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Biomedical subjects

K R Silk

Publications and source records attributed to K R Silk.

34 records · Page 2Linked to original sources
PubMed1989

The relationship between borderline personality disorder and anxiety disorders.

Eleven "pure" borderlines, ten borderlines with depression, 16 "pure" depressives, and 31 normal subjects were compared on a number of standardized inventories of anxiety. While patient groups experienced more anxiety of all types than did normals, borderlines did not emerge as more anxious than other patient groups. Qualitative differences in the anxiety experienced by borderlines and nonborderlines are discussed.

Adult↗
PubMed1988

Treatment of negative schizophrenic symptoms with trihexyphenidyl.

In an effort to investigate reports of possible benefits of trihexyphenidyl on residual schizophrenic symptoms, the drug was administered to five chronic schizophrenic patients with predominantly negative symptoms. These patients were simultaneously receiving various antipsychotic agents without extrapyramidal side effects. There was a marked improvement in four of the five patients, mainly in the areas of affective flattening, anhedonia-asociality, and avolition-apathy. Three of these four patients also reported a reduction in excessive dreaming and nightmares experienced prior to the introduction of trihexyphenidyl. Common pathogenetic mechanisms for negative schizophrenic symptoms and excessive dreaming are discussed. In view of these findings, an investigation of the therapeutic benefits of anticholinergic agents in the treatment of negative schizophrenic symptoms, and the use of decreased dreaming as a possible marker of response, is warranted.

Female↗
PubMed1985

Platelet alpha-2-adrenergic dysfunction in negative symptom schizophrenia: a preliminary study.

The specific binding to platelet membranes (Bmax) of 3H-clonidine, an alpha-2 agonist, and 3H-yohimbine, an alpha-2 antagonist, was measured in nine drug-free male schizophrenic patients and repeated after 2 weeks of chlorpromazine (CPZ) treatment. Patients with a lower pretreatment Bmax for 3H-clonidine showed a significantly smaller change in Bmax after treatment, less improvement in their clinical state, as indicated by the change in the Global Assessment Scale (GAS), and a lower posttreatment GAS. Also, they had a significantly higher score for negative symptoms on the Affect Rating Scale both before and after treatment. These findings suggest that schizophrenic patients with relatively subsensitive platelet alpha-2-adrenergic receptors, as measured by 3H-clonidine binding, tend to have more negative symptoms and a diminished alpha receptor binding response and diminished clinical response to CPZ. There were no clinical correlations to 3H-yohimbine binding.

Blood Platelets↗
PubMed1984

Platelet alpha 2-adrenergic receptors in schizophrenic patients before and after phenothiazine treatment.

The specific binding to isolated platelet membranes of 3H-clonidine, an alpha 2-adrenergic receptor partial agonist, and 3H-yohimbine, an alpha 2-adrenergic receptor antagonist, was measured in male, drug-free schizophrenic patients. The maximum number of binding sites (Bmax) for 3H-yohimbine was significantly lower in these patients than in normal subjects. Treatment with chlorpromazine (CPZ) for 2 weeks further decreased the Bmax for both ligands. Plasma catecholamine levels were determined before and after treatment. Before treatment, levels of dopamine and norepinephrine (NE) were within a normal range, while epinephrine (E) levels were significantly elevated. CPZ treatment significantly increased plasma NE levels, but decreased E levels to a normal range. These observations suggest that schizophrenia might be associated with abnormal noradrenergic function that is reflected by a decreased number of platelet alpha 2-adrenergic receptors.

Adult↗
PubMed1983

Test-retest reliability of the diagnostic interview for borderlines.

Gunderson's Diagnostic Interview for Borderlines (DIB) has gained increasing acceptance and use as a diagnostic research instrument. Although previous studies report interrater reliability for the DIB, no attention has been given to problems of test-retest reliability or variability among different clinicians conducting a semistructured clinical interview. This study demonstrated both interrater and test-retest reliability for the DIB when it is administered by trained clinicians. No effects of interviewer sex were found, but less experienced clinicians tended to give higher (more borderline) scores than more experienced clinicians.

Adult↗
PubMed1980

Eyeglasses and schizophrenic spectrum disease.

