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Biomedical subjects

R M Murray

Publications and source records attributed to R M Murray.

At least 271 records · Page 15Linked to original sources
PubMed1991

Assessing schizophrenia in adults with mental retardation. A comparative study.

Twenty-five patients with mild mental retardation were compared with 26 schizophrenic patients of normal intelligence. The patients with retardation had suffered an earlier onset and were less likely to have been married or employed. However, the clinical phenomena exhibited by the two groups, as elicited by a SADS-L interview, were very similar. Thus, standardised interviews and criteria for schizophrenia can be readily applied to those with an IQ between 50 and 70.

Adult↗
PubMed1991

The incidence of operationally defined schizophrenia in Camberwell, 1965-84.

We established first-contact rates of schizophrenia in the defined area of Camberwell between 1965 and 1984. The rate of schizophrenia, whether defined by ICD, RDC, or DSM-III criteria, rose over the period under study. This finding is at odds with reports of an overall decline in first-admission rates for schizophrenia in England, over the same period. The discrepancy was largely accounted for by the influx into Camberwell of individuals of Afro-Caribbean origin, who showed rates of schizophrenia between four and eight times that of their Caucasian counterparts.

Cohort Studies↗
PubMed1991

Comparison of sequential cyproterone acetate/estrogen versus spironolactone/oral contraceptive in the treatment of hirsutism.

The effects of the antiandrogen drugs cyproterone acetate (CPA) and spironolactone on hair growth and androgen levels were compared in a randomized study of 48 hirsute women. Twenty six subjects completed 6 months of therapy with 100 mg/day CPA and 19 subjects completed 6 months of 100 mg/day spironolactone. All except 10 subjects received concomitant estrogen therapy. Measured objectively, total hair diameter fell by 17.1% with spironolactone (P less than 0.001), and by 16.8% with CPA (P less than 0.001). The diameter of the hair medulla fell by 17.8% with spironolactone (P less than 0.01), and by 31.7% with CPA (P less than 0.001). There was no difference between the drugs in their effect on hair diameter. Plasma testosterone levels also fell significantly with both drugs. As a subjective assessment of treatment efficacy, the frequency with which subjects performed cosmetic measures was recorded. This fell by 38% with spironolactone and by 44.7% with CPA (P less than 0.001 both drugs), and again there was no difference between the drugs. Side effects caused cessation of treatment in one subject taking CPA and two subjects taking spironolactone, and milder side effects were noted in two further subjects from each treatment group. We conclude that spironolactone and CPA, in the dosages used in this study, are effective and well tolerated agents for the treatment of hirsutism, and that neither drug demonstrates a particular advantage over the other.

Adult↗
PubMed1990

Is schizophrenia disappearing?

The incidence of schizophrenia is regarded as being similar between different cultures and times. However, several studies, mostly based on first-admission rates, have suggested that the incidence has declined over the past 10-15 years. Data from England and Wales for 1952-86 have been examined: there has been a substantial decrease, beginning in the mid-1960s, in the incidence of schizophrenia.

Age Factors↗
PubMed1990

Does personality predict long-term outcome in depression?

In 1965/66, a consecutive series of 89 in-patients with depression were interviewed, given two personality tests (the EPI and LOI), and were accorded a score on a neurotic-psychotic continuum (DI). Eighteen years later, the series was followed up and the predictive power of the original data was determined. High neuroticism scores on the EPI on recovery and particularly when ill but referring to the pre-morbid state were associated with poor overall outcome and chronicity. High obsessional interference scores on the LOI on recovery were also associated with poor long-term outcome, impaired social adjustment, more time spent in hospital, and with the subsequent development of schizophrenic or schizoaffective episodes. High psychotic scores on the DI were also associated with poor long-term outcome, a greater length of time spent in hospital, and with bipolar affective disorder, and this effect was independent of the personality measures.

Adolescent↗
PubMed1989

Can a computer reliably elicit an alcohol history?

The drinking histories of 102 patients were elicited by both a computer and a nurse, with 48 of the patients also being interviewed by a psychiatrist. The computer agreed as closely with the nurse and the psychiatrist as they did with each other. For all three, there was better agreement for screening interviews whose questions are dichotomous (i.e. yes/no) than for interval data such as volume of alcohol consumed. Nevertheless, the agreement for alcohol volume was at least as good as that reported in the literature for inter-rater reliability. Thus a computer can interview patients about their drinking habits as accurately as a nurse or a psychiatrist. In many clinical settings computer interviewing might prevent patients with alcohol-related illnesses remaining undetected.

Adolescent↗
PubMed1989

The impact of molecular genetics on our understanding of the psychoses.

