Adult attention deficit disorder and child abuse.
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Adult↗
Biomedical subjects
M J Harris
Publications and source records attributed to M J Harris.
Sleep-disordered breathing and periodic limb movements in sleep in older patients with schizophrenia.
BACKGROUND: Since the prevalence of both sleep-disordered breathing (SDB) and periodic limb movements in sleep (PLMS) increase with age, we explored whether older schizophrenia patients would have a high incidence of SDB and PLMS. Correlations between sleep and clinical variables were also examined. METHODS: Fifty-two patients (mean age = 59.6 years, SD = 8.9) had their sleep/wake, respiration, and leg movements recorded using a modified Medilog/Respitrace portable recording system plus oximetry. A battery of clinical, psychosocial, and motor disturbance variables were collected by research center staff. RESULTS: Forty-eight percent of these patients had at least 10 respiratory events per hour of sleep. These patients reported more symptoms of daytime sleepiness than patients with fewer than 10 events per hour. The relatively high prevalence of SDB in this group may contribute to overall sleep disturbances, and does not appear to be a result of high body mass index. Only 14% of the patients had at least five limb movements per hour of sleep, suggesting the prevalence of PLMS is much lower than expected in this age group. The number of leg jerks was inversely related to symptoms of tardive dyskinesia. CONCLUSIONS: The disturbance of sleep in these patients may be due, in part, to SDB, but is unlikely due to PLMS.
Age Factors↗
Mini-review: toward understanding mechanisms of genetic neural tube defects in mice.
We review the data from studies of mouse mutants that lend insight to the mechanisms that lead to neural tube defects (NTDs). Most of the 50 single-gene mutations that cause neural tube defects (NTDs) in mice also cause severe embryonic-lethal syndromes, in which exencephaly is a nonspecific feature. In a few mutants (e.g., Trp53, Macs, Mlp or Sp), other defects may be present, but affected fetuses can survive to birth. Multifactorial genetic causes, as are present in the curly tail stock (15-20% spina bifida), or the SELH/Bc strain (15-20% exencephaly), lead to nonsyndromic NTDs. The mutations indicate that "spina bifida occulta," a dorsal gap in the vertebral arches over an intact neural tube, is usually genetically and developmentally unrelated to exencephaly or "spina bifida" (aperta). Almost all exencephaly or spina bifida aperta of genetic origin is caused by failure of neural fold elevation. The developmental mechanisms in genetic NTDs are considered in terms of distinct rostro-caudal zones along the neural folds that likely differ in mechanism of elevation. Failure of elevation leads to: split face (zone A), exencephaly (zone B), rachischisis (all of zone D), or spina bifida (caudal zone D). The developmental mechanisms leading to these genetic NTDs are heterogeneous, even within one zone. At the tissue level, the mutants show that the mechanism of failure of elevation can involve, e.g., (1) slow growth of adjacent tethered tissue (curly tail), (2) defective forebrain mesenchyme (Cart1 or twist), (3) defective basal lamina in surface ectoderm (Lama5), (4) excessive breadth of floorplate and notochord (Lp), (5) abnormal neuroepithelium (Apob, Sp, Tcfap2a), (6) morphological deformation of neural folds (jmj), (7) abnormal neuroepithelial and neural crest cell gap-junction communication (Gja1), or (8) incomplete compensation for a defective step in the elevation sequence (SELH/Bc). At the biochemical level, mutants suggest involvement of: (1) faulty regulation of apoptosis (Trp53 or p300), (2) premature differentiation (Hes1), (3) disruption of actin function (Macs or Mlp), (4) abnormal telomerase complex (Terc), or (5) faulty pyrimidine synthesis (Sp). The NTD preventative effect of maternal dietary supplementation is also heterogeneous, as demonstrated by: (1) methionine (Axd), (2) folic acid or thymidine (Sp), or (3) inositol (curly tail). The heterogeneity of mechanism of mouse NTDs suggests that human NTDs, including the common nonsyndromic anencephaly or spina bifida, may also reflect a variety of genetically caused defects in developmental mechanisms normally responsible for elevation of the neural folds.
Animals↗
Cloning of mammalian heparanase, an important enzyme in tumor invasion and metastasis.
The endoglycosidase heparanase is an important in the degradation of the extracellular matrix by invading cells, notably metastatic tumor cells and migrating leukocytes. Here we report the cDNA sequence of the human platelet enzyme, which encodes a unique protein of 543 amino acids, and the identification of highly homologous sequences in activated mouse T cells and in a highly metastatic rat adenocarcinoma. Furthermore, the expression of heparanase mRNA in rat tumor cells correlates with their metastatic potential. Exhaustive studies have shown only one heparanase sequence, consistent with the idea that this enzyme is the dominant endoglucuronidase in mammalian tissues.
