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Biomedical subjects

D S Schubert

Publications and source records attributed to D S Schubert.

At least 37 records · Page 2Linked to original sources
PubMed1989

Effect of liaison psychiatry on attitudes toward psychiatry, rate of consultation, and psychosocial documentation.

Prior literature suggested that psychiatric liaison on medical wards would produce a more positive attitude towards psychiatry, more psychosocial chart documentation, and a higher consultation request rate. Over 3 years, liaison was conducted on two medical wards, and its effect was contrasted with two control (consultation only) medical wards. Liaison activities were more favorably received by consultees than consultation alone and increased the consultation request rate, but produced no change in psychosocial documentation. Additional effectiveness of liaison activities might be achieved through direct, focused interventions, and through active involvement of senior medical faculty.

Attitude of Health Personnel↗
PubMed1989

Electroencephalographic changes and other indices of neurotoxicity with haloperidol-lithium therapy.

This prospective study was undertaken in order to establish indices of possible neurotoxicity due to the combination of lithium with haloperidol and a combination of lithium with other neuroleptics. Twenty-one subjects who were receiving neuroleptic-lithium combination were studied. Of them, 14 had a primary affective disorder-manic phase, and 7 had schizophrenia as judged by Feighner criteria. The subjects were evaluated on clinical, neuropsychological measures and EEG at baseline and 10-14 days after addition of lithium to the neuroleptic regimen. Of 11 subjects receiving the haloperidol-lithium combination, 5 (45.4%) showed abnormal responses on EEG. Of these 5 subjects, 3 showed abnormal photic responses, and 2 showed slowing in posterior alpha activity. These photoparoxysmal and photomyoclonic responses are indicative of cerebral pathophysiology resulting from the interactive effect of the haloperidol-lithium combination. The photic and other associated EEG abnormalities reported may be the earliest indication of neurotoxicity. No significant changes were observed in the EEG in 10 subjects treated with other neuroleptic-lithium combinations. In a statistical comparison the haloperidol-lithium combination had significantly more frequent EEG changes than the combination of lithium with other neuroleptics. This study presents sufficient evidence from reported photic and other associated EEG changes to pursue further investigation of neurotoxicity due to haloperidol-lithium therapy. Such a study should employ a larger number of subjects, random assignment of subjects to treatment and control groups, and blind evaluation of data.

Adult↗
PubMed1988

Reverse liaison rounds with a burn unit case.

A liaison rounds is presented, one attended by all members of a consultation-liaison (C-L) team along with the medical director of a burn unit. This structure is designated as a "reverse liaison rounds," as it is the opposite of the conventional liaison meeting, which consists of one C-L consultant and the total nonpsychiatric team. The content centered on a self-inflicted burn case in which countertransference issues involved a nonpsychiatrist. The unconventional format of the reverse liaison rounds provided all parties with new knowledge, perspectives, and insights into the interactions between the C-L consultant and the burn unit team.

Adult↗
PubMed1988

A statistical evaluation of the literature regarding the associations among alcoholism, drug abuse, and antisocial personality disorder.

Prior literature suggested an association among alcoholism, drug abuse, and antisocial personality disorder. A meta-analysis of inferential studies bearing on these associations was performed on 40 studies. Results demonstrated that each diagnosis in the triad had a significant positive association with each of the other two. Possible common etiologies of the diagnoses were discussed. Presence of one of the three diagnoses suggests that consideration of the other two is advisable. Finally, interrelationships among the diagnoses may explain treatment results common to several of the diagnoses.

Alcoholism↗
PubMed1986

Evaluation of studies on platelet alpha 2 adrenoreceptors in depressive illness.

Discrepant results have been reported from at least ten laboratories regarding the status of platelet alpha 2 adrenoreceptors in depressed patients. Using a statistical test to combine those studies which utilized radioligand binding techniques, we find the overall data support an elevation in density of platelet alpha 2 adrenoreceptors from drug-free depressed patients (p less than 0.05) and suggest a normalization to lower binding values following antidepressant drug treatment (0.05 less than p less than 0.10). However, these positive results are attributable to highly significant findings by only three laboratories. Much of the discrepancy may be attributable to numerous methodological variables which distinguish the studies. Foremost amongst these variables are the use of different platelet size populations, the use of different medium, and the choice of radioactive ligand and competitor (non-radioactive ligand) in the assay. We present a rationale for the proper choice of each methodological condition used in the clinical assessment of platelet alpha 2 adrenoreceptor status, hoping that improved experimental designs will resolve the current controversy.

Adrenergic alpha-Antagonists↗
PubMed1986

EEG observations during combined haloperidol-lithium treatment.

Some reports have indicated a neurotoxic interaction of haloperidol and lithium, whereas others have not found this interaction. This is a report on two patients who showed both photomyoclonic and photoparoxysmal responses while on combined lithium-haloperidol treatment. We suggest that these findings, which have not been previously reported to be associated with combined lithium-haloperidol treatment, reflect neurotoxicity and that electroencephalogram (EEG) monitoring should be done on patients receiving this combined medication regimen.

Adult↗
PubMed1985

Family size effects: a review.

Larger families are more frequent with early marriage and rapid birth of the first child. In larger families, child rearing becomes more rule ridden, less individualized, with corporal punishment and less investment of resources. Smaller families tend to result in higher IQ, academic achievement, and occupational performance. Large families produce more delinquents and alcoholics. Perinatal morbidity and mortality rates are higher in large families as birth weights decrease. Mothers of large families are at higher risk of several physical diseases. Common methodological errors are indicated and exemplary studies are described.

Adolescent↗
PubMed1984

Informed consent as a source of bias in clinical research.

Clinical observation suggested that schizophrenic patients more often refused to participate in experiments. In two studies psychiatric patient volunteers and nonvolunteers were compared on discharge diagnoses (psychiatric and medical), medication given, demographic measures, and hospitalization characteristics. In each study, patients with paranoid schizophrenia were more likely to refuse participation. Also, in each study, volunteers received more benzodiazepines and more nonpsychiatric medication. The latter difference could not be explained on the bases of rated severity of or probability of drug use in diagnosed medical illnesses, or number of medical illnesses. Characteristics of schizophrenic patients such as suspiciousness, negativism, and ambivalence were suggested as possible sources of their refusal to participate. Nonvolunteers were suggested to be less agreeable and compliant in general, and perhaps less likable, possibly explaining their receiving fewer benzodiazepines and nonpsychiatric medications. Attempts to characterize and correct the volunteer bias should be made, including offering tangible reward.

Benzodiazepines↗
PubMed1983

Child spacing effects: a comparison of institutionalized and normal children.

Data were collected on 52 psychiatrically abnormal and 101 normal children, as part of a study of the effects of sibship constellation variables on intellect, achievement, personality traits, and social adjustment. The two groups are closely equivalent with respect to age, social class (lower and lower-middle) and sibship size. There was a significantly higher percentage of psychiatrically abnormal than normal children having a sibling less than two years older. conversely, the normal children had a significantly higher percentage of widely spaced (to the next older) than did the psychiatrically abnormal children. Unwantedness by parents (especially the mother) may be a factor in increasing the likelihood of learning and behavioral difficulties and other social disarticulation.

Achievement↗