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Biomedical subjects

T H Turner

Publications and source records attributed to T H Turner.

At least 19 recordsLinked to original sources
PubMed1992

'Mentally disordered persons found in public places'. Diagnostic and social aspects of police referrals (Section 136).

A survey over 2 years of all Police Referrals (Section 136 of the Mental Health Act 1983) in an inner-city health district identified 163 cases, with a core group of repeat referrals. Previous psychiatric admissions, a diagnosis of schizophrenia, social deprivation, and a bias towards young men of Afro-Caribbean ethnicity were key features. The difficulty of obtaining clear data and uncertainties within the law rebound unfairly on patients, police and psychiatrists. Section 136, while not inappropriate diagnostically, can be seen as highlighting unmet social and medical needs in the context of community care. The requirement for coordinated resources, including acute in-patient services sufficient for deprived populations and legal provision for treatment beyond a hospital's boundaries, seems paramount.

Adult↗
PubMed1992

A diagnostic analysis of the Casebooks of Ticehurst House Asylum, 1845-1890.

Ticehurst House, a private asylum, flourished during the nineteenth century as the most expensive of such establishments, being owned and run by the Drs Newington over five successive generations. The discovery of the full set of patient casebooks begun in 1845-6 made it possible to review in detail the clinical features of a complete cohort of patients admitted to the asylum between 1845 and 1890. Six-hundred-and-one patients were thus analysed in terms of their age, sex, length of stay, symptoms, treatment and outcome. Modern operational diagnoses were used, and 80% of the cohort were found to conform to Research Diagnostic Criteria, in particular to the categories for schizophrenia and manic-depressive disorder. An additional finding was the high prevalence of movement and postural disorder among the schizophrenic group, as well as a significant trend towards the selection of a treatable, good-outcome group of patients with manic-depressive illness. These results are discussed by comparison with other modern studies of the asylum period, and in the contemporary context of Victorian psychological medicine. It is suggested that the violence, physicality and chronicity of psychotic illness must be seen as central to the debate about the rise of the asylum in nineteenth-century Britain. Furthermore, the similarity in core symptoms found in such patients and those seen in the 1980s indicates that the categories 'schizophrenia' and 'manic-depressive disorder' have a robust validity that is not confined to the social parameters of a particular time period.

Clinical Protocols↗
PubMed1992

Mania in association with hydrocortisone replacement for Addison's disease.

A 32 year old woman with untreated primary adenocortical insufficiency presented with prominent depressive symptoms. Upon treatment with physiological doses of glucocorticoids she developed a self-limiting acute manic illness. We suggest that up-regulation of hippocampal glucocorticoid receptors as a consequence of prolonged hypocortisolaemia resulted in increased cerebral sensitivity to exogenous corticosteroids, which are known to precipitate manic symptoms in some normal individuals when given in supraphysiological doses.

Acute Disease↗
PubMed1992

Effect of metyrapone on the pituitary-adrenal axis in depression: relation to dexamethasone suppressor status.

It has been suggested that the well-documented hypercortisolaemia found in a proportion of patients with severe depression occurs either in response to excessive secretion of corticotrophin-releasing hormone-41 (CRH-41) from the hypothalamus, or as a consequence of up-regulation of pituitary CRH-41 receptors. The attenuation of the normal ACTH response to CRH-41 in these subjects is thought to result from inhibition of corticotrophin secretion by elevated cortisol levels. We tested these hypotheses by examining ACTH responses to metyrapone, an 11 beta-hydroxylase inhibitor which blocks the formation of cortisol, followed by CRH-41 in 15 severely depressed in-patients diagnosed according to DSM-IIIR criteria. Patients were assigned to two groups according to their response to overnight administration of 1 mg dexamethasone: suppressors (8) and nonsuppressors (7). A third group consisted of 6 healthy matched controls. Metyrapone 750 mg was given 4-hourly for 24 h and samples were taken for cortisol and ACTH. Six of the original 15 patients (3 from each group) were given a bolus dose of 100 micrograms human CRH-41 intravenously after 24 h of metyrapone, and ACTH levels were measured over 2 h. Falls in circulating cortisol in response to metyrapone were similar in all three groups. However, we found exaggerated rises in ACTH amongst the nonsuppressors, as compared to the suppressors and the control group, after metyrapone.(ABSTRACT TRUNCATED AT 250 WORDS)

Adrenal Cortex Hormones↗
PubMed1989

Schizophrenia and mental handicap: an historical review, with implications for further research.