Adenocarcinoma↗
Lower incidence of tardive dyskinesia with risperidone compared with haloperidol in older patients.
OBJECTIVE: To compare the 9-month cumulative incidence of tardive dyskinesia (TD) with risperidone to that with haloperidol in older patients. DESIGN: A prospective longitudinal study. SETTING: An outpatient psychiatric clinic. PARTICIPANTS: Subjects were middle-aged and older (mean age 66 years) patients with schizophrenia, dementia, mood disorders, or other conditions with psychotic symptoms or severe behavioral disturbances. Sixty-one patients on risperidone were matched with 61 patients from a larger sample of haloperidol-treated patients in regard to age, diagnosis, and length of pre-enrollment neuroleptic intake to create clinically comparable groups. The median daily dose of each medication was 1.0 mg. MEASUREMENTS: Abnormal Involuntary Movement Scale, modified Simpson-Angus' scale for extrapyramidal symptoms, Brief Psychiatric Rating Scale, and Mini-Mental State Examination were administered at baseline, 1 month, and 3, 6, and 9 months. The diagnosis of TD was based on specific research criteria. The raters were blind to the patient's medication status. RESULTS: Life table analysis revealed that patients treated with haloperidol were significantly more likely to develop TD than patients treated with risperidone (P < .05, Peto-Prentice). CONCLUSIONS: The atypical antipsychotic risperidone is significantly less likely to result in TD than the conventional neuroleptic haloperidol in a high-risk group of older patients, at least over a 9-month period.
Aged↗
Depressive symptoms in schizophrenia.
OBJECTIVE: The authors assessed the presence and severity of depressive symptoms, as well as their associations with other clinical measures, in a group of mid- to late-life patients with schizophrenia who were not in a major depressive episode or diagnosed with schizoaffective disorder. METHOD: Sixty outpatients with schizophrenia between the ages of 45 and 79 years and 60 normal comparison subjects without major neuropsychiatric disorders, proportionally matched for age and gender, were studied. Depressive symptoms were rated primarily with the Hamilton Depression Rating Scale. Standardized instruments were also used to measure global psychopathology, positive and negative symptoms, abnormalities of movement, and global cognitive status. RESULTS: Depressive symptoms were more frequent and more severe in schizophrenic patients than in normal comparison subjects; 20% of the women with schizophrenia had a Hamilton depression scale score of 17 or more. Severity of depressive symptoms correlated with that of positive symptoms but not with age, gender, negative symptoms, extrapyramidal symptoms, or neuroleptic dose. CONCLUSIONS: Depressive symptoms are common in older patients with schizophrenia. They may be an independent, core component of the disorder or, alternatively, may be a by-product of severe psychotic symptoms.
Age Factors↗
Incidence of tardive dyskinesia in early stages of low-dose treatment with typical neuroleptics in older patients.
OBJECTIVE: The authors studied the risk of tardive dyskinesia for older patients in the early stages of treatment with typical neuroleptics. METHOD: They examined the cumulative incidence of tardive dyskinesia 1, 3, 6, 9, and 12 months after the institution of neuroleptic therapy among 307 psychiatric outpatients over age 45. The patients' median dose was 68.4 mg/day of chlorpromazine equivalent. RESULTS: In the patients who had never received neuroleptics at baseline (N = 87), the mean cumulative incidence of tardive dyskinesia was 3.4% and 5.9% at 1 and 3 months, respectively. There was no significant difference in the 12-month cumulative incidence of tardive dyskinesia among patients who had been neuroleptic-naive at baseline (22.3%) and the 89 patients who had received neuroleptics before baseline for 1-30 days (24.6%); however, the 131 patients who had received neuroleptics before baseline for more than 30 days tended to have a greater cumulative 12-month incidence of tardive dyskinesia (36.9%). CONCLUSIONS: The risk of tardive dyskinesia in older outpatients is high, even with relatively short treatment with low doses of conventional neuroleptics.
Age Factors↗
Training in geriatric mental health: needs and strategies.
This paper examines current numbers of U.S. mental health care professionals in psychiatry, psychology, social work, and nursing who are trained to treat late-life mental disorders and presents estimates of the increased numbers that will be needed by 2010. Strategies that may be effective in increasing the supply of geriatric mental health specialists are expanding incentives, such as fellowship stipends, loan forgiveness programs, and clinical reimbursement, to attract more clinicians to the field; encouraging professional organizations to offer certification in aging to highlight increased knowledge among professionals; and increasing core curricula in late-life mental disorders, or at least in aging, in all health professions. Other strategies are to diversify the range of training opportunities available by establishing short-term training initiatives to meet specific demands; use new technology to provide education to both professionals and the public; and establish "centers of excellence" to advance research training and clinical care in late-life mental disorders.
