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Biomedical subjects

A Bulbena

Publications and source records attributed to A Bulbena.

17 recordsLinked to original sources
PubMed1998

Differential effect of haloperidol and clozapine on plasma homovanillic acid in elderly schizophrenic patients with or without tardive dyskinesia.

BACKGROUND: Plasma homovanillic acid (HVA) changes in response to a challenge of several days with haloperidol have been found to be predictive of the therapeutic response to haloperidol over a longer period of treatment. METHODS: Twenty-six elderly women who gave informed consent were divided into two groups, with or without tardive dyskinesia, and subjected to an 80-day washout, after which both the dyskinetic and nondyskinetic group was divided, and half of each group given haloperidol or clozapine. CONCLUSIONS: The nondyskinetic group had a brief rise in plasma HVA, then a decline. The dyskinetic group had no change in plasma HVA. Neither group challenged with clozapine had any change in plasma HVA.

Aged↗
PubMed1998

Association between joint hypermobility syndrome and panic disorder.

OBJECTIVE: The purpose of this study was to assess whether joint hypermobility syndrome is more frequent in patients with panic disorder, agoraphobia, or both than in control subjects and, if so, to determine whether mitral valve prolapse modifies or accounts in part for the association. METHOD: A case-control study was conducted in a general teaching hospital outpatient clinic. Subjects were 99 patients, newly diagnosed and untreated, with panic disorder, agoraphobia, or both and two groups of age- and sex-matched control subjects: 99 psychiatric patients and 64 medical patients who had never suffered from any anxiety disorder. Measures consisted of the Structured Clinical Interview for DSM-III-R, Beighton's criteria for joint hypermobility syndrome, and two-dimensional and M-mode echocardiogram. The presence of mitral valve prolapse and joint hypermobility syndrome was explored by raters who were blind to subjects' psychiatric status. RESULTS: Joint hypermobility syndrome was found in 67.7% of patients with anxiety disorder but in only 10.1% of psychiatric and 12.5% of medical control subjects. On the basis of statistical analysis, patients with anxiety disorder were over 16 times more likely than control subjects to have joint laxity. These findings were not altered after the presence of mitral valve prolapse was taken into account. Of the patients with anxiety disorder, those who had joint hypermobility syndrome were younger and more often women and had an earlier onset of the disorder than those without joint hypermobility syndrome. CONCLUSIONS: Joint laxity is highly prevalent in patients with panic disorder, agoraphobia, or both and may reflect a constitutional disposition to suffer from anxiety. Mitral valve prolapse plays a secondary role in the association between joint hypermobility and anxiety.

Adult↗
PubMed1996

Somatotype in panic patients.

The aim of the study was to test whether an association exists between asthenic somatotype, as measured by the Quetelet index, and panic and or agoraphobia. Ninety-nine cases with panic and/or agoraphobia diagnosed at the psychiatric outpatient clinic of a general teaching hospital were compared to 99 controls with psychiatric conditions other than panic and agoraphobia, and to 64 medical controls, matched by age and gender. No differences in weight, height and raw Quetelet and ponderal indexes were found between panic cases and controls. However, 33.3% of cases, but only 19.2% of psychiatric controls and 18.7% of medical controls, were in the asthenic group as defined by the lower quartile of the Quetelet index (age and sex adjusted odds ratio = 2.33, 95% C.I.: 1.21-4.11). In the entire sample, the asthenic somatotype was associated with lower age and with the presence of hypermobility of joints. Since both panic disorder and mitral valve prolapse may be associated with the joint hypermobility syndrome (JHS), an inherited disorder of collagen synthesis, it is suggested that the relationship found between panic and asthenic somatotype might be mediated through JHS.

Adult↗
PubMed1993

Anxiety disorders in the joint hypermobility syndrome.

A case-control study was designed to test the association between joint hypermobility syndrome (JHS), an inherited disorder of collagen synthesis, and anxiety and phobic disorders. One hundred fourteen cases of JHS diagnosed at the rheumatology outpatient clinic of the Hospital del Mar (Barcelona) were compared to 59 control subjects randomly selected from patients seen at the same clinic. Both cases and controls were examined by a psychologist who used the Structured Clinical Interview for DSM-III-R and who was unaware of their medical diagnoses. DSM-III-R diagnoses of panic disorder, agoraphobia, and simple phobia, but not generalized anxiety disorder, dysthymic disorder, or major depression were found to be highly associated with JHS (age- and sex-adjusted odds ratio = 10.7). Mitral valve prolapse (MVP) was present only among JHS cases. Among cases of JHS, subjects with MVP were almost three times more likely to suffer from anxiety than subjects without MVP (odds ratio = 2.95), although the association was not statistically significant. The strong association between panic anxiety and JHS appears to occur at a higher level than the association between panic and MVP, and provides a new basis for further studies on the genetic background of panic-anxiety.

Adult↗
PubMed1993

Cognitive function in the affective disorders: a prospective study.

A prospective, controlled study of 50 subjects confirmed claims that major depression or mania may cause temporary disorders of attention, memory, visuo-spatial function, and choice reaction time, and cause-independently of medication-the appearance of glabellar tap, positive hand-face test, nuchocephalic reflex, and graphesthesia. On follow-up, all these phenomena either disappeared or markedly improved. Age and age of onset, but not pre-morbid intelligence or history of ECT, seemed to modulate the severity of the cognitive impairment. Presence of delusions predicted poor (but reversible) visuo-spatial function. Cognitive impairment accompanied by reversible soft neurological signs was more marked but patients thus affected surprisingly showed lower depressive scores; this was interpreted as representing a secondary, 'organic' form of affective disorder (i.e. a behavioural phenocopy of depression) characterised by a reduced capacity to experience depressive symptoms and by little improvement at follow-up.

