Search

The article studies reduction of stereotyped body-rocking using variable time reinforcement. The use of aversive stimulation, contingent on the stereotypy, may result in the patient refusing to return to the therapeutic situation, or even to escape from the situation. Research which compared differential reinforcement of other behaviour (DRO) and response-independent, non-contingent reinforcement using animals as subjects, suggests that DRO is the more effective schedule for reducing behaviour. The present experiments were intended to evaluate the feasibility of DRO and variable time schedules of reinforcement as a means of reducing the body-rocking stereotypy in ward environments and using available ward staff.

This article presents a study on the effect of music body-rocking manifested by severely mentally deficient patients in ward environments. The subjects were twelve adult patients, five males and seven females. They were aged from 17-45 years; average age: of males, 22.2 years; of females, 26.4 years. All were classified in their hospital notes as severely mentally deficient. They were chosen using the criterion that ward staff reported body-rocking at most times of the day. The patients were resident in three low grade wards in the same mental deficiency hospital in Central Scotland.

This article presents a study on the distributions of body-rocking manifested by severely mentally deficient adults in ward environments. The subjects for this study were twenty-seven adult patients, ten males, seventeen females. They were aged from, 17-54 years; average age of males, 28.1 years; of females, 32.1 years. All were classified in their hospital notes as severely mentally deficient. The patients were chosen using the broad criterion that ward staff reported "body-rocking at most times of the day". Due to the considerable time investment in anyone ward, only wards with three or more body-rocking patients were included in the study. The patients were resident in seven low-grade wards in four large mental deficiency hospitals in Central Scotland.

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 Maudsley Personality Inventory was given to an unselected group of psychiatric inpatients. All diagnostic groups were differentiated from normals on the Neuroticism scale but neither this nor the Extraversion scale distinguished between diagnostic groups. Contrary to Eysenck's claim, hysterics and dysthymics were not distinguished on the Extraversion scale. The negative correlation between Extraversion and Neuroticism in neurotic groups and the use of the short form of the scales are discussed. Because Eysenck's original report is not readily available, some general comments are offered about the methods used to devise and standardize the test. The results suggest that the test is unlikely to be of value in the individual case. [ABSTRACT FROM AUTHOR]

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.

Child psychiatric records of 33 girls given a diagnosis of "schizoid" personality in childhood, were compared with records of a control group of other referred girls and with those of 32 pairs of "schizoid" and control boys. Seventeen "schizoid" girls were seen again in adult life and compared with 32 "schizoid" boys previously followed up at the same age. The features of "schizoid" girls in childhood and adult life were very similar to those of the boys. A striking finding, possible due to referral bias, was the high rate of antisocial conduct in "schizoid" girls, both in childhood and later life. The dilemmas of diagnostic classification of this group of patients are discussed.

The Edinburgh Rehabilitation Status Scale (ERSS) measures four dimensions in which changes may occur in the course of a disabling illness or during rehabilitation: independence; activity; social integration; and effects of symptoms on lifestyle. It provides a profile of measures, the scores of which can be summated to indicate the overall level of performance of individuals or groups. Studies of its inter-observer reliability and of its application in various disability groups indicate that the ERSS reliably defines the characteristics of individual patients and of groups. The scale can be used conveniently by professional staff working independently or by a multiprofessional rehabilitation team to assess status and changes in patients. It can also be used for measurement of the effectiveness of services and for purposes of research, teaching, and administration.

Psychiatric morbidity, relevant symptoms and satisfaction with communication were assessed in patients suffering from malignant lymphoma. Before treatment started 15 of 40 patients had clinically significant psychiatric morbidity. Treatment, in its early stages, was not associated with a significant change in mean psychiatric morbidity scores but there was a decrease in ratings of concern about illness and an increase in ratings of nausea. Eleven of 31 patients seen for a second interview reported dissatisfaction with some aspect of communication with the medical staff. The findings suggest that emotional distress can be contained with a policy of frank communication; nevertheless dissatisfaction is common, being associated with initial less concern, good general health and neurotic personality traits. Personality assessment should be incorporated in future studies of doctor-patient communication.

Two self report questionnaires, the Anxiety and Depression scales of Bedford and Foulds (SAD), and 10 visual analogue scales were each administered on several occasions during pregnancy and the puerperium to a representative sample of 425 childbearing women. Those women who each completed the analogue scales during pregnancy at 12 and 23 weeks and at 1 week and 5 months after childbirth (N = 230) showed no association between depression or anxiety and either the gravidity or method of delivery on any of the four occasions. Depression, anxiety and tearfulness on the visual analogue scales increased significantly 1 week after delivery, when compared with the other 3 occasions. The SAD failed to detect an increase in depression or anxiety at this time and its validity during pregnancy was also not satisfactory. Only 3 women were referred to a psychiatrist during the study, none of whom had an affective illness.

Eighty one women were asked to rate their mood on a set of 6 visual analogue scales every day for the first 3 weeks after childbirth. The 6 scales were concerned with happiness, depression, tears, anxiety, irritability and lability. Ratings on the depression, tears and lability scales rose to a sharp peak on the 5th post partum day and declined steadily thereafter. This day 5 peak was the same in primiparae and multiparae, and in breast-and bottle-feeders, and was largely independent of the day of leaving hospital. Women who became clinically depressed later in the puerperium had higher depression and lability ratings, and a more pronounced day 5 peak, than those who did not.

Two groups of patients representing the common objectives of Day Hospitals, namely steady progress and maintenance in the community, were studied. The Morningside Rehabilitation Scale was used to measure dependency, inactivity, isolation and the effects of current symptoms on the patient's life-style. Small but significant changes including in some cases crucial changes which involve working capacity were observed. There is discussion on the value of standardised measurement and the expression of results in terms of levels of functioning. The effect on multi-professional communication and on the possibilities of comparison and planning of services is discussed.

The hypothesis that ECT produces selective effects on hypothalamic-pituitary activity was investigated by determining the effect of ECT on pituitary hormone release in nine depressed patients. After ECT there were massive and rapid increases in the plasma concentrations of nicotine- and oestrogen-stimulated neurophysin (NSN and ESN), prolactin (PRL) and adrenocorticotropin (ACTH), smaller increases in plasma luteinizing hormone (LH) and cortisol, a significant decrease in plasma growth hormone (GH) concentration but no change in plasma thyrotropin (TSH). There was significant attenuation of PRL responses with repeated ECT. The hormonal responses to ECT cannot simply be attributed to stress, since a similar pattern of increases in plasma hormone concentrations did not occur in psychologically normal patients in whom plasma hormone concentrations were measured during induction of anaesthesia and abdominal incision for cholecystectomy. Analysis of these hormonal responses in terms of the knowledge available on the neurotransmitter control of pituitary hormone release suggests that some of these hormonal responses to ECT may be mediated by the activation of serotonergic neurones, while others are probably due to direct stimulation of the neuroendocrine neurones themselves.

Experimental studies have suggested that a feature of the memory defect in some amnesic conditions may be a failure to inhibit competing responses at retrieval. It is not known whether this feature is present equally in different syndromes involving amnesia. Employing a recognition memory paradigm with varying numbers of response alternatives (based on Miller, 1978), three amnesic groups (Korsakov's, senile dementia, and multi-infarct dementia) were compared using four types of test material. The groups were not differentially affected by increasing numbers of response alternatives.