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Biomedical subjects

M Hodes

Publications and source records attributed to M Hodes.

18 recordsLinked to original sources
PubMed2000

Maternal expressed emotion and treatment compliance of children with epilepsy.

This study investigated the association between family relationships and compliance in the treatment of childhood epilepsy. It was a prospective study of 21 families with a child who had epilepsy attending Central Middlesex Hospital, London. There were 13 boys and eight girls, with a mean age of 12.0 years (SD 2.9) at initial assessment. Mothers were interviewed for assessment of expressed emotion as a measure of parent-child relationships. Assessment of the mothers' adjustment using the General Health Questionnaire (Goldberg 1978), and psychological adjustment of the children using the Rutter Scales (Rutter et al. 1970a), were completed by mothers and teachers. Reassessment was 3 to 4 years after initial contact, including a paediatric case-note review to assess clinic attendance and overall treatment compliance. Significantly more of the group who had a good level of compliance had recovered from epilepsy at follow-up. Good treatment compliance was found to be associated with less maternal hostility and criticism. Children and mothers in the good compliance group had fewer psychiatric symptoms. Poor treatment compliance and the associated psychological disturbances suggest that assertive paediatric and psychosocial intervention may be needed for some children with epilepsy.

Adolescent↗
PubMed2000

Psychopathology, adversity, and service utilization of young refugees.

OBJECTIVE: To investigate the psychopathology, social impairment, adversities, and service utilization of refugee families and their children seeking help at a child and adolescent psychiatry clinic in London. METHOD: A retrospective case-control study of 30 refugee children and families individually matched with nonrefugee immigrant families and white British families. Case note review was carried out to obtain data on diagnosis, social adjustment, past adversity, exposure to violence, current socioeconomic circumstances, and use of the child and adolescent psychiatric service. RESULTS: Refugee children tended to have disorders with a psychosocial etiology rather than neurobiological disorders. Refugees had similar levels of social impairment compared with the other groups. Refugees were much more isolated and disadvantaged and had different referral pathways but were not more likely to drop out of treatment prematurely. CONCLUSIONS: Refugee children and families had been exposed to high levels of adversity. The ability of community agencies to refer families who could use treatment has significant resource implications.

Adolescent↗
PubMed2000

Family therapy for adolescent anorexia nervosa: the results of a controlled comparison of two family interventions.

This paper reports the results of a randomised treatment trial of two forms of outpatient family intervention for anorexia nervosa. Forty adolescent patients with anorexia nervosa were randomly assigned to "conjoint family therapy" (CFT) or to "separated family therapy" (SFT) using a stratified design controlling for levels of critical comments using the Expressed Emotion index. The design required therapists to undertake both forms of treatment and the distinctiveness of the two therapies was ensured by separate supervisors conducting live supervision of the treatments. Measures were undertaken on admission to the study, at 3 months, at 6 months and at the end of treatment. Considerable improvement in nutritional and psychological state occurred across both treatment groups. On global measure of outcome, the two forms of therapy were associated with equivalent end of treatment results. However, for those patients with high levels of maternal criticism towards the patient, the SFT was shown to be superior to the CFT. When individual status measures were explored, there were further differences between the treatments. Symptomatic change was more marked in the SFT whereas there was considerably more psychological change in the CFT group. There were significant changes in family measures of Expressed Emotion. Critical comments between parents and patient were significantly reduced and that between parents was also diminished. Warmth between parents increased.

Adolescent↗
PubMed1999

The assessment of expressed emotion in a standardised family interview.

This study compared the expressed emotion (EE) scores obtained using individual interviews with parents with the scores obtained in whole family interviews. Interviews were carried out with 31 parents of 16 adolescents referred because of an eating disorder. There was moderate correlation of scores between the two interviews regarding critical comments, emotional overinvolvement, and warmth, but it was low for positive remarks. The study suggests that the whole family interview, which is time saving, is useful in assessing expressed emotion. The levels of expressed emotion, particularly the relatively low levels of critical comments and emotional overinvolvement, are similar to those of previous studies.

Adolescent↗
PubMed1999

Maternal expressed emotion and adjustment in children with epilepsy.

Epilepsy in childhood may alter family relationships but the relevance of these changes for the increased rates of psychopathology has been little investigated. This study uses maternal expressed emotion (EE) to examine family relationships of children with epilepsy and the association with high risk for psychiatric disorder. EE was assessed using the Camberwell Family Interview carried out with the mothers of 22 schoolchildren with chronic epilepsy who were attending a general hospital outpatient clinic. Sixteen of these children had similarly aged healthy siblings who served as controls. High risk for psychiatric disorder in the children and mothers was assessed using behavioural, mood, and self-esteem questionnaires completed by mothers, teachers, and children. It was found that mothers showed significantly more emotional overinvolvement and a trend for more hostility towards their children with epilepsy than towards sibling controls. For the 22 children with epilepsy, maternal emotional overinvolvement was not associated with child behavioural deviance. High levels of criticism and, to a lesser extent, hostility did show associations with child behavioural deviance, and the strongest links were between maternal criticism and maternal rated antisocial and overactive behaviour in the child. Fewer positive comments by mothers towards the children were associated with child emotional symptoms and lower self-esteem in a number of areas. This study suggests that further research could consider the appropriateness of psychological intervention for families in which mothers are critical and hostile and whose children show antisocial behaviour.

