[The normal brain: a new knowledge in different fields].
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Brain↗
Biomedical subjects
E L Mortensen
Publications and source records attributed to E L Mortensen.
Coping strategies among the long-term mentally ill: categorization and clinical determinants.
The aim of this study was to explore strategies for coping with symptoms in 98 long-term mentally ill patients. The following characteristics of the strategies were investigated: level, effectiveness, target symptom and problem orientation. In addition, we studied the association between measures of coping and psychopathology. An average of 3.8 coping strategies per patient was reported, and strategies involving behavioural change were most common (48%), followed by changes in socialization (24%) and in cognitive control (15%). Coping efforts were most commonly directed towards non-psychotic symptoms. A high load of general and affective symptoms, few negative symptoms and a high level of illness awareness predicted the total number of coping strategies. Separate analysis of active and passive strategies, including increased and decreased socialization, respectively, revealed very different patterns of clinical predictors. These results are discussed with reference to community-care programmes.
Activities of Daily Living↗
[Delayed effects of prenatal exposure to phenobarbital on intelligence--Phenemal].
Two double-blind studies were conducted on two independent samples of adult men prenatally exposed to phenobarbital and matched control samples using two different measures of general intelligence (WAIS and a draft board test (BPP)). The two studies included 33 and 81 exposed adult men respectively, and the two control groups included 52 and 101 unexposed men matched on a wide spectrum of maternal variables recorded pre- and perinatally. Based on data from control subjects, regression models were built relating intelligence scores to relevant pre-exposure matching variables. Models generated predicted scores for each exposed subject. Men exposed prenatally to phenobarbital had significantly lower verbal intelligence scores than predicted. Lower socioeconomic status and being the offspring of an unwanted pregnancy increased the magnitude of the negative effects. Exposure which includes the last trimester was the most detrimental. Physicians are urged to use increased caution in prescribing such medications during pregnancy or to premature neonates.
Adult↗
Aggression and personality: association with amino acids and monoamine metabolites.
Associations in 52 normal individuals were examined between plasma and cerebrospinal fluid (CSF) concentrations of tryptophan (Trp) and tyrosine, and concentrations of monoamine metabolites in the CSF, and scores on an aggression questionnaire, the Kinsey Institute Reaction List II, and the Eysenck Personality Questionnaire. There was a significantly positive correlation between CSF 5-hydroxyindoleacetic acid (5-HIAA) levels and extroverted aggression scores, and a significantly negative correlation between CSF 5-HIAA levels and introverted aggression scores. Males showed higher plasma Trp concentrations than females, and significantly positive correlations between plasma Trp concentrations and scores on extroverted aggression and the Eysenck E scale. Males, furthermore, showed a significantly negative correlation between CSF Trp levels and scores on the Eysenck P scale, and a significantly positive correlation between concentrations of 3-methoxy-4-hydroxy-phenylglycol in CSF and scores on moral aggression. These results suggest that central serotonin influences aggression in normal individuals through effects on personality.
Adult↗
Psychometric properties of the Danish 16PF and EPQ.
A Danish translation of the Cattell's 16PF has been used in studies evaluating the effects of prenatal drug exposure. This paper reports a psychometric analysis of the 16PF and Eysenck's EPQ based on a sample of 558 young Danes. Many 16PF scales had unacceptable psychometric properties (as indicated by coefficient alpha and item--total score correlations), but more satisfactory results were obtained with the EPQ N and E scales. A factor analysis of all 16PF and EPQ scales suggested a six factor solution that roughly corresponds to the second-order factor structure obtained by Krug and Johns (1986). It is concluded that the second-order factor structure should be the basis of interpretation of the 16PF in both practical and research contexts.
Adult↗
In utero exposure to phenobarbital and intelligence deficits in adult men.
OBJECTIVE: To test whether exposure to phenobarbital in utero is associated with deficits in intelligence scores in adult men and whether the magnitude of the postnatal effect is mediated by exposure parameters and/or postnatal environmental factors. DESIGN: Two double-blind studies were conducted on independent samples of adult men prenatally exposed to phenobarbital and matched control samples using different measures of general intelligence. Based on data from control subjects, regression models were built relating intelligence scores to relevant pre-exposure matching variables and age at testing. Models generated predicted scores for each exposed subject. Group mean differences between the individually predicted and observed scores estimated exposure effects. SETTING: Copenhagen, Denmark. PARTICIPANTS: Exposed subjects were adult men born at the largest hospital in Copenhagen between 1959 and 1961 who were exposed to phenobarbital during gestation via maternal medical treatment and whose mothers had no history of a central nervous system disorder and no treatment during pregnancy with any other psychopharmacological drug. Study 1 included 33 men and study 2, 81 men. Controls were unexposed members of the same birth cohort matched on a wide spectrum of maternal variables recorded prenatally and perinatally. Controls for studies 1 and 2 included 52 and 101 men, respectively. MAIN OUTCOME MEASURES: In study 1: Wechsler Adult Intelligence Scale (Danish version); in study 2: Danish Military Draft Board Intelligence Test (Børge Priens Prøve). RESULT: Men exposed prenatally to phenobarbital had significantly lower verbal intelligence scores (approximately 0.5 SD) than predicted. Lower socioeconomic status and being the offspring of an "unwanted" pregnancy increased the magnitude of the negative effects. Exposure that included the last trimester was the most detrimental. CONCLUSION: Phenobarbital exposure during early development can have long-term deleterious effects on cognitive performance. Detrimental environmental conditions can interact with prenatal biological insult to magnify negative outcomes. Physicians are urged to use increased caution in prescribing such medications during pregnancy.
