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Biomedical subjects

J W Goethe

Publications and source records attributed to J W Goethe.

13 recordsLinked to original sources
PubMed1991

Comparison of Diagnostic Interview Schedule to psychiatrist diagnoses of alcohol use disorder in psychiatric inpatients.

This study provides data about the extent of alcohol use disorders among general adult psychiatric inpatients. The accuracy of alcohol use disorder diagnoses given by the lay-administered Diagnostic Interview Schedule (DIS) and by staff psychiatrists, as compared to each other, was investigated. From consecutive admissions to a private psychiatric hospital, 55 patients with alcohol use disorders were identified by trained research assistants using the DIS (n = 162). A comparison of DIS diagnoses to clinicians' diagnoses revealed that 66 patients (40.7% of all admissions) were given an alcohol diagnosis by the DIS or clinician, 35 patients (21.6%) by DIS and clinician, 20 (12.3%) by DIS only, and 11 (6.8%) by clinician only. The two diagnostic approaches were also compared using several accuracy measures (sensitivity and specificity ratios, percentage of agreement, and kappa). With psychiatrists' diagnoses as reference, the DIS sensitivity ratio was 76 and specificity ratio 83. There were 12.3% false positive and 6.8% false negative diagnoses assigned by the DIS. Kappa was .56 and percentage of agreement 80.9%. Recomputing accuracy measures for the psychiatrist, using the DIS as the reference, clinician assessment sensitivity was 64 and specificity 90. Compared to each other, the DIS "overdiagnosed" and the staff psychiatrists "underdiagnosed" by about 1 in 20 cases. Among those alcohol use diagnoses upon which both clinician and DIS agreed, alcohol abuse was the predominant diagnosis. Among all patients with an alcohol diagnosis, the main nonsubstance abuse diagnoses (as assigned by the clinician) were: major depressive, dysthymic, bipolar, schizophrenic, and personality disorders.

Adult↗
PubMed1991

Suicidal behaviors among Connecticut youth.

In the United States, youth (15-24 years) suicide rates increased 191% between 1950 and 1986. This paper presents data regarding suicidal ideation and attempts, suicide-related hospitalizations, and completed suicides among Connecticut youth, comparing them with data from other states and the United States. Girls have higher rates of attempts and hospitalization, boys of completed suicide. Firearms are the suicidal method of choice for both sexes. Nonmetropolitan areas had higher rates than metropolitan. Reported suicidal ideation among students ranged from 10% to as high as 66%, while attempts range from 3% to 15%. The authors stress that caution is necessary when comparing rates, pointing to the need for standardized data collection and analysis. Reported rates of suicidal behavior are lower among Connecticut youth compared to their counterparts in other states, but suicide is increasing among young males in Connecticut and remains a major issue for health care providers.

Adolescent↗
PubMed1990

The effect of being reared with an alcoholic half-sibling: a classic study reanalyzed.

Data from an early study of alcoholism among half-siblings of alcoholic probands (17) was reanalyzed using log-linear analysis. The original study, which used chi-square analysis, identified genetic factors but found no environmental effects that contributed to the prediction of alcoholism. Log-linear analysis, however, reveals that being reared with a proband is associated with a reduced incidence of alcoholism in half-siblings. The results do not disconfirm the presence of genetic factors, but they do indicate that family dynamics make an independent and statistically significant contribution to the development of alcoholism not heretofore demonstrated. Similarities between these results and the results from studies of identical twins are discussed.

Alcoholism↗
PubMed1989

OVERSEER: a prototype expert system for monitoring drug treatment in the psychiatric clinic.

This paper describes the development of OVERSEER: a prototype knowledge-based system that monitors the drug treatment of psychiatric patients in real time. Using treatment protocols developed by the expert clinician, OVERSEER monitors the drug treatment process and issues alerts when standard clinical practices are not followed or when laboratory results are abnormal. Written in Prolog, OVERSEER is designed to interface directly with the hospital's database, and, thereby, utilizes all available pharmacy and laboratory data. Moreover, unlike the interactive expert systems developed for the psychiatric clinic, OVERSEER does not require extensive data entry by the clinician. Consequently, the chief benefit of OVERSEER's monitoring approach is the unobtrusive manner in which it evaluates psychopharmacological treatment and provides information regarding patient management to the hospital.

