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Biomedical subjects

T R Barnes

Publications and source records attributed to T R Barnes.

At least 91 records · Page 5Linked to original sources
PubMed1985

Long-term depot maintenance of chronic schizophrenic out-patients: the seven year follow-up of the Medical Research Council fluphenazine/placebo trial. III. Relapse postponement or relapse prevention? The implications for long-term outcome.

The relapse and admission histories revealed a positive correlation between number of schizophrenic episodes and time on maintenance medication, probably reflecting severity of illness. Relapse rates after drug discontinuation rose to 45% within 13 months. There were no differences of predictive value between those relapsing on or off medication. The relationship between relapse rates, drug treatment, and social outcome is complex; antipsychotic drugs may postpone relapse, and frequent relapses might inhibit improvement in social performance long after florid symptoms have been controlled by medication.

Clinical Trials as Topic↗
PubMed1985

Pharmacological strategies in depression.

Several pharmacological manoeuvres may be considered when the first attempt at antidepressant treatment fails. The importance of adequate dosage and duration in any treatment trial are emphasized, and the evidence in support of combined antidepressants, lithium-antidepressant combinations, the addition of triiodothyronine or tryptophan, the use of anticonvulsants, and the use of vanadium inactivators, is evaluated.

Antidepressive Agents, Tricyclic↗
PubMed1984

Coarse, jerky foot tremor: tremographic investigation of an objective sign of acute akathisia.

In a previous clinical investigation, jerky foot movements were observed in patients with akathisia. Tremographic techniques were employed in the present study to characterise this motor activity. Six psychiatric patients with signs and symptoms of akathisia, six control patients matched for antipsychotic drug dose, and five drug-free normal subjects, were selected and assessed for evidence of drug-induced movement disorders. The two patient groups proved to be closely matched on clinical and demographic variables. An accelerometer was used to record finger and toe tremor in all subjects according to a standard procedure. Analysis of the amplitude, frequency and wave-form data collected revealed that the akathisia patients were characterised by the presence of large amplitude, low frequency (less than 4 Hz), rhythmic foot movements. Changes in the severity of akathisia at follow-up were reflected in changes in the amplitude and frequency of this dyskinesia. Possible clinical and pathophysiological implications of the findings are presented.

Acute Disease↗
PubMed1984

Persistent akathisia associated with early tardive dyskinesia.

Two psychiatric patients developed moderate or severe oro-facial dyskinesia, and limb dyskinesia, at a relatively young age and within a year of starting antipsychotic drug-treatment. This early appearance of tardive dyskinesia was preceded by akathisia that had developed at the beginning of drug therapy and persisted, despite the reduction of their drug doses to maintenance levels. The possibility that persistent akathisia may herald the early onset of tardive dyskinesia, is discussed.

Adult↗
PubMed1983

Variation in oro-facial tardive dyskinesia during depot antipsychotic drug treatment.

Oro-facial (tardive) dyskinesia, occurring in patients on long-term antipsychotic (dopamine antagonist) medication, can be suppressed temporarily by increasing the drug dose. Lowering the dose can exacerbate the condition. In patients receiving regular fluphenazine decanoate (FPZ) and flupenthixol decanoate (FPT) injections, characteristic profiles of the fluctuations in plasma level concentrations, occurring during the injection interval, have been demonstrated. The possible effects of these relatively predictable plasma level changes on the severity of oro-facial dyskinesia, and parkinsonism, were investigated. Regular assessment of oro-facial dyskinesia throughout the injection interval was carried out in six patients receiving FPZ and two patients receiving FPT. In both groups, changes were observed in the severity of oro-facial dyskinesia consistent with the expected effects of drug level fluctuations. The main implication of this finding is that, in investigations of tardive dyskinesia in patients receiving depot medication, ratings should be carried out at a standard time relative to injections.

Aged↗
PubMed1983

Tardive dyskinesia: a 3-year follow-up study.

A prospective study of tardive dyskinesia was carried out to gain information regarding the natural history of the condition and to identify risk factors. Out of an original cohort of 182 psychiatric patients receiving maintenance antipsychotic drugs 99 were available for reassessment after 3 years. In this follow-up group the point prevalence of oro-facial dyskinesia increased from 39% to 47% over the 3-year period. Twenty-two patients developed the disorder, while remission occurred in 14 others. Risk factors predicting the presence of oro-facial dyskinesia at follow-up included being over 50 years of age and the presence of akathisia. There was no convincing association between the duration of antipsychotic drug treatment and the presence or severity of oro-facial dyskinesia. Patients receiving over 1000 mg chlorpromazine equivalents of antipsychotic drug per day were unlikely to have the condition. The amount of purposeless trunk and limb movement present proved to be a relatively stable phenomenon, showing only a slight increase with age and no change over the follow-up period. The implications of these findings are discussed, with particular consideration being given to the effects of loss of patients to follow-up.

Adult↗
PubMed1983

A comparison of purposeless movements in psychiatric patients treated with antipsychotic drugs, and normal individuals.

