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Biomedical subjects

E H Liston

Publications and source records attributed to E H Liston.

At least 37 records · Page 2Linked to original sources

Hospital treatment of elderly neuropsychiatric patients. I. Initial clinical and administrative experience with a new teaching ward.

Program planning and the initial experience of a new teaching ward for geriatric psychiatry are described. Elderly psychiatric patients, with diagnoses predominantly of depression and dementia, demonstrate more self-centeredness and less group awareness than do younger patients. Ward staff members often experience frustration, sadness and anger in response to working with them. Major problems unique to a geriatric psychiatry service include the paucity of adequate resources for post-discharge care and the necessity to obtain excellent medical-surgical consultation and support.

Aged↗

Phobic symptoms in an elderly woman: a multidisciplinary case conference.

A 67-year-old woman, previously self-sufficient, became housebound by phobic symptoms. During the patient's hospitalization for treatment of these disabling symptoms, a multidisciplinary case conference served to identify the underlying psychodynamic issues, which were related to separation anxiety. Treatment included helping the patient understand her relationships with her daughter and her own mother, and behavior modification to reduce the secondary gains of her symptoms. After treatment, the patient successfully returned to self-care.

Activities of Daily Living↗

The clinical phenomenology of presenile dementia. A critical review of the literature.

The more recent literature addressing the clinical phenomenology of presenile dementia is reviewed. This survey, spanning approximately the past 4 decades and comprising a large number of articles in scientific journals, reveals that reported epidemiological data, symptoms and signs, and results of ancillary tests often vary widely from study to study, especially as regards findings of history and of mental status and neurological examinations. There is considerable indication that diagnostic specificity in presenile dementia in the absence of pathological examination of the brain by tissue biopsy or at autopsy may not be as reliable as is generally thought to be the case. The observed problems with interstudy agreement are discussed and are seen to be due in large measure to methodological inconsistency and nonuniformity. Areas of difficulties in methods are identified and guidelines for subsequent, needed clinical studies are suggested.

Age Factors↗

Routine thoracic radiography for psychiatric inpatients.

Screening chest x-rays are routinely obtained for psychiatric as well as other patients. The authors present data that suggest that this practice no longer has a sound medical basis and should be eliminated or modified. It is unlikely that routine radiography of the chest is of practical benefit to adult psychiatric patients who are clinically healthy and are under age 40.

Adolescent↗

Bipolar affective disorder in aged patients.

Bipolar affective illness may be a relatively common missed diagnosis in the elderly. Inaccurate historical data, atypical course of illness and atypical clinical presentation are all sources of diagnostic error. Lithium and tricyclic antidepressants are effective agents in this age group but require close monitoring, with particular attention to their interaction with illness and other medications. A high index of suspicion for bipolar illness is suggested when elderly patients present with depression.

Age Factors↗

Diagnostic delay in presenile dementia.

In a retrospective study, patients with presenile dementia and histories of symptoms of depressive illness and of antecedent diagnosis of depressive disorder were found to have significantly longer intervals from initial physician contact to final diagnosis than patients without such histories. Patients with histories of psychiatric treatment prior to final diagnosis also had longer intervals, with differences approaching statistical significance. In contrast, intervals from symptom onset to first physician contact were noted to be shorter for those patients with these antecedent histories. A discussion of these results, a review of the relevant literature and an illustrative case report are presented.

Adjustment Disorders↗

Occult presenile dementia.

The medical records of 50 patients with a diagnosis of presenile dementia supported by radiological evidence of cerebral atrophy were examined for antecedent manifestations of depressive illness. Symptoms consistent with major affective disorder were present in one half and depressive spectrum diagnoses were made in one fourth of the cases prior to final diagnosis. A history of psychiatric treatment was common and was significantly more frequent in females than males, suggesting the possibility of sex-related bias. The findings demonstrate that presenile dementia is often occult, masked by superimposed symptoms and signs of depressive disorder.

Affective Symptoms↗

Use of problem-oriented medical record in psychiatry: a survey of university-based residency training programs.

A survey of university-based psychiatric residency training programs revealed that nearly one-half of them use the problem-oriented medical record (POMR) and that conversion to this system appears to be growing rapidly. Experiences with the method have in general been positive. The author identifies factors associated with successful operation of the POMR and suggests that an integrated, hospital-wide adoption of the system may be crucial.

Hospitals, University↗