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Biomedical subjects

P Tyrer

Publications and source records attributed to P Tyrer.

At least 181 records · Page 10Linked to original sources
PubMed1980

Awareness of cardiac function in anxious, phobic and hypochondriacal patients.

Awareness of pulse rate was tested in 60 psychiatric out-patients with anxiety, phobic or hypochondriacal neuroses by asking them to record how fast their hearts were beating during exposure to short film sequences. Correlations between subjective and objective heart rate (ECG) were significantly higher in anxious and hypochondriacal patients than in phobic ones. The results suggest that somatic symptoms in hypochondriacal and anxiety neurosis reflect increased awareness of bodily function.

Anxiety↗
PubMed1980

Responses of chronic agoraphobics to subliminal and supraliminal phobic motion pictures.

Fifteen agoraphobics took part in a study to investigate their responses to repeated presentations of a phobic motion pciture. Five patients were shown the film supraliminally, five were shown it subliminally, and the remaining five formed a control group. Subjective feelings were assessed with visual analogue scales, and three physiological measures, heart rate, skin conductance, and respiratory rate, were recorded. An earlier report showed that both subliminal and supraliminal presentation produced significant improvements in phobic fear and avoidance, and the present results show that the subliminal group found the procedure much less stressful than the supraliminal group. The physiological changes during treatment showed no consistent pattern and appeared to be independent of clinical response. The results show that repeated exposure to subliminal phobic motion pictures is not anxiety provoking to agoraphobic patients and so may be appropriate therapy for those unable to tolerate other forms of treatment.

Adult↗
PubMed1980

An extrapyramidal syndrome after lithium therapy.

Two patients developed an extrapyramidal syndrome after therapy with lithium carbonate. Although the clinical features of this syndrome were indistinguishable from those of drug-induced parkinsonism, it was made worse by the anti-parkinsonian drug, orphenadrine. These findings were reproduced later under laboratory conditions when extrapyramidal symptoms and physiological tremor were recorded before and after challenge doses of orphenadrine. This unwanted effect of lithium carbonate may be explained by selective blockade of dopamine receptors.

Aged↗
PubMed1980

Clinical and pharmacokinetic factors affecting response to phenelzine.

Sixty patients, 30 with depressive neurosis, 15 with anxiety neurosis and 15 with phobic anxiety states, were treated with the monoamine oxidase inhibitor, phenelzine, in two different dosage schedules for four weeks. All patients received an initial dose of 15 mg daily, increasing to 30 mg daily between the third and seventh day, but subsequently, using double-blind procedure, one group tooke the commonly prescribed dose of 45 mg daily and the other took 90 mg daily. Acetylator status was independently determined before the start of treatment. Each diagnostic group showed a similar response to treatment, but patients taking the higher dose improved significantly more than those taking normal dosage, and the rate of improvement, measured by weekly self-ratings, was also more rapid with higher dosage. Acetylator status did not affect clinical response. The results suggest that dosage is more important in determining clinical response to phenelzine in neurotic disorder than specific diagnosis or acetylator status.

Anxiety Disorders↗
PubMed1979

Finger tremor and extrapyramidal side effects of neuroleptic drugs.

Finger tremor and extrapyramidal side-effects (EPSEs) were measured in seven patients before and during neuroleptic drug treatment to assess the relationship between the onset of EPSEs and changes in finger tremor spectra. Tremor and EPSEs were also measured in twelve patients stabilized on neuroleptic drugs to determine whether tremor could provide a reliable index of the presence and severity of extrapyramidal system disturbance. A downward shift in peak tremor frequently was noted within 48 hours of starting neuroleptic drug therapy, usually before the onset of EPSEs, and a significant negative relationship between the severity of EPSEs and tremor frequency (but not tremor amplitude). The peak frequency of finger tremor is thus a sensitive index of extrapyramidal disturbance and might be of value in predicting which patients taking neuroleptic drugs need anti-parkinsonian therapy.

Antipsychotic Agents↗
PubMed1979

Classification of personality disorder.