Studies demonstrating the linkage to separate chromosomal locations of Alzheimer's disease, manic depression, and schizophrenia require re-evaluation of our ideas of their genetic aetiology. This article reviews the findings, and explores the increasing contribution of the 'new genetics' to our understanding of the organic and functional psychoses.

Cloning, Molecular↗
PubMed1989

Family history and cerebral ventricular enlargement in schizophrenia. A case control study.

Ventricular size was measured from CT scans in 48 patients meeting RDC for schizophrenia who had a first-degree relative with a history of treatment for major psychiatric disorder, in 48 age- and sex-matched schizophrenic patients with no such history in first- or second-degree relatives, and in 48 matched, healthy controls. There was no difference in ventricular size between those with and without a positive family history, although both groups showed ventricular enlargement with respect to normal controls. Ventricular enlargement was demonstrated in the subgroup of 23 patients with a family history of schizophrenia, but not in the subgroup of 18 patients with a family history of affective disorder. These observations provide further evidence that schizophrenics with a family history of affective disorder may constitute an aetiologically distinct subgroup.

Adult↗
PubMed1988

Blue genes.

Explore the source record for details and available documents.

Bipolar Disorder↗
PubMed1988

Comparison of early renal dysfunction in type I and type II diabetes: differing associations with blood pressure and glycaemic control.

This study has investigated the relationship of glycaemic control, blood pressure and proteinuria to early renal dysfunction in a cohort of 50 type I and 65 type II diabetics, with renal function ranging from normal to mildly impaired (serum creatinine less than 0.2 mM). Repeated measurements were made over a mean interval of 7 years and mean data from each subject were analysed by stepwise multiple linear regression. This enabled associations to be determined independently of the confounding influence of age and duration of disease. In type I diabetics, mean creatinine clearance was inversely related to systolic blood pressure (P less than 0.001), glycosylated haemoglobin (P less than 0.05), fasting plasma glucose (P less than 0.05) and to the renal clearance of albumin (P less than 0.001), transferrin (P less than 0.01) and IgG (P less than 0.05). By contrast, in type II diabetics, none of these associations were significant. No significant relationships were found with the rate of decline of creatinine clearance in either type of diabetic. Further studies will be needed to determine whether the changes in blood pressure and glycaemic control precede or follow the development of renal disease. However, these findings raise the possibility of a difference in the pathogenesis of renal disease in type I and type II diabetes.

Adult↗
PubMed1988

Obstetric complications and schizophrenia: a computed tomographic study.

All patients aged 16-50 years who had been discharged from the Maudsley Hospital over a 4-year period with a diagnosis of schizophrenia were ascertained retrospectively. Case records were rated blindly for a history of obstetric complications (OCs). Sixty-one patients who satisfied the RDC for schizophrenia had undergone CT scanning. Those with a definite history of OCs presented at an earlier age. In this group widening of cortical sulci and fissures was more strongly correlated with VBR than in subjects without OCs. Moreover, large VBRs when accompanied by widened cortical sulci and fissures occurred more commonly in subjects with OCs than in those without. These results support the hypothesis that OCs, or a factor associated with them, lead to brain damage of aetiological significance in some cases of schizophrenia.

Adolescent↗
PubMed1988

Response to drugs in schizophrenia: the influence of family history, obstetric complications and ventricular enlargement.

A prospective study of antipsychotic drug treatment showed no difference in response between schizophrenic in-patients with or without a familial predisposition to the illness (N = 53). All patients received at least 600 mg chlorpromazine equivalents antipsychotic medication for 6 weeks. Ventricle brain ratios, ratings of cortical sulcal widening and a history of obstetric complications also failed to account for the variability, but early age of onset was associated with unsatisfactory response.

Adult↗
PubMed1988

The long-term outcome of Maudsley depressives.

Eighty-nine consecutive admissions with primary depressive illness were prospectively ascertained and diagnosed in 1965-66 by R. E. Kendell, who also allocated each a position on a neurotic-psychotic continuum on the basis of previous discriminant function analysis. In 1983-84, 94% of the survivors were personally interviewed by a psychiatrist blind to index admission data. Operational outcome criteria were employed and longitudinal data were established for 98% of the series. Mortality risk was doubled overall, and increased sevenfold for women under 40 years at index admission. Less than one-fifth of the survivors had remained well, and over one-third of the series suffered unnatural death or severe chronic distress and handicap. Patients whose index episode marked their first psychiatric contact had a 50% chance of readmission within their lifetime, but those with previous admissions had a 50% chance of readmission within three years. Readmissions occurred even after 12 years of being symptom-free, and conversely patients recovered after as long as 15 years of illness. There was a high incidence of other disorders (schizoaffective disorder, alcoholism, schizophrenia), and only four patients showed pure recurrent unipolar histories. Patients at the psychotic end of the continuum were more likely to be readmitted and to have very poor outcomes.

Adolescent↗