This paper describes a set of proposed standardized quantitative descriptors of event-related potentials, based upon principal component varimax analysis (PCVA). No claim is made that these mathematical descriptors correspond to discrete neurophysiological processes which generate the ERP. However, adoption and prospective evaluation of such a set of precise, standardized descriptors of the quantitative ERP may eventually result in advances like those which resulted from adoption of equally arbitrary standardized descriptors for QEEG. PCVA was performed on data from normal subjects and from groups of patients with a wide variety of psychiatric disorders ("Abnormals"). This yielded two sets of factor waveshapes, Normal and Abnormal, which were closely similar. Reconstruction of the normal and abnormal ERP data with either set of factors yielded almost identical allocation of variance. These results gave acceptable reassurance that factors derived from normal population could reasonably be used to describe ERP waveshapes from patients. The ERPs at each electrode of the 10/20 System in a "training group" of normal subjects were then reconstructed. The resulting distributions of factor scores were transformed to achieve Gaussianity. Mean values and standard deviations were obtained for the normative distribution of each factor score, the root mean square deviation, the residual and the absolute ERP power at each electrode. Individual ERPs could then be reconstructed with the normal factors, and the resulting factor scores rescaled to "probability of abnormal morphology" by Z-transformation. Statistical probability maps could be generated by using a color scale in standard deviation units. These methods were used to evaluate visual and auditory ERPs from an independent normal "test group" and the patients in the Abnormal sample. High specificity and sensitivity were obtained for many factor Z- scores. Multiple discriminant functions were constructed which separated normal from abnormal patients with high, replicable accuracy. Further development and testing of these descriptors may make them clinically useful.
State hospitals are still being used as a dumping ground (the End of the Road) for geriatric patients who present serious nursing problems. The Geriatric Service at Bronx State Hospital, affiliated with the Albert Einstein College of Medicine, underwent a marked metamorphosis from the traditional custodial service to a community‐oriented unit with emphasis on treatment. This was accomplished only when the admission criteria were changed. The community can be educated to accept such a modern admission policy for geriatric patients in a state hospital by: 1) having definite criteria for admission; 2) explaining to the referring agency the reasons why patients may or may not be suitable for admission; 3) answering all complaints of public officials who intervene for their constituents; 4) advising the family what procedure should be followed to have the patient admitted to an old age home or nursing facility, or for obtaining a homemaker; 5) providing an out‐patient department (preferably to include a day hospital) for those patients who are not sufficiently ill to be admitted to the state hospital for 24‐hour maintenance; 6) providing a speaker to explain especially to hospital staffs the criteria for admission; and 7) providing a mobile psychiatric team to visit the patient in his home, hospital, nursing home or old age home, and also to consult with the family physician.
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