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Biomedical subjects

H Merskey

Publications and source records attributed to H Merskey.

At least 73 records · Page 4Linked to original sources
PubMed1993

Anxiety and depression in patients with abdominal bloating.

Eighteen patients with a syndrome of abdominal bloating and discomfort were examined to explore the relationship between their symptoms and their emotional problems. They were compared with 33 patients with Crohn's disease and 38 normal, healthy volunteers. Using the Hospital Anxiety and Depression Scale, patients with bloating were found to resemble patients with Crohn's disease. Both groups showed increased anxiety and depression. After controlling for age, sex, education, occupation, personality variables and childhood experience, there was a trend towards more anxiety in the bloating group compared with normal subjects and a significant difference for depression. These characteristics appear to be related to the effects of the illness or to selection, but not to personality or childhood experience. Although psychiatric problems are common among patients with abdominal bloating and pain who stay in touch with a clinic, they are not the primary cause of the disorder.

Abdominal Pain↗
PubMed1993

Hyperthyroidism after treatment with lithium.

The association between treatment with lithium and hypothyroidism is well documented. Reports of hyperthyroidism are rare and it is less well known among patients treated with lithium. It may be overlooked simply because the clinician will be watching for hypothyroidism, the reverse phenomenon. This paper describes the cases of four patients who have been on long term lithium treatment, all of whom developed Graves' disease, or an atypical form of hyperthyroidism. Some suggestions are offered to account for the mechanism underlying this unusual association. Although hyperthyroidism may be rare among patients receiving lithium, astute clinical observation and appropriate laboratory tests are called for to detect the early stages of such thyroid dysfunction and to provide appropriate intervention.

Adult↗
PubMed1992

Disruption of saccade production during oculomotor tracking in schizophrenia and the use of its changes across target velocity as a discriminator of the disorder.

A clear measure of eye movement disorder (EMD) that reliably separated schizophrenic individuals from others would both give insight into the brain control of the disorder and provide an aid in diagnosis. In the present study, a detailed analysis was carried out of the interactions between the pursuit and saccadic components of eye movements at different target velocities. The subjects comprised schizophrenic patients, unipolar depressed patients, and normal controls. The speed of the slow pursuit component did not differ among the groups, but schizophrenic subjects made more saccadic movements at low target velocities, though they started further away from the target at high target velocities. On the basis of these differences, a slope was computed of the linear function that related the number of saccadic eye movements to the velocity of a ramp visual target. Slope direction was negative for schizophrenic subjects but positive for unipolar depressive and normal subjects, and the correct classification rate for subjects was 84%.

Adolescent↗
PubMed1992

Chronic abdominal pain and depression. Epidemiologic findings in the United States. Hispanic Health and Nutrition Examination Survey.

We report data on abdominal pain and depression from a survey of Hispanic Americans by the United States National Center for Health Statistics. The point prevalence rates of chronic abdominal pain were 4.6% in Mexican Americans and 5.8% in Cuban Americans in a total of 4175 subjects. The rate was 8.3% among 1323 Puerto Ricans. In 53% the abdominal pain came in waves. Using the Depression scale of the Center for Epidemiologic Studies (CES-D), 18.7% of Mexican and Cuban Americans with pain were found to be depressed to an extent likely to require intervention, and 40.8% of Puerto Ricans were so affected. The Diagnostic Interview Schedule (DIS) gave more conservative figures for major depression in terms of DSM-III, viz., 6.8% for Mexican and Cuban Americans with chronic pain, and 12.6% for Puerto Ricans with chronic pain. Logistic regression analyses demonstrated links between depression and female sex, the single state, low education and income, and chronic abdominal pain. The most consistent relationships for depression were with chronic pain, female sex and the single state. The results confirm the strong relationships between chronic pain, mood and female gender, and other socio-demographic variables.

Abdominal Pain↗
PubMed1992

An examination of psychometric properties of the extended scale for dementia in three different populations.

The Extended Scale for Dementia (ESD), a development of the Mattis Dementia Rating Scale, has been used in the evaluation of dementia and aging and has shown substantial clinical utility. We report on analyses of its properties and internal structure in three samples of older people: 153 normals, 101 psychiatric hospital residents, and 114 patients with Alzheimer disease. The results showed good internal consistency in the two clinical samples, with much lower reliability in the normals, for whom the test was too easy. A review of the item statistics led to the use of 17 of the 23 ESD items in item component analyses in the three samples. Use of Horn's parallel analysis criterion led to the retention of three components in the normal group and one in both the hospital and Alzheimer groups. The results are compared with other work and are in accordance with the view that cognitive structure becomes more simple with increasing dementia.

