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G M de Moore

Publications and source records attributed to G M de Moore.

11 recordsLinked to original sources
PubMed2004

Cannabinoid hyperemesis: cyclical hyperemesis in association with chronic cannabis abuse.

BACKGROUND AND AIMS: To explore the association between chronic cannabis abuse and a cyclical vomiting illness that presented in a series of cases in South Australia. METHODS: Nineteen patients were identified with chronic cannabis abuse and a cyclical vomiting illness. For legal and ethical reasons, all patients were counselled to cease all cannabis abuse. Follow up was provided with serial urine drug screen analysis and regular clinical consultation to chart the clinical course. Of the 19 patients, five refused consent and were lost to follow up and five were excluded on the basis of confounders. The remaining nine cases are presented here and compared with a published case of psychogenic vomiting. RESULTS: In all cases, including the published case, chronic cannabis abuse predated the onset of the cyclical vomiting illness. Cessation of cannabis abuse led to cessation of the cyclical vomiting illness in seven cases. Three cases, including the published case, did not abstain and continued to have recurrent episodes of vomiting. Three cases rechallenged themselves after a period of abstinence and suffered a return to illness. Two of these cases abstained again, and became and remain well. The third case did not and remains ill. A novel finding was that nine of the 10 patients, including the previously published case, displayed an abnormal washing behaviour during episodes of active illness. CONCLUSIONS: We conclude that chronic cannabis abuse was the cause of the cyclical vomiting illness in all cases, including the previously described case of psychogenic vomiting.

Adolescent↗
PubMed1999

Suicide attempts by firearms and by leaping from heights: a comparative study of survivors.

OBJECTIVE: The purpose of this study was to compare the clinical and demographic profiles of patients who deliberately harmed themselves, either by jumping from a great height or by using firearms, and survived. METHOD: The study consisted of an 18-year retrospective case history analysis of survivors of jumping and shooting identified from the database of consultation-liaison psychiatry referrals at a hospital in Sydney, Australia. Clinical and demographic information was collated and analyzed. RESULTS: Fifty-one patients who had shot themselves and 31 patients who had jumped, all of whom had survived, were assessed by the consultation-liaison psychiatry team. There were clear differences between the two groups. Those who jumped were more likely to be single, unemployed, and psychotic. Those who used firearms were more likely to be male, abuse alcohol, have a forensic history, and have an antisocial or borderline personality disorder. CONCLUSIONS: In this study, the subjects who attempted suicide by shooting themselves and those who did so by jumping had different profiles of mental state, personality function, and psychiatric diagnosis. The importance of mental state and specific psychiatric diagnosis as determinants of the method used has been neglected in studies of suicide. These factors should be considered along with others such as accessibility and acceptability of means, since these differences may be important when suicide prevention is considered. It is also important for psychiatrists providing consultation-liaison services to be aware of these differences in order to ensure optimal treatment of survivors.

Adult↗
PubMed1999

Antidepressant treatment of depression in HIV-seropositive women.

BACKGROUND: This study aimed to assess the effectiveness of fluoxetine and sertraline in treating depressed women who are seropositive for the human immunodeficiency virus (HIV) and to document barriers to study participation. METHOD: Ambulatory HIV-seropositive women with DSM-IV depressive disorders were enrolled in an 8-week, open trial of fluoxetine (N = 21) or sertraline (N = 9) initiated at standard dosages. Outcome measures included the Clinical Global Impressions-Improvement scale (CGI), Hamilton Rating Scale for Depression (HAM-D), Beck Depression Inventory (BDI), physical function ratings, and CD4 count. RESULTS: Thirty-six women were screened for the study and 30 were enrolled. Mean age was 35.5 years and HIV risk was primarily intravenous drug use (N = 16; 53%) or heterosexual contact (N = 12; 40%). Sixteen (53%) were Hispanic, 11 (37%) were African American, and 3 (10%) were white. Mean +/- SD CD4 count was 463+/-312 cells/microL, and 30% had acquired immunodeficiency syndrome (AIDS). Eighteen women (60%) completed the trial (14 fluoxetine: dose range, 10-40 mg/day; 4 sertraline: dose range, 25-100 mg/day). Of completers, 14 (78%) were clinical responders by CGI and reduction in HAM-D > 50%. Statistically significant reductions were seen in HAM-D and BDI scores, but not in measures of physical function or CD4 count. The most frequent adverse effects were anxiety, overstimulation, and insomnia. Reasons for nonparticipation or dropout included refusal to accept antidepressants on account of negative bias, preferring psychotherapy alone, adverse effects, and relapse to illicit drugs. CONCLUSION: While HIV-seropositive women may benefit from antidepressant treatment, multiple barriers to successful treatment exist. Aggressive outreach, education, and attention to the complex psychosocial needs of HIV-seropositive women are essential components of depression treatment in this population.

