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Biomedical subjects

T R Dening

Publications and source records attributed to T R Dening.

14 recordsLinked to original sources
PubMed1992

Feelings of guilt in major depression. Conceptual and psychometric aspects.

A new scale for the evaluation of feelings of guilt is described. Two types of guilt feeling were of potential interest: 'delusional' guilt or shame (experienced in relation to one's actions), and 'affective' guilt (a more general feeling of unworthiness). Reliability and validity analyses for the first (15-item) version of the scale were performed in three separate and contrasting clinical samples. The second and final (seven-item) version was tested in another sample of major depressives and in normal controls. The HRSD was used as a measure of severity throughout. The BDI and Widlöcher psychomotor retardation scale were also used as external criteria for the seven-item scale. Exploratory factor analysis of this sample yielded two factors--'cognitive/attitudinal' and 'mood/feeling'--of which only the first correlated with scores for psychomotor retardation. It is suggested that these two factors represent two forms of guilt, but that only the former is related to a putative dopaminergic disorder. Guilt scores and measures of severity were not correlated. It is suggested that feelings of guilt should be considered as a behavioural marker for a subtype of depression.

Adult↗
PubMed1991

The neuropsychiatry of Wilson's disease: a review.

Psychiatric symptoms are frequently encountered in Wilson's disease (WD). The recent resurgence of interest in neuropsychiatry has led to a more detailed consideration of the psychopathology associated with WD. As suggested by Wilson, disorders of affect, behavior and personality are the most common features. Contrary to Wilson's view, recent evidence suggests that such symptoms have an organic basis. Cognitive impairments tend to be mild and improve with treatment. There is a lack of recent evidence for an association between WD and organic delusional disorders.

Hepatolenticular Degeneration↗
PubMed1990

Wilson's disease: a longitudinal study of psychiatric symptoms.

One hundred and twenty-nine cases of Wilson's disease (WD) were assessed at index admission and two follow-ups (F1 and F2) on a range of clinical and biochemical variables. The commonest psychiatric symptoms throughout were incongruous behavior, irritability, depression, and cognitive impairment. Among psychiatric cases, most improvements occurred in the interval index-F1, with subsequent leveling off. Significant improvement occurred only with incongruous behavior and cognitive impairment. Psychiatric cases whose psychiatric symptoms persisted to F2 differed from those who responded, in particular showing more dysarthria, incongruous behavior, and hepatic symptoms. Neuropsychiatric cases displayed more dysarthria and incongruous behavior than patients with neurological symptoms alone. Further evidence for associations between dysarthria and abnormal behavior emerged from this study.

Adolescent↗
PubMed1989

Wilson's disease. Psychiatric symptoms in 195 cases.

A series of 195 cases of Wilson's disease were assessed retrospectively on a range of variables, including psychiatric, neurologic, and hepatic symptoms, and biochemical data as recorded at first admission to a specialist clinic. Ninety-nine patients (51%) were rated as displaying some evidence of psychopathologic features, and 39 (20%) had seen a psychiatrist before the diagnosis of Wilson's disease. The most common psychiatric features were abnormal behavior and personality change, although depression and cognitive impairment were also rated frequently. Schizophrenialike psychoses were rare, apparently occurring at no more than chance frequency. Psychiatric symptoms were related to neurologic rather than hepatic symptoms, and certain symptoms (incongruous behavior, irritability, and personality change) had a particularly significant relationship with bulbar and dystonic disorders but not with tremor. Psychiatric manifestations are important in Wilson's disease, and many of the psychopathologic features seem to have an organic basis.

Adult↗
PubMed1989

Wilson's disease: clinical groups in 400 cases.

Existence of clinical subgroups among cases of Wilson's disease has long been postulated and various classifications suggested but none statistically tested. This study analyses, by means of pattern recognition techniques, 400 cases from 4 series including our own (n = 195). Factor analysis (to summarise variables) and cluster analysis (to derive groups of patients) were performed. From each series 4 clusters were derived, each containing a "hepatic" and at least one "neurological" cluster, other clusters being "mixed hepatic & neurological" (3 series) and "asymptomatic" (3 series). Two series contained 2 "neurological" clusters; one dividing in terms of age and the other in terms of presence or absence of psychopathology. At least 2 factors, "hepatic" and "neurological", emerged from each series. Reasons for differences are discussed. In conclusion, Wilson's disease is not homogenous: clinical groupings are supported by statistical classification.

Adolescent↗
PubMed1989

Multiple serial lycanthropy. A case report.

A case is described who exhibited lycanthropy during an acute psychotic illness. During a short period she experienced herself as four different species of animal, an occurrence not previously reported. The phenomenon of lycanthropy is most appropriately regarded as a delusion, but the abnormal subjective experience is stressed, not just the falsely-held belief.

Adult↗
PubMed1989

Wilson's disease: a prospective study of psychopathology in 31 cases.

A prospective neuropsychiatric study of 31 consecutive subjects with Wilson's disease is reported. Exploratory factor analysis yielded four factors: neurological, cognitive, hepatic/depressive and psychiatric. Significant associations were found between a 'psychopathic' personality factor and neurological and dysarthria scores. The d' and beta coefficients of a signal-detection memory task dissociated: the former correlated only with Mini-Mental State and Benton visuospatial task; and the latter with depressive symptoms. Using discriminant function analysis, there was efficient classification of 'psychopathic' personality by dysarthria, and of individual depressive symptoms by disturbance of gait. Biochemical markers of hepatic dysfunction were significantly associated with certain depressive symptoms. No evidence emerged to support the putative association with schizophrenia-like psychosis.

Adult↗
PubMed1988

Wilson's disease and epilepsy.

The relationship between Wilson's disease and epilepsy is explored, both in the literature and in a series of 200 cases of Wilson's disease. Details of 44 literature and 14 personal cases of both disorders are presented. The prevalence on December 1, 1986 of epilepsy in the Cambridge series was 6.2%, ten times higher than that of epilepsy in the general population. Seizures in Wilson's disease occur at any stage of the disease, but often begin shortly after the start of treatment. Prognosis of seizures was comparable with the best quoted figures for idiopathic epilepsy: at 7 years 60% of cases had been seizure-free for at least 5 years, and 75% for at least 2 years. Possible mechanisms of seizures are discussed. Penicillamine-induced pyridoxine deficiency is probably not involved in more than a minority of cases. It is more likely that a direct effect of copper deposition is responsible for most of the seizures.

Adolescent↗
PubMed1985

Psychiatric aspects of Wilson's disease.

A variety of psychiatric symptoms have been described in relation to Wilson's disease, an inherited disorder of copper metabolism. At least four symptom clusters can be identified: affective, behavioural/personality, schizophrenia-like, and cognitive; the first two groups appear to be the commonest. Four cases (three newly reported) are described, and current approaches to the psychiatric management of Wilson's disease discussed.

Adolescent↗