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Biomedical subjects

J B Williams

Publications and source records attributed to J B Williams.

At least 145 records · Page 8Linked to original sources
PubMed1989

Self-defeating personality disorder and DSM-III-R: development of the diagnostic criteria.

One of the major controversies during the development of DSM-III-R was the possible inclusion of self-defeating personality disorder. The authors review the clinical literature that serves as the conceptual basis for this diagnosis. The development of the diagnostic criteria is described, including the rationale for specific criteria and the objections raised by opponents of the category. The authors describe how some of these objections led to changes in the diagnostic criteria in an attempt to distinguish self-defeating personality disorder from normal reactions to victimization and abuse.

Female↗
PubMed1989

Psychotic disorders in DSM-III-R.

The authors review the important changes in the three sections of DSM-III-R that include only psychotic disorders (schizophrenia, delusional disorder, and psychotic disorders not elsewhere classified), outline the rationale for these changes, and, where available, review their empirical basis. In addition, they review two proposed changes that were not incorporated into DSM-III-R. They conclude by calling for an increasingly rigorous and data-based process of nosologic revision.

Adult↗
PubMed1988

A structured interview guide for the Hamilton Depression Rating Scale.

The Hamilton Depression Rating Scale (HDRS) is the most widely used scale for patient selection and follow-up in research studies of treatments of depression. Despite extensive study of the reliability and validity of the total scale score, the psychometric characteristics of the individual items have not been well studied. In the only reliability study to report agreement on individual items using a test-retest interview method, most of the items had only fair or poor agreement. Because this is due in part to variability in the way the information is obtained to make the various rating distinctions, the Structured Interview Guide for the HDRS (SIGH-D) was developed to standardize the manner of administration of the scale. A test-retest reliability study conducted on a series of psychiatric inpatients demonstrated that the use of the SIGH-D results in a substantially improved level of agreement for most of the HDRS items.

Depressive Disorder↗
PubMed1988

Having a dream. A research strategy for DSM-IV.

Psychiatric research has had a major impact on both DSM-III and its revision (DSM-III-R). We propose a strategy to maximize the impact of psychiatric research on DSM-IV. This strategy is an elaboration of a study design that was particularly helpful in developing criteria for several of the problematic diagnostic categories of DSM-II-R. The strategy, called a "multiplex study design," employs (1) multiple collaborating centers, (2) multiple experts in the diagnoses being studied at each site, and (3) multiple diagnostic criteria sets so that alternative definitions of disorders can be compared in terms of (4) multiple external validity criteria, such as familial aggregation, course, and differential response to treatment. This strategy is a particularly efficient method for providing an empiric base for further revisions in our official classification of mental disorders.

Autistic Disorder↗
PubMed1988

The relationship of serotonin to depression in Parkinson's disease.

We have previously reported a correlation between depression in patients with idiopathic Parkinson's disease and decreased concentrations of the cerebrospinal fluid content of the serotonin metabolite, 5-HIAA. To further examine this relationship, we repeated the study in a new cohort of patients while they remained on dopaminergic medications, conducted follow-up interviews and examinations in our original cohort, and conducted an open trial of the serotonin precursor, 5-hydroxytryptophan in a group of new patients with depression. We were again able to demonstrate a significant reduction in cerebrospinal 5-HIAA in depressed patients in comparison to controls and patients without depression. Demented patients with Parkinson's disease, particularly those with concurrent depression, had the lowest values of 5-HIAA. No new cases of depression occurred in our original cohort after 2 1/2 years of follow-up, and depression remitted following conventional or experimental treatment in four patients. Depression improved in six of the seven new patients following oral 5-hydroxytryptophan. Three of these patients allowed a repeat lumbar puncture, and the concentration of 5-HIAA increased following 5-hydroxytryptophan. These three studies support our hypothesis that depression in idiopathic Parkinson's disease is associated with a reduction in brain serotonin. However, it also suggests that other factors, biological or environmental, may be causal factors.

5-Hydroxytryptophan↗
PubMed1988

Revised diagnostic criteria and a new structured interview for diagnosing anxiety disorders.

In recent years there has been a growing interest in the diagnosis and treatment of Anxiety Disorders. A fundamental assumption of the newer treatments is the identification of specific subtypes of Anxiety Disorders. Although the DSM-III classification of Anxiety Disorders is widely accepted, research experience since its publication in 1980 has identified many problems with the classification and diagnostic criteria for the individual Anxiety Disorders. This paper discusses these problems and solutions proposed by an advisory committee to the American Psychiatric Association Work Group to Revise DSM-III. This paper also describes a new structured diagnostic interview that can be used to make the DSM-III-R Anxiety Disorders diagnoses in adults: the Structured Clinical Interview for DSM-III-R (SCID). The revised DSM-III-R criteria are embedded in this interview, which is modelled on the clinical diagnostic interview. Amongst the problems found in the DSM-III is that of multiple diagnoses and hierarchies. Although multiple diagnoses are encouraged where appropriate, the classification is organized hierarchically so that more pervasive disorders exclude the additional diagnosis of syndromes considered symptomatic of the more pervasive disorder. The exclusion criteria for the various disorders, which operationalize this hierarchical structure, have been criticized on various grounds, and research data on the concurrence of different syndromes suggest that the revision of DSM-III might do well to eliminate some of the diagnostic hierarchies that prevent the joint diagnosis of different syndromes. Revisions that address these concerns are proposed in the exclusion criteria for most of the Anxiety Disorders. Revisions are also proposed in the inclusion criteria for several of the Anxiety Disorders, based upon clinical and research experience with the DSM-III criteria since its publication.

