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Biomedical subjects

A Medalia

Publications and source records attributed to A Medalia.

18 recordsLinked to original sources
PubMed2001

The remediation of problem-solving skills in schizophrenia.

Efforts to remediate the problem-solving deficits of patients with schizophrenia have met with circumscribed success. This could be viewed as a sign of the immutability of the deficit or, alternatively, as a reflection of the inefficacy of the training techniques used. This study examined the feasibility of using problem-solving teaching techniques developed within educational psychology for remediating the problem-solving deficits of inpatients with schizophrenia spectrum disorders. These techniques rely on intrinsic motivation and task engagement, which are promoted through contextualization, personalization, and control of learning activities. A sample of 54 patients who demonstrated problem-solving and memory deficits on psychometric testing were randomly assigned to a problem-solving group, a memory training group, or a control group. Patients who received ten sessions of problem-solving remediation showed significantly more improvement on the outcome measure that assessed problem-solving skills required for independent living. Patients who received ten sessions of memory training did not improve on problem-solving measures. These results suggest that patients with schizophrenia spectrum disorders are responsive to problem-solving training techniques that promote intrinsic motivation and task engagement.

Adult↗
PubMed2001

The relationship between Usher's syndrome and psychosis with Capgras syndrome.

Usher's syndrome is a genetic disorder that causes congenital sensorineural hearing loss, visual impairment due to progressive pigmentary retinopathy, and, often, vestibular dysfunction. The aim of this article is to illustrate a case that clearly demonstrates psychotic symptoms in Usher's syndrome Type III and serves to increase clinical awareness of this disorder and its possible link to psychotic symptoms. There is some evidence in the literature of concurrent psychiatric symptoms, particularly psychotic symptoms, associated with Usher's syndrome, and several theories around this association have been proposed. These theories of associations include a genetic link between the genes responsible for schizophrenia and the genes for Usher's syndrome; a neuropathological explanation as radiologic studies have revealed that patients with Usher's syndrome have CNS abnormalities in multiple brain structures; and a sensory deficit model which proposes that the stressors associated with sensory impairment and the brain's adaptation to changes in sensory inputs place an individual at increased risk for psychopathology.

Aged↗
PubMed2000

Treating problem-solving deficits on an acute care psychiatric inpatient unit.

Neuropsychological deficits in problem-solving are commonly found in patients with schizophrenia and severe affective disorders. However, in an acute care setting, treatment efforts do not typically target these deficits, even though they can impede recovery. This study aimed to evaluate the effectiveness of short-term problem-solving remediation in acutely ill psychiatric inpatients. Twenty-eight psychiatric inpatients identified as having a verbal problem-solving deficit received 6 h of either verbal problem-solving remediation or placebo instruction. Before and after treatment a nurse rated the patient's psychiatric status and the patient completed verbal and nonverbal problem-solving tests, and a self-report rating of symptoms and ability to cope with symptoms. Both groups of patients improved on the measure of verbal problem solving, but those receiving problem-solving remediation improved significantly more. Both groups made symptomatic improvement, but the patients receiving problem-solving remediation made significantly more improvement on the measure of coping ability and the nurses rated them as more improved, both psychiatrically and with regard to coping skills. Verbal problem-solving deficits are responsive to short-term remediation in an acute care setting, and treatment effects may generalize to improve ability to cope with psychiatric symptoms.

Acute Disease↗
PubMed2000

Remediation of memory disorders in schizophrenia.

BACKGROUND: Memory deficits are commonly experienced by patients with schizophrenia, often persist even after effective psychotropic treatment of psychotic symptoms and have been demonstrated to interfere with many aspects of successful psychiatric rehabilitation. Because of significant impact on functional outcome, effective remediation of cognitive deficits has been increasingly cited as an essential component of comprehensive treatment. Efforts to remediate memory deficits have met with circumscribed success, leaving uncertain whether schizophrenia patients can be taught, without experimental induction, independently to employ semantic encoding or a range of other mnemonic techniques. METHOD: We examined the feasibility of using memory and problem solving teaching techniques developed within educational psychology--techniques which promote intrinsic motivation and task engagement through contextualization and personalization of learning activities--to remediate memory deficits in a group of in-patients with chronic schizophrenia spectrum disorders. RESULTS: Although our memory remediation group significantly improved on the memory remediation task, they did not make greater gains on measures of immediate paragraph recall or list learning than the control groups. CONCLUSIONS: Targeted remediation of memory appears to yield task specific improvement but the gains do not generalize to other memory tasks. Subjects receiving memory remediation failed to independently activate mnemonic encoding strategies learned and used successfully within training tasks to other general measures of verbal learning and memory.

Adult↗
PubMed1998

Effectiveness of attention training in schizophrenia.

This study assessed the impact of attention training on information processing in schizophrenia. Fifty-four inpatients with chronic schizophrenia were randomly assigned to two groups after baseline assessment with the Continuous Performance Test (CPT). Patients in the experimental group participated in individual sessions of computerized attention remediation, while patients in the control group participated in individual sessions during which they viewed video documentaries. After 18 sessions, reassessment with the CPT showed that patients in the experimental group had made significantly more improvement than the control group, which made no significant change. Brief Psychiatric Rating Scale assessments before and after the study phase indicated that both groups improved on the total score but the experimental group made significantly more improvement. These results suggest that it is feasible to use practice and behavioral learning to remediate a core attention deficit in chronic schizophrenia.

Adult↗
PubMed1995

Rate of information processing in patients with Wilson's disease.

