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J C Simpson

Publications and source records attributed to J C Simpson.

54 records · Page 3Linked to original sources
PubMed1985

Mortality studies in psychiatry. Should they stop or proceed?

Psychiatry as a medical discipline has a special concern for preventing premature deaths in psychiatric patients. Such patients continue to be at excess mortality risk despite changing patterns of causes of death and improvements in the treatment of some diagnostic groups. In this overview of current findings and research trends, we find a continuing need for mortality studies and increased opportunities for integrating these investigations with other longitudinal studies of psychiatric populations.

Follow-Up Studies↗
PubMed1985

Are there sex differences in the long-term outcome of schizophrenia? Comparisons with mania, depression, and surgical controls.

Female schizophrenics have been reported to have a better prognosis than male schizophrenics. However, earlier reports rarely used either operational criteria for schizophrenia or appropriate comparison groups. Using data collected as part of a long-term follow-up and family study, the authors examined outcome by sex of 186 schizophrenics, 212 depressives, 86 manics, and 145 surgical controls. When the authors controlled for differences in the age and sex distributions of the diagnostic groups, sex did not make a significant contribution to the explanation of outcome differences between diagnoses or within diagnoses. Examination of outcomes within diagnoses revealed only a nonsignificant trend for female manics to have a better long-term outcome than male manics.

Adult↗
PubMed1985

Contamination of internal jugular cannulae.

137 internal jugular vein cannulae from 113 patients undergoing open heart surgery were cultured using standard broth culture and a semiquantitative culture technique. 60 of the cannulae were placed using an aseptic technique and 77 using a standard non sterile technique. Significant contamination was found in 18.3% of the cannulae in the aseptic group and 15.6% in the standard group. The contaminating organism was Staphylococcus epidermidis in 87.1% of cases. No advantage in using an aseptic technique of cannula insertion was demonstrated. It was concluded that the major source of contamination was elsewhere.

Antisepsis↗
PubMed1984

Schizoaffective disorder: concept and reality.

A wide variety of concepts have been proposed to account for schizoaffective psychoses. Presenting a mixture of schizophrenic and affective symptoms, these psychoses have long defied classification in the usual scheme of the two major diagnostic categories, schizophrenia and major affective disorder. Empirical findings are often contradictory, and have sometimes supported the classification of schizoaffective disorder with schizophrenia, and, more recently, with major affective disorders. An alternative hypothesis is that schizoaffective disorder is fundamentally heterogeneous, and that research efforts should be directed toward the identification of homogeneous subtypes. To illustrate the latter research strategy, we describe our current research program of long-term followup and family studies of patients with schizoaffective psychoses and other atypical psychoses. Extensive data have been obtained using blind, structured psychiatric interviews with probands after 30 to 40 years of followup, and with their first degree relatives. In the same way, followup and family data were obtained for patients who met research criteria for schizophrenia, mania, and depression, and for matched surgical controls. By comparing these groups of "typical" psychotic patients with the schizoaffective patients, we can select homogeneous subgroups of schizoaffective patients and analyze their characteristics to refine clinical and research criteria for the differential diagnosis of schizoaffective subtypes.

Bipolar Disorder↗
PubMed1983

Physical diseases in schizophrenia and affective disorder.

Studies of the increased or decreased risk of specific physical diseases in patients with schizophrenia and affective disorder are reviewed. Existing data suggest further examination of the following relationships: (1) the presence in schizophrenics of increased incidence of gastrointestinal cancer and of cardiovascular and infectious diseases, and of decreased incidence of lung cancer and rheumatoid arthritis; and (2) the increased incidence of circulatory, respiratory, and atopic diseases, and of diabetes mellitus among patients with major affective disorder. A majority of the studies reviewed failed to meet methodologic standards necessary to provide conclusive evidence. An ongoing research project which generally meets these standards, the Oxford Record Linkage Study, is described.

Aged↗
PubMed1982

Subtypes of drug abuse with psychosis. Demographic characteristics, clinical features, and family history.

