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Biomedical subjects

W Guy

Publications and source records attributed to W Guy.

At least 19 recordsLinked to original sources
PubMed1994

Problems of service assessment ab intra: research and evaluation relating to a new early intervention community psychiatric nursing service.

This paper summarizes a 12-month evaluation of an emergency assessment and community care psychiatric nursing service to demonstrate the possibility and desirability of health service providers evaluating their own service provision. The radical question central to such an assessment is: 'What would have been the case if the service assessed had not existed?' This question is more difficult to answer than might at first appear. However, recent changes in UK legislation concerning health care in general, and community care of the mentally ill in particular, make the assessment of new services of great importance. What is most needed in making such assessments is not technical expertise in data collection and analysis but non-specialized critical acumen in making inferences from data routinely collected in the course of providing any service. This is illustrated using the example of a community psychiatric nursing service which afforded an opportunity to consider the impact of a new project on established services.

Adolescent↗
PubMed1986

The prevalence of abnormal involuntary movements among chronic schizophrenics.

In an international survey of chronic schizophrenia, data were collected on the Abnormal Involuntary Movements Scale (AIMS) to ascertain the prevalence of tardive dyskinesia. Abnormal movements were found to present in 28% of the sample of 739 patients. Using the more stringent Research Criteria for Tardive Dyskinesia (RD-TD) the prevalence rate was found to be 13.6%. Statistically significant differences were obtained between patients meeting RD-TD criteria and patients with abnormal movement who did not meet RD-TD criteria on total score, global severity, degree of incapacity and patient awareness--all reflecting greater severity in the RD-TD group. A much lower rate of moderate/severe tardive dyskinesia than that reported in the literature was obtained in this sample. Using the Leonhard classification of chronic schizophrenia, it was found that patients with prominent negative symptomatology had a high prevalence of tardive dyskinesia--confirming the previous reported relationship between these variables. Prevalence differences, possibly related to specific psychopathological syndromes, were also obtained.

Adult↗
PubMed1985

An international survey of tardive dyskinesia.

As part of an international study of chronic schizophrenia, data on tardive dyskinesia were collected by clinical judgment and a standard rating scale, on over 700 patients. The frequently-reported positive correlation between age and prevalence rate was confirmed in this sample. While not statistically significant, high prevalence rates were associated with higher dosage levels and length of hospitalization. Positive relationships were also found to exist among prevalence rates and schizophrenic subtypes--particularly among those with high degrees of negative symptomatology.

Adult↗
PubMed1985

Pharmacotherapy of chronic hospitalized schizophrenics: prescription practices.

Prescription practices were examined as part of a multinational study of chronic hospitalized schizophrenic patients. The study included a total of 768 patients from 8 countries. All patients had a diagnosis (ICD-9) of schizophrenia and met defined criteria for chronic hospitalization. The patients were treated with psychotropic drugs from 6 categories, i.e., neuroleptics, antidepressants, lithium salts, anxiolytics, anticonvulsants, and antiparkinsonian medications, as well as with a variety of nonpsychotropic drugs. The majority of the patients received concurrently more than 1 neuroleptic, medications from 2 or more categories, and neuroleptics combined with other agents. Polypharmacy appeared to be universal in this population.

Adult↗
PubMed1985

Neuroleptic-induced skin pigmentation in chronic hospitalized schizophrenic patients.

In the framework of a multi-national collaborative study carried out in eight countries, 768 chronic hospitalized schizophrenic patients were surveyed. Skin pigmentation was found to be present in 13 patients (1.7%), that is, within the same range (1-2.9%) of the initial reports. While the mean age and mean duration of hospitalization in the skin-pigmented population was slightly higher and larger than in the total population of our survey, no definitive relationships between sex, diagnosis, drugs and dosage of medication were revealed.

Adult↗
PubMed1985

Conditioning and learning in relation to disease.

Of the two generally recognized processes through which learning occurs--imprinting and conditioning--only the latter with its two paradigms, classical and operant, has both practical and heuristic implications for disease. From the classical conditioning experiments of Pavlov's laboratory over 100 years ago to the later work in operant conditioning by Skinner and others in the past four decades has evolved much of the basis of modern learning theory and its applications to disease in the form of behavior therapy. Variants of behavior therapy have been employed in the treatment of wide variety of medical and psychiatric illnesses. Recent developments in the study of brain function and biochemistry have led to renewed interest in the conditioning paradigm and its value as tool in these areas of research.

Animals↗
PubMed1984

The psychopharmacological treatment of depression in the medically ill patient.

With the introduction of effective antidepressants, pharmacotherapy has not been limited exclusively to the psychiatrically ill, but has been expanded to include medically ill patients exhibiting depressive symptomatology as well. This has led to problems in diagnostic differentiation and, just as important, problems with interactions resulting from multiple medications. By describing the coexistence of depressive symptomatology in a large variety of physical illness, the physician is alerted to the complexities of psychiatric illness in the medically ill patient as well as the caution necessitated by the poly-pharmacotherapy required in this population.

Antidepressive Agents↗
PubMed1984

Leonhard's classification of the chronic schizophrenias.

The conceptual development of Leonhard's classification of the chronic schizophrenias is outlined. The recognition within that classification of the importance of the polarity dimension has led to the identification of two distinct populations--atypical nonsystematic and typical systematic schizophrenia--each with a variety of different subtypes. It is hoped that recognition and validation of this group of illnesses which, for three-quarters of a century, have been called "schizophrenia" will provide a basis for meaningful biological research. Increasing interest in the system has already produced an awareness that future progress in the understanding of mental illness will greatly depend upon re-establishing the central place of psychopathology in psychiatric research.

Chronic Disease↗
PubMed1984

Description and distribution of the subtypes of chronic schizophrenia based on Leonhard's classification.

Prior to the introduction of neuroleptics a lack of interest in complex classifications of the chronic schizophrenias was due to the lack of effective treatment. With the recognition of neuroleptic response heterogeneity, and of the hazards of long-term neuroleptic administration, interest in subtype classification such as that of Leonhard has grown. A simplification of the Leonhard scheme is presented. The first distinction drawn is between systematic or process schizophrenia and nonsystematic or episodic schizophrenia. Both groups are further subdivided according to whether the symptomatology is dominated by cognitive, affective or motor features. In the case of the systemic schizophrenias, further subdivision of the 3 major types is made on the basis of both severity and specific symptom characteristics. If such a scheme were a natural or biologically-based classification, rather than merely an artificial subdivision of schizophrenia, one might expect that similar proportions of the different subtypes would be found in independently selected samples. Preliminary data composing subtype proportions in Leonhard's original group, a population reported by Astrup, and a recently obtained international sample are presented. Some significant correlations between the samples are observed, and despite methodological short comings, the similarities in the distribution of subtypes across time and across countries give some support to Leonhard's taxonomy.

Chronic Disease↗
PubMed1983

Organizing and conducting clinical trials.

Of the three stages of clinical trial, i.e. design, data collection, analysis, the second stage is the most neglected. The literature abounds with discussions on design and analysis, but there is a dearth of information on the organization and execution of the trial itself. Easily the most time-consuming aspect of a trial, data collection is frequently carried out by individuals who have not designed the study and who will not perform the analysis of results. With different individuals involved in each of the stages, intercommunication on substantive and procedural issues is essential for the successful culmination of the clinical project.

Clinical Trials as Topic↗