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Biomedical subjects

A H Crisp

Publications and source records attributed to A H Crisp.

At least 55 records · Page 3Linked to original sources
PubMed1987

Clomipramine and 'drive' in people with anorexia nervosa: an in-patient study.

Drugs can sometimes be helpful within the overall treatment and management of anorexia nervosa. In this study we have examined the impact of clomipramine on food and activity in anorectics engaged in a treatment programme enabling them to regain normal body weight. Consumption of the drug was associated with increased appetite, hunger and calorie consumption during the early stages of treatment. There was no impact on ultimate outcome. In this study it was evident that the drug was unnecessary for weight gain, but it may be helpful in other programmes, both short and long term, where the patient has sufficient trust (to tolerate the enhanced hunger experience) but is not involved in the same behavioural constraints. However, its possible value in such programmes has not been proven here. Meanwhile, we take our findings as further evidence that clomipramine increases drive behaviour and appetite in humans and may be beneficial in the treatment of affective disorders because of this effect.

Adolescent↗
PubMed1987

Brief psychotherapy in the treatment of anorexia nervosa. Outcome at one year.

Thirty out-patients with severe anorexia nervosa were randomly allocated to either 12 sessions of dietary advice or 12 sessions of combined individual and family psychotherapy. At one-year follow-up both groups showed significant overall improvement, and the dietary advice group showed significant weight gain. A similar mean weight gain for the psychotherapy patients did not reach statistical significance, but this group made significant improvements in sexual and social adjustment.

Adolescent↗
PubMed1986

The relationship between nocturnal motility and the enuresis alarm device.

The mode of action of the enuresis alarm is not clear. Earlier work suggested that the wire mesh itself may alter sleep and in this way affect nocturnal enuresis. Seven healthy males have been studied within a two-period cross-over design in which their nocturnal motility, on and off an enuresis wire mesh, was recorded using a motility bed. There were no order, treatment or day effects in any of the variables studied. However, the mean hourly motility for each subject averaged over the three nights shows a substantial trend towards increased motility on the mesh. This lends some support to the hypothesis and merits further study.

Adolescent↗
PubMed1986

Dexamethasone suppression and energy balance in eating disorders.

The dexamethasone suppression test (DST) was investigated in 45 female anorectic out-patients (cross sectional study) nine of whom were followed serially as in-patients (longitudinal study). DST non-suppression was strongly associated with negative energy balance (low body weight and low Ponderal Index) but there was no significant association with the presence of affective or neurotic disturbance in these patients. These findings cast doubt on the value of the DST in the management of depressive illness.

Adolescent↗
PubMed1986

Primary anorexia nervosa in the male and female: a comparison of clinical features and prognosis.

The clinical characteristics of a consecutive series of 36 male anorectics were compared with those of a similar series of 100 female cases. Social class background and mean age of onset were found to be similar as were the majority of clinical features at presentation. Anorexia nervosa was associated with diminished differences between the sexes in terms of physical, experiential and behavioural characteristics directly related to the condition, and in terms of general psychoneurotic characteristics. The condition is one within which the individual is sadly reduced to an existence rooted in the experience, behaviour and impulses of starvation including the impulse to ingest and the consequent defences against this latter propensity and its implication of weight gain. Only the 'choice' of defence relates to premorbid 'personality' characteristics and thereby continues to characterize the individual. Overall the same background and presentation factors in both sexes predict similar outcomes, though a vomiting defence at presentation predicts good outcome for males and poor outcome for females. The condition is very rare in the male and such presentations may help to shed light on its overall nature.

Adolescent↗
PubMed1986

Undergraduate training for communication in medical practice.

