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Biomedical subjects

J Opie

Publications and source records attributed to J Opie.

7 recordsLinked to original sources
PubMed2006

A comparison of the efficacy and safety of olanzapine and risperidone in the treatment of elderly patients with schizophrenia: an open study of six months duration.

BACKGROUND: Following an earlier study in which elderly patients with schizophrenia had their typical antipsychotic medication changed to olanzapine or risperidone, the 61 patients were followed for up to a further six months to see if either treatment was superior in terms of efficacy or side effects. AIMS: To determine whether either olanzapine or risperidone was superior in terms of efficacy or side effects when treating schizophrenia in late life. METHODS: Psychiatric symptoms, side effects and quality of life were rated every six weeks for 24 weeks of open label comparative treatment using standard measures. Group differences were examined using analysis of covariance and within-group changes over time were assessed using paired t-tests. RESULTS: There were 34 olanzapine and 32 risperidone patients who entered the study, but intention to treat data was only available for 61 of the 66 patients. There were no clinical or demographic differences between the groups. Parkinsonism, positive and negative symptoms of schizophrenia improved in both groups both from baseline switch to olanzapine or risperidone and during the six month follow-up after completion of crossover. No significant differences were seen between groups on most measures. However, patients treated with olanzapine showed a significantly greater improvement in quality of life from baseline compared to risperidone patients. CONCLUSIONS: Both drugs were well tolerated and their use was associated with fewer symptoms of schizophrenia and less adverse effects than were seen when the patients were taking a typical antipsychotic at baseline. Olanzapine appears to have particular benefit with regard to quality of life.

Aged↗
PubMed2003

The impact upon extra-pyramidal side effects, clinical symptoms and quality of life of a switch from conventional to atypical antipsychotics (risperidone or olanzapine) in elderly patients with schizophrenia.

BACKGROUND: Atypical antipsychotics are commonly used in the management of schizophrenia in late life with evidence suggesting they induce lower rates of motor disturbance, but have similar efficacy to conventional antipsychotics. Trials in the elderly have been either retrospective, small, of short duration or of a single-arm design. AIMS: To demonstrate the effects upon motor side-effects, efficacy, safety and quality of life (QOL) of switching elderly patients with schizophrenia from conventional antipsychotics to olanzapine or risperidone. METHODS: Elderly patients with schizophrenia were randomly allocated to olanzapine or risperidone and followed through an open-label crossover period. Between and within group intention to treat analyses were conducted. RESULTS: 66 patients were randomised (mean age 69.6 [SD +/- 6.2]). Four (11.8%) patients on olanzapine and 8 (26.7%) patients on risperidone failed to complete the crossover because of treatment failure [Odds Ratio (OR) = 2.73[0.73-10.2] p = 0.14]. The mean doses upon completion of switching in each arm were 9.9 mg (SD = 4.2) and 1.7 mg (SD = 1.2) for olanzapine and risperidone respectively. In both arms there was improvement in Parkinsonism, though only olanzapine was associated with a reduction in dyskinetic symptoms. The Brief Psychiatric Rating Scale, Scale for the assessment of Negative Symptoms and Montgomery and Asberg Depression Rating Scale scores all improved through the crossover period in both arms with no between group differences. Treatment with olanzapine was associated with a better response over risperidone on the psychological domain of the World Health Organisation-Quality Of Life [Brief] (WHO-QOL-BREF) scale ( p = 0.02). Patients in the olanzapine arm also demonstrated improvement from baseline in the WHO-QOL-BREF physical, psychological and health satisfaction domains, but risperidone had no effect on any Quality of Life (QOL) measure. CONCLUSIONS: After switching from a conventional antipsychotic, olanzapine and risperidone were associated with improvement in core symptoms of schizophrenia and motor side effects. Subjects switched to olanzapine were more likely to complete the switching process and show an improvement in psychological QOL.

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PubMed1999

A connectionist theory of phenomenal experience.

