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Biomedical subjects

C R Soldatos

Publications and source records attributed to C R Soldatos.

At least 19 recordsLinked to original sources
PubMed2006

Set shifting deficits in melancholic vs. non-melancholic depression: preliminary findings.

Twenty-two patients with major depressive disorder, 11 of them with melancholic features, and 11 controls were investigated with CANTAB subtests focusing in visual memory/learning and executive functions. Melancholic patients performed worse than the other groups in all tasks and manifested a significant impairment in set shifting. The results are discussed in association with prefrontal dysfunction.

Cognition Disorders↗
PubMed2006

Hip dysplasia following a case of olanzapine exposed pregnancy: a questionable association.

This is a case report of a 33 year old woman with a history of psychosis, who presented to the women's mental health clinic for consultation at the 12(th) week of gestation, having already received olanzapine throughout the first trimester. She was followed from that point on at our clinic and remained on small doses of olanzapine for the rest of her pregnancy, which was uncomplicated. She gave birth to a healthy female, which at the age of three months was diagnosed with developmental dysplasia of the hip and subsequently received appropriate treatment with favorable outcome. The possibility of the association of this congenital dysplasia with the use of olanzapine during pregnancy is further discussed in this paper.

Adult↗
PubMed2006

Switching to amisulpride monotherapy for treatment-resistant schizophrenia.

The objective of this study was to assess switching to amisulpride (AMS) in treatment-resistant schizophrenia. Seven male subjects were switched to AMS and followed for 8 weeks. PANSS scores improved from 123 to 66 over this period. We conclude that AMS is of interest in the treatment of refractory schizophrenia.

Adult↗
PubMed2003

Protracted acute stress reaction following an earthquake.

OBJECTIVE: To verify the official criteria of ICD-10 diagnosis of acute stress reaction (ASR) among earthquake victims. METHOD: Data on psychosocial variables and the diagnosis of ASR were collected from 91 subjects. RESULTS: The diagnosis of ASR was made in 70% of the sample. However, the restrictive duration criterion (i.e. symptoms not exceeding the first 48 h) was fulfilled only in 10%; in the remaining 60% the symptoms lasted for about another week. Thus, 60% of the sample constituted a group with protracted ASR (PASR) and 40% a group without it (n-PASR). Medical history was more frequent among PASR than n-PASR; PASR showed higher anxiety levels (both pre- and post-disaster) than n-PASR; finally, the persistence of ASR related positively to the fear of death at the time of the earthquake and pre-disaster anxiety levels. CONCLUSION: As in the vast majority of earthquake victims the ASR is protracted beyond 48 h, a revision of ICD-10 guidelines should be considered.

Acute Disease↗
PubMed2000

Sleep spindle incidence dynamics: a pilot study based on a Markovian analysis.

Results are reported, based on 5 healthy subjects, concerning patterns in the dynamics of the sequential arrangement of spindles in human stage 2 sleep. Specifically, the conditional probability of incidence of successive spindle lengths and successive inter-spindle intervals is investigated. The results show that successive spindle lengths may be statistically independent. However, their distribution (histogram) may be similar for two different stage 2 periods, one in the first third and another in the second third of the night sleep record. In contrast to the finding about spindle lengths, results show that successive inter-spindle intervals may not be statistically independent. Furthermore, the overall dynamics of the sequential arrangement of inter-spindle intervals may be similar for the two sleep periods. These findings are discussed in the context of the "sleep maintenance" role of spindles.

Adult↗
PubMed2000

Athens Insomnia Scale: validation of an instrument based on ICD-10 criteria.

