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Biomedical subjects

R K Ries

Publications and source records attributed to R K Ries.

At least 37 records · Page 2Linked to original sources
PubMed1990

Sleep disturbances in patients with mild-stage Alzheimer's disease.

We examined the ability of sleep/wake measures to discriminate 45 control subjects from 44 mild Alzheimer's disease (AD) patients. Sleep fragmentation was observed as indicated by significant increases in time awake (37-52%) and number of awakenings (31-36%) during the night as compared to controls. Further, slow wave sleep (SWS) was significantly reduced (22%) in AD patients relative to controls. These findings are consistent with our earlier observations of increased wakefulness and decreased SWS in mild-moderate, moderate-severe, and severe stage AD patients. However, when we used these sleep/wake stage measures in discriminant analyses to classify the current AD subjects vs control subjects, the analyses failed to confirm our earlier high classification rate (90%). The present groups were discriminated at overall classification rates of only 63-67%. We conclude that while sleep/wake patterns are significantly disturbed in AD, this phenomenon is not diagnostically useful for discrimination of mild stage AD.

Aged↗
PubMed1990

A pilot assessment at one month of 17 dual diagnosis patients.

A pilot one-month follow-up of 17 inpatients diagnosed with both psychiatric and substance abuse disorders showed that 12 patients reported abstinence and five had relapsed. Significant associations were found between reported abstinence and a diagnosis of a depressive disorder, high motivation for abstinence, and the patient's perception that a specific discharge plan for substance abuse treatment had been developed.

Adult↗
PubMed1989

Factitious AIDS.

Explore the source record for details and available documents.

Acquired Immunodeficiency Syndrome↗
PubMed1989

Carbamazepine treatment for benzodiazepine withdrawal.

Nine patients were given carbamazepine before rapid discontinuation of benzodiazepines. Most patients had had long-term benzodiazepine treatment and had abused benzodiazepines; five had taken high doses. All patients tolerated rapid discontinuation well and none developed significant withdrawal symptoms.

Adult↗
PubMed1988

Successful recruitment of elderly community-dwelling subjects for Alzheimer's disease research.

One hundred seventy-four healthy community-dwelling subjects were recruited for a research project investigating Sleep/EEG measures as biological markers for early-stage Alzheimer's Disease (AD). All subjects were age 55 or older. The subjects were divided into four groups: 46 subjects were diagnosed as having mild, uncomplicated AD, 31 had memory problems but did not meet the research criteria for AD, 43 had uncomplicated major depressive disorder, and 54 were normal controls. Male depressives and mild AD subjects were the groups most difficult to recruit. The ratio of initial inquiries from potential subjects to final study participants in all groups combined was 9 to 1. Successful recruiting strategies for each study group are discussed. News announcements and referrals from other AD researchers accounted for the greater number of study participants.

Advertising↗
PubMed1987

Antipsychotic drugs and plasma vasopressin in normals and acute schizophrenic patients.

Elevated plasma vasopressin concentrations have been documented in antipsychotic drug-treated patients as well as a drug-free acutely psychotic patients. To evaluate the effects of antipsychotic drugs on plasma vasopressin, we measured vasopressin response to a single dose of intramuscular chlorpromazine or intravenous haloperidol in normal individuals and to 2 weeks of oral antipsychotics in patients with acute schizophrenia. Neither intramuscular chlorpromazine nor intravenous haloperidol affected plasma vasopressin in normals, except in one subject who developed high plasma vasopressin concentrations coincident with marked hypotension following chlorpromazine. Prior to antipsychotics, two acute schizophrenia patients had elevated plasma vasopressin concentrations, which normalized during antipsychotic drug treatment. We conclude that antipsychotics do not directly stimulate vasopressin release, but may indirectly stimulate vasopressin release by well-described baroreceptor reflex mechanisms if hypotension occurs. Also, acute schizophrenia may be associated with increased plasma vasopressin levels in some patients.

Adult↗
PubMed1987

History of chronic alcohol abuse is associated with increased nighttime hypoxemia in older men.

The all-night blood oxygen saturations (SaO2) of 19 older abstaining male alcoholics and 19 healthy age-matched controls were recorded. The alcohol group had significantly lower nighttime mean and minimum oxygen saturations, significantly greater absolute (mean-minimum) SaO2 desaturations, and significantly more desaturations below 90% compared with the control group. Additionally, the alcohol group had significantly more individuals with nighttime SaO2 means below 95% and nighttime SaO2 minimums below 90%. Finally, within the alcohol group, alcohol history was found to significantly correlate with nighttime mean and minimum SaO2 and absolute SaO2 desaturation. This preliminary study finds evidence that chronic alcohol abuse may predispose an individual to nighttime hypoxemia, and, inferentially, to sleep apnea. However, the effect is modest and it will need to be confirmed in larger, more carefully controlled studies.

Age Factors↗
PubMed1985

Poor interrater reliability of MECTA EEG seizure duration measurement during ECT.

Seizure duration assessed from the MECTA EEG (mEEG) tape was not found to be a reliable measurement across five independent examiners. Although all examiners agreed that an electrical seizure was demonstrated on the mEEG, the examiners were markedly different in their duration assessments (p less than 0.0001). Criteria are needed for mEEG measurement and interpretation.

