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Biomedical subjects

H A Whiteford

Publications and source records attributed to H A Whiteford.

At least 19 recordsLinked to original sources
PubMed1998

Renewing Australia's mental health strategy.

The Second National Mental Health Plan, endorsed by Commonwealth, State and Territory governments on 30 July 1998, will pursue three key themes: (1) Promoting mental health, plus prevention of and early intervention in mental disorders, with a specific focus on depression; (2) continuing structural reform of mental health services, including better integration with general practice and the private psychiatric sector; and (3) implementing quality and outcome measures in mental health services, including evidence-based practice.

Australia↗
PubMed1995

Progress in Australia's mental health reforms.

The Second National Mental Health Report was released in June 1995 and documents progress in the 1993-94 financial year in implementing the five-year National Mental Health Plan. Expenditure on mental health rose by 4.1% and on community mental health services by 9.2%. State and Territory funding for non-government mental health services rose by 18% and more resources for those with disability were made available to those with psychiatric disability. The number of occupied-bed-days in standalone psychiatric hospitals fell by 10%. While the report shows that Australia has moved generally in the agreed direction, considerable work remains to be done in this historically neglected area.

Australia↗
PubMed1993

Mianserin-induced up-regulation of serotonin receptors on normal human platelets in vivo.

The antidepressant, mianserin, is a serotonin receptor (5-HT2) antagonist and produces down-regulation of 5-HT2 and 5-HT1c receptors in the cerebral cortex of rats. In preparation for testing the validity of platelets as a model system for changes in 5-HT2 receptors during antidepressant drug treatment, mianserin (40 mg daily), was given to five human volunteers for five days, and platelets were collected on days 0, 1, 6, and 8. 5-HT2 receptor affinity and density were measured by specific binding of 125I-LSD, with and without an excess of spiperone. 5-HT uptake site affinity and density were determined by 3H-paroxetine binding, with and without an excess of fluoxetine. Platelet serotonin content was measured using high pressure liquid chromatography and electrochemical detention. Platelet 5-HT2 receptor density was increased and the ligand affinity was decreased during mianserin administration. In contrast, platelet 5-HT content was not altered significantly by mianserin administration, nor was platelet uptake site density and ligand affinity.

Analysis of Variance↗
PubMed1993

Australia's national mental health policy.

In April 1992 the health ministers of all Australian states, territories, and the federal government endorsed Australia's first National Mental Health Policy. The major principles outlined in the policy include protecting consumers' rights, setting national service standards, mainstreaming mental health services with general health services, better integrating inpatient and community mental health services to ensure continuity of care, and linking mental health services and other social and disability services. A five-year National Mental Health Plan, accompanied by additional federal funding, has also been released, with time frames for implementing the policy in all states and territories and at the federal level.

Australia↗
PubMed1992

Determination of haloperidol and reduced haloperidol in the plasma and blood of patients on depot haloperidol.

We developed a sensitive HPLC assay to measure haloperidol (HA) and its metabolite, reduced haloperidol (RH), in plasma and whole blood. The conditions under which HA might be converted to RH during collection and analysis of blood were examined. Provided the blood was kept at 0 degrees C, erythrocyte ketone reductase activity was insignificant. The solid phase extraction method did not generate RH. We studied ten patients taking 25-400 mg/month of HA decanoate and one patient for 4 weeks after the daily oral dose of 120 mg HA was ceased. In the patients on depot HA, the plasma and blood concentrations of HA were not significantly different (P greater than 0.1). For the first time, RH was detected in plasma patients on depot drug, but only in three cases. In contrast, RH was present in the blood of eight of these patients. The accumulation of RH in red blood cells was also evident in the patient on oral HA, in whom the mean ratio of RH concentrations in whole blood to plasma was 3.6 +/- 1.1. Plasma concentrations of HA correlated highly with total neuroleptic activity measured by a radioreceptor assay. Compared to plasma, analysis of concentrations of HA and RH in blood has the advantages of greater sensitivity, of using smaller volumes of blood and of avoiding the efflux of HA and RH during separation of plasma and red cells.

Chromatography, High Pressure Liquid↗
PubMed1992

Placebo-controlled, double-blind study of the effects of proglumide in the treatment of schizophrenia.

A double-blind, placebo-controlled, randomized study was performed to determine whether proglumide added to ongoing neuroleptic medication was efficacious in the treatment of 32 patients with persistent positive and negative schizophrenic symptoms. Patients treated with both proglumide and placebo showed a significant improvement over the 8 weeks of the study, but no significant difference between the patients taking proglumide and those taking placebo could be demonstrated. In addition, proglumide had no effect on plasma homovanillic acid concentrations or neuroleptic drug activity. The results suggest that, at least for the dose of proglumide used in this study (15 mg/day), the addition of this particular cholecystokinin antagonist does not potentiate the antipsychotic efficacy of neuroleptic medication in patients with persistent schizophrenic symptoms.

Adult↗
PubMed1991

Identification of potentially neurotoxic pyridinium metabolite in the urine of schizophrenic patients treated with haloperidol.

