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Biomedical subjects

C A Galletly

Publications and source records attributed to C A Galletly.

At least 19 recordsLinked to original sources
PubMed2000

The effect of clozapine on the speed and accuracy of information processing in schizophrenia.

1. The study aimed to investigate the effects of clozapine on the speed and accuracy of information processing in patients with schizophrenia. Data are reported from 13 subjects with schizophrenia, treated with clozapine for 6.8 (+/- 1.8) months. 2. Reaction time and accuracy of target detection on a tone detection task were measured before and during clozapine treatment, and these results were compared with a matched control group. 3. Symptom severity and performance on three timed tests of cognitive function were also measured prior to clozapine treatment in the schizophrenia group, and these measures were repeated during treatment with clozapine. 4. Treatment with clozapine was found to significantly improve reaction time and the accuracy of target detection in patients with schizophrenia. Despite this improvement their performance remained significantly inferior to that of a matched control group. Both positive and negative symptoms improved with clozapine treatment, as did performance on the WAIS-R digit symbol substitution test. 5. Improved performance on the WAIS-R digit symbol substitution test correlated with reduction in negative symptoms, and faster reaction time showed some correlation with reduction in positive symptoms. 6. The results of this pilot study indicate that treatment with clozapine can produce limited improvement in cognitive function in schizophrenia.

Acoustic Stimulation↗
PubMed2000

Treating cognitive dysfunction in patients with schizophrenia.

Cognitive dysfunction is a common, chronically disabling component of schizophrenia. It has been proposed that many of the symptoms of schizophrenia can be understood as a result of disruption of fundamental cognitive processes. This paper reviews treatment strategies aimed at improving cognitive function in patients with schizophrenia. Nonpharmacologic interventions include instruction in the performance of tasks such as the Wisconsin Card Sorting Test. Mixed results have been achieved, but it appears that instruction methods involving reinforcement of information held in working memory are more successful. Computer-aided remediation has also been used with variable success. Novel antipsychotic drugs appear to have an advantage over conventional antipsychotic drugs in terms of their effect on cognitive function. The development of more precisely tailored methods of remedial teaching, along with optimal pharmacologic treatment, may lead to more effective treatment of cognitive dysfunction in patients with schizophrenia.

Cognition Disorders↗
PubMed1999

Effects of clozapine for non-treatment-resistant patients with schizophrenia.

Clozapine is generally used for patients meeting criteria for treatment resistance. In this study clozapine was given to 19 patients with schizophrenia who did not meet these criteria and whose symptoms were mild to moderate in severity. Clozapine was associated with significant improvement in positive and negative symptoms and quality of life. A more modest improvement on a range of tests of cognitive functioning was also noted. These results suggest that consideration should be given to broadening the usual criteria for patients' eligibility for clozapine treatment.

Adult↗
PubMed1997

Relationships between changes in symptom ratings, neurophysiological test performance and quality of life in schizophrenic patients treated with clozapine.

This study examined the correlations between reduction in symptoms, changes in neuropsychological test performance and improved quality of life in 19 schizophrenic outpatients treated with clozapine. Reduction in both negative symptoms and general psychopathology was associated with a better quality of life. Some improvement in neuropsychological test performance was found, with a variable pattern of association with change in psychopathology. Improved verbal fluency was associated with reduction in negative symptoms, while improved verbal concept formation was associated with reduction in positive symptoms.

Adult↗
PubMed1997

Antipsychotic drug doses and adjunctive drugs in the outpatient treatment of schizophrenia.

This study investigated factors associated with the dose of antipsychotic medication prescribed at a schizophrenia unit outpatient clinic. The antipsychotic drug dose prescribed for 364 patients was converted to chlorpromazine equivalents (CPE) per day and concurrent prescriptions of lithium, carbamazepine, benzodiazepines, and antiparkinsonian drugs were recorded. We found that patients prescribed lithium, carbamazepine, and/or benzodiazepines as adjunctive drugs were receiving significantly higher doses of antipsychotic medication (p < 0.05). Patients prescribed both depot and oral neuroleptic drugs concurrently were receiving higher CPE-equivalent doses than those receiving either drug type alone (p < 0.05), and high-potency oral drugs were prescribed in higher CPE-equivalent doses than low-potency oral drugs (p < 0.05). Patients prescribed antiparkinsonian drugs were not receiving significantly higher CPE-equivalent doses of antipsychotic medication than patients not prescribed these drugs. There were no significant gender differences in the use of adjunctive drugs or in CPE-equivalent antipsychotic drug dose. Further research is needed to determine whether these findings are related to factors such as illness severity or to physician's prescribing practices.

Adjuvants, Pharmaceutic↗
PubMed1996

Artificial neural networks: a prospective tool for the analysis of psychiatric disorders.

Artificial neural networks are computer simulations of biological parallel distributed processing systems. They are able to undertake complex pattern recognition tasks, including diagnostic classification, prediction of disease onset and prognosis, and identification of determinants of clinical decisions. These capabilities have been utilized in general medicine, but as yet there has been little application of artificial neural networks in psychiatric research. Artificial neural networks can also be used to create models of brain function, providing a paradigm for cognition and the organization of neural systems that demonstrates how changes at the cellular level can affect information processing. These models are able to encompass both the biological and the behavioral dimensions of psychiatric disorders.