This study investigated the rate of information processing, independent of motor speed, in neurologically affected Wilson's disease (WD) patients. Two scanning tasks based on the Sternberg item-recognition paradigm were administered to 17 neurologically symptomatic WD patients and 17 normal control (NC) subjects. Although WD subjects do have longer response latencies than NC subjects, their rate of information processing is the same as the rate of the NC subjects. The longer response latencies are attributable to their motor deficits. The clear impact of motor impairment on test performance underlines the necessity for specialized assessment measures that can accurately reflect the cognitive abilities of motor-impaired patients. These findings suggest that Wilson's disease is not characterized by slowed information processing.

Adolescent↗
PubMed1992

The interaction of motor, memory, and emotional dysfunction in Wilson's disease.

Measures of the degree of motor, psychiatric, and declarative memory disability were made in neurologically impaired and neurologically asymptomatic patients with Wilson's disease. All three types of disability were significantly greater in the neurologically impaired than in the asymptomatic patients. There was no significant interaction between these disabilities in the impaired patients suggesting that motor, psychiatric, and memory symptoms are three relatively independent sequelae of the copper-induced central nervous system (CNS) damage that underlies Wilson's disease.

Adult↗
PubMed1992

Treatment compliance after detoxification among highly disadvantaged alcoholics.

An outcome study was carried out on a series of 109 highly disadvantaged alcoholics discharged from the detoxification unit of a large municipal hospital in New York City. We examined the impact of a variety of clinical and demographic factors on retention in the initial phases of outpatient and inpatient treatment following discharge. Both high school completion and a history of at least 6 months of employment in the two years preceding admission correlated with frequency of registration for continued aftercare. Measurements of cognitive flexibility correlated with frequency of aftercare completion. An association strongly approaching significance was also found between length of hospital stay and aftercare completion. Some suggestions are made as to the assessment and aftercare planning for highly disadvantaged alcoholics.

Adult↗
PubMed1991

Memory deficits in Wilson's disease: a response to Lang.

Lang (1989) suggested that patients with Wilson's disease do not have memory deficits, unless they suffer from severe neurologic impairment. Results from three recent studies conflict with this view. The interaction of neurologic and cognitive deficits in Wilson's disease is discussed.

Hepatolenticular Degeneration↗
PubMed1989

Neuropsychological deficits in choreoacanthocytosis.

Little is known about the cognitive deficits associated with choreoacanthocytosis. This case report focuses on the neuropsychological deficits of a woman diagnosed with choreoacanthocytosis. The similarity between her cognitive deficits and those of patients with Huntington's disease is consistent with the neuropathology of the two disorders. The findings of this study suggest that careful neuropsychological assessment of patients with choreoacanthocytosis is warranted, since cognitive impairment may well be a clinical feature of the disorder.

Acanthocytes↗
PubMed1989

Verbal recall and recognition abilities in patients with Wilson's disease.

Tests of memory and verbal fluency were administered to 19 neurologically impaired Wilson's patients, 12 non-neurologically impaired Wilson's patients and 15 normal control subjects. Wilson's patients with neurologic disease recalled significantly fewer words on the delayed recall version of the Rey Auditory Verbal Learning Test than control subjects (p less than .05) but they showed no impairment on the recognition version of this test. On a verbal fluency test (FAS) requiring the subject to retrieve items from different categories, Wilson's patients with neurologic disease generated significantly fewer words than control subjects (p less than .01). Results suggest that retrieval memory is mildly impaired in the neurologic WD group but rate of learning and rate of forgetting is normal.

Adolescent↗
PubMed1989

Psychopathology in patients with Wilson's disease.

The authors used the MMPI to assess psychopathology in neurologically impaired and neurologically asymptomatic patients with Wilson's disease. Neurologically impaired patients showed more psychopathology on the schizophrenia and depression scales and had a significantly higher rate of severe depression.

Adult↗
PubMed1988

Neuropsychological impairment in Wilson's disease.

To examine the neuropsychological deficits of patients with Wilson's disease (WD), 19 neurologically impaired patients with WD were administered the Wechsler Adult Intelligence Scale (revised), Wechsler Memory Scale, Dementia Rating Scale, Wisconsin Card Sorting Test, Boston Naming Test, Trail Making Test, and Animal Naming Test. Their test scores were compared with those of 12 neurologically asymptomatic patients with WD and 15 normal controls. The neurologically impaired patients scored lower than did the control group on the Performance IQ, Full-Scale IQ, Dementia Rating Scale, and Trail Making Test, and they scored lower on the Wechsler Memory Scale than did both the asymptomatic and control groups. The major areas of deficit for the neurologically impaired WD group were in motor and memory functioning. Computed tomographic and neurologic examinations of the neurologically impaired patients with WD generally reflected abnormalities of the basal ganglia.

Adolescent↗
PubMed1988

The effects of neuroleptics on neuropsychological test results of schizophrenics.

This paper reviews the literature investigating antipsychotic medication effects on the neuropsychological test results of schizophrenics. A synthesis of findings suggests that specific cognitive functions are differentially affected. The toxic effects of dopamine and muscarinic blockade adversely affect find motor coordination and memory respectively. A decrement in maze performance is also suggested, raising the possibility that frontal lobe functioning is adversely affected by neuroleptic treatment. There is equivocal evidence for medication effects on primary language skills, IQ. Halstead Reitan scores, reaction time, and CPT performance. Antipsychotics probably do not have large effects on cognitive inhibition and visual-motor coordination. The implication of these findings for the understanding of schizophrenia are discussed.

Journal Article↗
PubMed1988

Neuropsychological sequelae of partial complex status epilepticus.

Relatively little is known about the risk of residual neurological deficit following partial complex status epilepticus (PCSE). To address this issue, we administered serial neuropsychological assessments and EEGs to a young cocaine abuser following the resolution of an extended episode of PCSE. Results suggest that PCSE may be associated with prolonged but reversible generalized neuropsychological and EEG abnormalities, as well as persistent focal deficits.

Journal Article↗