Biomedical subjects
Max Henderson
Publications and source records attributed to Max Henderson.
The willingness of palliative care patients to participate in research.
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Does having an occupational mental health service make any difference?
BACKGROUND: The effects of mental disorder on UK's workforce are increasing, yet most occupational health (OH) providers have limited expertise in dealing with mental health issues. AIMS: To examine the effectiveness in terms of organizational and clinical outcomes, of an OH liaison psychiatry service in an inner city area. METHODS: A retrospective survey of case notes from the first 2 years of an OH liaison psychiatry service was carried out. RESULTS: Seventy-six cases were identified and 68% were seen within 1 month of referral. After assessment, females were significantly more likely to be given a formal psychiatric diagnosis than males. Overall, 45% of patients had mood disorders, 14% anxiety disorders and two cases of psychosis were identified. Advice was offered to the referring OH practitioner in 80% of cases. CONCLUSIONS: This study found that liaison psychiatrists were able to fulfil a useful role in an OH department. Most of the cases seen within the department would not be classed as serious mental illness and therefore it is unlikely that community mental health teams would become involved in their routine care. Specialist mental health support from an 'in house' service is likely to be of considerable benefit from both occupational and medical perspectives.
Objective assessment of personality disorder in chronic fatigue syndrome.
OBJECTIVES: This study aims to objectively assess the prevalence and nature of personality disorders in depressed and nondepressed chronic fatigue syndrome (CFS) patients and compare this to depressed and healthy control groups. METHODS: Sixty-one patients attending a tertiary referral clinic with chronic fatigue syndrome, 40 psychiatric inpatients with depressive disorder and 45 healthy medical students completed the Structured Clinical Interview for DSM-III-R Diagnoses (SCID-II) in addition to providing routine clinical and demographic information. RESULTS: Thirty-nine percent of the CFS group, 73% of the depressed group and 4% of the healthy group were diagnosed with personality disorders. Cluster C disorders were the most common in both the CFS and depressed group. The depressed CFS patients had more Cluster B personality disorders than nondepressed CFS patients. Overall for CFS patients there was no association between mood state and personality disorder. CONCLUSIONS: High levels of personality disorder are found on objective assessment of CFS patients attending a teaching hospital clinic. This cannot be accounted for by comorbid depression.
Effects of very low birthweight on brain structure in adulthood.
Very-low-birthweight (VLBW) individuals are at high risk of brain injury in the perinatal period. We wished to determine how such early brain lesions affect brain structure in adulthood. Thirty-two VLBW adults (20 female, 12 male) and 18 term, normal birthweight sibling control individuals (nine female, nine male) underwent structural MRI at a mean age of 23 years 4 months (range 17 to 33 years; SD 3.4). Images were analyzed using an automated tissue segmentation algorithm in order to estimate whole brain tissue class volumes in native space. Images were then warped to a template image in standard space. There was no significant between-group difference in whole brain, grey matter, white matter, or total cerebral spinal fluid (CSF) volumes. However, lateral ventricular volume was significantly increased by 41% in those with VLBW. The ratio of grey to white matter was also significantly increased (by 10%) in those with VLBW. Group comparison maps showed widespread changes in the distribution of grey and white matter, and relative excess of ventricular CSF, in the brains of VLBW individuals. Increased ventricular volume predicted decreased grey matter in subcortical nuclei and limbic cortical structures, and decreased periventricular white matter. We conclude that these diffuse abnormalities of grey and white matter are a consequence of the interaction of perinatal brain injury and ongoing neurodevelopmental processes.
For: does workplace counselling work?
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