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Biomedical subjects

A H Crisp

Publications and source records attributed to A H Crisp.

At least 73 records · Page 4Linked to original sources

Myocardial infarction and the emotional climate.

Within the general population people destined for myocardial infarction are found to be more obsessional and greater worriers than others. Moreover, in the year before their infarction they display high levels of sadness, anxiety-related symptoms, loss of libido, and fatigue, unrelated to angina and other physical discomforts. They also claim, more so than others, to have no fear of having an incurable illness. Derived optimum weightings to responses to items in the Crown-Crisp Experimental Index permit the development of a simple scoring system which in the present study allows a two-thirds correct identification of those due for imminent infarction and an overall 81.5% correct classification of infarct/non-infarct cases. This apparent capacity of the instrument now needs to be tested in a prospective study. In the year after infarction survivors in the present study show very high levels of dysphoria and social withdrawal.

Adult↗

The reliability of estimates of body width and their relationship to current measured body size among anorexic and normal subjects.

Normal and anorexic subjects' estimates of their own body width were obtained. The estimates were reliable measures, but they did not correlate with the subjects' actual body widths. The implications of this finding especially when relating anorexic patients' self-perceptions to their clinical outcome, are discussed. It seems preferable to use such estimates untransformed by division with the subjects' actual body widths.

Adult↗

A future pattern of psychiatric services and its educational implications: some suggestions.

Psychiatry has expanded rapidly as a medical discipline in the last two decades but has not always been able to recruit sufficient young doctors of ability to its ranks. In view of recent governmental and professional reports on future medical practice we set up a study group comprising members from academic, NHS, sub-specialty, community and in-training psychiatry to examine the present tasks, attractions and constraints within a career in psychiatry and propose possible improvements for further consideration. In marrying these views to foreseeable developments we are sensitive to the requirement to take into account both the needs of the community and the job satisfaction of the future psychiatrist. To this end we indicate briefly our views concerning the attractions that a career in psychiatry currently has for the good graduate and ways in which the provision of interest and stimulation, educationally and professionally, can be increased so as to attract psychiatrists of high calibre both to general adult psychiatry and to areas of the specialist services which are at present unpopular. Finally, we propose a pattern of psychiatric services which we believe will embody both a useful and an attractive specialized job and interesting educational goal for future medical practitioners.

Career Choice↗

Nocturnal activity and the enuresis alarm device.

The effect on nocturnal activity of the wire mesh element within the 'buzzer and pad' enuresis alarm device was studied using healthy adult volunteers in a single or double cross-over design. On the nights when the mesh was in the bed there was less activity, supporting the finding of improved polygraphic sleep on the mesh and suggesting an unexpected therapeutic mechanism.

Adolescent↗

Anorexia nervosa in Down's syndrome--a case report.

A case is described of anorexia nervosa arising in a mentally-handicapped 35-year old person with Down's syndrome. The late onset is accounted for on the grounds that adolescent challenges had only recently arisen in this instance. Removal of the patient from the provocative situation, coupled with some effective psychotherapeutic 'grief work' with the family, was associated with restoration of normal body weight and menstrual function, following the patient's acceptance of the usual re-feeding treatment programme.

Adult↗

Outcome of anorexia nervosa in males.

Twenty-seven consecutive male patients suffering from anorexia nervosa were followed-up 2-20 years after presentation; 20 had been treated with an in-patient refeeding/psychotherapy regime. The outcome of the series compared very closely with a similar group of female anorectics: 12 (44%) had a good outcome, stable weight restoration and normal sexual functioning; seven (26%) had an intermediate outcome, and eight (30%) poor (weight more than 15% below normal, and poor or no sexual activity). No patient had died. Good outcome in terms of weight was associated with good psychological and social functioning, while poor outcome was clearly associated with a longer duration of illness, previous treatment, and greater weight-loss during illness, although not with any specific dietary behaviour. Poor relationship with parents during childhood and the absence of normal adolescent sexual behaviour premorbidly were also strongly predictive of poor outcome.

Adolescent↗

Anorexia nervosa: a study of 34 twin pairs and one set of triplets.

In a collaborative study between St George's and the Maudsley Hospitals, 34 pairs of twins and one set of triplets were identified in which the proband had anorexia nervosa. The diagnosis was based on standard criteria and zygosity was established by blood group analysis or by use of the physical resemblance questionnaire. In the 30 female twin pairs, 9/16 of the monozygotic (MZ) and 1/14 of the dizygotic (DZ) pairs were concordant for anorexia nervosa. Three of the non-anorexia co-twins had other psychiatric illnesses, and two had minor eating disorders. None of the male co-twins had anorexia nervosa.

Adult↗

Anorexia nervosa.

Explore the source record for details and available documents.

Adolescent↗

Reproductive hormone changes during weight gain in male anorectics.

Plasma LH, FSH, testosterone and sex-hormone-binding globulin have been measured in a total of ten male anorectics. There was no significant correlation between body weight and FSH levels or body weight and SHBG levels. Both LH and testosterone concentrations were significantly correlated with body weight. They were well below the adult normal range at low body weight and rose with weight gain although in many cases neither hormone reached normal levels at target weight. The plasma LH and FSH response to 50 micrograms LHRH was measured in five male anorectics on twelve occasions, and compared with the responses of twelve normal adult males. The anorectic patients showed a FSH response which was normal on eleven occasions and slightly raised on one occasion. The LH response was below normal at weights below 40 kg, exaggerated between 45 kg and 50 kg and within normal limits at other weight ranges. These results are compared with previous findings in female anorectics.

Adult↗

Sleep and the enuresis alarm device.

The effect on sleep of the wire-mesh element within the `buzzer and pad' enuresis alarm device was studied using healthy adult volunteers in a single or double crossover design. Polygraphic recording revealed a reduction in the number of shifts between sleep stages, and in the time spent in wakefulness, movement and stage 1, on the nights when the mesh was in the bed. This effect may be responsible for preventing some of the enuretic episodes which would otherwise have occurred at such times.

Adolescent↗

'Personality' and anorexia nervosa - the phobic avoidance stance. Its origins and its symptomatology.

Experience and behaviour in anorexia nervosa is subordinate to the need to achieve and maintain a low body weight in the presence of the impulse, generated by starvation, to forage and ingest, and moreover in the presence of abundant food supplies. The stance is a phobic avoidance one. Normal adult body weight and attendant post-pubertal 'fatness' is feared and avoided through the process of pubertal regression, facilitated primarily by dietary carbohydrate (and fat) avoidance, but otherwise and less effectively by the vomiting/purging syndrome. The maintenance of this stance requires a total commitment of self-control and control of the environment - which are experienced by others as a primary narcissism within the 'patient' and as a tyrannical manipulative attitude to those others.

Adolescent↗