In an attempt to understand the mystery of schizophrenia, researchers have often studied the eyes of schizophrenic patients. These investigations have included ophthalmological descriptions of the pupil and the disc, electrophysiological research into eye movements, and clinical phenomenological data concerning the bizarre symbolic significance that schizophrenics attach to eyes. This paper attempts to describe how patients who fit the broader definition of schizophrenic spectrum disorder use or misuse eyeglasses, especially in the clinical setting. These patients may lose or break their glasses and not replace them, they may refuse to wear them, or they may simply forget that they wear glasses altogether. The author explores this phenomenon through the study of four case reports and proposes a hypothesis to explain the meaning of this behavior. Its application to clinical treatment is then discussed.

Adult↗
PubMed1979

Racism as a response to change. The introduction of residents onto a psychiatry ward.

An outbreak of violence among inpatients coincident with the beginning of a residency training program is described. The phenomenon is viewed as an example of covert staff disagreement resulting in the scapegoating of black patients. Suggestions are made as to how to avoid the occurrence of similar phenomena through a process of re-education of ward staff.

Acting Out↗
PubMed1978

Hemodialysis and schizophrenia. A negative report.

A preliminary, uncontrolled study utilizing hemodialysis in the treatment of chronic schizophrenia reported a high success rate. Two patients are presented who had both schizophrenia and chronic renal failure and who underwent intensive, long term hemodialysis with no change in their schizophrenic symptomatology. This negative finding is consistent with other case reports. Retrospective or limited controlled studies based on previous research with false neurotransmitters, serum protein factors, or endorphins in schizophrenia are urged before further patients with normal kidney function are exposed to the risks of hemodialysis.

Adult↗
PubMedDate not supplied

DSM-III and DSM-III-R schizotypal symptoms in borderline personality disorder.

The frequency of DSM-III and DSM-III-R schizotypal personality disorder (SPD) symptoms and diagnosis was explored in 39 inpatients classified as borderline by the Diagnostic Interview for Borderlines (DIB) and 19 inpatient major depressive disorder (MDD) controls. Most SPD symptoms in all groups, except the nondepressed borderlines, derived from social-interpersonal items. By DSM-III, 24 borderlines (62%) but only six controls (32%) had cognitive-perceptual SPD symptoms (P = .03), whereas by DSM-III-R only 14 borderlines (36%) and seven controls (37%) had such symptoms. Of the 24 borderlines showing cognitive-perceptual symptoms, 16 also had MDD, a significant difference from the non-MDD borderlines (P = .04). This difference disappears in DSM-III-R. The results suggest that some SPD symptoms in borderlines may be related to a concurrent affective episode.

Adult↗
PubMedDate not supplied

History of childhood sexual abuse and general psychopathology.

Reported history of childhood sexual abuse (CSA) was correlated with general measures of psychopathology on the SCL-90-R in a sample that included inpatients with borderline personality disorder (BPD), inpatients with major depression, and a nonpatient control group. When subjects who reported abuse were compared with those who did not, scores for the Global Severity Index (GSI) and all subscales of the SCL-90-R, except for the obsessive-compulsive and somatization subscales, were significantly-higher. When only those subjects who reported CSA were studied and when specific measures of CSA were the independent variables and SCL-90-R subscales were the dependent variables, scores on the hostility, interpersonal sensitivity, and paranoia subscales of the SCL-90-R were significantly higher. Because a large proportion of the sample consisted of borderline patients, and because both the specific measures of CSA and the borderline diagnosis could predict similar SCL-90-R subscale results, a series of stepwise regressions were performed. In the first regression, diagnosis, gender, and specific measures of CSA were the predictor variables and SCL-90-R subscale scores were the dependent variables; in the second regression, SCL-90-R subscales and specific measures of CSA were the predictor variables and diagnosis was the dependent variable. Interpersonal sensitivity was the only significant predictor of the borderline diagnosis. We suggest that, at least in some cases, interpersonal sensitivity may be the constitutional/environmental substrate on which traumatic experiences interact to arrive at the borderline diagnosis.

Adult↗
PubMedDate not supplied

A review of inpatient group therapy for borderline personality disorder.

Because the average length of psychiatric hospitalization is decreasing, effective short-term treatments for patients with borderline personality disorder (BPD) are in greater demand. Of particular interest are group therapies, which have traditionally been a treatment of choice on inpatient units. We review empirical research and clinical descriptions of group psychotherapy for inpatients with personality disorders, especially BPD. Based on the existing literature on inpatient groups, supplemented by the most recent literature on outpatient groups for patients with BPD, we propose a framework within which an effective short-term group treatment may be developed for inpatients with this disorder. In particular, we discuss the advantages and disadvantages of adapting Linehan's Dialectical Behavior Therapy for short-term inpatient use.

Attitude to Health↗