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Biomedical subjects

J M Kane

Publications and source records attributed to J M Kane.

At least 163 records · Page 9Linked to original sources
PubMed1985

Compliance issues in outpatient treatment.

Estimated compliance rates of 40 to 50% are common among psychiatric outpatients. Likely noncompliers in the acute phase of illness include manic patients, paranoid schizophrenics, and the profoundly depressed. Noncompliance during the long-term prophylactic or maintenance treatment phase tends to increase with the passage of time. The cause of noncompliance is multifactorial. The use of long acting parenteral neuroleptic agents may help decrease the incidence of noncompliance, although documentation is difficult to obtain. Because of the risk of tardive dyskinesia, the lowest possible dose of the depot medication should be used. Studies are now under way to ascertain minimal effective doses necessary to prevent relapse and minimize adverse effects.

Adult↗
PubMed1985

Dexamethasone suppression tests in patients with obsessive-compulsive disorder.

Obsessive-compulsive disorder and major depressive disorder are associated by several lines of evidence. To explore the possible relationship between the two disorders, the authors administered 1-mg dexamethasone suppression tests to 18 patients with obsessive-compulsive disorder and 51 patients with major depressive disorder. None of the obsessive-compulsive patients were classified as nonsuppressors on the basis of a 4:00 p.m. serum cortisol level, whereas 37% of the depressed patients were nonsuppressors. The mean cortisol levels of the two groups differed significantly. Factors that may influence hypothalamic-pituitary-adrenal function, such as age, depressive symptoms, and severity of illness, are discussed in light of these results.

Adolescent↗
PubMed1985

Psychotic syndromes in epilepsy.

Claims have been made that epilepsy is associated with both brief psychotic episodes and persistent psychotic states. The existence of brief, nonconfusional psychotic episodes in epilepsy has received some formal support; these may be a function of temporal lobe subictal activity. Persistent psychosis is found in about 7% of patients with epilepsy; independent evidence indicates this to be a significant association. Temporal lobe seizure activity, again probably acting subictally, may be involved in the pathogenesis of these states, perhaps in interaction with other factors. Occurrence of psychotic syndromes in epilepsy may be relevant to kindling, atypical psychoses unrelated to epilepsy, and the psychotropic effect of carbamazepine.

Brain↗
PubMed1985

Variables affecting pure tone and speech audiometry in experimentally simulated hearing loss.

Previous studies have found that subjects simulating hearing losses can provide information which is useful to audiological clinicians when patients produce exaggerated hearing levels with no apparent organic aetiology. Two groups of normally-hearing subjects were used, designated unsophisticated or sophisticated in audiometric testing. Each subject was instructed to feign any amount of hearing loss in both ears prior to carrying out pure tone and speech audiometry using monosyllabic speech material. A number of variables was studied to identify factors influencing success or failure in simulating hearing loss and to investigate strategies used by the subjects. Analysis of the audiometric results revealed no typical degree of hearing loss for tones or speech. The majority of the subjects simulated sensori-neural pure tone losses with flat audiometric configuration. Approach mode, ascending or descending, had no significant effect on simulated tonal threshold. Four strategies for simulating a loss were identified. A fair degree of test/retest reliability in hearing loss for speech and tones was observed. Large discrepancies in hearing loss for speech and tones were recorded with the hearing loss for tones typically in excess of that for speech. Responses during speech audiometry showed a high occurrence of 'no response' errors. No significant differences were recorded between the sophisticated and unsophisticated groups, except in the pattern of response during speech audiometry, when the sophisticated subjects gave significantly fewer correct responses and 'no response' errors.

Adult↗
PubMed1985

Personality and experimentally simulated hearing loss.