Adaptation, Psychological↗
PubMed1998

Very early-onset bulimia nervosa: report of two cases.

Bulimia nervosa is very rare in children below the age of 14 years, and no reliable reports of prepubertal bulimia nervosa have been published. We describe two cases of early-onset bulimia nervosa who presented before the age of 14 years, and with premenarchal onset in one patient. Both girls demonstrated high levels of the risk factors known to play a part in the etiology of bulimia nervosa. Implications of these cases regarding the etiology and occurrence of bulimia nervosa in younger adolescents are discussed.

Adolescent↗
PubMed1998

A core curriculum for child and adolescent psychiatry.

This paper suggests that it will be increasingly necessary to have a core curriculum for training in child and adolescent psychiatry. The reasons include the growth of knowledge, need for selection of information, the influence of evidence-based practice and accountability, and recognition of training across the European community. The principles for organising a curriculum are coherence, accessibility, and the context of professional development. Implementation of these principles is illustrated by the St Mary's training programme in London. Important components are the reading seminars in developmental psychopathology and the psychological treatments course. Implementing a core curriculum nationally and internationally would have difficulties, which could be overcome by a compromise of central control and local interests and initiatives.

Adolescent↗
PubMed1996

Cross-cultural differences in maternal evaluation of children's body shapes.

OBJECTIVE: This study investigated cultural variation in mothers' attitudes to children's body shape. METHOD: One hundred thirty-one mothers from five cultural groups attending a pediatric clinic were approached, and data obtained from 114. Background information was obtained, including weight and height for themselves and their children. Mothers completed the Eating Attitudes Test (EAT-26) and rated drawings of children for attractiveness and health, using Likert scales, scored 1-7. RESULTS: Mothers from the different cultural groups had similar body mass index (BMI) and EAT scores, and their children had similar average body weight. However, UK mothers found slimmer girls attractive compared to mothers from South Asia, the Mediterranean or the Caribbean regions, and sub-Saharan Africa (p < .05). The differences occurred within the mid-range (median scores for all ethnic groups 4-5). South Asian mothers presented to the pediatric clinic with more worries about their children not gaining weight and growth (p < .01). DISCUSSION: These findings have implications for understanding cultural variation in the acquisition of attitudes to body shape, and these attitudes influence medical help seeking.

Attitude↗
PubMed1993

Expressed emotion in the investigation of eating disorders: a review.

Expressed Emotion (EE) is a measure of family interaction that has been shown to be useful for the investigation of many psychiatric disorders. This paper describes why it is appropriate to use it for the investigation of eating disorders. There is discussion of the findings that the levels tend to vary between the different eating disorders. The relationship between EE and treatment response is discussed. Suggestions are made for further research.

Adolescent↗
PubMed1992

Early onset bulimia nervosa: who is at risk? A retrospective case-control study.

The aim of the study was to compare the clinical features and predisposing characteristics of patients with an early onset of bulimia nervosa with those with a more typical onset. Twenty-three cases of early onset bulimia nervosa (onset age 15 or below) were compared with 23 sex- and class-matched cases of typical onset (onset age 17 to 21) using a retrospective case-control design. No difference was found in eating symptomatology between the two groups. Deliberate self-harm was more frequent in the early onset group, and there was a trend towards more depression among their relatives. Inadequate parental control occurred more often in the early onset group, but other indicators of intrafamilial disturbance did not differ in the two groups. There was also a trend for the early onset group to be exposed to more cultural stress as a result of family migration. Early onset patients were found to have a higher loading on risk factors than typical onset patients.

Adolescent↗
PubMed1990

Overdosing as communication: a cultural perspective.

The recent epidemic of suicide attempts by overdosing has been explained in different ways. The suggestion that overdosing is a form of language or communication is explored here. Understanding the meaning of the communication requires consideration of the culture in which overdosing occurs, and some relevant cultural changes are discussed. How the overdose functions as communication between people is explained in terms of the properties of a communication system. The full meaning needs to be understood in relation to the individual's social world. The overdose may have different meanings for different family members and these are linked to different affective responses. Overdosing occurs in individuals who are relatively powerless, and the implications of this are discussed.

Adolescent↗
PubMed1983

Parkinsonism: improvement by electroconvulsive therapy.

Not infrequently, patients with parkinsonism either do not respond to antiparkinsonian medications or cannot tolerate those medications because of side effects. We report a patient who, having responded poorly to every medical regimen for parkinsonism, showed marked improvement in gait and balance after electroconvulsive therapy (ECT) for treatment of concomitant severe depression. ECT has been found to increase the sensitivity of postsynaptic dopaminergic receptors and noradrenergic receptors and to facilitate, for a considerable period of time, the neurotransmission along dopaminergic and noradrenergic pathways in the brain. Thus, ECT may represent another important therapeutic modality for patients with parkinsonism.

Aged↗