Hospital records of 72 drug abusers with psychoses (DAP) were analyzed to clarify the relationship between drug abuse and psychosis. Comparison groups included schizophrenics and atypical schizophrenics without drug abuse and drug abusers without psychoses (DA). Compared with DAP in whom psychoses lasted less than six months before admission (DAP-short), drug abusers with psychoses of a longer duration (DAP-long) had more symptoms, more premorbid personality disorders, and greater familial risks of schizophrenia and affective disorder. The DAP-long group resembled atypical schizophrenia for clinical features and family history, whereas the DAP-short group resembled DA for some clinical features and family history. The results indicate that there are several subgroups of DAP. The importance of clinical features and family history in identifying subgroups of DAP was stressed.

Adolescent↗
PubMed1981

An evaluation of the Feighner criteria for schizophrenia and affective disorders using long-term outcome data.

Schizophrenia and affective disorders selected according to the Feighner criteria can be differentiated on the basis of 40-year outcome. Within schizophrenia the presence of disorganized thoughts at the index admission was associated with poor outcome, whereas better outcome was associated with the presence of delusions or hallucinations. Within the affective disorders, bipolar patients with grandiose delusions or ideas showed a poor outcome; a better outcome was found in unipolar patients with complaints of fatiguability or tiredness at the time of the index admission.

Adult↗
PubMed1980

The iowa structured psychiatric interview. Rationale, reliability, and validity.

The Iowa Structured Psychiatric Interview (ISPI) is an interview form designed for psychiatric epidemiological research in the general population. Its use provides detailed information about important aspects of psychiatric, social, and family history. Detailed information is gathered about the frequency and duration of symptoms that characterize schizophrenia, mania, depression, and neurosis. The instrument is also designed to be administered by well-trained nonmedical personnel in order to facilitate its utilization in large-scale field studies. Such interviewers are assumed to be blind to the study status of the informants, and the format of the ISPI maintains that blindness throughout crucial sections of the interview. In addition, the ISPI can be used without any implication that the informant or the informant's relatives have any type of psychiatric history or current psychiatric problems. This monograph discusses the rationale for the ISPI and gives a formative history of the instrument. We also present the results of studies investigating the reliability and validity of a set of twenty screening questions for schizophrenia, mania, depression, and neurosis - items which form the nucleus of the ISPI. The excellent reliability of these items is contrasted with the relatively poor reliability of a set of behavior ratings included in the ISPI. The ISPI itself is given in full in an appendix, along with detailed guidelines for use and suggestions for selecting and training personnel to administer the ISPI in the field. We hope that the ISPI can be further tested by other researchers in psychiatric epidemiology.

Adolescent↗
PubMed1976

The clinical aspects of mesothelioma.

Three hundred and twenty-seven cases of mesothelioma accepted by a panel of pathologists have been used to construct a clinical picture of the disease. The cases analysed died between 1 January 1960 and 31 December 1969 and consisted of 267 pleural, 37 peritoneal, and 23 cases which could have arisen in either site. Two hundred and sixty-eight were in men and 59 in women and the disease appeared to be the same in women as in men. The mean age at death was 59-37 (+/- SD 9-89) years but ranged from 29 to 88 years. The mode of onset was insidious in all but a few cases and the mean interval before reaching the hospital was 3-39 (+/- SD 4-64) months for pleural and 3-08 (+/- SD 3-22) for peritoneal cases. Patients usually noticed a dull non pleuritic pain first but suffered some breathlessness, lassitude and weight loss by the time they reached hospital. On examination there was little evidence of disease apart from the signs of pleural effusion or thickening or ascites. Clubbing and signs of asbestosis were rare except in the peritoneal cases who more frequently gave an occupational history of heavy exposure and showed the radiological consequences of this. At the time when these patients were investigated diagnostic procedures were unrewarding and many patients were only diagnosed in retrospect. The prognosis was somewhat better for patients shown to have mainly epithelial cell tumours, 17-89 (+/- SD 18-26) months, predominantly spindle cell lesions surviving on the average only 7-98 (+/- SD 8-55) months and mixed tumours 11-3 months. The criteria for the early clinical diagnosis are described with a view of facilitating the search for effective treatment.

Adult↗