Biomedical subjects

D Schotte

Publications and source records attributed to D Schotte.

11 recordsLinked to original sources

PubMed2000

Perceived expressed emotion in the siblings and parents of hospitalized patients with anorexia nervosa.

OBJECTIVE: The present study investigated the relationship between the level of perceived Expressed Emotion (EE) of the siblings and parents of patients hospitalized with anorexia nervosa and its effect on weight gain and psychological functioning. METHOD: The Level of Expressed Emotion (LEE) Scale was administered on admission to 19 patients with anorexia nervosa who completed the LEE three times so as to identify their perceptions of their relationship with their closest age sibling, mother, and father. They were also required to complete the Eating Disorder Inventory 2 (EDI-2). Patients' closest age sibling completed the Family Attitude Scale (FAS). The patients' body mass index (BMI) was calculated 6 weeks later, and the EDI-2 readministered. RESULTS: Perceived EE was not predictive of BMI change after 6 weeks of hospitalization. A composite perceived family EE score was a significant predictor of change on the Interpersonal Distrust, Maturity Fears, and Perfectionism subscales of the EDI-2. DISCUSSION: These findings suggest that patients' perceptions of their relationships with their closest aged sibling, mother, and father are poor predictors of weight gain and improvement in psychological functioning following 6 weeks of inpatient treatment.

Adult↗

PubMed2000

Development of an instrument to assess readiness to recover in anorexia nervosa.

OBJECTIVE: The degree to which patients with anorexia nervosa demonstrate readiness to recover from their illness has received scant theoretical or empirical attention. Investigating the prevalence and degree of amotivation for recovery in anorexia nervosa, its role in outcome, and the effectiveness of interventions designed to enhance readiness to recover necessitates the existence of a reliable and valid measure of motivational issues relevant to the disorder. The present study aimed to develop and evaluate an instrument for assessing readiness to recover in anorexia nervosa, namely, the Anorexia Nervosa Stages of Change Questionnaire (ANSOCQ), a 23-item self-report questionnaire based on Prochaska and DiClemente's stages of change model. METHOD: Seventy-one inpatients with anorexia nervosa participated in the study. On several occasions during their admission, participants completed the ANSOCQ as well as questionnaires assessing readiness to recover, anorexic symptomatology, general distress, and social desirability. RESULTS: The ANSOCQ demonstrated good internal consistency (.90) and 1-week test-retest reliability (.89). Various aspects of validity were also supported, such as significant relationships with other instruments assessing readiness to recover and the prediction of weight gain during different periods of treatment. DISCUSSION: The results suggest that the ANSOCQ is a psychometrically sound instrument that may prove useful in investigating the role of readiness to recover in anorexia nervosa.

Adolescent↗

PubMed2000

Interactions between HIV-infected monocyte-derived macrophages and human brain microvascular endothelial cells result in increased expression of CC chemokines.

The presence of perivascular monocytic infiltration is a major hallmark of HIV-1-associated dementia. Since CC chemokines are chemoattractant cytokines that are able to attract T cells and monocytes/macrophages to sites of inflammation, and since infiltrating monocytes/macrophages remain in close contact with the brain endothelium, we investigated whether interactions between HIV-1-infected macrophages and brain endothelium result in an altered chemokine production. We found an increased mRNA expression of monocyte chemotactic protein-1 (MCP-1), macrophage inflammatory protein (MIP)-1 alpha and MIP-1 beta, and RANTES by macrophages after HIV-1 infection. Interactions between HIV-infected macrophages and brain microvascular endothelial cells resulted in an additional upregulation of chemokine mRNA expression, during cell-cell contact as well as in a trans-well system. Since IL-1 beta can function as a modulator of chemokine expression we investigated if interleukin-1 beta could be involved in the regulation of chemokine induction. Coculturing of HIV-infected macrophages and endothelial cells resulted in immune-activation as indicated by increased mRNA expression of IL-1 beta. Subsequently, addition of a neutralizing antibody against IL-1 beta resulted in altered chemokine expression by macrophages, but not by endothelial cells. Thus, IL-1 beta appears to play a major role in the regulation of chemokines during cellular interactions in HIV-associated dementia, but other factors may also be involved.

