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Biomedical subjects

A Wiens

Publications and source records attributed to A Wiens.

9 recordsLinked to original sources
PubMed1999

Treatment of primary dysthymia with group cognitive therapy and pharmacotherapy: clinical symptoms and functional impairments.

OBJECTIVE: This study assessed the efficacy of antidepressant treatment (sertraline) and group cognitive behavior therapy, alone or in combination, in primary dysthymia. The clinical features of dysthymia, as well as the functional impairments associated with the illness (e.g., quality of life, stress perception, coping styles), were evaluated. METHOD: Patients (N = 97) diagnosed with primary dysthymia, but no other current comorbid disorder, received either sertraline or placebo in a double-blind design over 12 weeks. In addition, a subgroup of the patients (N = 49) received a structured, weekly group cognitive behavior therapy intervention. RESULTS: Treatment with sertraline, with or without group cognitive behavior therapy, reduced the functional impairment of depression. The reductions were similar in the drug-cognitive therapy group and in subjects who received the drug alone. Furthermore, while group cognitive behavior therapy alone reduced the depression scores, this effect was not significantly greater than the effect of the placebo. The drug treatment also induced pronounced improvement in the functional measures, and in some respects these effects were augmented by group cognitive behavior therapy. Among patients who responded favorably to cognitive behavior therapy, the improvements in the functional measures were similar to those who responded to drug treatment, whereas such functional changes were not seen among patients who responded to placebo. CONCLUSIONS: Sertraline treatment effectively reduces the clinical symptoms and functional impairments associated with dysthymia. Although the group cognitive behavior therapy intervention was less effective in alleviating clinical symptoms, it augmented the effects of sertraline with respect to some functional changes, and in a subgroup of patients it attenuated the functional impairments characteristic of dysthymia.

Adult↗
PubMed1998

Efficacy and tolerability of venlafaxine in the treatment of primary dysthymia.

OBJECTIVE: Currently, there is no documentation of the efficacy of venlafaxine (a serotonin norepinephrine reuptake inhibitor) in the treatment of dysthymia. This open-label pilot investigation examined the efficacy and tolerability of venlafaxine in patients with primary dysthymia without concomitant major depression. METHODS: Fifteen patients were treated with venlafaxine for 12 weeks, with a dose range of 75 mg to 225 mg daily (taken orally), and symptom changes were measured using standard instruments including the Hamilton Depression Rating Scale (HAM-D). RESULTS: Significant changes from pretreatment to posttreatment were observed (p < 0.001). Using the standard criteria of a 50% reduction in HAM-D scores, 73.3% of patients were rated as responders. About two-thirds of the patients reported adverse events, which were mostly mild and brief in duration. CONCLUSION: Venlafaxine may be useful in the treatment of primary dysthymia but placebo-controlled studies are required for confirmation.

Adult↗
PubMed1997

Fast onset: an open study of the treatment of major depressive disorder with nefazodone and pindolol combination therapy.

Pindolol, a beta-adrenergic and presynaptic 5-HT1 vA antagonist, when added to specific serotonin reuptake inhibitors, potentiates the antidepressant action, leading to an earlier onset of effect. Following on from the suggestion that nefazodone, a specific serotonin reuptake inhibitor and antagonist of 5-HT2, improves 5-HT1A-mediated transmission, we used a pindolol and nefazodone combination treatment for major depressive disorder. Twenty outpatients underwent a 4-week trial. Patients were seen twice a week, and completed efficacy and safety measures including the 17-item Hamilton Depression Scale, the Montgomery-Asberg Depression Rating Scale and the Clinical Global Impression scales. Results demonstrated significant improvement in all efficacy measures after one visit (2-4 days of treatment), with decreasing depression scores on all measures continuing throughout the trial. After 1 week of treatment, 15 out of 20 patients had experienced a 50% or greater reduction in their 17-item Hamilton Depression Scale scores. Remission rates were dramatic, with 40% of patients in remission after 1 week of treatment and 90% after 4 weeks. This open study of nefazodone-pindolol combination therapy suggests that this may be a new treatment option for patients with major depressive disorder; however, it needs to be replicated in a double-blind trial before conclusions regarding efficacy and safety can be made.

Adrenergic beta-Antagonists↗
PubMed1993

Ritanserin, imipramine, and placebo in the treatment of dysthymic disorder.

Fifty outpatients with dysthymic disorder (DSM-III) were divided by double-blind randomized assignment into three groups given ritanserin, imipramine, and placebo, respectively. The trial was of 7 weeks' duration; by week 6, imipramine was clearly superior to placebo, whereas by week 7, both drugs caused significantly more improvement than the placebo. Although imipramine had slightly greater efficacy than ritanserin, it also had significantly more side effects. This was particularly evident in the higher dropout rate with imipramine. The efficacy and side effect profile of ritanserin makes it well tolerated and acceptable with dysthymic patients who, although they do not respond as quickly as patients with major depressive disorder, do show significant improvement, given sufficient time.

Adult↗
PubMed1992

Exclusion of the gelsolin gene on 9q32-34 as the cause of familial lattice corneal dystrophy type I.

Familial lattice corneal dystrophy type I (LCD1) is a localized form of inherited amyloidosis limited to the corneal stroma. Recently the Finnish form of hereditary amyloidosis with lattice corneal dystrophy has been shown to be due to a mutation in the gelsolin gene (G654----A; Asp187----Asn). In this paper we exclude the gelsolin gene as the cause of the autosomal dominant form of isolated LCD1.

Amyloidosis↗
PubMed1992

A double-blind placebo-controlled comparison of moclobemide and amitriptyline in the treatment of depression.

The objective of this study was to determine if moclobemide is an effective treatment for depression and if it is well tolerated by patients. A randomized, double-blind placebo-controlled trial was conducted in a tertiary ambulatory clinic which treats depression. Fifty-five patients participated. They fit the DSM-III-R criteria for major depressive episode, scored at least 18 on the 17 item Hamilton Rating Scale for Depression (HRSD), were between the ages of 18 and 65, and were not suffering from a major medical illness. After a one week washout period, patients were randomly selected to receive placebo, amitriptyline or moclobemide for up to six weeks. Moclobemide is a well-tolerated medication at therapeutic doses; it is globally as effective as amitriptyline in the treatment of major depression.

Adult↗
PubMed1977

A rationale and method for the sexual history in family practice.

The taking of a sexual history produces a therapeutic effect for the patient by giving the patient permission to be sexual, filling patient knowledge gaps, providing a reality check, and beginning the process of self-acceptance by the patient. The physician's own empathy may seem to interfere with his feeling comfortable while eliciting a sexual history; at the same time the patient may struggle with feelings of shame and embarrassment. The physician can alleviate patient discomfort by being accepting and empathetic, and by assuming the patient has thought, felt, and done everything in the sexual area. He can also help by beginning with general questions, avoiding "why" questions and jargon, and gently reporting inconsistencies.

Attitude of Health Personnel↗