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Biomedical subjects

P M Kramer

Publications and source records attributed to P M Kramer.

23 records · Page 2Linked to original sources
PubMed1984

A brief instrument for longitudinal monitoring of mood states.

We describe the development of a practical instrument for longitudinal assessment of affective symptoms in large samples. An 11-item questionnaire was completed twice daily by normal and affectively disordered subjects for 90 days to determine which subjective states to measure; and to compare the 100 mm visual analogue format with a segmented visual analogue format on morning and evening ratings. The final instrument consists of three bipolar ratings--mood, anxiety, and energy levels--on a segmented visual analogue format, plus hours of sleep. It is administered once a day, in the morning. The instrument has high subject and rating compliance for studying infradian cycles.

Emotions↗
PubMed1984

The Clarke Institute experience with electroconvulsive therapy: I. Development of a clinical audit procedure.

Over the past forty-five years, there has been a progressive refinement of the standards of practice of electroconvulsive therapy (ECT). The need to review contemporary practice patterns to maintain and further improve those standards is discussed. In this context, the respective roles of medical audits and surveys of practice are described and the methodology of recent surveys critically examined. A procedure for the collection of reliable and complete data on the more than 22,000 treatments administered at one psychiatric hospital is described as the essential element of both an accurate survey of practice and a clinical audit. The audit is designed to retrospectively review and prospectively monitor the practice of ECT to identify the areas of conformity with and divergence from current standards of practice. it is recommended that this kind of audit procedure be an integral part of the present day administration of ECT. It is also suggested as a paradigm for hospital practice auditing with potential application to other specific treatments.

Data Collection↗
PubMed1984

The Clarke Institute experience with electroconvulsive therapy: II. Treatment evaluation and standards of practice.

Contemporary standards of practice of electroconvulsive therapy with respect to the treatment procedure, clinical indications, and dosage (number of treatments per course) are summarized. The actual clinical practice at one psychiatric hospital over a 16-year period, comprising 22,647 treatments, was compared to those standards. The most significant findings in this series were the over-representation of patients with a diagnosis of schizophrenia and the absence of any clinically significant difference in the treatment dosage for schizophrenia and affective disorders. The significance of these findings is discussed with respect to their identification of patient subgroups that warrant case auditing. In addition, the results are used as a basis for a critical examination of the rationale for the presently recommended maximum treatment dosages.

Affective Disorders, Psychotic↗
PubMed1982

Clinical significance of the interaction between lithium and a neuromuscular blocker.

Reports of delayed recovery from anesthesia by patients concurrently receiving lithium carbonate and a neuromuscular blocker have been followed by a recommendation to avoid such a combination and, hence, concurrent treatment with lithium and electroconvulsive therapy (ECT). The authors review the literature and their clinical experience with such a drug combination at one psychiatric hospital. They conclude that the clinical and experimental findings to date are insufficient to warrant proscribing the combination of lithium and ECT on the basis of possible potentiation of neuromuscular blockade by lithium.

Adult↗