Previous studies have suggested that personality factors may affect responses of the normally hearing and those with organic or non-organic hearing losses in audiological assessments. Audiometrically naive (n = 15) and sophisticated (n = 15) subjects who took part in a study of experimentally simulated hearing loss completed the Eysenck Personality Inventory in order that the relationship between personality dimensions and responses on audiometric tests could be investigated for all subjects and for males and females separately. The finding that more anxious males were less able to match pure tone losses with losses for speech suggests that differences in responses of male and female subjects to audiometric tests should be investigated, particularly in view of the preponderance of male subjects in studies of nonorganic hearing loss. A relationship between extraversion and correct speech responses on retest for the sophisticated subjects was thought to reflect abandonment of their strategies in the difficult task of matching hearing loss for speech with that for pure tones. No discernible trends were evident from the remaining analyses.

Adolescent↗
PubMed1985

Antipsychotic drug side effects: their relationship to dose.

The risk of adverse side effects of neuroleptic agents must be considered carefully in the treatment of acute and long-term psychotic states. Consequences should be assessed by analysis of dose-response relationships, risk factors, and central nervous system (especially extrapyramidal) side effects, as well as the influence of neuroleptics on neurotransmitter systems. Appropriate minimum dosages of neuroleptics must be further evaluated as an effective measure in reducing these side effects.

Agranulocytosis↗
PubMed1985

Neuromuscular effects of monoamine oxidase inhibitors.

The MAOI drugs produce neuromuscular effects at therapeutic and toxic doses when given alone or in combination with other drugs. These effects range from muscle tension and twitches to forceful myoclonic jerks. These effects may also be a part of a more pervasive toxic syndrome that includes autonomic and mental symptoms as well. There is some evidence that serotonergic mechanisms play a role in mediating the neuromuscular effects of MAOIs. The authors have hypothesized that MAOIs produce a condition of heightened neuromuscular excitability due to a combination of increased serotonergic tone and central disinhibition of alpha-motoneuron mediated spinal activity. Further study is needed in which objective pharmacologic and neurophysiologic measures are used.

5-Hydroxytryptophan↗
PubMed1984

Effect of daily dose of chronic haloperidol and chronic apomorphine on behavioral hypersensitivity in the rat.

Behavioral hypersensitivity in the rat consisting of increased dopamine-mediated stereotypic behaviors has been found to follow a 10-day course of treatment with the neuroleptic haloperidol as well as with the direct dopamine agonist apomorphine. The daily dose versus response relationship for chronic haloperidol indicates that a threshold daily dose exists and that behaviors increase with increasing daily dose. On the other hand, low rather than high daily doses of chronic apomorphine induce behavioral hypersensitivity and the response decreases with increasing daily dose. Prolonged functional denervation of striatal postsynaptic dopamine receptors by either neuroleptic blockade or autoreceptor stimulation may explain these findings. The results may help elucidate the relative risk of daily neuroleptic dose on tardive dyskinesia development and indicate a possible mechanism for chronic agonist-associated side effects like L-Dopa dyskinesias.

Animals↗
PubMed1984

Methylphenidate challenge as a predictor of relapse in schizophrenia.

Although neuroleptics are the major treatment for schizophrenia, there are no effective measures to determine the appropriate or necessary length of neuroleptic maintenance. To test the ability of a psychostimulant challenge to predict relapse following neuroleptic withdrawal, the authors administered methylphenidate and placebo infusions to 11 stable schizophrenic outpatients who had been on a neuroleptic maintenance regimen for at least 6 months. Patients withdrawn from neuroleptics were followed until relapse. All three patients with a positive response to methylphenidate challenge relapsed in 1 to 7 weeks; one of seven negative responders relapsed at week 21. Differences in relapse rates (p = .033) and survival time (p = .005) between negative and positive responders were significant.

Adult↗
PubMed1984

The use of depot neuroleptics: clinical experience in the United States.

The use of long-acting injectable preparations such as fluphenazine enanthate or decanoate can reduce patient noncompliance, but documenting this in a controlled research design is difficult. Several studies of relapse rates among patients receiving oral fluphenazine, depot fluphenazine, or placebo are reviewed. Factors that may explain the lack of significant differences among different drug treatments in preventing relapse are discussed. Indications are presented for the use of depot neuroleptics, and strategies for achieving minimum effective doses are reviewed. Adverse effects of depot medication are also discussed, so that the clinician may maximize the ratio of benefit to risk.

Administration, Oral↗