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M Folstein

Publications and source records attributed to M Folstein.

At least 37 records · Page 2Linked to original sources
PubMed1988

Neuropsychological and neuroradiological correlates in Huntington's disease.

Measurements of cortical and subcortical atrophy were made on CT scans of 34 patients with Huntington's disease. Significant correlations were found between the bicaudate ratio (BCR) and an eye movement scale (r = 0.44, p less than 0.01), and activities of daily living scale (r = 0.57, p less than 0.001) and the Mini-Mental State Exam (r = 0.49, p less than 0.01). No correlations were found between BCR values and severity of chorea or voluntary motor impairment. A detailed neuropsychological evaluation of 18 Huntington's disease patients showed significant correlations between the BCR and Symbol Digit Modalities test (r = 0.65, p less than 0.01), and parts A (r = 0.72, p less than 0.001) and B (r = 0.80, p less than 0.0001) of the Trail Making Test. These data support work in primates that demonstrates the role of the caudate nucleus in cognitive and oculomotor functions, but not in motor control (which is governed by putamino-subthalamic systems). The specific cognitive skills correlated with caudate atrophy in Huntington's disease are those reported in primate work to be served by the frontal-caudate loop system: eye movements, conceptual tracking, set shifting and psychomotor speed.

Adolescent↗
PubMed1985

Comparison of the lay Diagnostic Interview Schedule and a standardized psychiatric diagnosis. Experience in eastern Baltimore.

We studied DSM-III diagnoses made by the lay Diagnostic Interview Schedule (DIS) method in relation to a standardized DSM-III diagnosis by psychiatrists in the two-stage Baltimore Epidemiologic Catchment Area mental morbidity survey. Generally, prevalence estimates based on the DIS one-month diagnoses were significantly different from those based on the psychiatric diagnoses. Subjects identified as cases by each method were often different subjects. Measured in terms of kappa, the chance-corrected degree of agreement between the DIS and psychiatrists' one-month diagnoses was moderate for DSM-III alcohol-use disorder (abuse and dependence combined), and lower for other mental disorder categories. The unreliability of either the DIS or psychiatric diagnoses is one potential explanation for the observed disagreements. Others include the following: insufficient or inadequate information (on which to base a diagnosis); recency of disorder; incomplete criterion coverage; overinclusive DIS questions; and degree of reliance on subject symptom reports. Further study of the nature and sources of these discrepancies is underway. This work should produce a more complete understanding of obstacles to mental disorder case ascertainment by lay interview and clinical examination methods in the context of a field survey.

Adolescent↗
PubMed1985

Cerebrospinal fluid acetylcholinesterase activity in senile dementia of the Alzheimer type.

Acetylcholinesterase (AChE) activity was measured in cerebrospinal fluid (CSF) samples from 36 individuals, including 12 persons with Alzheimer's disease, 12 normal controls, and 12 patients with other dementias. AChE activity also was measured in 47 normal subjects whose ages ranged from 20 to 84 to evaluate the effect of age on AChE activity. CSF from patients with senile dementia of the Alzheimer type showed significantly lower mean AChE activity than in age-matched controls and patients with other dementia syndromes. No correlation was found between duration of illness, age, or severity of illness (as measured by the Mini-Mental State Examination score) and CSF AChE activity in Alzheimer's disease. AChE increased significantly over the age range of 20 to 84. CSF AChE activity may prove to be a useful diagnostic test to confirm the clinical diagnosis of moderate to severe Alzheimer's disease.

Acetylcholinesterase↗
PubMed1985

Prevalence of treated and untreated DSM-III schizophrenia. Results of a two-stage community survey.

Psychiatrists, using a standardized clinical method, examined a probability sample of 810 subjects in eastern Baltimore and made diagnoses of mental disorders among those subjects according to DSM-III criteria. The authors estimated that there were 4.6 active cases of schizophrenia per 1000 adult noninstitutionalized population, and 6.4 cases per 1000 population, including both active and remitted cases. Among the 17 active and remitted schizophrenics identified in the survey, one half were not receiving any form of mental health services at the time of the survey; these data yield a prevalence rate of untreated cases of 3.1 per 1000 population. All of the untreated schizophrenics were deemed by the examining psychiatrist to be in need of services.

