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Biomedical subjects

C A León

Publications and source records attributed to C A León.

At least 19 recordsLinked to original sources
PubMed2001

Recovery from psychotic illness: a 15- and 25-year international follow-up study.

BACKGROUND: Poorly defined cohorts and weak study designs have hampered cross-cultural comparisons of course and outcome in schizophrenia. AIMS: To describe long-term outcome in 18 diverse treated incidence and prevalence cohorts. To compare mortality, 15- and 25-year illness trajectory and the predictive strength of selected baseline and short-term course variables. METHODS: Historic prospective study. Standardised assessments of course and outcome. RESULTS: About 75% traced. About 50% of surviving cases had favourable outcomes, but there was marked heterogeneity across geographic centres. In regression models, early (2-year) course patterns were the strongest predictor of 15-year outcome, but recovery varied by location; 16% of early unremitting cases achieved late-phase recovery. CONCLUSIONS: A significant proportion of treated incident cases of schizophrenia achieve favourable long-term outcome. Sociocultural conditions appear to modify long-term course. Early intervention programmes focused on social as well as pharmacological treatments may realise longer-term gains.

Adult↗
PubMed1994

[Comparison of the effect of amisulpride and viloxazine in the treatment of dysthymia].

An evaluation of the therapeutic efficacy of Amisulpride as compared with Viloxazine in a group of patients diagnosed as dysthymic, according to the DSM-III-R criteria is presented. Study was a double-blind, randomized controlled trial: Subjects were assessed during an initial examination with informed consent, then entering a 4-week treatment trial. The Hamilton Depression Scale, the Widlocher Psychomotor Retardation Scale, and the Andreasen Negative Symptoms Scale were used for evaluating cases. Both the efficacy and safety of drugs were assessed. An analysis of results suggests a better therapeutic response among the Amisulpride group subjects.

Adolescent↗
PubMed1992

[Patients with panic disorder: a 5-year follow-up study].

The present study is aimed at assessing a 48-outpatient sample that had been diagnosed as Panic Disorder cases: Approximately 5 years ago, patients had been treated with either Alprazolam, Imipramine or placebo during an 8-week double-blind trial. (The original study was part of the International Study on Panic Disorder--see León C. A. et al., Acta Psiquiát Psicol Am Lat, 1990, 36 (1/2), 59-72). Course, as well as clinical evolution of disorders, and changes occurred during that period, such as remission, or persistence of initial symptoms, are worth being noted. On the other hand (a) the efficiency of the original treatment, (b) the subsequent resorting to other treatments, and (c) differences observed among patients that have been grouped according to the medication they had been given during the original trial, are to be emphasized.

Adult↗
PubMed1989

Clinical course and outcome of schizophrenia in Cali, Colombia. A 10-year follow-up study.

The present paper is a very succinct description of the findings from the 10-year follow-up of a group of 101 patients from Cali, Colombia who were included in the WHO International Pilot Study of Schizophrenia. It is based on a prospective study conducted with the use of standardized instruments and with clinical evaluations performed by the same examiners at the beginning and end phases. A classification of the varieties of clinical course observed throughout the 10-year period is presented, as well as a description of several aspects of the social and clinical condition of cases at the time of the last observation. The possibility of finding predictors of the outcome of the disorder is explored through the use of multivariate methods, and a series of comments and conclusions is formulated.

Colombia↗
PubMed1986

[Clinical course and outcome of schizophrenia in Cali. A 10-year follow-up study].

The present paper offers a summary description of the findings from the 10 year follow-up of a group of 101 schizophrenics who where included in the W.H.O. International Pilot Study of Schizophrenia. It is based on a prospective study conducted with the use of standardized instruments and with clinical evaluations performed by the same examiners at the beginning and end phases. A classificatory outline of the varieties of clinical course observed throughout the follow-up period is presented, as well as a description of several aspects of the social and clinical condition of cases at the time of the final observation. The possibility of finding predictors of the outcome of the disorder is explored through the use of multivariate methods and a series of comments and conclusions are formulated.

Colombia↗
PubMed1984

[Contribution of epidemiological research to the classification of mental disorders].

This is an attempt to have an overview of the problem of classification of mental disorders and of the various contributions offered by epidemiological research in the field. A brief introduction discusses the correct status of classification and its antecedents, supplemented by a glossary of terms used frequently in the field. A series of international studies bearing on the problem of definition of mental disorders in different cultures is presented and discussed as well as the matter of standards and comparison. The problems of validity, reliability and use of instruments are illustrated by the presentation of widely used instruments. A summary review of the rationale and principles for quantitative taxonomic methods is presented with special refference to numerical taxonomic and to the comparative evaluation of different methods of cluster-analysis. The subject of multiaxial classifications is presented through a brief description of currently used methods. Refference is also made to longitudinal studies both prospective and retrospective, and to their possible present and future value. Final comments are made about the present state of development and to the various obstacles which interfere with the task of finding a "common language" for classificación of mental disorders.

Culture↗
PubMed1983

[Training in psychiatry for health teams in Colombia].

About 90% of the 40 million victims of mental disorders in the developing countries receive no treatment, and little progress is being made in this respect. This article examines the use of new strategies for solving the problem. It is obvious that the traditional methods of mental health care have been ineffective and that new programs should now be undertaken that can ensure proper service within the coming decades for those being neglected. Based on the results of a practical experiment carried out in Colombia, the authors, without making any definitive recommendations, point to the usefulness of training auxiliary staff of urban and rural health centers to work as a team (under the supervision of a physician or a graduate nurse) in the care and management of psychiatric patients. They enumerate the advantages offered by training programs on various aspects of mental health for general practitioners (who usually have little interest in psychiatry), psychiatry residents, nurses, and auxiliaries.