Adult↗
PubMed1992

Feelings of guilt in major depression. Conceptual and psychometric aspects.

A new scale for the evaluation of feelings of guilt is described. Two types of guilt feeling were of potential interest: 'delusional' guilt or shame (experienced in relation to one's actions), and 'affective' guilt (a more general feeling of unworthiness). Reliability and validity analyses for the first (15-item) version of the scale were performed in three separate and contrasting clinical samples. The second and final (seven-item) version was tested in another sample of major depressives and in normal controls. The HRSD was used as a measure of severity throughout. The BDI and Widlöcher psychomotor retardation scale were also used as external criteria for the seven-item scale. Exploratory factor analysis of this sample yielded two factors--'cognitive/attitudinal' and 'mood/feeling'--of which only the first correlated with scores for psychomotor retardation. It is suggested that these two factors represent two forms of guilt, but that only the former is related to a putative dopaminergic disorder. Guilt scores and measures of severity were not correlated. It is suggested that feelings of guilt should be considered as a behavioural marker for a subtype of depression.

Adult↗
PubMed1992

Clomipramine versus phenelzine in obsessive-compulsive disorder. A controlled clinical trial.

A double-blind clinical trial of clomipramine versus phenelzine was carried out on 30 patients suffering from DSM-III obsessive-compulsive disorder. The study period was 12 weeks, and the maximum doses used (from the fifth week on) were 225 mg/day for clomipramine (14 patients) and 75 mg/day for phenelzine (12 patients); four patients dropped out. Obsessive symptoms improved significantly in both drug groups, but there was no significant difference between groups. Depressive symptoms improved before obsessive ones.

Adult↗
PubMed1992

Clinical assessment of hypermobility of joints: assembling criteria.

We carried out a prospective study to determine the validity of different sets of criteria to define the hypermobility syndrome (HMS), as well as the frequency, reliability and clinical features of HMS items. All consecutive cases of HMS attending the rheumatological outpatient clinic of Hospital del Mar (Barcelona, Spain) constituted the index group (n = 114). A control group of non-HMS rheumatological patients (n = 59) was randomly selected to assess suitable cutoff points and particular HMS item prevalences. Beighton's, Carter's and Rotés' HMS scores correlated very highly among them. Both the correlation coefficients obtained between each pair of sets of HMS criteria and the predictive efficiencies were uniformly high, suggesting high concurrent and predictive validity. All but 2 of the major items were more frequent among women. A basic set of criteria to define HMS is proposed. In relation to previous criteria the new scale shows better internal reliability and homogeneity. Results suggest that it may be suitable for screening studies and in clinical rheumatological settings.

Adult↗
PubMed1991

Predictors of antidepressant treatment outcome in melancholia: psychosocial, clinical and biological indicators.

Predictive variables of response to imipramine and to phenelzine at 6 weeks and 6 months were studied in 116 patients suffering from major depression with melancholia (DSM-III). Several sociodemographic, clinical, and biological variables were studied. For imipramine-treated patients, high social support predicted a better response at 6 weeks, while development of hypomania during follow-up was associated with a better response at 6 weeks; absence of life events during the 6-month follow-up and initial non-suppression of dexamethasone predicted a better outcome at 6 months. For phenelzine-treated patients, development of hypomania during follow-up was associated with a better outcome at 6 months and absence of life events prior to the onset of the episode was associated with a worse outcome at 6 months.

Adult↗
PubMed1987

Post psychotic depression: the Fulbourn cohort.

A comparison is reported, based on a 10 year follow-up, between an index sample of 29 subjects suffering from schizophrenia and post psychotic depression and a control sample of 41 subjects suffering from schizophrenia alone, all having had their first admission to the same hospital in 1974. The index subjects were significantly older on onset of schizophrenia and exhibited more auditory hallucinations. Follow-up patients with post psychotic depression were admitted more often, but their admissions were shorter. No difference was found between the two groups in the frequency of family history of affective disorder, in the duration of treatment with depot neuroleptics or in the dose level of the depot injection received immediately prior to readmission.

Adult↗
PubMed1986

Significant rise in plasma insulin after electroconvulsive therapy.

The effect of ECT on insulin plasma levels was studied in 10 single treatments in five patients suffering from DSM III-diagnosed schizophrenia. The treatments were chosen from early, middle and late ordinal positions. A significant rise was found 10, 20 and 30 min after an effective electrical stimulus. Values returned to normal in all cases at 60 min. The rise at 10 min occurred in all treatments, irrespective of ordinal position, but an incidental finding was that the higher the ordinal position of a given treatment, the higher the peak of insulin.

Electroconvulsive Therapy↗
PubMed1986

Pseudodementia: facts and figures.

The historical and conceptual aspects of the pseudodementia state are briefly touched upon. A "collective sample", composed of 61 cases culled from the literature, is analysed and compared with the "Fulbourn sample" consisting of 22 cases reported for the first time. Two sub-types of pseudodementia emerge, one associated with depressive illness and the other with delirium. A follow-up of the Fulbourn sample (1-4 years after discharge) showed 14 patients to be alive and 8 to show no signs of dementia. No variable except the diagnosis "non-specific psychosis" correlated with death during the follow-up period.

Aged↗
PubMedDate not supplied

Dexamethasone suppression test and primary obsessional compulsive disorder.

This report explores the role played by DSM-III Major Depression in the Nonsuppressor status of a sample of 29 subjects suffering from DSM-III Obsessive Compulsive Disorder (OCD). Five subjects were found to be Nonsuppressors. Further analysis showed that it is likely that Nonsuppressor status depended upon the concomitant presence of Major Depression rather than upon the OCD itself.

Adult↗