Evidence that the parkinsonian inducing agent MPTP is biotransformed to a pyridinium species that selectively destroys nigrostriatal neurons in humans and subhuman primates has prompted studies to evaluate the metabolic fate of the structurally related neuroleptic agent haloperidol. With the aid of a highly sophisticated atmospheric pressure ionspray HPLC/MS/MS assay, unambiguous evidence has been obtained for the presence of the haloperidol pyridinium species in extracts of urine obtained from haloperidol-treated patients and in extracts of NADPH-supplemented human liver microsomal incubation mixtures containing haloperidol. The potential significance of the formation of this putative neurotoxic pyridinium species is considered.

Adult↗
PubMed1991

Symptomatology and cognitive impairment associate independently with post-dexamethasone cortisol concentrations in unmedicated schizophrenic patients.

Serum cortisol concentrations were measured after dexamethasone administration (1 mg) in 21 neuroleptic-free schizophrenic inpatients. Patients were assessed using the Brief Psychiatric Rating Scale and a battery of cognitive tests. A significant correlation was found between negative symptoms and both 8:00 AM and 4:00 PM post-dexamethasone cortisol concentration (PDC). Cognitive impairment on several measures was also correlated with 8 AM PDC, but in an independent manner. Although positive and negative symptoms were unrelated, exploratory analysis revealed a significant inverse correlation between a positive symptom grouping and both 8:00 AM and 4:00 PM PDC.

Adult↗
PubMed1991

Biopsychosocial psychiatry and the criminal justice system: a case report.

In criminal proceedings a psychiatrist may be called upon to give evidence as to the state of mind of an accused at the time an alleged crime was committed. Seldom is the psychiatrist able to examine the person at or before the time of the offence and therefore arrives at an opinion by examining the person at some later time. Information gained by this examination is combined with all relevant reports and transcripts concerning the accused, collateral history from friends, relatives or other treating health professionals and the results of any clinical investigations. The psychiatrist ultimately forms an opinion as to the probable state of mind of the accused at the material time.

Adult↗
PubMed1991

Effects of nifedipine on psychosis and tardive dyskinesia in schizophrenic patients.

In an open label study, two fixed doses of nifedipine (30 mg and 60 mg daily) were added to the usual antipsychotic drug treatments of 10 patients suffering from chronic schizophrenia. While no patient experienced significant improvements, statistically significant falls in Brief Psychiatric Rating Scales scores were observed. A significant reduction in Abnormal Involuntary Movement Scale scores was observed in those patients with tardive dyskinesia. After the addition of nifedipine, four of the 10 patients showed large increases in plasma neuroleptic activity (radioreceptor assay) that decreased to baseline levels within two weeks. The possibility that this represents competitive inhibition and subsequent induction of the liver metabolism of the antipsychotic drugs is discussed. Adverse effects encountered are also discussed.

Adult↗
PubMed1990

CSF 5-HIAA, serum cortisol, and age differentially predict vegetative and cognitive symptoms in depression.

Prior studies have shown that both cerebrospinal fluid (CSF) concentrations of 5-hydroxyindolacetic acid (5-HIAA) and serum cortisol levels are related to overall symptom severity in depression. In the present study, 30 unmedicated inpatients meeting Research Diagnostic Criteria (RDC) criteria for depression participated in serum cortisol collection and a lumbar puncture for CSF. A multiple regression evaluated the ability of CSF 5-HIAA, serum cortisol, and age to predict cognitive and vegetative symptom clusters of the Hamilton Rating Scale for Depression. The multiple regression to predict the vegetative symptom cluster was highly significant overall (p = 0.002) and found that age and cortisol but not 5-HIAA predicted vegetative symptoms. The regression to predict the cognitive cluster narrowly missed overall significance (p = 0.06). Both CSF 5-HIAA and serum cortisol predicted cognitive symptoms and 5-HIAA predicted the cognitive cluster more strongly than cortisol. Age did not predict cognitive symptoms. The results suggest a dissociation between serum cortisol levels and CSF 5-HIAA in predicting vegetative and cognitive symptom clusters in depression.

Adult↗
PubMed1990

Dopaminergic supersensitivity and vomiting among schizophrenic patients.

The prevalence of vomiting among schizophrenic inpatients was determined over a 6-week period; 8 of 19 patients (42%) experienced at least one episode of vomiting and 3 (16%) experienced 4 episodes. A hypothesis that this may be a dopaminergic supersensitivity phenomenon is proposed, but no association with tardive dyskinesia, another putative supersensitivity phenomena, could be demonstrated. The authors suggest that vomiting among schizophrenic patients is usually underestimated and may at times be a serious clinical problem.

Dyskinesia, Drug-Induced↗
PubMed1989

The differential diagnosis of negative symptoms in chronic schizophrenia.

Negative symptoms in schizophrenic patients can have many causes. This paper briefly reviews some of those factors which may contribute to negative symptoms apart from the schizophrenic illness itself. Making these distinctions is crucial for accurate diagnosis, management and prognosis.

Antipsychotic Agents↗
PubMed1988

Dexamethasone nonsuppression in chronic schizophrenia.

It has been suggested that dexamethasone nonsuppression in schizophrenia is related to the presence of negative symptoms. In a sample of chronic schizophrenic outpatients we could find no relationship between dexamethasone nonsuppression and negative symptoms. In addition nonsuppression was not related to depressive symptoms, anxiety or age. The cause of hypothalamic pituitary adrenal dysregulation in schizophrenic patients remains unclear.

Adult↗