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Biomedical subjects

B T Carroll

Publications and source records attributed to B T Carroll.

At least 19 recordsLinked to original sources
PubMed2001

Loading strategies in acute mania.

Treatment of acute mania has been greatly influenced by loading strategies. Loading has potential benefits, including rapid symptom reduction in mania and a shortened length of stay. Disadvantages include an increased likelihood of adverse effects of the medications. Loading strategies for lithium, valproic acid (divalproex sodium), carbamazepine, oxcarbazepine, olanzapine, and haloperidol decanoate in the treatment of acute mania are discussed. Recent studies highlight this treatment option for selected patients. It is the unique properties of the medications that influence their use in loading. Issues in patient selection for loading strategies with each medication are also considered.

Journal Article↗
PubMed2001

Partial Kluver-Bucy syndrome: two cases.

Kluver-Bucy syndrome (KBS) is a rare neuropsychiatric disorder that may be characterized by visual agnosia, placidity, altered sexual activity, hypermetamorphosis, and hyperorality. Patients with KBS present with a complex behavioral syndrome. KBS is usually associated with lesions of the amygdala or amygdaloid pathways. However, partial KBS may occur in the absence of the classic bilateral temporal lesions. Pharmacologic treatment options have been developed from the results of case reports, which suggest that carbamazepine and antipsychotics may be helpful. We present the cases of two patients with partial KBS who responded favorably to antipsychotic medication.

Journal Article↗
PubMed2001

Kahlbaum's catatonia revisited.

Modern psychiatric nosologies separate catatonia along the lines of presumed etiology: bipolar, major depression, schizophrenia and due to a general medical condition. The presence of catatonia has always held diagnostic and prognostic value. Kahlbaum's description of catatonia includes careful documentation of phenomenology and the course of the illness. Since there were no effective treatments in his time, Kahlbaum was documenting the natural history of the illness. A review of classic studies of the natural history of catatonia demonstrates that the syndrome is episodic, may have few other psychotic signs, may have periods of remission and may, in some cases, be associated with the disorganized subtype of schizophrenia. The literature of the past 100 years supports the validity of Kahlbaum's description for a subset of patients with catatonia.

Bipolar Disorder↗
PubMed1999

Polymorphisms in PTEN in breast cancer families.

Germline mutations in PTEN are the underlying genetic defect in Cowden disease, which is associated with a lifetime risk of 25-50% of developing breast cancer. To investigate the role of PTEN in inherited breast cancer in the absence of manifestations of Cowden disease, we screened 177 unrelated subjects with breast cancer who also had a family history of breast cancer in at least one relative. We found no disease associated PTEN mutations in this cohort, supporting previous studies suggesting that PTEN mutations do not contribute to inherited susceptibility to breast cancer without associated manifestations of Cowden disease. We did identify an association between a common polymorphism in intron 4 and lower mean age of diagnosis of breast cancer. While preliminary, these findings suggest that further study is warranted to determine whether this allelic variant of PTEN could function as a low penetrance breast cancer susceptibility allele.

Age Factors↗
PubMed1996

Mania due to general medical conditions: frequency, treatment, and cost.

OBJECTIVE: Mania due to general medicine conditions may occur in patients in a variety of settings. METHODS: We reviewed the charts of patients admitted to an adult psychiatric service over a nine-year period (Jan. 1985 to Dec. 1993). Patients were diagnosed with Organic Affective Syndrome (ICD-9 code 293.83) in 241 episodes (N = 227 patients). There were forty-seven manic or mixed episodes in forty patients (0.72% of all admissions). RESULTS: When DSM-IV criteria for Mood Disorder due to a General Medical Condition manic or mixed type (MDGMC) was applied, we found twenty-five patients with twenty-seven episodes (N = 30 treatment trials). Irritable mood predominated in twenty-seven (90%) of the thirty trials. CONCLUSIONS: Treatment included anticonvulsants in 63 percent, neuroleptics 63 percent, and lithium 40 percent. Favorable responses to anticonvulsants were seen; however combination therapy was used more frequently. Further research in this area is needed.

