainstream American psychiatry.

Anorexia Nervosa↗
PubMed1986

Phenomenology of temporal lobe dysfunction: a link to atypical psychosis--a series of cases.

This report is a phenomenological study of 20 cases of temporal lobe disorders manifested as complex partial seizures. The major behavioral symptoms observed were episodic affective disturbances, episodic cognitive disturbances, and "spells," with normal functioning between episodes. The remarkable similarity of this phenomenology to what has been described as atypical or episodic psychosis provides a possible theoretical link to the etiology of atypical psychosis. These cases also establish atypical psychosis as an entity clearly different from the other major psychoses.

Adolescent↗
PubMed1985

Linguistic dimensions of affect and thought in somatization disorder.

DSM-III has established diagnostic criteria that separate somatization disorder from other overlapping symptom configurations. Nevertheless, information regarding the experience of somatization disorder is far from complete. Terms such as "masked depression" or "alexithymia" imply that a disturbance of affect is a central but guarded issue for at least some somatizing patients. Through content analysis of speech, the authors investigated the self-experience of somatization disorder in relation to affective disorder. Rather than defended depression, a distinctive characteristic found in the language of patients with somatization disorder reflects a confused, negative self-identity.

Adult↗
PubMed1979

Verbal behavior and schizophrenia. The semantic dimension.

Through the use of computer analysis, the content of the speech of schizophrenics is shown to be distinct from that of the speech of nonschizophrenic psychiatric patients. The data shed light on qualities that delineate some aspects of "bizarreness" in speech of schizophrenics, provide some insight into the diversity of postulated "defects" in schizophrenic thinking, and provide further understanding of the diagnostic process in schizophrenia.

Adult↗