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Biomedical subjects

H Merskey

Publications and source records attributed to H Merskey.

At least 127 records · Page 7Linked to original sources
PubMed1987

Correlates of suicide attempts and ideation in schizophrenia.

A group of 118 patients with a hospital diagnosis of schizophrenia was reviewed. The incidence of suicide attempts was significantly correlated with more frequent past psychiatric admissions, more frequent past diagnoses of schizophrenia, and poor work function. The apparent relationships could be spurious or based on a reversed causal sequence; for example, suicide attempts are likely to be followed by psychiatric admissions.

Anxiety↗
PubMed1987

Screening for alcoholism in family practice.

491 consecutive adult patients who consulted their family physician for routine medical problems completed a five item screening questionnaire for alcoholism and a checklist of 12 commonly occurring symptoms. More than 11% showed definite evidence of alcoholism while another 6% showed probable evidence. Review of the medical record for that visit revealed that a large proportion of the alcoholics detected through this method were not diagnosed as such nor was alcohol charted as a significant factor in their medical problems. Patients who reported common symptoms such as blackouts, tremors, temper outbursts, chest pain, unsteadiness, loss of appetite, vomiting, sadness and "stomach pain" had significantly higher rates of alcoholism than those who did not report these symptoms. In order to detect alcoholism in family practice, it may be useful to routinely ask a few inoffensive questions to increase significantly the detection rate.

Adolescent↗
PubMed1986

Temporomandibular pain and dysfunction syndrome: the relationship of clinical and psychological data to outcome.

A prospective study of 60 patients with the temporomandibular pain and dysfunction syndrome (TMPDS) was done using the General Health Questionnaire, the Crown-Crisp Experiential Index, and the Parental Bonding Instrument. Three months after an initial visit 59 patients were reassessed: 18 patients were completely better or improved a lot, 27 were improved a little, and 14 were the same or worse. Patients' outcomes were not related to the severity or duration of symptoms at the initial presentation. Thirty-five percent of the patients had not received any therapy in the 3-month interval. The outcomes of these patients were not different from the outcomes of patients who had received treatment. A significant relationship was found between initial psychological test scores and outcome (multivariate F = 3.80, P less than 0.05). This relationship was curvilinear: the group with the worst outcomes scored highest, that with the best outcomes scored in the middle, and that with intermediate outcomes scored lowest. These results imply that mild psychological distress may facilitate a successful outcome, whereas either excessive psychological disturbance or minimal psychological complaint is associated with poor results.

Adult↗
PubMed1986

The significance of white matter lucencies on CT scan in relation to cognitive impairment.

As part of a prospective clinicopathological study a cohort of "normal" elderly volunteers (n = 110) has been investigated with CT scans, psychometric testing (Extended Scale for Dementia) and neurological examination. CT scans were evaluated by a neuroradiologist for the presence or absence of white matter lucencies (WML). WML were defined as patchy or diffuse areas of decreased attenuation involving only white matter and with no change in adjacent ventricles or sulci. The 12 subjects with WML had lower scores on the ESD than the 98 subjects without WML (mean ESD with WML 229.5 +/- 14; without WML 236.7 +/- 8.6, t-test p less than .01) and the difference remains significant even after adjusting for the possible confounding effects of age (ANCOVA, P less than .043).

Aged↗
PubMed1986

The EEG in Alzheimer type dementia: lack of progression with sequential studies.

Our findings dispel the commonly held belief that the EEG always worsens progressively in dementia of the Alzheimer's type. In a continuing cohort analytical study of dementia, 139 patients with Alzheimer's disease and 148 controls were studied for EEG abnormalities and progression. EEGs were read without knowledge of the previous EEGs or clinical condition, and classified according to the presence of diffuse delta or theta, bisynchronous spikes, projected activity, and focal activity. EEGs were significantly different in the two groups. EEG scores generally worsened over 1-4 years, but most of the subjects showed no alteration in their EEG scores. A few patients with Alzheimer's disease showed improvement of EEG findings.

Alzheimer Disease↗
PubMed1986

Leuko-araiosis: an ancient term for a new problem.

Recent research with computerized tomography (CT) and magnetic resonance imaging (MR) of the brain has revealed a type of tissue change for which no fitting term exists. The change appears as areas of decreased density on CT and changed signals of the white matter in MR images. Because neither a definite pathological change nor a specific clinical deficit has been linked with the CT and MR changes, a designation is required that limits itself to describing the changes themselves. We propose "leuko-araiosis". The Greek root leuko-, signifying "white", has found wide usage in modern medical terminology: e.g. leucine, leukocyte, leukorrhoea. Also several precedents exist for its application to the white matter of the central nervous system: e.g. leukoencephalitis, leukomyelitis, leukotomy. Araios is an adjective meaning "rarefield", and the suffix -osis converts the adjective to a noun meaning "rarefaction, diminution of density", a word used in the Hippocratic Collection to describe a state of excessive porosity of the lung. A descriptive term precludes premature presuppositions and encourages the search for causes.

