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Biomedical subjects

C L Rich

Publications and source records attributed to C L Rich.

At least 55 records · Page 3Linked to original sources
PubMed1986

ECT response in psychotic versus nonpsychotic unipolar depressives.

Thirty primary unipolar depressives were studied to determine whether depressed patients with psychotic symptoms respond better to ECT than those without such symptoms. Psychotic (N = 9) and nonpsychotic (N = 21) patients showed equal therapeutic benefit in similar periods of time. Thus, the presence of psychotic symptoms did not enhance the degree of response to ECT in patients with primary unipolar major depression.

Delusions↗
PubMed1985

The efficiency of ECT: II. Correlation of specific treatment variables to response rate in unilateral ECT.

Determining the most efficient use of electroconvulsive therapy (ECT) for treating depression hinges on defining the crucial variable(s) related to the maximal efficacy of an individual seizure. In this study, we examined the relationships of several treatment variables to antidepressant effect of 109 individual unilaterally induced seizures. The seizures occurred during the maximal response phase of 39 courses of ECT judged to have been effective. The patients were divided according to whether or not they were receiving antidepressants during ECT. The variables were treatment number, seizure length, and type of seizure end point. In the total group, earlier treatments were significantly related to antidepressant effect. Seizure length and type of seizure end point appeared to be of little consequence. Further studies of ECT should focus particularly on the effects of the first treatment in order to define optimal ECT efficiency.

Adolescent↗
PubMed1985

The difference between date of suicidal act and recorded death certificate date in 204 consecutive suicides.

The date of death recorded on death certificates (DCD) was compared to the date of the suicidal act (DA) in a consecutive series of 204 suicides. The DA was known to be the same as the DCD in only 46 per cent of the cases. The DA was different from the DCD in 22 per cent of the cases. The difference between the DA and DCD should be taken into consideration in the analysis of temporal trends.

Death Certificates↗
PubMed1984

The efficiency of ECT: I. Response rate in depressive episodes.

A great deal of variation in opinion and practice remains regarding the most efficient use of electroconvulsive therapy (ECT) in treating depression. In this study we used an estimate of maximal improvement point to look at the rate of response to conventional ECT (one seizure per session, three times per week) in 66 patients with depressive episodes. Of the variables examined, increasing age was found to be significantly associated with slower response rate. Comparison of our results with studies of the multiple seizure technique suggests that giving multiple seizures per session does not speed response rate. We therefore conclude that within the limits of current clinical practice age is probably more important than number of frequency of seizures in determining the rate at which depression responds to ECT.

Adult↗
PubMed1984

Double suicides: four modal cases.

Double suicides, or suicide pacts, are relatively rare and usually involve older married couples. Histories of four such couples are reviewed. The participants were similar to other (nonpact) suicides with regard to recent visits to physicians, alcohol use, and communication of intent. They differ from other suicides in that they are more likely to have a first-degree relative who died by suicide. Similar DSM-III diagnoses were found in both members of each couple, and there was a complementary quality in their personal and family histories.

Age Factors↗
PubMed1984

DSM-III, RDC, and ECT: depressive subtypes and immediate response.

The usefulness of RDC and DSM-III diagnostic subtypes as predictors of response to ECT was examined in a multi-observer, multi-factorial study of 44 depressed patients. Most of the patients met criteria for "endogenous" and/or "melancholic" subtypes of major depressive disorders. None of the RDC or DSM-III subtypes (reactive, secondary, nonpsychotic) identified the least responsive patients. Thus, the presence of "reactive" factors, the absence of psychotic symptoms, or the presence of other illnesses did not reduce the likelihood or degree of immediate response to ECT in patients with major depression.

Adult↗
PubMed1983

The use of lithium during pregnancy and lactation.

Because of possible teratogenicity, lithium should be used during the first trimester only if clinically essential. Lithium levels should be monitored throughout pregnancy and dosage adjusted as necessary. Sodium-restricted diets and diuretics should be used with caution. Lithium dose should be reduced with the onset of labor. Mothers who choose to breast-feed should watch for signs of toxicity in their babies. With their consent, pregnant women on lithium should be reported to the American Register of Lithium Babies.

Abnormalities, Drug-Induced↗
PubMed1981

Anaesthesia for electroconvulsive therapy: a psychiatric viewpoint.

Brief general anaesthesia has added to the safety and comfort of electroconvulsive therapy (ECT). While usually a simple procedure, there are several areas in which ECT differs from other procedures requiring brief anaesthesia. These differences call for even more collaboration between psychiatrist and anaesthetist than is customary. This review details the areas where the anaesthetic management may affect the outcome of ECT for both an individual treatment and a treatment series. These include the patient evaluation, the patient preparation, the sequence and doses of anaesthetic agents, and the recovery period. Because each patient receives a series of treatments, an optimum regimen from both the psychiatric and anaesthetic standpoints can ultimately be achieved.

Anesthesia↗
PubMed1981

Modernization of a mental health act II: outcome effects.

The authors studied the effect of Pennsylvania's 1976 Mental Health Procedures Act on the hospital course of involuntarily detained patients. They found that more court hearings to extend commitment were requested, held and approved under the modern law. There was a decrease in the number of schizophrenic patients who signed in voluntarily. They found no change in the mean length of hospitalization under the new law whether patients were voluntary or involuntary. They found that patients did not often sign in voluntarily or go to court within the legally prescribed periods.

Commitment of Persons with Psychiatric Disorders↗