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Biomedical subjects

M A Jenike

Publications and source records attributed to M A Jenike.

At least 109 records · Page 6Linked to original sources
PubMed1989

Normal and disordered compulsivity: evidence against a continuum.

Sixteen patients with obsessive compulsive disorder and 16 mentally healthy control subjects of comparable gender, age, and educational level underwent psychometric testing with the Obsessive-Compulsive subscale of the Comprehensive Psychiatric Rating Scale, the Maudsley Obsessive-Compulsive Inventory, and the Obsessive subscale of the Lazare-Klerman-Armor (LKA) Personality Inventory. An interviewer also rated each subject as positive or negative for each of the five DSM-III elements of compulsive personality disorder. Patients scored significantly higher than controls on all measures except the Obsessive subscale of the LKA Personality Inventory, on which the controls actually scored slightly higher. The authors suggest that the failure of this last instrument to differentiate the subject groups can be interpreted as evidence against a continuum between a certain type of supposed normal personality pattern (obsessive or compulsive) and a corresponding psychopathologic state (obsessive compulsive disorder).

Adult↗
PubMed1989

Treatment of affective illness in the elderly with drugs and electroconvulsive therapy.

Affective illness is common, frequently debilitating, and sometimes life-threatening in the elderly. Considerations pertaining to treatment with heterocyclic drugs, MAOIs, lithium, psychostimulants and thyroid hormone, as well as ECT, have been reviewed. Amitriptyline and imipramine cause significant orthostatic hypotension and probably should be avoided in the elderly. In addition, amitriptyline is extremely anticholinergic. Amoxapine is essentially a neuroleptic sequelae, including tardive dyskinesia. If a patient has had a prior positive response or has a relative who had a good outcome from a particular drug, it may be best to begin treatment with that drug. Initial choice of antidepressant can be based largely on the clinical picture. For example, if a depressed patient is sleeping much more than usual, try a potentially activating agent like desipramine or protriptyline. if, on the other hand, the patient is unable to sleep, a more sedating agent like nortriptyline, maprotiline, trimipramine, or trazodone should be tried. Risks and side effects of these drugs, as well as their use in cardiac patients, have been reviewed in detail. Many clinicians avoid MAOIs in elderly patients because of fear of adverse reactions. This fear is largely unfounded. Precautions, side effects, and specific recommendations have been outlined. Using lithium in the elderly requires special precautions because of decreased GFR and potential interactions with concomitantly used drugs. This paper has discussed possible side effects and toxicity. The usage of psychostimulants, such as methylphenidate and amphetamine, to treat medically ill depressed patients is reviewed. These agents are also sometimes useful in demented individuals or in patients with abulic frontal lobe syndromes. Poststroke depressions are common, and recent evidence indicates that they can be adequately treated. Stroke patients have many difficulties dealing with rehabilitation and should not be forced to suffer concomitant depression when we have the tools at hand to effectively treat such symptoms. Recent data on the potentiation of antidepressant effects by lithium or T3 indicate that they may be useful adjuvants in some tricyclic-resistant patients. Risks, side effects, and recent procedural advances in the use of ECT have been reviewed. Electroconvulsive therapy is both more effective and faster-acting than drugs in the treatment of depression. Many depressed elderly patients, especially those with psychotic symptoms, do not respond to drugs but improve with ECT.

Aged↗
PubMed1988

Use of a portable computer program to assist behavioral treatment in a case of obsessive compulsive disorder.

This case study describes the development and use of a portable computer program to assist in behavioral treatment of obsessive compulsive disorder. A 58-year-old female with a 37-year history of compulsive checking rituals, who had mild improvement following 36 months of standard behavioral techniques and pharmacotherapy, showed improved compliance with behavioral treatments of exposure and response prevention following use of the portable computer program. Computer records indicated marked reductions in frequency of checking rituals and a 91-week follow-up indicated that treatment effects were maintained at home where the patient had resumed using the laptop computer. She had stopped using the pocket computer outside the home, and there her checking rituals had returned to baseline levels.

Behavior Therapy↗
PubMed1988

Coprolalia in obsessive-compulsive disorder: a missing link.

Although recent clinical research has emphasized the relationship between Tourette's syndrome (TS) and obsessive-compulsive disorder (OCD), coprolalia, the most dramatic of the TS symptoms, has not been described in DSM-III OCD. The case presented here shows that coprolalia can indeed occur in OCD. This finding further erodes the phenomenological distinction between these two disorders. It also supports the role of psychological factors in the genesis of tic symptomatology.

Adult↗
PubMed1988

Psychoactive drugs in the elderly: antipsychotics and anxiolytics.

Psychiatric disorders in the elderly are common and often overlap with multiple medical problems. If used inappropriately, psychotropic drugs can further compromise a difficult clinical situation. Management of elderly patients with agitation, psychosis, anxiety, and insomnia are reviewed with a discussion of the optimal use of antipsychotic, anxiolytic, and sedating drugs. Initial attempts to control symptoms should involve nonpharmacologic techniques, but, when absolutely required, psychotropic drugs will often relieve symptoms with a minimum of side effects. Dangers in the chronic use of neuroleptics are stressed.

Aged↗
PubMed1988

Psychoactive drugs in the elderly: antidepressants.

Clinical depression in community-dwelling elderly has been estimated to be as high as 13%. Depression is frequently seen in the typical geriatric scenario of concurrent medical illness, and the suicide rate among the elderly is disproportionately higher than other age groups. Recognizing depression in the typical geriatric setting of multiple medical problems and differentiating it from other psychologic disorders is discussed in this review, as is an approach to assessing suicidal potential. An enlightened approach to drug therapy is presented, incorporating knowledge of previous treatment response and anticipating therapeutic benefits and side effects in the individual patient. An update on electroconvulsive therapy, particularly in severe geriatric depression, is included.

Aged↗
PubMed1987

Clinical comparison of Tourette's disorder and obsessive-compulsive disorder.

The authors report on 16 outpatients with Tourette's disorder, 16 outpatients with obsessive-compulsive disorder, and 16 normal control subjects who underwent structured interviews and psychological testing. Previous findings of a high incidence of obsessive-compulsive disorder in patients with Tourette's disorder were confirmed. There was a significantly greater incidence of tics in the patients with obsessive-compulsive disorder and their relatives. Both patient groups had high rates of unipolar depressive and generalized anxiety disorders. Panic and phobic disorders were frequent in the patients with obsessive-compulsive disorder but not in the patients with Tourette's disorder. The patients with obsessive-compulsive disorder showed less coprolalia, echo phenomena, self-destructive behavior, and childhood attention deficit.

Adult↗
PubMed1987

Obsessive-compulsive disorder, depression, and the dexamethasone suppression test.

Five of 29 obsessive-compulsive disorder patients were dexamethasone suppression test (DST) nonsuppressors, all of whom met standard Hamilton Depression Rating scale criteria for at least mild depression. None of 24 nondepressed obsessive-compulsive disorder patients had an abnormal DST. The relationship of the DST to specificity of psychiatric diagnoses is discussed.

Adolescent↗
PubMed1987

Disabling obsessive thoughts responsive to antidepressants.

The authors report four patients with disabling obsessive thoughts who responded in dramatic fashion to antidepressant medication. None met criteria for major depression. This response is discussed in light of the current literature on obsessive-compulsive disorder.

Adolescent↗