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Biomedical subjects

H Warnes

Publications and source records attributed to H Warnes.

At least 19 recordsLinked to original sources
PubMed1999

Somnambulistic-like behaviour in patients attending a lithium clinic.

The prevalence of somnambulistic-like behaviour related to treatment with lithium alone or in combination with other psychotropic medications was evaluated in patients attending a lithium clinic. A written questionnaire on somnambulistic-like behaviour was completed by 389 patients. Information was provided on the time of occurrence, frequency and severity of the episodes, the presence of childhood somnambulism, and the temporal relationship between psychiatric treatment and somnambulistic-like behaviour. Twenty-seven (27) patients (6.9%) presented sleepwalking behaviour related to the onset of treatment with lithium alone or in combination with other psychotropic drugs. Forty-five patients (11.6%) reported childhood somnambulism and 12 of them (27%) had their childhood somnambulism reactivated by the medication. Most patients had a diagnosis of bipolar affective disorder but somnambulistic-like behaviour also occurred in patients with other axis 1 diagnosis. Sleep-related violence was seldomly reported. Therefore, lithium alone or in combination with other psychotropic drugs may induce somnambulistic-like behaviour. A history of childhood somnambulism may increase the risk of developing sleepwalking behaviour while under psychotropic drugs treatment.

Adult↗
PubMed1997

Alexithymia and impoverished dream recall in asthmatic patients: evidence from self-report measures.

Early clinical impressions that alexithymia is associated with diminished dream recall have been supported by more recent research. The present study was designed to examine this association using self-report measures and a carefully screened clinical population. Thirty-three male and 43 female asthmatics from an outpatient clinic were administered the Toronto Alexithymia Scale, the Eysenck Personality Questionnaire, and a questionnaire concerning retrospective recall of dreams and nightmares. Multiple regression analyses revealed that, among men, dream recall was negatively related to alexithymia, especially to the TAS analytical mode of thinking subscale, independent of age and neuroticism. Among women, dream and nightmare recall were positively correlated with neuroticism. These results are consistent with early clinical observations of pensée opératoire, with some research findings, and with the notion that dream recall may be differentially associated with components of alexithymia in men and women patients.

Adolescent↗
PubMed1995

Interrater reliability of the multiple sleep latency test.

The purpose of this study was to evaluate interrater reliability in the interpretation of the multiple sleep latency test (MSLT). We prospectively analyzed MSLTs performed on 21 patients with excessive daytime sleepiness. MSLTs were recorded on Grass Model 78 polygraphs with EEG, electro-oculogram, and chin EMG. Each test was performed simultaneously at paper speeds of 10 and 30 mm/sec and was scored blindly by 3 readers using standard criteria. For the quantitative variable (sleep latency), a LISREL model was used. For the binary variable (REM present or not), a kappa coefficient was used. Interrater reliability of sleep latency was 0.850 at speed 10, and 0.884 at speed 30. There was no significant difference between speed 10 and 30. Interrater reliability for the presence or absence of REM was 0.515-0.563 at speed 10, and 0.447-0.525 at speed 30. On the MSLT, the estimation of sleep latency showed excellent consistency between different readers. The determination of the presence or absence of REM only showed fair to good agreement among observers. There was no significant difference between a paper speed of 10 vs. 30 mm/sec.

Adolescent↗
PubMed1993

Periodic limb movements and sleep apnoea.

This study investigated the relationship of Periodic Leg Movements (PLMs) to the severity of Obstructive Sleep Apnoea (OSA) in 52 patients. In addition the prevalence of PLMs in OSA was compared with two other patient populations: narcolepsy and idiopathic PLM disorder (n = 38). All patients were between 20 and 50 years in age and were compared with a control group of 88 asymptotic paid volunteers aged between 20 and 50. PLMs were scored when tibialis anterior EMG activity lasted 0.5-5.0 s with an amplitude of at least half that of pre-sleep voluntary ankle dorsiflexion and when they were part of 4 or more consecutive events separated by 20-90 s. The prevalence of PLMs in OSA was 27.6%, which was similar to the prevalence in our normal controls of 20.5%. However, in the OSA group the majority of the PLMs occurred in the mild OSA patients (40.7%). This was similar to the prevalence of PLMs in narcoleptics (50%). The prevalence of PLMs in moderate OSA, was 24.5%; similar to that of normal controls. In severe OSA, PLMs were also low (12.5%). There is an inverse relationship between PLMs and the severity of OSA. The greater number of arousals and awakenings associated with respiratory irregularities seen in the severe OSA group produced an equivocal manifestation of PLMs.

Journal Article↗
PubMed1992

The treatment of the restless leg syndrome with or without periodic leg movements in sleep.

