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Biomedical subjects

E J Mikkelsen

Publications and source records attributed to E J Mikkelsen.

At least 19 recordsLinked to original sources
PubMed2001

Enuresis and encopresis: ten years of progress.

OBJECTIVE: To review the progress made over the past decade with regard to the treatment of enuresis and encopresis, as well as advances in the understanding of etiological mechanisms. METHOD: Separate computerized literature (English language only) searches of Medline and PsycINFO databases were conducted under the parameter of enuresis and children-adolescents, as well as encopresis and children-adolescents. RESULTS: There has been a substantial decrease in published research concerning the use of imipramine to treat enuresis compared with the prior two decades, accompanied by a corresponding increase in the number of papers concerning desmopressin acetate (DDAVP), which has become the primary pharmacological treatment. Genetic studies of large pedigrees have further confirmed the importance of heritable factors. With regard to encopresis, the research has focused primarily on pathophysiological factors related to the colon and anal sphincter. CONCLUSIONS: The widespread use of DDAVP has been the primary addition to treatment strategies over the past decade. The bell-and-pad method of conditioning, the only major treatment that has enduring benefit after being withdrawn, is the most cost-effective and appears to be underutilized. Research into etiological mechanisms has focused primarily on the mechanism of action of DDAVP and advances in the understanding of genetic factors. Advances in the treatment and etiological understanding of encopresis have been less impressive.

Adolescent↗
PubMed1993

Short-term family-based residential treatment: an alternative to psychiatric hospitalization for children.

A short-term treatment program designed as an alternative to psychiatric hospitalization for children and adolescents is described. The program utilizes a multidisciplinary professional team and specially trained individuals (mentors) who work with the child and the child's biological family in the context of a mentor's home. Admission, discharge, and follow-up data on a group of patients are reported.

Adolescent↗
PubMed1992

False sexual-abuse allegations by children and adolescents: contextual factors and clinical subtypes.

The authors review the empirical literature concerning the frequency of false allegations of sexual abuse as well as the case report literature that describes individual episodes of false allegations in detail. The authors then construct a clinical typology that is derived from the literature and their own clinical experience with similar cases. The specific subtypes of the typology are: (1) False allegation in the context of a custody dispute, (2) false allegations resulting from psychological disturbance on the part of the accuser, (3) false allegation as a conscious manipulation by the child or adolescent and, (4) false allegations based on iatrogenic factors. Clinical examples of each subtype are presented. The case material presented and reviewed indicates the importance of attending to the contextual factors surrounding the allegation and pursuing a detailed comprehensive evaluation that is as free of bias as possible.

Adolescent↗
PubMed1986

Beta-blockers in the severely and profoundly mentally retarded.

The authors present data from four different institutions from open clinical trials of propranolol in 19 mentally retarded patients with IQs less than 50. When customary forms of treatment had failed, propranolol was initiated. A table showing changes in the patients' behavior is included. Twelve patients demonstrated a pronounced improvement in self-abusive and aggressive behavior, four made moderate gains, and three were considered unchanged. The authors postulate that at least some aspects of the behavioral improvement were due to the peripheral anxiolytic action of the beta-blockers. Contrary to other reports of using higher doses (greater than 520 mg/day range), the authors used a mean dose of 120 mg/day and consider the duration of time spent on the medication as a crucial factor in its effectiveness.

Adrenergic beta-Antagonists↗
PubMed1982

Efficacy of neuroleptic medication in pervasive developmental disorders of childhood.

A number of studies pertaining to the use of antipsychotic medication in the treatment of pervasively disordered children are reviewed. The drugs examined are chlorpromazine, haloperidol, thioridazine, thiothixene, trifluoperazine, lithium, and other miscellaneous agents. Medication side effects are also reviewed with particular attention to extrapyramidal symptoms and tardive dyskinesia. Although methodological problems complicate the interpretation of the studies, the results support the use of antipsychotic medication in this population. The agents do not have the specificity for psychotic ideation that is seen in adult patients, but are useful for symptoms such as hyperactivity, stereotyped behavior, aggressiveness, impulsivity, self-abusive behavior, and social adaptation.

Antipsychotic Agents↗
PubMed1981

Patient viewing of videotaped psychotherapy. Part I: Impact on the therapeutic process.

