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Biomedical subjects

C S Fones

Publications and source records attributed to C S Fones.

9 recordsLinked to original sources
PubMed2000

History of childhood attention deficit hyperactivity disorder (ADHD) features among adults with panic disorder.

BACKGROUND: The prevalence of ADHD features during childhood and its relationship to the course and presentation of panic in adults with panic disorder was examined. METHODS: The presence of DSM-III-R ADHD was retrospectively ascertained in a cohort of 85 adults with panic disorder by structured interview. RESULTS: Childhood ADHD features occurred in 23.5% of panic subjects; 9.4% satisfied full DSM-III-R criteria for ADHD, 14.1% had 'subthreshold' diagnoses. Two-thirds of panic patients with ADHD indicated persistence of symptoms into adulthood. Fewer had married or completed college than those with panic alone. There was no significant difference in clinical pattern and severity of panic, or comorbidity of adult Axis I and childhood anxiety disorders in both groups. CONCLUSION: Given its frequency and persistence, ADHD comorbidity is an important clinical consideration in all panic patients. Its co-occurrence does not influence the clinical pattern of panic, but may contribute to adverse social outcome.

Adolescent↗
PubMed2000

Muscle dysmorphia in a young Chinese male.

INTRODUCTION: To describe a young Chinese male with muscle dysmorphia, a recently proposed variant of body dysmorphic disorder. CLINICAL PICTURE: A 24-year-old Chinese male with a morbid fear of weight and muscle loss with associated compulsive weight training, avoidance behaviour, forced eating, depressed mood and disturbed body image. TREATMENT: Antidepressants and cognitive-behavioural psychotherapy. OUTCOME: Preoccupation with muscularity was reduced. CONCLUSIONS: Muscle dysmorphia has been reported in Western populations, mostly among body builders and anabolic steroid abusers. To our knowledge, this is the first case report originating from a non-Western population. The patient illustrates the nosological difficulty of this recent entity. It is likely to be a culture-bound phenomena associated with a Western concept of an ideal body shape for males.

Adult↗
PubMed1999

Stress and the undergraduates.

OBJECTIVES: To assess the psychological health of undergraduates during their initial entry to the University, and to identify common sources of stress in their lives. METHOD: All first year law and medical undergraduates were administered a series of questionnaires. RESULTS: Of the 135 medical and 128 law first year undergraduates surveyed using the General Health Questionnaire (GHQ) to measure psycho-emotional distress, 77 medical students (57%) and 69 law students (47.3%) scored above the traditional cut-off of 4/5 points. Law students had significantly lower (p < 0.05) Life-Events Scores (mean 40.62, SD 29.30) than medical students (mean 55.62, SD 31.70). There was no statistical significant difference between medical (mean 89.32, SD 18.36) and law (mean 93.39, SD +/- 19.76) students (p = 0.88) in Type A Behavioural Pattern (TAPB). Hostelites (n = 67) reported significantly higher (p < 0.05) LES (mean 56.22, SD +/- 28.17) than non-hostelites (n = 196, mean 45.40, SD +/- 32.04). The commonest life events experienced in the past twelve months by the students were: (1) Difficulty keeping up with reading (84.4%), (2) Increased amount of academic work (82.5%), (3) Difficulty in tutorials (66.5%), (4) Little time for personal activities (61.6%) and (5) Difficulties in lectures as well as (6) peer competition (each 46.8%). Law students cited more relationship problems, while medical students were more troubled by academic work. When faced with a problem, more than seven out of ten students would turn to friends and classmates for help. The other common avenues of support were the family, and religion. A substantial proportion of law (37.5%) and medical (31.1%) students preferred to keep their problems to themselves; significantly (p < 0.00001) more of them (72.2%) were high GHQ scorers than other students (high GHQ scorers 47.4%). Interestingly 27.8% of these students turn to religion for emotional support. CONCLUSION: Health education programmes, mentorship and a reduction in information overload in the curriculum can be important strategies to enable undergraduates cope better with the demands of tertiary education.

Adaptation, Psychological↗
PubMed1998

'What makes a good doctor?'--views of the medical profession and the public in setting priorities for medical education.

AIM: The concept of the 'good doctor' was systematically studied by determining the view of doctors and non-physicians regarding the qualities and attributes of an ideal physician. METHOD: A list of characteristics of a good doctor was compiled from a Medline search, and from opinions generated by three focus groups (medical school academics, general practitioners and non-medical professionals). This was qualitatively categorised into five domains: 1. Cognitive, 2. Conative, 3. Emotional, 4. Interpersonal, and 5. Moral-ethical. An inventory comprising 25 statements, which reflected the most commonly and consistently identified characteristics was administered to 274 doctors and 400 members of the public. Each item was scored on a Likert scale (0 = not important, to 4 = absolutely essential). RESULTS: The public regarded being 1. knowledgeable and 2. keeping up-to-date most important; physicians regarded being 1. honest and 2. responsible and trustworthy as the two most important items. There was significant difference (p < 0.001) between physicians 'and the public' item ratings for 13 of the 25 items. The public rated cognitive qualities most highly; the ethical domain was most important to doctors. Healthcare consumers were significantly more concerned than doctors about domains of emotional regulation, and communication. Overall, the two groups had strong agreement on the rank order of both items and domains (Spearman r, 0.88 and 0.91). CONCLUSION: Medical education should inculcate the values and qualities desired by both the medical profession and public. Basic medical knowledge and reasoning are of prime importance; moral-ethical issues and communication skills should also be emphasised. Selection criteria for admission to medical school should also consider humanistic, non-cognitive traits.

