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PubMed1982

An investigation of the construct validity of the Bannister-Fransella Grid Test of Schizophrenic Thought Disorder.

An attempt was made to demonstrate the construct validity of the Grid Test in a psychiatric population by showing that: (a) judgements of thought disorder based on the Grid Test were associated with judgements based on a clinical interview; (b) Grid Test scores were not associated with measures of other forms of psychopathology, intelligence, or memory. Results of a principal components factor analysis confirmed both hypothesis, supporting the validity of the Grid Test as a measure of thought disorder.

Diagnosis, Differential↗
PubMed1984

Cognitive impairment in patients with severe migraine.

A controlled study of a group of patients with severe migraine revealed that they gave a consistently poorer performance on a series of memory and information-processing tests (12 subtests in all). Migraine sufferers were also found to differ from controls significantly on the anxiety, obsessionality and somatic scales of the Middlesex Hospital Questionnaire, although it was considered unlikely that the differences in cognitive performance could be explained by these results.

Adult↗
PubMed1989

In-patient psychiatric care: the patient's view.

Little attention has been paid to psychiatric patients' views on their treatment in the medical literature. We carried out a consumer survey of 99 in-patients at an inner London psychiatric hospital. Patients were asked to rate 10 non-treatment and treatment items. Most highly regarded was being free to leave the ward. Of the treatment items, talking to a member of staff was found to be most helpful. The relationships between different items and patient variables such as voluntary versus involuntary status, age and diagnosis are discussed. Sex and number of previous admissions exerted only minor effects. The results are compared with other studies and more work in this area is recommended in order to improve hospital care.

Adult↗
PubMed1975

Census of mental hospital patients and life expectancy of those unlikely to be discharged.

A census in a London mental hospital was performed so that the numbers of patients requiring permanent care for the next 20 to 40 years could be estimated. Of 1467 resident patients 20% had been admitted in the preceding five months and 15% in the year before that. Of the 65% who had been in hospital for over 17 months 1% (16 patients) had been in hospital for over 5o years. Altogether 257 (18%) patients would probably be discharged, 339 (23%) might possibly be discharged if there were adequate community facilities, but 871 (59%) were not likely to be discharged; 239 patients under the age of 65 who had been admitted between 1950 and 1973 were unlikely to be discharged. There were about 10 new younger long-stay patients from each year's admissions. Three conditions--schizophrenia, organic brain syndrome, and affective illness--affected 79% of the population. Fourteen per cent had been employed on admission and 28% were considered employable or possibly employable. Half of those who might be considered for discharge (296) would need a hostel. No rehabilitation was needed or possible for 40% of the patients; 299 (20%) patients were chairbound or bedridden and 400 (27%) were totally dependent on nursing and 587 (40%) partly dependent. Twenty months after the census 361 (25%) patients had left (59 had been readmitted), 284 (19%) had died, and 822 (56%) had remained as inpatients. The most realistic future prediction was that 210 (14%) of these patients would still be in the hospital in 20 years and 43 (3%) in 40 years. In the light of these findings and the scarceness of resources current Department of Health and Social Security plans for phasing out mental hospitals must be challenged.

Affective Symptoms↗
PubMed1974

Effect of cholinergic and anticholinergic agents on tardive dyskinesia.

Tardive dyskinesia, like several other choreiform disorders, is felt to be primarily related to dopaminergic activity within the striatum. Physostigmine has been demonstrated to improve the abnormal movements in patients with tardive dyskinesia while scopolamine tends to aggravate abnormal movements and in some cases elicits abnormal movement not previously observed. This evidence supports the hypothesis that anticholinergic therapy in patients prone to develop tardive dyskinesia may increase the incidence of this disorder by lowering the threshold for the appearance of these movements.

Adult↗
PubMed1978

Habituation of the orbicularis oculi reflex in dementia and dyskinetic states.