Electroconvulsive Therapy↗
PubMed1985

DSM-III implications of the diagnoses of catatonia and bipolar disorder.

Although catatonia has traditionally been thought of as a type of schizophrenia, the author presents studies indicating that catatonia may be at least as common in bipolar disorder as it is in schizophrenia. He points out that changing definitions of schizophrenia and affective disorder require a reassessment of catatonia and its incorporation in modern diagnostic systems. The discussion represents material presented at the Affective Disorders Advisory Committee of the American Psychiatric Association Work Group to Revise DSM-III.

Bipolar Disorder↗
PubMed1984

Tricyclic antidepressant therapy for peptic ulcer disease.

The role of tricyclic antidepressants (TCAs) as agents for treatment of peptic ulcer disease is of growing interest. In both placebo-controlled clinical trials and comparative studies with cimetidine, TCAs have proved effective and safe as ulcer-healing agents. The mechanism of action by which TCAs produce healing has not been fully elucidated. In vivo studies in man have generally shown that TCAs decrease gastric acid secretion. In addition to their well-known anticholinergic properties, in vitro studies have indicated potent H1- and H2-receptor blocking activities for these agents. Separate from these effects on acid output, the antipain/depression effect of TCAs may be of benefit in certain patients with ulcers. Other advantages of these agents include their long half-lives, low cost, and readily available serum monitoring. Further clinical studies with detailed physiologic and psychologic observations and serum monitoring using TCAs in patients with peptic ulcer disease are needed.

Cimetidine↗
PubMed1983

Factitious mourning: painless patienthood.

Of 20 patients who falsely reported the deaths of loved ones in order to assume the patient role, most presented with depression and suicidal ideation secondary to reported multiple dramatic deaths for which there was no available verification, and many had histories of factitious physical symptoms, manipulative suicide attempts, substance abuse, and sociopathy. Diagnostic categories were of limited usefulness for these patients. Factitious symptoms can better be understood as one form of dysfunctional care-eliciting behavior. The authors recommend early and repeated confrontations in a firm but nonjudgmental manner combined with referral to outpatient psychotherapy focused on the underlying characterological problems.

Adolescent↗
PubMed1981

The medical care abuser: differential diagnosis and management.

The differential diagnosis of patients who are abusive of or seem addicted to medical care is discussed using the approach outlined in the new Diagnostic and Statistical Manual III of the American Psychiatric Association. These are generally chronic disorders and their managements, using the substance abuse/addiction model, are aimed at protecting both patients and physicians from unnecessary, expensive, and potentially lethal medical interventions. The disorders considered include somatization disorder (Briquet's syndrome), psychogenic pain disorder (psychalgia), hypochondriasis, factitious disorder, and malingering.

Adult↗
PubMed1980

Psychiatric consultation-liaison service: patients, requests, and functions.

Prospective data were gathered from 388 psychiatric consultations performed in a general hospital setting. Data included demographic, medical, psychiatric, and illness behavior characteristics of the patients seen, as well as consultant functions and recommendations. Results indicate that consulted patients suffer from a wide variety of medical problems, are frequently taking psychoactive medications before the consultation, and experience a spectrum of psychosocial problems in coping with their disease. Primary physicians infrequently provided any psychiatric data or reasons for referral other than for depression. Consultants determined what they felt were the motivating reasons for referral and besides patient psychopathology found a significant amount of maladaptive illness behavior and staff/patient conflict. Comparison with other studies supports the high incidence of primary (21%) and secondary (18%) depression in this population and the active involvement in its treatment by consultation-liaison psychiatrists. Research, training, and clinical issues generated by the findings are discussed.

Adaptation, Psychological↗
PubMed1980

DSM-III differential diagnosis of Munchausen's syndrome.

Patients who have the wish to be admitted and treated repeatedly in hospitals are a fascinating although still poorly understood group. Those who have no apparent organic basis for their complaints are especially interesting and challenging, since they often demand and sometimes receive potentially dangerous somatic treatments such as operations and medications. Such patients receive a wide range of psychiatric diagnoses, such as hysteria, Briquet's syndrome, factitious illness, Munchausen's syndrome, malingering, and schizophrenia. We recently treated a young woman who had been given most of these diagnoses, whose case history presented us with an opportunity to review problems in differential psychiatric diagnosis as applied to this frequently confused and confusing problem area.

Adult↗
PubMed1980

Medical students and psychiatric patients: an encounter of the first kind.

The use of psychiatric patients in teaching interview techniques to inexperienced medical students is a common practice. This report describes the impact of this training as assessed through questionnaire analysis of 35 patients and 32 medical students involved in an interview course for second-year medical students. The experience was viewed by both patients and students as useful, and more students reported it as being stressful than did patients. Patients valued it because they thought it would improve medical education, while students found it personally helpful. Most patients (94 percent) and all students indicated they would participate in a similar experience. Most patients felt that the students understood them well in contrast to the student's perception of not understanding the patient.

Attitude to Health↗