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Biomedical subjects

J M Murphy

Publications and source records attributed to J M Murphy.

At least 145 records · Page 8Linked to original sources
PubMed1992

Response suppression induced with selective 5-HT agonists can be differentially blocked with LY53857 in an animal model of depression.

Studies from this laboratory have demonstrated that administration of the selective 5-HT2/1C antagonist LY53857 can block 5-HTP-induced response suppression. To further investigate the serotonergic mechanisms involved in this effect, we decided to test the capacity of LY53857 to block response suppression induced with two selective 5-HT agonists. After a 15 minute baseline period, rats trained to press a lever for milk reinforcement on a VI 1' schedule were given IP injections of 1.0 mg/kg DOI, or 1.0 mg/kg 8-OH-DPAT to induce response suppression. Subsequently, rats were injected with 1.0 mg/kg LY53857 1 hour prior to DOI- or 8-OH-DPAT-induced response suppression. Preinjections with LY53857 resulted in a 100% blockade of DOI-induced response suppression whereas the same dose did not block response suppression induced with 8-OH-DPAT. These results indicate that the 5-HTP-induced response suppression shows some pharmacological similarity to DOI-induced response suppression and may be mediated through 5-HT2 and/or 5-HT1C receptors.

8-Hydroxy-2-(di-n-propylamino)tetralin↗
PubMed1992

Serious child mistreatment in Massachusetts: the course of 206 children through the courts.

Two hundred and six severely abused and/or neglected children brought before the Boston Juvenile Court on care and protection petitions were followed prospectively for 4 years. Two thirds of all parents were found to be poor, 84% had one or more psychiatric disorders, and 81% had been known to the Department of Social Services prior to their court appearance. The average age of children at the start of the court process was 4.2 years, and the average length of temporary foster care was 2.3 years. Judges' decisions to return children to parental custody or to order permanent removal were most strongly predicted by parental compliance with court-order services. Of the 63 cases dismissed from court and thus returned to biological parents, 18 (29%) had substantiated reports of new mistreatment over an approximately 3-year follow-up period. We concluded that children are often poorly served by the current delays in the social service/legal system, and that further clinical research would provide needed empirical data on how best to protect mistreated children.

Adoption↗
PubMed1992

Screening for psychosocial dysfunction in inner-city children: further validation of the Pediatric Symptom checklist.

A sample of 123 6- to 12-year-old outpatients at an inner-city pediatric clinic was screened for psychosocial dysfunction using the Pediatric Symptom Checklist (PSC), a brief parent-completed questionnaire. The prevalence of positive screening scores on the PSC was 22%, significantly higher than the rate found in lower middle to upper middle-class samples. Comparing PSC case classifications with comprehensive assessments made by clinicians, overall agreement was 92% (kappa = 0.82; sensitivity = 88%; specificity = 100%); a comparison with several other measures provided additional support for the validity of the PSC. The PSC's reliability over time was also acceptable. These findings provide preliminary evidence that the PSC is as valid and reliable for screening children from economically disadvantaged and minority backgrounds as it is for middle and upper middle-class populations.

Affective Symptoms↗
PubMed1992

Screening for psychosocial dysfunction in pediatric practice. A naturalistic study of the Pediatric Symptom Checklist.

This study examined the routine implementation of the Pediatric Symptom Checklist (PSC), a brief questionnaire which screens for psychosocial dysfunction in school-aged children in an outpatient pediatric practice. Results indicated that the PSC was well-accepted by parents and adequately tolerated by busy clinic staff. When the PSC was included as part of the standard procedure for well-child visits, the referral rate for psychosocial problems due to positive PSC scores rose to 12% from the clinic baseline referral rate of 1.5%, a significant increase (P < .01). Half of the children who screened positive on the PSC had not been previously identified by their pediatricians as having psychosocial problems, and more than half had never received any psychological treatment. When implementation of the PSC was discontinued, the referral rate fell to 2%, a rate similar to baseline. The findings suggest that it is possible to incorporate the PSC into routine pediatric practice and that the PSC can help pediatricians identify and better serve children experiencing psychosocial difficulties. The study also suggests that further work is needed to understand the barriers to ongoing implementation.

