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Biomedical subjects

J E Overall

Publications and source records attributed to J E Overall.

At least 73 records · Page 4Linked to original sources
PubMed1988

Effects of acute alcohol intoxication on cerebral blood flow measured with PET.

Regional distribution of cerebral blood flow was assessed in a group of 13 normal social drinkers under baseline conditions and after acute alcohol intoxication. Blood flow measurements were done using 15O-labeled water and positron emission tomography (PET). Each subject underwent two control sessions under baseline conditions and two sessions after alcohol. Seven of the subjects were given 0.5 g/kg of alcohol and six were given 1 g/kg of alcohol p.o. The first and second post-alcohol scans were done 40 and 60 min after alcohol ingestion. The studies revealed that both the high and the low doses of alcohol reduced blood flow to the cerebellum. This effect was significant only for the high doses of alcohol, which also increased blood flow to the right temporal and the prefrontal cortex. The decrease in blood flow of the cerebellum could account for the muscular incoordination induced by alcohol.

Adult↗
PubMed1988

Long-term outpatient treatment of senile dementia with oral physostigmine.

The authors describe five patients with senile dementia of the Alzheimer type (SDAT) who were treated with oral physostigmine from 1 to 3 3/4 years. An abbreviated form of the Buschke selective reminding test was used to assess the patients' short-term verbal memory at periodic clinic visits. Although one of the patients deteriorated progressively from the start of the physostigmine therapy and was taken off the drug after 1 year, there was no evidence of deterioration in memory performance on the average in the other four patients. Equally important, this open trial provides evidence of the safety of long-term treatment with physostigmine on an outpatient basis. The authors view their results as supporting the potential value of cholinesterase inhibition as a means of forestalling memory decline in SDAT patients.

Administration, Oral↗
PubMed1987

Estimating sample size for longitudinal studies of age-related cognitive decline.

Cross-sectional age-group norms for cognitive tests reveal a progressive age-related decline. There is current interest in the possibility of developing interventions that forestall the normal cognitive decline in elderly adults. This raises new research design issues, one of which is the estimation of appropriate sample sizes for longitudinal studies when only cross-sectional data are presently available. Formulae for estimating change parameters from cross-sectional data are presented in this article. Based on age-related changes in cross-sectional norms for the Wechsler Adult Intelligence Scale (WAIS), the sample sizes required for controlled intervention studies of 1 to 3 years duration are very large. If cognitive decline within individuals is not as great as the decline evident in cross-sectional norms, the required sample sizes will be even larger.

Aged↗
PubMed1987

The neurobehavioural rating scale: assessment of the behavioural sequelae of head injury by the clinician.

To investigate the inter-rater reliability and validity of the Neurobehavioural Rating Scale at various stages of recovery after hospitalisation for closed head injury, we studied 101 head trauma patients who had no antecedent neuropsychiatric disorder. The results demonstrated satisfactory inter-rater reliability and showed that the Neurobehavioural Rating Scale reflects both the severity and chronicity of closed head injury. A principal components analysis revealed four factors which were differentially related to severity of head injury and the presence of a frontal lobe mass lesion. Although our findings provide support for utilising clinical ratings of behaviour to investigate sequelae of head injury, extension of this technique to other settings is necessary to evaluate the distinctiveness of the neurobehavioural profile of closed head injury as compared with other aetiologies of brain damage.

Adolescent↗
PubMed1987

Phenomenological correlates of metabolic activity in 18 patients with chronic schizophrenia.

Using [11C]-deoxy-D-glucose and positron emission tomography (PET), the authors measured brain metabolism in 18 patients with chronic schizophrenia to assess which of the metabolic measures from two test conditions was more closely related to the patients' differing clinical characteristics. The two conditions were resting and activation, and an eye tracking task was used. Patients with more negative symptoms showed lower global metabolic rates and more severe hypofrontality than did the patients with fewer negative symptoms. Differences among the patients were distinguished by the task: sicker patients failed to show a metabolic activation response. These findings suggest that cerebral metabolic patterns reflect clinical characteristics of schizophrenic patients.

Adult↗
PubMed1987

Computer-based monitoring of clinical care in a public psychiatric hospital unit.

