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Biomedical subjects

R F Woolson

Publications and source records attributed to R F Woolson.

At least 91 records · Page 5Linked to original sources
PubMed1981

An evaluation of the Feighner criteria for schizophrenia and affective disorders using long-term outcome data.

Schizophrenia and affective disorders selected according to the Feighner criteria can be differentiated on the basis of 40-year outcome. Within schizophrenia the presence of disorganized thoughts at the index admission was associated with poor outcome, whereas better outcome was associated with the presence of delusions or hallucinations. Within the affective disorders, bipolar patients with grandiose delusions or ideas showed a poor outcome; a better outcome was found in unipolar patients with complaints of fatiguability or tiredness at the time of the index admission.

Adult↗
PubMed1980

Premature deaths in schizophrenia and affective disorders. An analysis of survival curves and variables affecting the shortened survival.

We have found shortened survival in 200 schizophrenics, 100 manics, and 225 depressives by comparing them with the Iowa general population. The numbers of years of shortened survival were estimated from the survival curves of each diagnostic group by sex. Variables affecting shortened survival were diagnostic group, sex, age at admission, and pay status at admission. Excess causes of death were suicides, accidents, and infective and circulatory system diseases. The absolute mortality for deaths due to neoplasm in our sample was not significantly different than that in the Iowa general population. However, the proportional mortality from the same data showed a deficiency in deaths due to neoplasm in schizophrenia and affective disorders. Well-designed epidemiologic studies are needed to see if there is a real deficiency in deaths due to cancer in the major psychoses.

Adolescent↗
PubMed1980

Causes of death in schizophrenia and manic-depression.

Causes of death were studied in a cohort of 200 schizophrenic, 100 manic, and 225 depressive patients who were followed in a historical prospective study. These patients were admitted between 1934 and 1944 and were studied 30 to 40 years later. Five cause of death categories were considered in this analysis: (1) unnatural deaths, (2) neoplasms, (3) diseases of the circulatory system, (4) infective and parasitic diseases, and (5) other causes. For each cause of death, the expected number of deaths was calculated from vital statistics for the State of Iowa for the time period of follow-up. Observed numbers of deaths were contrasted with expected numbers of deaths to assess statistical significance for each diagnostic group. There was a significant excess of unnatural deaths in all diagnostic groups in both sexes, with the exception of female manics. This group, however, did show a significant excess of circulatory system deaths. Both male and female schizophrenics showed a substantial excess of infective disorder deaths.

Bipolar Disorder↗
PubMed1980

The iowa structured psychiatric interview. Rationale, reliability, and validity.

The Iowa Structured Psychiatric Interview (ISPI) is an interview form designed for psychiatric epidemiological research in the general population. Its use provides detailed information about important aspects of psychiatric, social, and family history. Detailed information is gathered about the frequency and duration of symptoms that characterize schizophrenia, mania, depression, and neurosis. The instrument is also designed to be administered by well-trained nonmedical personnel in order to facilitate its utilization in large-scale field studies. Such interviewers are assumed to be blind to the study status of the informants, and the format of the ISPI maintains that blindness throughout crucial sections of the interview. In addition, the ISPI can be used without any implication that the informant or the informant's relatives have any type of psychiatric history or current psychiatric problems. This monograph discusses the rationale for the ISPI and gives a formative history of the instrument. We also present the results of studies investigating the reliability and validity of a set of twenty screening questions for schizophrenia, mania, depression, and neurosis - items which form the nucleus of the ISPI. The excellent reliability of these items is contrasted with the relatively poor reliability of a set of behavior ratings included in the ISPI. The ISPI itself is given in full in an appendix, along with detailed guidelines for use and suggestions for selecting and training personnel to administer the ISPI in the field. We hope that the ISPI can be further tested by other researchers in psychiatric epidemiology.

Adolescent↗
PubMed1979

Quantification of visual fields for statistical analysis.

The importance of visual fields in the study of ocular vascular disorders prompted the development of a method to convert visual fields plotted on a Goldmann perimeter into a digital form so that the data could be analyzed and stored by a computer. An instrument called a scotometer was designed to measure the visual fields and the various scotomata, and a data coding form was developed to facilitate the entry of the data into the computer. After extensive testing, this method is now being used in several clinical trials. Statistics have been computed that support the reliability of the coding process.

Computers↗
PubMed1979

Long-term outcome of major psychoses. I. Schizophrenia and affective disorders compared with psychiatrically symptom-free surgical conditions.

