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Biomedical subjects

R E Kendell

Publications and source records attributed to R E Kendell.

At least 19 recordsLinked to original sources
PubMed1991

Relationship between the DSM-IV and the ICD-10.

The 10th revision of the International Classification of Diseases and Related Health Problems (ICD-10; World Health Organization, 1990) and the 4th edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-IV) will both come into use in 1993 and be much more alike than the ICD-9 (World Health Organization, 1978) and the DSM-III (American Psychiatric Association, 1980). The American Psychiatric Association's controversial decision to publish a revision of the DSM-III in 1987 before setting up the Task Force to produce the DSM-IV impaired the association's ability to influence the format of the ICD-10, because by then major decisions had already been made by the World Health Organization. The DSM-IV will be more soundly based on a wider range of empirical data than any previous classification, national or international, and should not be revised again without compelling scientific reasons.

Attitude of Health Personnel↗
PubMed1991

Prophylactic lithium in puerperal psychosis. The experience of three centres.

At three centres, 21 women at high risk for puerperal psychosis were given prophylactic lithium carbonate late in the third trimester of pregnancy or immediately after delivery. Only two of the women had a recurrence of their psychotic illness while on prophylactic lithium. One woman given lithium during third trimester had an unexplained stillbirth. Although a larger sample in a carefully controlled study is still required, there now seems to be grounds for the use of prophylactic lithium immediately after delivery in women not breastfeeding who have previously suffered from either puerperal psychosis or bipolar disorder.

Adolescent↗
PubMed1991

Unexplained fluctuations in the risk for schizophrenia by month and year of birth.

Variation in their year and month of birth was studied in the 13,661 schizophrenics born between 1914 and 1960 known to the Scottish Psychiatric Case Register. Year-to-year fluctuations in the number of schizophrenics per 10,000 live births were outside chance limits. So were month-to-month fluctuations between January 1932 and December 1960, and this was largely due to fluctuations in the numbers of schizophrenics born in February, March, April and May. Time-lagged correlations with mean monthly temperatures suggest that in these same four months the incidence of schizophrenia is influenced by temperature six months previously - the lower the temperature in the autumn the higher the incidence of schizophrenic births the following spring. If these findings can be confirmed in other data sets, they would suggest that some influence which varies consistently with season and temperature is contributing to the aetiology of schizophrenia and may exert its effects as early as the third or fourth month of foetal development.

Cohort Studies↗
PubMed1990

The physician's role.

Physicians can play an important role in society's response to alcohol problems. In diagnosis, alcohol problems among patients are frequently overlooked. Physicians should routinely ask patients about alcohol intake. In light of evidence on the effectiveness of brief interventions, especially with heavy-drinking but nondependent patients, physicians' treatment efforts should be focused in this direction. Patients who are alcohol dependent might best be treated by nonphysicians. Research contributions of physicians should be concentrated on topics for which physician input is needed: longitudinal studies of health consequences, factors contributing to mortality and health service costs, biochemical markers of alcohol use and basic pharmacology. Strong evidence links population alcohol consumption levels to overall harm. Therefore, prevention efforts should be aimed at the population as well as at people who may be at risk. Physicians can contribute to these efforts by influencing public policy and by setting healthy examples in their own alcohol use.

Adolescent↗
PubMed1990

Linguistic performance in schizophrenia: a comparison of acute and chronic patients.

A computer-assisted analysis of samples of free speech from acute schizophrenics (n = 50), chronic schizophrenics (n = 27) and normal subjects (n = 50) enabled a comparison of the linguistic profiles of the three groups. The chronic group consistently emerged as the most impaired, on measures of complexity, integrity (error) and fluency of speech, with the acute patients performing less well than normal speakers but better than chronic patients. Demographic differences could account for only a small number of the linguistic differences. A comparison of chronic schizophrenics from the community and those from long-stay wards suggested that their poor linguistic performance was in some way related to the illness process and not to institutionalisation. Three possible explanations for these results were considered, particularly the possibility that low complexity of speech, negative symptoms and poor outcome are in some way related.

Acute Disease↗
PubMed1990

Re-examination of the language of psychotic subjects.

To investigate whether language in schizophrenia deteriorated progressively, 11 schizophrenic subjects, 9 manic subjects and 9 controls were re-tested after an interval of three years using the computer-assisted syntactical analysis technique of Morice. In 13 of the 16 linguistic variables described as hallmarks of schizophrenic speech decline, deterioration was noted in schizophrenics in the direction predicted and relative to the manic and control groups. The deterioration was most pronounced in complexity and integrity of speech. One variable remained unchanged and two (semantic variables) showed marginal improvement. It was concluded that language, and in particular syntax, does deteriorate in the schizophrenic process.

Bipolar Disorder↗
PubMed1990

Time course of cerebra; magnetic resonance changes after electroconvulsive therapy.

