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B Pfohl

Publications and source records attributed to B Pfohl.

At least 19 recordsLinked to original sources
PubMed1995

Age-related differences in the symptomatic expression of major depression.

Hamilton Rating Scale for Depression and Beck Depression Inventory results were examined in a consecutive series of 174 female and 83 male patients, ranging in age from 18 to 81 years, admitted to a psychiatric hospital with a diagnosis of major depression. Items on the two scales were examined to determine the relationship between age and the symptomatic expression of major depression. Overall scores on the Hamilton scale revealed no relationship with age, but scores for males on the Beck Depression Inventory were negatively associated with age. In addition, the most prevalent types of depressive symptoms showed significant correlations with age. Items related to low self-esteem, such as guilt, sense of failure, self-accusations, and thoughts of suicide, showed a negative relationship with age for both males and females. It is possible that psychological maturation or other age-related factors reduce vulnerability to low self-esteem during episodes of clinical depression; however, selection bias or a cohort effect cannot be ruled out with the current methodology.

Adolescent↗
PubMed1993

Personality disorder in obsessive-compulsive volunteers, well comparison subjects, and their first-degree relatives.

OBJECTIVE: The authors sought to determine the frequency of DSM-III personality disorders in subjects with obsessive-compulsive disorder, well comparison subjects, and their first-degree relatives. METHOD: Thirty-two subjects with obsessive-compulsive disorder and 33 age-(within 5 years) and gender-matched well comparison subjects were assessed with the Structured Interview for DSM-III Personality Disorder and several self-report instruments. Their first-degree relatives were assessed in a blind manner with the same instruments. RESULTS: Subjects with obsessive-compulsive disorder were more likely than well comparison subjects to have a personality disorder, but compulsive personality was not the most frequent. No significant differences were found in the prevalence of personality disorders among first-degree relatives, including compulsive personality, or in obsessional, hysterical, or oral character traits. CONCLUSIONS: Personality disorders are highly prevalent among patients with obsessive-compulsive disorder, but the data do not support a relationship between obsessive-compulsive disorder and compulsive personality.

Adult↗
PubMed1993

Clinical correlates of self-mutilation among psychiatric inpatients.

The charts of 660 consecutive admissions to a university psychiatric hospital were examined. After excluding those with mental retardation, 32 patients who had mutilated themselves and 88 patients admitted for unsuccessful suicide attempts were identified. Women were significantly overrepresented among the mutilators, but the groups did not differ with respect to age. Most analyses were restricted to women, of whom 27 were self-mutilators and 51 were nonmutilating suicide attempters. Mutilators were less likely to receive diagnoses of major depression or adjustment disorder but were more likely to have a history of substance abuse and receive Axis II diagnoses. The mutilative behavior was generally repetitive. The most common form was superficial cutting of the arms and wrists. Reports of lifetime sexual or physical abuse were more common among mutilators. Mutilators also had frequent histories of suicide attempts distinct from their mutilation behavior, multiple hospitalizations, and transfer to state hospitals for longer-term care. These findings suggest a chronic course with significant morbidity and associated features which may be of clinical significance.

Adult↗
PubMed1992

Failed and short seizures associated with prior electroconvulsive therapy.

Electroconvulsive therapy (ECT) has not been associated with many long-lasting effects that are associated with the treatments itself. The impact of having prior ECT to determine if the increased seizure threshold that is noticed during the treatment course is long-lasting was studied. If so, more failed and short seizures should occur among those patients who have had prior electroconvulsive treatments. A review of the treatments of 114 males and 220 females indicated a strong association of prior ECT with failed as well as short seizures for men but not for women.

Adult↗
PubMed1991

Major depression and personality disorder.

The authors examined an interview and paper-and-pencil assessment of the DSM-III personality disorders (PDs) in depressed inpatients, and depressed relatives of psychiatric patients and never-ill controls who had a lifetime history of major depression. The rates of PDs according to the Structured Interview for DSM-III Personality Disorders (SIDP) were similar in the two groups, except for borderline PD which was more frequent in the inpatients. Of the individuals with a PD, the patients were more likely than the relatives to have two or more PDs, and the borderline and histrionic patients were more prototypic of these disorders than were the borderline and histrionic relatives. In contrast to the SIDP results, the rates of PDs according to the Personality Disorders Questionnaire (PDQ) were higher in the patient sample. These results thus extend the previously described high rates of PDs in depressed patients to a sample of individuals with a lifetime history of treated or untreated depression, and they suggest that interview assessments of personality may be less sensitive to the state effects of depression than are questionnaires.

