Biomedical subjects

J D Little

Publications and source records attributed to J D Little.

8 recordsLinked to original sources

PubMed2000

Successful ECT in a case of Leonhard's cycloid psychosis.

In Leonhard's nosological system, acute, episodic psychoses with good short-term and long-term prognoses, characterized by mixed affective and schizophrenic features, confusion, and alternating psychomotor retardation and excitement are called cycloid psychoses. According to clinical lore, patients with cycloid psychoses show an excellent and prompt response to electroconvulsive therapy (ECT). We describe a patient with typical motility psychosis, a subtype of cycloid psychoses, who failed to respond to a combination of antipsychotic and benzodiazepine medication but quickly recovered after the administration of ECT.

Adult↗

PubMed1996

Intervention and social breakdown in the elderly.

OBJECTIVE: To discuss the ethical and clinical issues associated with the management of social breakdown in the elderly (SBE) in relation to the case of a 76-year-old recluse who was referred following community concerns about her living conditions and behaviour. METHOD: Longitudinal assessment and management of the patient resulted in a diagnosis of schizophrenia and treatment with fluphenazine decanoate. RESULTS: The patient responded to treatment and was returned home, after which a relationship was maintained by community services. CONCLUSIONS: A coherent and defensible position on both clinical and ethical grounds may be made in favour of intervention with SBE. Practical aspects of the process are suggested.

Aged↗

PubMed1995

Effect of recommended dosage range on the prescribing of antidepressants.

The aim of the study was to explore the role that suggested dosage range may play in suboptimal prescribing practice of tricyclic antidepressants. Clinicians practising in adult psychiatry were shown a clinical vignette of melancholia (as per DSM-III-R). One of two questionnaires on treatment practices, specifying either 75-200 mg or 75-425 mg of an unnamed tricyclic antidepressant, were randomly distributed to subjects. A highly significant (p = 0.001) difference was found: those who were given a narrow dosage range prescribed an average of 82.5 mg/day less antidepressant than those for whom the dosage range had been widened, indicating that the range within which dosages are recommended affects prescribing practices. When erroneously constrained, the range may contribute toward sub-optimal prescribing practices and as a consequence toward treatment-resistant depression.

Adult↗

PubMed1993

Psychosis following readministration of diethyl proprion: a possible role for kindling?

The case of an organic psychosis following the readministration of an amphetamine-like anorexiant is described. Previous therapeutic use of the same drug 2 years earlier was without adverse effect. Similar phenomena have been reported with other drugs, and both behavioural sensitization and kindling are possible explanations. The latter, however, provides a parsimonious explanation, a therapeutic rationale, and brings together seemingly disparate laboratory and clinical phenomena.

Diethylpropion↗

PubMed1993

Physiological principles in the treatment of difficulty waking from sleep.

The case report of a young man with profound difficulty waking from sleep is presented. Successful management was predicted and instituted from an understanding of the physiological principles of circadian rhythmicity.

Adult↗

PubMed1992

Staff response to inpatient and outpatient suicide: what happened and what do we do?

Inpatient or outpatient suicide may have a marked effect on the staff or therapist. After reviewing the literature, a practical, clinically-based protocol for managing such an event is described. Additionally, it places one event, the psychological autopsy, within the general context of post-suicide management.

Adaptation, Psychological↗

PubMed1991

Disinhibition after lorazepam augmentation of antipsychotic medication.

Explore the source record for details and available documents.

Adult↗

PubMed1985

Progression of equinus deformity in Duchenne muscular dystrophy.

This study investigated the influence of orthoses, regular passive stretching, and surgery on progression of equinus deformity in Duchenne muscular dystrophy. The extent of passive dorsiflexion on the right foot of ambulant and wheelchair-ambulatory patients was measured monthly with an electronic ankle goniometer calibrated to an accuracy of 1 degree. The mean rate of equinus progression was 0.4 degree per month during the 12-month study. Progression was less in those boys who had prior surgery and were older. Progression was slowest during the first five months of the study (when night splints were used more frequently) and greatest during a long vacation when regular passive stretching by physiotherapists and supervision of splinting were unavailable. These results, although based on a limited patient sample size, indicate that gains from use of orthoses and passive stretching can be lost in the absence of professional supervision.

Adolescent↗