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Biomedical subjects

P Hays

Publications and source records attributed to P Hays.

At least 19 recordsLinked to original sources
PubMed1998

Dying in the dark: sunshine, gender and outcomes in myocardial infarction.

We report a natural experiment that took place in a cardiac intensive care unit (CICU). We had been alerted to the possibility that sunny rooms would be conducive to better outcomes by our findings in the psychiatric unit, and by reports that depressed cardiac patients did less well than those in normal mood. The 628 subjects were patients admitted directly to the CICU with a first attack of myocardial infarction (MI). Outcomes of those treated in sunny rooms and those treated in dull rooms were retrospectively compared for fatal outcomes and for length of stay in the CICU. Patients stayed a shorter time in the sunny rooms, but the significant difference was confined to women (2.3 days in sunny rooms, 3.3 days in dull rooms). Mortality in both sexes was consistently higher in dull rooms (39/335 dull, 21/293 sunny). We conclude that illumination may be relevant to outcome in MI, and that this natural experiment merits replication.

Aged↗
PubMed1997

Phototherapy is a useful adjunct in the treatment of depressed in-patients.

Phototherapy is regularly used in the treatment of seasonal affective disorder. There is evidence that it is also useful in the treatment of non-seasonal depression, but relevant controlled experiments are difficult to design. In this study we randomly assigned depressed in-patients to high and low levels of artificial light, the high levels exceeding those most commonly used in earlier reported trials. Both unipolar and bipolar depressions responded when phototherapy was used as an adjunct to pharmacotherapy, and mood improvement was related to the intensity of illumination, that is, patients treated with high levels of illumination improved significantly more than those who received low levels (P < 0.02). Our findings suggest that light therapy is generally applicable to depressive illnesses, and that the light intensities commonly used are suboptimal.

Adult↗
PubMed1996

Dreaming away depression: the role of REM sleep and dreaming in affective disorders.

REM sleep and dreaming may play a crucial role in the processing of affect. In a recent study, we demonstrated that dream content is related to prevailing mood state and that certain types of dream precede upward mood changes in bipolar disorder (manic-depression). To replicate and extend initial findings, we monitored sleep, dream content and mood, in both bipolar and unipolar patients hospitalized for depression. All patients (n = 24) were recruited in a depressed state. During this trial, subjects reported their dreams and rated their mood each morning. They also had their sleep recorded intermittently using the Nightcap, a compact computerized home sleep monitoring device. We found that: (i) REM latency tends to increase as the mood improves in bipolars but is stable (and even decreases with mood improvements) in unipolar depressives; (ii) dream content continues to systematically relate to prevailing mood state, but the patterns seen are different in unipolars and bipolars; (iii) dreams of death are frequent in bipolar disorder and mark the transition of a mood shift upward.

Adult↗
PubMed1996

Sunny hospital rooms expedite recovery from severe and refractory depressions.

Bright light therapy is an effective treatment for seasonal affective disorder, an uncommon condition marked by mild winter depression. Bright lights have been used as adjuncts in the pharmacological treatment of other types of depressive illness. The rooms in our psychiatric inpatient unit are so placed that half are bright and sunny and the rest are not. Reasoning that some patients were getting light therapy inadvertently, we compared the lengths of stay of depressed patients in sunny rooms with those of patients in dull rooms. Those in sunny rooms had an average stay of 16.9 days compared to 19.5 days for those in dull rooms, a difference of 2.6 days (15%): P < 0.05.

Bipolar Disorder↗
PubMed1995

Prevailing mood, mood changes and dreams in bipolar disorder.

In this preliminary and exploratory study, we collected the dream reports and mood ratings of 6 outpatients with bipolar disorder over a 6-month period to compare the relationship between dream themes and mood states. We found that neutral mood states were associated with mundane, routine or uneventful dreams while manic states featured bizarre and improbable dream themes. Neither depressed nor mixed states showed a consistent trend in dream themes. By categorizing the dreams that preceded mood shifts, we were able to identify a particular type of dream that seemed to precede a mood shift, particularly in the direction of mania. Shifts to mania were heralded by dreams of death and bodily injury. Forthcoming depression was more clearly associated with a decrease in overall number of dreams reported. The significance of dreaming in relation to mood is discussed in terms of these preliminary findings and our bipolar dream scale is offered for the convenience of subsequent investigators.

Adult↗
PubMed1993

A new sampling strategy for linkage studies in psychoses.

Linkage between stuttering and manic-depression has been postulated to account for the reported association between these conditions, in three large pedigrees. This finding permits a novel and potentially more productive sampling strategy to be used in future linkage studies.

Adolescent↗
PubMed1992

Multiple sclerosis and delayed mumps.

To test the hypothesis that mumps occurs less frequently and later in patients with multiple sclerosis, histories were taken from patients and matched controls by a single observer at a university hospital in Canada, and in the course of domiciliary visits in England. 63 consecutive patients with multiple sclerosis in two neurological practices, and 63 controls matched for age, sex and childhood domicile, together with 29 sibs of English patients were studied. Patients had mumps at an older age (12.3:8.6, p less than 0.04) and less frequently (33/63 vs 60/92, p = 0.08). Multiple sclerosis patients display a partial immunity to mumps, of which the most obvious explanation is a preceding infection by an antigenically related paramyxovirus, that is, by either the Newcastle Disease virus, or parainfluenza.

Adult↗
PubMed1991

Florid refractory schizophrenias that turn out to be treatable variants of HLA-associated narcolepsy.

Narcolepsy in which the hallucinatory component is unusually prominent may lead to the development of an illness indistinguishable from the schizophrenic syndrome. Psychotic symptoms dominate the symptomatology, so that the primary illness is obscured. Five patients are described for whom conventional antipsychotic drugs were ineffectual, but for whom treatment with stimulants produced substantial improvement. The diagnosis of narcolepsy was confirmed by Human Leukocyte Antigen typing and sleep laboratory testing. These results support the "REM intrusion" hypothesis of the causation of schizophrenia in as many as 7% of a series of schizophrenic patients. Implications for diagnosis and treatment are discussed.

Adult↗
PubMed1987

Age at onset in schizophrenia. A familial perspective.

We examined the impact of familial factors on age at onset in schizophrenia. Results from a literature review and from new analyses of two family studies and one twin study of schizophrenia support the following hypotheses: (1) no strong or consistent relationship exists between age at onset in schizophrenia and recurrence risk for schizophrenia in relatives; (2) age at onset in schizophrenia is not strongly related to the recurrence risk for other psychiatric disorders in relatives; and (3) in systematically ascertained pairs of affected siblings, the age at onset of schizophrenia is modestly correlated, whereas the correlation in age at onset in concordant monozygotic twin pairs is much higher. These results suggest that (1) from a familial perspective, early- and late-onset adult schizophrenia appear to be the same disorder, and (2) given that an individual will develop schizophrenia, familial factors, which may be genetic, influence the age at onset of the condition.

Adult↗
PubMed1986

Alcoholism followed by schizophrenia.

On the basis of findings of earlier workers, and our own unsystematic observations, we put forward the hypothesis that alcohol abuse was an important etiological factor in some schizophrenia-like psychoses. We tested the hypothesis by comparing schizophrenic patients who had abused alcohol with schizophrenic patients who had not. The findings generally support the hypothesis, and indicate that a chronic psychosis distinguishable by a hallucinatory onset and, at its height, by visual hallucinations, may be one of the complications of alcohol abuse.

Adult↗