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Biomedical subjects

Michael Philpot

Publications and source records attributed to Michael Philpot.

7 recordsLinked to original sources
PubMed2007

A randomized, controlled trial with 6-month follow-up of repetitive transcranial magnetic stimulation and electroconvulsive therapy for severe depression.

OBJECTIVE: Repetitive transcranial magnetic stimulation (rTMS) has been reported to be as effective as electroconvulsive therapy (ECT) for major depression. The authors conducted a multicenter randomized, controlled trial to test the equivalence of rTMS with ECT. METHOD: Forty-six patients with major depression referred for ECT were randomly assigned to either a 15-day course of rTMS of the left dorsolateral prefrontal cortex (N=24) or a standard course of ECT (N=22). The primary outcome measures were the score on the 17-item Hamilton Depression Rating Scale (HAM-D) and the proportion of patients with remissions (Hamilton score, <or=8) at the end of treatment. Secondary outcomes included mood self-ratings on the Beck Depression Inventory-II and visual analogue mood scales, Brief Psychiatric Rating Scale (BPRS) score, and both self-reported and observer-rated cognitive changes. The patients were followed up after 6 months. RESULTS: HAM-D scores at the end of treatment were significantly lower for ECT, with 13 patients (59.1%) achieving remission in the ECT group and four (16.7%) in the rTMS group. However, at 6 months the HAM-D scores did not differ between groups. Beck scale, visual analogue mood scale, and BPRS scores were lower for ECT at the end of treatment and remained lower after 6 months. Self- and observer-rated cognitive measures were similar in the two groups. CONCLUSIONS: rTMS was not as effective as ECT, and ECT was substantially more effective for the short-term treatment of depression.

Aged↗
PubMed2004

An attempt to determine the benefits of a 'home-for-life' principle in residential care for people with dementia and behavioural problems: a comparative cohort study.

It is not clear whether moving individuals with dementia and behavioural problems as part of a rehabilitation and relocation ('intermediate care', IC) nursing home model worsens behaviour, compared with a 'home for life' philosophy. We studied this in contiguous services with the same formal admission criteria but different models of subsequent care. 37 patients admitted to 'homes for life' and 24 to IC homes were followed up for 1 year using the BEHAVE-AD. Scores were lower at baseline in the IC group. Both groups deteriorated over the year, although more in IC patients (trend), and those actually moving home were worse after the move. Use of neuroleptic medication increased significantly in the IC group. Our results confirm previous studies of the disruptive effects of re-location for patients with severe dementia but do not suggest major differences between the two models of care.

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PubMed2002

Attributions of physical symptoms in patients of an old age psychiatry service.

BACKGROUND: Somatization is a phenomenon found across all medical specialities and in all types of care. There has been little in the way of systematic investigation of the phenomenon in older people. OBJECTIVES: The objective was to establish whether treatment for psychiatric illness would be accompanied by a fall in somatic attributions. METHOD: Patients' attributions of physical symptoms were studied in a consecutive group of older people with functional disorders (mostly depression) referred to an old age psychiatry service. Depression, anxiety, physical illness and attributional style were measured soon after referral and seven months later. RESULTS: 41 subjects were interviewed in the first leg. Anxiety was the chief association of abnormal attributional style. At follow up (n = 29) mean depression and anxiety scale scores and somatic attributions of symptoms had fallen significantly. CONCLUSION: Abnormal focus on physical symptoms in depressed elderly patients may resolve with treatment.

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PubMed2002

Genetics, molecular biology, neuropathology and phenotype of frontal lobe dementia: a case history.

BACKGROUND: Mutations in tau have been found in a group of related disorders including the frontal lobe dementias. AIMS: To describe the clinical features and molecular pathology changes in a single case of a patient with frontal lobe dementia. METHOD: A case report was compiled from neuropathological reports and genomic and gene expression analyses. RESULTS: A case with a splice-site mutation resulting in a typical frontotemporal clinical and neuropathological phenotype was found. Gene expression analysis suggests differential expression of isoforms of tau in regions in the brain. CONCLUSIONS; Frontotemporal dementia can result from gene mutations that alter splicing and expression of tau.

Dementia↗