There are presently three main treatments for restless leg syndrome-periodic leg movements in sleep (RLS-PLMS). The benzodiazepines (especially clonazepam) are considered by most clinicians to be the treatment of choice in mild cases, especially in young subjects. In our experience, however, L-dopa and bromocriptine are more effective treatments, although no controlled studies have ever been conducted to compare their therapeutic benefits and the side effects of benzodiazepines and dopaminergic drugs. The use of opioids should be restricted to patients who have severe symptoms and who fail to respond to benzodiazepines or L-dopa. Propoxyphene was found less effective than L-dopa in decreasing PLMS, but some patients resistant to L-dopa may exhibit a masked therapeutic response to opioids. However, there is currently no method to predict the response to any treatment modality.

Anti-Anxiety Agents↗
PubMed1987

International trends of therapy and research in psychosomatic medicine.

Against the background of the holistic concept of illness trends of psychosomatic therapy and research are identified in major countries. Different countries tend to concentrate on different aspects of research or praxis based largely on their compatibility with cultural or social assumptions of illness. The psychotherapies, behavioral medicine, social therapies and biological approaches are underscored in a given country and even within the same country competing therapies strive for hegemony. Problems and limitations of the reductionistic versus the holistic approaches in psychosomatic research are highlighted.

Humans↗
PubMed1986

Alexithymia, clinical and therapeutic aspects.

The clinical observations on alexithymia which were initiated by Sifneos and Nemiah in the earlier 1970s have given rise to a host of studies with implications beyond the psychosomatic field of enquiry. Is alexithymia a pathology of affect or a character neurosis; is it primary or secondary; genetic or developmental? Is it an adaptational deformation related to social class and low psychological sophistication, a life style or a cerebral deficit? Is it global and consistent (trait) or partial and temporary (state)? Is it part of the necessary and sufficient condition for the development of a psychosomatic symptom or is it a nonspecific autoplastic alteration? It is quite possible that alexithymia is one of several mediating processes between stress and disease along with genetic susceptibility, developmental variables, context and reaction to untoward life events, coping dispositions, psychosocial support and sociocultural factors. Therapeutic approaches would depend on whether we are dealing with a primary affectless condition or a secondary one. A differential diagnosis is essential since self-numbing following psychic trauma or a pathological grief, masked and atypical depression are treatable. Blocking of affect may have dire effects on the psychosomatic economy and on the capacity for intimacy. Muscular and psychological rigidity, weariness, ennui and anhedonia may be the only clues to the presence of alexithymia. Since we may be dealing with a spectrum disorder, there is no single treatment modality. There are no controlled studies on the use of psychotropic drugs and psychoanalytic-oriented and behavioral approaches have been shown to be of some benefit.

Affective Symptoms↗
PubMed1986

The mind-body problem from a medical perspective.

Classical philosophical ideas on the mind-body problem were interpreted in the light of contemporary theories. There are two mind-body theories that are suspect for a natural scientist, namely, parallelism and panpsychism. There are three further theories that are considered radical and not supported by current research: epiphenomenalism, central-state materialism and behaviorism. That leaves us with the two most prevalent theories, namely, interactionism and neural identity. The authors discuss the evidence for and against each theory.

Humans↗
PubMed1982

The dream specimen in psychosomatic medicine in the light of clinical observations.

The author attempts to demonstrate a relationship between dreams and symptom formation in the psychosomatic patient. The egos of many patients predisposed to psychosomatic illness have shown a deformation of a defensive nature because of early impingement of the protective shield (a maternal function) which caused a precocious development of a false-self in Winnicott's sense. In a series of dreams the failure of one or more dream functions became evident. Such failures are often found in patients with psychosomatic symptoms and depend on the severity of illness and preillness factors such as personality, body image and type of object relationships. The dream functions identified were the traumatolytic, the wish-fulfilling, the symbolizing and the integrating ones. The author further speculates on the relationship between the physical symptom, the failure of a particular dream function, the physiological correlates of the manifest versus the latent content of the dream, the breakdown of the process of symbolization and the activation of an archaic body image representation.

Adult↗
PubMed1980

The clinical features of migraine as a manifestation of allergic disease.

Patients with a clinical history of migraine were evaluated psychiatrically, and by electroencephalography. They were challenged with food antigens by skin-prick test, and abdominal symptoms were evaluated following oral ingestion of food allergens. A significant correlation was found between challenge with specific food allergens and the development of migraine headaches, the appearance of abdominal symptoms and the occurrence of positive skin reactions. Psychiatric abnormalities and EEG alterations were associated with the occurrence of headaches and allergic clinical features. It is suggested that the clinical features of migraine can be explained as a result of release of chemical mediators following antigen-antibody reactions in the brain and other tissues where specific antibodies are localized. The continuous ingestion of the responsible food allergens would account for the raised tissue concentrations of noradrenaline, histamine and other mediators to which the clinical features of migraine are attributed.

Adolescent↗