Adult↗
[Symptoms of depression in cancer patients undergoing chemotherapy].
Symptoms of depression and anxiety were measured in a prospective follow-up study of 36 cancer patients before and during chemotherapy by means of the Hamilton rating scales and the Melancholia Scale. These scales proved useful in the examined population. Moderate or severe depression was seen in almost half of the patients before chemotherapy, but this figure decreased during follow-up. The symptomatology resembled that of primary depression, and the brief rating scales for depression seemed suitable for screening purpose. Problems in identifying morbid states of anxiety and depression are discussed.
Adult↗
Depressive symptoms in cancer patients undergoing chemotherapy: a psychometric analysis.
Depressive psychopathology was measured in a prospective follow-up study of 36 cancer patients. The psychometric properties of the Hamilton rating scales for depression and anxiety and the Melancholia Scale were examined. The scales proved useful, indicating that the symptomatic structure of depression in cancer patients is rather identical to that seen in primary depression. Depressive states were found in about 40% of patients before the start of chemotherapy. The frequency of intermediate and high scores on the depression scales showed a low to moderate decrease after 6 months. Aspects of depression in the medically ill are discussed, and screening routines suggested.
Adaptation, Psychological↗
The interrelationship of weight loss, dietary intake, and quality of life in ambulatory patients with cancer of the lung, breast, and ovary.
One hundred four consecutive patients with newly diagnosed small cell lung cancer, metastatic breast cancer, and ovarian cancer in good physical functional condition (performance rating 0-1 on Eastern Cooperative Oncology Group scale) were divided into a weight-losing group (> or = 5% unintentional weight loss within 3 mo; n = 48) and a weight-stable group (n = 56). Dietary intakes in relation to fat-free mass were not different in the two groups. According to the Quality of Life index and the General Health Questionnaire, weight-losing patients had significantly lower quality of life than weight-stable patients. In patients with weight loss, daily intakes of energy and protein correlated significantly with scores on the General Health Questionnaire. This study has shown that many ambulatory cancer patients do not eat enough to maintain weight and that even a moderate weight loss is associated with psychological distress and lower quality of life.
Adult↗
The Prenatal Development Project.
The primary aim of the Prenatal Development Project (PDP) is to evaluate the developmental effects of prenatal exposure to steroid hormones and psychoactive drugs, particularly synthetic progestin, corticosteroids and barbiturates. Data collection has taken place at the Psykologisk Institut, now the Institute of Preventive Medicine, since 1981. The PDP database is unique for its breadth and depth as well as its combination of prospective longitudinal and cross-sectional perspectives. This article describes the database, including subject selection, perinatal information, the comprehensive contemporary evaluation and archival information from Danish registers. The unique matching procedures designed specifically for these projects and data analytic strategies are explained. The value of the PDP database is discussed both in relation to specific project aims (evaluating effects of prenatal drug exposure) and in relation to developmental and psychological research in general.
Adult↗
Effect of dietary counseling on food intake, body weight, response rate, survival, and quality of life in cancer patients undergoing chemotherapy: a prospective, randomized study.
PURPOSE: This study examined the effect of frequent nutritional counseling on oral intake, body weight, response rate, survival, and quality of life in patients with cancer of the lung (small-cell), ovary, or breast undergoing cyclic chemotherapy. PATIENTS AND METHODS: Of 105 assessable patients, 57 were randomized to receive nutritional counseling, and 48 to receive no nutritional counseling and consumption of an ad lib oral intake. The intervention group was counseled to achieve a daily energy and protein intake according to recommended dietary allowances. Counseling was standardized and performed by a trained dietitian, and took place twice monthly during a 5-month period from start of chemotherapy. RESULTS: Dietary counseling increased daily energy intake by approximately 1 MJ and protein intake by 10 g over the entire study period. There was no change in the control group. Counseling led to an insignificant increase in body weight, but triceps skinfold measurement increased significantly after 5 months. Response rate and overall survival did not differ between the groups. Quality of life measured by the Quality-of-Life index (QL-index) increased significantly in both groups, but did not differ between groups. CONCLUSION: No clinical benefit could be demonstrated despite long-term and continuous improved food intake in cancer patients with solid tumors undergoing aggressive chemotherapy.
