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 172,036 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

A previously studied group of newly blind adults was followed up after four years. There was only a slight increase in the acquisition of blind skills, while there was a surprising continuing pervasiveness of depression and poor health. A number of variables from the original study and from the follow-up data predicted outcome measures. Significant predictors of depression and distress were poor health, being married, being nonProtestant in this predominantly Protestant London population, and lacking ability to be more independent. Higher social class and an absence of a family history of blindness predicted greater distress. Earlier acceptance of blindness, early learning of blind skills, and better preillness adjustment predicted better coping and greater use of blind skills at follow-up. The extent of the depression and poor health are discussed, and recommendations are made for caregivers.
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PMID:Reactions to blindness: a four-year follow-up study. 358 83

Six thousand consecutive patients in whom retrobulbar anesthesia was performed by an anesthesiologist before ophthalmic surgery were studied. Sixteen patients (1 in 375) developed signs and symptoms presumed to be caused by the direct spread of the local anesthetic agents to the central nervous system. These signs and symptoms ranged from drowsiness, blindness of the contralateral eye, abnormal shivering, or vomiting, through to respiratory depression, apnea, hemiplegia, aphasia, convulsions, unconsciousness, and cardiopulmonary arrest. The severity of the symptoms was unrelated to the dose of anesthetic administered. The time of the onset of symptoms after the retrobulbar injection was variable (average 8 min, range 2 to 40 min). The possibility of a life-threatening complication occurring was rare (1 in 750) but unpredictable. The need for closely monitored anesthesia care of all patients having surgery under retrobulbar anesthesia is stressed.
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PMID:Central nervous system complications after 6000 retrobulbar blocks. 368 1

Even in the presence of normal blood pressure (B.P.) in both arms in some individuals, abnormal B.P. and circulatory disturbances can be found in the brain and lower extremities. The author discovered the following five types of abnormal B.P. in the brain in the presence or absence of normal B.P. in the arms: unilateral cephalic hypertension; bilateral cephalic hypertension; unilateral cephalic hypotension; bilateral cephalic hypotension; mixed cephalic hypertension and hypotension. When the B.P. of the head exceeds about 160 mm Hg, patients experience sensation of increased pressure buildup in the head to moderate headache. When it exceeds over 220 mm Hg, most of them experience severe headache in that side of the head. When the B.P. is very low (less than 30 mm Hg in both sides), majority of the subjects experience sleep disturbance pattern, mainly insomnia and some develop excessive sleepiness; difficulty in concentration and easy forgetfulness of recent events; various degrees of irritability. They are often associated with injury of neck-shoulder area with the presence of spastic muscles in the area. Relaxation of the spastic muscles by acupuncture, TES or soft laser beam from He-Ne (7 approximately 15m Watts) often change the abnormal cephalic B.P. toward normal. Among individuals with cephalic hypotension some of them develop eye problems. Blind patients with macular degeneration and retinitis pigmentosa often have severe cephalic hypotension and reduced blood flow. Improvement of B.P. and blood flow induced by safe and effective electrical stimulation resulted in significant improvement in vision. In some patients, abnormal B.P. and blood flow of the brain are dependent on the position of the head and neck which can be classified as "Cephalo-cervical Position Dependent Dysfunction Syndrome" which interferes with the function of some of the internal organs. In many psychiatric patients with schizophrenia or severe depression, cephalic B.P. and blood flow are often reduced significantly with additional abnormal function of pancreas, thyroid gland or liver. These abnormalities can explain some of the abnormal behavior, particularly when hypoglycemia, decrease in serotonin level and decreased circulation in the brain coexist.(ABSTRACT TRUNCATED AT 400 WORDS)
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PMID:Non-invasive circulatory evaluation and electro-acupuncture & TES treatment of diseases difficult to treat in Western medicine. 614

1 Following a seven day drug-free period, 80 depressed outpatients were randomly allocated to receive mianserin 60 mg nocte or nomifensine 150 mg daily. Blindness was maintained by the use of a double-dummy technique. 2 All measures of efficacy showed a trend in favour of mianserin throughout the four week trial, including the Hamilton Depression Scale (HDS), the Beck Self-rating Depression Inventory (BDI), the Clinical Global Impression (CGI) and the Efficacy Index. 3 Significant advantages in efficacy for mianserin were observed at day 14 on the HDS and at days 7, 14 and 21 on the CGI. 4 Substantially more patients experienced marked or moderate improvement during treatment with mianserin than with nomifensine. Side-effects were low with both drugs. 5 On the basis of the present trial and a previous comparison, mianserin appears to be a more effective antidepressant than nomifensine.
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PMID:A double-blind trial of mianserin and nomifensine in depressed outpatients. 633 9

The Iowa Structured Psychiatric Interview (ISPI) is an interview form designed for psychiatric epidemiological research in the general population. Its use provides detailed information about important aspects of psychiatric, social, and family history. Detailed information is gathered about the frequency and duration of symptoms that characterize schizophrenia, mania, depression, and neurosis. The instrument is also designed to be administered by well-trained nonmedical personnel in order to facilitate its utilization in large-scale field studies. Such interviewers are assumed to be blind to the study status of the informants, and the format of the ISPI maintains that blindness throughout crucial sections of the interview. In addition, the ISPI can be used without any implication that the informant or the informant's relatives have any type of psychiatric history or current psychiatric problems. This monograph discusses the rationale for the ISPI and gives a formative history of the instrument. We also present the results of studies investigating the reliability and validity of a set of twenty screening questions for schizophrenia, mania, depression, and neurosis - items which form the nucleus of the ISPI. The excellent reliability of these items is contrasted with the relatively poor reliability of a set of behavior ratings included in the ISPI. The ISPI itself is given in full in an appendix, along with detailed guidelines for use and suggestions for selecting and training personnel to administer the ISPI in the field. We hope that the ISPI can be further tested by other researchers in psychiatric epidemiology.
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PMID:The iowa structured psychiatric interview. Rationale, reliability, and validity. 693 87