Aged↗
Behavioral and electrophysiologic predictors of treatment response to stimulants in children with attention disorders.
Behavioral and quantitative electroencephalography (EEG) techniques were used to evaluate treatment response to stimulant therapy in children with attention disorders. A sample of 130 children with attention disorders were evaluated with Conners and Diagnostic and Statistical Manual of Mental Disorders--III rating scales, and with neurometric quantitative EEG before and 6 to 14 months after treatment with stimulants. Significant quantitative EEG differences were found between the normal control population (N = 31) and the children with attention problems. Quantitative EEG abnormalities involved increased theta or alpha power, greatest in frontal regions, frontal theta/alpha hypercoherence, and posterior interhemispheric power asymmetry. Behavioral improvement after stimulant treatment was seen in 81.5% of the children with attention-deficit hyperactivity disorder and 44.7% of the children with attention-deficit disorder, with the degree of correspondence between behavioral and quantitative EEG changes at 78.5%. Pretreatment clinical and quantitative EEG features could predict treatment response with a sensitivity of 83.1% and a specificity of 88.2%. A combined behavioral and quantitative EEG approach can be useful for following and predicting treatment response to stimulants in children with attention disorders.
Adolescent↗
Gender-related clinical differences in older patients with schizophrenia.
BACKGROUND: Gender differences in the clinical presentation of young patients with schizophrenia have been well-documented, yet few studies have investigated gender-related clinical differences in older patients. Furthermore, the symptoms of late-onset schizophrenia have been described, but the interaction between gender and age at onset has not been examined. METHOD: In an older (46-85 years of age) outpatient sample, we assessed clinical characteristics of women and men with early-onset schizophrenia (N = 90) and late-onset schizophrenia (N = 34). Subjects did not differ with respect to age, education, ethnicity, severity of depression, daily neuroleptic dosage, subtype of schizophrenia, total score on the Mini-Mental State Examination, or severity of overall psychopathology. Diagnosis was made using the Structured Clinical Interview for the DSM-III-R or DSM-IV. RESULTS: A significantly greater proportion of women had late-onset schizophrenia (41% vs. 20%), and women overall had more severe positive psychotic symptoms. Although there was no overall gender difference in severity of negative psychotic symptoms, women with late onset had significantly less severe negative symptoms than men with early onset, men with late onset, and women with early onset. Furthermore, age at onset of schizophrenia was inversely correlated with severity of negative symptoms for women, but not for men. These results indicate that women overall may develop more severe positive symptoms than men, and that when women develop schizophrenia after age 45, they may suffer less severe negative symptoms than men or than women with earlier onset. Our results suggest that some of the clinical differences between late-onset and early-onset schizophrenia may relate to gender effects, and that there may be inherent differences in the clinical presentation of schizophrenia that are related to gender and gender by age at onset interactions. CONCLUSION: These differences may reflect the influence of sex hormones and menopause on the clinical presentation of schizophrenia or the possible existence of an "estrogen-related" form of schizophrenia in women with late-onset schizophrenia.
Adult↗
Conventional vs. newer antipsychotics in elderly patients.
Elderly patients with schizophrenia and dementia patients with agitation are frequently candidates for antipsychotic treatment. Conventional neuroleptics have relatively little effect on negative symptoms and may cause considerable side effects, especially in elderly patients. The authors have found a 29% cumulative annual incidence of tardive dyskinesia (TD) in middle-aged and elderly outpatients treated with relatively low doses of conventional neuroleptics Newer antipsychotics are less likely to cause extrapyramidal symptoms and may be associated with a lower risk of TD. They are generally effective for both positive and negative symptoms and may also improve some aspects of cognition, but these drugs have their own side effects. Dosing requirements for elderly patients tend to be much lower than those for younger adults.
Adult↗
Polymorphism of the Pi class glutathione S-transferase in normal populations and cancer patients.
Deficiencies of the glutathione transferase isoenzymes GSTM1-1 and GSTT1-1 have been shown to be risk modifiers in a number of different cancers but there have been no similar studies with GSTP1-1, the only member of the Pi class of glutathione S-transferases expressed in humans. Over-expression of GSTP1-1 in tumours suggests that it may be a significant factor in acquired resistance to certain anticancer drugs. We previously identified a cDNA clone with two amino acid substitutions (I105V, A114V). This clone suggests that the GSTP1 gene is polymorphic and it is possible that the different genotypes may be associated with altered cancer risk or drug resistance. In the present study, we report methods for genotyping individuals at codons 105 and 114 of GSTP1 and demonstrate that these two loci are polymorphic in several different racial groups. We also detected significant linkage disequilibrium between these two loci. To determine if either of the alleles at these two loci were associated with altered cancer susceptibility, we genotyped individuals with colorectal cancer or lung cancer. A total of 131 colorectal and 184 lung cancer patients were compared with 199 control individuals. Overall, there were no significant associations between the GSTP1 polymorphisms and either form of cancer.