Adolescent↗
PubMed1995

CRH challenge test in anxious depression.

Recently, renewed interest has developed in the concept of anxious depression. Using an operational definition of "anxious depression" based on the SADS interview, 25 patients with major depressive disorder were separated into anxious (n = 14) and nonanxious (n = 11) subtypes. These two patient groups and normal control subjects received an intravenous corticotropin-releasing hormone challenge test. Adrenocorticotropic hormone (ACTH) and cortisol responses were compared among the three groups. Patients with anxious depression had significant attenuation of ACTH response when compared to nonanxious patients and normal control subjects.

Adrenocorticotropic Hormone↗
PubMed1995

Clinical electroencephalograms in patients with catatonic disorders.

Catatonia is a neuropsychiatric syndrome of motor signs most frequently found in affective disorders and schizophrenia. Catatonic disorder due to a general medical condition has been added to the DSM-IV nosology. Laboratory studies, such as electroencephalography (EEG) may assist in the differential diagnosis of catatonic disorders. Twenty-six patients hospitalized on a general psychiatric unit or medical psychiatric unit received electroencephalograms (EEGs) as part of their routine care. Clinical EEG abnormalities were reported in 17 of these patients. The presence of abnormalities was associated with age greater than 40, diagnosis of neuroleptic malignant syndrome and the presence of general medical conditions associated with the development of catatonia. Although no specific EEG patterns were associated with catatonic disorder due to general medical conditions, these findings suggest that the EEG is an important tool in the evaluation of patients presenting with catatonia.

Adolescent↗
PubMed1994

Catatonic disorder due to general medical conditions.

Catatonia is a neuropsychiatric syndrome that may present a difficult diagnostic dilemma. Catatonic disorder due to general medical conditions must be considered in every patient with catatonic signs. Four patients with this disorder are presented. In these patients, general medical conditions associated with catatonic disorder included dystonia, HIV encephalopathy, progressive multifocal leukoencephalopathy, encephalitis, and renal failure. Three of these patients had multifactorial presentations of medical conditions or prior psychiatric disorders. A critical literature review concerning catatonia and associated nonpsychiatric medical conditions only infrequently supported causal relationships between organic factors and the development of catatonia. The majority of patients have multifactorial etiologies.

AIDS Dementia Complex↗
PubMed1994

Catatonia on the consultation-liaison service: a replication study.

OBJECTIVE: The aim of this study is to identify the frequency, presentation, identification, treatment recommendations and outcome of patients with catatonia in the general hospital setting. METHOD: All patients seen on a consultation-liaison (C-L) service over a six-month period were screened prospectively for catatonic disorders. Research and DSM-IV criteria for catatonic disorder were applied. Treatment and outcome were naturalistic. RESULTS: Five (1.6%) of 297 patients met restrictive criteria for catatonic disorder. Data were extracted from medical charts. Case reports are presented to reflect the diagnosis and treatment. Extensive medical treatment was required in most cases and most had an unfavorable outcome. CONCLUSION: Catatonia is infrequent but underrecognized in medical-surgical settings. The C-L clinician should screen for catatonic signs in order to diagnose and treat patients with the catatonic disorders.

Adult↗
PubMed1993

Screening for depression and anxiety in cancer patients using the Hospital Anxiety and Depression Scale.

Nine hundred and thirty inpatients and outpatients with cancer were approached to complete the Hospital Anxiety and Depression Scale (HADS). Eight hundred and nine (86.9%) of those approached participated in this screening. Using the suggested cutoff score of 8 for the anxiety and depression subscales, we found that 47.6% of this population would warrant further psychiatric evaluation. Twenty-three percent (23.1%) had scores 11 or greater and would be the most likely to have had anxiety (17.7%) or depressive (9.9%) disorders based on DSM-III-R criteria. Patients with active malignant disease and inpatient status were more likely to have higher depression scores. The HADS was an easily administered tool that identified a large proportion of cancer patients as having high levels of anxiety or depression. However, clinical psychiatric interviews were not performed, so it is not possible to determine what proportion of patients would benefit from treatment.

Adult↗