Adult↗
PubMed1991

Association between post-dexamethasone cortisol level and blood pressure in depressed inpatients.

We examined the clinical data for 230 depressed inpatients who had completed a dexamethasone suppression test (DST) to determine whether those with an elevated post-DST serum cortisol level exhibited any of the classic physiological stigmata of Cushing's syndrome. Hypertension was significantly more frequent among DST nonsuppressors (21.2%) than among normal suppressors (11.3%). Percent blood lymphocyte count was significantly lower among nonsuppressors. Confounders such as gender, age, body weight, and use of antihypertensives did not account for the findings. Implications for morbidity and mortality rates among patients with affective disorder are discussed.

Adult↗
PubMed1991

Results of a survey of forensic psychiatrists on the validity of the sadistic personality disorder diagnosis.

OBJECTIVE: The purpose of this study was to determine how often forensic psychiatrists evaluated individuals with sadistic personality disorder; their views about the usefulness of the diagnosis; the frequency of certain childhood factors; and the sensitivity and specificity of the individual diagnostic criteria. METHOD: A questionnaire to be answered anonymously was sent to all of the 1,390 members of the American Academy of Psychiatry and the Law. Two hundred seventy-nine usable questionnaires were returned for data analysis. RESULTS: Approximately 50% of the respondents had, at some time, evaluated in a forensic setting a subject who exhibited behavior that met the criteria for the disorder. Four percent of the cases seen in the preceding year by those respondents who had ever seen a case would have met the criteria for the disorder. Most of the forensic psychiatrists who had experience with the disorder believed that the diagnosis is useful for a variety of clinical and forensic purposes, but most also believed that the category has significant potential for being misused in legal settings. Almost all cases described by the respondents involved male patients, and there was frequently a history of childhood abuse and parental loss. The diagnostic criteria in these cases had high sensitivity and specificity. CONCLUSIONS: In forensic settings the diagnosis of sadistic personality disorder is probably not rare. The results of this study suggest that the diagnosis has both descriptive and construct validity and that further study of the disorder with the DSM-III-R diagnostic criteria is needed.

Antisocial Personality Disorder↗
PubMed1990

A test of the tridimensional personality theory: association with diagnosis and platelet imipramine binding in obsessive-compulsive disorder.

We administered the Tridimensional Personality Questionnaire (TPQ) to a sample of 25 individuals with obsessive-compulsive disorder (OCD) and 35 normal controls. As predicted, OCD cases scored much higher on the harm avoidance dimension than normal controls. Findings for the novelty seeking and reward dependence dimensions were less dramatic, although compatible with the underlying theory. Despite a theoretical link between the harm avoidance dimension and serotonin-mediated neuropathways, we failed to find an association between this dimension and platelet imipramine binding in either OCD cases or controls.

Arousal↗
PubMed1990

Outcome of panic disorder. Relationship to diagnostic subtypes and comorbidity.

Eighty-nine subjects with panic disorder, who had been naturalistically treated, and 46 nonanxious controls were followed up after 3 years. Although they remained symptomatic, most subjects with panic disorder reported relatively little distress or social maladjustment. The course of panic disorder was characterized by fluctuating anxiety and depressive symptoms. Panic subtypes (uncomplicated, limited phobic avoidance, and extensive phobic avoidance) and Axis I and II comorbidity (major depression and personality disorders) were highly predictive of symptoms and social adjustment after 3 years. Abnormal personality was, in fact, the strongest predictor of social maladjustment in both subjects with panic disorder and controls. The results showed that while panic disorder has a favorable outcome, the illness is a chronic one that may require continuing treatment. They also show that subtypes and comorbid disturbances are important predictors of outcome.

Adult↗
PubMed1988

Reliability of the telephone interview in diagnosing anxiety disorders.

The reliability of psychiatric diagnosis using the Schedule of Affective Disorders and Schizophrenia-Lifetime Version in personal and telephone interviews with 39 subjects was assessed using a 12- to 19-month test-retest design. Interrater reliability was high (kappa, .69 to .84) for the diagnosis of panic disorder, agoraphobia with panic attacks, probable panic disorder, major depression, and alcohol abuse. We conclude that it is possible to reliably make these lifetime diagnoses in a family study using the telephone interview.

