Papers by Marshal Folstein
The Journal of Nervous and Mental Disease, 1988
Genetics and Alzheimer’s Disease, 1988
Clinical features related to age of onset, including amnesia, aphasia, apraxia, agnosia, depressi... more Clinical features related to age of onset, including amnesia, aphasia, apraxia, agnosia, depression, and fingerprint and platelet abnormalities, suggest heterogeneity in Alzheimer’s disease. Since some of these features run in Alzheimer’s disease families there could be genetic heterogeneity. Understanding the mechanisms which determine the age of onset and related features will be as important as the discovery of the genes, because delay of the age of onset could push it beyond the normal life span and thus eliminate expression of Alzheimer’s disease in human populations even though the genes themselves and their possible beneficial effects would remain.
NIDA research monograph, 1978
Whereas precise caloric intake occurs in normal and obese individuals on an acute basis, obese su... more Whereas precise caloric intake occurs in normal and obese individuals on an acute basis, obese subjects do not maintain caloric regulation when there is a long overnight delay detween the preload and the subsequent meals.
Biological psychiatry, 1973
APA PsycNET Our Apologies! - The following features are not available with your current Browser c... more APA PsycNET Our Apologies! - The following features are not available with your current Browser configuration. - alerts user that their session is about to expire - display, print, save, export, and email selected records - get My ...
Maryland medical journal (Baltimore, Md. : 1985), 1990
The emergence of Alzheimer's disease from relative obscurity to front-page news is related to... more The emergence of Alzheimer's disease from relative obscurity to front-page news is related to the increased life expectancy and increased proportion of the population over 65 years old. About 8 percent of the US elderly population suffer from the disease.
The American journal of psychiatry, 1992
The aim of this study was to assess the relationships between specific personality disorders and ... more The aim of this study was to assess the relationships between specific personality disorders and DSM-III axis I conditions in a community sample. A total of 810 subjects were examined by psychiatrists in the second stage of the Eastern Baltimore Mental Health Survey, part of the Epidemiological Catchment Area Program of the National Institute of Mental Health. A semistructured examination, the Standardized Psychiatric Examination, was employed to assess axis I and axis II conditions. Scales for compulsive and antisocial personality disorders were derived from DSM-III criteria. The relationships between scores on these personality disorder scales and the presence of generalized anxiety disorder, alcohol use disorders (alcohol abuse and alcohol dependence), and simple phobia were evaluated by using logistic regression. Higher compulsive personality scores were associated with a greater odds of generalized anxiety disorder and simple phobia but a smaller odds of alcohol use disorders. ...
Psychosomatics, 1989
Giving medications in nursing homes is time consuming and expensive. The orders for medications i... more Giving medications in nursing homes is time consuming and expensive. The orders for medications in a community nursing home were examined to determine if nursing time could be saved by consolidating the administration ofmedications. Nineteen percent of the medication administration visits could be eliminated by this method according to the independent judgments oftwo physicians. This could save up to $19,000 in nursing time per year, and the time could be redirected to other nursing activities that could improve the quality ofcare in nursing homes.
Psychosomatics, 1985
Abstract Psychiatric consultants’ ratings of the clarity of requests for 203 psychiatric consulta... more Abstract Psychiatric consultants’ ratings of the clarity of requests for 203 psychiatric consultations by medical and surgical services were studied prospectively during a three-month period. The subsequent psychiatric diagnoses were grouped depending on whether or not a major mental illness (MMI), mainly in the form of dementia, delirium, affective disorders, and schizophrenic disorders, was present according to DSM-III criteria. An MMI was diagnosed in 61% of cases in which the reason for the consultation request was considered unclear, but in only 32% of cases in which the reason was considered clear. These findings support earlier speculations that patients with serious psychiatric disturbances tend to affect the clarity of communications among members of the treatment team.
Psychological Medicine, 1991
SYNOPSISA two-stage probability sample of community subjects was developed with a full psychiatri... more SYNOPSISA two-stage probability sample of community subjects was developed with a full psychiatric examination employing DSM-III criteria in conjunction with the Epidemiological Catchment Area (ECA) survey conducted in Baltimore, MD. This report details the observation on those subjects diagnosed with compulsive personality disorder and compulsive personality traits. The results indicate that this condition has a prevalence of 1·7% in a general population. Male, white, married and employed individuals receive this diagnosis most often. Our data suggest a dimensional rather than categorical character for this disorder. The disorder imparts a vulnerability for the development of anxiety disorders.
Psychological Medicine, 1979
SYNOPSISFood intake, appetite and a variety of feelings were measured pre- and post-operatively i... more SYNOPSISFood intake, appetite and a variety of feelings were measured pre- and post-operatively in obese patients undergoing jejuno—ileal bypass surgery. Decreased food intake correlated closely with the amount of weight loss at both 4 and 30 months after surgery. Malabsorption correlated with weight loss at 4 months but not 30 months post-operatively. The cause of the decreased food intake is unknown and cannot be completely explained by either depression, nausea, malabsorption, liver disease, an attempt to avert diarrhoea, or decreased appetite.