Adult↗
PubMed1998

Studying the mental health of a nation: a preliminary report on a population survey in Singapore.

AIM: A Singapore Mental Health Survey was designed to study the prevalence and pattern of psychiatric morbidity of the general population. Community surveys reveal the true pattern of mental disorders, free from any self-selection into, or referral within the health care system. METHODS: A cross-sectional survey design was used to estimate the point prevalence of minor psychiatric morbidity (MPM) in an area-probability sample drawn from different regions. Disproportionate quota sampling yielded approximately equal numbers of Chinese, Malays and Indians for inter-ethnic comparison. The General Health Questionnaire, 28-item version (GHQ-28) measured psychoemotional symptoms in 3,020 subjects aged between 13-65 years. The GHQ-28 was validated against ICD-10 psychiatric diagnoses derived from structured psychiatric interview with the Composite International Diagnostic Interview (CIDI). RESULTS: The optimal cut-off point for the GHQ-28 was determined to be 4/5 for Chinese, and 5/6 for Malays and Indians. Using the validated ethnic-specific cut-offs, MPM rate for Chinese was 17.4%, Malays 15.1% and Indians 17.8%. The population MPM prevalence rate was estimated to be 16.6% after standardisation with population census data. Specific types of ICD-10 psychiatric disorders which give rise to MPM were mainly anxiety and depressive disorders. Twelve percent of individuals with MPM had at least one ICD-10 disorder in the previous year. CONCLUSION: Two-staged methodology is an efficient, cost-effective approach to study population prevalence of mental illness. Screening instruments utilised should be validated specifically for the culture and setting. Information from population surveys of psychiatric morbidity are important for the planning of mental health services for the country.

Adolescent↗
PubMed1998

Nefazodone for social phobia: a clinical case series.

A number of pharmacological agents, including the monoamine oxidase inhibitors, benzodiazepines, selective serotonin reuptake inhibitors, and beta blockers, have proven effective for the treatment of social phobia. Nefazodone, a relatively novel antidepressant, has demonstrated potential efficacy for the treatment of panic disorder but has not been formally studied in patients with social phobia. The authors conducted a clinical case study in which five consecutive patients meeting DSM-IV criteria for generalized social phobia were treated with nefazodone (dose range: 200-600 mg/day) for 3 months. Three of the patients completed all 3 months of the treatment, one discontinued after 2 1/2 months due to adverse gastrointestinal effects and one discontinued after 2 months due to lack of efficacy. The patients completed the Liebowitz. Social Phobia Scale and the Sheehan Disability Scale at every clinic visit, and were evaluated by the clinicians with the Brief Social Phobia Scale and CGI-Severity and CGI-Improvement scales. Analysis of endpoint data demonstrated significant improvement on most measures of outcome. Results from this case series suggest that nefazodone may be an effective treatment for social phobia and that formal randomized trials are warranted.

Adult↗
PubMedDate not supplied

The sexual struggles of 23 clergymen: a follow-up study.

Nineteen clergymen, 17 of whom were Catholic, were followed up 1 to 6 years after their initial evaluation in a program designed to assess the sexual offenses and rehabilitation potential of offending professionals. Methods used included a semistructured interview with a research psychiatrist and a repeat of the MCMI-III. At follow-up, the clergymen were relatively psychologically healthy. The vast majority of the men had returned to previous or higher levels of vocational functioning and felt that they had benefited from their initial evaluation and therapy. None of those who were initially suspected of sexual compulsivity met criteria for excessive sexual expression at follow-up, and none had re-offended. The typical clergyman, whether heterosexual or homosexual, was struggling with loneliness, masturbation conflicts, and the wish to be known beyond their role by others. The confrontative style of the evaluators in pursuing the veracity of the clergy's initial explanations of their behaviors and the use of penile plethysmography were the primary objections to the methods used. Brief psychotherapy seemed to be a cost-effective, well-received intervention for clergy struggling with their sexual conflicts.

Adult↗
PubMedDate not supplied

Social phobia: an update.

The literature on social phobia is reviewed in this article. Social phobia has undergone considerable diagnostic evolution to reach its present form in DSM-IV. Its differential diagnosis includes panic disorder with agoraphobia, avoidant personality disorder, depression, and "shyness." Cross-cultural issues are important to consider because the disorder may manifest differently in different cultures and social settings. It is common, with a lifetime prevalence of 13.3% in the United States according to recent epidemiological studies. Underrecognition of social phobia remains an issue of concern. Comorbidity with other psychiatric disorders, including other anxiety disorders, depression, alcohol abuse, and personality disorders, frequently occurs. Current conceptualizations of the etiology of social phobia reflect psychodynamic theories and evidence from family and genetic studies, neurobiological research, and neuroimaging. Drugs such as monoamine oxidase inhibitors, selective serotonin-reuptake inhibitors, benzodiazepines, and beta3-adrenergic blockers have proven to be efficacious, as has cognitive-behavioral treatment, including group approaches.

Cross-Cultural Comparison↗