Search PubMed⌕ Search

Biomedical subjects

J E Overall

Publications and source records attributed to J E Overall.

At least 91 records · Page 5Linked to original sources
PubMed1985

Efficacy of oral physostigmine in primary degenerative dementia. A double-blind study of response to different dose level.

To examine the efficacy of cholinergic enhancement in senile dementia of the Alzheimer type (SDAT), oral physostigmine was given to eight patients in a cross-over trial of three dose levels and a matching placebo. A dose-related improvement in memory as measured by objective verbal memory tests was observed. Performance was significantly better on the highest dose, 2 mg every 2 h, than on the lower doses. The effect was most systematically present for very short-term memory, which raises the question of whether the improvement may involve attention rather than longer term storage and retrieval.

Administration, Oral↗
PubMed1985

Beta, or type II error in psychiatric controlled clinical trials.

Fifty-two reportedly "negative" psychiatric controlled clinical trials from 1980-1984 were re-examined to note if large enough samples had been studied to give a high probability (greater than 0.90) of detecting a 20% or 50% improvement in therapeutic response, defined as a reduction in the non-response rate. Forty-four of the trials had a larger than 10% risk of missing a true 20% difference in non-response rates, and with the same risk, 25 of the trials could have missed a 50% difference between treatments. Based on estimates of 90% confidence intervals, a potential 20% difference was possible for 47, and 30 had a potential true difference of 50% in non-response rates between experimental and control conditions. Far more reports describing "non-significant" studies could not be re-examined, due to lack of reporting part or all of the relevant results. The possibility of missing considerable therapeutic improvement, or important clinical differences, because of small sample size demands more concern in psychiatry.

Clinical Trials as Topic↗
PubMed1985

Reliability of rapid clinical staging of all night sleep EEG.

The recording of all night sleep EEGs on a portable cassette recorder, and the rapid visual staging of the sleep records at 20 times real time, represent innovations in sleep research methodology. The reliability of sleep stager percentages obtained in this way is examined in this article. In the first of two studies, all night sleep records for six individuals were each staged twice by each of two qualified electroencephalographers. Inter-rater and intra-rater reliability assessed by intraclass correlation methods was modest, requiring the averaging of results from two judges to reach acceptable levels. Following consistency training, the two electroencephalographers staged all night sleep records for six additional subjects. Acceptable reliability was achieved in measurement of stages 2, 3, 4 and REM, although difficulty in reliably distinguishing stage 1 from the awake stage persisted. On the basis of these results, rapidly paced visual interpretation of sleep records at 20 times real time is recommended as a feasible way of meeting demands imposed by innovations in the technology of recording sleep EEGs.

Electroencephalography↗
PubMed1985

Factor structure of the drinking behavior interview in a private inpatient treatment program.

The 32-item Drinking Behavior Interview (DBI) was administered to 103 patients newly admitted to a private, inpatient, alcohol problems treatment unit. When intercorrelations among the 32 variables were subjected to factor analysis, DBI profiles of alcoholics in this population differed primarily along four major dimensions: close interpersonal relationships, physical symptoms, societal functioning and alcohol consumption. Whereas the DBI has previously been used to define a single composite alcoholism index, these results suggest the importance of considering differences in components of the DBI profile pattern.

Alcohol Drinking↗
PubMed1985

The dexamethasone suppression test and unipolar/bipolar distinctions.

In an attempt to validate several subtypes of affective disorders, 52 consecutive patients hospitalized at a clinical research center were comprehensively classified along several diagnostic and phenomenologic axes. Cortisol levels of each patient were evaluated at baseline and after the administration of 0.5 and 1.0 mg dexamethasone. None of the depressive subtypes responded significantly differently to the 1.0 mg dose. However, the bipolar subtype was associated with significantly different DST responses to the 0.5 mg dose. Patients with bipolar affective disorder, both manic and depressed, had higher postdexamethasone mean cortisol levels than all other groups. The results support the distinctiveness of the bipolar diagnosis.

Adolescent↗
PubMed1984

The Brief Psychiatric Rating Scale (BPRS) in geropsychiatric research: I. Factor structure on an inpatient unit.