Antibodies↗

PubMed1999

Measuring self-esteem in dieting disordered patients: the validity of the Rosenberg and Coopersmith contrasted.

OBJECTIVE: In order to ascertain the most appropriate measure of self-esteem for dieting disordered patients, this study contrasted the construct and convergent validities of two widely used measures. In addition, dieting disordered subgroups were compared on levels of self-esteem. METHOD: One hundred and seventeen male and female patients diagnosed with anorexia nervosa, bulimia nervosa, or eating disorder not otherwise specified completed the Rosenberg Self-Esteem Scale (SES), the Coopersmith Self-Esteem Inventory (SEI), and measures of dieting disorder pathology and depression. RESULTS: No significant differences among the three dieting disorder subgroups were found. In determining convergent validity, regression analyses indicated that the SES was a significant predictor of dieting disorder psychopathology whereas the SEI was not. Of the two self-esteem measures, only the SES showed evidence of convergent validity. DISCUSSION: The results suggest that the SES has sounder construct and convergent validity than the SEI. Hence, the SES may be more appropriate for use with dieting disordered populations.

Adult↗

PubMed1998

Perceptions of bed rest by anorexic patients.

OBJECTIVE: Few studies have investigated perceptions of operant conditioning programs by anorexic patients. This study examined patients' perceptions of the Bed Rest (BR) component which is employed in some operant conditioning programs. METHODS: A sample of 48 anorexic inpatients was administered a survey to elicit their attitudes towards BR. RESULTS: Results from the survey suggested that most patients perceived BR in a negative way. The main complaint, however, was not punishment or humiliation, as predicted, but isolation and boredom. A number of patients concluded that they wanted more individualization and distraction and less restriction while on BR. DISCUSSION: The findings justify the use of BR within a humane framework in the inpatient treatment of anorexia nervosa, but suggest that patients' perceptions of BR warrant systematic scrutiny.

Adolescent↗

PubMed1995

Cognitive-behavioural therapy versus EMG biofeedback in the treatment of chronic low back pain.

Forty-four chronic, but relatively well functioning, low back pain patients were assigned to either Cognitive Behaviour Therapy (CBT). Electromyographic Biofeedback (EMGBF) or Wait List Control (WLC). Both treatments were conducted over eight sessions in groups of four subjects. Results at post-treatment indicated significant improvements in functioning on measures of pain intensity, perceived level of disability, adaptive beliefs about pain and the level of depression in both the CBT and EMGBF conditions. These improvements were not evident for the WLC condition. At 6 months follow-up, treatment gains were maintained in the areas of pain intensity, pain beliefs, and depression, for both treatment groups, with further improvements occurring in anxiety and use of active coping skills. No significant differences were found between CBT and EMGBF on any of the outcome measures at either post-treatment or at 6 months follow-up. Further research is required to determine the degree to which these results reflect the mild level of psychological impairment and disability status of patients in the present study.

Adult↗

PubMed1995

The role of autonomic arousal in problem gambling.

The present study investigated the role of arousal in problem gambling. Three groups of subjects were recruited into the study corresponding to problem gamblers, high and low frequency social gamblers. For the two gambling groups, the preferred form of gambling was poker machine playing. Five different conditions were employed in order to determine under which conditions gambling related cues were related to increased autonomic arousal, as measured by skin conductance level (SCL), heart rate (HR) and frontalis electromyography (EMG). The five conditions were a neutral task, a videotaped poker machine gambling scenario presented with and without distraction, a personally relevant "win" situation and a videotaped horse race. Comparisons between responses for the videotaped poker machine gambling stimuli versus a horse-racing video task demonstrated differences only for the problem gambling group and only for SCL. No differences between these tasks emerged on the HR and EMG indices and no differences were evident for either of the social gambling groups. No changes were observed in any group when subject's cognitions were prevented by asking patients to count the number of wins made during the video play period while watching the same poker machine video. However, when personally relevant situations were presented and compared to a neutral task, differences were observed in all three groups. However, the nature of these differences varied between the groups and the different indices of arousal. For problem gamblers, increases were evident in all three measures. Increases were also observed for the control groups in comparison to the neutral task, but only in HR and SCL and not for EMG. For HR, the increases were equivalent across all three gambling groups. However, for SCL the problem gambling group became significantly more aroused than the control groups, but no differences were observed between the high and low frequency gamblers. Only the problem gambling groups evidenced significant increases in the personally relevant task compared to the neutral task for EMG. Theoretical and clinical implications of these results for the development, maintenance and treatment of problematic levels of gambling are discussed.

