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Biomedical subjects

S Gowers

Publications and source records attributed to S Gowers.

15 recordsLinked to original sources
PubMed2001

Enuresis and encopresis in a south Indian population of children.

INTRODUCTION: Though bladder and bowel control are important developmental milestones in all cultures, the prevalence of enuresis and encopresis has rarely been studied in developing countries despite there being factors in these countries that could affect it. This study reports the prevalence and associations of enuresis and encopresis in children in Kerala, India. METHOD: The parents of 1403 randomly selected 8-12-year-old children were interviewed. The prevalence of enuresis and encopresis was ascertained using Rutter's A2 scale. Subsamples of children underwent psychiatric, physical and psychometric evaluations. RESULTS: Of the children, 18.6% had had an episode of enuresis in the past year and 4.3% in the past week. Four per cent had had an episode of encopresis in the past year. Enuresis was associated with parents' education, physical and psychiatric symptoms in the child, poor academic achievement and lax parental attitudes to toilet training. Encopresis was associated with male sex, physical and psychiatric symptoms, poor academic achievement, early separation and not having a toilet. DISCUSSION: The prevalence of enuresis compares with western countries, but encopresis is commoner. The associations of enuresis suggested a multifactorial model in which parental competence was prominent. This study de-emphasized the importance of neurodevelopmental factors in enuresis and encopresis in this age group.

Child↗
PubMed2000

Life events in a South Indian population and their association with psychiatric disorder in children.

Western research suggests that life events contribute to childhood psychiatric disorder but no studies have examined this in developing countries. During a population-based study of 1,403 8-12 year old children in Kerala, South India, a life events schedule was administered to parents of children with ICD10 psychiatric disorders (n = 72) and controls. Life events were associated with lower social class, greater poverty, less educated parents, worse physical health and psychiatric disorder. Multivariate analysis confirmed the association of life events with psychiatric disorder, independent of indices of social adversity.

Child↗
PubMed1999

Anorexia nervosa, psychopathology, and outcome.

OBJECTIVE: To examine for specificity of Eating Disorders Inventory (EDI) ratings and differences in self-reported cognitions and clinical outcome between adolescent cases of anorexia nervosa (AN) with and without comorbid depression. METHOD: Thirty-five subjects with AN and matched psychiatric and community controls received the EDI and a structured diagnostic interview. AN subjects were followed up at 1 and 2 years using the EDI and a semistructured interview to assess outcome. RESULTS: Subjects with AN and those with other psychiatric disorders scored similarly on the EDI. Differences between AN cases and community controls were marked for comorbid cases but rare for noncomorbid cases. Comorbid AN cases had an equally good outcome compared to those with AN alone. DISCUSSION: Abnormal cognitions reported in the EDI are much greater in those cases with comorbid depression, but neither the presence of depression nor high EDI scores appears to adversely affect prognosis.

Adolescent↗
PubMed1999

Difficulties in family functioning and adolescent anorexia nervosa.

BACKGROUND: Difficulties in family functioning are often evident when an adolescent has anorexia nervosa, and the possible causative or contributory role of such difficulties in the illness is unclear. AIMS: To elucidate the relationship between severity of anorexia nervosa and difficulties in family functioning and whether clinical improvement results in diminution of self-rated family difficulties. METHOD: Thirty-five adolescents with anorexia nervosa and their mothers completed the Family Assessment Device (FAD) while clinicians administered the McMaster's Structured Interview of Family Functioning (McSIFF). Severity of anorexia nervosa was rated at baseline and at one year follow-up using the Morgan-Russell Schedule. RESULTS: Clinicians and patients were more critical of the families' functioning than parents. There was an inverse association between the extent of family difficulties and severity of anorexia nervosa. Over time subjects improved clinically but this was not matched by improvement in family functioning. CONCLUSIONS: Difficulties in family functioning do not appear to be directly associated with severity of anorexia nervosa nor do these difficulties reduce with clinical improvement, in the short term.

Adolescent↗
PubMed1999

The prevalence and associations of psychiatric disorder in children in Kerala, South India.

This study aimed to identify the prevalence and associations of childhood psychiatric disorder in Calicut District, South India. Among 1403 children aged 8 to 12 years selected by random cluster sampling, a projected prevalence of 9.4% (95% CI 7.9-10.8%) was found. Associations of disorder with male sex, the Muslim religion, lower social class, less parental education, school failure, and impaired reading and vocabulary were found, but not with malnutrition or perinatal problems. The similarity to associations of disorder in Western studies was noted. The discussion focuses on the validity of comparisons of prevalence across cultures.

Affective Symptoms↗
PubMed1997

Family functioning and life events in the outcome of adolescent anorexia nervosa.

BACKGROUND: This study investigates the outcome of anorexia nervosa in adolescents in relation to precipitating life events and changes in family functioning over time. METHOD: Thirty-five adolescents with anorexia nervosa and their mothers were administered measures of life events and family functioning at initial assessment and 1 and 2 year follow-up, when outcome was also assessed. RESULTS: Fifty-five per cent of patients had a good outcome. Patients from initially well-functioning families or those with precipitating life events improved more in the first year, than those with dysfunctional families or without events. Subjects perceived a deterioration in family functioning at 1 year follow-up but an improvement at 2 years. Mothers reported no changes. CONCLUSIONS: Approximately half of a series of early onset cases of anorexia nervosa can be expected to recover by 2 years. Healthy family functioning and presence of a precipitating life event predict good short-term outcome. The relationships between subjects' perceptions of family functioning and their recovery from anorexia nervosa is discussed.

