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J R DeQuardo

Publications and source records attributed to J R DeQuardo.

6 recordsLinked to original sources

Comparison of indices of premorbid function in schizophrenia.

There has been a resurgence of interest in the area of premorbid functioning in schizophrenia as it provides clues to onset and etiology. Most studies rely on retrospective estimates of premorbid status that are incomplete, such as the Premorbid Adjustment Scale (PAS). Even prospective high-risk studies are hampered by the narrow range of premorbid functions assessed and are thus unable to answer crucial questions related to onset of illness. This study was undertaken to assess the relationship between several indices of premorbid functioning. Sixty four in-patients with schizophrenia were assessed at medication-free baseline and post-treatment with BPRS and SANS. PAS scores were derived from all available sources. Premorbid cognitive ability was estimated by the mean of WAIS-R Vocabulary and Information subscale scores. Estimated premorbid IQ was obtained using a demographic regression formula. Years of education and predicted VIQ, PIQ, and FSIQ were found to correlate with estimated premorbid cognitive ability. Predicted VIQ, PIQ, and FSIQ were associated with years of education and PAS childhood, early and late adolescence, and general scores. Each estimate of premorbid ability demonstrated a different pattern of association with clinical ratings, symptom change, and outcome. The results suggest that education, PAS, predicted IQ, and WAIS-R estimates of premorbid cognitive ability assess different but overlapping areas of pre-morbid functioning.

Adult

Tinnitus and ECT.

We report the case of a 69-year-old man with major depressive disorder and occupational tinnitus; both problems were refractory to several different treatment modalities, but were successfully treated with electroconvulsive therapy (ECT). The tinnitus was present for 15-20 years, but had worsened during the 3 years before treatment, causing him significant distress. Extensive organic workup did not identify a treatable etiology for his symptoms. To date, he has been hospitalized four times due to depressive symptoms associated with tinnitus. He has received ECT each time, and has responded well on each occasion.

Aged

Subclinical status epilepticus following ECT.

Subclinical status epilepticus is a rare complication of electroconvulsive therapy (ECT). We describe the case of a 70-year-old man with psychotic depression who developed prolonged subclinical status epilepticus following an initial ECT treatment; he subsequently received a course of ECT without complications. It is important to consider status epilepticus in the differential diagnosis of patients who do not regain consciousness following ECT, even in the absence of overt motor seizure activity. The development of this complication does not preclude the future use of ECT; in fact, ECT has been repeated successfully in individuals who developed this complication, including this case. Identification of potential risk factors, appropriate preventive measures, and early intervention are important in the management of this complication. The literature is reviewed and appropriate preventive and treatment measures are discussed.

Aged

Effect of anticholinergics on positive and negative symptoms in schizophrenia.

Anticholinergic drugs have been assumed to have no effects on schizophrenic symptomatology. Some studies suggest, however, that anticholinergic agents may antagonize the beneficial effect of neuroleptics on positive symptoms and partially ameliorate negative symptoms. Virtually all studies have been conducted in patients receiving concomitant neuroleptic treatment, raising the possibility that neuroleptics may obscure or modify any "true" anticholinergic effect on schizophrenic symptoms. To evaluate the hypothesis that anticholinergics may increase positive and decrease negative schizophrenic symptoms, we assessed the effect of biperiden on symptoms in the medication-free state. We studied the effect of biperiden 8 mg/day for 2 days on positive and negative symptoms in 40 otherwise drug-free schizophrenic inpatients. Biperiden produced a significant increase in positive symptoms (t = 6.7, p < .001) and reduction in negative symptoms (t = -3.4, p < .01). These data indicate that cholinergic modulation significantly affects positive and negative schizophrenic symptoms and suggest the need for systematic trials of cholinergic and anticholinergic agents in the treatment of positive and negative symptoms of schizophrenia, respectively.

Adult