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Biomedical subjects

H Merskey

Publications and source records attributed to H Merskey.

At least 181 records · Page 10Linked to original sources
PubMed1980

Relationships between psychological measurements and cerebral organic changes in Alzheimer's disease.

Twenty-two patients were carefully defined as having progressive dementia without other known cause and not complicated by clinical or laboratory evidence of multiinfarct dementia. Their degree of dementia measured by the ESD correlated highly with EEG disturbance (r=-0.79). The LPRS correlated 0.73 with ventricular enlargement. Although the EEG and CT scan only correlated significantly with each other in advanced cases, a combined index of EEG and CT Scan change, (Physical Measures Index) achieved a correlation of 0.93 with a combined index of psychological change (Psychological Measures Index). The results indicate the possiblity of using physical and psychological measures to monitor quantitative change in Alzheimer's Disease, the EEG contributing more initially and the CT scan more in the most advanced cases.

Alzheimer Disease↗
PubMed1979

The lateralisation of pain.

Pain is more often lateralised on the left, except in the case of trigeminal neuralgia. The factors which promote lateralisation of pain are reviewed and it is noted that hysterical conversion symptoms are also more common on the left. Experimental evidence implies that the right hemisphere is less efficient than the left in processing cutaneous sensory input. Neurological and psychiatric data support the view that the right hemisphere is dominant for emotional experience and this may help to determine the left-sided preponderance of pain.

Chronic Disease↗
PubMed1979

Personality, sexual adjustment, and brain lesions in patients with conversion symptoms.

To clarify the interrelationships of conversion symptoms, hysterical personality, sexual adjustment, and cerebral organic disorders the authors studied 89 patients with classic motor conversion symptoms (group L) and compared a subgroup of 24 of these patients (group H) with 24 matched control patients (group C). They found hysterical personality in 19% of group L, 21% of group H, and none of group C and passive-immature-dependent personality in 19% of group L, 21% of group H, and none of group C. Forty-eight percent of group L, 50% of group H, and 58% of group C had some cerebral disorder. Patients with conversion symptoms who also had hysterical and passive-immature-dependent personalities were especially likely to have sexual abnormalities.

Adult↗
PubMed1978

Insomnia: anxiety, sleep-incompatible behaviors and depression.

Evaluated the relevance of the physiological-arousal model, the stimulus-control paradigm, and depression to insomnia both as a unitary construct and to its components. The Manifest Anxiety Scale, the Sleep Behavior Self Rating Scale and the Zung Depression Scale were administered to 81 clinical Ss. Three separate discriminant function analyses were performed with self-reported "sleeping difficulty," "latency of falling asleep," and "total hours of sleep" as criterion variables. The above three scales and the following four sleep patterns were used as indices: number of nocturnal wakings, latency to fall asleep once awake, number of early wakings, and frequency of feelings of fatigue upon wakings. The findings indicated that the physiological-arousal model was relevant both to insomnia overall and to its component of sleep-onset insomnia. The stimulus-control paradigm was found to be relevant only to sleep-onset insomnia. Depression was not a sensitive discriminator, possibly due to the heterogeneity of the patient population studied. It is emphasized that different mechanisms might be operating with the heterogeneous symptom "insomnia," and the replication of findings with criteria that include significant others and electroencephalographic measures is suggested.

Adolescent↗
PubMed1978

Significance of pain in psychiatric hospital patients.

In a consecutive series of 227 psychiatric hospital admissions, data were recorded in respect of the complaint of pain. Eighty-six (38%) had pain. Fourty-four (19%) mentioned it spontaneously and 49 (22%) had no relevant physical cause. Women were affected more often than men (P less than 0.01) and tended to complain more often of severe pain (P less than 0.01). Severe pain was more often reported spontaneously (P less than 0.02). Also, the longer pain lasted the more likely the patient was to report it spontaneously (P less than 0.02). Men more often had a relevant physical diagnosis (P less than 0.05) and the low back was the commonest site of pain in them. Pain was relatively often associated with diagnoses of anxiety and personality disorder and relatively infrequently with schizophrenia, organic brain syndromes and transient situational disturbances. It is concluded that whilst there is a strong association between pain and psychiatric illness, this is less prominent, paradoxically, in some of the more severe psychiatric disturbances.

