R L Suddath — Page 2 | PubMed Health

PubMedDate not supplied

Shape analysis of the middle cranial fossa of schizophrenic patients. A computerized tomographic study.

Recent morphometric studies indicate that both right and left temporal lobe volumes are reduced in schizophrenic patients. Subsequent studies suggested that this volumetric reduction is the result of focal or multifocal gray matter abnormalities. Since in early life brain growth or lack thereof influences the overlying skull configuration, we attempted to elucidate the time of onset of the temporal lobe lesion in schizophrenic patients by quantifying both the volume and shape of their middle cranial fossa. Computerized tomographic scans of 17 schizophrenic patients and an equal number of age-matched controls were digitized using a LOATS image analysis system. The middle cranial fossa was manually outlined and software routines allowed the quantification of volume and shape parameters. Our results showed that no significant differences were present between schizophrenic patients and controls. If the bilateral reduction in temporal lobe volumes in schizophrenic patients is the result of an early onset (e.g., developmental) lesion, the resultant foci of gray matter abnormality may occur distant to the base of the skull. Alternatively, tissue loss may be insufficient to alter the development of the overlying skull or to be detected by our methods.

Dominance, Cerebral↗

PubMedDate not supplied

Preliminary evidence of the reliability and validity of the prospective life-chart methodology (LCM-p).

This article describes the use of the NIMH prospective life-charting methodology (NIMH LCM-p) in the context of a formal double-blind, clinical trial and provides preliminary evidence of its reliability and validity. Subjects included in this report were 30 outpatients with bipolar I and II disorder who completed the first 2 years of a long-term maintenance study: 1 year on carbamazepine or lithium and a crossover to the other in the second year. The LCM-p follows the same types of guidelines and principles utilized in the previously described retrospective life-chart process, allowing for continuity of illness assessment prior and subsequent to study entry. In the LCM-p, daily ratings of severity of mood symptoms based on the degree of associated functional incapacity, provide a more detailed topography of manic and depressive fluctuations. Inter-rater reliability was examined by comparing the severity of daily LCM-p ratings assigned by two raters. In order to assess the validity, we correlated the LCM-p ratings with well-standardized scales, including Hamilton and Beck Depression Ratings, Young Mania Ratings and the Global Assessment Scale (GAS). The Kappa scores for inter-rater reliability demonstrated significant and satisfactory strength of agreement with no fall off over 14 days prior to the rating interview. Strong correlations were found: (1) between the LCM-p average severity for depression rating and the mean Hamilton Depression Rating (r = 0.86, p < .001), and the Beck Depression Inventory (r = 0.73, p < .001); 2) between the LCM-p average severity for mania rating and the Young Mania Rating Scale (r = 0.61, p < .001); and (3) between the LCM-p average severity and the GAS (r = -0.81, p < .001). These preliminary data suggest the reliability and validity of the NIMH-LCM-p in assessing manic and depressive episode severity. It also provides a useful continuous daily measure of affective illness-related symptom fluctuations that allows for detailed prospective assessment of frequency and pattern of illness, treatment response, and continuity with retrospective life chart assessments.

Anticonvulsants↗