To assess the psychiatric knowledge of medical housestaff, the authors devised an oral examination based on two simulated clinical encounters and administered it to 26 medical residents. The case material embodied those psychiatric problems known to be common in medical populations, namely depression, delirium, dementia, and "psychogenic" pain. The standardized simulations were punctuated by standardized "open" questions with followup probes. A panel of experienced clinicians developed rating criteria for each question such that responses could be categorized ad "good," "adequate," "inadequate," or "poor," in terms of "what an internist needs to know." Blind raters of the exam achieved an interrater reliability of 0.08. The results indicate major deficits in the knowledge needed for assessment and treatment of these common problems. Only 16% of answers were "good," where as 42% were "inadequate" or "poor". For example, 88% of the doctors could not name three factors that help distinguish organic from "functional" psychosis, and 88% could not list three side-effects of tricyclic antidepressants. The doctors' level of experience was not correlated with test scores, either overall or question by question. These results, together with measures of attitude and skill, have been used to develop a needs-based liaison psychiatry curriculum and to evaluate the effectiveness of that curriculum.
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PMID:An oral examination of the psychiatric knowledge of medical housestaff: assessment of needs and evaluation baseline. 711 26

After remarks on the uncritical use of the term "hysteria" in some investigations on psychosomatic phenomena in ophthalmology some recent reviews are presented, followed by the results of psychosomatic research on specific ophthalmological diseases. Dealing with glaucoma controlled studies are emphasized which attempt to determine the structure of neuroses and the importance of environmental situations. Using the MMPI high values on the scales 'depression', 'hypochondria' and 'hysteria' were observed. In previous attempts to influence glaucoma psychotherapeutically mainly autosuggestive and hypnotizing methods have been applied. The number of reported cases of psychogenic blindness has decreased considerably. We discuss, that it may not only be caused by the mechanism of hysterical conversion but also by a tendency to regression in schizoid neurotic structure. Concerning asthenopia and amblyopia the dependence of vision and visual acuity of the level of vegetative innervation is being accentuated; there appear to be correlations between certain errors of refraction and certain personality patterns. Psychiatric diseases may also influence vision: observations in paranoid and affective psychoses of later life and in schizophrenic children confirm it. This leads to the question, if schizoid neurotic structure can also be characterized by a specific disturbance in affective relations to sensations. Examples are given for investigations on other diseases (ablantio retinae, retinopathia centrales serosa), on the problem of self mutilation (auto-enuclation) and on neurophysiological question (psychogenic influences on pupil size).
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PMID:[Psychosomatic diseases of the eye--a review]. 712 41

It has been suggested that if a person's sexual orientation is unconventional, their nonsexual psychological problems will be construed in sexual terms to a marked degree. An experiment is described in which undergraduates read a case study of a man troubled by depression, catastrophizing, heavy drinking, and other maladaptive behavior not obviously related to his sexuality. Half the subjects were told that the patient had had several extramarital affairs, exclusively with men; the others, affairs exclusively with women. Blind content analyses of subject responses revealed that when the man was described as having had homosexual involvements, he was more likely to receive a diagnosis of sexual deviation or have his nonsexual diagnosis justified on the basis of homosexuality, more likely to have his sexual or marital life investigated, and more likely to have his sexuality construed as important in the etiology of his nonsexual psychological problems. The authors' analogue findings confirm cautions voiced by previous researchers regarding predictable distortions to which clinicians may be susceptible in their interpretation of patient problems when homosexuality is part of the patient's past or present life-style.
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PMID:Sexual orientation stereotypy in the distortion of clinical judgment. 734 65

Blind raters applied research criteria to the charts of patients whose discharge diagnosis changed through several hospital admissions from depression to schizophrenia and to the charts of matched control patients. Fewer diagnostically unstable patients than control patients satisfied research criteria for depression despite matching discharge diagnoses. The use of operational criteria, then, can be expected to reduce diagnostic instability in depression and thus improve prognostic accuracy. Some patients satisfied the research criteria for depression when they were initially admitted and for schizophrenia at their final admission. This suggests that diagnostic error may not account for all cases of major diagnostic instability.
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PMID:Diagnostic instability and depression. 735 62

Open or uncontrolled studies have suggested that providing cancer patients with audiotapes of their clinical interviews can improve information recall and reduce psychological distress. We tested these hypotheses in a 'clinician-blind', prospective, randomised controlled trial. A total of 117 patients newly referred to a medical oncology clinic who were to be given 'bad news' had their consultations audiotaped. Blind to the clinician, patients were randomly allocated to receive a copy of the tape to play at home or not (control group). At 6 months follow-up, tape group patients reported positive attitudes to the audiotape and were shown to recall significantly more information about their illness than did controls. Overall improvement in psychological distress at 1 and 6 months follow-up, as measured with the 30-item General Health Questionnaire and the Hospital Anxiety and Depression Scale was no different in the two groups. However, a second-order interaction suggested that poor-prognosis patients were disadvantaged specifically by access to the audiotape, with less improvement in psychological distress at 6 months follow-up than non-tape controls. Patient access to audiotapes of clinical interviews promotes factual retention but does not reliably reduce psychological distress and may be actively unhelpful in some subgroups of patients.
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PMID:The efficacy of audiotapes in promoting psychological well-being in cancer patients: a randomised, controlled trial. 784 Oct 58


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