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Biomedical subjects

J Tiller

Publications and source records attributed to J Tiller.

32 records · Page 2Linked to original sources

Self-treatment of bulimia nervosa: a pilot study.

Twenty-eight patients with ICD-10 bulimia nervosa or atypical bulimia nervosa were given a cognitive-behavioral treatment handbook and were reassessed 4-6 weeks later. On a clinician-rated global improvement scale 12 patients had much improved and 8 patients had somewhat improved. Fifteen patients were abstinent of vomiting or laxatives at reassessment as opposed to five patients before treatment. Of the 21 patients who were bringing before treatment, 7 had a 75-100% reduction of binges and 5 had a 50-75% reduction of binges. Patients' nutritional knowledge increased significantly. A patient-administered hand-book may be a useful first intervention in the treatment of patients with bulimia nervosa.

Adult↗

Setting the scene for eating disorders: childhood care, classification and course of illness.

The aim of this study was to determine whether the childhood experiences of patients with anorexia nervosa and bulimia nervosa differ and affect the course of the illness. A semistructured interview developed by Harris et al. (1986) was used to assess the childhood family environment of 64 patients with restricting anorexia nervosa (RAN), 23 patients with bulimic anorexia nervosa (BAN), 37 bulimic patients with a history of anorexia nervosa (BN/HistAN) and 79 patients with normal weight bulimia nervosa (BN). There were no significant differences between groups in terms of parental mental disorder, low parental control or childhood sexual abuse. BN patients had had significantly more family arrangements and had experienced more parental indifference, excessive parental control, physical abuse, and violence against other family members than RAN patients with the BAN and BN/HistAN group being intermediate. There was a trend for BN-patients to have had more intra-familial discord than the other groups. Different aspects of adversity tended to cluster in the same patients and 65% of the bulimic group had experienced two or more types of childhood adversity. These results suggest that childhood experiences contribute to the form of eating disorder which later develops.

Adult↗

Childhood adversity and adult defence style in eating disorder patients--a controlled study.

The aims of the study were (1) to compare the defence style of patients with anorexia nervosa with that of patients with bulimia nervosa and of female controls; (2) to establish whether a link exists between childhood adversity and adult defence style in eating disorder patients. Twenty-six patients with restricting anorexia nervosa (RAN), 61 patients with bulimia nervosa (BN), 37 patients with bulimic anorexia nervosa or bulimia nervosa with a history of anorexia nervosa (BAN/BN-HistAN) and 88 female controls were given the short Defense Style questionnaire (Andrews, Pollock & Stewart, 1989). Eating disorder patients were asked about their childhood care using a semi-structured interview (Harris, Brown & Bifulco, 1986). Bulimia nervosa patients had a significantly less mature defence style than the other groups and like the BAN/BN-HistAN group more immature defences than the control group. In the RAN group no childhood predictors of adult defence style were found, whereas in bulimia nervosa, excessive parental control during childhood was a negative predictor of mature defences and physical abuse a positive predictor of immature defence style. These results provide some evidence that childhood adversity may constitute a vulnerability factor for the later development of bulimia nervosa, mediated by personality development.

Adolescent↗

Obsessive compulsive disorder: a sufferer's viewpoint.

This is a personal account of trying to live and cope with obsessive compulsive disorder (OCD) written primarily by a sufferer attending the Victorian OCD Support Group. It outlines some of the suffering and distress of having the disorder, some of the efforts and techniques used in trying to understand and cope with the disorder, the fortitude and endurance required, the difficulty in seeking and accepting treatment and some of the sufferer's hopes for a better future.

Adaptation, Psychological↗

Treatment of atypical depression with moclobemide: a sequential double controlled study.

A double-blind controlled study of moclobemide and diazepam in patients with atypical depression showed both to be effective antidepressants and anxiolytics. Statistical comparison showed diazepam to be significantly better than moclobemide at week 4. However, by week 8 there was no significant difference between the two drugs for depression scores although diazepam was a significantly better anxiolytic. Side-effects were minimal, and the most common side-effects emerging for both drugs were sleep disturbance and physical tiredness.

Adult↗

Increased urinary tribulin output in generalised anxiety disorder.

Urinary output of an endogenous monoamine oxidase inhibitor and benzodiazepine receptor binding inhibitor (tribulin) was raised in a group of patients with generalised anxiety disorder compared with controls. Tribulin levels remained relatively constant in individual patients over the 6-week period of observation, mean values remaining high even after reduction of anxiety following non-drug behaviour therapy.

Adult↗

Anxiety disorder and perception of inspiratory resistive loads.

Sensations of breathlessness in the absence of respiratory disease are common in anxiety disorders. Perceptions of breathlessness in eight patients with anxiety disorder were compared with eight normal control subjects, matched for age and sex, by the application of Steven's law to the magnitude of resistive load test. All subjects estimated the magnitudes of resistive loads to inspiration while peak inspiratory mouth pressures were monitored. Anxious patients' perceptions of the added loads were significantly less sensitive than normal, even though the effort, determined by peak inspiratory mouth pressure, in overcoming each load was normal. Correlations between estimates of resistive loads and peak inspiratory mouth pressure were significantly less for the anxious patients than for normal subjects. Thus, perception of breathlessness in anxiety disorders may be affected by factors not normally associated with breathlessness and may help account for the greater than normal variability in resistive load perception in respiratory disease.

Airway Resistance↗

Treatment of functional chronic stooped posture using a training device and behavior therapy. A case report.

Functional posture problems and related gait problems are often difficult to manage clinically because of the difficulty of providing immediate feedback to clients during walking or standing and because of secondary personal gains provided the client for having the "disability." This article describes an inexpensive posture training device and treatment of a client with developmental disabilities and a long history of posture problems and secondary gait pattern abnormalities. Thirty-six short training sessions, coupled with a supportive daily living situation, produced marked improvements in the client's posture and gait.

Adult↗

A sequential double-blind controlled study of moclobemide and diazepam in patients with atypical depression.

A double-blind controlled study comparing moclobemide and diazepam in patients with atypical depression was carried out. Statistical comparison of the 14 pairs completing 4 weeks showed that significant reductions in depressive symptomatology as measured by the Hamilton and Carroll depression rating scales occurred in both drug groups, and that diazepam was significantly better than moclobemide. A separate analysis of the 10 pairs completing 8 weeks treatment showed that significant decreases in depression ratings occurred in both drug groups but that by week 8 there was no significant difference between the two drugs for depression scores. Side-effects were minimal, and the most common side-effects emerging for both drugs were sleep disturbance and physical tiredness.

Adult↗