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Biomedical subjects

F J Kane

Publications and source records attributed to F J Kane.

At least 19 recordsLinked to original sources
PubMed1993

Nonulcer dyspepsia associated with psychiatric disorder.

Studies of dyspepsia show a 1% to 2% prevalence in adults, and 25% to 40% of these patients do not have a physical reason for their symptoms. These findings prompted us to do a retrospective follow-up study of 390 patients having motility studies for chest pain and gastrointestinal (GI) symptoms; 278 (71%) responded. Patients were asked to complete a self-rating symptom questionnaire regarding current GI symptoms and current symptoms of anxiety, panic, and depression; they were also asked to complete the Brief Symptom Inventory. Two groups were compared--those with known heart disease and those without heart disease. Substantial numbers of patients in both groups satisfied criteria for generalized anxiety disorders (> 70%), panic disorder (> 30%), and major depression (> 35%). GI symptoms compatible with nonulcer dyspepsia were strongly associated with a psychiatric diagnosis. Our data suggest that anxiety and depressive states are strongly associated with dyspepsia and other GI symptoms not caused by ulcer disease.

Anxiety Disorders↗
PubMed1993

Recognizing and treating delirium in patients admitted to general hospitals.

We report a retrospective study of 59 patients for whom our university hospital nursing service had required the use of lay sitters because of the need for constant observation. Of 54 charts examined, 28 noted a need for psychiatric consultation, mostly because of delirious states. Quality of care deficits discerned included (1) inadequate pharmacotherapy of alcoholic and nonalcoholic delirium, (2) inadequate search for treatable causes of delirium (thyroid, B12, and folate deficiencies), (3) insufficient awareness of persistent cognitive deficits, which influence the patient's ability to care for himself or give informed consent. The knowledge and skills deficits we found are not unique to this hospital and reflect the failure of most graduate programs to reinforce basic psychiatric teaching. The quality of care issues indicate that more serious consideration should be given to providing necessary psychiatric training.

Adult↗
PubMed1992

Psychotherapy: past training and current practice.

Our 1988 survey of Texas psychiatrists indicates that hospital work is more common, and long-term psychotherapy less common than it had been in the 1982 APA survey. Almost 85% reported long-term psychotherapy experience as residents. Thirty-nine percent reported multiple patients treated for approximately 2 years. Use of audio techniques by resident and teacher in the post-1970-trained group predicted current long-term therapy activity as did an experience of personal therapy and seeing a patient at least twice weekly in training. Concurrent drug use is widely reported for long-term psychotherapy patients and to a lesser degree in psychoanalysis. Our data suggest a shift to increased hospital work and decreased long-term psychotherapy.

Attitude of Health Personnel↗
PubMed1991

Noncardiac chest pain in patients with heart disease.

This is a retrospective study of cardiac patients with noncardiac chest pain referred for evaluation of esophageal motility. Sixty-eight patients with heart disease were compared with 210 patients without heart disease according to findings from symptom questionnaires and a psychologic test (Brief Symptom Inventory). More than 70% of each group qualified for an anxiety or depressive diagnosis on the symptom questionnaire. These diagnoses were supported by significant elevations of scores on the anxiety and depression scales of the Brief Symptom Inventory. Male gender and a diagnosis of panic disorder occurred significantly more often in the patients with heart disease. "Stress" was cited as the cause of illness in about half the sample, but this led to less than satisfactory rates of psychiatric evaluation or pharmacotherapy. This is of particular concern for the cardiac patients because of the known adverse effect of anxiety and depression in those with heart disease.

Adolescent↗
PubMed1990

Chest pain and anxiety disorder.

Chest pain is a common clinical expression of coronary artery disease. Less well known is that chest pain is far more frequently a somatic expression of inner stress. This study reports on data gathered from all patients with completely normal angiograms studied in the Catheterization Laboratory of The Methodist Hospital in the years 1984 and 1985. Questionnaires were sent to 570 patients, and there were 371 replies. Of those who replied, 26% qualified for a diagnosis of "generalized anxiety disorder" only, while an additional 43% qualified for a diagnosis of "panic attacks" or "panic disorder." Stress was frequently diagnosed, but seldom treated. This article includes suggestions about identification of these disorders and their treatment.

Anxiety Disorders↗
PubMed1988

Angina as a symptom of psychiatric illness.

We retrospectively studied all patients who had normal coronary angiograms at The Methodist Hospital during the year 1984 (8% of all angiograms). Patients were surveyed eight to 18 months after angiography. Of the 216 patients (83% of total sample), 130 were female and 86 male. Sixty-three percent of the women and 50% of the men satisfied the criteria for generalized anxiety disorder, and 20% satisfied the criteria for panic attacks. On the Brief Symptom Inventory (BSI) Somatization Scale, 64% had scores above the average reported for psychiatric outpatients. Eighty-one percent received only reassurance about the absence of heart disease, and 25% received continuing nitrate therapy in the absence of heart disease. A majority of these patients remain untreated functional "cardiac neurotics" with untreated anxiety symptoms. We make suggestions regarding a clinical profile to identify these patients and appropriate measures to avoid prolonged disability.

Adult↗
PubMed1976

Evaluation of emotional reactions to oral contraceptive use.

A review of available clinical studies indicates that 10 to 40 per cent of oral contraceptive users may suffer mild to moderate depression syndromes. Clinical and animal data indicate that a variety of mechanisms may be involved, including alterations in folate, pyridoxine, and vitamine B12 metabolism, as well as related effects on biogenic amine metabolism. Interactive effects may result, such as impairment of usual coping mechnisms and psychological defenses by altered central nervous system function.

Ascorbic Acid↗
PubMed1975

Mental and emotional disturbance with pentazocine (Talwin) use.

Pentazocine (Talwin) originally was believed to be a safe, nonaddictive analgesic, but further experience has shown that severe mental and emotional disturbance, as well as addiction, may occur. This survey documents the experience in the Texas Medical Center and elsewhere. The accumulated data show the following: (1) Depressive states are reported most frequently, while toxic psychoses, hallucinogenic reactions with panic, and paranoid states on withdrawal of the drug are less frequent. (2) Of the 197 cases of addiction reported to date, only six were related to oral use of the drug. The abstinence syndrome is mild, consisting usually of restlessness, nausea, cramps, and insomnia. (3) Convulsions have been reported on four occasions. Euphoria and psychotomimetic effects may relate to rapid release of noradrenaline and dopamine. Oral use of the drug is advised to avoid euphoriant effects and addiction, and physicians should alert patients to report unusual visual phenomena. Tranquilizers are of value in cases of severe reactions.

Acute Disease↗