A seminar for psychotherapy supervision of residents employed videotapes of interviews as the focus. When patients and therapists together reviewed the tapes, a number of therapeutically valuable results ensued including a) retelling of corrected histories and new commitment to the therapy; b) increased awareness of denied areas of experience and insight into transference, defense, hidden affects and so on; c) a variety of forms of confrontation. In addition, this report reviews indications, difficulties, problems, and failures encountered with this technique.

Adult↗
PubMed1981

School avoidance and social phobia triggered by haloperidol in patients with Tourette's disorder.

Fifteen patients with Tourette's disorder developed school and work avoidance syndromes when treated with low doses (mean 2.5 mg/day) of haloperidol for short periods of time (mean, 8 weeks). The phobic syndromes disappeared completely with discontinuation or reduction of the haloperidol dose. Haloperidol's effects on dopaminergic functioning support a role for catecholamines in the pathogenesis of phobic syndromes. It is not known whether phobias are precipitated by haloperidol only in patients with Tourette's disorder as a consequence of the specific metabolic alterations in this disorder or are a medication side effect in other psychiatric disorders as well.

Adolescent↗
PubMed1980

Dextroamphetamine. Its cognitive and behavioral effects in normal and hyperactive boys and normal men.

The effects of a single oral dose of dextroamphetamine sulfate on motor activity, vigilance, learning, and mood were compared for normal and hyperactive prepubertal boys and normal college-aged men using a double-blind crossover design. Both groups of boys and men showed decreased motor activity increased vigilance, and improvement on a learning task after taking the stimulant drug. The men reported euphoria, while the boys reported only feeling "tired# or "different# after taking the stimulant. It is not clear whether this difference in effect on mood between adults and children is due to differing experience with drugs, ability to report affect, or a true pharmacologic age-related effect. While there were some quantitative differences in drug effects on motor activity and vigilance between these different groups, stimulants appear to act similarly on normal and hyperactive children and adults.

Adolescent↗
PubMed1980

Childhood enuresis. I. Sleep patterns and psychopathology.

Forty severely enuretic boys (mean age, 10.8 years) were selected; 20 had associated psychiatric disturbance and 20 had enuresis as an isolated symptom. Psychiatrically disturbed enuretics had both slightly higher scores on a neurological examination for "soft signs" and more "stressful" background events. Enuretic events were not associated with a particular sleep stage; disturbed and nondisturbed enuretics did not differ from each other with respect to the distribution of enuretic events by sleep stage. The results do not support the concepts of enuresis as an arousal disorder or of there being different sleep profiles of enuresis in relation to behavioral pathology.

Adolescent↗
PubMed1980

Childhood enuresis. II. Psychopathology, tricyclic concentration in plasma, and antienuretic effect.

The efficacy of treatment with imipramine hydrochloride, desipramine hydrochloride, methscopolamine bromide, and placebo was compared in a study with 40 severely enuretic boys. Both tricyclic antidepressants were superior to placebo and methscopolamine, but they did not differ from each other. Psychiatric disturbance, sleep measures, and other clinical parameters did not predict antienuretic response to tricyclics nor was there a psychotropic response. Plasma concentrations of imipramine and desipramine showed a significant correlation with clinical effect. However, true nonresponders were found, and tolerance to the antienuretic drugs developed in some boys.

Child↗
PubMed1980

The Bridgewater 100: an analysis of admissions to a hospital for the criminally insane.

One hundred admissions to a hospital for the criminally insane are reviewed. Within this sample 20% were referrals from psychiatric hospitals and 30% were transferred from prison. The remainder were referred from the courts for evaluations. In 44 cases this was for an evaluation of competency to stand trial and in 6 cases the referrals were for evaluation prior to sentencing. An analysis of the subgroups and individual cases indicates that mentally ill patients are often referred to facilities for the criminally insane because the appropriate wards do not exist within the mental health system. This exposes them to a criminal population and results in negative social labelling. A large proportion of those referred from prisons have consciously manipulated their transfer in order to do "soft time". This also confers on them future advantage by virtue of being labelled more mental than criminal. The majority of those referred for competency evaluations could easily have been assessed in a non-inpatient setting. In these cases the referral appeared to be a covent request for treatment or a legal maneuver. Methods for solving these problems are briefly discussed.

Adult↗