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Biomedical subjects

D Tantam

Publications and source records attributed to D Tantam.

36 records · Page 2Linked to original sources

Psychiatric day hospitals--another route to institutionalization?

Nineteen long-stay day patients were referred to a rehabilitation team and their outcome after a year is compared with 19 day patients who were not referred, but were matched for age, sex and diagnosis. Seven rehabilitation team patients had been discharged at 12 months as against 3 of the non-rehabilitation patients, but this was not a significant difference. Discharged patients were less disturbed at the beginning of the study and had fewer negative symptoms throughout. Discharge did not reduce the frequency of social contact. There was a suggestion that morale was sustained better in the rehabilitation patient and in their nurses. We conclude that rehabilitation planning may have beneficially accelerated the discharge of less ill day-patients, but that more resources are needed to prevent 'institutionalization' within the day-hospital.

Adult↗

Autistic children's ability to interpret faces: a research note.

Ten autistic children were compared with 10 non-autistic children matched for chronological age and performance IQ on two tests of finding the odd face out of a set of photographs of faces, two tests of labelling photographs of faces, and a test of labelling photographs of common objects. The autistic children were significantly worse than the non-autistic children at finding the odd person out and the odd facial expression of emotion out, and at labelling facial expressions of emotion. They did no worse than the non-autistic children at labelling upside down faces or at labelling objects. The results, which replicate the findings of Hobson (J. Child Psychol, Psychiat. 27, 321-342, 671-680, 1986; Communication, 20, 12-17, 1986) are consistent with other evidence for a specific perceptual abnormality in at least some children with autism, the nature of which is discussed.

Adolescent↗

Clinical characteristics, health beliefs and compliance with maintenance treatment: a comparison between regular and irregular attenders at a depot clinic.

This study investigated the relationship between clinical characteristics, health beliefs and compliance with depot neuroleptic maintenance treatment in schizophrenic patients by comparing a group of 40 irregular clinic attenders with another group of regular attenders matched by age and sex. While the 2 groups showed no difference in drug-induced extrapyramidal effects, the former were significantly more often depressed than the latter. Test-retest reliability coefficients of a 4-section health belief questionnaire showed marked variation in individual items. The 2 groups showed no difference in their perception of past effect of illness, likelihood of a relapse if maintenance treatment was stopped and effects of maintenance treatment.

Adult↗

The incidence of negative symptoms in early schizophrenia, mania and other psychoses.

Despite increasing interest in negative symptoms in schizophrenia there has been little work on their incidence in early schizophrenia or in other psychoses. This study examined 79 nondepressive psychotics within 2 years of onset of illness, diagnosed by Research Diagnostic Criteria and assessed for negative symptoms using the Scale for the Assessment of Negative Symptoms. Marked negative symptoms were observed in nearly half of patients diagnosed as suffering definite schizophrenia and were rarely found in other psychoses. Negative symptoms were not significantly correlated with positive symptoms, depression or exposure to neuroleptics, but were correlated with developing extrapyramidal side effects.

Adult↗

Lifelong eccentricity and social isolation. I. Psychiatric, social, and forensic aspects.

Sixty individuals are described who have lifelong eccentricity and social isolation and who have sought psychiatric treatment as a direct or an indirect result. They were predominantly young and, as in other samples of autistic people, male (6M: 1F). Most of them were of normal intelligence. They were all profoundly socially handicapped: few had lived independently, had lasting sexual relationships or spent much time in employment. Nearly a half of the subjects had been involved in antisocial behaviour at some stage. Nearly a quarter had committed a criminal offence. Violence was usually domestic, most often directed against the mother. Forty-eight per cent of subjects had a second psychiatric disorder (11.7% had a psychosis).

Adolescent↗

Lifelong eccentricity and social isolation. II: Asperger's syndrome or schizoid personality disorder?

