Assessment of neuropsychological status and mood was carried out on 36 patients who had been treated for pituitary tumour and on 36 healthy controls. Impairments in memory and executive function were exhibited by the patients even when other known causes of cognitive dysfunction had been excluded. There was no difference in mood between the two groups, and the deficits in cognitive dysfunction were not related to mood disturbance or to the effects of radiotherapy. The defects were however, related to the presence of surgery, although not to the type of surgery. Reasons for the cognitive dysfunction are unclear but are likely to be multifactorial possibly including the effects of neurosurgery and/or hormone imbalance resulting from pituitary surgery.
Patients treated for pituitary tumour, excepting those treated with transfrontal surgery and to a lesser extent those treated with radiotherapy, suffer from mild mood disturbance and self-perceived decreased social adjustment. All patient groups are seen by others as having decreased social adjustment, raising the possibility that the transfrontal patients and possibly those who have had radiotherapy, lack insight. This may explain some of the discrepancies in the previous literature and needs to be taken into account when using self-report measures with these patients.
Children with combined type ADHD have mild to moderate global cognitive impairment together with some impairment of functions subserved by the frontal lobes. Longitudinal studies are required to determine if the deficit in global cognitive functioning is a primary deficit or secondary to the deficit in frontal lobe functioning. The importance of neuro-psychological assessment and follow-up for children with ADHD is stressed. Study limitations relate to the generalizability of the findings and the absence of a psychiatric control group.
The assessment of health status and quality of life among chronically ill patients is an area of current scientific interest. This paper considers the utility of a short but comprehensive instrument to assess the quality of life for end-stage renal failure patients. the Spitzer QL-Index was completed by 8 nurses for all patients in the Wellington region currently being treated with home hemodialysis (n = 58); hospital hemodialysis (n = 13); and continuous ambulatory peritoneal dialysis (n = 37). Results indicated that home hemodialysis patients achieve the highest quality of life in comparison to the other two treatment modalities. It is concluded that the QL-Index has some discriminative validity for this patient population, and its use may contribute to informed decision making by both patients and doctors.
A computerized version of the MMPI was developed that incorporated both administration and scoring. This method was compared with the original manual form (N = 87). The results indicated that the test‐retest reliability was high regardless of the method of administration and that similar results were obtained on the computer and on the manual forms of the MMPI.
This prospective study examined the concept of pre-admission adaptive functioning and its relationship with outcome. Pre-admission adaptive functioning was assessed by the self-report Social Adjustment Scale and the therapist rated Axis V of DSM-III. In addition, an instrument designed to look separately at the areas of interpersonal relationships, occupational functioning and use of leisure time was given to a subgroup. These measures were compared with outcome at six months as assessed by the General Health Questionnaire. Adaptive functioning proved to be a significant predictor of outcome, with the Social Adjustment Scale being a better predictor than Axis V for the whole group. In contrast, for patients with schizophrenia, the initial Axis V rating was the best predictor of the outcome score. Statistically significant correlations were found between the three areas of adaptive functioning for the group as a whole but, when examined by diagnosis, they proved to be statistically significant only in the schizophrenia sub-group, suggesting that it would be invaluable to rate the three areas separately in non-psychotic patients.
Clinical auditing and the setting of goals for continuing education are often based on case note reviews. Deficiencies in the comprehensiveness of the recorded case history place some restrictions on the usefulness of such reviews as guides to continuing education programmes. In this study, attempts were made to improve the quality of the data in psychiatric case notes by peer discussion, and by altering the case note recording guidelines. After each educational intervention a further detailed audit of the subsequent case histories was performed. Significant differences emerged in a few subsections of the case notes, but overall there was little change. Possible explanations for these findings are discussed.
Over the past 50 years the relationship between alcoholism and psychiatric disorders, such as depression, anxiety and schizophrenia, has been the subject of a great deal of research. Psychiatric problems have been seen as both a cause and a result of alcoholism. Whatever the relation between alcoholism and psychiatric disorder is, it may have significance for the development of differentially effective treatment strategies. Several authors have argued that the presence and nature of psychiatric symptoms should form the basis of a classification system for alcoholics. Given the potential rewards of such a system for both understanding the aetiology of alcoholism and developing effective treatment strategies, it is important to have a clear picture of the nature and extent of this relationship. This paper reviews critically the published studies of the association between alcoholism and psychiatric disorder and outlines directions for future research.
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