ISSN:0894-878X    

出版商:OVID    

年代:2002

数据来源: OVID

摘要:

ObjectiveThe aim of this study was to assess the potential influence of body consciousness and levels of somatic symptom report upon information processing speed in patients with chronic fatigue syndrome (CFS).BackgroundAccording to a model of a fixed information processing capacity, it was predicted that in a group of patients with CFS, high body consciousness in combination with a high report of somatic symptoms would affect information-processing speed negatively.MethodsInformation- and motor-processing speed were simultaneously measured with a simple- and a choice-reaction time task, whereas cognitive complaints were rated with two questionnaires. The hypothesized influence of private body consciousness and somatic symptom report upon information-processing speed was tested in a model. A symptom-validity test was used to screen for possible illness behavior.ResultsPrivate body consciousness was directly related to information-processing speed and somatic symptom report. Somatic symptom report was related to both test performance and memory and concentration complaints.ConclusionsLevels of private body consciousness directly affected somatic symptom report and information-processing speed. This finding supports the role of attentive processes in CFS, and offers, besides possible cerebral dysfunction, an alternative explanation for slowing of information processing in CFS.

ISSN:0894-878X    

出版商:OVID    

年代:2002

数据来源: OVID

摘要:

ObjectiveTo examine plasma cortisol, adrencorticotropin hormone, and indicators of catecholamine activity in monozygotic twins discordant for schizophrenia or major affective disorders.BackgroundPrevious research has suggested that catecholamines play a role in the etiology of major mental illness. Several findings have also shown an inverse relation between hippocampal volume and cortisol levels in psychiatric populations including patients who are depressed and patients with Cushing disease.MethodIn this study, plasma obtained from monozygotic twin pairs discordant for schizophrenia (n = 10) or major affective disorder (n = 3) was assayed for epinephrine, norepinephrine, dihydroxyphenylacetic acid, homovanillic acid, adrencorticotropin hormone, and cortisol.ResultsThere was significant concordance for levels of dihydroxyphenylacetic acid and homovanillic acid, consistent with the high concordance for indicators of dopamine activity observed in healthy monozygotic pairs. There was also concordance for adrencorticotropin hormone. However, in contrast to findings on healthy monozygotic pairs, there was no relation for epinephrine, norepinephrine, or cortisol. Among patients, there was an inverse correlation between cortisol and the magnitude of the reduction in hippocampal volume, relative to that of the healthy co-twin.ConclusionThese findings suggest the potential role of adrenal steroids and hippocampal function in the expression of psychosis.

ISSN:0894-878X    

出版商:OVID    

年代:2002

数据来源: OVID

摘要:

ObjectiveWe examined whether baseline-affective responses to lateral visual-field stimulation could predict clinical responses to left, prefrontal, transcranial, magnetic stimulation (TMS) in patients who are depressed.BackgroundSchiffer et al have reported that left and right lateral visual-field stimulation can often evoke different (positive versus negative) psychologic responses in a given patient. Some had improvements while looking to the left and others while looking to the right.MethodsWe asked 37 patients who were severely depressed and resistant to treatment (26 women, 11 men) to report changes in affective state in response to two pairs of goggles, each allowing vision out of either the left or right visual field. We then evaluated whether these responses predicted clinical responses to TMS as measured by the percent decrease in the Hamilton Depression Rating Scale (HDRS.4%) scores between baseline and 4 weeks (2 weeks after a 2-week course of daily TMS).ResultsThe 20 patients who felt more improvement with right than left lateral visual-field stimulation with 45-second baseline goggle trials had a 42% (± SD 22.2) reduction in HSDR.4%. The 15 patients who felt more improvement looking to the left than to the right had an 11% (± SD 28.4) decrease in HSDR.4%. Seventy-five percent of the 20 patients in the first group had a decrease in HSDR.4% more than 20%, and 80% of the 15 in the second group had a decrease in this score of less than 20%. A two-tailed Fisher exact test showed a significant difference between the two groups (p= 0.002).ConclusionBaseline affective responses to lateral visual-field stimulation predicted clinical responses to left, frontal TMS in depressed patients.