Ambulatory Care↗
PubMed1998

Delirium in hospital: does it increase length of stay?

OBJECTIVE: To determine the effect of delirium, as a comorbid diagnosis in hospitalised patients, on patient length of stay (LOS). METHOD: Prospective study comparing LOS of delirious patients with controls matched by age, gender, principal diagnosis and date of admission. Medical and surgical inpatients of Westmead Hospital with delirium were identified from a Consultation Liaison (CL) psychiatry database and were matched with controls from the hospital medical records. RESULTS: Delirious patient LOS was found to be significantly longer (2.2-fold; 95% confidence interval 1.5-3.3) than matched controls. CONCLUSIONS: Delirium, as a comorbid diagnosis in general hospital patients, is associated with an increased use of resources. Its early diagnosis may limit this and morbidity.

Adolescent↗
PubMed1996

Psychogenic vomiting complicated by marijuana abuse and spontaneous pneumomediastinum.

OBJECTIVE: This case illustrates an unusual physical sequel of psychogenic vomiting. CLINICAL PICTURE: A 22-year-old man with a picture of psychogenic vomiting and marijuana use developed the complications of a pneumomediastinum and subcutaneous emphysema. TREATMENT: Therapy included gradual exposure to anxiety provoking stimuli, psychotropics to reduce vomiting and psychotherapeutic exploration of family relationships. OUTCOME: The patient's vomiting and physical state resolved without complication. Follow-up at 12 months revealed continued improvement with occasional less severe vomiting. CONCLUSIONS: Psychogenic vomiting as a manifestation of anxiety can result in serious physical and psychological sequelae. This patient's desperate attempts to control such vomiting complicated the picture. Successful short term intervention included the use of several treatment modalities.

Adult↗
PubMed1994

Survivors of self-inflicted firearm injury. A liaison psychiatry perspective.

OBJECTIVE: To examine the clinical profile and, in particular, the psychopathology of 33 survivors of self-inflicted firearm injury. DESIGN: An eight-year retrospective case history analysis. Information was obtained from databases in the Psychiatry, Trauma and Medical Records departments of Westmead Hospital. RESULTS: In the sample most survivors of self-shooting were young men who did not suffer from major depression or psychosis. Most shootings occurred in the context of interpersonal disputes with sexual partners or family members. CONCLUSIONS: Most patients who survive self-inflicted firearm injuries have shot themselves impulsively in a crisis, are not psychotic, and have ready access to firearms. Psychiatric care is usually given in the trauma ward. Close cooperation is required between psychiatric and surgical teams in management. Recommendations to assist in the more accurate assessment of patients with self-inflicted firearm injury include: careful scrutiny of alleged accidental shootings; the inclusion of police information in the assessment; routine drug screening and determination of blood alcohol level; repeated interviews and corroboration of patient claims by family and friends; and psychiatric review of all patients with self-inflicted injury.

Adolescent↗
PubMedDate not supplied

The suicide of Thomas Wentworth Wills.

Thomas Wentworth Wills was the most important Australian sportsman of his time. He captained the Victorian colony at cricket and was the first hero of Australian Rules football. Although his picture now adorns the conservative Melbourne Cricket Club, he died in 1880, an isolated, destitute alcoholic, after stabbing himself in the heart. Wills embodied a tradition, as prevalent today as it was over 100 years ago, that weds sport with alcohol in Australian culture.

Alcoholism↗