When cognitive scientists apply computational theory to the problem of phenomenal consciousness, as many have been doing recently, there are two fundamentally distinct approaches available. Consciousness is to be explained either in terms of the nature of the representational vehicles the brain deploys or in terms of the computational processes defined over these vehicles. We call versions of these two approaches vehicle and process theories of consciousness, respectively. However, although there may be space for vehicle theories of consciousness in cognitive science, they are relatively rare. This is because of the influence exerted, on the one hand, by a large body of research that purports to show that the explicit representation of information in the brain and conscious experience are dissociable, and on the other, by the classical computational theory of mind--the theory that takes human cognition to be a species of symbol manipulation. Two recent developments in cognitive science combine to suggest that a reappraisal of this situation is in order. First, a number of theorists have recently been highly critical of the experimental methodologies used in the dissociation studies--so critical, in fact, that it is no longer reasonable to assume that the dissociability of conscious experience and explicit representation has been adequately demonstrated. Second, classicism, as a theory of human cognition, is no longer as dominant in cognitive science as it once was. It now has a lively competitor in the form of connectionism; and connectionism, unlike classicism, does have the computational resources to support a robust vehicle theory of consciousness. In this target article we develop and defend this connectionist vehicle theory of consciousness. It takes the form of the following simple empirical hypothesis: phenomenal experience consists of the explicit representation of information in neurally realized parallel distributed processing (PDP) networks. This hypothesis leads us to reassess some common wisdom about consciousness, but, we argue, in fruitful and ultimately plausible ways.

Cognition↗
PubMed1999

The efficacy of psychosocial approaches to behaviour disorders in dementia: a systematic literature review.

OBJECTIVE: This paper provides a systematic review of research findings published between 1989 and 1998 concerning non-pharmacological strategies to alleviate behavioural disturbances in elderly persons with dementia. METHOD: Data collection strategies included computer literature searches, manual searches of selected journals and checks of references listed in previous reviews. To warrant inclusion, studies were required to include some measure of behaviour before and after the introduction of an intervention. Papers were appraised in the following domains: design, sampling technique, setting, behaviours studied, measurement tools, data collection methods, type of interventions and feasibility. An overall validity rating was assigned to each article using predetermined rules. RESULTS: Forty-three studies met criteria for inclusion including five randomised controlled trials. Validity ratings were as follows: one strong, 15 moderate, and 27 weak. Areas of scientific weakness included small numbers of subjects, inadequate descriptions of study participants, imprecise data collection methods, high attrition rates and insufficient statistical analysis. Despite this, there is evidence to support the efficacy of activity programs, music, behaviour therapy, light therapy, carer education and changes to the physical environment. The evidence in favour of multidisciplinary teams, massage and aromatherapy is inconclusive. CONCLUSIONS: It was easier to interpret the results of rigorously designed studies that focused on a single behaviour or single intervention tailored to the needs of individuals and carers. Future studies should seek to replicate the findings outlined here, improving methodologies where necessary and including outcome measures that encompass the interests of people with dementia, family caregivers and health professionals.

Aged↗
PubMed1999

The effect of long-term deafness on speech recognition in postlingually deafened adult CLARION cochlear implant users.

Research suggests that duration of deafness prior to cochlear implantation affects postoperative speech recognition in adults. Duration of deafness usually is defined as the number of years between the onset of profound deafness and implantation. The purpose of this study was to examine the effects of duration of deafness--expressed as percentage of life with deafness--independent of age at implantation on postoperative speech recognition in adult postlingually deafened CLARION Multi-Strategy Cochlear Implant users. Speech recognition tests (CID sentences and NU6 words) were administered to 202 consecutively implanted adults preoperatively and at 3 and 6 months after initial device fitting. Patients implanted at a younger age and those with smaller percentages of their lives with deafness achieved the highest levels of short-term postoperative speech recognition. Patients who had been deaf for > or =60% of their lives demonstrated a slower rate of speech recognition improvement than those with shorter durations of deafness, but still continued to improve with increased implant experience.

Adult↗
PubMed1989

Modulation interference in detection and discrimination of amplitude modulation.

Two experiments were conducted to assess the effect of the rate of sinusoidal amplitude modulation (SAM) of a masker tone on detection of SAM of a probe tone (experiment 1) or on SAM-rate discrimination for the probe tone (experiment 2). When modulated at the same rate as the probe, the masker interfered with both the detection of probe modulation and the discrimination of the rate of probe modulation. The interference was obtained when the masker was either higher or lower in frequency than the probe (the probe and masker were separated by 2 oct). The amount of interference in detecting probe modulation (experiment 1) decreased as the common base rate of modulation was increased from 5 to 200 Hz. For rate discrimination (experiment 2), the amount of interference remained approximately the same for base rates of 2-40 Hz, the range over which rate discrimination was measured. In both experiments, the amount of interference was reduced when the masker was modulated at a different rate than the probe.

Acoustic Stimulation↗