Biomedical subjects
Publications and source records attributed to N L Holden.
Between 1975 and 1985, 3.8% of patients referred to the Maudsley Hospital with anorexia and bulimia were adoptees. This exceeds the rate of adoption (1.5%) in the general population matched for year of birth. The 18 adoptees with eating disorders had significantly more associated behavioural disturbance and lower academic achievement than the 18 matched controls, and different precipitating factors.
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Explore the source record for details and available documents.
Explore the source record for details and available documents.
Explore the source record for details and available documents.
Explore the source record for details and available documents.
Explore the source record for details and available documents.
Thirteen black patients were referred over 5 years to the eating-disorders unit at the Maudsley Hospital. Two suffered from anorexia nervosa and 11 from bulimia nervosa. This group was compared with a matched white control group from the total clinic population during that period. The Blacks had more commonly experienced parental divorce or separation, and premorbid obesity, and were more likely to be referred by the emergency services. Their lower educational achievements, and fathers of lower socio-economic status, reflected variation among the general black and white populations in this country, but their educational levels and social statuses were higher than in the general black population.
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This study describes a survey of prescribing to psychiatric patients on long-stay wards, together with a follow-up survey carried out after a 2-year period. Our findings show that there had been no significant improvement in polypharmacy and overprescribing of psychotropic drugs over that period, 1983-1985. Guidelines for improvement are suggested.
This study describes 47 cases of paranoid psychosis occurring for the first time after the age of 60. Cases were drawn from the Camberwell catchment area and were followed up for 10 years or until death. The clinical picture of patients showed few differences from those described in earlier studies. Subgroups are described with contrasting clinical features and differing outcome. The findings suggest that late paraphrenia is a heterogenous syndrome giving the appearance of a spectrum of overlapping conditions with paranoid delusions.
Nine male patients with bulimia nervosa, accounting for one in 24 bulimic patients attending a clinic for eating disorders, are described. Symptomatology and demographic characteristics were similar in males and females. A history of either anorexia nervosa or obesity was always present, and a chronic course was seen in 6 patients. Five of the men showed atypical sexuality.
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The results of 41 standardised dexamethasone suppression tests (DST) with the Newcastle Scale diagnostic weighting for endogenous depression correlated significantly (P less than .001). Specificity of the DST was found to be 89 per cent, sensitivity 82 per cent and the diagnostic confidence for endogenous depression 94 per cent. This strongly supports the validity of the Newcastle Scale diagnostic weighting for endogenous depression.
The re-examination of a patient in front of two examiners is a major part of the clinical exams in psychiatry. However, for the candidate it is the most anxiety-provoking part of the exam, and possibly the area of greatest weakness.
Although many trainees have gained considerable experience in answering MCQs in undergraduate examinations, these papers are still a frequent cause of problems and failure for candidates of postgraduate examinations. This article aims to help trainees improve their technique so that their performance can more accurately reflect their knowledge and ability.