Biomedical subjects

E Rockwell

Publications and source records attributed to E Rockwell.

22 records · Page 2Linked to original sources

PubMedDate not supplied

Adverse neurobiological effects of long-term use of neuroleptics: human and animal studies.

Neuroleptics have revolutionized the treatment of schizophrenia and other psychoses since the early 1950s. Several adverse neurobiological effects are, however, associated with the long-term use of these agents. This article will review human and animal studies of these adverse effects, and also present some new data. Tardive dyskinesia (TD) is the most widely studied potentially persistent movement disorder resulting from long-term neuroleptic treatment, and several risk factors for TD development have been identified. Although drug-induced parkinsonism (DIP) usually disappears after the offending agent is withdrawn, a small portion of patients may have persistent parkinsonism. It is however, unclear if this is an aging-related effect. Persistent cognitive impairment associated with long-term use of typical neuroleptics has not been well documented. Atypical antipsychotics may produce improvement in cognitive performance in patients with chronic schizophrenia. MRI changes that are secondary to neuroleptics are possible, but have not yet been studied adequately. There is one unconfirmed report of neurofibrillary tangles associated with long-term neuroleptic use. A number of investigators have reported vacuous chewing movements, and neuropathologic changes following prolonged administration of neuroleptics in animals. We discuss the implications of the various reported adverse effects of long-term use of neuroleptics.

Aged↗

PubMedDate not supplied

Late-onset psychosis with somatic delusions.

The authors studied 10 patients who had late-onset psychosis with somatic delusions and 2 comparison groups similar in age and education: 9 late-onset psychosis patients without somatic delusions and 10 normal control subjects. Demographic, clinical, and neuropsychological data were obtained. Brain magnetic resonance imaging was also done and compared. The patients with somatic delusions were somewhat more likely to be women, have been ill longer, and meet DSM-III-R criteria for delusional disorder, compared with late-onset psychotic patients without somatic delusions. Patients with somatic delusions also had lower scores on a full-scale IQ test, compared with the normal comparison subjects. The patients with somatic delusions rarely benefitted from and poorly complied with treatment with psychotropics. The study's limitations, such as small sample size and heterogeneity of diagnosis, as well as the possible clinical implications of these findings are also discussed.

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PubMedDate not supplied

Changes in psychiatric diagnoses from admission to discharge: review of the charts of 159 patients consecutively admitted to a geriatric psychiatry inpatient unit.

The diagnosis of psychopathology among geriatric acute inpatients requires comprehensive evaluation. To our knowledge, no recently published papers in the geriatric psychiatry literature have systematically examined diagnostic changes during single admissions. We reviewed the charts of 159 patients consecutively admitted to an acute geriatric psychiatry unit over 18 months. We recorded admission diagnoses from initial treatment plans, and discharge diagnoses from discharge summaries. Mean patient age was 80 years and average length of stay was 17 days. The most common primary diagnoses were psychotic and depressive disorders. The most common secondary diagnoses were dementias and depressive disorders. Primary diagnoses changed from admission to discharge in 31 patients (20%), and secondary diagnoses changed in 76 patients (48%). There was a significant change involving the diagnosis of dementia, but not that of depressive or psychotic disorders. A large proportion of inpatients had their diagnoses altered, especially those involving dementias, during hospitalization. Inpatient admission may be valuable for clarifying the diagnoses of elderly psychiatric patients.

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PubMedDate not supplied

Preexisting psychiatric disorders in burn patients.

The authors studied 51 of 56 consecutive eligible patients admitted to a burn unit. Sixty-nine percent of the patients had a preburn psychiatric diagnosis. Depression alone was present in more than half the sample. Few burns were strictly accidental; 68% involved some degree of complicity on the victim's part, but intentional burns were rare. Patients with depression were more likely to sustain their burns in a setting of risk-enhancing behavior.

Adult↗