Adolescent↗
PubMed1996

Pilot study of continuation cognitive-behavioral therapy for major depression in adolescent psychiatric patients.

OBJECTIVE: To determine whether continuation of cognitive-behavioral therapy (CBT-C) could prevent relapse in adolescent psychiatric patients who had remitted from major depressive disorder (MDD). METHOD: Seventeen patients who continued to have CBT-C for 6 months after remission from MDD were compared with a historical control group of 12 cases who had no further treatment after remission. RESULTS: Only 1 of the 17 cases who continued with CBT-C dropped out. The cumulative relapse risk during CBT-C was significantly lower (0.2) than it had been in the historical control group (0.5). CONCLUSIONS: CBT-C warrants further investigation in a randomized, controlled trial.

Cognitive Behavioral Therapy↗
PubMed1995

Family functioning in adolescent anorexia nervosa.

BACKGROUND: Difficulties in family functioning have been noted since early descriptions of anorexia nervosa and may be of importance aetiologically. Previous studies have a number of methodological problems. METHOD: Thirty-five anorexic adolescents were age/sex matched with psychiatric and community controls. A diagnostic interview and a questionnaire, the Family Assessment Device (FAD) were administered to control subjects and their mothers. Anorexic families only received the McMaster Structured Interview of Family Functioning. RESULTS: Multivariate analyses of FAD scores showed pathological ratings for psychiatric control but not anorexic families, compared with community controls. By contrast objective ratings revealed marked dysfunction in anorexic families (greater in the purging subgroup). CONCLUSION: Family functioning in anorexic families is normal by self-report but not by an objective measure. Anorexic families in the purging subgroup appear most dysfunctional.

Adolescent↗
PubMed1994

Outcome of outpatient psychotherapy in a random allocation treatment study of anorexia nervosa.

Ninety subjects with DSM-III-R anorexia nervosa were randomly allocated to four treatment options, one inpatient, two outpatient, and one comprising an assessment interview only. Twenty were thus offered a package of outpatient individual and family psychotherapy. At 2-year follow-up, 12 of the 20 were classed as well, or very nearly well, according to operationally defined criteria. Statistically significant improvements over time were obtained for weight, mean body mass index (BMI), and also for psychological, sexual, and socioeconomic adjustments. Weight and BMI changes were significantly better than for the assessment only group, some of whom had received extensive treatment elsewhere. The style of the outpatient therapy and compliance with it are described in some detail and prognostic indicators for the treated and untreated groups presented. Lower weights at presentation and vomiting were associated with poorer outcome, although age and length of history were not.

Adaptation, Psychological↗
PubMed1994

Reliability and validity of the Westminster Substance Use Questionnaire among Lancashire adolescents.

The reliability and validity of the Westminster Substance Use Questionnaire (WASQ) was examined in a pilot study involving a sample of secondary school pupils in Blackburn borough, Lancashire, UK. The questionnaire performed well on all the indices tested and the findings of the exercise facilitated a fairly accurate and meaningful interpretation of the prevalence data obtained in the main study. The instrument is thus recommended for use in adolescent substance use surveys in the UK and elsewhere although further validation or slight modification may be necessary to suit local needs.

Adolescent↗
PubMed1993

Social and family factors in adolescent psychiatry.

A retrospective analysis of referrals to a regional adolescent psychiatric service over two years was conducted, focusing on selected social and family variables, to identify areas of potential unmet need and the relationship between these factors and clinical variables. Social and family disadvantage was well represented in our patients, but few were over the age of 17 and fewer from ethnic minority backgrounds. Associations between social, family factors, diagnostic and treatment variables are presented and their implications discussed.

Adolescent↗
PubMed1991

A controlled study of the effect of therapies aimed at adolescent and family psychopathology in anorexia nervosa.

Ninety patients with severe anorexia nervosa fulfilling DSM-III-R criteria were assessed in depth in terms of their family developmental psychopathology and then randomly allocated to either one of three treatment groups or to no treatment. In three treatment regimes, a behavioural approach to diet and weight gain was coupled with individual and family psychotherapy directed at the adolescent maturational problems. All three treatment regimes were highly significantly effective at one year in terms of weight gain, return of menstruation, and aspects of social and sexual adjustment. Body weights above those at pubertal onset were achieved for the group mean maximum and one-year follow-up weights for all three treatment groups but not the control group.

Adolescent↗
PubMed1985

Family structure and birth order of patients with anorexia nervosa.

A retrospective case-notes study of 252 patients was undertaken, to focus on their birth order, and other aspects of their sibships. There is little evidence of a relationship to birth order using an established measure (Slater, 1962). Previous researchers have found a preponderance of female siblings in the families of patients with anorexia nervosa. We have not found this, neither is our sample characterised by older or younger siblings of any one sex. This is true for both female and male anorexics. These results are discussed in terms of experimental and family theories concerning the development of anorexia nervosa.

Anorexia Nervosa↗