Showing papers by "Robin M. Murray published in 1978"

The health of doctors: a review.

Abstract: Do doctors, perhaps because of their life-style, long hours of work or close k contact with disease, suffer more illness than the general population? Certainly there are occasional circumstances in which a doctor's work may endanger his physical health. Infection can be a hazard. Reid (1957) noted that pathologists had an increased risk of tuberculosis, but this no longer appears to be the case (Harrington and Shannon, 1975). Hepatitis reached epidemic proportions in European dialysis units in 1968-69; 61 units reported outbreaks and one surgeon

Drug response and psychiatric nosology.

Abstract: The possibility that pharmacological response might help to refine psychiatric nosology has been the subject of recurrent speculation, but few clear-cut results have been obtained. Only bipolar depressives and several other minor patient subgroups manifest consistent drug responses in association with characteristic psychobiological features. The presence of multiple intervening variables, such as individual differences in drug metabolism, drug-taking behaviour and biological sensitivity to drugs, may mitigate against the reliable identification of clinically distinguishable drugresponding subgroups. Furthermore, the majority of available psychoactive drugs have either multiple or broad spectrum effects inconsistent with hypotheses utilizing the mechanism or site of drug action to argue for a diagnosis-specific biological disorder at such sites.Nonetheless the successful use of drug-response models in other areas of medicine suggests a rationale for continued exploration in this area, and a number of recent advances make this approach potentially more productive. Pharmacological developments have rendered it possible to assess the biological availability of drugs in potential responders, thus eliminating some of the confounding intervening variables. Further consideration should also be given to the use of drugs with more specific neurochemical effects, even when they themselves are not necessarily therapeutic. The comparison of drug responder and non-responder groups has also been made more meaningful by the availability of more reliable methods of assessing clinical phenomena, more sophisticated diagnostic models and the introduction of other biological measures. Combining several of these approaches may allow the use of one to validate the other.