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M E Dewey

Publications and source records attributed to M E Dewey.

At least 37 records · Page 2Linked to original sources
PubMed1999

Undifferentiated dementia, Alzheimer's disease and vascular dementia: age- and gender-related incidence in Liverpool. The MRC-ALPHA Study.

BACKGROUND: Does incidence of dementia follow the age pattern of prevalence? Is gender a risk factor? Do patterns of incidence differ between dementias? AIMS: To assess age-specific incidence rates of undifferentiated dementias, Alzheimer's disease and vascular dementia. METHOD: 5222 individuals aged > or = 65 years, were interviewed using the Geriatric Mental State/History and Aetiology Schedule. The AGECAT package was used to identify cases at three interviewing waves at two-year intervals. Diagnoses were made using ICD-10 Research Criteria and validated against neurological and psychological examination, with imaging and neuropathology on unselected subsamples. RESULTS: Incidence rates of the dementias increase with age. Age patterns are similar between Alzheimer's disease and vascular dementia. Gender appears influential in Alzheimer's disease. In England and Wales, 39,437 new cases of Alzheimer's disease (4.9/1000 person-years at risk); 20,513 of vascular dementia (2.6/1000 person-years) and 155,169 of undifferentiated dementia (19/1000 person-years) can be expected each year. CONCLUSIONS: Incidence rates for Alzheimer's disease and vascular dementia appear to behave differently, with an increased risk of Alzheimer's disease for women compared to vascular dementia.

Age Factors↗
PubMed1998

Do experienced diagnosticians agree about the diagnosis of dementia from survey data? The effects of informants' reports and interviewers' vignettes.

Dementia in community settings is often diagnosed by computerized algorithms. This study examines the extent to which independent diagnosticians agreed among themselves in diagnosing dementia, severity and type when presented with data obtained during a population-based incidence study of cognitive decline and dementia. Secondly, it examines how judgements, based initially on respondents' self-reports and cognitive performance, were affected first by informants' reports and then by short case-vignettes written by trained lay interviewers. Thirdly, it compares diagnosticians' diagnosis of dementia with the algorithmic diagnosis (AGECAT). The items presented were selected from two screening interviews at wave 1 and wave 2 separated by an interval of 2 years and from wave 2 assessment and informant interviews, and included medical, psychiatric and ADL items and interviewers' own observations. The sample (N = 42) was derived from the first year of the wave 2 assessments, potential dementia cases entering consecutively while presumed normals were selected randomly. Informants were available in 30. Agreement on diagnosis and type of dementia improved with increasing information, particularly from informants, but remained poor regarding severity. The number of cases of dementia, defined operationally, increased from 10 to 12 and uncertain cases fell from eight to six, but no respondent initially diagnosed as a dementia case was rediagnosed as a non-case, or vice versa. Dementia type changed from agreement about Alzheimer's disease to agreement about vascular dementia in one case. Operational and algorithmic diagnoses showed good agreement. Causes of disagreement, the role of vignettes and the relevance of the results for population surveys are discussed.

Aged↗
PubMed1998

Outcome of the depressed elderly living in the community in Liverpool: a 5-year follow-up.

BACKGROUND: Comparatively little is known about the long-term natural history of depressive disorders in the elderly living in the community. This is a follow-up of a subsample of the Continuing Health in the Community study random sample of the elderly population living in Liverpool. METHODS: The investigators followed up 120 cases of depression identified by a semi-structured interview schedule (GMS) for a period of 5 years. A similar number of other subjects defined as subcases of depression, other cases of mental illness and a random selection of non-cases were also included. RESULTS: The 5-year outcome for the cases of depression was worse than the outcome of the non-cases (relative mortality risk of 2.1, 95% confidence interval 1.1 to 3.9). Thirty-four per cent of the cases of depression died and 28% had dropped out during the follow-up. Of the 46 cases of depression who had a complete follow-up, 22% recovered from their symptoms, 30% were found to be AGECAT cases at one of the three follow-up waves, 24% were AGECAT cases at two of the three follow-up waves and the remaining 24% were AGECAT cases at each follow-up wave. Fifteen per cent of the surviving cases of depression were organic cases at the follow-up. Their anxiety comorbid state and depression score were identified as predictors of poor outcome. CONCLUSION: The findings of this study indicate that depressive disorders (most of which were untreated) found in the elderly community have a poor prognosis.