Adult↗
Nonallelic noncomplementation models in mice: the first arch and lidgap-Gates mutations.
We tested for complementation between two Mendelian mutations in mice, Far (first arch) and lgGa (lidgap-Gates). Each of these mutations gives greater than 70% risk of the birth defect, open eyelids, in homozygotes and gives little or no risk in heterozygotes. Far and lgGa are known to not be alleles; Far maps to Chr 2 and lgGa maps to Chr 13. However the cross between +/Far (on the BALB/cGaBc strain) and lgGa/lgGa (on the LGG/Bc strain) gave 32% (48/149) of progeny affected with open eyelids at birth: 63% (45/71) of the double heterozygote, +/Far, +/lgGa, compared with 4% (3/78) of the +/+, +/lgGa progeny. That is, the complementation test suggests that Far and lgGa are alleles, whereas the mapping data show that they are not. We interpret the result of the Far by lgGa test as an example of nonallelic noncomplementation (or "false allelism") in mammals, and suggest that this phenomenon might be expected because open eyelids at birth involves a developmental threshold. Our data also show that both the embryonic and the maternal background genotypes strongly influence the risk of open eyelids in the Far by lgGa crosses. The risk to the double heterozygote (+/Far, +/lgGa) is highest (77%) with Far from the BALB/cGaBc rather than the ICR/Bc (0%) strain and in a BALB/cGaBc (77%) rather than an LGG/Bc (50%) dam in the reciprocal cross. This effect of genetic context on risk is also predicted by the threshold model. Based on our data on open eyelids at birth, we suggest that false allelism may be common in mammalian birth defects that result from failure to meet developmental thresholds, even when the "causal" mutations are Mendelian.
Animals↗
Why's my boss always holding me down? A meta-analysis of power effects on performance evaluations.
One factor with potential links to performance evaluation is evaluator power. In a meta-analytic review of the available literature, the relation between power and performance evaluation was examined. Results indicate that as power levels increase, evaluations of others become increasingly negative and evaluations of the self become increasingly positive. We examined moderators of these relations, and methodological variables caused the most differences in effect sizes across studies. The article addresses implications of these findings for businesses and social psychological theories of power.
Journal Article↗
Hematozoa in the endangered wood stork from Georgia.
Thin blood smears of 75 wood storks (Mycteria americana) from Georgia (USA) were made during the summers of 1994-96 and examined for blood parasites. Haemoproteus crumenium was found in one of 71 juveniles and in two adults from a sample of two subadults and two adults. Intensity of infection in the juvenile and in each of the two adults was 11, 3, and 2 parasites/5,000 erythrocytes, respectively. This is the first record of H. crumenium in the wood stork from Georgia and the second published record of H. crumenium infecting this host in North America. Additionally, one juvenile was infected with a microfilarid.
Animals↗
ADD/ADHD and hypermobile joints.
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Attention Deficit Disorder with Hyperactivity↗
Tai-Kwan-Do in relation to ADD.
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Attention Deficit Disorder with Hyperactivity↗
Validity of specific subscales of the positive and negative symptom scales in older schizophrenia outpatients.
We investigated the construct validity of subscales of the Scale for the Assessment of Positive Symptoms (SAPS) and the Scale for the Assessment of Negative Symptoms (SANS) along with other measures of psychopathology in 109 schizophrenia outpatients aged 45-84 years. Scores on subscales of the SAPS, SANS and Brief Psychiatric Rating Scale (BPRS) and on the Hamilton Depression Scale (HAM-D) were subjected to a principal components analysis and orthogonal rotation followed by an extension analysis. In both analyses, three of four SAPS subscales had their highest loading on the positive symptom factor and four of five SANS subscales had their highest factor loading on the negative symptom factor. The SAPS bizarre behavior subscale, however, had a much higher loading on the depressive symptom factor than on the positive symptom factor, and the SANS avolition-apathy subscale had moderate loadings on both the negative symptom factor and the depressive symptom factor. The use of SAPS and SANS subscales to represent two constructs was largely (but not entirely) validated among middle-aged and elderly schizophrenia outpatients. The SAPS bizarre behavior subscale and, to a lesser extent, the SANS avolition-apathy subscale appear to represent in this older population a separate construct which may be related to depressive symptoms.
Age Factors↗