Search

Background: Little is known about the impact of personality pathology on the treatment outcome of major depressive illness in primary care in the UK.Method: Patients meeting criteria for DSM-III major depressive disorder were randomly allocated to one of four treatments each lasting 16 weeks, then followed up for 18 months. Assessments were made of depressive symptoms, personality and social functioning. Personality was assessed at maximum improvement or 16 weeks.Results: The prevalence of personality disorder (PD) in the sample of 113 patients was 26%. Patients with a PD were significantly younger and rated more depressed at entry than patients with no personality disorder (NoPD). On completion of treatment patients with a PD were significantly more depressed and had poorer social functioning than the NoPD group. After 18 months there were no differences in ratings of depression or social functioning between the groups.Conclusions: There was substantial improvement in both the PD and NoPD groups. The presence of personality pathology delays recovery from major depressive illness. [ABSTRACT FROM AUTHOR]

Chronically ill day patients were followed up 3 years after identification in the catchment areas of 13 psychiatric hospitals serving 54% of the Scottish population. Five per cent had died, 6% were in-patients, 56% remained day patients and 14% were supported by community psychiatric nurses or attended an out-patient clinic; contact had been lost with 19%. Over 3 years, 32% had had at least one admission to in-patient care; a wide range of other services was also used. There was little change in the level of disability; a typical patient in contact at follow-up was single, schizophrenic, and rather disabled. [ABSTRACT FROM AUTHOR]

The depression and lability of mood which have been previously reported on the fifth day after childbirth are largely restricted to women with high neuroticism scores. The pattern of day-to-day mood changes is the same after Caesarian section as after vaginal delivery, but there is no 'day five' phenomenon after hysterectomy. Post-partum mood disturbance is less prominent in women who return home 48 hours after delivery. [ABSTRACT FROM AUTHOR]

The recognition of rehabilitation as a special interest in psychiatry, and its practice by professional teams, raises the need for some uniformity in examining patient outcome. The features required in a scale designed for this purpose are considered and the Morningside Rehabilitation Status Scales, which have been prepared specifically for psychiatric rehabilitation, have their development and use described. They measure the dimensions of dependency, inactivity in occupation and leisure, social integration/isolation, and current symptoms and deviant behaviour. The measures can be expressed as a profile of the dimensions, with the total a measure of overall level of functioning; reliability has been established, and validity assessed. The scales are not difficult to apply when the patients are known to the staff using them. They should be useful to rehabilitation teams for defining the current status of patients, measuring changes produced by rehabilitation programmes, deciding areas where treatment or service deficits may exist which the team should be attempting to remedy, as well as for teaching purposes. [ABSTRACT FROM AUTHOR]

Patients receiving prophylactic lithium therapy for primary affective disorder during a four year period were studied for recurrence of affective illness. Patients who had affective episodes during this period did not differ from those who remained well in age, sex or diagnosis. Those with a favourable outcome had spent significantly less time at serum lithium levels above 0.9 mmol/litre than those who had a recurrence of affective episodes. [ABSTRACT FROM AUTHOR]

Classroom Reality Orientation was investigated with a sample of dements drawn from a psychogeriatric hospital and an old people's home. Treatment effects were examined on a range of cognitive and behavioural measures, and compared with the effects of a specific behaviourally directed orientation training in the ward. Class RO improved cognitive functioning but not behaviour, irrespective of degree of dementia. Highly significant behavioural change was demonstrated for ward behaviour orientation training and this technique is not only cheaper but has potential in managing dements. [ABSTRACT FROM AUTHOR]

The article describes a double-blind drug trial to assess the effect of sulthiame on the behavior of very disturbed mentally handicapped patients. Sulthiame was investigated as a tranquillizer in a double-blind trial on 34 severely subnormal patients with disturbed behavior. Nurses used a special rating scale in assessing behavioral changes in hyperactivity, aggressiveness, destructiveness, and anti-sociability. The results showed that sulthiame was significantly effective in reducing disturbed behavior in general, and aggressiveness and hyperactivity in particular.

The article presents a study on the persistence of extra-pyramidal disorders and psychiatric relapse after withdrawal of long-term phenothiazine therapy. In this study, sixty-two chronic schizophrenics in hospital were studied, about 32 male and 30 female patients and they had all been on regular phenothiazines principally trifluoperazine. The study has noted that the trifluoperazine withdrawal was therefore followed by a psychiatric relapse in 28 percent of the patients, persistence of parkinsonian rigidity and tremor and oral dyskinesia-tremor, and worsening of motor restlessness.

The article cites a survey on the extrapyramidal disorders within a population of chronic schizophrenics in Naburn and Bootham Park Hospitals in York, England. The static tremor, muscular rigidity, dystonic spasms, choreiform dyskinesia, and restlessness were the five important types of extrapyramidal phenomena studied within the said population, and their individual prevalencies were determined. Only one of the 63 patients studied was rated clearly free of any kind of motor abnormality. It also found that articulation of speech was disturbed in 75% of the patients.

An abstract of the study "The Effect of Sulthiame on Disturbed Behaviour in Mentally Subnormal Patients" is presented. The study investigates the effects of sulthiame, when used as a tranquillizer, on severely subnormal patients with disturbed behavior. Nurses used a special rating scale to determine the patients' behavioral changes after taking the drug. Findings reveal that sulthiame is effective in reducing disturbed behavior, particularly aggressiveness and hyperactivity.

An abstract of the article "Extrapyramidal disorders after prolonged Phenothiazine Therapy," by P. F. Kennedy, H. I. Hershon and R. J. McGuire.