Activities of Daily Living↗
PubMed1998

Schizophrenia and delusional disorder in older age: community prevalence, incidence, comorbidity, and outcome.

The opportunity to assess prevalence, incidence, and outcome of schizophrenia and delusional disorder was provided by an age- and sex-stratified random sample of 5,222 persons age 65 years and over. This sample was chosen from general practitioner lists, and interviewed by psychiatric nurses trained to use the Geriatric Mental State (GMS)-AGECAT computerized diagnostic system. GMS-AGECAT ensured the reliability of the selection of cases between the two waves of the study. A subsample was interviewed by a research psychiatrist. The sample was followed up 2 years later using the same method by interviewers blind to the initial findings. The protocols of all nominated cases and subcases of schizophrenia/paranoid disorder diagnosed by AGECAT were reviewed by a clinician and DSM-III-R diagnoses were made. Refusal rate was 13 percent for initial interviews (wave 1) and 15 percent for reinterview 2 years later (wave 2). The prevalence of DSM-III-R schizophrenia was 0.12 percent (95% confidence interval [CI] 0.04-0.25) and delusional disorder 0.04 percent (95% CI 0.00-0.14). The minimum incidence of schizophrenia for new cases was 3.0 (95% CI 0.00 to 110.70); for new and relapsed cases, 45.0 (95% CI 3.54-186.20); and for delusional disorder, 15.6 (95% CI 0.02-135.10) per 100,000 per year. Two of the five cases with schizophrenia were known to have been first diagnosed before age 65. After 2 years, none of the cases of schizophrenia had recovered fully, but none was deluded at followup. Two had developed dementia. The outcome was bad because they remained cases of some type of psychiatric illness but good because of the improvement in their schizophrenia/delusion disorder symptoms.

Aged↗
PubMed1997

Two predictions about paranoid ideation: deluded, depressed and normal participants' subjective frequency and consensus judgments for positive, neutral and negative events.

Two groups of patients suffering from persecutory delusions, one consisting of patients also suffering from depression and a non-depressed group, together with clinically depressed and normal controls matched with the deluded patients for age and intelligence, were asked to rate the frequency with which selected positive, negative and neutral events had happened to themselves and to an average other person in the past, and the frequency with which these events were likely to happen to themselves and to an average other person in the future. Results were similar for both past and expected future events. Non-depressed-deluded, depressed-deluded and depressed patients rated negative events as occurring relatively more frequently in comparison to the normal controls. Depressed participants rated positive events as occurring more frequently to others, whereas the normal participants rated negative events as occurring more often to others. Correlational analyses indicated that depression scores were associated with low estimates of the frequency with which positive events happen to self and high estimates of the frequency with which negative events happen to self. Magical ideation scores, an index of psychosis, were associated with high estimates of the frequency of negative events for both self and others. These findings are interpreted in the context of previous evidence on cognitive biases in deluded patients.

Adult↗
PubMed1997

Physical illness and disability among elderly people in England and Wales: the Medical Research Council Cognitive Function and Ageing Study. The Analysis Group.

STUDY OBJECTIVE: This study was conducted as part of the MRC cognitive function and ageing study. It aimed to estimate the lifetime prevalence of self reported physical illnesses and other health related events, and the prevalence of limiting disability in people over 65 in six areas of England and Wales. DESIGN: Screening phase of a two stage prevalence study. SETTING: Geographically delimited areas in four urban and two rural areas including institutions. PARTICIPANTS: Random population samples of people in their 65th year and above on the sample definition date, interviewed between 1989 and 1994. In Newcastle, Nottingham, and Oxford (urban) and in Cambridgeshire and Gwynedd(rural), the sample was stratified to provide equal numbers in the 65-74 and 75 years and over age groups. In Liverpool (urban), equal numbers in the five year age groups were taken. MAIN RESULTS: Age standardised prevalences were calculated for each geographical area, sex, and age group (65-74, 75+). Many conditions were more prevalent in the older age group including stroke, Parkinson's disease, arthritis, diabetes, and shingles but hypertension was more common in the younger age group. Conditions that were more prevalent in men included angina, heart attack, stroke, head injury, and peptic ulcers while hypertension, shingles, pernicious anaemia, and thyroid disease were more common in women. There was a complex pattern of area differences for individual conditions. Cambridgeshire had generally low prevalences for many diseases, including vascular problems, Gwynedd and Newcastle had less healthy elderly populations, and Nottingham and Newcastle had the highest percentages of housebound. CONCLUSIONS: This study provides the most robust available estimates for life-time prevalence of a variety of health conditions on a regional and national basis. It shows the greatly increased prevalence of disability in the very old population, particularly women.