ISSN:0894-878X    

出版商:OVID    

年代:2002

数据来源: OVID

摘要:

ObjectivesTo present a new version of the Modified Mini-Mental State Examination (3MS-R), provide normative information extending to individuals in the 10th decade, and examine the effects of demographic variables on test performance.BackgroundThe Modified Mini-Mental State Examination, based originally on the Mini-Mental State Examination, has been used to screen populations for dementia. Providing normative information and an analysis of demographic variables on test performance for this version would support broader use in clinical and other settings.MethodsTwo thousand, nine hundred thirteen elderly individuals determined to be free of dementia and other neurologic and psychiatric conditions served as subjects. An analysis of variance was conducted to examine the effects of age, gender, and education on test performance. Descriptive statistics (means, standard deviations, and percentile ranks) were calculated to summarize the range of normal performance. To examine the sensitivity/specificity of the suggested cut-off points at the 7th and 10th percentiles, two subsamples of elderly individuals, on whom clinical dementia assessments were available, were used to classify individuals with regard to dementia status.ResultsLower age, higher education, and female gender were associated with higher 3MS-R scores. Gender effects were among the weakest, but most important at lower levels of education. Education effects were most prominent in the youngest age groups. Selection of a cut-off point at the 7th percentile revealed 69%–70% sensitivity for detecting dementia, and higher sensitivity for individuals in the youngest age groups. Specificity at this cut-off point was 89%. Raising the cut-off point to the 10th percentile improved sensitivity to 73%–76%, but reduced specificity to 85%–86%.ConclusionWe present a version of the Modified Mini-Mental State Examination that has demonstrated utility in screening a population for dementia. An analysis of normative information and the effects of demographic influences suggest that the 7th percentile cut-off point performs very well in detecting dementia in 65–79-year-old individuals but less well for individuals in their 80s and 90s. To increase the sensitivity of the 3MS-R to detect dementia or other forms of cognitive impairment, particularly among the “old-old,” the test user may wish to raise the cut-off point for impairment in some demographic groups or to supplement the test with additional cognitive measures.

ISSN:0894-878X    

出版商:OVID    

年代:2002

数据来源: OVID

摘要:

ObjectiveThe Trail Making Test (TMT) is a psychomotor task that is used routinely in clinical evaluations and consists of two parts: TMT-A and TMT-B. The purpose of the present study was to examine the relations of two derived-TMT indices with age, education, and gender and to establish normative data.BackgroundPrior research has suggested that these derived indices provide purer measures of the executive skills required to complete TMT-B. It has also been suggested that these scores can be effectively used to detect cognitive impairment, and that they are relatively free from the impact of age.MethodDifference scores (B − A) and ratio scores (B:A) were computed from the TMT performance of 285 adults who have no history of substance abuse or psychiatric or neurologic disorder and who are not currently being treated with any type of psychotropic medication.ResultsSubjects ranged in age from 18 to 90 years and in education level from 6 to 20 years. For the entire sample, (B − A) scores ranged from 6 to 248 seconds (M, 62.15; SD, 49.44), and (B:A) scores ranged from 1.23 to 9.54 (M, 2.81; SD, 1.13). Significant correlations were noted with age and (B − A) and (B:A) scores, accounting for 28% and 6% of the variance, respectively. Subjects were assigned to one of eight age groups, which were formed by decade. Univariate analyses of variance were significant for (B − A) (p< 0.0001) and (B:A) (p< 0.0004) scores. Post hoc analyses indicated that the two oldest age groups had significantly larger (B − A) scores than the younger age groups. However, post hoc analyses with (B:A) scores indicated that only the 70–79-year-old age group significantly differed from the three youngest age groups. No other age groups significantly differed from another on this measure.ConclusionsNormative data are presented for clinical use, and recommendations are made for future research. In addition, the current results suggest that normal aging has a significant impact on cognitive flexibility and indicate that previous suggestions for impairment cut-off scores based on the (B:A) ratio may result in erroneous classification of healthy older adults.

