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Biomedical subjects

D Perlick

Publications and source records attributed to D Perlick.

13 recordsLinked to original sources
PubMed1992

Daily sleep reports and circadian rest-activity cycles of elderly community residents with insomnia.

Sleep patterns were investigated in 29 insomniacs and 22 controls selected from a large sample of elderly residents of an urban community. According to sleep logs kept for a mean of 14.7 days, insomniacs took longer to fall asleep and stayed awake longer when they woke at night. In 14 insomniacs and 8 controls, wrist movements were monitored with a portable instrument. A circadian rhythm of motor activity was found in both groups, with some notable differences. Insomniacs were more active during periods of bedrest, and their mean daily rest-activity pattern--representing mean activity at equivalent times of day--was flatter. The mean level of activity over the entire experiment was similar in both groups. Insomnia in many elderly persons is thus associated with diffusion of activity over the 24-hr day, leaving bedrest periods only partially filled by rest or sleep.

Activities of Daily Living↗
PubMed1992

Contribution of family, cognitive and clinical dimensions to long-term outcome in schizophrenia.

A multivariate approach incorporating both biological and psychosocial factors was used in a cross-sectional study of schizophrenic inpatients and outpatients selected to represent opposite ends of the outcome spectrum. Twenty-six RDC-diagnosed chronic schizophrenic patients hospitalized continuously for 18 months or longer, and 26 patients with a history of at least three years of community tenure without rehospitalization were matched for sex, age, ethnicity, SES and chronicity, and assessed on a structured family interview (Social Behavior Assessment Schedule), neuropsychological test battery, Brief Psychiatric Rating Scale and Premorbid Asociality Scale. Stepwise discriminant function analysis was performed; family ratings of patients' problem behaviors was the most powerful discriminator between the two groups and a composite measure of neuropsychological functioning ranked second. Other significant discriminators were BPRS scores, availability of social support to the family and age of onset. Family ratings of patient behavior were related to ratings of family burden and to BPRS scores. Further research is needed to understand the complex interactions between the diverse sets of social, clinical and neurobiological factors that determine long-term outcome in schizophrenia.

Activities of Daily Living↗
PubMed1992

Gender differences in cognition in schizophrenia.

Gender differences in cognition were investigated in schizophrenic inpatients and outpatients using the Dementia Rating Scale. Females displayed greater impairment on Attention and Conceptualization than males. Gender interacted with patient group for construction: females performed worse than males among inpatients and better among outpatients. Results may be related to the atypically early age of onset of females relative to males; attention to sampling and selection biases is needed in evaluating gender differences in cognition in schizophrenia.

Adult↗
PubMed1992

Neuropsychological discriminators of long-term inpatient or outpatient status in chronic schizophrenia.

This study investigates specific neuropsychological functions discriminating schizophrenic patients with hospitalization beyond 18 months from patients residing in the community without rehospitalization beyond 3 years. Twenty-six Research Diagnostic Criteria-diagnosed chronic schizophrenic outpatients and 26 inpatients matched for sex, ethnicity, socioeconomic status, and chronicity completed a comprehensive neuropsychological battery and responded to an inventory of psychopathology. Discriminant function analyses showed that measures of motor coordination, preservation, memory, and attention discriminated between patient groups. Bilateral simultaneous fine motor coordination was the most potent discriminator between patient groups, independent of psychopathology. Implications for treatment and research on course and outcome in schizophrenia are discussed.

Activities of Daily Living↗
PubMed1991

Gender differences in depression: historical changes.

Depression has been widely reported to be more prevalent among females than among males. In this study we demonstrate that gender differences in depression occur only among individuals born during particular historical periods, and test the utility of a model focusing on changes in women's opportunities for academic and professional achievement in predicting periods of significant gender differences in depression. Based on reanalysis of data reported by Klerman et al., we find gender differences in depression among people 40 years of age and older to be high among cohorts that reach adolescence during periods of increasing opportunities for female achievement. Among cohorts that reach adolescence during periods of stable or decreasing opportunities for women, gender differences in depression are not significant at any age.

Achievement↗
PubMed1990

Sleep problems in the community elderly as predictors of death and nursing home placement.

In 1984-85, 1855 elderly residents of an urban community responded to a comprehensive baseline interview that included questions regarding an extensive set of sleep characteristics and problems. During the subsequent 3 1/2 years of follow-up, 16.7% of the respondents died and 3.5% were placed in nursing homes. The predictive significance of each sleep characteristic for mortality and for nursing home placement was determined separately for males and females, using Cox proportional hazards models. Selected demographic and psychosocial variables were also entered into the models. Age, problems with activities of daily living (ADL), self-assessed health, income, cognitive impairment, depression and whether respondents were living alone were controlled for statistically. Of the many variables analyzed, in males insomnia was the strongest predictor of both mortality and nursing home placement. For mortality, the relative hazard associated with insomnia exceeded the hazards associated with age, ADL problems, fair-poor health and low income. For nursing home placement, the hazard associated with insomnia exceeded that associated with cognitive impairment. The relationships of insomnia to mortality and nursing home placement were U-shaped, with a worse outcome if insomnia complaints over the preceding 2 weeks were either prominent (numerous or frequent) or absent. For females, insomnia was a borderline predictor of mortality and did not predict nursing home placement at all. Symptoms of the restless legs syndrome predicted mortality for females in some Cox regression models. Reported sleep duration, symptoms of sleep apnea and frequent use of hypnotic drugs did not predict mortality or nursing home placement in either sex.

Aged↗
PubMed1986

Memory deficits and anticholinergic levels in chronic schizophrenia.

Recent memory correlated inversely with serum anticholinergic levels for verbal recall but not for recognition memory in 17 chronic schizophrenic inpatients taking neuroleptic medications. The results indicate that anticholinergic activity does not impair primary memory functioning in chronic schizophrenia.

Adult↗
PubMed1985

Multiple contributions to clinical presentation of flat affect in schizophrenia.

Flat affect has long been recognized as a central manifestation of schizophrenia, and has more recently been appreciated as a stable and prognostically important attribute of this disorder. Yet, because it is thought to be difficult to evaluate, flat affect has been deemphasized in criterion-based diagnostic systems. Results of this study suggest that the clinical evaluation of flat affect may be contaminated by a number of behaviorally similar processes. The components we identified included right hemisphere dysfunction, retardation and extrapyramidal effects, as well as the sequelae of hospitalization. Thus, in the clinical evaluation of flat affect, a multivariate approach in which these different components are considered separately might improve the reliability of evaluation and make this important sign more useful.

Chronic Disease↗
PubMedDate not supplied

Sleep problems and institutionalization of the elderly.

This study examined the role of sleep problems in the decisions of families to institutionalize elderly relatives. Previous work on institutionalization of the elderly has given little attention to the contribution of nocturnal, sleep-related problems. Seventy-three primary caregivers of elders recently admitted to a nursing home or psychiatric hospital were asked to identify the problems the elder was having during the night and day and rate the degree to which these influenced their decision to institutionalize the elder. Seventy percent of the caregivers in each sample cited nocturnal problems in their decision to institutionalize, often because their own sleep was disrupted. The most frequent disruptive nocturnal events were micturition, pain, and complaints of sleeplessness. Sleep problems of the elderly contribute heavily to the decision to institutionalize an elder and thus to the social and economic cost of institutional care. They appear to do this largely by interfering with the sleep of caregivers. The nature, prevalence, and treatability of the sleeping problems of both elders and their caregivers need further study.

Activities of Daily Living↗