The relationship between schizophrenia and 'mental handicap' has been obscured by historical changes and varying diagnostic criteria. It has been generally accepted that there is an increased incidence of psychotic illness among people with intellectual retardation, but detailed community surveys are limited. Catatonia, severity of illness and research potential are all to be found in this 'dual diagnosis' group. The value of an historical analysis is underlined.

England↗
PubMed1988

Tardive dyskinesia.

Explore the source record for details and available documents.

Dyskinesia, Drug-Induced↗
PubMed1988

Running amok.

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Bipolar Disorder↗
PubMed1987

Naloxone has no effect on hormonal responses to ECT in man.

Although there is clear evidence in other species that electroconvulsive therapy (ECT) is associated with changes in endogenous opioid activity, there are few data available for such a role in man. Since ECT leads to changes in certain hormones in man, particularly serum prolactin, it was postulated that such changes may represent an increase in endogenous opioids. Six unmedicated patients with major depressive illness were therefore administered either 4 mg i.v. of the opiate antagonist naloxone or a saline control infusion, just before successive treatments with ECT, in a double-blind, randomized crossover design. Blood was sampled at intervals for serum prolactin, growth hormone (GH), and cortisol. ECT led to a clear rise in serum prolactin, with no significant change seen in either serum GH or serum cortisol during the 20-min sampling interval. Naloxone had no significant effect on any of these changes. It is concluded that the rise in serum prolactin in response to ECT is not mediated by changes in endogenous opioid peptide activity.

Adult↗
PubMed1986

Indicators of psychiatric disorder among women admitted to prison.

A random sample of 708 women prisoners recently admitted to Holloway Prison was screened for evidence of psychiatric disorder. Of the 708 women, 195 had a history of self harm, 44 of whom had a history of cutting themselves, 125 had a history of psychiatric illness, 99 were dependent on opiates, and 89 took psychotropic drugs regularly. These findings suggest that there is a need for psychiatric units in women's prisons such as Holloway Prison, and that initiatives to alter policies of admission to psychiatric hospitals should be pursued.

Adult↗
PubMed1986

The early outcome of admission to an adolescent unit: a report on 100 cases.

Data are presented on the outcome of 100 adolescents after discharge from an adolescent inpatient unit. Outcome is recorded in terms of placement at home, day care provision, and partial or full-time residential care provision, relating this to diagnosis, sex, age, duration of admission and evidence of family pathology. Of these only duration of admission was significantly related to outcome. More than two thirds (69 per cent) of all patients are discharged home. At six months, of those traced, 82 per cent are at home. Stability of outcome is the norm. This reflects the bio-psycho-social approach of the unit and refutes the notion that psychiatric institutional care for adolescents merely predicts a continued need for therapeutic resources.

Adolescent↗
PubMed1985

Personality and theophylline pharmacokinetics.

Thirteen volunteers received an iv dose of theophylline followed by blood sampling for 8 h to calculate pharmacokinetic parameters. Ten patients with asthma undergoing chronic dosing with slow release aminophylline underwent 12 h of blood sampling to calculate theophylline clearance. Both groups completed an Eysenck Personality Inventory (EPI) from which was derived scores for neuroticism (N) and extroversion (E). Using multiple regression analysis no independent effect of either N or E score on theophylline clearance or half-life could be demonstrated.

Half-Life↗
PubMed1985

Huntington's chorea without dementia. A problem case.

An unusual case of Huntington's Chorea, without dementia, is described. The diagnostic issues are discussed with particular reference to the problems of psychiatric assessment and management of the disease.

Dementia↗