Adult↗
Linear versus normalized T scores as standardized neuropsychological test scores.
In this paper we present and discuss standardized T score systems for neuropsychological test data. Both linear and normalized T scores were calculated for 141 normal subjects and a group of 141 patients with diffuse or focal brain damage. Many standard neuropsychological tests have skewed raw score and linear T score distributions, and we argue that normalized T scores have practical advantages because they permit simple descriptions of both patient groups and individual test score distributions. We also argue that skewness can be partially explained by ceiling effects and other test construction artefacts and that skewed raw score distributions do not necessarily reflect skewed distributions of the underlying mental abilities. Consequently, use of normalized T scores seems appropriate in many research and clinical contexts.
Adult↗
A critical note on Lezak's 'best performance method' in clinical neuropsychology.
A fundamental problem in clinical neuropsychology is the estimation of premorbid levels of cognitive functioning. Lezak (1983) described the so-called 'best performance method' of estimating premorbid abilities. Essentially, this method consists in using the highest test scores or the best performance in everyday tasks as the best estimate of premorbid ability. This paper describes three studies of the empirical consequences of using the 'best performance method': The first study demonstrates that application of this method on WAIS subtests leads to a gross overestimation of intelligence as measured by the IQ. The second study corroborates this finding and also shows that overestimation of intelligence leads to systematic errors in the expected performance in neuropsychological tests in normal subjects. Finally, the third study shows that this is also the case in patients with diffuse cerebral atrophy.
Adult↗
Temporal gradient in the remote memory impairment of amnesic patients with lesions in the basal forebrain.
Recall and recognition of premorbid public events were studied in four groups of subjects. Dementia patients showed equal losses from all time periods compared to normal controls. In contrast, two groups of amnesic patients showed extensive remote memory losses, which were most marked for the last few years prior to onset. The difference between recall and recognition was similar in the groups. The results indicate that the retrograde amnesia associated with aneurysms of the anterior communicating artery cannot be distinguished from that of amnesia with other etiologies. Implications of the finding of a temporal gradient in the retrograde amnesia of non-alcoholic amnesics are discussed.
Adult↗
Psychometric properties of the Danish MCMI-I translation.
A translation of the MCMI-I has been in use in Denmark for some years. An untested assumption in the interpretation of the pattern of test results is that the psychometric characteristics of the Danish and American versions are similar. The purpose of this study was to evaluate the psychometric properties of the questionnaire by using traditional psychometric analysis techniques on the results of a sample consisting of 423 patients and 179 normal controls. Coefficient alpha was calculated for the 20 clinical subscales of the test and the Danish results were strikingly similar to the original coefficients reported by Millon. Furthermore, factor analysis of the subscales showed a factor structure very similar to American findings, and it is concluded that the psychometric properties of the Danish MCMI are not significantly different from the original.
Adolescent↗
Mixed solvent exposure and organic damage: the missing table.
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Humans↗
"Chronic painter's syndrome". A reanalysis of psychological test data in a group of diagnosed cases, based on comparisons with matched controls.
Twenty solvent-exposed workers, most of them painters, had been diagnosed as cases of toxic encephalopathy in 1978/79. Two years later they were re-examined with an extensive battery of neuropsychological tests. Their performance was unchanged on retesting. We have now compared their test results with those of non-exposed control subjects. Previous impressions of significant intellectual impairment in the solvent-exposed patients could not be confirmed when the influence of age, education, and intelligence was taken into consideration. The present group with presumed toxic encephalopathy is assumed to be representative of other patients who were similarly diagnosed in our department. The presently reanalyzed cases had been diagnosed as brain damaged and reported as such in the literature. Thus, they may have contributed to the formation of the concept of the "chronic painters' syndrome" with dementia.
Adult↗
Conservatively treated patients with cerebral arteriovenous malformation: mental and physical outcome.
Twenty five patients with conservatively treated cerebral arteriovenous malformation were followed up for a mean of 10.6 years after diagnosis. The follow up included neuropsychological examination. Bleeding did not occur after the time of diagnosis. Three patients had moderate to severe neurological deficits, five had moderate to severe intellectual impairment. Nineteen had an unaffected occupational status. It is concluded that the outcome in conservatively treated patients may be no worse than in surgically treated patients.
Adolescent↗