Allied Health Personnel↗
PubMed1981

The temporo-spatial context. A neglected aspect of the depressive response.

This study deals with the role of time or space factors in bringing about depressive disorders. Anniversaries, dates or sensory perceptions associated with a depressive experience are seen to act as cues which can automatically unchain a depressive response at a later occasion. In a series of 53 patients suffering with different types of depressive disorders, a group of 18 (one third) were identified as presenting this kind of response. Clinical illustrations and descriptive characteristics are presented, together with an attempt at explantation of some of the mechanisms involved.

Adult↗
PubMed1979

Therapeutic effects of clozapine. A 4-year follow-up of a controlled clinical trial.

The double-blind method was used to compare the therapeutic effects of clozapine and chlorpromazine in a sequential cohort of 50 schizophrenic patients with similar demographic characteristics, randomly allocated to two groups ("experimental" and "control") of 25 patients each. At the end of the 6-week trial period, statistically significant differences were found between the two groups in both the symptom check-list score and the overall clinical evaluation. Follow-up evaluations conducted at 3- and 4-year intervals show that the differences between the two groups are presistent, which points in the direction of a better and more sustained therapeutic effect of clozapine over chlorpormazine. No discernible ill effects which could be attributed to either drug were detected throughout the 4-year period.

Adult↗
PubMed1978

Who shall be hospitalized? Some social and psychological correlates of alternative dispositions of the mentally ill.

This study conducted in Cali, Colombia, focuses on the question of why persons sharing similar background characteristics and even the same diagnosis often receive varying prescriptive evaluations which lead to alternative types of psychiatric care: hospitalization, outpatient care and no systematic treatment at all. An index group of 70 hospitalized patients is compared with 53 outpatients and 30 "nonpatients" matched for sex, age, marital status, social class and diagnosis. Interviews were conducted with patients, relatives and the admitting doctors. A selected group of variables representing perceptions, opinions and attitudes of the relatives, subjective evaluations of the patients and perceptions of the admitting physician are examined in terms of their association with the three types of care. It is concluded that interpersonal factors exert a significant influence on the process of assigning cases to alternative types of psychiatric care. Typical profiles for each category are outlined.

Adult↗
PubMed1976

[International pilot study on schizophrenia, its implications for Latin America].

This is a succint description of the International Pilot Study on Schizophrenia, sponsored by the World Health Organization and conducted in field research centers located in 9 different countries. The main objective of this study was the development of standard procedures for case finding, assessment of damage caused by Schizophrenia and observation of the course and outcome of the disorder. Starting in 1968, groups of approximately 120 patients who met the criteria both for inclusion and exclusion were studied in each center. They were subject to study by means of several instruments and were given a clinical diagnosis. On that basis, comparative analysis within and between centers were conducted, as well as reliability tests for the procedures used. Two follow-ups took place at 2 and 5 year intervals in order to obtain information about the course and outcome of cases. The emphasis of this presentation is placed on the findings at the Cali (Colombia) field reserach center and their comparison with the global results of centers in the rest of the world. In that context, the findings show that centers in developping countries are at least as capable for conducting research work as those in the developped countries. There is also the suggestion that mental disorders in developping countries apparently tend to more benign course and outcome.

Humans↗
PubMed1975

"El duende" and other incubi. Suggestive interactions between culture, the devil, and the brain.

The belief in persecution or possession by evil sprits is still popular in Latin American countries. Observations were made on 12 Columbian families who were haunted by 'el duende' (a special kind of imp, goblin, or poltergeist) and other spirits. Interviews elicited a detailed account of events, a demographic and socioeconomic description ofthe families, exploration of the psyhosocial antecedents, and a psychiatric evaluation of individual members of the group regared as key persons. Possible psychodynamic mechanisms are involved in the production of the phenomenon and factors in the successful 'therapeutic'interventions of spiritualist rather than psychiatric or religious healers. The interaction of culture , folk belief, and the brain impaired by lesion or faulty learning appears as the important accountable dimension.

Adolescent↗
PubMed1975

Sequelae of Venezuelan equine encephalitis in humans: a four year follow-up.

The purpose of this study was the identification of possible sequelae of the infection of human individuals with Virus of Venezuelan Equine Encephalitis (VEE). Special emphasis was laid on exploring neurological, psychological and behavioural aspects and particularly on the search for a possible association of the disease with epileptic phenomena, brain damage and/or mental deficiency. A four-year period of observation was conducted on a sample of children from El Carmelo (Colombia) where an epidemic of VEE took place in 1967. A group of seven children who presented the encephalitic type of the illness and were hospitalized with symptoms of CNS involvement and a confirmed diagnosis of VEE constituted the index group. This group was compared with four control groups of children with matched demographic characteristics but separated according to whether they were ill at the time of the epidemic and whether they presented serological evidence of having been infected with VEE Virus. Evaluations were conducted at three points in time during the follow-up period and they included the following procedures: (1) Survey on personal background and behaviour (through a standard questionnaire dealing with all areas of functioning); (2) Complete paediatric examination, including a careful neurological check-up; (3) Psychological examination using intelligence tests; (4) Electro-encephalographic examination according to standard techniques, with the patient awake, asleep and under photic stimulation; (5) Bi-weekly home visits to keep a record on intercurrent illness throughout the observation period. Statistical analysis of results shows significant differences between the groups in regard to the distribution of abnormalities.

Child↗