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Biomedical subjects

I Fishman

Publications and source records attributed to I Fishman.

5 recordsLinked to original sources
PubMed2005

Interpreting patient/informant discrepancies of reported cognitive symptoms in MS.

Although numerous studies have shown that brain-damaged patients tend to underestimate neuropsychological (NP) impairment when self-ratings are compared to informant ratings, the meaning of such discrepancies is not well studied in multiple sclerosis (MS). We compared patient self- and informant-report questionnaire ratings of NP functioning in 122 MS patients and 37 age- and education-matched normal controls. In addition to completing the Multiple Sclerosis Neuropsychological Questionnaire (MSNQ), participants underwent NP testing and assessment of depression, personality, and neuropsychiatric symptoms. Based on the normal distribution of discrepancy scores, patients were classified according to whether they overestimated or underestimated their cognitive ability, relative to informant ratings. ANOVAs comparing test scores derived from overestimators, underestimators, and accurate estimators were significant for multiple measures of cognitive function, depression, personality, and neuropsychiatric symptoms. Overestimators were characterized by less depression and conscientiousness, and greater degrees of cognitive impairment, euphoric behavioral disinhibition, and unemployment as compared to underestimators. We conclude that patient/informant discrepancy scores on the MSNQ are associated with the aforementioned neuropsychiatric features, and that the MSNQ has potential utility for predicting euphoria and disinhibition syndromes in MS.

Adult↗
PubMed2003

Validity of the Beck Depression Inventory-Fast Screen in multiple sclerosis.

INTRODUCTION: The Beck Depression Inventory-Fast Screen (BDI-FS) is a brief self-report inventory designed to evaluate depression in patients with medical illness. As depressive disorder is especially prominent in multiple sclerosis (MS), a cost-effective procedure for identifying depressive disorder in MS is sorely needed. The BDI-FS may be useful in this regard although, to date, its validity in MS patients has not been assessed. METHODS: Fifty-four consecutive MS patients were studied. All underwent psychological assessment, which included the BDI-FS and other self-report measures of depression. Forty-eight caregiver/informants were interviewed using the Neuorpsychiatric Inventory (NPI). Retrospective chart reviews were conducted by a single trained research assistant, blind to the results of psychological testing and interviews, to determine if antidepressant medications had been prescribed. RESULTS: The BDI-FS was significantly correlated with other self-report measures of depression (P < 0.001) and with informant reported dysphoria (P < 0.01), In addition, BDI-FS scores discriminated MS patients undergoing treatment for depressive disorder from untreated MS patients (P = 0.01). CONCLUSION: These data support the concurrent and discriminative validity of the BDI-FS in MS. As the test is brief and not confounded with neurological symptoms, it is recommended for depression screening in this population.

Adult↗
PubMed1993

Microalbuminuria in a normotensive insulin-treated diabetic population.

Thirty-five insulin-treated diabetics without overt proteinuria or hypertension, and taking no antihypertensive medications were screened at three clinical centers for the presence of microalbuminuria. In addition to the presence of albuminuria, patients were evaluated for duration and type of diabetes, retinopathy, blood pressure, and degree of diabetic control. In these patients, it was possible to examine the degree of microalbuminuria as a function of systolic and diastolic blood pressures, age and sex of the patient, site of recruitment, duration of diabetes, and glycemic control. On multivariate statistical analysis, systolic blood pressure was the only factor that contributed to microalbuminuria. An additional 37 patients had urinary albumin excretion measured, although biochemical and clinical characteristics were incompletely determined. Blood pressures were documented to be normal in 23 of these individuals, while the other fourteen were normal by history. The range of urinary albumin excretion was comparable in the patients with complete data bases and those without. Overall, 22.2% of the normotensive insulin-treated patients screened had microalbuminuria, 5.5% had gross albuminuria, while 72.2% had normal urinary albumin excretion. We agree with previous reports that microalbuminuria is relatively uncommon in the normotensive diabetic population, but further conclude that even in the context of "normal" blood pressure, systolic blood pressure should be carefully observed in diabetic patients. It is possible that these individuals should be considered for more aggressive monitoring programs, e.g., ambulatory blood pressure recording.

Adult↗