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Biomedical subjects

J W Goethe

Publications and source records attributed to J W Goethe.

At least 37 records · Page 2Linked to original sources
PubMed1991

Suicidal behaviors among Connecticut youth.

In the United States, youth (15-24 years) suicide rates increased 191% between 1950 and 1986. This paper presents data regarding suicidal ideation and attempts, suicide-related hospitalizations, and completed suicides among Connecticut youth, comparing them with data from other states and the United States. Girls have higher rates of attempts and hospitalization, boys of completed suicide. Firearms are the suicidal method of choice for both sexes. Nonmetropolitan areas had higher rates than metropolitan. Reported suicidal ideation among students ranged from 10% to as high as 66%, while attempts range from 3% to 15%. The authors stress that caution is necessary when comparing rates, pointing to the need for standardized data collection and analysis. Reported rates of suicidal behavior are lower among Connecticut youth compared to their counterparts in other states, but suicide is increasing among young males in Connecticut and remains a major issue for health care providers.

Adolescent↗
PubMed1990

The effect of being reared with an alcoholic half-sibling: a classic study reanalyzed.

Data from an early study of alcoholism among half-siblings of alcoholic probands (17) was reanalyzed using log-linear analysis. The original study, which used chi-square analysis, identified genetic factors but found no environmental effects that contributed to the prediction of alcoholism. Log-linear analysis, however, reveals that being reared with a proband is associated with a reduced incidence of alcoholism in half-siblings. The results do not disconfirm the presence of genetic factors, but they do indicate that family dynamics make an independent and statistically significant contribution to the development of alcoholism not heretofore demonstrated. Similarities between these results and the results from studies of identical twins are discussed.

Alcoholism↗
PubMed1989

OVERSEER: a prototype expert system for monitoring drug treatment in the psychiatric clinic.

This paper describes the development of OVERSEER: a prototype knowledge-based system that monitors the drug treatment of psychiatric patients in real time. Using treatment protocols developed by the expert clinician, OVERSEER monitors the drug treatment process and issues alerts when standard clinical practices are not followed or when laboratory results are abnormal. Written in Prolog, OVERSEER is designed to interface directly with the hospital's database, and, thereby, utilizes all available pharmacy and laboratory data. Moreover, unlike the interactive expert systems developed for the psychiatric clinic, OVERSEER does not require extensive data entry by the clinician. Consequently, the chief benefit of OVERSEER's monitoring approach is the unobtrusive manner in which it evaluates psychopharmacological treatment and provides information regarding patient management to the hospital.

Drug Therapy, Computer-Assisted↗
PubMed1988

A comparison of adequately vs. inadequately treated depressed patients.

The authors reviewed the records of 201 nonbipolar depressed inpatients to a) determine the level of somatic therapies prescribed and b) compare the characteristics and global outcomes of patients given "adequate" vs. "inadequate" treatment. A stepwise multiple regression analysis revealed that patients given higher levels of somatic therapy were significantly (p less than .001) more likely to be older and have depression with psychotic features and less likely to have compulsive personality disorders. These patients also had significantly longer hospitalizations. A separate stepwise regression analysis showed that patients given higher levels of somatic therapy had superior outcomes (p less than .001). The proportion of this sample given no antidepressant medication or electroconvulsive therapy (18.4%) and the proportion given "adequate" treatment (45.3% to 63.7%, depending on the criteria applied) were comparable to the findings of other published reports.

Adolescent↗
PubMed1988

Do DSM-III criteria for major depression define distinct subtypes?

The authors used a large (n = 437) sample of depressed inpatients to determine if DSM-III criteria applied in a clinical setting defined distinct subgroups. Patients with diagnoses of depression, depression with melancholia, and depression with psychotic features were compared by age, sex, diagnoses (Axes I-V), treatment received, and treatment outcome. These data failed to support the DSM-III distinction between a melancholic and psychotic subtype. However, compared to other patients with major depression, patients with melancholic and/or psychotic features were: (a) older, (b) more likely female, and (c) more likely to be treated with somatic therapy.

Age Factors↗
PubMed1987

Expert systems in psychiatry. A review.

Existing computer-based decision aids in the areas of psychiatric diagnosis and consultation are reviewed, and the prospects for expert system development within the mental health field are discussed. Emphasis is placed upon the decision-making models used in these systems rather than on their particular application area. The decision-making paradigms discussed are (1) data bank analysis, (2) statistical pattern recognition, (3) Bayesian analysis, (4) logical flow chart method, and (5) knowledge-based (expert system) approaches. For each paradigm, its essential features, its strengths and weaknesses, and some example applications are presented.

