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Biomedical subjects

Paul Mackin

Publications and source records attributed to Paul Mackin.

12 recordsLinked to original sources
PubMed2006

Executive and visuospatial sketchpad resources in euthymic bipolar disorder: Implications for visuospatial working memory architecture.

Visuospatial working memory theory is used to interpret the cognitive impairment in euthymic bipolar disorder. Such patients show deficits in the Corsi Blocks Test (CBT) and executive control. To understand these deficits, 20 euthymic bipolar patients and controls were administered the CBT, Visual Patterns Test (VPT), and a new visual memory task designed to make minimal demands on executive resources. Initial analyses validated the visual memory task and implicated executive involvement in the CBT and VPT. Subsequent analyses on a number of tests confirmed CBT and executive deficits while performance was normal on the VPT and visual memory test. ANCOVA indicated that impaired executive function underpinned patients' CBT performance. Implications for the interface between executive and slave systems of working memory are discussed.

Adolescent↗
PubMed2006

Culture and assessment of manic symptoms.

Cultural background may influence the perception of psychiatric symptoms. We examined the effects of cultural biases on the identification of manic symptoms using the Young Mania Rating Scale. Two video interviews, each with an American person with mania, were shown to psychiatrists from three countries (US, UK and India). Total scores on the scale differed significantly between the US and UK (P<0.001) and between India and UK (P<0.001) rater groups. Overall, differences between India and US rater groups were less marked (P=0.28). These differences suggest that cultural biases influence the interpretation of manic symptoms.

Analysis of Variance↗
PubMed2005

QTc interval measurement and metabolic parameters in psychiatric patients taking typical or atypical antipsychotic drugs: a preliminary study.

BACKGROUND: Antipsychotic drugs have been associated with prolongation of the QTc interval on the electrocardiogram, and QTc prolongation is, in turn, associated with an increased risk of cardiac arrhythmias and sudden death. Antipsychotic polypharmacy has been implicated in reduced survival, possibly secondary to cardiotoxic effects of antipsychotic medication. Abnormalities of glucose homeostasis, which may be more common in individuals with major mood disorders and schizophrenia, also affect the QTc interval. METHOD: We performed detailed assessment of metabolic parameters in 103 psychiatric out-patients, from across the diagnostic spectrum, who had been taking antipsychotic medication (typical, atypical, or a combination thereof) for a minimum of 6 months. We measured the QTc interval in a subset of these patients (N = 65). RESULTS: Only 2 patients (3%) had a prolonged QTc interval. There was a statistical trend (p = .08) toward a lower QTc interval in patients receiving antipsychotic polypharmacy. QTc interval was associated with age (p = .04) but not with any metabolic parameter. CONCLUSION: QTc prolongation in this population is uncommon. There was a significant association between increasing age and QTc interval, but cardiac repolarization was not related to any metabolic parameter. Further large prospective studies of similar patients are needed to confirm these findings.

Alcohol Drinking↗
PubMed2004

Rapid cycling bipolar disorder: historical overview and focus on emerging treatments.

OBJECTIVE: Rapid cycling bipolar disorder presents a significant challenge with respect to treatment. The cyclical nature of bipolar disorder has been well recognised for over a century, and following Dunner and Fieve's landmark paper in 1974, investigators have increasingly turned their attention to issues such as the definition of rapid cycling, demographic characterisation, treatment response and pharmacologic intervention. METHODS: A literature search using Medline was performed, and selected articles which consider important developments in the definition, demographics and course of rapid cycling are reviewed. In addition, a systematic review of the literature published during the past 5 years (1999-2004) relating to treatment was conducted. RESULTS: Relevant articles are reviewed. CONCLUSIONS: This review highlights the important developments in our understanding of rapid cycling bipolar disorder, and focuses particularly on the recent literature regarding treatment.

Anticonvulsants↗
PubMed2003

Significance of microalbuminuria in long-duration type 1 diabetes.

OBJECTIVE: The value of microalbuminuria (MA) in predicting renal disease and premature mortality in longer duration type 1 diabetes is unclear. RESEARCH DESIGN AND METHODS: We followed 135 patients with long-standing type 1 diabetes (>30 years' duration) over a 7-year period, recording albuminuria and other clinical variables. Vital status was ascertained and cause of death was recorded. RESULTS: A total of 27 of 135 patients (20%) died during the follow-up period. Patients with MA (10 of 30, 33.3%) or proteinuria (5 of 6, 83.3%) at initial examination were more likely to die during follow-up than patients who had normal albumin excretion at baseline (12 of 99, 12%; chi(2) for trend 21.9, P < 0.0001). The presence of abnormal albumin excretion and low BMI were independent risk factors of premature death. The causes of death were similar in patients with normal and abnormal urine albumin excretion. A total of 24.4% of initially normoalbuminuric survivors developed MA, and persistent proteinuria developed in 3.5%. Progressors had significantly higher albumin excretion rate at baseline compared with those who remained normoalbuminuric: 9.0 microg/min (3.8-18) vs. 4.0 microg/min (0.4-17.5); P < 0.001. A total of 21% of patients with MA at baseline reverted to normoalbuminuria, and persistent proteinuria developed in 32%. The likelihood of progression to persistent proteinuria was significantly greater in those with baseline MA compared with those with normal albumin excretion (P < 0.001). CONCLUSIONS: Even in long-standing type 1 diabetes of >30 years' duration, MA and proteinuria predict all-cause mortality. MA is a good predictor of persistent proteinuria.

Adult↗