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Biomedical subjects

D A Smelson

Publications and source records attributed to D A Smelson.

13 recordsLinked to original sources
PubMed2001

Electroretinogram and cue-elicited craving in withdrawn cocaine-dependent patients: a replication.

BACKGROUND: We previously reported that cocaine-dependent patients with a reduced blue cone b wave electroretinogram (ERG) responses had significantly more cue-elicited craving. METHODS: A new series of 21 recently withdrawn cocaine-dependent patients completed a craving questionnaire at baseline and following cue exposure; an ERG was also performed. RESULTS: Cocaine-dependent patients with a blunted ERG blue cone response (<0.5 microV) showed greater increases in craving following cue exposure. When subjects were included from our preliminary study (N = 14), these differences became highly significant. CONCLUSIONS: Patients with a reduced ERG response may represent a subgroup more vulnerable to cocaine craving and future relapse.

Adolescent↗
PubMed1999

Initial validation of the Voris Cocaine Craving Scale: a preliminary report.

Although cocaine craving can persist for weeks after the last use and is thought to play a role in future relapses, few short, reliable, and valid instruments exist to measure craving. Therefore, we wished to examine the validity of the 4-item Voris Cocaine Craving Scale (VCCS), which was previously found reliable. A consecutive series of 41 recently withdrawn cocaine-dependent patients completed the 4-item VCCS and the Cocaine Craving Questionnaire (CCQ), which was used as the criterion measure. The VCCS items 1 "craving," 2 "mood," and 3 "health" were significant and highly correlated with the CCQ total craving score. The VCCS may prove to be useful in future outcome studies involving cocaine craving and in routine clinical treatment.

Adult↗
PubMed1999

Neuropsychological deficits in withdrawn cocaine-dependent males.

Previous research suggests that cocaine abuse may result in neuropsychological deficits. To examine this further, we compared cocaine-withdrawn patients (N = 35) to normal controls (N = 17) on tasks of attention, concentration, perceptual-motor speed, and cognitive flexibility. The withdrawn cocaine patients performed significantly worse on Arithmetic, Grooved Peg Board Dominant and Non-Dominant, and Trails B tests. These findings suggest that withdrawn cocaine-dependent patients have more neuropsychological impairment than normal controls.

Adult↗
PubMed1999

The efficacy and safety of clozapine versus chlorpromazine in geriatric schizophrenia.

BACKGROUND: There has been an absence of controlled studies focusing specifically on neuroleptic treatment in the elderly schizophrenic population. Therefore, we conducted a 12-week double-blind comparison study to assess the efficacy and tolerability of clozapine and chlorpromazine in a group of elderly inpatients with chronic schizophrenia. METHOD: Forty-two elderly DSM-IV schizophrenic veterans were randomly assigned to clozapine or chlorpromazine and assessed for efficacy at baseline and at termination with the Positive and Negative Syndrome Scale (PANSS) and the Clinical Global Impressions scale (CGI). Side effects were also monitored. Medications were titrated, on the basis of clinical response and side effects, to a maximum dose of 300 mg/day of clozapine or 600 mg/day of chlorpromazine. RESULTS: The results suggest that both the chlorpromazine and clozapine groups improved their PANSS scores at termination compared with baseline, but the difference between the 2 groups was not statistically significant. The mean CGI scores reflecting severity of illness also demonstrated improvement in both groups over time. Both groups had similar incidences of side effects. One patient in each group had a life-threatening side effect. More patients taking clozapine had tachycardia and weight gain, while more chlorpromazine patients noted sedation. CONCLUSION: We concluded that both clozapine and chlorpromazine are effective treatments for psychosis and behavioral disturbances in geriatric schizophrenia. Both agents had similar incidences of side effects. With careful monitoring and titration of dosage, both clozapine and chlorpromazine were fairly well tolerated in this population.

Age Factors↗
PubMed1998

Electroretinogram in withdrawn cocaine-dependent subjects. Relationship to cue-elicited craving.

BACKGROUND: We have previously reported that people who are cocaine-dependent have reduced blue cone b-wave electroretinogram (ERG) responses. In this preliminary study, we examined the relationship between blue cone ERG amplitudes and craving response to cocaine cues. METHOD: A new series of 14 recently withdrawn subjects who were cocaine-dependent completed a cocaine craving questionnaire at baseline, and again following exposure to laboratory cues; an ERG was also performed. RESULTS: Cocaine-dependent subjects with a blunted ERG blue cone response (< 0.5 microV) showed significantly greater increases in craving following cue-exposure than subjects without the blunted ERG blue cone response. CONCLUSIONS: Subjects with a blunted ERG response may represent a subgroup more vulnerable to cocaine craving and relapse.

Adult↗
PubMed1997

Evaluating the diagnostic interview: obstacles and future directions.

The diagnostic interview plays a prominent role within the field of clinical psychology and occupies a fundamental component in graduate training. Educators seem to be focusing less on objective measures to evaluate student skill performance and the overall quality of the interview. The authors review the current methods for evaluating the diagnostic interview in psychology training and identify some of the major obstacles in accurately assessing student interview proficiency. Recommendations are made to address these difficulties, and the authors note some promising future directions.

Attitude of Health Personnel↗
PubMed1996

Abnormal electroretinogram in cocaine-dependent patients. Relationship to craving.

BACKGROUND: The retina contains high concentrations of dopamine. We previously reported that recently withdrawn cocaine-dependent patients had significantly reduced blue cone b wave amplitude responses on the electroretinogram (ERG). In this study we wished to examine if there was a relationship between cocaine craving and reduced blue cone b wave ERG responses. METHODS: A series of 14 recently withdrawn cocaine-dependent patients completed a 45-item cocaine craving questionnaire shortly before the ERG. RESULTS: Cocaine dependent patients who had a reduced ( < 0.5 microvolts) blue cone b wave ERG response had significantly higher cocaine craving scores than patients without a reduced blue cone ERG response. There was also a significant negative correlation between blue cone b wave amplitude responses and scores on the cocaine craving questionnaire. CONCLUSIONS: A reduced blue cone b wave ERG response may identify recently withdrawn cocaine-dependent patients with biological dysregulation and increased cocaine craving.

Adult↗
PubMed1993

Adolescent substance abuse prevention.

Increasing attention is being focused on the prevention of substance use, rather than treatment. The author critiques the literature and provides a conceptual framework for a better understanding of adolescent substance abuse prevention under school-based, psychosocial, and legislative models.

Adolescent↗