Age Distribution↗
PubMed1995

Maternal attachment status, psychosocial stressors and problem behaviour: follow-up after parent training courses for conduct disorder.

37 Mothers of children with conduct disorder who had received Parent Management Training (PMT) were interviewed using the Adult Attachment Interview, 13-43 months after treatment. Child behaviour levels at follow-up were strongly associated with the scores at referral in the unresolved attachment group, but not in the resolved group. This was reflected in a statistical interaction between referral behaviour score and resolved/unresolved attachment status in a regression model. This model, which also included a strong independent contribution from a composite psychological stress index, explained 66% of the variance in follow-up behaviour scores. The implications of these results for predicting the outcome of PMT are discussed.

Child↗
PubMed1995

Cross-national comparison of prevalence of symptoms of neurotic disorders in older people in two community samples.

The objective of this research was to compare the prevalence of symptoms characteristic of neurotic disorders in two different cultural settings. The design was two random community samples in Liverpool (United Kingdom) and Zaragoza (Spain), of 1070 and 1080 people aged 65 and over. The main outcome measures were the rating of symptoms on the Geriatric Mental State and syndrome levels using the Automated Geriatric Examination for Computer Assisted Taxonomy. The results showed substantial differences between the two cities in the symptomatic pattern of phobias, but both the symptomatic and syndrome presentation of obsessional, hypochrondriacal and anxiety disorders were much more similar.

Aged↗
PubMed1995

Blood pressure as a risk factor for depression in elderly people: a prospective study.

A total of 1070 men and women aged 65 years and over living in the community in Liverpool were interviewed using the Geriatric Mental State. Diagnoses of depression at case and subcase level were made using the GMS-AGECAT package from an initial interview and at follow-up three years later. Data relating to blood pressure at year 0 was available on 748 subjects. Men not taking anti-hypertensives or antidepressants with diastolic blood pressure greater than 85 mmHg were significantly less likely to be subcases than men with low or normal diastolic pressure. People in this group were also significantly less likely to be cases 3 years later. There were no other significant findings. These results do not support an association between low blood pressure and coincidental or future subcase- or case-level depressive illness.

Aged↗
PubMed1994

Preliminary development of a questionnaire designed to measure neurotic perfectionism in the eating disorders.

The preliminary development and validation of a new self-report questionnaire (the NPQ) for measuring neurotic perfectionism in the eating-disorder population is described. The 42-item instrument demonstrated satisfactory internal consistency. All test items correlated significantly with both SCANS P and SCANS D (subscales of the SCANS [Slade & Dewey, 1986]), thus indicating neurotic perfectionism according to Slade, Newton, Butler, and Murphy (1991), and discriminated well between controls and eating-disorder patients. NPQ scores demonstrated significant group differences on comparison of neurotic perfectionists with normal and non-perfectionists (defined by the SCANS) and with subjects who scored above the EAT-26 (Garner, Olmsted, Bohr, & Garfinkel, 1982) subscale cut-offs when compared with those who scored below.

Adolescent↗
PubMed1994

The differential response of chronic fatigue, neurotic and muscular dystrophy patients to experimental psychological stress.

A group of patients suffering from chronic fatigue (CF) attending a medical clinic were compared with a group of muscular dystrophy (MD) patients from the same clinic and a psychiatric control (PC) group who were attending a psychiatric unit. A checklist was used to assess the patients' subjective physical and psychological state before and after exposure to a psychological stressor. For both physical and psychological symptoms the CF group had the largest response, the PC group was intermediate, and the MD group had the least response. Explanations may involve physiological arousal and attentional focusing.

Adaptation, Psychological↗
PubMed1994

Affective disorders among elderly general practice patients. A two-phase survey in Brescia, Italy.

