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Biomedical subjects

I Marks

Publications and source records attributed to I Marks.

134 records · Page 8Linked to original sources
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Can opiate addicts tell us about their relapse risk? Subjective predictors of clinical prognosis.

Given the high relapse rate of opiate addicts following detoxification, it is pertinent to identify whether any subjective variables mediate outcome, since these may then be targets of treatment. The present study assessed personality, cue-elicited craving, outcome expectancies for drug use, and self-efficacy for resisting drug use, in 43 opiate addicts receiving inpatient detoxification in either a specialist drug-dependence unit or a behavioral/general psychiatric ward, within the context of a randomised, controlled-treatment trial. Subjects were followed-up at between 1 and 3 months and again at 6 months after discharge. Frequency of drug use was not predicted by any of the subjective variables at the first follow-up; but at 6 months, subjects with lower self-efficacy and higher positive outcome expectancies were found to be using less often. Latency to first lapse was greater in subjects with higher anxiety and neuroticism scores. Precipitants to the first lapse were identified, but none of the predicted relationships between subjective variables and circumstances of lapse emerged. It is suggested that greater awareness of personal vulnerability may promote effective coping strategies.

Adult↗
PubMedDate not supplied

Adult gender identity disorder can remit.

A 4-year remission in a case of gender identity disorder (GID in DSM-IV, previously termed transsexualism) plus obsessive-compulsive disorder (OCD) prompted a search for further similar cases. Reports were reviewed for apparent remissions in adult GID. GID and paraphilias may wax and wane. This fluctuation can be in tandem with that of comorbid psychopathology or in response to sexual and other life events. Remission has been documented at up to 10 years. If evaluated over many years, GIDs and paraphilias can be less fixed than is often thought. The frequency of permanent remission may be underestimated, as such subjects may not consult clinicians. Implications for the clinician are that such subjects require a long trial period of cross-gender living prior to any surgical interventions.

Adult↗
PubMedDate not supplied

Family and past history of mental illness as predisposing factors in post-traumatic stress disorder.

BACKGROUND: Family studies of post-traumatic stress disorder (PTSD) have given inconsistent results to date. Identifying predisposing factors in PTSD compared to anxiety disorders may help to clarify the classification of PTSD as a diagnostic entity. METHOD: Retrospective case note study of 87 PTSD patients who participated in an RCT, and 51 PTSD patients and 87 agoraphobics treated routinely in outpatients. RESULTS: Compared to agoraphobics, PTSD patients had significantly less family history of anxiety disorder but not mental illness in general. They also had significantly less personal history of mental illness prior to the index episode. CONCLUSIONS: Trauma precipitated PTSD in subjects who had significantly fewer premorbid predisposing factors than did agoraphobics. Such factors may predispose agoraphobics to become psychiatrically ill after more minor trauma. Research is needed to systematically compare the events which precipitate PTSD as opposed to agoraphobia and other anxiety disorders.

Adult↗