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Biomedical subjects

J L Woolston

Publications and source records attributed to J L Woolston.

At least 19 recordsLinked to original sources
PubMed1994

Clozapine in the treatment of a young adolescent with schizophrenia.

Although recent reports have suggested that clozapine may be efficacious in the treatment of adolescents with schizophrenia, few studies have examined the use of clozapine in patients younger than 17 years of age. We describe highly successful trials of clozapine conducted in a 13-year-old girl and her cousin, both of whom developed severe symptoms of schizophrenia, which were refractory to neuroleptic medication, at the ages of 11 and 13 years, respectively. The pharmacology of and clinical experience with clozapine are reviewed.

Adolescent↗
PubMed1991

The boundaries of attention deficit disorder.

This report examines distinctions and interrelationships among attention deficit disorder (ADD) and two closely related conditions: learning disability (LD) and oppositional/conduct (O/C) disorder. To evaluate our hypothesis that some of the difficulty in resolving the relationship between ADD and, particularly, O/C may reflect the consequences of selective referral patterns, we studied groups of children diagnosed as ADD from different referral sources. Results suggest that referral bias does exist and that children referred to mental health settings differ from those referred to pediatricians, child neurologists, or psychologists. Because of the nature of the subjects referred to mental health services, nonrepresentative associations may emerge. Rather than being considered as prototypical of all children with attention disorder, children referred to mental health facilities may represent simply an extreme of the continuum of ADD. Evidence suggests that many children with ADD will be represented by those referred primarily for attentional deficits and learning problems, rather than those with inattention, hyperactivity, or aggression referred for child psychiatric evaluation.

Adolescent↗
PubMed1990

Fluoxetine treatment of children and adolescents with Tourette's and obsessive compulsive disorders: preliminary clinical experience.

Fluoxetine hydrochloride is the first selective serotonin uptake inhibitor introduced commercially in the United States. This report describes preliminary clinical experience with fluoxetine in 10 children and adolescents, aged 8 to 15 years, with primary obsessive compulsive disorder (OCD) or Tourette's syndrome (TS) plus OCD. In general, fluoxetine, which was administered from 4 to 20 weeks at a dosage of 10 or 40 mg per day, was well tolerated. Adverse effects included behavioral agitation/activation in four patients and mild gastrointestinal symptoms in two patients. No abnormalities were noted in the seven children who had follow-up EKGs. Five of the 10 patients (50%) were considered responders; their obsessive-compulsive symptoms decreased substantially during treatment with fluoxetine. Responder rates were similar in the primary OCD (two of four, 50%) and TS + OCD (three of six, 50%) groups. In conclusion, short-term fluoxetine administration appears to be safe in children and adolescents. Placebo-controlled trials are needed to further assess the efficacy of fluoxetine.

Adolescent↗
PubMed1990

The role of advanced technology in inpatient child psychiatry: leading edge or useful aid?

New technology has played a catalytic role in advancing understanding of etiology, diagnosis, and treatment in virtually all fields of medicine. Child psychiatry, a relatively new medical specialty, has begun to employ such advanced technology in diagnosis and treatment monitoring. This current study demonstrates that, in an inpatient child psychiatric setting, such advanced technology has a positive diagnostic yield of 5% for new medical diagnoses and a cost of about 0.5% of the hospital bed cost. Other tests, such as psychotropic blood level monitoring and psychometric evaluation of cognitive functioning, have a much higher yield.

Adolescent↗
PubMed1989

Transactional risk model for short and intermediate term psychiatric inpatient treatment of children.

The transactional model provides a novel guide for the psychiatric hospital treatment of children by improving the attunement between the child and his or her important interpersonal environment. Since children's development is highly context dependent, generalization of the gains made in the hospital will largely depend upon how well the child's parents and school can internalize the hospital experience. One method to implement this transactional model is to bring the child's parents and school into the hospital to join the child's treatment team.

Child↗
PubMed1989

Fluoxetine overdose in an adolescent.

The response to and management of an acute ingestion of a large quantity of fluoxetine hydrochloride in a 13-year-old boy with Tourette's syndrome and obsessive compulsive disorder is described. The patient's symptomatic course following the ingestion included a grand mal seizure, depressed ST segments on EKG, nausea, dizziness, and headache. In general, the fluoxetine was well tolerated: all of the symptoms and signs remitted spontaneously.

Adolescent↗
PubMed1989

Childhood comorbidity of anxiety/affective disorders and behavior disorders.

Considerable data have been reported concerning comorbidity of various individual psychiatric disorders in children within the diagnostic supradomains of affect/anxiety disorders and behavior disorders as well as between these supradomains. To further examine such comorbidity, 35 psychiatrically hospitalized children were studied in terms of the prevalence of comorbidity, demographic and cognitive characteristics, adaptive functioning and maladaptive behaviors. The prevalence of comorbid behavior + affect/anxiety disorders exceeded 50% of the samples. Children with such comorbidity were similar to children with Behavior only diagnoses in terms of demographic and cognitive characteristics but differed in terms of adaptive functioning and maladaptive behaviors.

Anxiety Disorders↗
PubMed1980

Behavior modification protocols on a pediatric adolescent unit.

The use of operant conditioning protocols for the management of behavioral disturbances of hospitalized adolescents with serious chronic medical illnesses is discussed in this paper. The use of the protocol from the point of view of changing hospital staff interaction is emphasized. Three cases are used to illustrate the process by which the protocol is created and its therapeutic effect on the patient and staff.

Adolescent↗