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Biomedical subjects

D R Brightwell

Publications and source records attributed to D R Brightwell.

At least 19 recordsLinked to original sources

Disulfiram treatment of alcoholism. A Veterans Administration cooperative study.

We conducted a controlled, blinded, multicenter study of disulfiram treatment of alcoholism in 605 men randomly assigned to 250 mg of disulfiram (202 men); 1 mg of disulfiram (204 men), a control for the threat of the disulfiram-ethanol reaction; or no disulfiram (199 men), a control for the counseling that all received. Bimonthly treatment assessments were done for one year. Relative/friend interviews and blood and urine ethanol analyses were used to corroborate patients' reports. There were no significant differences among the groups in total abstinence, time to first drink, employment, or social stability. Among the patients who drank and had a complete set of assessment interviews, those in the 250-mg disulfiram group reported significantly fewer drinking days (49.0 +/- 8.4) than those in the 1-mg (75.4 +/- 11.9) or the no-disulfiram (86.5 +/- 13.6) groups. There was a significant relationship between adherence to drug regimen and complete abstinence in all groups. We conclude that disulfiram may help reduce drinking frequency after relapse, but does not enhance counseling in aiding alcoholic patients to sustain continuous abstinence or delay the resumption of drinking.

Actuarial Analysis

Effects of behavioral and pharmacological weight loss programs on nutrient intake.

Behavior therapy is a widely used method for short-term weight control. Formal nutrition counseling is not included in many behavioral programs. To determine what types of diets were self-selected by patients and to see how they compared with individuals participating in a relaxation group with anorectic medication, the eating diaries compiled by participants in such a program were analyzed for 20 different nutrients. In general, pretreatment intakes were nutritious and typical for Americans. Both the behavioral and a relaxation-medication treatment produced weight loss and reduction in calorie intake. Both treatments were associated with the consumption of a fairly nutritious diet not much different from the pretreatment intake except for a reduction in the amount eaten.

Adult

Effects of a combined behavioral and pharmacological program on weight loss.

The effects of an 'anorectic' drugs as an adjunct to a behavioral weight-loss programme were investigated. Four groups of 20 began an initial two weeks of instruction. Groups 1, 2, and 3 were instructed in a behavioral programme utilizing a food diary, stimulus control techniques, and reinforcement. Group 4 was instructed in a relaxation programme. Group 1 took phentermine resin 30 mg for eight weeks, followed by a placebo for eight. Group 2 took placebo for eight and phentermine for eight. Group 3 took placebo for 16. Group 4 took placebo for eight and phentermine for eight. All groups were followed for an additional eight weeks. A significant number of subjects in all behavioral groups achieved some weight loss. (A significant difference among the mean percentage body weight reduction for the three behavioral groups was also found.) In addition, a group of 'slow losers' who initially lost less than one half-pound (0.2 kg) per week and were subsequently placed on phentermine lost significantly more weight than a similar group which continued on placebo. These differences were maintained for 24 weeks.

Behavior Therapy

Marijuana: effects on free recall and subjective organization of pictures and words.

The free recall of pictures and words was compared following the administration of marijuana or placebo in a multitrial free recall task. Since pictures are thought to be registered in both visual and verbal memory stores with this encoding being mediated by some form of mental imagery, it was predicted that marijuana would produce a greater deficit in word recall in comparison to picture recall because the drug has been reported to facilitate imagery. A trend in the opposite direction followed intoxication; picture recall was inferior to word recall in the later stages of acquisition. Although overall recall was inferior under marijuana, no differences were found between the treatment conditions in subjective organization as determined by a variety of clustering measures. Recall performance following marijuana intoxication was positively related to level of recall performance in the placebo condition.

Adult

Marijuana: effects on storage and retrieval of prose material.

In a two phase design, an attempt was made to differentiate the effect of marijuana on the storage and retrieval of prose material. In the first phase, 40 male subjects were administered a single 500 mg marijuana cigarette containing 2.1%delta9-THC or a placebo cigarette. Fifteen minutes after smoking, they listened to and at the same time read a narrative passage of approximately 200 words in length. Subsequently, an immediate free recall test was given in which subjects were required to write down as much of the story as they could remember. The second phase was conducted 24h later. Marijuana and placebo subjects were randomly subdivided into four groups with half of the subjects participating in the same drug condition as occurred on day one while the others switched drug state. Fifteen minutes after smoking, all subjects recalled the passage presented on day one and then were given 24 questions concerning facts and events in the story which could be answered in a few words. These questions served as retrieval cues. Following this, a new passage was presented in the same manner as occurred on day one. After an immediate free recall test, another cued recall test was administered. Results indicated that marijuana reduced immediate recall under both cued and uncued conditions incomparison to placebo. No relative cued recall advantage was found in the marijuana groups for the old or new story and marijuana produced only a moderate decrement in recall of the old story on day two. However, marijuana given in the second phase significantly reduced memory for items recalled in the initial phase irrespective of drug or cueing condition in phase one, suggesting that retrieval was also affected. Some decrement in recall of the new story did occur as a function of drug state change in group M-P. This effect was related to the serial position of input items. Serial position did not interact with drug state under any other recall condition.

Cannabis

Cancer, emotions and mental illness: the present state of understanding.

The authors review recent and current literature on the relationship between psychological factors and cancer. They discuss the roles of predisposing personality patterns and emotional stress in the development, site, and course of cancer; the influence of awareness of terminal illness on the behavior of cancer patients; and the management of psychiatric symptoms in these patients.

Anxiety

Self-training of new eating behavior for weight reduction.

The problems of obesity are well documented, but few medical treatment programs have proven successful. Recently developed behavioral techniques have offered promise in the treatment of obesity. However, the time invested by a therapist limited their practical use and adoption by the general physician. A pilot study was conducted which employed a brief period of explanation of behavior modification techniques, development of an individualized program of eating behavior and recording of weight changes to provide feedback on progress. The program is carried out by patients at home with a minimum of physician supervision. The results indicate that such an approach is feasible and successful. Comparing this program to other programs is difficult because of the variability in reporting data and results.

Adult

Personality characteristics in patients with vertigo.

The role of emotional factors in patients with vertigo has been widely debated. Patients with vertigo, as well as patients in two separate control groups, were tested with the Eysenck Personality Inventory (EPI), the Cornell Medical Index (CMI), and a questionarie designed to evaluate the severity of the patients symptoms in order to further investigate the role of personality and its relationship to the symptom of vertigo. In patients with Meniere disease, a strong positive correlation was found between the severity of vertigo and the EPI and CMI scores. The concept of the psychological vulnerability" is useful in explaining these findings.

Ear Neoplasms