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Biomedical subjects

R Chandrasena

Publications and source records attributed to R Chandrasena.

15 recordsLinked to original sources
PubMed1992

A dose-finding study with remoxipride in the acute treatment of schizophrenic patients.

Two hundred and forty-two patients with acute schizophrenia were enrolled in a double-blind, comparative, dose-finding study of a novel antipsychotic, remoxipride. Remoxipride was evaluated in a low (30 to 90 mg), medium (120 to 240 mg) and a high (300 to 600 mg) dose range and compared with a haloperidol (15 to 45 mg), which was administered to a similar group of patients. The results support the antipsychotic effect of remoxipride, with maximum efficacy occurring at daily doses between 120 mg and 600 mg. Side-effects were more frequent at doses of remoxipride over 300 mg. In all groups, remoxipride caused consistently fewer extrapyramidal side-effects than haloperidol. The antipsychotic effect of remoxipride may be derived from specific blockade of dopamine D2 receptors in the mesolimbic tract. The findings also suggest that remoxipride may have a therapeutic effect on negative symptoms of schizophrenia.

Dose-Response Relationship, Drug↗
PubMed1991

Suicide among immigrant psychiatric patients in Canada.

Ninety-four Canadian-born psychiatric patients who committed suicide were compared with 23 foreign-born patients committing suicide in Canada. East Europeans were over-represented, and significant differences were found in the age distribution, stress, level of education, social isolation, and methods of suicide. Most foreign-born patients had come to Canada for family or economic reasons but were unemployed, with poor social integration. Employment, housing, education, social integration and a support network seem to be important in preventing these deaths. Cultural evaluation of the patient and early intervention is recommended.

Acculturation↗
PubMed1989

Electroconvulsive therapy: a consensus on contemporary issues.

Electroconvulsive therapy remains a clinically useful, efficacious and safe treatment. All scientific studies, task force reports and legal evaluations attest to this. Nevertheless its use remains controversial. Administration of ECT is a skilled procedure requiring an up-to-date knowledge of the technology, techniques, clinical implications, possible adverse effects and an awareness of the medico-legal and administrative requirements. Only then will this treatment be administered in the highest acceptable clinical standards. This paper reviews of recent advances in ECT where broad consensus exist.

Depressive Disorder↗
PubMed1987

Schneider's First Rank Symptoms: an international and interethnic comparative study.

419 patients in Sri Lanka, 150 patients in U.K. and 172 patients in Canada who were suffering from "Functional Psychoses" were interviewed using the Present State Examination to elicit Schneider's First Rank Symptoms (FRS). Nationality and ethnicity were found to be significant variables associated with lower prevalence of FRS. Higher prevalence of cultural and subcultural beliefs among ethnic minorities may contribute towards this lower prevalence but a true reduction also appears to be present. Prevalence of some individual FRS also vary with ethnicity and nationality. Universally, FRS had a good discriminative value.

Canada↗
PubMed1987

Premature discharges: a comparative study.

One hundred and ninety-eight AMA and 81 AWOL discharged patients were compared with a control group of 256 inpatients. Each group had sociodemographic and clinical characteristics which were predictors of their hospitalization outcome and both AMA/AWOL discharges were at high risk of readmission in the short and long-term following their discharge. These patients occupy a significant amount of hospital resources and have an adverse effect on ward milieu. Their management raises moral, ethical and medicolegal concerns. The data offers a Canadian perspective to the literature and discusses reasons for possible differences between AMA and AWOL discharges. Some remedial measures for the caring of these "revolving door patients" are suggested.

Hospitals, Psychiatric↗
PubMed1986

Catatonic schizophrenia: an international comparative study.

Thirty-five hospitalized catatonic schizophrenic patients from Sri Lanka were compared with 22 patients in the U.K. and 13 in Canada. The phenomenology was established using the Present State Examination. Results suggest that ethnicity, chronicity of illness and reception of neuroleptic treatment may influence the lower prevalence of catatonic symptoms among the U.K. and Canadian schizophrenics. Onset of illness appears to be among young adults and mutism, stupor, mannerisms, stereotypes and negativism were the common catatonic symptoms observed.

Adolescent↗
PubMed1986

Regional Review Boards of Ontario: a medico-legal review.

The functioning of the Regional Review Boards of Ontario (RRB) or their equivalents in other provinces has not been previously reviewed. This study reviews socio-demographic and clinical data of 248 patients seen between 1974 and 1983 by the RRB. The RRB heard 132 applications as 116 were withdrawn. The results are compared with 173 matched inpatient controls. Applications by psychiatrists were infrequently withdrawn or revoked. Long delays between the time of application and the hearing, and a trend towards increasing numbers of applications were noted. Schizophrenia and affective disorder were the most prevalent diagnosis with alcohol abuse and organic brain syndrome being less common among applicants. An increase in duration of stay and transfer to chronic care institutions were found among applicants. Results suggest that RRB's are not 'rubber stamping bodies' and should be more readily available and should have increased public accountability. Future changes to the Mental Health Act should be based on scientific data.

Commitment of Persons with Psychiatric Disorders↗
PubMed1981

A transcultural evaluation of "self poisoning" in Sri Lanka.

64 patients admitted to Kandy General Hospital, Sri Lanka, following 'self-poisoning' were interviewed. The sample resembled those from Western countries in that a major cause was inter-personal disputes, but differed from the West in that the disputes were mainly between patient and kin. Other differences were that social isolation was not a cause, agricultural pesticides were the commonest poisons used, relatively few patients were referred for psychiatric advice, and recidivism was very infrequent. An attempt is made to explain the differences on a socio-cultural basis.

Adolescent↗