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Biomedical subjects

J Volavka

Publications and source records attributed to J Volavka.

At least 73 records · Page 4Linked to original sources
PubMed1991

HIV seroprevalence and risk behaviors in psychiatric inpatients.

The seroprevalence of the human immunodeficiency virus (HIV) in 515 patients consecutively admitted to a state psychiatric hospital in New York City was 8.9%. There were 365 patients whose results were individually traceable; the remaining 150 patients were tested anonymously. Risk factors including parenteral drug abuse, male homosexual behaviors, and other sexual behaviors were studied in the traceable patients. Logistic regressions indicated that parenteral drug abuse was the main risk factor in both males and females. In females, two additional factors were significant: sex with parenteral drug users or with partners who have the acquired immunodeficiency syndrome (AIDS), and sex with bisexual men. Females with bipolar disorders were particularly likely to report sex with parenteral drug users or with partners who have AIDS.

Adult↗
PubMed1991

Relationship between the Brief Psychiatric Rating Scale and the Scale for the Assessment of Negative Symptoms: a study of their correlation and redundancy.

Because overlapping psychometric scales are used frequently in psychiatric research, examination of the relationship between scales has become increasingly important. The concept of relationship is the focus of this article. By way of illustration, the Brief Psychiatric Rating Scale (BPRS) and the Scale for the Assessment of Negative Symptoms (SANS) were compared for correlation and redundancy. Since these scales are frequently represented by derived summary variables (e.g., factors, total scores), it is also important to assess the effect of such representation on measures of relationship. The SANS and the BPRS were found to be highly intercorrelated. Nevertheless, the individual items and the subscale scores of the SANS contain information independent from the BPRS: the best BPRS predictor variates can explain only approximately half of the total variance of the SANS. When the SANS, however, is represented by a single variable (composite score), it becomes highly redundant with the anergia factor of the BPRS.

Adult↗
PubMed1991

The concept of the neuroleptic threshold: an update.

The authors review the development and the controversies of the neuroleptic threshold theory. According to this theory, the minimum effective antipsychotic dose of a neuroleptic ("threshold dose") correlates with the appearance of "fine motor" symptoms (micrography) as opposed to the appearance of manifest or "coarse motor" extrapyramidal side effects. About half of the acutely exacerbated schizophrenic patients respond to threshold doses, but no predictors are known to characterize the responders. The neuroleptic threshold doses were found to be low, and the low dose treatment strategy is supported by the results of current PET and neuroleptic plasma level studies.

Antipsychotic Agents↗
PubMed1990

Tryptophan treatment of aggressive psychiatric inpatients.

This double-blind, placebo-controlled study tested the effectiveness of tryptophan (TRP) in the treatment of aggressive psychiatric inpatients. After a baseline observation period of 1 month, patients were randomly assigned to treatment either with TRP (up to 6 g/day) or with placebo. There were 10 subjects in each treatment group. These treatments were administered for 25-35 days, after which the patients were observed for 1 month. Throughout this study, patients were receiving other medications. Injections of antipsychotics and sedatives were administered as needed to control agitated or violent behavior. Blood levels of TRP and other large neutral amino acids were obtained repeatedly, and ratios between TRP and other amino acids were computed. These analyses confirmed significant increases of TRP ratios in TRP-treated patients. TRP treatment had no effect on the number of violent incidents, but it significantly reduced the need for injections of antipsychotics and sedatives. The study thus provided indirect support for beneficial effects of TRP in aggressive psychiatric inpatients.

Adult↗
PubMed1990

Validity of self-reports of criminal activity in psychiatric inpatients.

Self reports of criminal activity are known to be valid in general populations. Little is known about the validity of self-reports of crime in psychiatric inpatients. A group of 41 psychiatric inpatients had their self-reported arrests contrasted with their official arrest records. Sixty-six percent of the patients gave accurate reports. Twelve percent denied having arrests when their record showed arrests. Twenty-two percent reported arrests when their official records showed none. The authors discuss the implications of these findings.

Crime↗
PubMed1990

Characteristics of repeatedly assaultive psychiatric inpatients.

Investigations of assaults in psychiatric hospitals have found that a small proportion of inpatients are responsible for a large percentage of the violence that occurs. In a large state hospital patients who were repeatedly violent (recidivists) were compared with patients who were violent only once or twice (nonrecidivists), and the relationships between repeatedly violent behavior and gender, age, and diagnosis were examined. All reports of violent incidents over a six-month period for a population of 1,552 inpatients--a total of 497 incidents involving 313 patients--were reviewed. Seventy patients were involved in three or more incidents each and were responsible for 53 percent of all violence. Recidivist men inflicted serious injuries at a rate ten times higher than that for all the other violent patients. Recidivist women were significantly younger than nonrecidivist assaultive women and were about the same mean age as the assaultive men. Recidivist women were also more likely to have organic brain disorder or personality disorder.

Adult↗
PubMed1990

Akathisia and violence.

Akathisia is a common side effect of neuroleptic drugs that may present with behavioral disturbances. There have been preliminary reports on the association between violence and akathisia. We report the first observational study of this relationship. Patients studied were from a special unit for violent patients. A closed-circuit television camera was installed in each of the corners in its dayroom. Incidents of assault plus the 5 minutes preceding each assault were recorded on videotape. Participants and bystanders were rated for the motor component of akathisia. For each of nine incidents, we compared the akathisia scores for participants and for bystanders. Both victims and assailants were akathisic before about half of all incidents; bystanders rarely were. The classification of the movements we rated and the implications for further studies are discussed.