Adolescent↗
PubMed1992

Patterns of illicit drug use at the time of labor in a private and public hospital.

The majority of prevalence data on perinatal substance abuse describe low socioeconomic patient populations. This study of illicit drug use at the time of labor was done to identify patterns of drug use in both private and nonprivate patients. Anonymous urine samples were collected from 1000 patients, 500 admitted in labor to a private hospital and 500 admitted to a public hospital. All samples were screened for cocaine, opiates, cannabinoids, and amphetamines. A positive result of screening for any drug was detected in 8.2% of patients. More positive results of screening for any drug were found in nonprivate patients (11.4%) than private patients (5%), with nonprivate patients significantly more likely to test positive for cocaine or cannabinoids or both. Black patients contributed 64.5% of the positive tests for cocaine, significantly more than white (17.6%) or Hispanic patients (17.6%), whereas white patients contributed significantly more positive tests for cannabinoids (85%) than black (5.4%) or Hispanic patients (7.1%). Assessment of patterns of perinatal drug use in communities will support appropriate allocation of resources and targeting of patient and provider education.

Amphetamines↗
PubMed1991

Molecular screening of cystic fibrosis patients.

A method for the direct direction of the delta F508 mutation in the cystic fibrosis gene has been developed and applied to the analysis of over 280 individuals including 104 individuals with cystic fibrosis. This technique allows the rapid analysis of DNA from whole blood, Guthrie card blood spots, and the antenatal diagnosis of cystic fibrosis from chorionic villus biopsy samples. Based on these analyses, the delta F508 mutation is found in 77.88% of cystic fibrosis chromosomes in New Zealand cystic fibrosis patients. Thus this test can be used to establish a direct DNA diagnosis in over 60% of cystic fibrosis patients. Approximately a further 30% are heterozygous for this mutation.

Alleles↗
PubMed1991

Depression and anxiety in relation to social status. A prospective epidemiologic study.

Longitudinal research in Stirling County, Atlantic Canada, indicated that during the 1950s and 1960s the prevalence of depression was significantly and persistently higher in the "low" socioeconomic status population than at other socioeconomic status levels. Anxiety was found to show a less clear picture. Incidence of depression after the study started was also higher among those who were initially in the low socioeconomic status group, supporting the view that the stress of poverty may be causally related to depression. There was also a trend for prior depression to be associated with subsequent downward social mobility, supporting the view that the concentration of depressed people at the lower end of the social hierarchy may result from handicapping aspects of the illness. Neither of these trends was statistically significant. More striking was evidence that, irrespective of socioeconomic status, depression carried a substantial risk for poor clinical course and outcome. Both depression and poverty tended to be chronic, and, accordingly, their association at the end of the study was influenced by their association at its beginning. The stability of the relationship between poverty and depression warrants the attention of caregivers and policymakers and raises new questions about strategies for the study of causal sequences.

Adult↗
PubMed1991

Chronic alcohol consumption in alcohol-preferring P rats attenuates subsequent conditioned taste aversion produced by ethanol injections.

Rats of the P line were tested for the development of tolerance to the aversive effects of ethanol during 33 days of continuous availability of food, water and a 10% (v/v) ethanol solution. Beginning on the day following the removal of ethanol, five daily conditioned taste aversion (CTA) trials were administered to the ethanol-drinking P rats and an ethanol-naive control group. The CTA trials consisted of a 20-min access to a Polycose solution, followed by IP injection of saline, 0.5, 1.0, or 1.5 g ethanol/kg. The ethanol-drinking rats developed a preference for the Polycose solution when it was paired with 0.5 g ethanol injections, but the control rats did not. Both control and ethanol groups had similar CTAs at the 1.5 g dose. However, at the 1.0 g dose, the ethanol group had an attenuated CTA compared with the water control group. The results suggest that P rats develop tolerance to aversive effects of ethanol during chronic drinking. This tolerance could contribute to the high ethanol intake in these selectively-bred rats.

