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Biomedical subjects

D G Folks

Publications and source records attributed to D G Folks.

At least 19 recordsLinked to original sources
PubMed1992

The role of psychological factors in gastrointestinal conditions. A review pertinent to DSM-IV.

The authors reviewed the literature to assess the relationship between psychological factors and gastrointestinal conditions. The conditions that were found to be more relevant and worthy of future investigation were nonulcerative dyspepsia, inflammatory bowel disease (regional enteritis), and irritable bowel syndrome. The pertinent findings suggest that an important link exists between psychological factors and gastroenterological disorders, which supports the need for modification of the DSM-III-R's diagnostic category, "Psychological Factors Affecting Physical Condition." In concert with a subcommittee addressing other organ systems and psychological factors, the authors conclude that a diagnostic approach with greater utility would be useful for both researchers and clinicians. A conceptual framework as proposed in DSM-IV could also advance knowledge of psychological factors and their contribution or role in the etiology, perpetuation, and exacerbation of certain gastrointestinal conditions.

Acute Disease↗
PubMed1992

The role of psychological factors in dermatologic conditions.

Knowledge about the psychiatric factors affecting dermatologic illness is far from conclusive. Studies in the past decade have strengthened concepts regarding associated psychological factors. Many dermatologic conditions are now considered in the context of genetic predisposition, personality, and biopsychosocial factors. Several psychotropic medications have been observed to affect dermatologic conditions. This article reviews the research and clinical reports of the past decade that address nosologic and diagnostic aspects of psychological factors affecting dermatologic conditions. This article is a result of the efforts of a work group to propose revisions to the DSM-III-R diagnostic category of psychological factors affecting physical condition and supports the need for a systematic, nosologic schema that would potentially increase our knowledge and improve our understanding of this important psychosomatic domain.

Humans↗
PubMed1991

The relationship of high-intensity signals on magnetic resonance images to cognitive and psychiatric state in Alzheimer's disease.

In Alzheimer's disease (AD), the relationship between white-matter changes on magnetic resonance images and behavior are unclear. Therefore, magnetic resonance images, cognition, and psychiatric state were assessed in patients with AD with depression (AD/DEP; n = 18) and without depression (AD; n = 45), older depressed patients (n = 12) and older normal individuals (n = 25). High-intensity signals in the cortex and subcortical regions were similar in number and proportions among all groups, even when hypertensive patients were excluded. No correlations to cognitive or psychiatric state were found. Periventricular signals were categorized using a 1- (absent) to 6- (thick, irregular caps and stripes) point scale. The categories were similar among groups except that patients with AD exhibited more category 5 changes than did normal subjects, neuropsychological performance was significantly worse in patients with AD who had category 5 and 6 changes when compared to those in category 1. These results suggest that periventricular changes may predict poor neuropsychological performance in patients with AD. However, neither deep white-matter lesions nor periventricular changes are useful for diagnostic purposes.

Aged↗
PubMed1991

Alternatives to lithium in the treatment of bipolar disorder.

Bipolar disorder is a serious mental illness affecting a large number of Americans. While lithium, the treatment of choice for this disorder, is usually effective, a substantial number of individuals with bipolar disorder are not helped by lithium or are intolerant to its side effects. Consequently, investigators are searching for alternative drugs in order to treat lithium-resistant patients. Although a number of alternative drug treatments have been discussed in the literature, only the anticonvulsants carbamazepine and valproate appear to warrant serious consideration at this time. Future research will further define their roles as antimanic agents.

Bipolar Disorder↗
PubMed1988

Cognitive dysfunction after coronary artery bypass surgery: a case-controlled study.

Twenty-two patients screened from a sample of 391 having coronary artery bypass grafting (CABG) showed significant declines on the Mini-Mental State Examination (MMSE) administered preoperatively and four days postoperatively. The MMSE is a 30-point cognitive function screening instrument for dementia and delirium. These patients were compared with 22 matched control subjects who exhibited intact cognitive function postoperatively. The study assessed the association between postoperative cognitive dysfunction and socioeconomic status, potential effects of selected surgical/anesthetic factors, and preoperative anxiety and depression (Zung Anxiety and Center for Epidemiologic Studies-Depression [CES-D] self-rating scales). The results indicate that a higher preoperative level of depression reported on the CES-D (mean score of study patients 22.1 versus 12.7 for controls) is significantly associated with the development of postoperative cognitive dysfunction (P less than .01). The educational and occupational levels of study patients were significantly below those of controls (P less than .01, P less than .02). Occurrence of a postoperative complication was the only surgical/anesthetic factor found to be significantly associated with cognitive dysfunction (P less than .01). These findings suggest that preoperative depression significantly increases the risk for immediate postoperative cognitive dysfunction, and that lower socioeconomic status may confer greater risk for postoperative cognitive morbidity.