We conducted a 30- to 40-year field follow-up of 685 patients with schizophrenia, affective disorders, and nonpsychiatric conditions. Long-term outcome was analyzed in terms of the patients' marital, residential, occupational, and psychiatric status. On the whole, psychiatric patients showed a significantly poorer outcome than the surgical controls. On the basis of long-term outcome, schizophrenia, and affective disorders, selected according to the specified research criteria, were significantly different: schizophrenia definitely showed poorer outcome than affective disorders. However, no significant differences in all four outcome variables were found between mania and depression. We hope that the present data on long-term outcome of the typical cases can be used to compare outcome of other psychiatric disorders, such as undiagnosed psychoses, having mixtures of schizophrenic and affective features. In doing this, we hope to charify our understanding of undiagnosed psychoses and their relationship to schizophrenia and affective disorders.

Adult↗
PubMed1979

Comparing psychological and pharmacological treatments for hyperkinetic boys and their classmates.

This study compares the short-term effects of methylphenidate and of teacher consultation on the on-task behavior of diagnosed hyperkinetic outpatient boys and selected classmates. Statistically significant treatment effects were found for both drug-treated and behaviorally treated hyperkinetic boys; the size of these effects did not differ between the two types of treatment. Within the behavioral group, the treatment effect spilled over, so that there was also a significant treatment effect on overactive classmates of the behaviorally treated hyperkinetic children and a trend toward a significant treatment effect on their average classmates. Some implications of the findings are discussed.

Attention↗
PubMed1979

Direct and indirect laser photocoagulation of central serous choroidopathy.

A 3 1/2-year prospective randomized clinical trial showed a definite superiority of direct argon laser photocoagulation to the fluorescein leaking site compared to indirect treatment away from the leak in patients with central serous choroidopathy. One patient in each treatment group developed a subretinal neovascular membrane after photocoagulation to the fluorescein leak. Moderate prolongation of the neurosensory detachment did not adversely influence the final visual acuity in the indirect treatment group. Although direct laser photocoagulation reduces the duration of central serous choroidopathy, there is a risk of producing subretinal neovascularization. The principles of risk vs benefit should be explained to all patients and treatment should be advised only for compelling reasons.

Adolescent↗
PubMed1979

A computer program for survival comparisons to a standard population.

PROPHAZ is a computer program created for the analysis of survival data using the general proportional hazards model. It was designed specifically for the situation in which the underlying hazard function may be estimated from the mortality experience of a large reference population, but may be used for other problems as well. Input for the program includes the variables of interest as well as the information necessary for estimating the hazard function (demographic and mortality data). Regression coefficients for the variables of interest are obtained iteratively using the Newton-Raphson method. Utilizing large sample asymptotic theory, x2 statistics are derived which may be used to test hypotheses of the form C beta = 0. Input format is completely flexible for the variables of interest as well as the mortality data.

Computers↗
PubMed1978

Excess mortality in schizophrenia and affective disorders. Do suicides and accidental deaths solely account for this excess?

Excess mortality was found in the first decade of follow-up for schizophrenia and affective disorders. This trend continued for schizophrenia throughout the entire four decades of the follow-up period. Suicides were higher than expected for all psychiatric groups except female schizophrenics and male manics. Accidental deaths were higher in these two groups, which did not show significantly excessive suicide rates. Suicides and accidental deaths were then excluded from the mortality analysis to determine their contribution to excess nortality. We conclude that death due to suicides and accidental deaths is not the sole cause for excess mortality, especially in schizophrenia.

Accidents↗
PubMed1977

Mortality in patients with schizophrenia, mania, depression and surgical conditions. A comparison with general population mortality.

Mortality data are presented from a four-decade follow-up study of 200 schizophrenic, 100 manic, 225 depressive patients, and 160 surgical controls (80 appendicectomy; 80 herniorrhaphy). Data for this analysis were available on 648 (95 per cent) members of the study population. Using sex-age standardized mortality ratios (SMR), the mortality experience of the study population was compared with that of the state of Iowa, the geographical area served by the admitting medical facility for the study group. Results are presented for a four-decade period beginning 1935-44, and ending 1965-74. All three psychiatric groups had a significant increase in mortality risk. This was most pronounced in the first decade following admission, although schizophrenic patients, especially females, continued to show a significant excess of deaths throughout the entire four decades of the follow-up period. During no decade of the follow-up period did the mortality of the surgical controls differ significantly from that of the Iowa population.

Adult↗
PubMed1976

Osmoltye and tryptophan receptors controlling gastric emptying in the dog.

