Biomedical subjects
Publications and source records attributed to J B Murray.
Tardive dyskinesia is a motor disorder, persistent, at times irreversible, a side effect of the antipsychotic medications which have been so helpful for schizophrenia; no adequate therapy for it has been developed. Research on this troublesome disorder was reviewed under the following headings: description, etiology, treatment, and prevention.
Research on psychoactive drugs: antianxiety, antidepressant, and antipsychotic was reviewed. The drug families and their usual side effects were described. Proliferation of drug use, polypharmacy, and tardive dyskinesia were seen as areas of concern; advances in biological explanations of schizophrenia and manic-depressive disorders, and increasing knowledge about the brain's neurotransmitters brightened the investigative efforts.
The radiographic demonstration of contrast medium extravasation from a rupturing intracranial aneurysm is rare. We have detected this occurrence a mere thrice in 15 years, a period in which angiography was routinely used for the investigation of subarchnoid haemorrhage. We have added these three cases to 14 others that were previously reported in the literature and summarised the total. There does not appear to be a common aetiological factor, though further experimental studies on intracaratid pressures distal to the site of injection seem to be warranted. Ventricular opacification during cerebral angiography occurred in five of the 17 cases: in our most recent case the contrast medium outlined intraventricular haematomata, a finding not hitherto reported in the literature and a feature of prognostic significance. Mortality in this series was extremely high and in excess of that usually found either with an aneurysmal re-bleed or an intracerebral haematoma or both. However, although a combination of these two lesions is notoriously hazardous, perhaps the added insult of the contrast medium extravasation is the cause for the inordinately high fatality rate. Only three of the 17 cases survived, two of whom had a significant residual neurological deficit.
Advances in physiological psychology and neuroendocrinology, together with epidemiological studies, have added new dimensions to psychosomatic research. Psychological influences still are accepted as exacerbators or trigger mechanisms, if less often as causes. Theories of psychosomatics which connected specific personality profiles with specific psychosomatic illnesses have lost favor, and multifactorial explanations, which include heredity, environment, social class, life stress, endocrines, brain areas, neurohormones, and immunological mechanisms, are new areas of research. Research methods have become more sophisticated scientifically, particularly in the selection and size of samples tested, and the variety of situations investigated. Psychological reactions to illness in general, terminal disease, and death, and psychological experiences of pain, in addition to variable effects of psychotherapeutic methods and psychotherapists' personality, are identifiable but unquantified influences which seem acceptable as contributors to, if not causes of, psychophysiological disorders.
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