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Biomedical subjects

T P Berney

Publications and source records attributed to T P Berney.

At least 19 recordsLinked to original sources
PubMed2003

Preliminary evaluation of a scale to assess cognitive function in adults with Down's syndrome: the Prudhoe Cognitive Function Test.

BACKGROUND: In the clinical diagnosis of dementia in Down's syndrome (DS), it may be difficult to distinguish between cognitive deterioration and the various degrees of pre-existing intellectual disability (ID). Serial measurements of both cognitive function and behaviour are required. The aim of the present study was to evaluate the performance of non-demented adults with DS on a subject-directed instrument, the Prudhoe Cognitive Function Test (PCFT), preliminary to its serial use in a prospective study. METHODS: From 1985 to 1986, 85 non-demented hospitalized adults with DS were interviewed using the PCFT. The Adaptive Behavior Scale (ABS) was administered to the carers. The subjects' levels of ID (graded from mild through moderate, severe and profound to untestable) were based on their scores on the Stanford-Binet Intelligence Scale, as reported in the medical records, and the relationship between level of disability and performance on the PCFT and ABS, and their respective domains, was examined. RESULTS: Both scales produced a wide range of scores and the correlation between them was highly significant. Both scales correlated highly significantly with the degree of ID, but more subjects with high levels (i.e. profound to untestable) of disability obtained very low or zero scores on the PCFT and its domains than on the ABS. CONCLUSIONS: The PCFT provides a reliable quantitative measure of cognitive function in subjects with DS, and could be a useful adjunct to the diagnosis of dementia in prospective studies. However, the almost uniformly low scores obtained by those with high levels of ID suggests that its power to detect cognitive decline will be limited to those who are less disabled, while the ABS may be more useful than the PCFT in detecting deterioration in people with profound ID.

Adult↗
PubMed2000

Autism--an evolving concept.

BACKGROUND: The rapid increase in research endeavour has not kept pace with the advent of well-publicized theories and treatments for autism. AIMS: To explore some of the newer developments in biological research into autism. METHOD: A review of recent publications and presentations. RESULTS: The concept is shifting from the narrow perception of aloof autism, described by Kanner, to a wider one that includes a spectrum extending to a broader, subclinical phenotype. The genetic basis has been established; now we need to discover the location and interaction of the relevant sites. There is considerable interest in the bowel as a pathogenetic agent, particularly in the effects of exogenous opioids and multiple viral infection (the latter posing a public health problem). Also of concern is the role of (potentially treatable) epilepsy, analogous to the Laudau-Kleffner syndrome. CONCLUSIONS: In the absence of a cure, the implementation of ideas will continue to outstrip factual evidence. Clinicians are challenged by the availability of information (and misinformation), particularly on the internet.

Autistic Disorder↗
PubMed1999

Behavioural phenotype of Cornelia de Lange syndrome.

A postal questionnaire was used to study 49 individuals with Cornelia de Lange syndrome (including both the classical and the mild forms) to ascertain behavioural phenotype. Ages ranged from early childhood to adulthood (mean age, 10.2 years; SD, 7.8) and the degree of mental retardation from borderline (10%), through mild (8%), moderate (18%), and severe (20%) to profound (43%). A wide variety of symptoms occurred frequently, notably hyperactivity (40%), self injury (44%), daily aggression (49%), and sleep disturbance (55%). These correlated closely with the presence of an autistic like syndrome and with the degree of mental retardation. The frequency and severity of disturbance, continuing beyond childhood, is important when planning the amount and duration of support required by parents.

Adolescent↗
PubMed1997

The use of seclusion and emergency medication in a hospital for people with learning disability.

BACKGROUND: The management of disturbed behaviour in facilities for those with learning disabilities involves a spectrum of approaches including the prescription of emergency medication, restraint and seclusion. The use of these techniques has recently come under close scrutiny. METHOD: All incidents requiring emergency medication or seclusion that occurred in a large hospital for those with learning disabilities were studied over a six-months period. The precipitating factors, course and outcome of those who had received emergency medication or seclusion were then examined. RESULTS: In all, 286 incidents involving 72 individuals occurred during the study period. The episodes requiring seclusion comprised 19% of all incidents. Two-thirds of the patients involved were male but six female patients accounted for 36% of all incidents. During the second part of the study, when the staff knew that the treatments used were being monitored, there was a significant reduction in use of restraint and emergency drugs given intramuscularly. Patients receiving seclusion were judged to have a better outcome one hour after the onset of the incident compared with those who received medication. CONCLUSIONS: Despite concerns about the use of seclusion, the results of this survey suggest that procedures that remove the patient from the environment contributing to the disturbance may have certain advantages in this population.

Adult↗
PubMed1996

PPM-X: a new X-linked mental retardation syndrome with psychosis, pyramidal signs, and macroorchidism maps to Xq28.

We report a three-generation family manifesting a previously undescribed X-linked mental retardation syndrome. Four of the six moderately retarded males have had episodes of manic-depressive psychosis. The phenotype also includes pyramidal signs, Parkinsonian features, and macroorchidism, but there are no characteristic dysmorphic facial features. Affected males do not show fragile sites at distal Xq on cytogenetic analysis, nor do they have expansions of the CGG repeats at the FRAXA, FRAXE, or FRAXF loci. Linkage analyses were undertaken, and a maximal LOD score of 3.311 at theta = .0 was observed with the microsatellite marker DXS1123 in Xq28. A recombination was detected in one of the affected males with DXS1691 (Xq28), which gives the proximal boundary of the localization. No distal recombination has been detected at any of the loci tested.

Adolescent↗
PubMed1991

Diagnosing childhood depression who should be interviewed--parent or child? The Newcastle Child Depression Project.

