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Biomedical subjects

G Shugar

Publications and source records attributed to G Shugar.

At least 19 recordsLinked to original sources
PubMed2000

Prevalence of obsessive-compulsive disorder in schizophrenia and significance of motor symptoms.

To investigate the differences between schizophrenic subjects with and without obsessive-compulsive disorder (OCD), the authors systematically assessed 76 schizophrenic subjects for OCD. Subjects with and without OCD were then compared with regard to motor symptoms, including catatonia, and several measures of psychopathology. Treatment strategies were evaluated retrospectively. The 12 subjects with OCD (15.8%) had more motor symptoms, including catatonia, than non-OCD schizophrenic subjects. Some differences were found with regard to psychopathological symptoms. Treatment strategies also differed in the two groups. The high prevalence of motor symptoms in these subjects supports the hypothesis of a basal ganglia-frontal lobe connection linking OCD with schizophrenia.

Adult↗
PubMed1999

[Prevalence and clinical significance of catatonic symptoms in mania].

OBJECTIVE: The study investigates the prevalence, clinical characteristics and implications of catatonic symptoms in mania. METHODS: Sixty-one in patients with DSM-III-R bipolar disorder, manic or mixed episode established by SCID were assessed for the presence of catatonia by a 21-item rating scale. Associated symptoms, comorbidity and severity of the manic episode were also systematically assessed. RESULTS: Nineteen patients fulfilled criteria for catatonic mania exhibiting between 5 and 16 catatonic symptoms. Catatonic manics had more mixed episodes, more severe manic symptoms, more general psychopathology, a higher prevalence of comorbidity, longer hospitalization and lower GAF-scores than the non-catatonics. CONCLUSIONS: The results indicate that catatonic symptoms are a marker of a more severe course and outcome in mania.

Adult↗
PubMed1998

Delusions and self-esteem.

OBJECTIVE: To investigate the hypothesis that the content of delusions and hallucinations is significantly influenced by subjects' global self-esteem and by 5 specific areas of self-esteem. METHOD: The delusions and hallucinations of 40 psychotic patients were assessed by 2 independent raters for content indicative of positive or negative self-esteem and for the extent to which the delusional content would be self-enhancing (or diminishing) and comforting (or discomforting) to the subject. These ratings were correlated with the results of self-esteem inventories completed by the subjects. RESULTS: The content of delusions reflects both global self-esteem and self-regard. CONCLUSIONS: This study demonstrates that 2 specific personality factors, global self-esteem and self-regard, are reflected in the content of delusions and influence whether those delusions are experienced as comfortable (or uncomfortable) and enhancing (or diminishing). Delusional content is therefore consistent with patients' views of themselves, and this may partially account for the persistence of delusions.

Adult↗
PubMed1996

Comparative evaluation of two self-report Mania Rating Scales.

Two brief patient-rated scales, the Internal State Scale (ISS) and the Self-Report Manic Inventory (SRMI), have been shown to reliably diagnose mania. In the current study we further evaluated the utility of these scales relative to each other and to the observer-rated Young Mania Rating Scale (YMRS), for quantifying the severity of manic/hypomanic symptoms cross-sectionally and over time, in 20 patients with rapid-cycling bipolar disorder. The self-report scales correlated well with each other and with the YMRS, but each covered a somewhat different domain of the manic syndrome. The SRMI and the ISS were more sensitive than the YMRS to the mood fluctuations in the euthymic to hypomanic range observed in our subjects. Used in tandem, the two self-report scales may find application in clinical research with outpatients with bipolar disorder, and as an adjunct to clinical monitoring in this patient population.

Bipolar Disorder↗
PubMed1996

Comorbidity of binge eating disorder and the partial binge eating syndrome with bipolar disorder.

OBJECTIVE: The authors examined the prevalence of binge eating disorder (BED), partial binge eating syndrome, and night binge eating syndrome in subjects with bipolar disorder (BD). METHOD: Sixty-one subjects in whom BD was established using DSM-III-R criteria received a semistructured clinical interview including a detailed description of binge eating behavior and of night binge eating. Frequencies were compared to prevalence estimates in community samples. RESULTS: Eight subjects (13%) met DSM-IV criteria for the diagnosis of BED. An additional 15 subjects (25%) exhibited a partial binge eating syndrome. These two otherwise identical groups of binge eaters were separated only by the DSM-IV frequency criterion. The rates found were higher than rates found in community samples. Ten subjects reported night binge eating in addition to their usual binge eating behavior. This occurred consistently between 2:00 and 4:00 a.m. CONCLUSIONS: Possible underlying mechanisms for the high frequency of binge eating among bipolar subjects are discussed including a model of serotonin-mediated self-modulation of mood. The finding of two groups of binge eaters separated only by the frequency criterion raises questions as to whether the frequency criterion as presently defined in DSM-IV is valid or should be modified.

Adult↗
PubMed1996

Familial dementia of frontal lobe type.