BACKGROUND: We investigated the prevalence of depression among 255 elderly general practice patients and the practitioners' performance in identifying depression. METHOD: Elderly patients attending 14 general practices entered a screening phase with GHQ-12 and MMSE. Those positive were then interviewed with GMS and HAS. RESULTS: DSM-III-R major depression affected 22.4%, dysthymic disorder 6.3%, not otherwise specified (n.o.s.) depression 7.1%. General practitioners performed fairly well: identification index 88.4%, accuracy 0.49, bias 1.85. CONCLUSIONS: Depression was markedly high. A selective progression of depressed elderly from the community to general practitioners is implied.

Age Factors↗
PubMed1993

Authors have rights too.

Without publication research can be of little value. When researchers approach publication there is ample published guidance for them on what their obligations are, and there are well known style guides within each scientific discipline including, in medicine, the Vancouver style. This article gives a series of anonymous examples to suggest that the impact of similar guides for editors has been patchy and to make some suggestions for better communication.

Authorship↗
PubMed1993

Expressed wish to die and mortality in older people: a community replication.

Three-year mortality of 1063 community residents aged 65 and over interviewed with the Geriatric Mental State Schedule was analysed to examine the influence of specific depression symptoms and physical illness in order to test theoretical predictions from models proposed by Macdonald and Dunn, and by Jorm and colleagues. Expressed wish to die was confirmed as a predictor of mortality, controlling for age, sex, and cognitive impairment. The suggestion that the effect of depressive symptoms on mortality might be a masked effect of physical illness was not confirmed. In general the more specific severe symptoms were better predictors of mortality.

Aged↗
PubMed1993

The prevalence of dementia, depression and neurosis in later life: the Liverpool MRC-ALPHA Study.

Prevalence rates for psychiatric disorders in the elderly are presented from the initial cross-sectional stage of a longitudinal community study of the incidence of dementia in the city of Liverpool. Together with five other centres in the UK the MRC-ALPHA project forms part of the MRC multicentre incidence study of dementia and cognitive decline. An age- and sex-stratified random sample of 5222 subjects aged > or = 65 was interviewed at home using the Geriatric Mental State-AGECAT package to provide computer diagnoses. The overall age-standardized prevalence rates for organic disorder (4.7%) depressive illness (10.0%) and the neuroses (2.5%) are consistent with levels found in previous smaller studies that have used GMS-AGECAT. Each of these diagnoses is more common in females than males. A rise in organic disorder with age is confirmed as continuing into the oldest age groups for both sexes. An apparent decline with age observed for depression and neurosis diagnoses disappears when organic cases are excluded from the analysis.

Age Distribution↗
PubMed1993

Cross-cultural comparison of depression and depressive symptoms in older people.

This article presents data on the prevalence of depression and the profile of depressive symptoms in 2 groups of people aged 65 and over: 1070 living in Liverpool, United Kingdom, and 1080 living in Zaragoza, Spain. Similar prevalence figures were found for women (Liverpool first); 14.2% vs 14.8% and, for men, 7.2% vs 6.2%. No age differences were found. The figures are lower than those found using similar methods in London and New York, but higher than those from Iceland. The article also compares the profile of depressive symptoms between Liverpool and Zaragoza and explains these by reference to social and cultural differences.

Aged↗
PubMed1993

Prospective data on the prevalence of abnormal involuntary movements among elderly people living in the community.

Trained raters from the Liverpool Continuing Health in the Community study interviewed 1070 people over the age of 65 in 1982-1983 using the Geriatric Mental State (GMS) examination. Three years later the cohort was re-interviewed, this time by psychiatrists trained in the GMS, who used the GMS and the History and Aetiology Schedule (HAS). The cohort had fallen in size to 875, because of mortality; 701 were re-interviewed. The cohort was followed up again 6 years after the first interview by trained nurse raters using the GMS (A3) and the Mini-Mental State Examination. Cases of mental disorder identified by the computer diagnostic program AGECAT were re-interviewed by psychiatrists along with a number of controls using the GMS and the HAS on the remaining 450 individuals. Observational behavioural ratings from the GMS and summary sheets were analysed along with AGECAT diagnoses and data on medication gained at the 3 assessments. The community prevalence of tardive dyskinesia and other movement disorders in elderly people over a 6-year follow-up appears to be very low (the community prevalence of tardive dyskinesia being 0.22% and akathisia 1.57%), is usually associated with organic mental disorder (and consequently higher mortality) and is furthermore not usually associated with antipsychotic medication.

Aged↗