Oro-facial dyskinesia and purposeless trunk and limb movements were assessed, using a standard videotape rating technique, in 182 psychiatric patients receiving antipsychotic medication, in a second sample of 43 elderly psychiatric patients also receiving antipsychotic drugs, and 85 normal, drug-naive subjects. In both the first patient sample and the group of normal subjects, oro-facial dyskinesia was more common over 50 years of age. Statistical analysis of the data suggested that drug-induced oro-facial dyskinesia has a characteristic pattern of movement distribution significantly different from that of idiopathic oro-facial dyskinesia. The videotapes of the first patient sample and the normal subjects were viewed by a neurologist who assessed and categorised all movements. Purposeless trunk and limb movements were classified as either normal or abnormal. Normal purposeless movements were significantly more common in the drug-naive subjects. The presence of abnormal movements such as choreiform movements, dystonias and stereotypies and mannerisms was limited, almost exclusively, to the patients.

Adolescent↗
PubMed1983

Late-onset akathisia--an indicant of covert dyskinesia: two case reports.

Two patients receiving long-term depot antipsychotic treatment developed late-onset akathisia characterized by emergence toward the end of each injection interval. Drug dose reduction provoked exacerbation of the akathisia and the appearance of choreiform limb dyskinesia. The authors discuss a possible pathophysiological mechanism.

Adult↗
PubMed1983

Clinical characteristics of akathisia. A systematic investigation of acute psychiatric inpatient admissions.

Assessment of drug-induced movement disorders was carried out regularly on 104 psychiatric patients requiring antipsychotic medication on admission to hospital. The data relevant to motor restlessness were subjected to a principal components' analysis. According to their component scores, patients were then classified into two main groups: an akathisia group and an illness-related-movement group, the former group showing the clinical and pharmacological characteristics expected of akathisia. Clinical features which distinguished between the two groups, and between grades of akathisia severity, were identified, so an objective, phenomenological description of the akathisia syndrome was possible. Our observations suggested two distinct types of acute akathisia; one related to severe parkinsonism and one not. The implications of these findings are discussed.

Adult↗
PubMed1983

Transverse compounding in the discriminative learning of moderately and mildly mentally retarded adolescents.

For adolescents in the range of moderate to mild retardation, the salience of transverse compound stimuli (combinations of positive and negative cues) was found to be low in two-choice visual discriminations. In problems allowing optional use of transverse compounds, no use whatever was made of these stimuli. In problems requiring use of transverse compounds, only the more intelligent subjects were able to learn to attend to such compounds, but this learned salience faded in a new problem that allowed optional compound use. These results were interpreted as an instance of developmental changes in unlearned stimulus salience hierarchies. We speculated that the low saliency of transverse compounds may be related to reading difficulties.

Adolescent↗
PubMed1982

Reliability and validity of a tardive dyskinesia videotape rating technique.

Ninety-four psychiatric in-patients, receiving regular antipsychotic medication, were videotaped using a standard procedure. The tapes were rated by blind observers using a simple scoring system for the duration of abnormal movements. Using this combined videotape and rating scale assessment technique the re-rating reliability, inter-rater reliability and test-retest reliability were high. In order to demonstrate the validity of the technique the rating scale scores in a sub-sample of 30 patients, were compared with the assessment of three experienced clinicians on the same patients, and AIMs scores. Central (lip, tongue, jaw and neck movements) scores showed close agreement with the clinicians' assessment, suggesting that clinical diagnosis is based principally on the presence and severity of oro-facial dyskinesia. Total rating scale scores were in close accord with total AIMs scores. When the two scales were carried out on the same patients on the same occasion a diagnostic criterion level of 2 or more on the central score produced a tardive dyskinesia prevalence rate identical to that produced by an AIMS criterion level of 2 or more on the global severity rating. The tardive dyskinesia prevalence rate based on the central score criterion level showed an increase with age.

Aged↗
PubMed1981

School follow-up of adolescents treated in a psychiatric hospital.

Parents of 25 patients discharged from an adolescent psychiatric ward over a one-year period were interviewed to determine their child's school adjustment. Satisfactory or excellent adjustment was reported in 84 percent of the cases. Findings were discussed in terms of the role of hospital school staff in assisting adolescents to make the transition to community school settings.

Adolescent↗
PubMed1981

Senile parkinsonism, a study of current treatment.

In a survey of all 2069 in-patients at 14 geriatric centres, 249 patients were found to have received drugs for the treatment of parkinsonism. There was a wide variation in point prevalence which varied from 4.6% to 22.6% between centres. Levodopa, usually in combination with a decarboxylase inhibitor, was the most frequently prescribed drug. Compared with the recommendations for its use in Parkinson's diseases, over 75% of patients received inadequate and widely spaced doses. Furthermore, dopamine antagonists were concurrently prescribed to one-third of patients who received levodopa. There was a high incidence of treatment failure (30%), and a low incidence of drug-induced dyskinesia (3%). Dementia was closely associated with the onset of parkinsonism. These findings suggest that many of these patients did not have Parkinson's disease but rather rigid-akinetic syndromes associated with degenerative brain disease. The treatment of parkinsonism in the elderly requires reevaluation.

Aged↗