Psychological Medicine, 1990
SynopsisIn conjunction with the Epidemiological Catchment Area (ECA) survey conducted in Baltimor... more SynopsisIn conjunction with the Epidemiological Catchment Area (ECA) survey conducted in Baltimore, MD, a two-stage probability sample of community subjects was developed with a full psychiatric examination employing DSM-III criteria. This report details the observations on those subjects diagnosed with the DSM-III diagnosis Histrionic Personality Disorder. The results indicate that this condition can be diagnosed reliably and that it is a valid construct. It has a prevalence of 2·1 % in a general population. Males and females are equally affected, suggesting that prior reports of an increased prevalence in females was an expression of ascertainment bias found in hospital-based studies. The diagnosis is associated with clear evidence of disturbance in the emotional, behavioural, and social realms. Individuals with this disorder tend to use health care facilities more frequently than others.
Neuroscience Letters, 1996
We determined the apolipoprotein E4 (apoE) genotype in 12 cases of autopsy-confirmed hippocampal ... more We determined the apolipoprotein E4 (apoE) genotype in 12 cases of autopsy-confirmed hippocampal sclerosis dementia (HSD), a disorder characterized pathologically by neuronal degeneration, predominantly of temporal lobe structures, without senile plaques or neurofibrillary tangles. The frequency of the apoE4 allele in HSD was 12.5%, similar to that of a control population and significantly different from the-40% found in Alzheimer's disease (AD) (P < 0.001). These observations suggest that apoE4 is not a risk factor for HSD.
Neurobiology of Aging, 1990
An approach to etiology and prevention. NEUROBIOL AGING 11(6) 641-648, 1990.-Epidemiologic studie... more An approach to etiology and prevention. NEUROBIOL AGING 11(6) 641-648, 1990.-Epidemiologic studies of environmental factors associated with risk of Alzheimer's disease (AD) have produced inconsistent and disappointing results. By contrast, family/genetic studies and case control investigations suggest that genetic causes of AD are important. The investigation of such genetic causes remains an important aim in all forms of AD including typical, late-onset disease where linkage work is impractical. But the public health burden of AD creates an especially urgent need to identify environment risk factors, if these exist, since they will more likely be susceptible to intervention. Such environmental factors may interact with genetic susceptibility to accelerate or retard disease expression, and environmental interventions that delay onset may constitute an important strategy for prevention. All these issues may be addressed by twin studies of AD, but the few such studies to date have been limited by small samples and other methodologic difficulties. This paper reviews the rationale for twin studies of AD, and describes briefly the work in this area to date. It also discusses a number of suggestions for methodologic improvements. We conclude that the time is ripe for twin studies of AD, and that such work holds considerable potential for the investigation of etiology and, possibly, for the identification of strategies for prevention.
Journal of Psychiatric Research, 1975
The Journal of Nervous and Mental Disease, 1988
JAMA: The Journal of the American Medical Association, 1991
To determine the prevalence rates of major depressive disorder and of depres-sive symptoms and th... more To determine the prevalence rates of major depressive disorder and of depres-sive symptoms and their relationship to mortality in nursing homes, research psychiatrists examined 454 consecutive new admissions and followed them up longitudinallyfor 1 year. Major depressive disorder ...
International Psychogeriatrics, 1990
The prevalence of psychiatric disorders among new admissions to nursing homes is unknown. Such da... more The prevalence of psychiatric disorders among new admissions to nursing homes is unknown. Such data are needed to estimate the psychiatric needs of this population. We report the prevalence of specific psychiatric disorders in 454 consecutive new nursing home admissions who were evaluated by psychiatrists and diagnosed according to the Diagnostic and Statistical Manual of Mental Disorders, third edition, revised. Eighty percent had a psychiatric disorder. The commonest were dementia syndromes (67.4%) and affective disorders (10%). Also, 40% of demented patients had additional psychiatric syndromes such as delusions or depression, and these patients constituted a distinct subgroup that predicted frequent use of restraints and neuroleptics, and the greatest consumption of nursing time. These data demonstrate that the majority of nursing home residents have psychiatric disorders on admission, and that their management is often quite restrictive. Research is now needed to determine the ...
Comprehensive Psychiatry, 1994
The object of this study is to assess the internal sis was used in the confirmatory mode to test ... more The object of this study is to assess the internal sis was used in the confirmatory mode to test whether validity of DSM-III personality constructs and to ex-a single factor explained each of the 11 DSM-III personplore whether the constituent elements are better ality disorders. This approach rejected a single explanaexplained by an alternate internally coherent classifica-tory factor for all but compulsive personality disorder. tion. A two-stage stratified random sample of subjects Exploratory factor analysis showed that these DSM-III identified at the Baltimore site of the Epidemiologic personality features are parsimoniously described by a Catchment Area (ECA) program were examined by five-factor model. These factors are warmth, animapsychiatrists for DSM-III personality attributes using a tion, timidity, trust, and scrupulousness. semistructured instrument. Dichotomous factor analy
Clinical Neuropharmacology, 1984
Uploads
Papers by Marshal Folstein