Drug Therapy, Computer-Assisted↗
PubMed1988

A comparison of adequately vs. inadequately treated depressed patients.

The authors reviewed the records of 201 nonbipolar depressed inpatients to a) determine the level of somatic therapies prescribed and b) compare the characteristics and global outcomes of patients given "adequate" vs. "inadequate" treatment. A stepwise multiple regression analysis revealed that patients given higher levels of somatic therapy were significantly (p less than .001) more likely to be older and have depression with psychotic features and less likely to have compulsive personality disorders. These patients also had significantly longer hospitalizations. A separate stepwise regression analysis showed that patients given higher levels of somatic therapy had superior outcomes (p less than .001). The proportion of this sample given no antidepressant medication or electroconvulsive therapy (18.4%) and the proportion given "adequate" treatment (45.3% to 63.7%, depending on the criteria applied) were comparable to the findings of other published reports.

Adolescent↗
PubMed1987

Expert systems in psychiatry. A review.

Existing computer-based decision aids in the areas of psychiatric diagnosis and consultation are reviewed, and the prospects for expert system development within the mental health field are discussed. Emphasis is placed upon the decision-making models used in these systems rather than on their particular application area. The decision-making paradigms discussed are (1) data bank analysis, (2) statistical pattern recognition, (3) Bayesian analysis, (4) logical flow chart method, and (5) knowledge-based (expert system) approaches. For each paradigm, its essential features, its strengths and weaknesses, and some example applications are presented.

Diagnosis, Computer-Assisted↗
PubMed1986

EEG coherence and power in the discrimination of psychiatric disorders and medication effects.

Electroencephalogram (EEG) coherence (COH) and power measures were included in a series of stepwise discriminant analyses to determine which variables were most sensitive in the differentiation of four psychiatric inpatient groups and two major classes of psychotropic medication. Eight channels of eyes-closed, bipolar EEG activity were recorded from 74 inpatients (paranoid schizophrenics, dysthymics, major affectives receiving tricyclics, neuroleptics, or no medication, and geriatrics). Discriminant analyses were conducted for theta, alpha, and fast beta frequency bands for power variables, COH variables, and the resultant significant power and COH discriminating variables. Without exception, COH measures, usually in the alpha band, were more sensitive than power measures in differentiating the various groups. Results suggested that COH decreases with age, is greatest in paranoid schizophrenics, decreases with neuroleptic medication, and increases with tricyclic antidepressants. Group differences were interpreted in accordance with an arousal model for COH.

Affective Disorders, Psychotic↗
PubMed1986

EEG coherence and power changes during a continuous movement task.

EEG coherence (COH) is a mathematically derived measure of the time- and frequency-related similarities between a pair of EEG channels. In this report, COH was measured during an externally verified motor task in which the areas of cortical involvement are known, with special consideration given to procedural and artifactual issues. Fourteen right-handed women (ages 18-39, means = 26.7 years) were instructed to alternate continuously between fist-clenching and finger extension of the right hand, left hand, both hands, or neither hand (rest condition) in a counter-balanced sequence (4 one-minute trials for each condition; 16 total minutes). One minute each of intentional eye-movement (EOG) and intentional facial muscle tension (EMG) was recorded for artifact assessment. Eight channels of eyes-closed EEG were recorded from Fp1, Fp2, F3, F4, C3, C4, P3 and P4, each referenced to the ipsilateral earlobe. FFT spectral power analyses were conducted on 8 EEG channels and COH analyses (percentage of seconds/minute in which COH greater than or equal to 0.80) were performed on 16 pairs of leads: 4 interhemispheric, 6 intrahemispheric (left) and 6 intrahemispheric (right). COH measures increased during hand movement conditions, especially in the 9-12 Hz range, and were most apparent from prefrontal, premotor and motor areas. Parietal sources were essentially unchanged. Power measures were unchanged for virtually all leads and conditions. Increases in COH were not due to EOG or EMG artifact contamination. Evidence for lateralized increases was equivocal; significant bilateral increases were observed more often regardless of the hand clenched. Implications and suggested areas for future research are discussed.

Adolescent↗