Brain↗
PubMed1986

Variable meanings for the definition of disease.

It is argued that there is no agreed definition of disease. Purely biological definitions are inadequate and combined biological and social definitions are not yet satisfactory. One approach has been to say that what doctors treat is disease. We are uncomfortable with that because we feel it releases people from obligations on a basis of convenience. In practice the weight given to the idea of disease varies according to what it will imply about obligations and privileges. It is suggested that what doctors treat can be accepted as disease provided that we recognize that the significance of disease must vary with circumstances. Those circumstances include the agreement, more or less, of all persons affected when someone is considered to be a patient. The individual must also be competent and not constrained except by his own biological or psychological characteristics.

Disease↗
PubMed1986

Political hazards in the diagnosis of 'sluggish schizophrenia'.

The concept of 'sluggish schizophrenia' is virtually limited to the USSR and some other East European countries, and may contribute to the mis-diagnosis of democrats as psychiatric patients. Recently, a number of articles have appeared in the Soviet literature relating the diagnosis of 'sluggish schizophrenia' or 'slowly progressive schizophrenia' to affective disorders, especially hypomania. Soviet publications on this theme from 1980 to 1984 are discussed, together with their relationship to questions on the abuse of psychiatry.

Adult↗
PubMed1985

A new definition of Alzheimer's disease: a hippocampal dementia.

Preliminary data support the hypothesis that the decline of all higher cognitive functions in senile dementia of the Alzheimer type is attributable to histopathological changes in the hippocampal formation, with or without neocortical neuronal lesions. Previous literature amply supports the critical role of this "locus minoris resistentiae" in memory processing and cognitive physiology. New observations include quantitative morphometric evaluations of the hippocampal formation from a longitudinal study of prospectively tested patients and histological and neurochemical data from patients with a clinical presentation consistent with typical Alzheimer's disease, in whom the only neuropathological abnormality was devastating nerve cell loss and gliosis in the hippocampi.

Aged↗
PubMed1985

Correlative studies in Alzheimer's disease.

An approach is described for establishing and maintaining a correlative study of Alzheimer's Disease. A sample of the findings by the University of Western Ontario (U.W.O.) Dementia Study Group is provided.

Aged↗
PubMed1985

Representation of the thoracic outlet syndrome as a problem in chronic pain and psychiatric management.

The diagnosis of thoracic outlet syndrome depends upon subjective complaints and sometimes rather limited physical findings. There is a tendency to favour other non-specific diagnoses, like 'soft tissue damage' or to suspect neurosis, particularly in patients who have had motor vehicle or other injuries for which they claim compensation. We report here 3 patients in whom the diagnosis of thoracic outlet syndrome was overlooked and who responded to surgical treatment with good or excellent results.

Accidents, Traffic↗
PubMed1985

Psychological normality and abnormality in persistent headache patients.

One hundred and three patients referred to a neurological outpatient clinic were examined to assess the relationship between persistent headache, not due to significant physical illness, and emotional disturbance. Overall, the patients showed slightly more evidence of emotional disturbance than a general practice population but less than psychiatric outpatients. Thus, with cut-off points of 4/5 and 9/10 on the General Health Questionnaire (GHQ 28) the whole group had 52% or 20% of psychiatric 'cases' respectively. On the Crown-Crisp Experiential Index the 70 females had mean total scores of 37.19 +/- 11.11 and the 33 males had scores of 31.79 +/- 11.36. In addition the childhood experiences measured by the Parental Bonding Instrument appeared to be normal. Seven patients had significant depressive illness, according to the Levine-Pilowsky Depression Questionnaire. Statistically significant differences in psychological state did not emerge between the diagnoses of cluster headache, classical migraine, common migraine, tension headache or combined headache. However, negative correlations were found between the duration of illness and measures of anxiety. It is concluded that although the emotional state contributes to the development of pain and headache in some patients, there are others in whom comparable headaches are unlikely to be due to emotional factors. Selection effects are held to be important and some of the emotional changes will vary at different phases of a chronic disorder. A new symptom may initially cause anxiety but when a condition persists some patients will be increasingly concerned or depressed whilst others develop tolerance for the situation.

Adolescent↗