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Biomedical subjects

A DiMascio

Publications and source records attributed to A DiMascio.

At least 19 recordsLinked to original sources
PubMed1980

Prevention of relapse in schizophrenia. An evaluation of fluphenazine decanoate.

We tested the role of guaranteed delivery of medication in the prevention of relapse and the enhancement of adjustment in the community in patients with schizophrenia. Two hundred and ninety newly hospitalized patients at four hospitals were randomly assigned to groups receiving either long-acting injectable fluphenazine decanoate or short-acting oral fluphenazine hydrochloride. After discharge and stabilization, patients were treated in the community for up to one year. By the end of the year, 28% of all the patients had relapsed. Contrary to hypothesis, differences between the two treatment groups in relapse percentages were not significant. Furthermore, there were no differences between the treatment groups as to development of affective symptomatology or social adjustment. Patients who rated themselves as having more symptom distress at the start of the community-maintenance phase of the study relapsed much earlier while receiving fluphenazine decanoate rather than fluphenazine hydrochloride. The results suggest that compliance is not an important determinant of relapse among newly discharged schizophrenic patients.

Adult↗
PubMed1979

Differential symptom reduction by drugs and psychotherapy in acute depression.

A randomized, controlled trial compared the combination of amitriptyline hydrochloride and short-term interpersonal psychotherapy, either treatment alone, and a nonscheduled treatment control group in ambulatory acute, nonbipolar, nonpsychotic depressives. Results show the efficacy of both psychotherapy and amitriptyline in overall symptom reduction. Amitriptyline and psychotherapy were about equal, and the effects of both treatments in combination were additive. The additive effect of combined treatment was largely due to the differential effects of the two treatments. Amitriptyline had its effect mainly on the vegetative symptoms of depression such as sleep and appetite disturbance, these occurred early in treatment, often within the first week. Psychotherapy had its effect mainly on mood, suicidal ideation, work, and interests; these effects occurred slightly later, at four to eight weeks.

Adolescent↗
PubMed1976

A controlled trial of amantadine in drug-induced extrapyramidal disorders.

Presently marketed antiparkinsonism drugs are potent anticholinergic agents that, while effective in treating extrapyramidal symptoms (EPS), also are productive of or can exacerbate a number of side effects associated with psychotropic drugs. Some of these include gastrointestinal disturbances, visual difficulties, and tardive dyskinesia. A double-blind study was carried out to assess the efficacy (and adverse effects) of amantadine hydrochloride--an agent without appreciable anticholinergic activity--for the treatment of drug-induced EPS. Amantadine was found to be comparable in effect to benztropine mesylate, but with fewer side effects. The potential role of amantadine may be in the treatment of patients with drug-induced EPS for whom medication with anticholinergic properties is contraindicated.

Amantadine↗
PubMed1976

Maintenance therapy of depression.

This paper summarises findings from a study of maintenance treatment in predominantly neurotic depressive responding to initial treatment with amitriptyline. Patients were continued on amitriptyline for eight months, withdrawn double-blind to placebo after two months, or withdrawn overtly to no medication, with and without individual psychotherapy from social workers in the factorial design. Continuation significantly reduced early relapse and symptom return, compared with either condition of early withdrawal. Psychotherapy improved social adjustment after eight months in patients who did not relapse, without any significant interactions. Side effects were minimal, except for carbohydrate craving. These findings suggest that tricyclic antidepressants should be routinely continued for several months after drug-induced remission.

Amitriptyline↗
PubMed1975

Deprivation in the childhood of depressed women.

With recent developments in community psychiatric services, concern with prevention has become an urgent social, as well as medical challenge. Comprehensive investigation into causation must therefore be given systematic emphasis. This paper is an effort toward clarification of etiology, specifically of the depressive disorder, in terms of early childhood experiences. The work is based on social and psychiatric history data collected by experienced psychiatric social workers on two groups of subjects from the National Institute of Mental Health (NIMH) Collaborative Depression Studies under the direction of Allen Raskin, Ph.D, of the NIMH Psychology Research Branch, and a third group of subjects from Boston State Hospital. The hypothesis that childhood deprivation, defined as "the lack, loss or absence of an emotionally sustaining relationship prior to adolescence", has a meaningful association with the occurrence of adult depression was tested in a sample of 347 depressed inpatient women and 114 outpatient women in comparison to 198 normal women used as a control or reference population. The subjects were all Caucasian. Events occurring during childhood that could be considered within the definition of deprivation were documented. Further, subjects were assessed as to depriving childrearing experiences. The findings revealed no association of adult depression with overt childhood loss events, but did provide evidence to support an association of depriving childrearing processes with adult depression. The findings also revealed evidence of a relationship between the degree of the depriving childrearing experience with the severity of the adult illness as measured by hospital status. The results are discussed in relation to findings from other studies of childhood deprivation and psychiatric disorder.

Adolescent↗
PubMed1975

Rapidity of symptom reduction in depressions treated with amitriptyline.

A group of depressed women treated with amitriptyline was studied with particular attention to the speed of response in different symptoms of depression and in psychotic as compared to neurotic depressives. The findings showed rapid improvement in suicidal feelings, insomnia, and anorexia, but slower and more gradual improvement in impaired work and interests, retardation and pessimism and hopelessness. Psychotic depressives did not show substantial improvement until the third week of treatment whereas neurotic depressives improved markedly within the first week. It is suggested that the psychotic classification may be more useful as a predictor of speed of response than as a predictor of final treatment outcome.

Adjustment Disorders↗
PubMed1975

Relative safety of amitriptyline in maintenance treatment of depression.

In the course of long term treatment with amitriptyline of 212 depressed women, the patients' somatic complaints were assessed. These somatic complaints included most symptoms generally attributed as being adverse effects of amitriptyline and other tricyclics. The reputed adverse effects were very often reported by patients prior to the initiation of antidepressant medication. Except for reports of dryness of mouth, all somatic complaints were reduced in frequency and intensity during the course of clinical improvement. When patients relapsed, regardless of whether they were or were not on maintenance medication, these somatic complaints returned. Except for dryness of mouth, no relationship between somatic complaints and dosage of amitriptyline was found. Amitriptyline is relatively safe. No espisodes of death, cardiac arrhythmia liver, blood or central nervous system reaction occurred.

Adjustment Disorders↗
PubMed1975

Saliva lithium levels: clinical applications.

The authors note that despite a few reports in the literature indicating that saliva lithium levels could adequately replace serum determinations in monitoring patients being treated with lithium salts, this procedure has not received much clinical application. A study of 20 patients investigated correlations between serum and mixed saliva and parotid fluid lithium levels and documented the reliability of this procedure. The authors suggest that an individual patient's ratio of serum to saliva concentrations should be calculated and used as a constant in the determinations. Patients can collect saliva samples and send them to the laboratory prior to their visits, decreasing the facility's sample collection costs and the patients' inconvenience and discomfort.

Bipolar Disorder↗