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Biomedical subjects

R M Murray

Publications and source records attributed to R M Murray.

At least 343 records · Page 19Linked to original sources
PubMed1980

A longitudinal study of urinary excretion of N,N,-dimethyltryptamine in psychotic patients.

The excretion of N,N,-dimethyltryptamine (DMT) has been measured in longitudinal studies of five patients with schizophrenic illnesses and in four patients with rapidly or slowly cycling manic-depressive illness. The excretion of DMT was frequently raised in patients when they were psychotic but was usually normal when they had recovered. However, rapid changes in the severity of illness or sudden switches from one mood state to another were not accompanied by changes in the excretion of DMT. These findings contrast with the immediate hallucinogenic effects of an injection of DMT, and suggest that the extracerebral production of DMT (as measured by its urinary excretion) does not provoke the experience of hallucinations in psychotic patients.

Bipolar Disorder↗
PubMed1979

A reappraisal of American psychiatry.

Remarkable changes have taken place in American psychiatry over the past twenty years. The era of psychoanalytical supremacy has passed, and realism is replacing the exaggerated claims which were made of psychiatry's ability to produce personal, social, and even political change. The importance of phenomenology and accurate diagnosis is increasingly recognised, and American researchers have made many impressive contributions to psychiatric genetics and to psychopharmacology. Despite these advances, office practice generally continues to function on an outmoded model and psychiatric resources remain inequitably distributed.

Evaluation Studies as Topic↗
PubMed1979

Increased excretion of dimethyltryptamine and certain features of psychosis: a possible association.

The excretion of the hallucinogen dimethyltryptamine (DMT) and its precursor N-methyltryptamine (NMT) was studied among 74 recently admitted psychiatric patients and 19 normal persons. Both compounds were detected in 24-hour urine samples from all subjects. Dimethyltryptamine excretion was greatest in schizophrenia, mania, and "other psychosis" and tended to decline as clinical state improved. Psychotic depressives excreted smaller amounts of DMT more akin to those excreted by neurotic and normal subjects. Urinary NMT excretion was unrelated to psychiatric diagnosis. Ratings on the Present State Examination (PSE) also indicated that increased excretion of DMT was associated with psychotic rather than neurotic psychopathology. Forty-three percent of the variance in urinary DMT levels could be explained in terms of six of the 38 PSE syndromes. Syndromes suggesting elation, perceptual abnormalities, and difficulty in thinking and communicating were most correlated with raised urinary DMT excretion.

Adolescent↗
PubMed1979

The Leyton Obsessional Inventory: an analysis of the responses of 73 obsessional patients.

The Leyton Obsessional Inventory was administered to 73 obsessive-compulsive neurotics, and their responses compared with those of 100 normal subjects. The ratio of the mean patient to normal scores ranged from 2.4:1 for obsessional traits and 3.2:1 for symptoms to 6.2:1 for resistance and 12.5:1 for interference with other activities. A principal components analysis on the patients' replies produced 3 unitary components (household order, personal contamination, and doubting) plus 2 bipolar components (checking/parsimony and desire for closure/unpleasant ruminations). These appeared to be more definitive representations of components identified from a similar analysis on normal subjects, suggesting that obsessional neurotics differ from normal subjects quantitatively rather than qualitatively. A cluster analysis on the patients' responses produced 3 subgroups. Thirty-two patients were predominantly hesitant and indecisive ('doubters'), 30 were concerned with bodily and clothing contamination ('contaminators'), and 7 were preoccupied with checking ('checkers').

Adolescent↗
PubMed1978

Drug response and psychiatric nosology.

The possibility that pharmacological response might help to refine psychiatric nosology has been the subject of recurrent speculation, but few clear-cut results have been obtained. Only bipolar depressives and several other minor patient subgroups manifest consistent drug responses in association with characteristic psychobiological features. The presence of multiple intervening variables, such as individual differences in drug metabolism, drug-taking behaviour and biological sensitivity to drugs, may mitigate against the reliable identification of clinically distinguishable drug-responding subgroups. Futhermore, the majority of available psychoactive drugs have either multiple or broad spectrum effects inconsistent with hypotheses utilizing the mechanism or site of drug action to argue for a diagnosis-specific biological disorder at such sites. Nonetheless, the successful use of drug-response models in other areas of medicine suggests a rationale for continued exploration in this area, and a number of recent advances make this approach potentially more productive. Pharmacological developments have rendered it possible to assess the biological availability of drugs in potential responders, thus eliminating some of the confounding intervening variables. Further consideration should also be given to the use of drugs with more specific neurochemical effects, even when they themselves are not necessarily therapeutic. The comparison of drug responder and non-responder group has also been made more meaningful by the availability of more reliable methods of assessing clinical phenomena, more sophisticated diagnostic models and the introduction of other biological measures. Combining several of these approaches may allow the use of one to validate the other.

Antidepressive Agents, Tricyclic↗
PubMed1978

Genesis of analgesic nephropathy in the United Kingdom.