Adult↗
PubMed1988

Denial: predictor of outcome following coronary bypass surgery.

Using a modified version of the Hackett-Cassem denial scale we measured preoperative denial in 121 patients scheduled for CABG surgery. A significant inverse relationship was found between the denial scale and Hamilton Anxiety measures four days postoperatively (p less than .02). Longitudinal assessments were carried out using the Spielberger State Anxiety Inventory (SSAI), the Zung Self-Rating Depression Scale (Zung SDS) and the Psychosocial Adjustment to Illness Scale (PAIS). Six months following the surgery, significant negative relationships between denial and these self-report outcome measures were observed as follows: denial and SSAI (p less than .001), denial and Zung SDS (p less than .01), and denial and PAIS (p less than .01). However, the same analysis at twelve months showed no statistically significant correlations between denial and these psychologic outcome measures. Our findings suggest that denial serves as an adaptive mechanism, especially in the immediate postoperative period. Furthermore, higher levels of denial may be predictive of improved psychologic outcome for up to six months following surgery. Subsequently, however, other events, unrelated to the surgery, may be of greater importance than preoperative denial in determining psychological outcome from CABG surgery.

Anxiety Disorders↗
PubMed1986

Factitious disorder and coexisting depression: a report of successful psychiatric consultation and case management.

The authors present a case illustrating factitious illness with a coexisting depressive disorder. The factitial presentation involved self-mutilation that served to procure and prolong patient status, while obscuring the recognition of a major depressive episode. The importance of accurate assessment and prompt recognition of factitious illness is discussed, with emphasis upon the identification of contributing psychodynamics, underlying psychopathology and ongoing psychosocial stressors. Psychiatric consultation efforts were successful, but in the context of considerable morbidity. Psychotherapeutic gains occurred only after vigorous antidepressant drug therapy and substantial psychotherapeutic efforts that empathically addressed the patient's masochism and dependency.

Adult↗
PubMed1986

Coronary artery bypass surgery in older patients: psychiatric morbidity.

Coronary artery bypass grafting in older patients usually results in a favorable surgical outcome. To assess whether age confers greater risk for postoperative psychiatric symptoms in these patients, we retrospectively examined 58 cases (mean age 62.5 years) comparing pertinent clinical features of the index patients to matched controls (mean age 51.7 years). Analysis of the data, including scores on preoperative and postoperative scales measuring anxiety, depression, and cognitive function, showed a statistically significant difference in the cognitive performance of the elderly as shown by lower scores on the Mini Mental State examination (chi-square, P less than .025). Our findings support future efforts to address the clinical relevance of cognitive dysfunction in older coronary bypass patients.

Age Factors↗
PubMed1986

Quality of life six months after coronary artery bypass surgery: a preliminary report.

Ninety-six patients who had coronary artery bypass grafting showed improvement on the Psychosocial Adjustment to Illness Scale at six months postoperatively. Findings of improved sexual function and vocational status were unexpected in light of previous studies. Older patients showed less psychologic distress than younger ones after coronary artery bypass surgery.

Adaptation, Psychological↗
PubMed1986

Alprazolam treatment of postcoronary bypass anxiety and depression.

The effectiveness of alprazolam in treating symptoms of anxiety and depression in 60 patients undergoing coronary bypass surgery was assessed in a double-blind, placebo-controlled study. The results indicate that alprazolam treatment for anxiety following coronary bypass surgery, particularly symptoms occurring in the immediate postoperative period, can significantly affect patient outcome. Specifically, only modest but statistically significant improvement was observed in the alprazolam-treated groups at 1-month follow-up; however, alprazolam-treated patients were significantly more likely to experience a very rapid anxiolytic effect by postoperative day 8. The implications of this study are discussed with respect to patient management and models for future studies of anxiety in postoperative patient populations.

Adult↗