Bennett S. Gurian

Borderline Personality Disorder in Late Life

Records of eight elderly patients identified as BPD by a geriatric team were analyzed for compliance with DIB-R and DSM-III-R criteria. A nonborderline control group was randomly selected and matched for age, gender and residence. Clinicians experienced in geriatric mental health performed retrospective chart reviews and found that not one clinically diagnosed BPD patient was identified by either instrument. Although there appear to be a number of constant features of BPD throughout life, this study delineated two major areas of change in BPD in late life.

Informed Consent for Neuroleptics with Elderly Patients in Two Settings

This paper presents the results of four studies that evaluated the use of neuroleptics in an aging population both in nursing homes and in a psychiatric teaching hospital. The purpose was to determine the degree to which prescribing practices were in compliance with recent court rulings respecting the right of patients to informed consent to “exceptional” medication. The results indicate that physicians in nursing homes do not inform their patients of the risks of neuroleptics, do not seek consent, and do not consider competency to be even an issue. Elderly patients in the acute academic setting were informed of risks and benefits. However, both consent to medication and the competency to give this consent were presumed until or unless the patient failed to acquiesce. The degree to which these practices might be in potential conflict with state law, ignore the benefits of a negotiated doctor/patient partnership, and demonstrate one aspect of poor quality of care are discussed, and policy recommendations are made.

Low-Dose Methylphenidate in the Very Old

Two patients, aged 104 and 91 years, who presented with medical problems and depression were successfully treated with 1.25 to 5 mg of methylphenidate without evidence of tolerance or toxicity. Benefits were sustained for more than 8 months on smaller amounts of this central nervous system stimulant than has been previously reported. (J Geriatr Psychiatry Neurol 1990;3:152-154).

Methylphenidate Treatment of Minor Depression in Very Old Patients

Seven patients age 80-106 who presented with signs and symptoms of depression were successfully treated with 1.25-10 mg of methylphenidate per day without evidence of toxicity or tolerance. Treatment was continued for up to 24 months with sustained benefits.

Recording of Single Unit Activity in Isolated Central Nervous Tissue

The retina and attached segment of optic nerve isolated from the rabbit were maintained in a functioning state in vitro. Microelectrodes, introduced into the nerve, recorded unit discharges in response to light stimuli. The characteristics of these evoked discharges are described.

Electrical potentials within the intact frog retina.

Abstract There is now an extensive literature on the electrical characteristics of the vertebrate eye. Much of it is concerned with the frog, since the eye of that animal remians functional for a limited time after it has been excised and deprived of its blood supply. The present experiments were primarily on the eye of the frog in situ, with the circulation remaining intact. The main purpose of the experiments was to compare the resulting electrical measurements with the corresponding ones that have been reported for the excised eye. The results confirmed most of the earlier findings, with the exception of measurements of the resting potential, which showed no constant diference in potential across the intact retina. The electroretinogram was shown to be a mass response resulting from large-area stimulations; its origin localized at the receptor-bipolar layers. The predominantly negative intraretinal action potential, reported by Tomita, was demonstrated in response to a tiny, focused spot of light on this retina.