Adolescent↗
PubMed1990

Haloperidol blood levels and effects in schizophrenia and schizoaffective disorder: a progress report.

To test the hypothesis of a "therapeutic window," we have randomly assigned acutely exacerbating schizophrenic or schizoaffective patients to one of three plasma levels of haloperidol (HAL): 2-13, 13.1-24, or 24.1-35 ng/ml. Patients who did not improve after 6 weeks of this treatment were randomly assigned to one of the three haloperidol levels for another 6 weeks. The improvement was defined as at least 50 percent reduction of the Brief Psychiatric Rating Scale (BPRS) total score. The results obtained in 111 patients do not support any consistent relationship between plasma level of haloperidol and clinical improvement. Patients in the high haloperidol plasma range tended to have more side effects. These results suggest that the haloperidol doses used in clinical practice may be higher than necessary.

Adult↗
PubMed1989

Inpatient violence: trait and state.

This study compared patients who showed persistent violence, transient violence and no violence. The presence of neurological abnormalities was found to be the factor that differentiated most clearly among the three groups. The persistently violent patients, in addition to showing significantly more neurological abnormalities, also evidenced a more disturbed family background. Both violent groups had a higher incidence of violent crime prior to hospitalization than the nonviolent controls. A logistic regression model simultaneously relating the effects of six factors on violent behavior was developed and used to predict violent group membership.

Adult↗
PubMed1989

Neurological impairment in violent schizophrenic inpatients.

This study relates violent behavior of schizophrenic inpatients to demographic, historical, EEG, neurological, and neuropsychological variables. Patients were classified into high (N = 28), low (N = 27), or no (N = 34) violence groups. There were no significant differences among the groups on demographic or historical variables, except for prevalence of violent crime, which was higher in both violent groups than in nonviolent patients. Neurological and neuropsychological abnormalities differentiated the groups, with the high violence group evidencing more abnormalities than the other two groups in the area of integrative sensory and motor functions. The authors suggest that violence as well as neurological and neuropsychological deficits may characterize a more severe form of schizophrenia.

Adult↗
PubMed1989

Subjective symptoms: part of the negative syndrome of schizophrenia?

We present the psychometric and clinical psychopathological properties of the SDSS for the assessment of subjective symptoms as applied to various schizophrenic samples. The subjective deficit syndrome has not been obvious to most investigators, in part because the currently available scales, even those assessing negative symptoms, were not designed to capture it. While the subjective deficit syndrome is not specific to schizophrenia, it may explain what is widely observed as a major public health problem, namely, that officially "remitted" patients continue to fail in social and occupational functioning. The understanding of this syndrome is a prerequisite for better management of these remitted schizophrenic outpatients. Future longitudinal studies including outpatients are needed to address these issues further.

Antipsychotic Agents↗
PubMed1988

Can aggressive behavior in humans be modified by beta blockers?

Persistent aggressive behavior may develop in patients with brain disorders of various types, including seizure disorders, mental retardation, metabolic disorders, head injury, and in some instances schizophrenia. Although a neurochemical basis for aggression in these cases is unclear, a hyperadrenergic state is considered to be one possibility. This has led to the hypothesis that beta blockers may be useful in the control of aggression. The original assumption was that the site of antiaggressive action of beta blockers is in the brain. However, the antiaggressive efficacy of nadolol, which does not cross the blood-brain barrier to any great extent, suggests a peripheral site or sites. A review of several studies in which both old and young aggressive patients with various organic brain disorders received propranolol showed that aggressive behavior was reduced in 75 (86%) of 87. These results are encouraging because none of the patients had responded to earlier drug treatment. However, with the exception of one study of nine patients, none of the studies were controlled for placebo effects and most were retrospective. Preliminary results suggest tentative guidelines for treatment of aggressive behavior with beta blockers. Further studies are needed, and these should use a prospective, longitudinal double-blind design; large enough patient samples to permit testing hypotheses about disease-specific or symptom-specific responses to beta blockers; and improved instruments for measuring and classifying aggression.

Adolescent↗
PubMed1988

Pattern reversal visual evoked potentials after alcohol administration among men at risk for alcoholism.

The P100 component of the pattern reversal visual evoked potential was used to compare men at high risk for alcoholism and control subjects before and after a low (0.5 g/kg) dose of ethanol. The high risk and control subjects did not differ in age, self-reported ethanol consumption, or estimates of ethanol metabolism rates, but changes in the occipital P100 latency differentiated them following ethanol administration. The P100 latency changes that distinguished high risk from control subjects were lateralized and provide preliminary evidence that perceptual visual stimulus processing is differentially affected in the two groups following ethanol administration.

Adult↗
PubMed1988

Underreporting of physical assaults in schizophrenic inpatients.

The authors followed prospectively a group of 79 newly admitted male schizophrenics for 6 months or until discharged, whichever came first, and monitored their assaultive behavior by review of their charts and the ward journals. Assaults were detected reliably by this method. When the assaultive behavior monitored in this way was contrasted with officially reported assaultiveness, 50% more assaults and 34.5% more patients who had one or more instances of assaultive behavior during the study period were detected. There were no differences in the number of injuries detected by the two methods. The authors contend that a realistic estimate of the incidence of physical assaults in young male schizophrenic inpatients is no less than 1.5 times that reflected by official reports.

Adult↗