Search PubMed⌕ Search

Biomedical subjects

R F Ulrich

Publications and source records attributed to R F Ulrich.

At least 55 records · Page 3Linked to original sources
PubMed1980

Effects of aging on EEG sleep in depression.

Many of the same electroencephalographic sleep measures which differentiate between normals and depressed patients have also shown differences among age groups within a normal population. The present study examines sleep measures in 87 inpatients with a major depressive syndrome, examining the specific sleep variables which are correlated with age between 18 and 60 years. REM latency shows a distinct decline with age, an effect not well demonstrated in normals. Thus, REM latency may differ from variables which measure aspects of awakening and which show a clear age trend in normal subjects. Since many sleep measures are greatly skewed or have truncated distributions, the present paper provides several alternative styles of measurement which allow comparisons to be made easily and also facilitate multivariate testing.

Adolescent↗
PubMed1978

Normative data on revised Conners Parent and Teacher Rating Scales.

Normative data are presented for 570 children on newly revised versions of the Conners Parent and Teacher Rating Scales. Symptom ratings were factor analyzed and structures compared favorably with those obtained using earlier versions of the questionnaires. Interrater correlations (mother-father, parent-teacher) were also reported. Age and sex effects were found to be significant determinants of children's scores, while social class effects were nonsignificant.

Adolescent↗
PubMed1978

The application of EEG sleep for the differential diagnosis of affective disorders.

On the basis of two EEG sleep criteria, REM latency and REM activity, the authors achieved 81% accuracy in distinguishing between 47 patients with primary depression and 48 patients with secondary depression using discriminant analysis. Sleep efficiency, the percentage of delta sleep, and the percentage of REM sleep discriminated between psychotic and nonpsychotic subgroups in the group with primary depression with 75% accuracy. REM activity and intermittent nocturnal awakening accurately discriminated two subtypes of patients with secondary depression at a level of 81%. These results suggest that EEG sleep measurements can yield significant data to aid in differential diagnosis in psychiatry.

Adult↗
PubMed1977

Temporal effects of drug and placebo in delaying relapse in schizophrenic outpatients.

The potential for unwanted side effects, particularly tardive dyskinesia, following long-term after care maintenance with antipsychotic medication has led to serious questioning of its continued use for schizophrenic patients. Does the risk of relapse decline with the passage of time? If so, is the advantage of drug therapy sustained and large enough to justify continued treatment beyond one or two years? More appropriate methods for analyzing the after care experience of 374 schizophrenic patients treated with drug or placebo reveals that while the risk of relapse does decline substantially, it remains twice as high for placebo-treated patients than drug-treated patients even after two years of treatment. The prophylactic effect of maintenance chemotherapy appears to be one to two times larger than generally estimated by the less precise "cumulative percentage" method.

Aftercare↗
PubMed1974

Neurological manifestations of acute granulocytic leukemia.

Of 17 consecutive patients with acute granulocytic leukemia, all of whom were treated with cytosine arabinoside, eight had neurological complications during some stage of their disease. This high occurrence of neurological findings represents a significant increase compared with the authors' experience and, in general, with that cited in the literature. The neurological findings were usually related to significant morbidity and to mortality. Early recognition of neurological problems depends mainly upon clinical and cerebrospinal fluid findings. Progression of neurological manifestations, which can be satisfactorily treated with radiotherapy or neurosurgical methods, may result in unnecessary morbidity and premature death.

Adolescent↗
PubMedDate not supplied

Black-white differences in psychopathology in an urban psychiatric population.

The study was conducted in a psychiatric setting that services a large metropolitan population. It relied on the semi-structured Initial Evaluation Form which is completed by expert trained clinicians and which is geared to a comprehensive evaluation along the lines stipulated in DSM-III. The symptoms of a large sample of white and black patients are compared. The study relied on an Analysis of Variance (ANOVA) procedure which controlled for age, gender and education and concentrated exclusively on ethnic differences in clinically homogenous subgroups. The sample was partitioned into relatively pure groups of DSM-III diagnoses that are frequent in the population, including schizophrenia, affective and anxiety disorders, dementia, paranoid and manic disorders. Prominent black/white differences in psychopathology were noted, but in only a few instances included items generally thought of as typical of a specific disorder. Some differences appeared to be due to selection factors and others raised the question of alternate expressions of psychopathology among blacks as versus whites. The significance of the results obtained is discussed together with questions requiring further research. Some of the issues involved in the study of black/white differences in psychopathology are critically analyzed.

Adult↗
PubMedDate not supplied

Characterizing organic hallucinosis.

A first comprehensive description of the clinical features of patients with the rare diagnosis of organic hallucinosis (OH) is presented, based on information from 11 OH patients among 14,889 patients who presented for evaluation over a 5-year period at our institution. This characterization is of particular current relevance to diagnosticians and clinicians because of the proposed major changes in the diagnostic system for OH in the upcoming DSM-IV and because of the virtual total lack of published information concerning this syndrome. This description includes a listing of the prevalence and mean severity of each symptom. The severity of the symptoms of OH are then compared with those of its crude "functional" equivalent of schizophrenia to determine which symptoms distinguish between these categories. Associated factors are also presented concerning demographics, modes of treatment, level of functioning, and current physical problems associated with OH.

Adult↗
PubMedDate not supplied

Characterizing organic mood syndrome, depressed type.