Factor analysis of symptom ratings recorded on the Brief Psychiatric Rating Scale (BPRS) for a sample of 87 geropsychiatry inpatients resulted in five relatively independent factors. The factor structure differed in two important respects from that previously observed in numerous analyses of BPRS ratings of patients from the general adult psychiatric population. The symptom of depressive mood combined with emotional withdrawal and motor retardation to define a withdrawn depression factor, whereas depressive mood has routinely evidenced greater affinity for anxiety and tension in younger adults. In addition, the unitary thinking disturbance factor that has been observed routinely in data from the younger adult psychiatric population split into separate factors of cognitive dysfunction and psychotic distortion. Construct validity of the cognitive dysfunction factor was examined with reference to an objective mental status questionnaire.

Aged↗
PubMed1984

The Brief Psychiatric Rating Scale (BPRS) in geropsychiatric research: II. Representative profile patterns.

Cluster analysis methods were used to classify Brief Psychiatric Rating Scale profiles for a sample of 88 geropsychiatric patients. Five distinct profile patterns were found to represent adequately most differences in symptom and behavior characteristics of the aged patients. The five phenomenological types are described as agitated dementia, retarded dementia, anxious depression, withdrawn depression, and paranoid psychosis. The appropriateness of this nomenclature is examined with reference to clinical diagnosis, mental status examination, and drug treatment. Prototype profile patterns that can be used to classify future geropsychiatric patients are presented, and a sequence of clinical decisions that should result in similar partitioning of the patient population is discussed.

Aged↗
PubMed1984

Effects of age and alcohol abuse on pattern reversal visual evoked potentials.

The Pattern Reversal Visual Evoked Potential (PRVEP) was recorded in normal subjects and alcoholics. The recordings were made from the patients during withdrawal and repeated after three weeks of detoxification. It was found that the N76 latency was longer in the alcoholic patient in the withdrawal phase than in the normal subjects. The latency returned to normal range after detoxification in younger alcoholic patients but did not in the older alcoholics. The age-related increase in the N76 latency in the alcoholic patients was similar to that in normal subjects but more exaggerated. For alcoholics, the age-related change in the N76 latency reached significance, but was only a trend in normal subjects. The P100 latency demonstrated significant age-related change, but far less modification related to the alcoholism than the N76 latency. It is unclear at present whether the failure of the latency to return to normal in older patients after detoxification is related to longer periods of excessive drinking, or to a particular vulnerability of the older patients to continued use of alcohol.

Adolescent↗
PubMed1984

Efficacy of nomifensine in different depressive syndromes.

Results from 11 independent double-blind placebo controlled studies of nomifensine were analyzed to assess the efficacy of the active drug vs. placebo in four depressive subtypes classified by Hamilton Depression Rating Scale profiles. Substantial nomifensine-placebo differences were seen in the anxious, suicidal, and vegetative subtypes; high rates of placebo response in the somatizing subtype resulted in nonsignificant treatment effects. Differing responses to antidepressant drugs based on phenomenologic subtypes of depression appear to merit further investigation.

Anxiety Disorders↗
PubMed1983

K-scale correction and percentile norms for MMPI-168 factor scores.

Appropriate K-corrections for MMPI-168 factor scales and for a general psychopathology screening scale (PSY) were derived empirically. Percentile distributions of the K-corrected scales in a large normal sample (N = 1438) were determined, and a percentile profile sheet was constructed to facilitate clinical use (N = 1048). The validity of the K-corrected scales in distinguishing psychiatric patients from normals is examined.

Adult↗
PubMed1983

Screening for borderline personality disorders with the MMPI-168.

Investigated the possible use of the MMPI-168 as a screening instrument for identifying individuals (N = 27) with DSM III diagnosed borderline personality disorder. Using previously reported percentile norms for bright young college graduates as a reference, borderline patients as a group fell above the 98th percentile on the F, Hypochondriasis, Depression, Hysteria, Psychopathic Deviate, Psychasthenia and Schizophrenia scales, as well as the general psychopathology scale (PSY). Additionally, the borderline sample's mean score on the Paranoia scale was above the 95th percentile, and the mean Social Introversion scale was above the 90th percentile. Almost equally distinguishing was the finding that the mean K scale score for the borderline sample fell as low as the 8th percentile for the normative college sample. These results demonstrate that the MMPI-168 response pattern of borderline patients was clearly distinguishable from the great majority of college graduates.

Adult↗