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V Leslie

Publications and source records attributed to V Leslie.

5 recordsLinked to original sources
PubMed1992

Primary and preschool immunisation in Grampian: progress and the 1990 contract.

OBJECTIVE: To examine changes in immunisation performance in Grampian region after the introduction of the 1990 contract for general practitioners. DESIGN: Retrospective descriptive study using data held on the Grampian immunisation record system's computer. SETTING: All 95 general practices in Grampian region (313 general practitioners). PATIENTS: All children in the primary immunisation and preschool booster age groups. This formed two groups of children for each of the four calendar quarters of 1990 and first three quarters of 1991 analysed as (a) those aged 2 years on the first day of the relevant quarter and (b) those aged 5 years on the first day of the relevant quarter, with an average population of 6600 and 6400 respectively. MAIN OUTCOME MEASURE: Percentage immunised by practice. RESULTS: For primary immunisation the number of practices achieving immunisation rates of at least 95% increased from 29 (31%) to 76 (81%), and practices achieving 90% rates rose from 69 (73%) to 87 (93%). For preschool boosters, the number of practices achieving at least 95% immunisation rates increased from 22 (23%) to 61 (64%). By the end of September 1991, 76 (80%) practices were achieving at least 90% levels compared with 36 (39%) at the beginning of 1990. Since the beginning of 1989 the proportion of immunisations not given by general practitioners declined from 14% to 2%. CONCLUSIONS: Primary and preschool immunisation rates for preschool children in Grampian showed a sustained improvement during 1990 and consolidation in 1991. Although overall trends were unchanged, 18 months after the introduction of the 1990 contract only one practice failed to meet lower target levels of 70% for both primary and preschool immunisation. By September 1991 more than three out of four practices had reached levels of at least 95% for primary immunisation.

Child, Preschool↗
PubMedDate not supplied

Psychiatric disorders in patients with fibromyalgia. A multicenter investigation.

The authors conducted an investigation in four tertiary-care centers to determine if psychiatric comorbidity and psychological variables were predictive of functional impairment in patients with fibromyalgia syndrome (FMS). Seventy-three individuals were administered the Structured Clinical Interview for DSM-III-R, the Rand 36-item Health Survey (SF-36), and multiple self-report measures. The patients with FMS were found to have a high lifetime and current prevalence of major depression and panic disorder. The most common disorders were major depression (lifetime [L] = 68%, current [C] = 22%); dysthymia (10% [C only]); panic disorder (L = 16%, C = 7%); and simple phobia (L = 16%, C = 12%). The self-report scales revealed significant elevations in depression, anxiety, neuroticism, and hypochondriasis. Functional impairment on all measures of the SF-36 was severe (e.g., physical functioning = 45.5 and role limitations due to physical problems = 20.0). Stepwise multiple-regression analysis revealed that current anxiety was the only variable that predicted a significant proportion of the variance (29%) in SF-36 physical functioning. Thus, in this multicenter study, the persons with FMS exhibited marked functional impairment, high levels of some lifetime and current psychiatric disorders, and significant current psychological distress. Current anxiety level appears to be an important correlate of functional impairment in individuals with FMS.

Adult↗
PubMedDate not supplied

Axis I and Axis II disorder comorbidity in unipolar depression with anger attacks.

OBJECTIVE: We evaluated whether anger attacks in patients with major depressive disorder (MDD) are associated with higher rates of panic or other Axis I or II comorbid disorders. METHODS: 306 out-patients (163 women, mean age 39.5+/-10.5) with MDD were administered the Structured Clinical Interviews for Axis I and II Disorders, and the Anger Attacks Questionnaire. RESULTS: Patients with anger attacks showed only a trend toward a significantly higher rate of current panic disorder (P = 0.06) but no other difference in Axis I comorbidity. In addition patients with anger attacks had a slightly but significantly greater degree of depression severity. Consistent with previous studies, we have also found that depressed patients with anger attacks had significantly higher rates of dependent, avoidant, narcissistic, borderline, and antisocial personality disorders than those without anger attacks. CONCLUSION: Anger attacks do not appear to be associated with any specific pattern of Axis I comorbidity, but they are certainly linked with certain personality disorders. It is possible that the acute depressive state may have confounded the assessment of personality disorder rates, as well as the presence of anger attacks. On the other hand, both depressed patient groups (with or without anger attacks) were subject to the same confounding effect as their depression severity was rather comparable, thereby limiting the impact of this potential bias.

Adolescent↗