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Biomedical subjects

P J Tyrer

Publications and source records attributed to P J Tyrer.

At least 19 recordsLinked to original sources

Personality, functioning and symptomatology.

A random sample of 200 people selected from urban and rural communities was assessed using structured interview schedules to measure the prevalence of personality disorder and psychiatric illness and their relation to social functioning. Explosive personality disorder was the most prevalent type of abnormal personality. Social functioning was significantly worse in those with personality disorder than those with normal personality but there was no difference between the various diagnostic categories of abnormal personality. Social functioning differed between some PSE diagnostic categories. An assessment was made of the variables contributing to mean social functioning score, of the interactions between them, and of the correlation between social functioning symptomatology.

Adult↗

The diagnostic status of patients with conspicuous psychiatric morbidity in primary care.

A 7% one-year prevalence rate of conspicuous psychiatric morbidity was found in patients attending a single general practice. The nature of the morbidity was examined by a detailed assessment of mental state and personality, using interview schedules administered by a psychiatrist. Depressive disorders were presented by nearly half of the patients. The overall sex incidence of the disorders was equal, but alcohol abuse was more common in males. A personality disorder was present in 33.9% of all patients seen, although it was rarely diagnosed as the primary problem and was linked to the diagnosis of anxiety states, rather than depressive neurosis. These findings are discussed in relation to other epidemiological studies in primary care.

Alcoholism↗

Prognostic factors determining response to antidepressant drugs in psychiatric out-patients and general practice.

The outcome of antidepressant drug treatment was measured in 200 patients, 145 seen in psychiatric out-patient clinics and 55 in general practice, after 4 weeks of therapy. The results of the 200 patients taken together suggested that prognosis was largely determined by factors dependent on the natural history of the disorder and that clinical symptoms were unimportant, but when the results for patients in each drug group were analysed separately symptoms were more important than natural history factors. We conclude that clinical symptoms are only important predictors of response to antidepressant drugs when the patients studied are homogeneous with regard to natural history factors, particularly duration of illness.

Antidepressive Agents↗

Antipyrine elimination by patients under treatment with monoamine oxidase inhibitors.

1 Antipyrine elimination kinetics have been determined in fifteen patients before and after 4 weeks treatment with monoamine oxidase inhibitors and in five patients after treatment only. 2 Antipyrine elimination was slightly but significantly slowed by 28 days treatment with phenelzine but the degree of slowing was uninfluenced by acetylator phenotype or dosage of phenelzine administered. 3 The findings suggest that at the dosage used phenelzine is a weak inhibitor of hepatic microsomal mixed function oxidase in man and it is concluded that this is likely to provide an important source of drug interaction in some patients.

Adult↗

Controlled comparison of day-hospital and outpatient treatment for neurotic disorders.

106 patients with anxiety, phobic, and depressive neuroses referred to the outpatient clinics of 6 psychiatrists were randomly assigned to outpatient care or two forms of psychiatric day care. Ratings of symptoms and social adjustment were recorded before treatment and after 4 and 8 months in 89 patients. There were no important differences in the outcome of day care and outpatient treatment although patients were more satisfied with the outpatient service. Because outpatient care is more economical of time and personnel it should be preferred to psychiatric day care for many neurotic disorders.

Ambulatory Care↗

Comparative reliability of categorical and analogue rating scales in the assessment of psychiatric symptomatology.

The reliability of 26 items from the ninth edition of the Present State Examination (PSE) was assessed using both the conventional categorical scales and separately constructed analogue scales. Reliability was also calculated when the analogue responses were rescaled down to 2, 3 and 4 categories. The levels of inter-rater agreement obtained were comparable to those achieved in previous studies of PSE reliability, although as expected the levels of agreement on audiotapes were greater than those for independent interviews performed on the same day. These levels were not significantly affected by any of the changes in scale format, but there were apparent differences in reliability depending on the statistics used. In selecting or constructing a psychiatric rating scale, the question of reliability should not influence the choice of a categorical or continuous scale, or the number of scored points in the scale.

Psychiatric Status Rating Scales↗