ISSN:0894-878X    

出版商:OVID    

年代:2002

数据来源: OVID

摘要:

ObjectiveTo evaluate neuropsychologic performance among women occupationally exposed to products commonly used in nail studios.BackgroundOrganic solvents and (meth)acrylates commonly used in nail studios have known neurotoxic properties. Few studies have examined the potential for cognitive and neurosensory effects of occupational exposure to these substances, and none has addressed exposure occurring in the cosmetics industry.MethodsParticipants in this study included nail-salon technicians (n = 33) and demographically similar controls who had no known history of exposure to toxic chemicals (n = 35). The groups were administered psychologic, neuropsychologic, and neurosensory tests. Aspects of the workplace environment (e.g., square footage of the salon, adequacy of ventilation, and hours worked) also were assessed.ResultsMultivariate analysis of variance (MANOVA) revealed that the nail technicians performed more poorly than did controls on tests of attention and processing speed (p= 0.015; eta2= 0.20). Olfaction among the nail technicians was below expected performance based on normative data (p< 0.001). A trend toward poorer performance by the nail technicians was observed on the MANOVA investigating executive functioning; individual tests within that domain may be worthy of future investigation (ps = 0.03–0.10). No significant group differences were observed in the domains of learning and memory, visuospatial ability, or fine motor coordination, or on measures of depression and anxiety. Multiple regression indicated that level of occupational exposure as measured by time worked in the industry, adequacy of ventilation, and workplace size predicted 29% of the variance of performance on attentional tasks (p= 0.04).ConclusionExposure to low-level neurotoxicants common to nail studios may result in mild cognitive and neurosensory changes similar to those observed among solvent-exposed workers in other settings.

ISSN:0894-878X    

出版商:OVID    

年代:2002

数据来源: OVID

摘要:

ObjectiveTo investigate underlying mechanisms of cognitive dysfunction in whiplash syndrome, focusing on psychologic factors and coping mechanisms.BackgroundPatients with whiplash often experience cognitive-functioning impairments, although neurologic and neuropsychologic test results do not always support this. Psychologic factors are also hypothesized to influence the existence of whiplash-related cognitive impairments. This has led to a controversy about the etiology of these experiences.MethodsIn this retrospective study, 31 patients with whiplash were compared with 30 neurologic patients and a non-neurologic control group (i.e., subjects with “nonorganic” psychologic symptoms) on memory, attention, and cognitive flexibility. In addition, psychologic questionnaires (Minnesota Multiphasic Personality Inventory, Symptom Checklist, and Utrecht Coping List) were used to investigate psychologic functioning and coping in these patient groups.ResultsPatients with whiplash performed similarly to neurologic patients on the cognitive tasks and performed worse on memory and attention tasks compared with the control group. Furthermore, patients with whiplash had high scores on subscales measuring somatization and displayed a predominantly active and palliative coping style.ConclusionsSomatization, in combination with inadequate coping, might play a role in the development, persistence, or aggravation of whiplash-related symptoms, such as pain or cognitive dysfunction.

ISSN:0894-878X    

出版商:OVID    

年代:2002

数据来源: OVID

摘要:

ObjectivesTo present the case of a patient with acquired deafness who experienced musical hallucinations (MH) and to conduct a review of the relevant literature.BackgroundAlthough MH have been known to occur in some people with deafness, literature on this phenomenon, especially from the perspective of etiology and treatment, is limited.MethodsThe case report was prepared using a detailed history, general psychiatric and neurologic examinations, and neurobehavioral assessments, and the pertinent literature from 1965 to 2000 was reviewed.ResultsThe patient whose case is reported here had acquired deafness and was assessed to have MH and obsessive-compulsive symptoms that responded to the use of nonantipsychotic medication.ConclusionThe phenomenon of MH with hearing problems that are either prelingual or acquired can exist separately or be a part of constellation of psychiatric symptoms. No precise etiologic basis is yet clearly identifiable; however, this report offers support for a central mechanism explained by the “Release Theory.” Additionally, it appears that such hallucinations might be managed safely with psychotropic medications other than antipsychotics.

ISSN:0894-878X    

出版商:OVID    

年代:2002

数据来源: OVID