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Biomedical subjects

H R Millar

Publications and source records attributed to H R Millar.

11 recordsLinked to original sources
PubMed2001

Season of birth in females with anorexia nervosa in Northeast Scotland.

OBJECTIVE: To determine whether patients with anorexia nervosa exhibit an abnormal pattern in their season of birth. METHOD: Case records of female patients presenting to secondary services in Northeast Scotland from 1965 to 1997 who received a clinical diagnosis of anorexia nervosa were examined. The months of birth of the 446 anorexic patients with a confirmed diagnosis were compared with 5,766 female control subjects born locally in 1951, 1961, 1971, and 1981. RESULTS: Patients with anorexia nervosa had an excess of births in the first 6 months of the year (p =.013). The greatest excess was from March to June. DISCUSSION: This provides further evidence that birth dates of anorexics peak in the late spring and early summer. There are parallels with the epidemiology of schizophrenia. The evidence suggests that a seasonally fluctuating factor, most plausibly an intrauterine effect of common infectious agents during the winter months, is of etiological significance.

Adult↗
PubMed1999

Changes in the presenting features of females with anorexia nervosa in northeast Scotland, 1965-1991.

OBJECTIVE: Rates of anorexia nervosa among females presenting to specialist services in northeast Scotland had increased significantly between 1965 and 1991. We sought to elucidate possible causes of this change. METHOD: Hospital and primary care records were searched. Age, weight, and body mass index (BMI) were determined for 196 patients and duration of symptoms from onset to presentation was established in 190 cases. Changes in these parameters were investigated over the 27-year period of the study. RESULTS: There was no significant change in duration of illness or in age at presentation. BMIs increased significantly, but this arose because patients decreased in height, not because they increased in weight. There was no increase in seriously underweight patients with BMIs of < or =15. DISCUSSION: Anorexic females were not referred at an earlier stage of their illness, but primary care teams may be identifying and referring milder cases. Alternatively, the findings may reflect an increasing incidence of eating disorders coupled with changes in their presenting symptomatology.

Adult↗
PubMed1997

General practice consultation patterns preceding diagnosis of eating disorders.

OBJECTIVE: To see whether patients with eating disorders consult general practitioners more frequently than control subjects and, if so, to describe the pattern of consultation. METHOD: General practitioner case record review of patients with anorexia nervosa, bulimia nervosa, and partial syndromes referred to a specialist eating disorder service. RESULTS: Seventy-eight of 100 case records were available for analysis. Eating disorder patients consulted significantly more frequently than controls over 5 years prior to the diagnosis of the eating disorder. They presented to the general practitioners with a variety of symptoms including psychological, gastrointestinal, and gynecological complaints. DISCUSSION: The findings suggest that methods could be developed to enable earlier diagnosis of eating disorders in general practice. This will enable the earlier application of effective treatments with the prospect of improved outcome.

Adolescent↗
PubMed1995

Increasing incidence of anorexia nervosa in the female population of northeast Scotland.

OBJECTIVE: The aim of the study was to determine whether there has been an increase in the incidence of anorexia nervosa in the female population in the northeast of Scotland since the 1960s. METHOD: Standardized diagnostic criteria were applied to the case records of female subjects who had been diagnosed as suffering from anorexia nervosa and had presented for the first time to psychiatric services between 1965 and 1991 or had been admitted for the first time to a general hospital between 1970 and 1991. Age-standardized annual incidence rates were calculated from 1965 through 1991. As a broad measure of severity, the weights of patients in 3 early years of the study, 1970-1972, were compared with those of patients in the last 3 years, 1989-1991. RESULTS: Over the 27-year period studied, 287 patients received confirmed diagnoses of anorexia nervosa, and the mean annual increase in incidence was 5.3%. The rate of increase was highly statistically significant. Comparison of weights at presentation showed a trend for patients presenting in 1970-1972 to be lighter than those presenting in 1989-1991. CONCLUSIONS: Rates of referral for female subjects with anorexia nervosa have greatly increased since the 1960s. These rates likely reflect a genuine increase in incidence, but the data suggest that less severely ill patients are now being referred.

