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Biomedical subjects

E R Gardner

Publications and source records attributed to E R Gardner.

25 records · Page 2Linked to original sources
PubMed1980

Physical illness manifesting as psychiatric disease. II. Analysis of a state hospital inpatient population.

One hundred patients of lower socioeconomic class were intensively evaluated medically on a research ward for the presence of unrecognized medical illnesses that might have affected their hospitalization. Forty-six percent were thought to have medical illnesses that directly caused or greatly exacerbated their symptoms and were consequently responsible for their admission, while an additional 34% of patients were found to be suffering from a medical illness requiring treatment. A diagnostic battery of physical, psychiatric, and neurologic examinations, coupled with a 34-panel automated blood analysis, complete blood cell count, urinanalysis, ECG, and sleep-deprived EEG established the presence and nature of more than 90% of the illnesses detected, and is therefore recommended as an initial evaluation battery, particularly for patients facing involuntary commitment to a mental hospital.

Adolescent↗
PubMed1979

Presentation of the steroid psychoses.

This study suggests that patients receiving daily doses of 40 mg of prednisone or its equivalent, are at greater risk for developing steroid psychosis. Psychotic reactions were twice as likely to occur during the first 5 days of treatment as subsequently. Premorbid personality, history of previous psychiatric disorder, and a history of previous steroid psychosis did not clearly increase the patient's risk of developing psychotic reaction during any given course of therapy. Steroid psychoses present as spectrum psychoses with symptoms ranging from affective through schizophreniform to those of an organic brain syndrome. No characteristic stable presentation was observed in these 14 cases reported here. The most prominent symptom constellation to appear some time during the course of the illness consisted of emotional lability, anxiety, distractibility, pressured speech, sensory flooding, insomnia, depression, perplexity, agitation, auditory and visual hallucinations, intermittent memory impairment, mutism, disturbances of body image, delusions, apathy, and hypomania. Phenothiazines administered in average daily doses of 212 mg produced excellent response in all patients studied. Of particular note was the fact that tricyclic antidepressants produced an exacerbation or worsening of the clinical state in all patients to whom they were administered.

Adrenal Cortex Hormones↗
PubMed1978

Covert outpatient drug abuse. Incidence and therapist recognition.

One hundred ninety-five consecutive psychiatric outpatients were surveyed for covert drug abuse by a standardized technique for determining opiates, cocaine, barbiturates, and amphetamines in urine samples. On the basis of demographic variables, diagnostic information, and treatment course, patterns of abuse were defined for the 13.3 per cent with positive test results. Covert abusers demonstrated a higher incidence of adverse drug reactions and a less favorable therapy course than controls. Covert abuse was meaningfuly related to misdiagnosis, management problems, and therapist's response. Demographic variables and patient reports of previous abuse were not found to be reliable predicators of covert drug abuse. Urine screening for drug use is recommended as an aid to proper diagnosis of psychiatric outpatients that present diagnostic questions.

Adolescent↗
PubMedDate not supplied

Psychological aspects of long-term home hyperalimentation.

Ten patients (24--66 yr), maintained on ambulatory home intravenous hyperalimentation (HIVH) for 1/2--3 1/4 years, have undergone psychological evaluation. Acceptance of oral deprivation and the inconveniences, restraints, and risks of long-term or life-long HIVH, and the mechanisms for coping with these stresses, varied among this group. At times, the fear related to the HIVH apparatus and its function assumed almost delusional proportions; at other times, the patients acted indifferently or even irresponsibly toward the management of their life-sustaining system. These patients had to cope with public inquisitiveness as well as their own self-consciousness in public. Stress seemed to be related to the patient's prognosis, not only regarding recovery from the primary pathologic process, but also his/her prospects for return of normal gastrointestinal function. Stress reactions also varied among the spouses and families of the patients, and the quality of their psychological support appeared to affect the patient's mental, physical, and social wellbeing significantly. An entirely new spectrum of psychologic and social problems have emerged to challenge the IVH team who successfully manage patients unable to sustain themselves nutritionally. It is imperative that we recognize, prevent, ameliorate, and treat these problems with the same degree of enthusiasm and competence with which we nourish the patients.

Activities of Daily Living↗