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Biomedical subjects

H Merskey

Publications and source records attributed to H Merskey.

At least 163 records · Page 9Linked to original sources
PubMed1982

Amitriptyline versus placebo in postherpetic neuralgia.

To study the effects of amitriptyline in treating postherpetic neuralgia, 24 patients were randomly assigned to either drug or placebo in a double-blind crossover study. We found good to excellent pain relief in 16 of 24 patients (p less than or equal to 0.001). We did not find an antidepressant effect in most patients (p greater than 0.05). The median dose of amitriptyline was 75 mg. The median blood level was 65 ng per milliliter, and of nortriptyline 30 ng per milliliter. Good responses were maintained in 12 of 22 patients. Amitriptyline is useful in treating postherpetic neuralgia and may not act as an antidepressant.

Aged↗
PubMed1981

Compliance by physicians with the 1978 Ontario Mental Health Act.

In a survey of 102 patients admitted involuntarily to a psychiatric hospital, a statement of potential danger, required by law, was found to be provided on all the committal forms. Closer enquiry suggested that although 89% of these patients were admitted involuntarily in accordance with strict legal requirements the legal justification for involuntary admission was questionable in 11 cases. Of these 11 admissions, 10 were thought to be warranted if medical considerations were given priority and on humane grounds. For 6 of the 10 patients treatment was clearly beneficial. One patient suffered hardships as a result of his involuntary admission that were not compensated for by any likelihood that he could have benefited medically from psychiatric care. Apparently humane considerations and the possibility that a mentally ill person could benefit from treatment led to some committals that were legally uncertain. It is concluded that the Mental Health Act should be revised to take account of such situations.

Adolescent↗
PubMed1981

A note on the occurrence of pain in psychiatric patients from a Canadian indian and Inuit population.

Fifty patients are reported from a psychiatric service to a Native population. Thirty-two (64%) had pain of whom 19 had physical lesions. The number with pain is thought to be somewhat higher than might have been predicted from a priori considerations. Depression was the commonest psychiatric diagnosis both with and without pain. The head was the commonest site for pain whilst no patient had pain in the back as a primary complaint and only two had back pain as a secondary complaint.

Adult↗
PubMed1981

Headache and hysteria.

The concepts of Hysteria, Hypochondriasis and Hysterical Personality are reviewed and their relationship to pain and headache examined. It is further noted that many patients with supposed "tension headache" do not respond to measures which relieve anxiety. Electromyographic studies indicate that "tension headache" is not associated with the expected amounts of frontalis muscle tension. It is argued that much headache cannot be explained in organic terms or as a result of muscle tension and that hysterical mechanisms are important in causing it.

Conversion Disorder↗
PubMed1981

Briquet's concept of hysteria: an historical perspective.

Paul Briquet's Traité de l'Hystérie was published in 1859 and is a comprehensive clinical and epidemiological study of 430 patients with hysteria. It was widely known and quoted in its time, but was submerged by the rise of the psychoanalytic concept of hysteria at the end of the 19th century. Briquet's work was resurrected in 1971 with the recommendation that the term Briquet's Syndrome be used for certain forms of hysteria. This paper translates into English those sections of his monograph devoted to his concept of hysteria and discusses these in an historical framework. Briquet regarded hysteria as a "Neurosis of the Brain" in which a variety of unpleasant environmental events acted upon the "affective part of the brain" in a susceptible and predisposed individual. He considered the brain to be the "seat of hysteria" because it was the source of the multiple manifestations of the condition. Amongst its many other notable contributions, Briquet's study finally laid to rest hysteria's historic association with physical disease of the female genitalia.

Female↗
PubMed1981

Clinical data from a psychiatric service to a group of native people.

Clinical data are reported from a psychiatric service to Native Canadian patients, mainly Cree Indians. Eighteen out of 41 had a clinical diagnosis of depression, three of mania and only one of schizophrenia. Thirty-seven percent used alcohol to excess but alcoholism was rarely the primary diagnosis. Reasons are given for the belief that schizophrenia has been over-diagnosed in Native populations in the past. Seventy-eight percent spoke Cree/Inuit as their primary language. The patients usually held their parents in high regard despite often reporting that they were alcoholic. In reply to tentative enquiries into feelings about their Native identity, only 5% of the patients indicated a preference for another identity, but this figure is only considered to give a minimum estimate of the possible dissatisfaction with being Native in Canada today.

Adult↗
PubMed1981

Clinical patterns in a behavior modification unit.

The principles and practice of a Behavior Modification Unit in a psychiatric hospital are described. A simple but consistent program of rewards related to privileges is employed together with attention to individual counseling and family therapy. A consecutive series of 56 patients is reported. They had a high frequency of personality disorders, behaviour disorders and past psychiatric treatment irrespective of diagnosis. Improvement was measured in terms of success, three months after discharge, in staying out of hospital and maintaining an independent existence in the community. By this criterion 42 out of 56 patients (75%) were improved. Patients who improved had had less past treatment of various types and this relationship was highly significant. The justification for this type of program is briefly discussed.

Adolescent↗
PubMed1981

Relationships between pain and schizophrenia.

In an examination of the phenomenology of pain in 78 patients with schizophrenia, 29 had current pain complaints. Of these 13 had an appropriate physical cause, leaving 16 with pain of seemingly psychological origin. The head, leg and back were the commonest sites. Complaints were most often described in sensory terms. Pain plausibly related to a specific delusion or hallucinatory process occurred only once, and no gross examples of insensitivity to noxious stimuli or to self-mutilation were seen. Patients with schizophrenia may have less pain than those with anxiety or depression but certainly do experience pain both from physical and psychological causes. The influence of phenothiazines on pain experience is uncertain.

Adult↗
PubMed1980

Briquet's Treatise on hysteria. A synopsis and commentary.

Paul Briquet's Treatise on Hysteria, published in 1859, consists of a clinical and epidemiologic study of 430 patients with hysteria seen over a ten-year period. The etiologic factors were youth, female sex, "affective" and "impressionable" temperament, family history of the disorder, low social class, migration, sexual licentiousness, situational difficulties, and poor physical health. He considered the "effective part of the brain" the final common pathway that mediated these causative agents. In treatment, Briquet emphasized the importance of an improvement in social circumstances and the need to minimize environmental problems. The monograph is not only fascinating to read; the clinical and investigative approach of Briquet has an enduring relevance in the context of modern concepts of hysteria.

Adolescent↗
PubMed1980

Treatment of tardive dyskinesia with dihydrogenated ergot alkaloids (hydergine): a pilot study.

Five patients with abnormal involuntary movements of tardive dyskinesia were treated with dihydrogenated ergot alkaloids (Hydergine) in doses of 3 to 4 milligrams a day for six weeks. Blind ratings of standard videotape recordings indicated significant differences between the patients. Worsening occurred in three patients during treatment and to a lesser extent after treatment; improvement during treatment appeared in one patient and more sustained improvement in one patient.

Adult↗