Search PubMed⌕ Search

Biomedical subjects

H Merskey

Publications and source records attributed to H Merskey.

At least 91 records · Page 5Linked to original sources
PubMed1991

Evidence that defence mechanisms are more related to personality than to symptoms.

The Defense Mechanisms Inventory is one of the more popular instruments for examining hypothetical dynamic mechanisms. It is known to correlate with some measures of personality and mood. We proposed that, as measures of personality and measures of defence mechanisms are considered to have a common origin in early experience, they should be more strongly correlated than measures of mood, given equal power in the measures of the dependent variables. In this connection we report the relationship which were found between scores on the subscales of the Inventory and the Hysteroid/Obsessoid Questionnaire and the Hospital Anxiety and Depression Scale. There was only a weak relationship between anxiety or depression on the one hand and the Defense Mechanisms Inventory on the other. The highest correlation noted in this regard was Pearson's r = .18, p = .065 between anxiety and the scale Turning Against Self (TAS). The Hysteroid/Obsessoid Questionnaire showed a positive relationship between high scores (hysteroid, i.e. extraverted) and the scale TAO (Turning Against the Object) and a negative relationship for the TAS scale (r = -.290, p = .003). Thus the Defense Mechanisms Inventory showed a stronger relationship with personality than with mood.

Adult↗
PubMed1991

Coherence on electroencephalography and aberrant functional organisation of the brain in schizophrenic patients during activation tasks.

Thirty schizophrenic patients (20 medicated, 10 off medication) were compared with 30 normal control subjects matched for age, sex, handedness, and intelligence. During the performance of left-hemisphere cognitive activation tasks, normal subjects had significantly increased EEG alpha coherence in areas related to left focal frontal sites, with decreases in temporal and posterior areas. Schizophrenic patients did not show the same degree of focal activation of left frontal areas. During the performance of right-hemisphere cognitive activation tasks, normal subjects and schizophrenic patients had similar patterns of right posterior increases in alpha coherence. Discriminant analyses were able to classify 81.4% of all subjects correctly. It is suggested that the findings indicate an aberrant functional organisation of the brain in schizophrenia, particularly affecting the left hemisphere.

Arousal↗
PubMed1990

Quantitative electroencephalographic correlates of cognitive decline in normal elderly subjects.

We obtained a topographic computer analysis of the electroencephalogram in 53 normal elderly subjects. Normal aging was not associated with an increase in slow (delta) activity. However, cognitive performance correlated positively with fast (beta) activity particularly in frontal leads, even after controlling for age, education, occupation, and medication. Five subjects who showed early signs of cognitive decline, had all a marked reduction in beta activity suggesting that this may be an early indication of intellectual loss.

Aged↗
PubMed1990

Schizophrenic performance on line bisection: no simple lateralization defects.

Many studies have assessed the possible lateralization deficits of schizophrenics, and the results usually suggest left hemisphere dysfunction. Nevertheless, they have been variable. This may have been due to cognitive demand of the different tasks, not to changes in brain lateralization itself. In order to circumvent this problem, the present study evaluates the performance of schizophrenics on a simple but lateralized task, line bisection. Subjects bisected a line using either visual or tactile information, with the left or right hand, when it was placed in their left or right hemispace or directly in front of them. Schizophrenic subjects were not more erroneous than normals (variable error), nor were they biased differently from normals in either direction with either modality of sensory input (constant error). There were only two significant effects of group on the tactile line bisection, one of position x length x group and one of position x hand x end x length x group, both on constant error (directional bias). The lack of main effects and presence of interactions on these basic tasks suggests that apparent lateralization differences found in schizophrenic subjects are due not to a simple defect of brain lateralization but may stem from task demands and attention allocation.

Attention↗
PubMed1990

An ethical issue in the psychotherapy of pain and other symptoms.

Pain presents an ethical problem in psychotherapy which it shares with other symptoms. It presents this problem because initially it does not give rise to the same expectations as overt psychological complaints such as depression or anxiety. At first glance pain appears to represent an obvious example of the traditional doctor/patient relationship...I hope to demonstrate that what began as a transaction in the medicine of organic disease, may become, before the patient recognizes it, a process of personal change of which the consequences may often not be foreseen. Such a development poses a problem in bioethics. If the development can be foreseen, the problem may be forestalled. If not, the proceedings may reflect paternalism and we need to consider if that is acceptable. The problem is not unique to pain but tends to be masked by the initial context of somatic treatment.