Alcohol Drinking↗
PubMed1991

Diagnosed intellectual and emotional impairment among parents who seriously mistreat their children: prevalence, type, and outcome in a court sample.

A substantial body of research evidence over the past three decades has indicated that intellectual and emotional impairment among parents is a factor contributing to child abuse and neglect. This study examined the court records of 206 seriously abused or neglected children and their families in a large urban area and found that in over half the records a parent had been diagnosed as having an emotional disorder and/or low IQ, with a majority of these diagnoses indicating significant impairment. Although type of impairment (emotional, low IQ, and a subsample of substance abusers) did not predict type of mistreatment, higher predicted risk for continued mistreatment, or greater likelihood of permanent removal of the child by the court, low IQ parents revealed significantly less prior court involvement and greater acceptance of court-ordered services. Parents diagnosed with serious emotional disorders were significantly more likely than less disturbed parents to have their children permanently removed despite findings of no significant differences in risk or compliance factors.

Affective Symptoms↗
PubMed1991

Substance abuse and serious child mistreatment: prevalence, risk, and outcome in a court sample.

This study examined the prevalence and specific types of substance abuse in a sample of 206 cases of serious child abuse or neglect brought before a metropolitan juvenile court on care and protection petitions. In 43% of the cases, at least one of the parents had a documented problem with either alcohol or drugs, a figure which rose to 50% when alleged instances of substance abuse were included. Alcohol, cocaine, and heroin were the three most frequently mentioned abused substances. Parents with documented substance abuse were significantly more likely than nonsubstance-abusing parents to have been referred previously to child protective agencies, to be rated by court investigators as presenting high risk to their children, to reject court-ordered services, and to have their children permanently removed. When the two factors of court investigator high risk ratings and presence of parental substance abuse were combined, it was possible to obtain even higher levels of prediction of which parents would reject services and have their children permanently removed. Results suggest (1) the importance of increased screening, evaluation, and treatment of parental substance abuse in cases of serious child mistreatment; and (2) the possibility of adopting a predictive approach as to which families will be able to respond to court-ordered treatment requests and have their children returned.

Alcoholism↗
PubMed1991

Uncovering psychiatric test information with graphical techniques of Exploratory Data Analysis.

This article illustrates how Exploratory Data Analysis (EDA) can complement conventional statistical methods in evaluating psychiatric tests. Using one recent EDA computer program, we evaluated the ability of repeated psychiatric screening tests (the General Health Questionnaire [GHQ]) to predict medical and psychiatric service use in a Health Maintenance Organization (HMO), the Harvard Community Health Plan (HCHP). Using a stratified random sample of 244 new HCHP enrollees and viewing three-dimensional graphs of their data from multiple perspectives, we found two subpopulations: low GHQ scorers, for whom the tests did not predict service use; and high scorers, for whom they did. Surprisingly, improving scores forecast increased use and chronically high scores predicted diminished use. Using another stratified random sample of 213 new HCHP enrollees, and with scatterplot matrices from another interactive computer program, we found that high and unchanging GHQ scores forecast HMO dropout. We examine possible interpretations--for example, that chronically distressed patients may become immobilized, diminish service use, and ultimately leave the HMO. We also explain how EDA methods may help uncover elusive results in other data (e.g., mental health outcomes).

Adult↗
PubMed1991

Performance of a five-item mental health screening test.

We compared the screening accuracy of a short, five-item version of the Mental Health Inventory (MHI-5) with that of the 18-item MHI, the 30-item version of the General Health Questionnaire (GHQ-30), and a 28-item Somatic Symptom Inventory (SSI-28). Subjects were newly enrolled members of a health maintenance organization (HMO), and the criterion diagnoses were those found through use of the Diagnostic Interview Schedule (DIS) in a stratified sample of respondents to an initial, mailed GHQ. To compare questionnaires, we used receiver operating characteristic analysis, comparing areas under curves through the method of Hanley and McNeil. The MHI-5 was as good as the MHI-18 and the GHQ-30, and better than the SSI-28, for detecting most significant DIS disorders, including major depression, affective disorders generally, and anxiety disorders. Areas under curve for the MHI-5 ranged from 0.739 (for anxiety disorders) to 0.892 (for major depression). Single items from the MHI also performed well. In this population, short screening questionnaires, and even single items, may detect the majority of people with DIS disorders while incurring acceptably low false-positive rates. Perhaps such extremely short questionnaires could more commonly reach use in actual practice than the longer versions have so far, permitting earlier assessment and more appropriate treatment of psychiatrically troubled patients in primary care settings.

