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Biomedical subjects

R F Kokes

Publications and source records attributed to R F Kokes.

36 records · Page 2Linked to original sources
PubMed1981

Established chronicity of psychotic symptoms in first-admission schizophrenic patients.

The course of schizophrenia before a patient's first admission is important theoretically, prognostically, and from a preventive psychiatric perspective. However, there is little systematically collected information on this topic. In this evaluation of a representative sample of first-admission schizophrenic patients, there was a wide variation in chronicity of psychotic symptoms before admission, with 20% of the patients having been symptomatic for more than 2 years and 28% for less than 1 week. Delusions of grandeur, delusions of reference, and suspiciousness were more common in the more chronic patients than in the most acute patients; symptoms of withdrawal and retardation showed the opposite pattern. The authors discuss the implications of these findings for prognosis, prevention, and theory.

Acute Disease↗
PubMed1980

Child Competence and psychiatric risk. VI. Summary and integration of findings.

A review of the major findings of the five previous papers in the series is presented and points of integration of the results are noted. Particular emphasis is placed on the role of diagnosis in predicting child competence as well as on differences related to whether or not the mother or the father is the patient. Also, the need to design studies to tease out the relative contributions of patient and family variables is pointed out.

Achievement↗
PubMed1980

Schizophrenia: affect and outcome.

Considerable data suggest that schizophrenic patients with affective symptoms have a more favorable outcome than other schizophrenic patients. This may indicate that such patients are more validly regarded as having either an affective disorder or a schizoaffective psychosis. Studies of this issue have suffered from significant methodologic problems, including inappropriate sampling, unsystematic collection of symptom data, unreliable diagnostic procedures, and restricted outcome assessment. The present study, designed to surmount these methodologic difficulties, indicates that while levels of psychotic symptoms in schizophrenic patients correlate with poor outcome, affective symptoms have little prognostic power.

Adolescent↗
PubMed1980

Child competence and psychiatric risk. III. Comparisons based on diagnosis of hospitalized parent.

The school competence of children whose parents were previously hospitalized for psychiatric disorder was studied. These children, at risk themselves for behavioral disorder, were compared to classmates as well as to each other based upon the diagnosis of the hospitalized parent. Four diagnostic groups were employed: narrowly defined schizophrenic, broadly defined schizophrenic, affective psychotic, and hospitalized nonpsychotic patients. Significant differences between the risk sample and classmates are reported along with differences among the diagnostic groups. Sons of nonpsychotic hospitalized patients were functioning most poorly and were in marked defiance of peer and adult norms. Parental and child IQ were found to have had little impact upon the data and were not considered major interactive variables. Issues concerning systems of diagnoses and the developmental implications of the findings are presented.

Achievement↗
PubMed1979

Do psychiatric patients fit their diagnoses? Patterns of symptomatology as described with the biplot.

Systems of psychiatric diagnosis have been regularly criticized for their low reliability and their inability to fit accurately the kinds of patients coming for treatment. To explore the reasons for these problems, this study utilizes a new method, the biplot, for defining groups of similar patients and the relationships of these groups to key symptom clusters. Using this technique to analyze data from a representative sample of first admissions for psychiatric disorder, results showed: a) symptom clusters representing the classical diagnostic categories, mania, schizophrenia, neurotic depression, and psychotic depression, were readily identified; b) however, only a few patients were clustered near these traditional syndromes. These findings suggest that although syndromes do exist that fit traditional diagnostic categories, the vast majority of patients fall between these syndromes, having characteristics from several of them. For most patients, forcing the diagnostician to choose among the categories requires an arbitrary decision that may contribute to dissatisfaction in the diagnostician who recognizes how misleading the diagnosis can be.

Adjustment Disorders↗
PubMed1978

Patterns of disorder in first admission psychiatric patients.

Are there patterns of characteristics in psychiatric patients, different from traditional diagnostic considerations, that could provide important information for understanding, treatment, and research? To pursue this question, this report describes an investigation of clinical and demographic characteristics in a representative sample of first admissions for functional psychiatric disorder. Analyzing the patterns of these characteristics showed that social class had a particularly key role relating to a larger number of characteristics than did symptom and functioning measures. Symptoms when analyzed together revealed replicated factors not corresponding to diagnostic types. The implications of these and other findings for considering a broad perspective in conceptualizing, studying, and treating psychiatric disorder are discussed.

Adolescent↗
PubMed1977

Lost subjects. Source of bias in clinical research?

This report describes a study of subject refusal as a source of bias limiting the generality of psychiatric research results. Fifty psychiatric patients who refused to participate in a battery of research interviews and psychological tests were compared with 50 participant patients. Between-group comparisons were made on an extensive and detailed set of clinical, treatment, and demographic data. Results revealed a remarkable lack of difference between the participant and refusal groups in demographic features, type or duration of hospitalization, and type or degree of pathology as defined by symptoms, prognostic measures, and diagnoses. These results and a review of related studies suggest that sample bias in psychiatric research resulting from loss of eligible subjects by refusal depends on the amount of institutional contact and the severity of disorder in the sample studied.

Adolescent↗
PubMed1977

Prognostic implications of various drinking patterns in psychiatric patients.

The authors examined the drinking patterns of 198 first admission nonalcoholic psychiatric patients to determine the relationship among drinking behavior, severity of pathology, and prognosis. Heavy drinking in the psychiatric sample was not associated with increased levels of pathology and poor prognosis. To the contrary, among these nonalcoholic patients the abstainers and occasional drinkers showed the most severe pathology and poorest prognosis of all drinking groups.

Adult↗