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Biomedical subjects

J L Woolston

Publications and source records attributed to J L Woolston.

At least 19 recordsLinked to original sources
PubMed2000

School-based HIV prevention. A promising model.

This article explores connections between the mental health and educational systems by profiling the Redefining Actions and Decisions (RAD) curriculum, a theory-based, developmentally informed HIV education program for middle and high schools. RAD was developed by Deborah R. Schoeberlein and evaluated by Dr. John Brett. RAD's public health approach, which has gained considerable attention at the national level, argues that HIV prevention, either through risk-abstinence or risk-reduction techniques, is an appropriate strategy for safeguarding community health.

Acquired Immunodeficiency Syndrome↗
PubMed1999

Case study: carbamazepine treatment of juvenile-onset bipolar disorder.

The literature devoted to juvenile-onset bipolar disorder has rapidly expanded in the past 5 years with an emphasis on new concepts of prevalence and comorbid conditions. In the process of enlarging the knowledge base about the phenomenology of juvenile-onset bipolar disorder, this new literature has generated considerable controversy but has provided little information about pharmacotherapy. In the following case series, carbamazepine appeared to be a safe and effective treatment for juvenile-onset bipolar disorder. Controlled studies are necessary before any definitive conclusions can be reached about the efficacy of carbamazepine in the treatment of this form of bipolar disorder.

Adolescent↗
PubMed1999

Case study: missed diagnosis and mistreatment of unrecognized comorbid Graves disease.

Comorbid medical conditions are known to complicate the course and treatment of psychiatric disorders. This case study provides the first published report of Graves disease exacerbating the symptoms of Tourette's disorder and attention-deficit hyperactivity disorder (ADHD). The lack of diagnosis of the Graves disease compromised the efficacy of the treatment of Tourette's disorder and ADHD. This case study supports the need to the consider increased risk of a second immunoendocrinological disorder in the presence of diabetes mellitus type I, one of the several disorders that comprise the syndrome of polyglandular autoimmune endocrinopathy type II.

Attention Deficit Disorder with Hyperactivity↗
PubMed1998

Intensive, integrated, in-home psychiatric services. The catalyst to enhancing outpatient intervention.

The authors introduce the Yale Intensive In-Home Child and Adolescent Psychiatric Service, a model of home-based care for children with severe psychiatric disturbances. This model synthesizes the principles and method of the wrap-around paradigm and in-patient child psychiatric practice within the reality of the managed care system. A clinical team, under the direct supervision of a child psychiatrist, works directly within the family to understand and address the multilevel transactions that have affected the child's ability to function in various domains and resulted in recommendations for intensive intervention, including psychiatric hospitalization. This article suggests that if the psychiatrist is to provide the highest level of care, cognizance of and involvement in the child's ecology are as essential for the child and adolescent psychiatrist as other aspects of the child's world and life. In the days of ever shortening patient lengths of stay, this model of care offers promise for both clinical and fiscal effectiveness.

Adolescent↗
PubMed1994

Clozapine in the treatment of a young adolescent with schizophrenia.

Although recent reports have suggested that clozapine may be efficacious in the treatment of adolescents with schizophrenia, few studies have examined the use of clozapine in patients younger than 17 years of age. We describe highly successful trials of clozapine conducted in a 13-year-old girl and her cousin, both of whom developed severe symptoms of schizophrenia, which were refractory to neuroleptic medication, at the ages of 11 and 13 years, respectively. The pharmacology of and clinical experience with clozapine are reviewed.

Adolescent↗
PubMed1991

The boundaries of attention deficit disorder.