In this report, a first comprehensive description of the clinical features of patients with organic mood syndrome, depressed type (OMS-D), in a psychiatric hospital population is presented. This description is based on information from 130 OMS-D patients among 14,889 patients who presented for initial evaluation over a 5-year period. This description includes an enumeration of the common clinical symptoms of this syndrome. Following this, the severity of the symptoms of OMS-D are compared with those of its crude "functional" equivalent of major depressive disorder, single episode (MDD-SE). In addition, associated factors are presented concerning demographics, level of functioning, comorbidity, electroencephalographic and computed tomographic abnormalities, and current physical problems. These findings provide preliminary support for the validity of this diagnostic category, and provide relevant information concerning proposed changes in this category as listed in the DSM-IV Options Book.

Adult↗
PubMedDate not supplied

Characterizing organic mood syndrome, manic type.

The purpose of this study is to provide the first empirically based description of the clinical features of organic mood syndrome, manic type (OMS-M). During a recent 5-year period, 14,889 new patients presented for initial evaluation and care at our institute. Of these patients, a total of 12 cases of OMS-M were diagnosed. Evaluations were conducted using the Initial Evaluation Form, which was developed to be compatible with the DSM-III. The symptom profile of OMS-M was compared with that of "functional" manics (bipolar disorder, manic type [BD-M]). A variety of associated clinical factors were also assessed. The OMS-M patient demonstrated somewhat less severe acute symptomatology but more longstanding functional impairment than in BD-M. OMS-M patients also displayed a lower age at onset of illness and a higher level of perinatal problems and developmental delays compared with BD-M patients. The OMS-M group displayed a low family burden of mania. The most striking distinguishing feature of OMS-M was the prevalence of neurological disorders, with a surprisingly high prevalence of seizure disorders. Seizure disorders were more prevalent in OMS-M than in other organic brain syndromes (OBS).

Adult↗
PubMedDate not supplied

Gender effects on the clinical presentation of alcoholics at a psychiatric hospital.

Despite the clinical importance of gender effects on symptom patterns and comorbidity patterns in alcoholics, little is known about such effects in treatment facilities other than alcoholism treatment centers. This study evaluated the effect of gender on the clinical profile of 604 alcoholics who presented for initial evaluation and treatment at a psychiatric hospital. It demonstrated that major depression and accompanying depressive and anxiety-related symptoms are more prominent in female alcoholics than in male alcoholics, whereas antisocial personality disorder and antisocial symptoms are more prominent in male alcoholics presenting to a psychiatric hospital. The study also demonstrated that reversed neurovegetative symptoms are more severe in female than in male alcoholics.

Adult↗
PubMedDate not supplied

Racial effects on the clinical presentation of alcoholics at a psychiatric hospital.

Despite the clinical importance of race effects on comorbidity and symptom patterns in recent community studies, little is known about such effects in various treatment facilities. This study evaluated the effect of race on the clinical profile of 604 alcoholics who presented for initial evaluation and treatment at a psychiatric hospital. The factor that most strongly distinguished the racial groups was socioeconomic status (SES). After controlling for SES and other factors, no significant difference was noted between ethnic groups in the prevalence of major depressive disorder (MDD) or antisocial personality disorder. However, after controlling for SES and other factors, alcohol and drug use were more severe in African-American alcoholics, along with four symptoms associated with alcohol and drug use. In contrast, reversed neurovegetative symptoms, anxiety-related symptoms, and some personality-related symptoms were more severe in white alcoholics.

Adult↗
PubMedDate not supplied

Age effects on the clinical presentation of alcoholics at a psychiatric hospital.

Little is known about the effects of age on the clinical presentation of alcoholism in various treatment settings, despite the clinical importance of this factor. This study evaluates the effects of age on the clinical profile of 604 alcoholics who presented for initial evaluation and treatment at a psychiatric hospital. Young alcoholics displayed the most prominent substance use, antisocial behavior, depressive symptoms (including suicidality), and impulsivity. Early middle-aged alcoholics displayed the highest levels of drinking. Elderly alcoholics displayed the highest levels of cognitive dysfunction, although some level of cognitive dysfunction was present among even the youngest alcoholics. These findings confirm and clarify the effects of age on the clinical profile of alcoholics presenting for initial evaluation at a psychiatric hospital.

Adult↗
PubMedDate not supplied

The limitations of antipsychotic medication on schizophrenia relapse and adjustment and the contributions of psychosocial treatment.

Whether psychosocial treatment adds substantially to the prophylactic efficacy of maintenance antipsychotic monotherapy requires a more accurate estimate of relapse risks than those contained in recent reviews. A reappraisal of the literature suggests a 1-year, post-hospital, relapse rate of 40% on medication, and a substantially higher rate among patients who live in stressful environments, rather than earlier estimates of 16%. Relapse rates of 65% at 1 year and over 80% by 2 years among drug discontinued or placebo substituted outpatients are also more accurate than the 53% relapse rate previously estimated. When psychosocial treatment is added to maintenance chemotherapy, there is compelling evidence that relapse rates are reduced by as much as 50% compared with relapse associated with medication and standard care. However, psychosocial treatment without medication is as ineffective as placebo. The additive effects appear greater for recent, theoretically based psychosocial approaches than earlier atheoretical, altruistic forms of caring. However, effects vary according to the patient's clinical state, the nature and timing of the intervention, and the presence of environmental stressors. Regarding adjustment, very little definitive information regarding psychosocial treatment effects has existed until recently. A novel, disorder-relevant approach has now been shown to have broad and significant effects on social adjustment compared with medication and support. However, the magnitude of effects is not fully realized until a third year of treatment: a distinct challenge in the era of managed care. Atypical antipsychotics and more definitive psychosocial strategies that target social cognitive deficits hold promise for enhanced outcomes in the next generation of studies.

Antipsychotic Agents↗