The effect of three monosaccharides, three disaccharides, two dipeptides, combinations of tryptophan with two hexoses, one hexitol, and two amino acids ongastric emptying was studied in dogs to further define the samll intestinal receptors responsive to osmolytes and tryptophan. On a molar basis the disacchardies and dipeptides were almost twice as potent as their respective constituent monosaccharides or amino acids implying that the osmoreceptor is deep to the brush border disaccharidases and cytosol dipeptidases. Tryptophan probably acts by a mechanism different from the osmoreceptor since slowing of gastric emptying by tryptophan was inhibited by methionine which has no effect on a stimulant of the osmoreceptor mechanism. Lysine unlike methionine does not share the neutral amino acid transport pathway with tryptophan. Lysine did not change the inhibitory effect of tryptophan on gastric emptying. This imples that transport of tryptophan into the intestinal cell is necessary for its slowing effect. Glucose and galactose also inhibited the tryptophan effect whereas a nonabsorbed hexitor, mannitol, was without effect. Interference by the hexoses was also probably by competition with tryptophan for transport into the cell. These studies further indicate that the tryptophan receptor is different from the osmoreceptor.

Alanine↗
PubMed1975

The relative risk of spontaneous complete atrioventricular block in elderly patients with impaired intra-ventricular conduction.

We reviewed 144 consecutive patients with symptomatic high grade atrioventricular block. Cases due to congenital heart disease, acute myocardial infarction, cardiac surgery or digitalis toxicity were excluded. Of the remaining, we chose 71 patients in whom atrioventricular conduction was observed either intermittently during complete heart block (CHB) or in electrocardiograms taken within two years prior to documentation of CHB. The mean age was 69 years, with the peak incidence in the seventh decade in 43 men and eight decade in 28 women. Bundle branch block (BBB) was present in 76% of patients as follows: 47% had right BBB (20% with normal QRS axis, 20% with left axis deviation and 7% with right axis deviation), 17% had left BBB (11% with normal QRS axis and 6% with left axis deviation) and 12% had either alternating BBB, right BBB with alternating axis deviation or atypical BBB. "Trifascicular block" patterns accounted for 21% of the total group of CHB. We also studied the prevalence of various patterns of BBB in a group of 2000 random hospital patients of comparable age and sex exclusive of those with acute myocardial infarction and heart surgery. The risk of CHB for the various patterns of BBB was calculated relative to normal intraventricular conduction. All patterns of BBB carried a considerably increased relative risk of CHB, (P smaller than .01). The relative risk was highest for RBBB with left axis deviation and lowest for LBBB with normal or left axis deviation. In the men, 74% had QRS patterns of "bifascicular" or "trifascicular" block during atrioventricular conduction. By contrast, 71% women had atrioventricular beats showing either no BBB or right BBB with normal QRS axis. QRS pattern during CHB was unchanged from that during atrioventricular conduction in 52% if cases (rabge 38%-76% with different QRS patterns) suggesting idiojunctional pacemaker. CHB in these cases was thought to be due probably to coexistent disease in the AV node or His bundle. Although the concept of uni-, bi- and trifascicular block patterns has been useful in identifying patients at greater risk of CHB, the predictability of the electrocardiogram has obvious limitations, particularly in women.

Aged↗
PubMed1975

Effects of essential and nonessential amino acids on gastric emptying in the dog.

Five dogs with gastric fistulas were studied to assess the effect on gastric emptying of two potent cholecystokinin (CCK) releasers (tryptophan and phenylalanine) and six other essential amino acids; the nonessential amino acids alanine, beta-alanine, arginine, asparagine, aspartic acid, citrulline, cysteine, cystine, glutamic acid, glutamine, D-glutamine, histidine, hydroxyproline, ornithine, proline, serine, tyrosine, and D-tryptophan; four peptide and amino acid preparations; and solutions of glucose, glycine, and mannitol. Of the essential amino acids, only tryptophan significantly slowed emptying and it was above 4 mM that there was a difference between control and test meal. The delay in response to tryptophan was dose-related and approached maximum at 40 mM; D-tryptophan had no effect at these concentrations. In concentrations up to 80 mM, none of the nonessential amino acids slowed emptying significantly. The four peptide and amino acid preparations in concentrations ranging from 80 to 700 milliosmoles had dose responses identical to those of D-glucose, glycine, and mannitol at similar osmolalities. It is concluded that L-tryptophan is a uniquely potent delayer of gastric emptying in the dog which is dose-dependent and stereospecific. Phenylalanine, a potent CCK releaser, did not slow emptying, which suggests that CCK release may not be the only mechanism by which tryptophan acts. The peptide and amino acid preparations (casein hydrolysate, Bacto-peptone, Amigen, FreAmine) seem to delay emptying by stimulation of osmoreceptors which is distinct from the mechanism of action of tryptophan.

Amino Acids↗