Altruism↗
PubMed1990

A questionnaire investigation of anxiety and depression in early dementia.

We report findings on a study of anxiety and depression by questionnaire in 50 patients with mild dementia and 134 control subjects using the Hospital Anxiety and Depression Scale. Thirty-eight percent of patients and 9% of controls had a possible or probable diagnosis of an anxiety disorder. Possible or probable depression was found in 28% of the patients and 3% of the controls. These rates for the patients were above those in normal populations. All patients and control subjects were tested with the Extended Scale for Dementia (ESD). Neither group showed a significant relationship between depression and ESD scores. In the control subjects there was a negative correlation (P less than .006) between anxiety and cognitive scores, one that was not found in the patients.

Aged↗
PubMed1990

The attitudes toward committal of patients hospitalized in a psychiatric facility for the first time.

This study examines the attitudes toward committal of patients admitted to a psychiatric facility for the first time. Sixteen patients, from a group of 28 patients consecutively admitted to hospital on an Ontario Form 1 certificate were able to complete a satisfactory interview. In general, patients viewed the committal procedure favourably. They endorsed medical professionals as being best qualified to institute the committal procedure. A discrepancy between behaviour documented on the committal form and the patients' own perception of their mental state at the time of committal was noted. These findings are discussed with reference to previous research on civil commitment.

Adjustment Disorders↗
PubMed1990

The positive triad of schizophrenic symptoms. Its statistical properties and its relationship to 13 traditional diagnostic systems.

Using data from the WHO International Pilot Study of Schizophrenia and from our own previously reported series of 120 patients receiving treatment for schizophrenia, we ascertained the degree of agreement between 13 different systems for diagnosing schizophrenia. We identified a triad of symptoms similar to that from the International Pilot Study: auditory hallucinations, passivity feelings, and disturbances of affect. This triad correlated very strongly with the diagnosis of schizophrenia as determined by the 13 diagnostic systems, as well as with response to fluphenazine in our series. The triad should serve as a core set of symptoms in the study of schizophrenic illness. It represents the leading phenomena in a group of patients having what is generally considered to be schizophrenia, although it does not provide a definitive diagnosis. Evidence is needed on its specificity.

Dependent Personality Disorder↗
PubMed1990

A systematic inquiry into recollections of childhood experience and their relationship to adult defence mechanisms.

The relationships between childhood experience, measured by the PBI, and adult defence mechanisms, evaluated through the DMI, were examined in 114 subjects. There were modest but significant correlations between the primitive defences of 'turning against others' and 'projection' on the one hand, and a lack of parental care, as experienced by the subjects, on the other. 'Principalisation' (e.g. intellectualisation, isolation and rationalisation) and 'reversal' (e.g. negation, reaction formation, denial and repression) were positively associated with parental care. These findings account for only a small portion of the variance but show that, as with certain personality traits, actual or perceived childhood experience contributes in a recognisable fashion to the patterns of adult defences and behaviour.

Adult↗
PubMed1989

[Psychological factors associated with chronic pain].

Current knowledge of the complex relationship between chronic pain and its several psychological aspects is reviewed. After a word of caution concerning the selection biases frequently present in the samples described in the literature, the authors examine the relationships between pain and personality, pain and psychopathology and lastly pain and environment (stress). While chronic pain and depression share some neurochemical abnormalities suggesting new lines of research, much remains to be done to improve the clinical characterization of pain and notably its prognostic aspects.

Anxiety↗
PubMed1989

Neuropathologic correlates of leuko-araiosis.

We describe the pathologic findings in 17 persons with dementia, 12 of whom exhibited leuko-araiosis on computed tomographic scan. The presence of white matter pallor was confirmed on autopsy in 11 of these 12 cases, 9 with Alzheimer's disease and 2 with multi-infarct dementia. Two further patients, 1 with Alzheimer's disease and 1 with multi-infarct dementia, proved to have white matter changes on pathologic examination. White matter pallor coexisted with cerebral amyloid angiopathy in the brains of the patients with Alzheimer's disease. The presence of severe white matter pallor in patients with Alzheimer's disease correlated with early death, while the presence of cortical scars was associated with prolonged survival. Because early death in patients with Alzheimer's disease has been linked with severe pathologic and chemical changes, the presence of white matter pallor may be further evidence of a particularly severe process in patients with early onset of Alzheimer's disease.