Communication is a major aspect of medical practice in such areas as the consultation, counselling, team work, management duties, health education and teaching. Many communication skills essential to the clinical consultation are different from those used in everyday life. They require an understanding of the doctor/patient relationship and of the self as well as of others. They also require a subserving repertoire of specific behavioural skills. The present paper sets out to emphasize this pervasive importance of communication skills in medical practice and to suggest some educational goals and objectives for those skills of particular relevance to the consultation. It describes one attempt to pursue these within the author's own school despite the piecemeal nature of such teaching. In Britain great emphasis is placed on the importance of clinical skills and this is reflected in the priority given to them in the final professional examination, and yet their communication aspects are rarely well defined within the curriculum or directly assessed. The author advocates the teaching and assessment of communication skills as a continuous process throughout undergraduate and postgraduate medical education for clinical practice.

Audiovisual Aids↗
PubMed1985

Dexamethasone suppression and energy balance: a study of anorexic patients.

The performance of the dexamethasone suppression test (DST) was investigated in 45 female anorexic out-patients (cross-sectional study) and in nine female anorexic in-patients (longitudinal study). DST non-suppression was strongly associated with negative energy balance (low body weight and low Ponderal Index) but there was no significant association with the presence of affective or neurotic disturbance in these patients. These findings cast doubt on the value of the DST in the management of depressive illness.

Adolescent↗
PubMed1985

Family structure and birth order of patients with anorexia nervosa.

A retrospective case-notes study of 252 patients was undertaken, to focus on their birth order, and other aspects of their sibships. There is little evidence of a relationship to birth order using an established measure (Slater, 1962). Previous researchers have found a preponderance of female siblings in the families of patients with anorexia nervosa. We have not found this, neither is our sample characterised by older or younger siblings of any one sex. This is true for both female and male anorexics. These results are discussed in terms of experimental and family theories concerning the development of anorexia nervosa.

Anorexia Nervosa↗
PubMed1985

Symbolic functioning in anorexia nervosa.

This study examined 20 patients with anorexia nervosa using a projective test with a quantitative scoring system (the SAT9), and an indirect measure of symbolic function (the interoceptive awareness subscale of the EDI). The findings support the clinical observation that patients with anorexia nervosa are often arrested developmentally, and are without the ability to deal adequately with the anxieties created by the process of maturation. The results of this study have significance for the psychotherapy techniques used in the treatment of these patients.

Adult↗
PubMed1985

Factors affecting prognosis in male anorexics.

Twenty-seven male anorexics have been followed up over 2-20 yr (mean 8 yr) and their outcome assessed. This has been compared with outcome in female patients with similar pictures at presentation (Burns and Crisp, 1984). Features of the family and personal history and clinical aspects of the disease at presentation were compared with outcome and a number found to be significantly associated with it. Poor relationship with parents during childhood and the absence of normal adolescent sexual behavior and fantasy premorbidly were strongly predictive of a poor outcome. Long duration of illness, previous treatment and greater weight loss during illness were also associated with poor outcome, although no specific dietary behaviour was predictive. The remarkable similarity in outcome pattern between the male and female prompts re-evaluation of some theories of the nature of the role of sexual conflicts in anorexia nervosa.

Adult↗
PubMed1985

Why do some anorexics steal? Personal, social and illness factors.

There is a recognised association between anorexia nervosa and stealing. Anorexics who steal are usually also bulimic. However, not all bulimic anorexics steal. The question of why some do and others do not is explored with respect to features of the illness and personal and social variables. Bulimic anorexics who stole differed from their non-stealing counterparts in older age at presentation and in terms of greater sexual activity. These and other findings are discussed with reference to clinical understanding and aetiological theories of other aberrant behavior displayed by the adolescent female.

Adolescent↗
PubMed1985

Cerebral hemisphere function and laterality of migraine.

We report preliminary findings of a study exploring the hypothesis that migraine is the experience of a protective cerebrovascular mechanism arising in response to unilateral cerebral information overload. The necessary population to be studied, namely those with exclusive one-sided migraine, proved to be rare. The measures of cerebral hemisphere function were the verbal and non-verbal scales of Wechsler's Adult Intelligence Scale. Preliminary results suggest that it is worthwhile continuing to explore the notion using additional and more sophisticated measures.

Adult↗