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Biomedical subjects

J A Wilcox

Publications and source records attributed to J A Wilcox.

At least 19 recordsLinked to original sources
PubMed2000

The prognostic value of thought disorder in psychotic depression.

Thirty-eight patients with psychotic depression were compared to 40 patients with severe, nonpsychotic depression. Psychiatric variables, along with demographic data, were used to predict relapse over a 7-year period in a multiple regression model. Initial formal thought disorder was a strong predictor of relapse during the follow-up (F = 43, p < .001). The predictive value of this symptom in psychotic depression was not enhanced by the addition of other symptomatic or demographic variables. It appears that individuals with psychotic depression who experienced formal thought disorder are much more likely to have a relapse within a 7-year period than other people with depression.

Adult↗
PubMed1995

Divalproex sodium as a treatment for borderline personality disorder.

Divalproex sodium was given to a series of individuals with the diagnosis of borderline personality disorder. Objective measures of agitation and anxiety were then used to assess the effect of divalproex sodium on such symptoms. Data were collected on the subjects and the amount of time spent in the agitated state was evaluated. We found that divalproex sodium reduced agitation in our subjects.

Adolescent↗
PubMed1993

Structural brain abnormalities in catatonia.

In this study, the ventricle to brain ratios of catatonic subjects were compared and evaluated with respect to the underlying diagnoses. Catatonic individuals with the diagnosis of schizophrenia were more likely to have greater ventricle to brain ratios than other catatonic subjects. The association of large ventricles with chronic, deteriorating psychosis is maintained and the heterogeneity of the syndrome of catatonia is apparent. It is possible that the presence of large ventricles may be useful to predict the chronicity of disability for some cases of catatonia.

Adult↗
PubMed1992

Nutritional support in children with end-stage liver disease: a randomized crossover trial of a branched-chain amino acid supplement.

Malnutrition is common in children with end-stage liver disease (ESLD) awaiting orthotopic liver transplantation (OLT), and nutritional support is assuming an important role in preoperative management. To evaluate preoperative nutritional therapy, 19 children (median age 1.25 y) with ESLD awaiting OLT were prospectively studied. Two high-energy, isoenergetic and isonitrogenous nutritional formulations delivered nasogastrically were compared: a branched-chain amino acid (BCAA)-enriched semielemental formulation and a matched standard semielemental formation. Twelve of 19 patients completed a randomized controlled study before OLT and 10 of 19 completed a full crossover study. Improvements in weight and height occurred during the BCAA supplements, with no statistical change on the standard formulation. Significant increases in total body potassium, midupper arm circumference, and subscapular skinfold thickness occurred during the BCAA supplements, whereas no significant changes occurred during the standard formulation period. Significantly fewer albumin infusions were required during the BCAA supplement. These findings suggest that BCAA-enriched formulas have advantages over standard semielemental formulas in improving nutritional status in children with ESLD, and are deserving of wider application and study.

Albumins↗
PubMed1992

The nature of malnutrition in children with end-stage liver disease awaiting orthotopic liver transplantation.

To evaluate malnutrition in chronic liver disease, and its relationship to nutrient deficiencies and hepatic dysfunction, 27 children with end-stage liver disease were studied. Mean protein-energy intakes were 70% of recommended daily intakes. The patients were underweight and stunted with reduced mean triceps and subscapular skinfold thicknesses and midupper arm circumference. Mean total body potassium was only 63 +/- 18% of that expected for age and sex. Deficiency of essential fatty acids (32%), and low concentrations of fat-soluble vitamins (A, 92%; E, 32%), iron (32%), zinc (42%), and selenium (13%) were common. Serum ammonia concentrations were raised in all patients, and increased methionine, tyrosine, and glutamic acid, and reduced glutamine concentrations were noted. There was no correlation between the degree of malnutrition and the degree of liver synthetic function, the degree of cholestasis, or the degree of liver injury. We suggest that potentially correctable factors in addition to liver failure (eg, inadequate absorbed intake) were important determinants of malnutrition in these patients.

Amino Acids↗
PubMed1992

The predictive value of thought disorder in manic psychosis.

Twenty-two patients with mania were evaluated for a variety of psychiatric phenomena. These items along with demographic data were used to predict relapse over a 36-month period in a multiple regression model. Formal thought disorder at the onset of illness was a strong predictor of relapse (F = 39, p < 0.001). The quality of the thought disorder was the most significant prognostic indicator. The predictive value of negative thought disorder was not enhanced by the addition of other symptomatic or demographic variables.

Adult↗
PubMed1991

Informal helpers of elderly home care clients.