The extent of the similarities and discrepancies in the reporting of depressive symptomatology by children and their mothers was examined. Child-parent agreement was not always impressive, particularly for more subjective symptoms. It is suggested that direct psychiatric assessment of children provides a more accurate picture of their mental state regardless of presenting disorder, but particularly where depression is suspected.

Adolescent↗
PubMed1991

The context of childhood depression. The Newcastle Childhood Depression Project.

This paper examines the family background, premorbid personality traits and adverse life events preceding childhood depression. The non-depressed group proved more likely to have experienced pre-school bereavement and familial disturbance, and to come from the more deprived background; there was also an excess of premorbid anxiety and hysterical personality traits in this group. School phobia and premorbid obsessional traits were associated with the depressed group. Although there was an association between depression and the total number of adverse life events, this was more substantial when the perceived impact of the events was taken into account. Of the individual classes of life event, only illness and a change in social relationships were associated specifically with depression.

Adaptation, Psychological↗
PubMed1991

Reliability and validity of two self-rating scales in the assessment of childhood depression.

A comparison was made of the reliability and validity of two self-rating scales, the Children's Depression Inventory (CDI) and Depression Self-Rating Scale (DSRS), in the diagnosis of depression in 93 children (aged 8-16 years) attending a university child psychiatry department. The two scales were of comparable merit but had only moderate discrimination between depressed and non-depressed children, with each scale having a misclassification rate of 25%. Better agreement was obtained in more verbally intelligent children, irrespective of age. Girls scored higher on the instruments than boys. No significant relationship was found between teacher assessment of classroom behaviour and the two self-rating depression instruments.

Adolescent↗
PubMed1991

The Newcastle Child Depression Project. Diagnosis and classification of depression.

A total of 275 successive referrals to a university child psychiatry unit out-patient department were examined using the Child Depression Inventory. Of these, 95 children were examined further by a structured clinical interview, and the relationship between different instruments for the assessment of depression in childhood was investigated. Just over one-third of the children (35%) had significant depression, and it was found that depression may be missed unless children with other psychiatric diagnoses are examined closely. Multivariate analyses of the clinical data provided factorial validation of diagnoses when employing different clinical diagnostic schemas.

Adolescent↗
PubMed1990

Reduction in antipsychotic drug dosage in mentally handicapped patients. A hospital study.

An investigation in a large mental handicap hospital revealed that 24% of the in-patients were receiving antipsychotic drugs. Chlorpromazine and thioridazine prescriptions accounted for 62% of the total while 10% of patients received depot preparations. Fifty-five per cent of the patients receiving these drugs had no established psychiatric diagnosis; most of these could be categorised as having a behaviour disorder. Patients aged 30-50 received higher doses, and female patients received a significantly higher mean dosage than male ones. In the patients receiving neuroleptic drugs who had also been taking them four years previously, there was a significant reduction in the dosage of the drugs received and the extent of polypharmacy of these agents. A mandatory requirement to review all prescriptions annually, implemented in 1984, may be a reason for this.

Adolescent↗
PubMed1987

Early onset rapid cycling bipolar affective disorder.

Four cases of rapid cycling bipolar affective disorder are described; the diagnosis being made by DSM(III) criteria. All are children, aged between 11 and 12 at the onset of the illness and all are of low intelligence. The follow-up has ranged from three to five years. The clinical symptoms and their response to treatment are described and the implications of this unusual presentation are discussed.

Adolescent↗
PubMed1984

Factors associated with a good response to lithium in aggressive mentally handicapped subjects.

Twenty-five (25) mentally handicapped in-patient adults with persistent aggressive behaviour took part in a double-blind crossover trial lasting 5 months comparing the effects of lithium with placebo on aspects of aggressive behaviour. All patients were receiving neuroleptic and/or anticonvulsant drugs which were continued during the trial. Seventeen (17) of the patients showed greater improvement during the lithium phase compared to placebo. Multiple regression analysis was carried out to determine which of 17 background variables were related to outcome. The following factors were associated with a good response to lithium: less than one aggressive episode per week before starting treatment, overactivity, stereotypic behaviour, female sex and epilepsy. No patient became toxic during the investigation although lithium levels were maintained within the therapeutic range (0.5-0.8 mmol/l).

Adolescent↗
PubMed1984

Classification and diagnosis of depression in school phobia.

Fifty-one school phobic children, aged nine to fourteen years, were assessed for psychiatric diagnosis; this revealed the presence of two clinically meaningful sub-groups--depressed and residual school phobic. A wide range of symptoms were studied to identify those which might prove useful in diagnosing adult-type depression in childhood and early adolescence, both in terms of frequency of symptoms in the depressed group and the extent of the distinction between the two groups. Eleven such key symptoms were identified and based on these, a formula for diagnosing adult-type depression was evolved. The validity of several different ways of classifying the above cases were explored; these covered: kind of disorder; type of onset; adolescence versus pre-adolescence; and sex of the child. However, on only one dichotomy--depression versus absence of depression--were there many significant discriminants. Affective symptomatology of more recent onset was contrasted with pre-morbid personality traits, usually associated with school phobia. There was no evidence to support the concept of 'masked depression' in childhood.

Adolescent↗
PubMed1981

Effect of discothèque environment on epileptic children.

A free-field study of 22 epileptic children, selected on the basis of past electroencephalographic abnormality, identified a group who exhibited a significant increase in epileptiform discharge rate on electroencephalography in a discothèque environment (p less than 0.05). Laboratory investigations showed that these children were activated by a wide range of stimuli, including intermittent photic stimulation and exercise. The response to exercise was a good predictor of a child's electroencephalographic response in a discothèque. The findings suggest that most epileptic children are not particularly vulnerable in a discothèque environment.

Acoustic Stimulation↗