Agoraphobia↗
PubMed1988

Comparison of the fractionation and assay of domestic duck and fowl pituitary gonadotrophins.

1. Pituitary glycoproteins from domestic ducks and fowls were fractionated to separate luteinising hormone (LH) and follicle stimulating hormone (FSH) activities using the same chromatographic steps. 2. Fractions were bioassayed for LH using the release of progesterone from fowl granulosa cells and for thyroid stimulating hormone (TSH) by measuring the release of thyroxine in 3-d-old chicks. Follicle stimulating hormone activity was measured either in a cockerel-testes radioreceptor assay or by the release of oestrogen from cultured rat Sertoli cells. 3. Fractions containing predominantly FSH or LH activity were isolated from the fowl glycoproteins. Duck gonadotrophin did not occur in fractions corresponding to those containing fowl FSH. 4. Duck gonadotrophin was found in a fraction corresponding with the most highly purified fowl LH fraction. A duck LH fraction was found with little FSH activity for which there was no corresponding fowl LH fraction. 5. It is concluded that domestic fowl and duck gonadotrophins have different chromatographic properties. Further study is required to determine whether the purified duck gonadotrophin preparation comprises proteins with similar physico-chemical properties but with separate FSH and LH biological activities.

Animals↗
PubMed1988

Combined Escherichia coli and Staphylococcus aureus thyroid abscess in an asymptomatic man.

Patients with acute suppurative thyroiditis usually have pain or tenderness in the anterior part of the neck associated with erythema and dysphagia. An elderly man with none of these symptoms presented with fever and a urinary tract infection. When his systemic infection failed to respond to antibiotics, a search for an occult abscess was undertaken. An 111Indium leukocyte scan indicated a localized abscess in the right lobe of his thyroid from which Escherichia coli and Staphylococcus aureus coagulase positive were isolated. This case demonstrates that a thyroid abscess can occur in a completely asymptomatic patient without a clinically enlarged thyroid.

Abscess↗
PubMed1988

DSM-III-R criteria for posttraumatic stress disorder.

The authors describe the changes in DSM-III criteria for posttraumatic stress disorder (PTSD) that have been included in DSM-III-R. DSM-III-R includes specification of generic characteristics of traumatic stressors, clearer organization of symptoms around three dimensions of stress response (reexperiencing, avoidance and numbing, and physiological arousal), inclusion of symptoms specific to children, and specification of onset and duration of the disorder. The importance of these changes in the evolution of the diagnosis of PTSD is discussed.

Adolescent↗
PubMed1988

The DSM-III-R personality disorders: an overview.

The revision of DSM-III (DSM-III-R) includes substantial changes in the axis II personality disorders. The authors present and critically review these revisions and suggest directions for further research. The issues discussed include the multiaxial system, the use of a categorical rather than a dimensional format, the change from monothetic to polythetic criteria sets, the reduction in overlap among criteria sets, the decrease in the amount of unnecessary inferential clinical judgment required to make diagnoses, and the addition of two new personality disorders in an appendix. The criteria sets for many of the DSM-III personality disorders were also substantially revised in DSM-III-R. Changes in each of these are discussed in turn.

Humans↗
PubMed1987

Assessment of retinoid-induced differentiation of F9 embryonal carcinoma cells with an enzyme-linked immunoadsorbent assay for laminin: statistical comparison of dose-response curves.

A convenient procedure, using enzyme-linked immunoadsorbent assay of laminin, to measure retinoid-induced F9-cell differentiation into parietal endoderm was developed. Dose-response curves were fitted with the Allfit program, a statistical method for the analysis and simultaneous comparison of sigmoidal curves, which has been modified for use with a microcomputer. The procedure was standardized with respect to time of retinoid incubation, time-course of laminin production, effects of dibutyryl cAMP, and nature of individual dose-response curves. Retinoic acid produced a half-maximal response at 1.3 nM. Retinol was 175-fold less potent than retinoic acid and required 72 h to effect a maximum response, in contrast to 48 h for retinoic acid. Six oxidized and/or isomerized metabolites of retinoic acid, including 13-cis-retinoic acid, were less potent than retinoic acid, but were more potent than retinol. The dose-response curves had identical slopes with the exception of those obtained with 13-cis-4-oxo- and 4-oxo-16-hydroxyretinoic acids, the only metabolites tested with two structural alterations relative to retinoic acid. Multiple functional group alterations were synergistic in deactivating retinoic acid. The synthetic retinoids 13-cis-N-ethylretinamide and 4-hydroxyphenylretinamide and the steroid hormone 1,25-dihydroxycholecalciferol were inactive.

Animals↗
PubMed1987

A field trial of DSM-III-R psychoactive substance dependence disorders.

The authors field-tested proposed criteria for diagnoses of psychoactive substance use disorders in the revision of DSM-III (DSM-III-R) and compared them with DSM-III criteria in a treated group of 83 patients. They found a high level of agreement between the diagnostic systems in rates of diagnosis and in the individuals receiving the diagnosis. The greatest cross-system agreement occurred when the minimum number of symptoms required to make the DSM-III-R diagnosis was set at three. Discrepant diagnoses between systems related to removal of social consequences as a requirement for the DSM-III-R diagnoses, less emphasis on physiological tolerance in DSM-III-R, and disagreement in subjects with mild symptoms.

Adult↗