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Biomedical subjects

I W Miller

Publications and source records attributed to I W Miller.

51 records · Page 3Linked to original sources
PubMed1986

Stroke: morale, family functioning, health status, and functional capacity.

Twenty-two stroke patients and their spouses were studied. All patients were living at home and had had a stroke at least one year previously. Of the 22 patients 14 were men and eight were women. Couples were assessed on the variables of morale, family functioning, health status, and patient functional capacity. For all variables, patient-spouse and husband-wife differences were tested. Couples from a previously studied random community sample were matched to the stroke couples on age and socioeconomic status (SES). Identical morale, family functioning, and health status data collected on these couples were compared to the stroke data. The results included the following: Stroke patients and their spouses were healthy on all variables. Members of the couple did not differ on most variables whether compared as husband-wife or patient-spouse. Wives from the two samples did not differ on any variable. Husbands from the stroke sample differed from the matched husbands on only one health variable--the number of doctor visits made in the past six months.

Activities of Daily Living↗
PubMed1986

Psychosocial characteristics of "double depression".

Thirty-nine patients with "double depression" (major depression and dysthymia) were compared to 38 patients with recurrent major depression without dysthymia on a number of severity of illness, psychosocial, and biological variables. No significant differences were found on any psychosocial or biological measure.

Adult↗
PubMed1985

MMPI, personality dysfunction and the dexamethasone suppression test in major depression.

In this study we examined the relationship of psychopathology and personality dysfunction to neuroendocrine functioning. MMPI profiles were examined for 30 psychiatric inpatients with major depression who were suppressors (60%) and nonsuppressors (40%) on the dexamethasone suppression test. There were no differences between suppressors and nonsuppressors on any of the MMPI scales or on DSM-III Axis-II diagnosis. When subdivided according to T-score elevations above 70 on MMPI scales 4 and 6, or 4 and 9, 30% of the sample, however, met criteria for personality dysfunction. Furthermore, a significantly higher proportion of suppressors (50%) evidenced personality dysfunction than did the nonsuppressors (8%). This suggests that certain MMPI scales are able to identify a subgroup of depressed patients with personality disturbances who also have a hypothalamic-pituitary-adrenal dysfunction.

Adult↗
PubMed1985

The Modified Hamilton Rating Scale for Depression: reliability and validity.

While the Hamilton Rating Scale for Depression (HRSD) has been the standard instrument for the assessment of the severity of depression for many years, this scale has a number of limitations. We developed the Modified Hamilton Rating Scale for Depression (MHRSD) to overcome some of these limitations and to enable paraprofessional research assistants to make reliable and valid assessments of depressive symptoms. The present study investigates the reliability and validity of the MHRSD. Interrater reliability among paraprofessional research assistants was excellent. The relationship between the MHRSD and expert clinician ratings on the MHRSD and the original HRSD was also high. Thus, the MHRSD appears to be a useful addition to the clinical researcher's assessment battery.

Adolescent↗
PubMed1977

The role of alienation in mental hospitalization.

A scale that assesses alienation was constructed from seven previously reported scales and administered to 74 psychiatric inpatients for whom behavioral and demographic data also were compiled. Factor analysis of alienation items yielded no major factors, which suggests that the construct is not unitary. A rotated factor matrix of alienation scores and behavioral and demographic variables showed that alienation does not account for a major proportion of variance in life history variables or current interpersonal functioning. Regression analysis indicated that alienation scores were predicted poorly from other variables. Moreover, alienation scores were poor predictors of length of hospitalization, which indicates that alienation has little power to account for relative severity of deviance.

Adult↗
PubMedDate not supplied

Compounded depression and family functioning during the acute episode and at 6-month follow-up.

Thirty-seven inpatients with pure major depression were compared with 41 inpatients with compounded depression (major depression with coexistent axis I, II, and/or III disorders) to assess the impact of the patients' illness on their families. Families of patients with compounded depression had worse family functioning (especially in their ability to solve problems and in maintaining acceptable standards of behavior), both during the acute depressive episode and at 6-month follow-up. A significantly smaller percentage of patients with compounded depression had recovered by 6 months (28%) than those with pure depression (51%).

Adaptation, Psychological↗
PubMedDate not supplied

Treatment response of high cognitive dysfunction depressed inpatients.

A sample of depressed inpatients was subdivided according to their initial levels of cognitive dysfunction. These high cognitive dysfunction (HCD) patients and low cognitive dysfunction (LCD) patients received either pharmacotherapy or combined pharmacotherapy plus cognitive-behavioral psychotherapy. Treatments began in the hospital and continued for 20 weeks on an outpatient basis. Results indicated that HCD patients had significantly better treatment response to the combined treatment than pharmacotherapy alone, while LCD patients responded equally to pharmacotherapy alone and combined treatment.

Adult↗
PubMedDate not supplied

Prodromal and residual symptoms in bipolar I disorder.

The objective of the current study was to better understand the nature of prodromal and residual symptoms of mania and depression, as reported by patients with bipolar I disorder and their family members. Prodromal and residual symptoms of mania and depression were elicited from 74 patients with bipolar I disorder. In 45 cases, an adult family member provided similar information. Three clinicians classified the symptoms into six broad categories: behavioral, cognitive, mood, neurovegetative, social, and other. The clinicians also categorized symptoms as typical or idiosyncratic. Seventy-eight percent of the patients reported prodromal depressive symptoms and 87% reported prodromal manic symptoms; greater than half of the patients disclosed residual symptoms of depression (54%) and mania (68%). Within each of these four illness categories, cognitive symptoms were consistently the most common symptoms reported by patients. A substantial number of symptoms were idiosyncratic, particularly those reported for residual depression. Agreement between patient and family members on reported symptoms was strong for the prodromal phase of both polarities, but less so for the residual phases. These preliminary results suggest that patients with bipolar I disorder and their family members can identify prodromal and residual symptoms, that these symptoms are quite common, and that prodromal symptoms may be more prevalent or easier to identify than residual symptoms. Cognitive symptoms were consistently the most common symptoms reported by patients.

Adult↗
PubMedDate not supplied

Family functioning and suicidality in depressed adults.

This study examined the association between suicidality, family factors, and clinical and diagnostic variables in depressed adult inpatients. The subjects were 121 depressed adult inpatients living with a family member or significant other. Demographic, clinical, and diagnostic information about the patient, and subjective and observer ratings of family functioning were obtained. Trained interviewers rated families of suicidal depressed patients as more dysfunctional than families of patients with no history of attempted suicide. In a logistic regression model, earlier age of depression onset, number of psychiatric hospitalizations, and objectively rated poorer family communication were associated with a history of a prior suicide attempt. Also, modest evidence suggested that patients with a prior suicide attempt perceived their families as more dysfunctional than did their respective family members. Variations in family functioning are associated with different degrees of suicidality. However, prospective longitudinal designs would elucidate the causal relation between family dysfunction and suicidal behavior.

Adult↗