Humans↗
PubMed1995

Medical student attitudes to psychiatry: lack of effect of psychiatric hospital experience.

Medical students' attitudes toward psychiatry before and after their final (sixth) year psychiatric clerkship at a large psychiatric hospital were measured. We anticipated that exposure to severe, chronic psychiatric illness would affect student attitudes, and we undertook this study to investigate the direction and parameters of attitude change. However, no significant change in attitude was found. Variables considered included the students' interest in a career in psychiatry, their perception of the adequacy of their psychiatric training, their final examination results, and the gender of students and preceptors, none of which were found to correlate with attitudes.

Attitude↗
PubMed1993

Low-dose depot medication in schizophrenia.

Depot antipsychotic medication is a major component of the maintenance treatment of schizophrenia, but it is still not clear what constitutes an appropriate dose. A number of studies comparing low with standard doses of depot antipsychotic medication on a variety of outcome measures have been published in the last decade. A review of these studies indicates that, compared to standard-dose treatment, low-dose medication tends to improve psychosocial function and reduce the frequency of side effects but may result in an increase in positive symptoms. In such cases, a temporary increase in dose appears to control symptoms and terminate relapse episodes. An explanation of the relative efficacy of low-dose treatment may be derived from recent work in radioreceptor ligand binding.

Antipsychotic Agents↗
PubMed1993

Psychiatrist-patient sexual relationships: the ethical dilemmas.

Sexual relationships between psychiatrists and their patients raise a number of important ethical issues. The power inequality, transference and dependence which often occur in a therapeutic relationship render patients vulnerable to exploitation. Psychiatrists informed by a patient of sexual contact with a previous psychiatrist face a complex ethical dilemma. Attempts at regulation by professional organisations, or by the legal system, may create conflicts between the rights of the persons involved. The role of the psychiatric profession in confronting the problem of sexual exploitation of patients is discussed.

Australia↗
PubMed1992

Antipsychotic drug doses in a schizophrenia inpatient unit.

Dose-effect studies have found that 600 mg/day of chlorpromazine (or its equivalent) is generally sufficient to treat acute psychosis. This paper reports on the doses of antipsychotic medication prescribed for inpatients in a Schizophrenia Unit at an Australian state hospital. Fifty five percent of patients received daily doses equivalent to more than 600 mg of chlorpromazine and 26% received daily doses equivalent to more than 1500 mg of chlorpromazine. Low potency drugs were prescribed in lower doses than high potency drugs. Patients prescribed depot medication tended to receive higher doses of medication than those prescribed oral medication only.

Acute Disease↗
PubMed1991

Changing patterns of electroconvulsive therapy use: results of a five-year survey.

Despite its proven efficacy and safety, electroconvulsive therapy (ECT) continues to be a controversial treatment. Ongoing scrutiny is therefore particularly important. We reviewed 315 patients who received 3903 ECT treatments over a five year period, and found a gradual decline in the use of ECT, due mainly to a reduction in ECT for schizophrenic patients. Eighty percent of treatments were given with bilateral electrode placement, although we did find the incidence of adverse effects to be greater with bilateral ECT. Most patients concurrently received medications which raise the seizure threshold. The administration of ECT to patients unable or unwilling to give informed consent raises ethical and medicolegal issues. We found that such difficulties had arisen with at least 16% of patients.

Adult↗
PubMed1987

Learning and memory impairment with benzhexol.

A double-blind trial to determine the effects of a single dose of 2 mg benzhexol on cognitive functioning was undertaken using normal volunteers. Ninety minutes after the drug or placebo was taken, subjects completed a battery of psychological tests designed to measure learning, memory and motor skills. Benzhexol ingestion was associated with significant impairment of short-term memory and slowing of the rate of new learning.

Adult↗
PubMed1987

An audit of electroconvulsive therapy.

OBJECTIVE: To audit five years experience with electroconvulsive therapy (ECT). METHOD: Retrospectively audit the case records of all patients receiving ECT from 1981 to 1985. This enabled us to compare our clinical practise with published guidelines for optimal use of ECT. RESULTS: Review 486 courses of ECT yielded a total of 3936 treatments. The audit identified several areas of clinical practise which do not comply with recommended standards for ECT.

Data Collection↗
PubMed1985

The dexamethasone suppression test in elderly, non-depressed patients with dementia.

Attempts have been made to use the dexamethasone suppression test (DST) to distinguish patients who have a primary depressive disorder from those suffering a degenerative cerebral disorder. It has been suggested however, that organic brain damage reduces neuroendocrine sensitivity and can be associated with failure to suppress on the DST. This study investigates the DST in 21 patients, over 65 years, with dementia but no evidence of depression on a variety of clinical criteria. Seven patients had abnormal DSTs.

Aged↗
PubMed1982

Survey of children and their families presenting at a child psychiatric service.

This paper describes the source of referral, presenting problems and family characteristics of all children referred to the department of child psychiatry in Dunedin in 1980. This is the sole child psychiatric service for a child population of approximately 35 064, within a total population 120 426. Two hundred and six children were referred, mainly by general practitioners, but a number were referred by other agencies. The most common presenting problems were behaviour and anxiety disorders. The most striking finding was the excess of children of divorced or separated parents and the absence of any referrals of the children of single women who had not been previously married. Possible reasons for this are discussed.

Adolescent↗