This report examines distinctions and interrelationships among attention deficit disorder (ADD) and two closely related conditions: learning disability (LD) and oppositional/conduct (O/C) disorder. To evaluate our hypothesis that some of the difficulty in resolving the relationship between ADD and, particularly, O/C may reflect the consequences of selective referral patterns, we studied groups of children diagnosed as ADD from different referral sources. Results suggest that referral bias does exist and that children referred to mental health settings differ from those referred to pediatricians, child neurologists, or psychologists. Because of the nature of the subjects referred to mental health services, nonrepresentative associations may emerge. Rather than being considered as prototypical of all children with attention disorder, children referred to mental health facilities may represent simply an extreme of the continuum of ADD. Evidence suggests that many children with ADD will be represented by those referred primarily for attentional deficits and learning problems, rather than those with inattention, hyperactivity, or aggression referred for child psychiatric evaluation.

Adolescent↗
PubMed1990

Fluoxetine treatment of children and adolescents with Tourette's and obsessive compulsive disorders: preliminary clinical experience.

Fluoxetine hydrochloride is the first selective serotonin uptake inhibitor introduced commercially in the United States. This report describes preliminary clinical experience with fluoxetine in 10 children and adolescents, aged 8 to 15 years, with primary obsessive compulsive disorder (OCD) or Tourette's syndrome (TS) plus OCD. In general, fluoxetine, which was administered from 4 to 20 weeks at a dosage of 10 or 40 mg per day, was well tolerated. Adverse effects included behavioral agitation/activation in four patients and mild gastrointestinal symptoms in two patients. No abnormalities were noted in the seven children who had follow-up EKGs. Five of the 10 patients (50%) were considered responders; their obsessive-compulsive symptoms decreased substantially during treatment with fluoxetine. Responder rates were similar in the primary OCD (two of four, 50%) and TS + OCD (three of six, 50%) groups. In conclusion, short-term fluoxetine administration appears to be safe in children and adolescents. Placebo-controlled trials are needed to further assess the efficacy of fluoxetine.

Adolescent↗
PubMed1990

The role of advanced technology in inpatient child psychiatry: leading edge or useful aid?

New technology has played a catalytic role in advancing understanding of etiology, diagnosis, and treatment in virtually all fields of medicine. Child psychiatry, a relatively new medical specialty, has begun to employ such advanced technology in diagnosis and treatment monitoring. This current study demonstrates that, in an inpatient child psychiatric setting, such advanced technology has a positive diagnostic yield of 5% for new medical diagnoses and a cost of about 0.5% of the hospital bed cost. Other tests, such as psychotropic blood level monitoring and psychometric evaluation of cognitive functioning, have a much higher yield.

Adolescent↗
PubMed1989

Transactional risk model for short and intermediate term psychiatric inpatient treatment of children.

The transactional model provides a novel guide for the psychiatric hospital treatment of children by improving the attunement between the child and his or her important interpersonal environment. Since children's development is highly context dependent, generalization of the gains made in the hospital will largely depend upon how well the child's parents and school can internalize the hospital experience. One method to implement this transactional model is to bring the child's parents and school into the hospital to join the child's treatment team.

Child↗
PubMed1989

Fluoxetine overdose in an adolescent.

The response to and management of an acute ingestion of a large quantity of fluoxetine hydrochloride in a 13-year-old boy with Tourette's syndrome and obsessive compulsive disorder is described. The patient's symptomatic course following the ingestion included a grand mal seizure, depressed ST segments on EKG, nausea, dizziness, and headache. In general, the fluoxetine was well tolerated: all of the symptoms and signs remitted spontaneously.

Adolescent↗
PubMed1989

Childhood comorbidity of anxiety/affective disorders and behavior disorders.

Considerable data have been reported concerning comorbidity of various individual psychiatric disorders in children within the diagnostic supradomains of affect/anxiety disorders and behavior disorders as well as between these supradomains. To further examine such comorbidity, 35 psychiatrically hospitalized children were studied in terms of the prevalence of comorbidity, demographic and cognitive characteristics, adaptive functioning and maladaptive behaviors. The prevalence of comorbid behavior + affect/anxiety disorders exceeded 50% of the samples. Children with such comorbidity were similar to children with Behavior only diagnoses in terms of demographic and cognitive characteristics but differed in terms of adaptive functioning and maladaptive behaviors.

Anxiety Disorders↗