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Biomedical subjects

J E Overall

Publications and source records attributed to J E Overall.

At least 19 recordsLinked to original sources

Comparative evaluation of research diagnostic criteria for schizophrenia.

Criteria for establishing a diagnosis of schizophrenia have been proposed by several different authors. This study compared six different research diagnostic criteria (RDC) in a series of 166 patients who received a clinical diagnosis of schizophrenia in a multicenter study. The alternative criteria differed in the proportion of clinical diagnoses that were confirmed, with the Washington University (Feighner) criteria accepting only 26%. The criteria also disagreed concerning which particular patients qualified for the diagnosis. The Washington University and New York RDC disagreed 50% of the time, and some other disagreement rates were even higher. More evaluative research is needed before arbitrary criteria are permitted to redefine the concept of schizophrenia.

Computers

The effects of stimulant medication on the growth of hyperkinetic children.

This article reviews the literature on possible growth-suppressing effects of stimulant medications in the long-term treatment of children with the hyperkinetic behavior syndrome. The evidence clearly indicates a temporary retardation in the rate of growth in weight and suggests a temporary slowing of growth in stature, but no effect on adult stature or weight. This temporary effect on growth is present during the first few years of treatment and seems related to drug dosage and to the presence or absence of drug holidays. These conclusions related specifically to treatment during the prepubertal period; little is known of the growth-related effects of treatment extending through pubescence.

Adolescent

Prior psychiatric treatment and the development of breast cancer.

Computerized records of a large university hospital were searched to identify all women from 1967 to 1976 whose conditions had been diagnosed as breast cancer or primary cancer of another site. The records for those women with diagnoses of cancer were then examined to identify any prior psychiatric diagnoses. The rationale was that most patients treated in this hospital setting for psychiatric disorders received neuroleptic drugs, and patients with a diagnosis of schizophrenia are almost certain to be treated with major neuroleptic drugs over a prolonged period of time. No substantial difference in the relative frequency of prior psychiatric treatment was observed between breast cancer and other cancer groups.

Adult

Excretion of MHPG in normal subjects: implications for biological classification of affective disorders.

Exretion of 3-methoxy-4-hydroxyphenylglycol (MHPG) was measured repeatedly in 17 normal subjects. The amount of MHPG excreted over a 24-hour period was fairly stable over a period of three consecutive 24-hour samplings, but stability was rather poor over subsequent periods of several weeks, suggesting that execretory patterns are not traits. A normal range of MHPG excretion was estimated to be 900 to 3,500 micrograms/24 hr. This range covers the majority of persons with affective disorders whose excretion patterns have been measured, although comparisons of absolute values between laboratories must be made cautiously. Further, substantial changes within this range may occur in normal subjects with no accompanying change in affect. A slight but definite diurnal pattern of excretion was found, with a peak at the period of 1600 to 1800 hours. No clear relationship to MHPG excretion to state of physical activity, recent consumption of foods or beverages, or prevailing affective state was defined in those subjects living under normal conditions. While MHPG excretion may yet prove useful for categorizing depressed patients and predicting response to drugs, any inferences drawn regarding the pathogenesis of affective disorders must be guarded.

Adolescent

Correcting for cultural factors in evaluating intellectual deficit on the WAIS.

Obtained estimates of the effects of ethnic group, sex, education, and clinical diagnosis on WAIS IQ scores of 776 psychiatric patients by least squares regression methods. Estimates of expected IQ for various demographically defined segments of the general population were obtained by setting the expected IQ for white high school graduates at 101 and then adding or subtracting the specific effects associated with different ethnic group, sex, and education. A formula for norming WAIS Full Scale IQ scores to X = 100 and SD = 15 within various demographically defined segments of the population is proposed.

Adult

Pharmacotherapy for organic brain syndrome in late life. Evaluation of an ergot derivative vs placebo.

Evaluation of treatment modalities, including pharmacotherapy, for organic brain syndrome (OBS) has been difficult because of sampling and methodological problems, and comparisons of research studies are all but impossible. In this study, an ergot derivative, a combination of dihydroergocornine mesylate, dihydroergocristine mesylate, and dihydroergokryptine mesylate (Hydergine) was compared with placebo, using a double-blind technique in a sample of nursing home residents with evidence of OBS. An 18-category symptom rating scale was used for periodic assessment over a six-month interval. Comparisons of the two groups of subjects disclosed that the Hydergine-treated group showed statistically significantly more improvement in most of the variables measured, especially during the last three months of treatment. Furthermore, sophisticated analysis revealed that positive changes in cognitive function cannot be accounted for as a mere reflection, or "halo" effect, associated with improved mood and general sense of well-being.

Administration, Oral

The Brief Outpatient Psychopathology Scale (BOPS).

The pertinence of a rating scale capable of characterizing presenting psychopathology and measuring degrees of change for psychoneurotic patients treated in an outpatient setting is described. Data for 328 patients who represent 1191 rating profiles were used to develop the factor structure for the New Physician's Rating List, a rating scale completed by health professionals after Patient interviews. Findings were used to develop the new Brief Outpatient Psychopathology Scale. A proposed factor structure is discussed. The structures of both scales include an Anxiety Syndrome composed of Anxiety and Psychomotor Activation Factors. The scales also include Depression and Somatization factors.

Ambulatory Care

An application of actuarial methods in psychiatric diagnosis.

An actuarial program for psychiatric diagnosis is evaluated for agreement with final clinical diagnosis in a series of 288 patients. The acturial program provides a probability differential diagnosis based on an analysis of history and background data, symptom rating profiles, and MMPI clinical scale profiles. The observed agreement with final clinical diagnosis is approximately 50% higher than previously reported for psychological testing in this same setting. The results emphasize the importance for psychologists of clinical interview and observation skills.

Brief Psychiatric Rating Scale