Most functionally impaired elderly people rely exclusively on family and other informal helpers. This article examines whether elderly people who turn to formal service providers also receive help from informal sources. A sample of 100 clients of a statewide home care program were interviewed about the informal help they received. Most had family, friends, or neighbors who helped. However, the helping networks were fragile. Only 18 percent of clients had a helping spouse. Only half had more than one helper. Several had only nonkin helpers. Few had a helper living with them. The fragility of these helping networks, compared with those identified in other studies, may explain why these elderly people applied for services. Implications for the respective roles of social services programs and natural support networks are discussed.

Activities of Daily Living↗
PubMed1991

Pituitary microadenoma presenting as panic attacks.

A woman with pituitary microadenoma presented with panic attacks. This case illustrates the need both for routine medical screening of psychiatric patients and for psychiatrists to remain aware of the clinical features of medical syndromes.

ACTH Syndrome, Ectopic↗
PubMed1990

Thought disorder and relapse in schizophrenia.

Twenty-eight patients with chronic schizophrenia were evaluated for a variety of psychiatric symptoms. These variables along with demographic data were used to predict relapse over a 24-month period in a multiple regression model. Initial formal thought disorder was a strong predictor of relapse (F = 79; p less than 0.001). The predictive value of this symptom was enhanced by the addition of age of onset of psychosis but not by the addition of other symptomatic or demographic variables.

Adolescent↗
PubMed1988

Sydenham's chorea and psychopathology.

Sydenham's chorea is a movement disorder seen in rheumatic fever with basal ganglia pathology. This disorder has been associated with an increased frequency of psychopathology in both the acute choreiform stage and later in life. We conducted a prospective study of 29 subjects with Sydenham's chorea and 29 age- and sex-matched controls. The total number of psychiatric symptoms 10 years after the initial contact was much greater in the study group than in controls (p less than 0.001). Similarly, schizophrenia was more common in the study group compared to controls (p less than 0.01). Possible neuropathological associations and treatment are discussed.

Chorea↗
PubMed1987

Childhood head trauma and psychosis.

The medical histories of 200 schizophrenic patients were compared to those of 203 depressed patients, 122 manic patients, and 134 surgical controls. All subjects were hospital inpatients. Charts were specifically examined to record any head injury before age 10 that had required medical attention or caused loss of consciousness. Schizophrenics had a significantly greater history of head trauma than the manics, depressives, and surgical controls. There were no significant differences between manics and depressives or between affective disorders as a group and surgical controls. Childhood trauma may be a contributing factor to the development of psychosis in some individuals.

Adolescent↗
PubMed1987

Perinatal distress and prognosis of psychotic illness.

The medical histories of a group of 511 patients hospitalized for schizophrenia were examined for the occurrence of perinatal distress. These patients were part of a 40-year follow-up study, so that their prognostic outcome was known at the time of this study. In this way, 200 cases of chronic schizophrenia were compared with 311 cases of psychotics with good prognosis. It was found that a history of perinatal distress was much more common in the poor prognosis group than in the good prognosis group. This difference could not be accounted for by age or family history of psychiatric illness.

Adult↗
PubMed1987

Perinatal insult as a risk factor in paranoid and nonparanoid schizophrenia.

The medical histories of 30 paranoid schizophrenics were compared to those of 60 patients with nonparanoid schizophrenia. History of perinatal distress was more common in patients with chronic nonparanoid schizophrenia (p less than 0.005). A significant trend was noted for perinatal distress to be more common among cases with no family history of psychiatric illness (p less than 0.05). It is suggested that perinatal distress may be an organic risk factor for chronic nonparanoid schizophrenia and that this risk is independent of the genetic risk for this disease.

Female↗
PubMed1987

Psychosis.

This article is intended to expand the clinician's understanding of psychosis. The concept of psychosis and the differential diagnosis of this condition are discussed. The treatment of psychotic illness also is briefly addressed.

Adult↗
PubMed1986

Pharmacologic approaches to psychogenic polydipsia: case reports.

Psychiatric patients presenting with chronic psychogenic polydipsia are often difficult to treat with standard psychiatric interventions. Pharmacologic intervention was attempted in three patients and was successful in one. One patient had a significant and sustained reduction of water intake while on 160 mg of propranolol. One patient did not improve with either propranolol or captopril while a third patient showed no improvement of serum sodium with demeclocycline nor reduction of water intake with propranolol. The potential mechanisms by which these pharmacologic agents might alter thirst in patients with primary polydipsia are discussed.

Adult↗
PubMed1986

Sydenham's chorea and psychosis.

The medical histories of 600 psychotic and 369 nonpsychotic subjects were examined for the occurrence of rheumatic chorea. There was significantly more rheumatic chorea in the histories of psychotic patients than in nonpsychotics (p less than 0.01, chi-square). Neuropathological associations are discussed.

Brain↗