Adult↗
PubMed1978

A note on the description of pain and its causes.

The adjectives used by 72 psychiatric patients to describe pain were examined. Patients with physical lesions tended to have physical precipitants and physical relieving factors. Patients with psychologically based pain often recognized both physical and emotional preciptation. Most adjectives used were sensory rather than affective or evaluative.

Female↗
PubMed1978

Emotional adjustment and chronic pain.

Previous work has suggested that patients with organic lesions causing pain may show as much emotional disturbance as patients with pain but without lesions. This study examined 141 chronic pain patients for their life experience, both currently and premorbidly, in terms of upbringing, neurotic traits and personality disturbance. Patients with an organic cause for pain reported significantly less family disturbance in childhood, less premorbid personality problems and less neurotic traits than patients who did not have any organic cause for their pain. The data provide support for the view that a significant proportion of the emotional disturbance associated with chronic pain is a secondary effect. Adjectives used to describe pain and factors causing exacerbation and relief of pain, although overlapping, also differed in the two groups.

Adolescent↗
PubMed1978

Diagnosis of the patient with chronic pain.

The problems of classification of pain syndromes are briefly reviewed. A completely satisfactory taxonomy of pain has to be exhaustive and its categories must be mutually exclusive. This is not feasible in medicine in general and even less so in regard to pain which requires classification using several axes. Practical groupings of syndromes can be made which are helpful clinically. A list of these is provided, and principles which apply to the clinical investigation of patients with pain are stated.

Chronic Disease↗
PubMed1978

Political neutrality and international cooperation in medicine.

International cooperation is an integral part of furthering medical and scientific progress. Many specilist societies exist for that purpose and have written into their constitutions that such cooperation and coordination is their aim. They hope to achieve their aims by exchange, in all languages, of information and by so doing strengthen the relations between individual physicians and scentists as well as between corporate professional bodies from different countries. However, at the same time emphasis is laid on the political neutrality of such organsations. Increasingly, this 'neutrality' is being questioned as doctors and scientists become aware of abuse and distortion of their profession taking place in other countries. H Merskey highlights the problems and offers his opinion on the ethics of maintaining these professional relationships with colleagues abroad who are involved in such abuse and distortion.

Ethics, Medical↗
PubMed1978

Effects of antianxiety agents on relaxation training: a preliminary investigation.

The purpose of this preliminary study was to investigate the effects of certain antianxiety agents, that is, minor tranquilizers, sedatives, and hypnotics, on relaxation training. Twelve inpatients and two outpatients were referred to group relaxation training because of tension-anxiety complaints and underwent three training sessions. Results for those patients who were not having any psychotropic medication (Relaxation Only group) were compared with results for those who were receiving anxiolytic drugs (Medication-Relaxation group). Patients in the second group were on antianxiety medication prior to and during relaxation training. Self-report measures indicate that the Relaxation Only group benefited more from relaxation training and showed more treatment generalization effects. The results are interpreted as lending some support to the view that antianxiety drugs may have an interfering effect on relaxation training. Implications and limitations of the study are discussed.

Adolescent↗
PubMed1976

Words of chronic pain.

An analysis of the language of pain complaints, employing categories of descriptors, was used to determine if chronic pain of either psychiatric of organic origin might be depicted in terms specific for the disease. The complaints of 128 patients with chronic pain were studied for characteristic patterns. Patients with pain of organic etiology used sensory-thermal (e.g., hot, burning) words more frequently than those with pain of psychiatric origin. Female patients with pain attributed to anxiety used sensor-temporal words (e.g., throbbing) more frequently than those with other psychiatric diagnoses. There was also a statistically significant preponderance of pain on the left when the groups of patients with physical and psychological illness were combined.

Adult↗
PubMed1975

Variations in pain complaint threshold in psychiatric and neurological patients with pain.

The threshold at which noxious stimulation with a pressure algometer gives rise to a complaint of pain has been studied in neurological and psychiatric patients with pain and in two patients with fluctuating pain of organic origin. A correlation of r = 0.69 (P less than 0.0025) was demonstrated between two observers using the pressure algometer independently. Patients with organic causes for their pain had higher pain complaint thresholds. The threshold was also raised, outside the affected areas, in the two patients with fluctuating pain when the latter was more severe. Some requirements for an improved technique of pressure algometry are discussed.

Adult↗