Adolescent↗
PubMed1993

Comparison of eating disorders and other dietary/weight groups on measures of perceived control, assertiveness, self-esteem, and self-directed hostility.

Anorexic and bulimic patients were compared to obese dieters, nonobese dieters, and normal controls on measures of perceived control, assertiveness, self-esteem, self-directed hostility, and psychiatric caseness. The anorexic and bulimic groups both scored significantly differently in the expected direction from the other three groups on all measures. There were no significant differences between the anorexic and bulimic groups and in turn, no significant differences among the obese, nonobese dieters, and normal controls. Results are in keeping with the notion that perceived control, low assertiveness, low self-esteem, and self-directed hostility are characteristics of eating disorder patients that differentiate them from individuals who display dietary/weight features, as well as from normal controls.

Adult↗
PubMed1990

Eating disorders, perceived control, assertiveness and hostility.

There are anecdotal claims that eating disorder patients perceive themselves as highly controlled by the family and by society, but that they do not show assertive behaviour towards controllers. Anorexic and bulimic females were compared with female psychiatric patients, dieters and non-dieting controls on measures of eating disorder symptomatology, locus of control, assertiveness, inwardly directed hostility, family control and family encouragement of independence. Eating disorder patients reported significantly more external control, more inwardly directed hostility, less self-assertion and less family encouragement of independence than dieters and non-dieting controls, but they did not differ from psychiatric controls. Most of the characteristics seen in eating disorder subjects were also reported by psychiatric controls.

Adolescent↗
PubMed1985

Anorexia nervosa in Glasgow.

A case note review of referrals to psychiatrists in Glasgow for 1979-1983 yielded 122 patients. Demographic and clinical data are described and compared to findings in earlier British series. Social class distribution for the Glasgow patients was no different from that of the local general population. This finding contrasted with the upper social class bias found in earlier studies and possible reasons for this difference are discussed.

Adolescent↗
PubMed1981

Psychiatric morbidity in elderly surgical patients.

One hundred patients aged 65 and over were psychiatrically assessed before and in the first week after elective surgery. Thirteen were psychiatrically ill before operation and 21 developed post-operative illness. Post-operative confusional states (14 patients) were associated with physical complications but not with environmental or pre-operative psychiatric variables. Affective disorders either improved following successful surgery (5 patients) persisted or developed after operation in association with continuing physical illness (6 patients).

Aged↗
PubMed1977

Prevention of adverse drug interactions.

1 The awareness and recognition of adverse interactions between drugs by prescribers is low. 2 A 6-month prospective study on patients on long-term outpatient anticoagulant therapy in the Grampian area has been carried out to evaluate a simple and cheap warning system. 3 The practitioners of patients in the test group were issued with warning labels which showed drugs known to interact. A reduction in the initiation of prescriptions for potentially interacting drugs was shown between the test and control groups (no warning labels). 4 The 140 practitioners who completed the study found the system to be convenient and useful. Extension to other high-risk drugs with the potential to interact with other drugs is planned. This system has the advantage of being drug and patient-orientated whereas lists of drug interactions or drug discs require more conscious effort by the prescriber.

Barbiturates↗
PubMed1976

Methyldopa and propranolol or practolol in moderate hypertension.

The effect of a low dose of methyldopa combined with (a) a non-selective and (b) a selective beta-adrenoceptor antagonist was studied in a double-blind crossover trial in 24 carefully selected patients with moderate hypertension (mean initial lying blood pressure 189/117 mm Hg). Each patient received methyldopa 750 mg/day, propranolol 240 mg/day, practolol 600 mg/day, methyldopa 750 mg/day combined with propranolol 240 mg/day, methyldopa 750 mg/day combined with practolol 600 mg/day, and placebo for four weeks each according to a random sequence. After four weeks of therapy the most effective treatment, methyldopa combined with propranolol, reduced lying and standing blood pressures by 36-5/21-4 mm Hg and 44-7/25 mm Hg respectively. Thic combination had similar effects to those of the combination of methyldopa with the cardioselective agent practolol except that it reduced lying diastolic pressure further. The combination was more effective than either treatment alone. No significant differences were found between the effects of propranolol, practolol, or methyldopa at the doses used.

Adult↗