Nuclear magnetic resonance images of the non-dominant cerebral hemisphere were obtained in 20 unipolar depressed patients immediately before and 25 minutes after electroconvulsive therapy (ECT). T1 values rose about 1%. Repeated scanning up to 24 hours after ECT was carried out in 13 of these patients. The greatest change in magnetic resonance images was two hours after ECT, and thereafter images gradually returned to baseline values. There was no correlation between magnetic resonance changes and the time taken to become reorientated after ECT.

Adult↗
PubMed1989

Maternal influenza in the etiology of schizophrenia.

There are epidemiological reasons for suspecting that infections may contribute to the etiology of schizophrenia, and it is claimed that the birth cohort that was in utero during the 1957 influenza epidemic in Helsinki, Finland, now has an increased incidence of schizophrenia. Three studies, all based on the admission statistics of Scottish psychiatric hospitals, were therefore undertaken to determine whether those who were in utero during the influenza A epidemics of 1918 to 1919 and 1957 were subsequently at increased risk of schizophrenia. Edinburgh data suggest that those who were in the sixth month of intrauterine development during the 1957 epidemic were subsequently at increased risk, but Scottish national data do not reveal any increased risk associated with either the 1918 to 1919 or 1957 epidemics. Overall, the hypothesis that maternal influenza may contribute to the etiology of schizophrenia is not supported, but the possibility cannot yet be discounted.

Cohort Studies↗
PubMed1989

Clinical validity.

Few psychiatric disorders have yet been adequately validated and it is still an open issue whether there are genuine boundaries between the clinical syndromes recognized in contemporary classifications, or between these syndromes and normality. In the long run validation depends on the elucidation of aetiological processes. There are, however, a number of strategies which clinicians could use, but at present rarely do, in order to improve and validate existing classifications. Most of these involve studying populations which have been deliberately chosen to represent a broader grouping than a single diagnostic category, or even a group of related categories.

Humans↗
PubMed1988

Long-term followup studies: a commentary.

Recent followup studies establish that schizophrenia, however defined, is a disease of very variable outcome. Many patients recover completely and improvements can occur after many years. This is difficult to reconcile with the concept of slowly progressive brain disease, and it seems increasingly likely that the neuropathology observed in chronic schizophrenia largely precedes the onset of symptoms. The adverse effect of a hostile or overprotective emotional environment on the prognosis of schizophrenia, and recently reported differences in family environments between industrial and Third World countries, may account for the relatively good outcome of schizophrenia in the latter. Despite its many imperfections, the concept of schizophrenia is unlikely to be abandoned until we have radical new insights into the etiology of the "functional psychoses."

Follow-Up Studies↗
PubMed1988

A matched-control follow-up and family study of 'puerperal psychoses'.

A hundred and ten women admitted to a psychiatric hospital within 90 days of childbirth were individually matched for age, psychiatric syndrome, and year of admission with women admitted to the same hospital with illnesses unrelated to childbirth. Both groups were followed up after a mean interval of nine years, and 72 matched pairs of patients for whom adequate information was obtained were then compared. The previous and subsequent psychiatric morbidity of these two groups, their subsequent obstetric careers, and the psychiatric morbidity of their first-degree relatives were all very similar. However, the puerperal women had significantly fewer relapses in the follow-up period, fewer committed suicide, and the psychiatric morbidity of their relatives tended to be lower. This better outcome was most marked in puerperal subjects with major depressions; those with manic disorders fared no better than controls. These results suggest that puerperal psychoses are basically the same as affective illnesses occurring at other times but, because childbirth is a uniquely potent precipitant of affective illness, some of those who develop puerperal episodes have a lesser genetic predisposition to affective illness than the generality of women with affective disorders.

Affective Disorders, Psychotic↗
PubMed1987

Epidemiology of puerperal psychoses.

Computer linkage of an obstetric register and a psychiatric case register made it possible to investigate the temporal relationship between childbirth and psychiatric contact in a population of 470 000 people over a 12-year period: 54 087 births resulted in 120 psychiatric admissions within 90 days of parturition [corrected]. The 'relative risk' of admission to a psychiatric hospital with a psychotic illness was extremely high in the first 30 days after childbirth, particularly in primiparae, suggesting that metabolic factors are involved in the genesis of puerperal psychoses. However, being unmarried, having a first baby, Caesarian section and perinatal death were all associated with an increased risk of psychiatric admission or contact, or both, suggesting that psychological stresses also contribute to this high psychiatric morbidity. Women with a history of manic depressive illness, manic or depressive, had a much higher risk of psychiatric admission in the puerperium than those with a history of schizophrenia or depressive neuroses, and the majority of puerperal admissions met Research Diagnostic Criteria for manic or depressive disorder. Probably, therefore, puerperal psychoses are manic depressive illnesses and unrelated to schizophrenia.

Adolescent↗