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Biomedical subjects

P Sachdev

Publications and source records attributed to P Sachdev.

90 records · Page 5Linked to original sources
PubMed1992

Amygdalo-hippocampectomy for pathological aggression.

Two patients are reported, one with severe brain damage and epilepsy, and the other with limbic epilepsy, who were treated with unilateral microsurgical amygdalo-hippocampectomy for the control of rage and aggression. Both had significant improvement in their aggressiveness, and the second patient also improved in the frequency of his seizures and psychotic episodes. The significance of these observations for our understanding of the morphophysiological basis of rage and aggression is discussed.

Adult↗
PubMed1992

Drug-induced movement disorders in institutionalised adults with mental retardation: clinical characteristics and risk factors.

Fifty-three institutionalised adults with mental retardation, the majority (73.5%) moderate to severe, were examined for drug-induced movement disorders. Using a global AIMS score of 2 or more, 16 (34%) of the 47 subjects who had been exposed to neuroleptics had tardive dyskinesia (TD). Three of these had developed the dyskinesia upon withdrawal of neuroleptics. The dyskinetic movements were mainly seen in the lingual, perioral and other facial muscles. Two (33%) out of 6 subjects with no history of exposure to neuroleptics also had similar dyskinetic movements. The total neuroleptic dose significantly, and age marginally, but not sex, brain damage or level of mental retardation, emerged as risk factors for TD. Two (3.7%) subjects had definite akathisia and 16 (30.8%) significant extrapyramidal side effects. This study supports the findings of previous studies of considerable neurological adverse effects of neuroleptics in this patient group and cautions against their injudicious use. It provides further evidence for some putative risk factors for TD and is noteworthy for its lack of support for the contentious issue of brain damage as a risk factor.

Adult↗
PubMed1991

Acute drug-induced akathisia is not associated with low serum iron status.

The iron status of 50 consecutively admitted psychiatric patients due to be started on neuroleptic medication was examined. Fifteen of the patients developed akathisia in the 2 weeks of follow-up. The patients did not differ significantly from the 35 non-akathisic patients in serum iron and transferrin levels and haemoglobin values. The findings do not support the postulated association between low serum iron status and acute neuroleptic-induced akathisia.

Acute Disease↗
PubMed1991

Achieving openness in adoption: some critical issues in policy formulation.

Despite some recent attitudinal and legislative changes, release of adoption information is largely limited and conditional. This paper identifies several issues inherent in the sealed records controversy and argues that cohesive policy formulation depends on systematic examination of the views of those most directly affected. Findings of a three-year study of adoptees, adoptive parents, birth parents, and adoption agency workers are presented.

Adolescent↗
PubMed1991

The present status of akathisia.

Akathisia is a common and distressing side effect of antipsychotic and some other psychotropic medications. This paper reviews the current state of knowledge of its clinical features, pathophysiology, and treatment. Restless legs syndrome and akathisia associated with Parkinson's disease are discussed in so far as they help understand drug-induced akathisia. The complexity of the disorder, and the difficulty in characterizing and quantifying it, may explain why researchers have relatively neglected akathisia for so long. The recent upsurge of research interest promises the hope of a better understanding of its pathophysiology so that effective therapy may result.

Akathisia, Drug-Induced↗
PubMed1990

Pharmacological characterization of tardive akathisia.

A patient with tardive neuroleptic-induced akathisia was investigated with multiple pharmacological challenges. It was noted that the patient responded positively to benztropine, bromocriptine, and propranolol, and negatively to physostigmine, and showed little or no response to discontinuation of neuroleptics and challenges with metoclopramide, metoprolol, atenolol, and clonidine. The implications of this pharmacological characterization for the understanding of the pathophysiology of tardive akathisia in relation to acute akathisia and tardive dyskinesia are discussed.

Administration, Oral↗
PubMed1990

Magnetic resonance imaging in clinical psychiatry.

Although psychiatric researchers have been quick to adopt magnetic resonance imaging (MRI) of the brain in their investigations, its clinical application has been slow to develop and most psychiatrists remain unaware of its potential advantages and disadvantages compared with CT scanning. In this article the procedures are compared and the potential advantages of MRI highlighted with the help of neuropsychiatric case histories. Clinical situations are then discussed in which a psychiatrist should consider ordering a MRI scan subsequent to or instead of a CT scan.

Adult↗
PubMedDate not supplied

Vascular dementia: an Australian perspective.

We performed a review of the published literature on dementia, stroke, and vascular dementia (VaD) emanating from Australia and sought the opinions of senior clinicians and investigators in the field of dementia. We conclude from these sources that the public health importance of cognitive impairment and dementia secondary to cerebrovascular disease is recognized in Australia as is the potential to alter the public health burden significantly by preventative strategies. VaD is considered to be a heterogenous group of syndromes, and there is a lack of consensus on the appropriate diagnostic criteria. The concept is considered to be in evolution and empirical support is needed for its definition, subtyping, and the understanding of the pathophysiological mechanisms. An alternative term--vascular cognitive disorder--is suggested to overcome some of the difficulties inherent in the concept of "dementia" as used currently. The importance of noncognitive disorders of vascular origin is highlighted. No treatment is recognized to be specifically effective in VaD. Australian clinicians and researchers are beginning to grapple with the many difficulties entailed in our understanding of the cognitive and noncognitive consequences of cerebrovascular disease. There is a need for an international consensus on diagnostic criteria, particularly for drug development and research.

Australia↗