A computer-based clinical monitoring system on a 40-bed university hospital psychiatric unit provides documentation to justify clinicians' diagnosis and choice of treatment and facilitates evaluation of patients' progress at scheduled intervals. The microcomputer system was developed to meet state guidelines for monitoring patients receiving neuroleptic drug treatment. A weekly status report generated for each patient alerts the treating physician to cases in which data do not justify clinical decisions, identifies potential problems, and suggests considering for discharge patients whose symptoms have sufficiently abated. The system is also useful in supervision and research.

Diagnosis, Computer-Assisted↗
PubMed1987

Comparison of alprazolam and imipramine for treatment of outpatient depression.

A 6-week double-blind comparison of the therapeutic efficacy of alprazolam and imipramine in 90 depressed psychiatric outpatients revealed a significantly superior response to alprazolam in the first 2 weeks of treatment as measured by total scores on the Hamilton Rating Scale for Depression and the Brief Psychiatric Rating Scale. Further analyses revealed that all significant differences could be accounted for by the superior effect of alprazolam on sleep disturbance. By the end of Weeks 4 and 6, no significant differences in therapeutic response between the two treatment groups were noted, with patients in both groups evidencing improvement on all measures. A differentially high dropout rate among patients in the imipramine treatment group posed a problem for interpretation of results in the latter weeks of treatment.

Adolescent↗
PubMed1987

Implications of restrictive diagnosis for compliance to antidepressant drug therapy: alprazolam versus imipramine.

Early dropouts from a double-blind comparison of the therapeutic efficacy of alprazolam and imipramine were examined. The dropout rate across the total sample of 99 analyzable outpatients with major depression was 3 times higher in the imipramine treatment group. Although essentially all patients met DSM-III criteria for major depressive episode, only two thirds of the total sample met the restrictive Feighner criteria for primary depressive disorder. Early termination in the imipramine group was concentrated in the group of depressed outpatients who failed to satisfy the Feighner criteria. Implications of these and other recently reported results for choice of drug treatment for depressed psychiatric outpatients are discussed.

Alprazolam↗
PubMed1986

The Nurses Evaluation Rating Scale (NERS).

The Nurses Evaluation Rating Scale (NERS) consists of 16 items designed to capture salient dimensions of psychopathology and nursing care requirements for psychiatric patients. Reliability and validity of the NERS were evaluated by using a total of 3,052 sets of ratings accomplished by 19 staff nurses on a total of 235 adult psychiatric inpatients. All items of the NERS were utilized in describing psychopathology in this sample of patients, although no patient was positive on all items. Factor analysis revealed four distinct clusters of items, which represented higher-order constructs of thinking disturbance, depression, anxiety, and psychomotor retardation. Test-retest reliability was found to be comparable to the reliability of most other clinical assessments of psychopathology. Scoring for the four factors was defined, and analysis of change during first 10 days of hospital stay revealed statistically significant improvement. The NERS appears to be a promising instrument for longitudinal, daily evaluations of inpatient psychopathology as seen in the routine clinical practice of psychiatric nurses.

Factor Analysis, Statistical↗
PubMed1986

Brief psychiatric rating scale for children: quantitative scoring of medical records.

The utility of the Brief Psychiatric Rating Scale for Children (BPRS-C) for transcribing narrative medical records into standard quantitative form for research purposes is examined. Three clinicians independently read and rated the records of 40 child and adolescent patients. Interrater reliabilities were adequate in most major domains of psychopathology, the one notable exception being symptoms in the anxiety domain. On the basis of these results, the BPRS-C appears appropriate for use in administrative and audit reviews, as well as in epidemiological and program evaluation research in which medical records are the primary sources of information.

Adolescent↗
PubMed1986

Reduced sensitivity of red blood cell (Na+,K+)-ATPase to ethanol in vitro in male alcoholic patients: relationship to clinical characteristics.

We examined red blood cell (Na+,K+)-ATPase, its sensitivity to inhibition by ethanol in vitro, and its relationship to clinical characteristics and history in 41 newly admitted alcoholic patients and 14 age-matched healthy controls. Sensitivity to ethanol was significantly lower in the alcoholic patients and correlated negatively with ethanol intake. In addition, sensitivity of enzyme to ethanol was lower in patients with high agitation-anxiety ratings and correlated negatively with agitation and anxiety scores on the Brief Psychiatric Rating Scale. There were no relationships between (Na+,K+)-ATPase measures and depressive symptoms, history of treatment for depression, or family history of depression. These data suggest that tolerance to the effects of ethanol on (Na+,K+)-ATPase occurs in man and may be related to the severity of ethanol dependence or withdrawal.

Adult↗