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Biomedical subjects

K V Wild

Publications and source records attributed to K V Wild.

9 recordsLinked to original sources
PubMed1998

The rate of progression of Alzheimer's disease in the later stages: evidence from the Severe Impairment Battery.

This study describes changes in cognitive function in patients who are typically excluded from longitudinal studies due to their inability to complete most standardized batteries. Thirty-three patients with moderate to severe Alzheimer's disease were assessed by means of the Severe Impairment Battery (SIB), Mini Mental State Examination (MMSE), Clinical Dementia Rating (CDR), and measures of functional status. Follow-up evaluations were conducted, and annual rates of change were calculated. Patients with severe cognitive impairment demonstrated rates of progression similar to patients who were moderately impaired at initial evaluation. Rates of decline on the SIB were unrelated to baseline cognitive function, and annual rate of decline in Year 1 was not correlated with disease progression in the subsequent year. This study demonstrates that, with appropriate assessments, severely impaired patients can exhibit a range of performance and rates of decline that are comparable to those of moderately impaired patients.

Aged↗
PubMed1996

Measures of psychiatric symptoms in Alzheimer patients: a review.

This review of instruments for the identification and quantification of psychiatric symptoms in Alzheimer disease (AD) is intended as a reference source for clinicians and researchers concerned with evaluating, quantifying, and managing psychiatric symptoms in AD. We review 16 clinician- and caregiver-rated scales selected from >30 scales on the basis of their face validity, their psychometric properties, the frequency of their use, and their promise as assessment instruments. Instruments are described in terms of the population on which they were developed, the symptoms assessed, informant, by whom administered, time to administer, time interval covered, number of items, measurement of frequency and severity, assessment of impact on caregiver, reliability, validity, and scoring. Recommendations are made concerning the best use of each scale. We summarize in table form the sources of information for instruments, characteristics of the instruments by domain, and potential use of instruments for quantification or management of symptoms and for estimation of caregiver burden. There are a number of reliable and valid scales for the assessment of psychiatric symptoms in AD, each with specific assets and liabilities. Knowledge of the specifics of these scales will enable clinicians and researchers to select the best instruments for their particular needs and to design more effective instruments.

Activities of Daily Living↗
PubMed1986

Combined psychotherapy and pharmacotherapy for depression. A systematic analysis of the evidence.

To determine whether combined psychotherapy and pharmacotherapy is superior to alternative therapies for unipolar depression, we reviewed all controlled studies of outpatients treated for unipolar depression reported between 1974 and 1984. To accomplish this, we developed a new statistical approach that is specific in its method of evaluating the quality of each study and specific about the weights given to each outcome. The combined active treatments (drugs plus psychotherapy) were appreciably more effective than the placebo conditions but only slightly superior to psychotherapy alone, pharmacotherapy alone, or either of these combined with a placebo.

Adolescent↗
PubMed1984

Psychodynamic variables as predictors of psychotherapy outcome.

Predicting the outcome of psychotherapy is a central concern in psychiatry. Twenty-one medical students seeking psychotherapy were evaluated on a number of psychodynamic and process variables using self-report scales and scales completed by the therapist before, during, and after psychotherapy. There were significant differences between patients and a comparison group on eight variables before therapy. Ten psychodynamic variables (six representing ego defense mechanisms) and four process variables were found to be highly correlated with outcome measures; the process variables were the best predictors of outcome. The data support the use of psychodynamic and process variables as predictors of outcome in psychoanalytically oriented psychotherapy.

Adult↗
PubMed1982

Learning dynamic psychotherapy: a longitudinal study.

The authors investigated the evolution of psychotherapeutic skills over time in a group of psychiatric residents in their third year of training. A 29-item Supervisors Evaluation Scale measuring psychotherapy skills was developed. Each resident who began his or her clinical experience in conducting individual analytically oriented psychotherapy was rated by his or her supervisors on this scale toward the beginning of training and again 8 months later. Statistically significant changes were found for 7 of the skills measured. The authors feel that these may reflect those aspects of psychotherapy which the beginning therapist can readily learn with supervision and experience.

Attitude of Health Personnel↗
PubMedDate not supplied

Early noncognitive change in Alzheimer's disease and healthy aging.

Recent studies in Alzheimer's disease have focused on behavioral disturbances in the more advanced stages of the illness rather than behavioral and personality changes occurring early in the disease course. We present a new instrument, the Oregon Noncognitive Inventory for Dementia (ONID), that was developed specifically for patients in the early stages of dementia, to identify subtle behavioral alterations that may precede the more severe cognitive changes of Alzheimer's disease. Mildly demented Alzheimer's patients were compared with age-matched healthy subjects on the ONID. Caregivers of these patients reported significantly more of the behaviors addressed by the ONID than did relatives of the healthy elderly. The results indicate that changes in behavior and personality can be reliably reported by family caregivers of patients with mild dementia. Future clinical applications of the ONID might include measuring change in drug trials, longitudinal studies of the progression of change, and differentiating Alzheimer's disease from other dementias based on a characteristics pattern of change.

Activities of Daily Living↗