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Biomedical subjects

B Ustun

Publications and source records attributed to B Ustun.

4 recordsLinked to original sources
PubMed2000

Lifetime panic-depression comorbidity in the National Comorbidity Survey. Association with symptoms, impairment, course and help-seeking.

BACKGROUND: Most prior studies of panic-depression comorbidity have been limited methodologically by use of small clinical samples and incomplete analyses. AIMS: General population data were used to study the association of lifetime and recent (12 months) panic-depression comorbidity with symptom severity, impairment, course and help-seeking in the National Comorbidity Survey (NCS). METHOD: The NCS is a nationally representative survey of the prevalences and correlates of major DSM-III-R disorders in the US household population. RESULTS: Strong lifetime and current comorbidity were found between panic and depression. Comorbidity was associated with greater symptom severity, persistence, role impairment, suicidality and help-seeking, with many findings persisting after controlling for additional comorbid diagnoses. Findings did not differ according to which disorder was chronologically primary. CONCLUSIONS: Both lifetime and current panic-depression comorbidity are markers for more severe, persistent and disabling illness. Neither additional comorbid diagnoses nor the primary-secondary distinction were important moderators of these associations.

Adolescent↗
PubMed1999

Assessment of toxic interactions of heavy metals in binary mixtures: A statistical approach

Toxicity of zinc, copper, cobalt, and chromium ions and their binary interactions were studied at varying test levels by using a battery of two tests, Microtox and duckweed with Vibrio fisheri and Lemna minor as test organisms, respectively. The type of toxic interaction at each test combination was assessed by a statistical approach based on testing the null hypothesis of "additive toxicity" at 95% confidence level. The interactions were called "antagonistic," "additive," or "synergistic" in accordance with the statistical significance and the sign of the difference between the tested hypothesis and the value of the observed toxicity at the binary test level concerned. In the majority of the combinations studied by the two bioassays, the interactions were of antagonistic nature. Additive toxicity was the next frequently predicted interaction in both test results, the frequency being much higher in Microtox responses than in those of duckweed. Finally, synergism was found to be a rare interaction in Microtox results, but totally unlikely in duckweed within the selected test combinations.

Journal Article↗
PubMed1998

The effects of detection and treatment on the outcome of major depression in primary care: a naturalistic study in 15 cities.

BACKGROUND: This study reports the responses of patients with confirmed depressive illnesses to different treatments in the WHO Mental Disorders in General Health Care study, conducted in 15 cities around the world. AIM: To discover how depressions recognized by the doctor compare with unrecognized depressions, both in terms of the initial illnesses and their outcomes, and to compare the outcomes of those depressions treated with antidepressants with those treated with daytime sedatives. METHOD: The design of the study was naturalistic, in that physicians were free to treat patients however they wished. Patients with confirmed depressive illnesses were assigned to four groups: treatment with an antidepressant; treatment with a daytime sedative (usually a benzodiazepine); patients recognized as having depression by the physician but were not offered drug treatment; and patients unrecognized as having depression by their physician. RESULTS: Both groups receiving drugs had illnesses of equal severity, were demographically similar to one another, and had similar previous histories of depression. Those receiving antidepressants had significantly fewer overall symptoms and fewer suicidal thoughts than those treated with sedatives. By the end of one year, differences between the groups had disappeared: patients not given drugs had milder illnesses but did significantly better than those receiving drugs, both in terms of symptoms lost and their diagnostic status. Unrecognized depressions were less severe than recognized depressions, and had a similar course over the year. CONCLUSIONS: Patients receiving antidepressants were better in terms of overall symptoms and suicidal thoughts than those treated with sedatives at three months, but this advantage does not persist. Depression emerges as a chronic disorder at one-year follow-up--about 60% of those treated with drugs, and 50% of the milder depressions, still meet criteria for caseness. The study does not support the view that failure to recognize depression has serious adverse consequences, but, in view of the poor prognosis of depression, measures to improve compliance with treatment would appear to be indicated.

Adolescent↗