An interview schedule was used to record the personality traits of 130 psychiatric patients, 65 with a primary clinical diagnosis of personality disorder and 65 with other diagnoses. The results were analysed by factor analysis and three types of cluster analysis. Factor analysis showed a similar structure of personality variables in both groups of patients, supporting the notion that personality disorders differ only in degree from the personalities of other psychiatric patients. Cluster analysis revealed five discrete categories; sociopathic, passive-dependent, anankastic, schizoid and a non-personality-disordered group. Of all the personality-disordered patients 63 per cent fell into the passive-dependent or sociopathic category. The results suggest that the current classification of personality disorder could be simplified.

Humans↗
PubMed1979

Reliability of a schedule for rating personality disorders.

The inter-situational, inter-rater and temporal reliability of a schedule for rating personality disorders is described. In an initial study with a simplified form of the schedule in patients from different wards of a psychiatric hospital inter-situational reliability between raters was higher for patients with personality disorders than with no personality disorder. Using the full schedule, inter-rater reliability, using audiotaped and separate interviews, and temporal reliability at interviews conducted a mean of 12.5 months apart all reached a satisfactory level, suggesting that the schedule may be a useful instrument for measuring deviant personality traits. The interview may be used with a subject or an informant but agreement between ratings made with informants and psychiatric patients during illness was low, and the schedule is not recommended for use with patients alone during acute episodes of illness.

Humans↗
PubMed1978

Drug treatment of psychiatric patients in general practice.

The prescribing of psychotropic drugs by general practitioners was assessed by analysing the drug treatment of all patients referred from general practice to a psychiatric outpatient clinic over four years. Of the 287 patients, 220 were taking one or more of 56 different psychotropic drugs at referral, diazepam being the most common. Benzodiazepines and barbiturates had been taken for significantly longer than other drugs, and, of a total of 342 drugs, 61 had been prescribed regularly for over a year. Half of the drugs were considered to be incorrectly prescribed on pharmacological grounds, the main errors being unnecessarily prolonged regular treatment, incorrect dosage (particularly common with antidepressants), and polypharmacy with drugs of similar pharmacological action. A basic grounding in the pharmacology of psychotropic drugs might help practitioners to avoid prescribing errors of this kind.

Adult↗
PubMed1978

Treatment of agoraphobia by subliminal and supraliminal exposure to phobic cine film.

Three groups of 5 chronically agoraphobic patients were treated by repeated exposure to cine film at weekly intervals for six weeks. A supraliminal group saw an agoraphobic film specially made for the study illustrating a range of phobic situations. A subliminal group viewed the same film at a level of illumination below the threshold of awareness. A control group saw a blank screen with no filmed material for the same length of time. The films were screened five times at each treatment and were alternated with neutral film shown under normal viewing conditions. Ratings of phobic and other symptoms were made by a separate assessor who was unaware of the patient's treatment. The supraliminal and subliminal groups improved significantly more than the control group with regard to phobic fears, avoidance, and overall assessment.

Adult↗
PubMed1978

Effects of subliminal and supraliminal stress on symptoms of anxiety.

Two experiments were carried out with volunteer subjects to test whether the subliminal viewing of emotive material induced anxiety and its associated bodily symptoms. In one experiment 24 subjects looked at anxiety-inducing words presented singly through a tachistoscope under supraliminal or subliminal conditions, and in the other study 50 subjects looked at a neutral and an emotive movie film under similar conditions. Subliminality was insured in the first experiment by reducing the duration of exposure and in the second by reducing the level of illumination. The results showed that ratings of anxiety were significantly increased under subliminal emotive conditions, and reduced following subliminal neutral exposure. Correlations between psychic and somatic symptoms of anxiety were significantly higher under supraliminal conditions compared with subliminal ones. The possible role of subliminal stimulation in investigating the psychic and somatic components of anxiety is discussed.

Adolescent↗
PubMed1976

Towards rational therapy with monoamine oxidase inhibitors.

A rational approach to the use of monoamine oxidase inhibitors (MAOIs) is outlined. Patients suitable for treatment cannot be classified adequately using conventional diagnostic labels. They include those with primary symptoms of hypochondriasis, agoraphobia and social phobias, irritability, somatic anxiety and anergia; those with primary depressed mood, guilt, ideas of reference and personality disorders seldom respond. There is great variation in the interval between the first administration of these drugs and clinical response, and this may account for the inconsistencies in published trials. The type of drug and its dose may affect rate of response, as may biochemical factors, including acetylator and monoamine oxidase status. To obtain maximum benefit, a course of therapy with MAOIs should last for several months.

Adjustment Disorders↗