OBJECTIVE: To describe an unusual case of familial frontal lobe dementia (FLD) with probable spongiform encephalopathy (SE). METHOD: The patient's clinical presentation, neuropsychological test results, family history, and results on magnetic resonance imaging (MRI) and positron emission tomography (PET) scans, among other routine investigations, are described. His leucocyte deoxyriboneucleic acid (DNA) was isolated, and his Prp (prion protein) gene was amplified with the polymerase chain reaction and sequenced using the Sanger method. RESULTS: Clinically, the patient had a presenile frontal lobe dementia. Four of the 8 members of the generation preceding the patient had presenile dementia. Autopsies performed on 2 of these cases revealed SE, and a pathological diagnosis of Creutzfeldt-Jakob disease (CJD) was made. One other member of that generation died of a limbic encephalitis, although the neuropathological findings were atypical. Sequencing of the patient's Prp gene did not reveal the abnormalities expected in a familial case of CJD. The results of other investigations were compatible with FLD but were not specific to a particular diagnosis. CONCLUSIONS: This case is a novel type of SE. The patient presented clinically with FLD, but based on the family history and neuropathology, a diagnosis of prion dementia seems likely. There were no mutations found in the Prp gene, so it is possible that there are SEs caused by genes or other pathological processes unrelated to the Prp gene.

Adult↗
PubMed1995

Aggressive family communication, weight gain, and improved eating attitudes during systemic family therapy for anorexia nervosa.

During systemic family therapy with 15 hospitalized anorexics, family communication was evaluated, using a Family Aggression Scale developed by one of the authors. Initially members communicated aggression covertly. This finding may partially explain the common clinical observation that the families of anorexics present a strong facade of togetherness and avoid overt conflict. During therapy members shifted from covert communication of aggression to covert communication of aggression. This shift correlated with improvement in subjects' eating attitudes reflected by their EAT-26 scores. All subjects gained weight. Greater weight gain occurred in subjects whose families had low levels of covert or indirect aggression. A regression analysis showed that 86% of the variance in weight gain was predicted by two leading indicators in the middle phase of treatment. Two other factors accounted for 64% of the variance in EAT scores. The findings of this study suggest that family aggression as measured by the Family Aggression Scale is a significant index of pathology in anorexics' families and is also a clinically meaningful measure of improved conflict resolution during systemic family therapy.

Adolescent↗
PubMed1993

Residents' and nurses' perceptions of difficult-to-treat short-stay patients.

OBJECTIVE: Characteristics attributed by nurses and by psychiatric residents to difficult-to-treat inpatients in a short-stay setting were compared to determine whether discipline-specific perceptions of such patients existed. METHODS: A total of 117 patients consecutively admitted to a short-stay inpatient unit were assessed by both psychiatric residents and nurses during the third week of hospitalization using subscales of the Hospital Treatment Rating Scales. The degree of management difficulty presented by each patient in 28 areas was rated, and an overall rating was calculated. Two separate regression analyses were used to examine characteristics of patients rated difficult. RESULTS: Self-harm behaviors, violence toward others, and behaviors that sabotage treatment were identified by both nurses and residents as characteristics of difficult patients, although these characteristics contributed less to residents' perceptions of patient difficulty than to nurses'. For nurses, the most important additional characteristics contributing to treatment difficulty were related to patients' inability to form a therapeutic alliance. For residents, by far the most significant contributor to overall treatment difficulty was lack of response to medication. CONCLUSIONS: The discipline-specific differences in perceptions of difficult-to-treat patients were associated with differences in professional roles. Communication problems between physicians and nurses may be due in part to their different perceptions of treatment and management difficulty.

Adult↗
PubMed1992

Transfer of psychiatric inpatients: the family perspective.

Data from semistructured interviews with families of psychiatric inpatients revealed both satisfaction and dissatisfaction with hospital psychiatry professionals' practices in the course of patient transfer between units. The most significant issues were involvement of families in planning the transfer, provision of timely and adequate information to families, and availability and support of the staff. Recommendations are made for easing family stress and increasing family cooperation about the transfers.

Adult↗
PubMed1991

Thought disorder and verbal recall in acutely psychotic patients.

This study examined the relationship between thought disorder and verbal recall in schizophrenic, manic, and schizoaffective inpatients. Based on previous research, it was predicted that subjects who demonstrated only positive thought-disorder would differ from those with positive and negative thought-disorder in terms of their ability to encode short descriptive passages. Unlike controls, who were able to encode organized material better than unorganized material, neither thought-disorder group improved its encoding when the material to be remembered was more organized. Both thought-disorder groups remembered more when the material was less organized. These findings raise a number of issues with regard to the interrelationship among thought disorders, psychiatric diagnoses, and information-processing deficits.

Adult↗
PubMed1991

Pattern of substance abuse in psychiatric inpatients.

This study examined the pattern of substance abuse in a sample of 114 psychiatric inpatients using a standardized diagnostic interview. As predicted, psychiatric inpatients reported a significantly higher rate of substance abuse than a randomly selected community sample. Approximately three-quarters of the inpatients abused at least one substance. Almost one-half of the patient sample reported abusing more than one substance. These findings emphasize the need to screen psychiatric inpatients for substance abuse using a standardized diagnostic instrument and to develop treatment programs for substance abuse in psychiatric patients.

Adolescent↗
PubMed1986

Moving experiences: a model for inpatient transfer based on interviews with patients and their families.

Although transfer of psychiatric patients from one unit to another is a routine clinical procedure, it may constitute a crisis for patients and their families. The 61 recently transferred patients and 46 family members interviewed for this study expressed substantial dissatisfaction with the transfer process, especially with the planning and preparation stages. Based on their responses, the authors developed a model for understanding and improving inpatient transfers. The transfer process consists of four stages--planning, preparation, transfer, and adjustment--each of which presents different tasks for the patient, his family, and staff. The authors believe their transfer model is applicable to the transfer of medical inpatients and psychiatric outpatients.

Adolescent↗