Adolescent↗
PubMed1985

Diagnosing dementia. Univariate and multivariate analyses of the mental status examination.

Investigators have reported poor recognition of dementia by primary physicians. For this reason, mental status examinations were performed on 72 demented and 144 nondemented medical inpatients to assess the sensitivity, specificity, and predictive value of components of this examination in the diagnosis of dementia. Sensitivity of individual level-of-orientation items was low (15.3 to 56.9%), though specificity was high (91.7 to 100%). Sensitivity of several nonorientation items was high (80.6 to 100%), though specificity was low. A multivariate discriminant equation using both orientation and nonorientation items achieved high sensitivity (89.6% test cases, 87.5% validation cases) and specificity (78.1% test cases, 87.5% validation cases). Adding the easily obtained patient characteristic of age to the equation further increased sensitivity (95.8%, 91.3%), while maintaining specificity (82.3%, 85.4%). From these results, it is concluded that the level-of-orientation screening examination used by clinicians to detect dementia is unacceptably insensitive. In contrast, a composite decision rule including nonorientation items achieves high sensitivity with relatively high specificity.

Adult↗
PubMed1985

The meaning of cognitive impairment in the elderly.

In order to determine the meaning of cognitive impairment in community dwelling elderly, 3,481 adults were interviewed in their homes using the Mini-Mental State Examination. Ninety-six per cent of the population aged 18-64 scored 23 or higher, whereas 80 per cent of the population 65 and over scored 23 or higher. Individuals with low scores were suffering from a variety of psychiatric disorders including dementia. Thirty-three per cent of the elderly population scoring in the range of 0-23 had no diagnosable DSM-III condition. Prevalence of dementia from all causes was 6.1 per cent of the population over age 65. Two per cent of the population over age 65 were diagnosed as having Alzheimer's disease.

Adolescent↗
PubMed1984

Clinical diagnosis of Alzheimer's disease: report of the NINCDS-ADRDA Work Group under the auspices of Department of Health and Human Services Task Force on Alzheimer's Disease.

Clinical criteria for the diagnosis of Alzheimer's disease include insidious onset and progressive impairment of memory and other cognitive functions. There are no motor, sensory, or coordination deficits early in the disease. The diagnosis cannot be determined by laboratory tests. These tests are important primarily in identifying other possible causes of dementia that must be excluded before the diagnosis of Alzheimer's disease may be made with confidence. Neuropsychological tests provide confirmatory evidence of the diagnosis of dementia and help to assess the course and response to therapy. The criteria proposed are intended to serve as a guide for the diagnosis of probable, possible, and definite Alzheimer's disease; these criteria will be revised as more definitive information become available.

Alzheimer Disease↗
PubMed1983

Utilization of psychiatric consultation for elderly patients.

Six hundred fifty-one psychiatric consultations performed during a one-year period were reviewed retrospectively. Cognitive impairment was present in 54 per cent and depression in 27 per cent of the elderly patients in the population studied. A second study of the point prevalence of cognitive and emotional disorders in the hospital was carried out using the Mini-Mental State Exam and the General Health Questionnaire. Emotional disorders had similar prevalences in all age groups but cognitive disorders were more common in the elderly. Twenty-one per cent of consultations were done on patients over the age of 60, although elderly patients occupied 28.5 per cent of hospital beds. Thus, elderly patients were less often referred for psychiatric consultation than younger patients, although the incidence of psychiatric disorders increases with age.

Adolescent↗
PubMed1981

Psychiatric effects of alternate day steroid therapy.

The prevalence of emotional disorder in a total of 72 patients suffering from myasthenia gravis of from peripheral neuromuscular disorders was assessed, using the General Health Questionnaire and Present State Examination. Approximately half the patients were being treated with an alternate day regime of prednisone, receiving high dosage one day and low the next. Emotional disorder was found to be less prevalent among these patients than among patients not on steroids. The significance of the finding is discussed.

Adult↗
PubMed1980

Emotional disturbance in hearing clinic patients.

A group of outpatients scheduled for hearing evaluation were screened for psychiatric morbidity using the General Health Questionnaire (GHQ-30). There was an association between objective hearing loss and elevated GHQ-30 score. An association was also found between the presence of tinnitus and vestibular symptoms and elevated GHQ-30 score.

Adult↗