Analgesic nephropathy is more common in Western Scotland than elsewhere in the United Kingdom. This appears to be a consequence of the frequency with which local people take Askit, a preparation different from most other British analgesics in that they contain more caffeine and in their presentation as powders. Surveys of different populations in Glasgow suggest that while aspirin and paracetamol tend to be taken relatively infrequently and for appropriate reasons such as pain, Askit is more likely to be taken with excessive frequency for its supposed mood-altering properties. Working-class women with psychiatric problems are especially prone to daily self-medication. Study of individuals with analgesic nephropathy reveals that in Western Scotland, at least, the cause is dependence on analgesics. The characteristics of this include a need to continue taking and to slowly increase the dose of analgesics, partly owing to tolerance and partly to treat symptoms the analgesic ingestion has caused, as well as a psychic dependence resulting from appreciation of the psychotropic effects of the compound analgesics. When compared with matched controls, those who develop the "analgesic abuse syndrome" are more likely to have a family history of analgesic abuse, alcoholism, and psychiatric disorder. They tend to be introverted and neurotic, are prone to abuse other drugs and many have had previous psychiatric treatment.

Adult↗
PubMed1978

Methane production in the rumen and lower gut of sheep given lucerne chaff: effect of level of intake.

1. Methane production rates were estimated simultaneously in the rumen and caecum of sheep given 200, 400, 600, 800 and 1000 g lucerne (Medicago sativa) chaff/d using isotope dilution techniques. Estimates were also made of volatile fatty acid (VFA) production in the rumen at each level of feeding. In all studies three to four animals were used at each level of intake. 2. Production of VFA and of methane were both related to digestible energy (DE) intake. Regression lines for both VFA production and methane production v. DE intake had significant intercepts indicating an input of endogenous, fermentable organic matter into the rumen in excess of 50 g/d. 3. The values obtained for rates of methane production were compared with those calculated from stoicheiometric equations relating rates of methane and VFA production. Comparisons of methane production with that predicted from DE intake were also made. 4. Balances for digestion of food determined for the rumen indicated that the energies in the end-products were more than 100% of the DE intakes of lucerne chaff. Correction for fermentation of apparent endogenous materials resulted in more realistic values. Endogenous materials appeared to make a significant contribution to VFA and methane production, particularly at low levels of intake.

Animals↗
PubMed1977

Factors affecting the urinary excretion of endogenously formed dimethyltryptamine in normal human subjects.

The hallucinogenic substance N',N'-dimethyltryptamine and its precursor N-methyltryptamine were found in 24-h specimens of urine from 19 normal human subjects; the mean excretion rates were 386 ng 24 h(-1) and 856 ng 24 h(-1) respectively. The urinary excretion of both compounds was unrelated to age, sex, urinary volume, or creatinine, nor was any consistent diurnal pattern observed. Rates for the mono and dimethylated compounds were not correlated. Diet and the intestinal flora were excluded as a source of urinary dimethyltryptamine. Administration to 4 subjects of sufficient ammonium chloride to increase the H ion concentration of the urine caused a transient increase in dimethyltryptamine excretion but no consistent increase in the rate for N-methyltryptamine. Acidification of the urine did not appear to be the determining factor in this result since in one subject the same drop in urinary pH was achieved by feeding methionine without any increase in dimethyltryptamine excretion.

Adult↗
PubMed1977

Psychiatric illness in male doctors and controls: an analysis of Scottish hospitals in-patient data.

An investigation was undertaken into the first admissions to (for the years 1963, 1965, 1968, 1972) and the total discharges from (for the years 1963-72) Scottish mental hospitals and psychiatric units of male doctors and other social class I males. The overall rates for both first admission and for all discharges were more than twice as high among male doctors as among other social class I males. First admission and total discharge rates for drug dependence, alcoholism, neurotic and 'functional' depression and for affective psychosis were all significantly higher among doctors than non-doctors. Doctors were more likely than non-doctors to have been referred by themselves or by medical sources other than general practitioners, and were as willing as non-doctors to enter hospital voluntarily. Creater access to psychiatrists may have contributed to their higher rates in in-patient care, but it is improbable that such factors accounted for all of the excess in rates of drug dependence, alcoholism and depression.

Adult↗
PubMed1976

Characteristics and prognosis of alcoholic doctors.

Five medically qualified women and 36 men who were being treated for alcoholism at a London postgraduate hospital were studied. Most were middle-aged and at an advanced stage of alcoholism. They had usually started drinking heavily in the wake of well-established drug dependence or other psychiatric disorder; as students or housemen; and in the armed forces. Thirty-six doctors were followed up for a mean of 63 months. Five doctors either killed themselves or died of cirrhosis, and nine persisted in almost continuous dependent drinking, while seven completely overcame their alcohol problem and 10 had only occasional relapses. Their prealcoholic careers had ranged from repeated failure to spectacular success, but of 29 doctors alive at follow-up only eight were practising satisfactorily.

Adult↗