The habituation index is a quantitative expression of the ability of the orbicularis oculi (blink reflex) to adapt to a series of electrical stimuli applied to the supraorbital region. This parameter has been studied in a group of normal control subjects, and the results compared with those in cases of idiopathic and drug-induced Parkinsonism, states of dementia, and dyskinesias such as Huntington's chorea and senile chorea. Patients with Huntington's chorea showed a tendency for the reflex to habituate readily in contrast to patients with dementia caused by cortical atrophy and those with Parkinson's disease. Younger patients with Huntington's chorea had indices within the normal range. It seems unlikely that this test will prove of value in the detection of clinically unaffected relatives. Where dementia was associated with a reversible intracranial lesion, the habituation index was studied before and after treatment. Failure of habituation in this condition appears to be due to the release of a primitive protective reflex.

Adolescent↗
PubMed1982

Interictal behaviour in hospitalised temporal lobe epileptics: relationship to idiopathic psychiatric syndromes.

Temporal lobe epileptics undergoing psychiatric hospitalisation were contrasted with patients suffering idiopathic psychiatric syndromes or other epilepsies. Quantitative ratings from blind interviews conducted according to a protocol confirmed the appearance of a statistically distinctive behavioural profile, including the desire for social affiliation, circumstantiality, religious and philosophic interests, and deepened affects, among the temporal lobe epileptics.

Adult↗
PubMed1984

Late outcome of very severe blunt head trauma: a 10-15 year second follow-up.

Forty patients with very severe blunt head trauma (post-traumatic amnesia greater than or equal to 1 month) were initially examined at an average of 4.5 months after the injury. The patients were visited in their homes 2.5 years and 10-15 years after the accident and questionnaires were presented to patients, relatives and/or staff. Though physical impairment, dysarthria and defects of memory remained severe in many cases, the psychosocial sequelae presented the most serious problems. Permanent changes in personality and emotion were reported in two thirds and were especially frequent among the youngest patients. The worse overall outcome was seen in cases with severe brainstem involvement or anterior lesions or both. In spite of the great frequency of deficits long-term improvement of functional state was common and several regained at least some work capacity.

Adolescent↗
PubMed1993

Migraine madness: recurrent psychosis after migraine.

A 69 year old man with longstanding migraine with aura had four episodes of psychosis lasting 7-28 days during a 17 year period. During attacks he had formed visual hallucination and delusions, including reduplicative paramnesia. His mother was similarly affected. His EEG showed symmetrical frontal delta waves. The time course and EEG changes are similar to acute confusional migraine. The reduplicative paramnesia suggests a focal non-dominant hemisphere dysfunction.

Aged↗
PubMedDate not supplied

Experience and perspectives on the classification of organic mental disorders.

The official diagnostic classification systems have been increasingly employed in the last few years, and this is true of both ICD-10 and DSM-IV. We will propose a few principles which should be considered when revisions are attempted. Our existing classifications should be simplified, but new syndromes incorporated where they have pathological justification. Links to other specialist diagnostic classifications should be made (e.g. in epilepsy, sleep disorders, dementias) wherever possible. A broader range of 'Neuropsychiatric Disorders' should be incorporated, including alcohol-related organic disorders, head injury, sleep disorders, if possible including the 'psychogenic syndromes'. Progressive, degenerative disorders need to be clearly distinguished from non-progressive syndromes, and some gradation of severity needs to be built into the classificatory system. Finally, the definitions need to be concise and accurate.

Humans↗
PubMed1984

Psychiatric assessment of children. I. Diagnostic method.

An account is given of a diagnostic method which appears to be little known in child psychiatry. It is based on observable deviations in facial expression and motor functions. In the author's opinion it helps to distinguish depressions of different origin as well as symptoms suggesting mild brain lesions.

Attention Deficit Disorder with Hyperactivity↗
PubMed1986

Diagnostic and therapeutic problems in the psychopharmacological treatment of the elderly patient.

Ageing is certainly one of the most important current problems; in fact, according to statistics, the old population of the world is continuously increasing. Depression represents the most frequent psychiatric problem in the aged, if it is considered that almost 25% of the old population are affected by it. An early diagnosis and a proper treatment are crucial problems. Because of the numerous side effects of tricyclic antidepressants, today we are able to use some third-generation antidepressants which show unquestionable advantages in the therapy of depression in the elderly. Trazodone is one of these antidepressive drugs and represents a real leader among the antidepressants. Our care is to work so that these recent and efficient drugs may be correctly and properly utilized by physicians prepared to face this often totally new task.

Aged↗