Adult↗
PubMed1991

Phenytoin intoxication.

We studied the clinical features of 85 cases of phenytoin toxicity in 76 patients treated at a general hospital. Serum levels of phenytoin on admission ranged from 30.3 to 95.0 micrograms/mL (median, 46.5). Iatrogenic causes of intoxication were common and included increased daily dosage and intravenous loading in the emergency room for single seizures in patients with subtherapeutic serum phenytoin levels. The most frequent neurologic findings were nystagmus (95%), ataxia (88%), lethargy (22%), and seizures (19%). Outcome was usually good, but three patients had serious complications.

Adult↗
PubMed1991

Screening for dysfunction in the children of outpatients at a psychopharmacology clinic.

OBJECTIVE: The goals of this study were 1) to determine whether the use of the Pediatric Symptom Checklist in an adult-oriented psychiatric practice was feasible, 2) to determine if scores indicative of dysfunction on the Pediatric Symptom Checklist were associated with parental or background factors, 3) to determine whether children flagged by their scores on the Pediatric Symptom Checklist were receiving psychiatric services, and 4) to compare the psychosocial dysfunction in this group of children with that found in children screened as part of routine pediatric visits. METHOD: Adult outpatients in a hospital's clinical psychopharmacology unit were asked to complete the Pediatric Symptom Checklist regarding their children. These patients were the parents of 100 school-aged children. Factors such as the parents' diagnoses and demographic variables were also examined. RESULTS: The Pediatric Symptom Checklist was readily accepted by parents and fit easily into the routine of general psychiatric practice. Significantly more of the children of these outpatients than of children in comparable pediatric offices had scores indicative of psychiatric dysfunction (scores above the cutoff). Children of parents who were single, of low socioeconomic status, or with a diagnosis of personality (especially borderline) or mood disorder were more likely to have scores above the cutoff. More than a third of the children who had scores above the cutoff on the Pediatric Symptom Checklist were not currently receiving psychiatric services. CONCLUSIONS: The Pediatric Symptom Checklist provided a rapid and simple method for general psychiatrists to identify psychosocial dysfunction in their patients' children.

Adult↗
PubMed1991

Psychosocial screening in pediatric practice: a survey of interested physicians.

This study followed up on 201 pediatricians and family practitioners who had requested information about the Pediatric Symptom Checklist (PSC), a parent-completed questionnaire which screens for psychosocial dysfunction in school-aged children. The physicians were sent a postcard survey asking whether they had used the PSC in their practices. Of the 157 (78%) who responded to the postcard survey, 36 (23%) reported that they had used the PSC. On a follow-up questionnaire, all of these physicians rated the PSC as useful, and nearly 80% reported that it led to increased case-finding and/or referrals. Ninety-six percent stated that they will continue to use the PSC; more than half of them routinely or frequently. The findings indicate a widespread interest in psychosocial screening, and suggest that additional educational efforts may be necessary to support the acceptance of the PSC in pediatric practice.

Attitude of Health Personnel↗
PubMed1991

Screening for psychosocial dysfunction in pediatric dermatology practice.

The Pediatric Symptom Checklist, a brief psychosocial screening questionnaire, was used in a multi-center study of pediatric dermatology clinics (n = 377). Overall rates of positive screening indicated that approximately 13% of patients screened positive, a rate similar to findings in primary care pediatric settings. Examining the sample in greater detail demonstrated that children whose dermatologic disorder is perceived to have a greater impact on their appearance are at higher risk for psychosocial dysfunction.

Child↗