Aged↗
PubMed1989

Release of saccades in schizophrenics: inattention or inefficiency?

This paper attempts to distinguish between inattention and inefficiency as the cause of the eye movement problems of schizophrenic subjects. It focuses on their release of fast saccadic eye movements in four different situations: interrupting smooth tracking, as double-jumps in refixation, and as inadvertent departures from steady fixation or too-early prediction moves. If an attention deficit causes saccades during tracking, they should be reduced only for schizophrenic subjects in the dark, when there is no contrasting background. Instead the reduction was present for all groups. If double-jumps in saccadic refixations were caused by inattentional instability, they should increase in schizophrenic subjects when the target is a temporary flash of light. Instead, they were reduced in all groups to almost none, suggesting a perceptual processing cause for the excess double jumps. If a global attentional problem of schizophrenia caused saccade release, saccade number should be correlated across the four situations. Instead, there were significant correlations only between departures and predictions in paranoid schizophrenic subjects (r = 0.728) and between predictions and looking in nonparanoid schizophrenic subjects (r = -0.855). This lack of over-all correlations suggests that a common inattentional problem does not produce these eye movement deficiencies. Instead, the perceptual influence on tracking and looking suggests that processing inefficiency is responsible for at least part of the deficit.

Adolescent↗
PubMed1989

Screening for psychiatric illness in patients with oral dysesthesia by means of the General Health Questionnaire--twenty-eight item version (GHQ-28) and the Irritability, Depression and Anxiety Scale (IDA).

Thirty-one consecutive subjects suffering from oral dysesthesia and without detectable organic disease were seen in a university outpatient dental clinic. They were assessed with a screening test for psychiatric illness, the General Health Questionnaire, 28-item version (GHQ-28). Twelve subjects also completed the Irritability, Depression and Anxiety Scale (IDA). At the 4/5 cutoff on the GHQ, 51.9% of the patients showed evidence of psychiatric illness. The IDA appeared to be more sensitive than the GHQ-28 in terms of detecting psychiatric illness, especially depression, and 75% of the 12 subjects who completed both scales were found to be depressed on the IDA. These results were compared to results obtained by another cross-sectional study of different types of pain clinics in which the same scales were used to screen for psychiatric illness. The subjects with oral dysesthesia as measured by the IDA appeared to have psychiatric illness more often than the other subjects with chronic pain, except those attending a psychiatric clinic. The GHQ-28 results on the other hand showed less psychiatric illness in the latter group. Our findings indicate that psychiatric illness, especially depression, may play an important role in this disorder and that the IDA may be more sensitive than the GHQ for detecting depression.

Adult↗
PubMed1989

An open label trial of the possible analgesic effects of dipyridamole.

There is experimental evidence that adenosine and the adenosinergic agent dipyridamole may inhibit the activity of nociceptive neurons. Dipyridamole was given to 15 patients with chronic pain in an open uncontrolled investigation. Eleven patients tolerated the drug well and seven of these patients obtained subjective benefit. The results are held to justify further investigation under controlled blind conditions. A possible ceiling effect of dipyridamole was noted.

Adult↗
PubMed1989

The inability to name a child.

A patient, whose presenting complaint is the inability to decide on a name for her child, is presented. A review of the literature on the significance of names is included, and comments are made on panelists from psychoanalytic and phenomenological perspectives. Management of the patient's depression is discussed.

Child, Preschool↗
PubMed1989

Psychiatry and chronic pain.

Pain and chronic pain have been defined by the International Association for the Study of Pain. Psychological mechanisms are recognized in the production of pain, but their importance has probably been overstated. Selection factors have not been attended to sufficiently, and traditional methods which have been relied upon for the diagnosis of hysterical pain have been misleading. Much emotional change seen with pain is a consequence of the physical disorder. Types of illness, seen by psychiatrists working with patients in pain, are described, and brief comments offered on their management.

Chronic Disease↗