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Biomedical subjects

J J Jeffries

Publications and source records attributed to J J Jeffries.

28 records · Page 2Linked to original sources
PubMed1984

Total and free plasma neuroleptic levels in schizophrenic patients.

Nineteen male patients, under 35 years of age, newly admitted with a diagnosis of schizophrenia, were treated with either chlorpromazine or haloperidol at a fixed dosage for 25 days. Both total and free plasma neuroleptic levels were measured using a radioreceptor assay. Clinical response was measured by the Brief Psychiatric Rating Scale (BPRS). On day 25, nonresponders (those with a decrease of less than 8 points on the BPRS) had both total and free plasma neuroleptic levels within the range observed in responders. It is therefore concluded that lack of therapeutic response is generally not due to inadequate plasma drug levels.

Adult↗
PubMed1984

The dexamethasone suppression test in schizophrenia.

In a study of 20 inpatients who met DSM-III criteria for schizophrenia, there was a high incidence of depressed mood (N = 14), DSM-III melancholia (N = 6) and dexamethasone nonsuppression (N = 7). This incidence of positive DSTs (serum cortisol greater than 5 micrograms/dl at 3:30 or 10:00) was significantly higher than the expected rate based on a literature review (35% vs. 4%, p less than .001). A positive DST did not result in all cases in antidepressant pharmacotherapy, nor did a negative result preclude such treatment. Hence, clinicians in the study did not "treat the DST" in the absence of clinical evidence of depression. This study is consistent with others reporting a significant proportion of depressed schizophrenics. However, some studies have claimed no differences in response to dexamethasone between nondepressed and schizophrenic patients. These findings do not support a biological basis for the RDC differentiation of primary and secondary depression and challenge the DSM-III concept of schizophrenia as excluding the diagnosis of major depression. Viewed from a different perspective, the data may support recent reports casting doubt on the specificity of the DST.

Adult↗
PubMed1984

The role of cerebral arteriovenous malformations in psychiatric disturbances: case report.

A patient is described who had congenital vascular malformation of the vein of Galen, with several psychiatric, as well as neurologic, manifestations. Prior to this patient's death, there was an increase in some psychiatric manifestations in response to suggestions of surgical therapy for the cerebral venous anomaly. Other symptoms appeared to represent direct organic effects of the lesion. The medical literature on the anomalies of the great vein of Galen reveals a frequent but not specific relationship to concomitant psychiatric manifestations.

Adolescent↗
PubMed1983

ECT as a form of restraint.

ECT is controversial as a form of therapy, with lay and psychiatric objectors. Restraint is also controversial, though often necessary. The Ontario Mental Health Act of 1978 allows the psychiatrist to restrain patients without consent if there is risk of physical danger. The act mentions "chemical and mechanical" means. ECT is not dealt with as a form of restraint. A case is described of a manic male who during 2 episodes of psychosis presented a serious threat of assault to staff. The next of kin was reluctant to sign consent for "treatment" because of fear of the patient's later resentment. An application to the Review Board for permission to treat would have taken a week. On both occasions attempts to control the patient with chemotherapy were totally unsuccessful despite the use of rapid neuroleptization, paraldehyde, barbiturates and mechanical restraints. In both admissions 4 ECT given over 2 days produced rapid behavioural control. ECT was then discontinued because the patient declined to give consent for ECT as treatment and he no longer presented a threat. Medical and legal consultation were necessary and the consensus was that ECT as restraint may be justified on the basis of clinical judgment. In such cases ECT is safer, more reliable and more humane than chemotherapy or mechanical restraints. The authors discuss the current public and professional antipathy towards ECT. There is risk of death for the patient in circumstances where legal barriers prevent the appropriate use of electro-shock and a U.S. case is mentioned.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1977

The trauma of being psychotic: a neglected element in the management of chronic schizophrenia?

A hypothesis is put forward in regards to what is called "chronic schizophrenia" that those observations which suggest a continuing disease process may turn out not to be intrinsic facets of schizophrenia as a neurochemical instability but rather neurotic reactions to the acute schizophrenic process. The hypothesis goes on to suggest that this reaction to the acute psychosis is such as to constitute a traumatic neurosis and that while controlling the psychosis with an "umbrella" of major tranquilizers, it is possible to resolve this neurosis. Resolution of the neurosis requires a particular approach to therapy. This is a hypothesis which is very much open to experimental examination and one which may, if proven, markedly affect the postpsychosis management of schizophrenia.

Adjustment Disorders↗