Agoraphobia↗
PubMed1988

The reliability of the family history method for psychiatric diagnoses.

We evaluated the test-retest interrater reliability of the Family History Research Diagnostic Criteria (FH-RDC) in 58 depressed patients who described 341 first-degree relatives. Reliability was examined as a function of the threshold to determine caseness. In general, diagnostic reliability was good-excellent for specific FH-RDC disorders, but not for the residual category of other psychiatric disorder. A higher diagnostic threshold was associated with greater reliability, especially for the diagnosis of depression. Patient variance accounted for a greater percentage of the disagreements between the interviewers than did rater variance.

Data Collection↗
PubMed1988

Diagnosing personality disorder in depressed patients. A comparison of patient and informant interviews.

Personality disorder (PD) diagnosis were made in 66 depressed patients based on independent interviews of the patient and a close informant. The patients and informants markedly differed in their descriptions of the patients' normal personality. The kappa coefficient of agreement for the diagnosis of any PD was .13, and all kappa values for the individual PD diagnoses were below .35. Informants reported more pathologic conditions than the patients, such that PDs were diagnosed in 57.6% (38/66) of the patients, based on the informant interview, and in 36.4% (24/66), based on the patient interview. We also examined dimensional scores. In general, we found only modest correlations between the patient and informant dimensional scores and that the ratings based on the informant interviews were higher. These results varied by specific PD diagnoses. Consensus ratings, which were based on both sources of information, were sometimes more strongly associated with patient information and sometimes with informant information, and this, too, varied among the different PDs.

Adult↗
PubMed1988

Prognostic validity of the familial subtypes of depression.

We examined the prognostic validity of Winokur's familial subtypes of depression in 184 in-patients with primary unipolar major depression. Patients with familial pure depressive disease had a more favorable hospital course and reported less symptoms during a 6-month follow-up evaluation than patients with depressive spectrum disease or sporadic depressive disease. Consistent with previous studies of the validity of the familial subtypes, the use of stringent thresholds to diagnose the patient's relatives increased the validity of classification.

Antidepressive Agents↗
PubMed1987

The prognostic validity of DSM-III axis IV in depressed inpatients.

DSM-III suggests that axis IV should have prognostic value--that patients with higher scores will have a better outcome than patients with low ratings. The authors used axis IV to assign scores to 130 depressed inpatients and examined these scores in association with the patients' course during the index hospitalization and at 6-month prospective follow-up. Higher axis IV scores were associated with more depressive symptoms on hospital discharge, but they did not predict follow-up outcome. These results are consistent with other studies of the prognostic value of ratings of psychosocial stress and indicate that, at least for depression, there is little empirical support for DSM-III's suggestion that stress is a favorable prognostic sign.

Adolescent↗
PubMed1987

Prognostic validity of the dexamethasone suppression test: results of a six-month prospective follow-up.

In a 6-month prospective follow-up study, the authors located and interviewed 165 (88.2%) of 187 primary unipolar depressed inpatients to whom a 1-mg dexamethasone suppression test (DST) had been given during their first week of hospitalization. Longitudinal ratings of symptoms over the follow-up period and 6-month cross-sectional ratings on the Hamilton Rating Scale for Depression, the Beck Depression Inventory, and the Global Assessment Scale were obtained for each patient. The authors also collected information on rehospitalization after discharge from the index episode. Baseline DST results were not associated with any of the outcome variables.

Adult↗
PubMed1987

An American validation study of the Newcastle Diagnostic Scale. II. Relationship with clinical, demographic, familial and psychosocial features.

We completed the Newcastle Diagnostic Scale on 152 unipolar depressed in-patients: its validity was supported by the findings that endogenous depressives were, in contrast to neurotic depressives, older, more severely depressed, with better social support, fewer life events, less personality disorder, and a lower morbid risk of alcoholism and antisocial personality in their first-degree relatives. The relationship between Newcastle scores and the morbid risk for alcoholism was non-linear, such that a cut-off score of 4, rather than 5, maximised the difference between the endogenous and neurotic groups with respect to familial alcoholism rates as well as other validating variables.

Cognition Disorders↗