Adult↗

PubMed1994

Family planning needs of male chronic mental patients in the general hospital psychiatry clinic.

We investigated the parenting history, contraceptive behavior, and contraceptive needs of 35 male chronic mental patients seen at an urban outpatient psychiatric clinic. Most patients had fathered children, but 60% of the children less than 16 years of age were not being reared by their biological father. Forty-one percent of the patients who had sexual intercourse during the preceding year and had not wanted children reported that they or their sexual partner had not used contraception at the time of last intercourse. Patients were reportedly at significant risk of fathering unwanted children and sexually transmitted diseases. Strategies for preventing unwanted pregnancies within this population are discussed.

Acquired Immunodeficiency Syndrome↗

PubMed1987

Reliability and significance of increased creatine kinase MB isoenzyme in the serum of uremic patients.

The authors quantified creatine kinase MB (CK-MB) isoenzyme activity and mass in the serum of 81 uremic and 20 nonuremic (control) patients who had no clinical or electrocardiographic evidence of acute myocardial infarction. CK-MB was quantified by three methods: electrophoresis, the QuiCK-MB (International Immunoassay Labs), and the Tandem-E CK-MB (Hybritech, Inc.). The authors then followed all uremic patients for subsequent hospitalization for cardiac disease. Median CK-MB was increased in the serum of the uremic patients as compared with the control patients by all methods. Most uremic patients had CK-MB in serum above the median CK-MB of the control group. Seventeen (21%) uremic patients had CK-MB in serum elevated above the reference range by at least one method. All control patients had CK-MB in the serum within the reference range. Twelve of 81 (15%) uremic patients have subsequently developed acute myocardial infarction (six patients; four died) or angina pectoris (six patients; one died). Eleven patients were specifically hospitalized for cardiac symptoms. One patient had acute myocardial infarction three weeks after renal transplant. With the use of the chi-square test and 2 X 2 contingency tables, patients with CK-MB in serum above 5 U/L by electrophoresis (chi 2 = 5.47; P less than 0.05) or at least 2.9 EU/L by the QuiCK-MB (chi 2 = 6.56; P less than 0.01) appeared to be at increased risk of subsequent hospitalization. The authors conclude that a slight increase of CK-MB in serum is found in most uremic patients. However, CK-MB elevated above reference range in the serum of uremic patients without clinical or electrocardiographic evidence of acute myocardial infarction is not common. When found, elevated CK-MB isoenzyme appears to be associated with an increased risk of subsequent cardiac disease. Therefore, quantification of CK-MB in the serum of uremic patients is more reliable than is implied in the literature.

Adult↗

PubMed1985

Differentiation between classically conditioned and cognitively based neurotic fears: two pilot studies.

The ability of clinical trainees to learn to distinguish between classically conditioned and cognitively based neurotic fears was examined in two small-scale studies. The first study showed that they readily learned to make the distinction on the basis of transcripts of key excerpts of actual patient sessions, and that ability to do so increased with training. The second study showed a high degree of inter-rater reliability among assessor ratings of fear type on the basis of independent interviews of phobic patients.

Clinical Competence↗

PubMedDate not supplied

Giant ovarian cysts: is a pre- and intraoperative drainage an advisable procedure?

There has been a considerable debate over the merits of a pre- or intraoperative drainage of giant ovarian cysts, which represented a very frequent approach before definitive surgery in the past. Including our presented case of a 57-year-old woman with a 49 kg mucinous cystadenoma, 19 patients with giant ovarian cysts weighing more than 40 kg were reported in the literature since 1970. An incidence of 37% of malignant and low malignant potential tumors was found. Based on a critical evaluation of the medical courses and the discussed miscellaneous advantages and complications, we conclude that a pre- and intraoperative drainage should be avoided.

Contraindications↗