Aged↗
PubMed1992

Frontal, temporal, and striatal proton relaxation times in schizophrenic patients and normal comparison subjects.

Spin-lattice (T1) and spin-spin (T2) magnetic resonance relaxation times were examined in frontal, temporal, and striatal regions of 24 patients with schizophrenia and 10 normal comparison subjects. The schizophrenic patients had more prolonged T2 values than did the comparison subjects, particularly in the left temporal cortex and white matter, suggesting tissue pathology.

Adult↗
PubMed1992

The manufacture of personalities. The production of multiple personality disorder.

Unprecedented numbers of cases of MPD have been diagnosed, mainly in North America, since 1957. Widespread publicity for the concept makes it uncertain whether any case can now arise without being promoted by suggestion or prior preparation. In order to determine if there is any evidence that MPD was ever a spontaneous phenomenon, a series of cases of MPD from the earlier literature has been examined, with particular attention given to alternative diagnoses which could account for the phenomena reported and to the way in which the first alternate personality emerged. The earlier cases involved amnesia, striking fluctuations in mood, and sometimes cerebral organic disorder. The secondary personalities frequently appeared with hypnosis. Several amnesic patients were trained with new identities. Others showed overt iatrogenesis. No report fully excluded the possibility of artificial production. This indicates that the concept has been elaborated from the study of consciousness and its relation to the idea of the self. The diagnosis of MPD represents a misdirection of effort which hinders the resolution of serious psychological problems in the lives of patients.

Diagnosis, Differential↗
PubMed1992

Anna O. had a severe depressive illness.

The information available on the illness of Anna O. is reviewed together with follow-up data from the literature. It is concluded that the diagnosis of a severe depressive illness with depressive delusions is well justified. Hysterical symptoms which appeared can be understood as part of the depressive state modified by the expectations of the period and by the intervention of physicians. The illness was a very protracted one, with fluctuations or exacerbations lasting from 1880 to 1887, and was complicated by dependence upon morphine and chloral hydrate. However, by 1888, the patient appears to have made a considerable recovery, and she went on to lead an effective and fruitful life, demonstrating high intelligence and the resilience of the cyclothymic temperament.

Austria↗
PubMed1992

Psychiatric aspects of the neurology of trauma.

This article discusses posttraumatic stress disorders, their relationship to conversion and dissociation responses, and the role of neurologic examination in diagnosis. The concentration camp syndrome (CSS) and its organic and psychological components, the emotional impact of physical illness, and psychiatric syndromes related to brain lesions are presented also.

Adaptation, Psychological↗
PubMed1991

Clinical correlates of white-matter changes on magnetic resonance imaging scans of the brain.

We report our observations on the clinical and radiologic correlates of changes in cerebral white matter based on 94 subjects undergoing magnetic resonance imaging in a prospective study of dementia. Periventricular hyperintensity occurred twice as often in patients with Alzheimer's disease as in healthy control subjects. Within the control group, the presence of periventricular hyperintensity correlated significantly with one measure of cerebral atrophy and with the presence of changes in the adjoining deep white matter. The significance of white-matter changes distinct from the ventricles (leuko-araiosis) remains unsettled. Leuko-araiosis on the magnetic resonance imaging scan, unlike its correlate on the computed tomographic scan, was not shown to relate to cognitive decline or to the presence of focal abnormalities on neurologic examination. This is likely to reflect the heterogeneity of the changes detected with magnetic resonance imaging and their limited extent in our subjects.

Aged↗
PubMed1991

Improved recognition of leukoaraiosis and cognitive impairment in Alzheimer's disease.

We identified 85 patients in a longitudinal study of dementia who had uncomplicated Alzheimer's disease and in whom computed tomography of the head and psychometric testing were conducted within a 6-month period following their entry into the study. Thirty-four patients (40%) had leukoaraiosis, which was disproportionately common in female patients (62% vs 15% in male patients). Analysis of covariance demonstrated a relative reduction of scores on the Extended Scale for Dementia in those patients who had leukoaraiosis, after adjusting for the confounding effects of age, sex, educational level, and duration of illness. Leukoaraiosis was also much more common in women, even after adjusting for the possible confounding effects of age, duration of illness, Extended Scale for Dementia score, and hypertension. Multiple regression analysis showed that leukoaraiosis accounted for 11.6% of the variance of the Extended Scale for Dementia scores. Leukoaraiosis, together with duration of illness, accounted for 18.2% of the variance. Leukoaraiosis is associated with a greater degree of cognitive impairment in patients with Alzheimer's disease.

Aged↗