Several scales are described for measuring aspects of eccentricity and social isolation; in particular, for assessing schizoid and schizotypal personality and for rating abnormal non-verbal expression. The latter is shown to be reliable, and the former to have a measure of validity. There was an association between schizoid personality traits and abnormalities of speech and non-verbal expression. However, abnormal non-verbal expression, but not schizoid personality traits or DSM-III schizotypal personality disorder, was particularly likely to occur in those subjects who had evidence of neurological deficit, and childhood symptoms indicative of developmental disorder. Abnormal non-verbal expression, but not personality disorder, was also associated with other characteristic features of Asperger's syndrome, such as unusual, 'special' interests. It is suggested that Asperger's syndrome is a distinct syndrome from either schizoid or schizotypal personality disorder, but may be a risk factor for the development of schizoid personality disorder.

Autistic Disorder↗

Long-stay patients in a psychiatric day hospital. A case note review.

The case notes of all non-psychogeriatric patients attending the Psychiatric Day Hospital at the University Hospital of South Manchester during one week in October 1982 were reviewed. Clinical, demographic, social and occupational data were gathered for all patients, and their attendance at the day hospital monitored for the year following the census period. No significant differences between patients could be found on any of the factors that it was predicted would distinguish short from long-stay patients. The best predictor of length of day hospital attendance in the current admission was the total quantity of previous hospital treatment whether as an in-patient or a day-patient. It is concluded that in the day hospital studied all patients had similar characteristics, and the majority could be seen as 'new long-stay' patients. The implications of this finding are discussed.

Day Care, Medical↗

Use of a general medical setting to teach medical students about neurosis.

A new way of teaching medical students about minor psychiatric illnesses is described. Psychiatric morbidity on general medical wards was identified, using medical students to administer the screening instrument to all routine admissions and interview possible cases. This was linked to a weekly teaching round in the same setting conducted by a psychiatrist. Advantages of this method of teaching were (1) it increased the overall numbers of patients clerked by our students during their psychiatric clerkship; (2) it increased the number of cases of neurosis seen by students as compared with psychotic illnesses; and (3) it related teaching on psychiatric conditions to settings where most students would eventually practise. The aim was both to increase the students' factual knowledge about minor psychiatric illnesses as encountered in these settings, and to improve their skills at identifying and treating such illnesses. An attempt was made to measure the effectiveness of this teaching method. All students showed an improvement in test scores, whether taught under the new regime or not, but it proved impossible to distinguish those taught on medical wards from those taught primarily in psychiatric wards. The implications of this finding are discussed. There was uniformly positive feedback from the students who took part in the study.

Clinical Clerkship↗

Anorexia nervosa: starvation dependence.

A case is presented, based on clinical observation and a sharing of fundamental features, for viewing anorexia nervosa as a dependence disorder. This view lends a coherence to the clinical picture and generates some new hypotheses for research.

Alcohol Drinking↗

Sleep, scratching and dreams in eczema. A new approach to alexithymia.

6 patients with itching due to skin disorder and 6 student controls were studied in the sleep laboratory. It was found that some of the patients had personality characteristics consistent with Sifneos' concept of alexithymia and that these were associated with a trend towards less REM sleep and with a significant lack of involvement in dreams collected under standardised sleep laboratory conditions. It is suggested that dreams collection in a sleep laboratory may be a valuable new method in the study of the link between emotional life and psychosomatic disorders.

Adolescent↗

An international comparison of two systems of community mental health care.

A neighbourhood health centre in the US is compared with the mental health services in an area of the UK. Patients with severe, but long-standing psychiatric illnesses, or patients with transient emotional problems are likely to be treated by a general practitioner in London and by non-medical mental health specialists in Boston. These patients receive more overall care, more specialist, non-medical care but make as many visits to a medical provider, other than a psychiatrist, in Boston as they do in London. Psychiatrists see more acutely ill patients for a shorter time than non-medical specialists in both places, and in both Boston and London there is a highly selective referral process which results in psychiatrists from both areas seeing approximately the same proportion of the population of their catchment areas. The integration of these findings with community attitudes in planning services is discussed.

Adolescent↗