Diagnosis, Computer-Assisted↗
PubMed1986

EEG coherence and power in the discrimination of psychiatric disorders and medication effects.

Electroencephalogram (EEG) coherence (COH) and power measures were included in a series of stepwise discriminant analyses to determine which variables were most sensitive in the differentiation of four psychiatric inpatient groups and two major classes of psychotropic medication. Eight channels of eyes-closed, bipolar EEG activity were recorded from 74 inpatients (paranoid schizophrenics, dysthymics, major affectives receiving tricyclics, neuroleptics, or no medication, and geriatrics). Discriminant analyses were conducted for theta, alpha, and fast beta frequency bands for power variables, COH variables, and the resultant significant power and COH discriminating variables. Without exception, COH measures, usually in the alpha band, were more sensitive than power measures in differentiating the various groups. Results suggested that COH decreases with age, is greatest in paranoid schizophrenics, decreases with neuroleptic medication, and increases with tricyclic antidepressants. Group differences were interpreted in accordance with an arousal model for COH.

Affective Disorders, Psychotic↗
PubMed1986

EEG coherence and power changes during a continuous movement task.

EEG coherence (COH) is a mathematically derived measure of the time- and frequency-related similarities between a pair of EEG channels. In this report, COH was measured during an externally verified motor task in which the areas of cortical involvement are known, with special consideration given to procedural and artifactual issues. Fourteen right-handed women (ages 18-39, means = 26.7 years) were instructed to alternate continuously between fist-clenching and finger extension of the right hand, left hand, both hands, or neither hand (rest condition) in a counter-balanced sequence (4 one-minute trials for each condition; 16 total minutes). One minute each of intentional eye-movement (EOG) and intentional facial muscle tension (EMG) was recorded for artifact assessment. Eight channels of eyes-closed EEG were recorded from Fp1, Fp2, F3, F4, C3, C4, P3 and P4, each referenced to the ipsilateral earlobe. FFT spectral power analyses were conducted on 8 EEG channels and COH analyses (percentage of seconds/minute in which COH greater than or equal to 0.80) were performed on 16 pairs of leads: 4 interhemispheric, 6 intrahemispheric (left) and 6 intrahemispheric (right). COH measures increased during hand movement conditions, especially in the 9-12 Hz range, and were most apparent from prefrontal, premotor and motor areas. Parietal sources were essentially unchanged. Power measures were unchanged for virtually all leads and conditions. Increases in COH were not due to EOG or EMG artifact contamination. Evidence for lateralized increases was equivocal; significant bilateral increases were observed more often regardless of the hand clenched. Implications and suggested areas for future research are discussed.

Adolescent↗
PubMed1984

Multiple-monitored electroconvulsive therapy: safety and efficacy in elderly depressed patients.

Forty-four patients with severe endogenous depression, all of whom had been administered multiple-monitored electroconvulsive therapy (MMECT), were studied by retrospective chart review. The subjects were divided into two groups, the elderly and the nonelderly, and compared for number of anesthesia inductions (treatment sessions), total number of seizures, total seizure time, and therapeutic outcome. One myocardial infarction occurred in an elderly man, and a confusional state developed whenever MMECT was administered simultaneously with lithium. The conclusions from this project are that MMECT is as safe and efficacious for the elderly as for the nonelderly and that the elderly tolerate many seizures as well as do the nonelderly. While other variables were similar between groups, the overall number of anesthesia inductions in both groups was less than is expected with conventional electroconvulsive therapy.

Adult↗
PubMed1982

Psychiatric education and the future of psychoanalysis.

Given all that is invested in psychoanalytic training and practice, it is understandable that psychoanalysts wish to view the future as promising. Those who have contributed to the development of The Academy can be proud of their past and present efforts, and undoubtedly hope that these contributions will be lasting. However, to ensure the future of The Academy, we must invest in education. Whatever the location of the psychoanalytic institute, the location of medical training will always be in the universities. As psychoanalysts, we must remain visible to the medical student; we must participate actively in the training of the psychiatric resident. We must be able to demonstrate the relevance of psychoanalysis. Exactly what lies ahead is uncertain, but without a commitment to education there will be no future. Because of its history, The Academy has a special opportunity to ensure the future of psychoanalytic contributions to psychiatry.

Forecasting↗