OBJECTIVES: To describe and validate the Athens Insomnia Scale (AIS). METHODS: The AIS is a self-assessment psychometric instrument designed for quantifying sleep difficulty based on the ICD-10 criteria. It consists of eight items: the first five pertain to sleep induction, awakenings during the night, final awakening, total sleep duration, and sleep quality; while the last three refer to well-being, functioning capacity, and sleepiness during the day. Either the entire eight-item scale (AIS-8) or the brief five-item version (AIS-5), which contains only the first five items, can be utilized. The validation of the AIS was based on its administration to 299 subjects: 105 primary insomniacs, 144 psychiatric patients and 50 non-patient controls. RESULTS: Regarding internal consistency, for both versions of the scale, the Cronbach's alpha was around 0. 90 and the mean item-total correlation coefficient was about 0.70. Moreover, in the factor analysis, the scale emerged as a sole component. The test-retest reliability correlation coefficient was found almost 0.90 at a 1-week interval. As far as external validity is concerned, the correlations of the AIS-8 and AIS-5 with the Sleep Problems Scale were 0.90 and 0.85, respectively. CONCLUSION: The high measures of consistency, reliability, and validity of the AIS make it an invaluable tool in sleep research and clinical practice.

Adolescent↗
PubMed1999

Tolerance and rebound insomnia with rapidly eliminated hypnotics: a meta-analysis of sleep laboratory studies.

Differences in development of tolerance and occurrence of rebound insomnia have been well established between rapidly and slowly eliminated benzodiazepine hypnotics. Based on meta-analytic methodology, this study assesses whether there are such differences among the rapidly eliminated benzodiazepine and benzodiazepine-like hypnotics (brotizolam, midazolam, triazolam, zolpidem and zopiclone). All sleep laboratory studies of these drugs (n = 137) published from 1966 to 1997 were obtained, mainly through a MEDLINE search. Rigorous selection criteria resulted in the inclusion of 75 studies employing 1276 individuals (804 insomniacs and 472 healthy volunteers). Using a mixed effects regression model, reliable estimation of the effects on insomniacs of the recommended dose of each drug could be obtained. All five rapidly eliminated hypnotics showed statistically significant initial efficacy. Tolerance with intermediate and long-term use was clearly developed with triazolam and was only marginal with midazolam and zolpidem; it could not be estimated for brotizolam or zopiclone because of insufficient data. Rebound insomnia on the first withdrawal night was intense with triazolam and mild with zolpidem; data were unavailable for brotizolam and inadequate for midazolam and zopiclone. In conclusion, there are differences among the rapidly eliminated hypnotics with respect to tolerance and rebound insomnia suggesting that, in addition to short elimination half-life, other pharmacological properties are implicated in the mechanisms underlying these side-effects.

Anti-Anxiety Agents↗
PubMed1998

Growth hormone secretion during sleep in male depressed patients.

1. Growth hormone (GH) secretion during sleep was studied in ten male patients with major depression according to DSM III and eight normal controls. 2. Samples were collected through a continuous blood withdrawal pump while sleep was recorded in the laboratory. 3. The results showed a marked decrease in the GH secretion mainly during the first three hours of sleep in depressed patients as compared to normal controls. DST and TRH tests were also administered to the same patients but no correlation was observed between a positive test and a blunted GH secretion, suggesting that the various neuroendocrinological disturbances do not coexist in all depressed patients. 4. This disturbance in GH secretion during sleep, along with reduced slow wave sleep (SWS), gives support to the theory that GHRH is the common stimulus of SWS and GH release and that the ratio of GHRH and its counterpart CRH plays a major role in the pathophysiology of disturbed endocrine activity during sleep in depression.

Aged↗
PubMed1997

Discriminating borderline from antisocial personality disorder in male patients based on psychopathology patterns and type of hostility.

Dimensions of psychopathology and patterns of hostility, as well as the relationship of hostility to psychopathology, were studied in 85 male young adults: 41 with borderline personality disorder (BPD) and 44 with antisocial personality disorder (APD). Diagnoses were based on DSM-III. The following instruments were also used: Brief Psychiatric Rating Scale, Hamilton Depression Rating scale, State-Trait Anxiety Inventory, and Hostility and Direction of Hostility Questionnaire. BPD patients compared with APD patients showed higher levels of overall psychopathology and depression, whereas both groups had equally high anxiety. Total hostility was quite high in both groups. However, BPD patients had more introverted hostility and APD patients had more extroverted hostility. In BPD patients, introverted hostility was related to overall psychopathology, depression, and trait anxiety, whereas in APD patients, no significant relationship of any type of hostility to various dimensions of psychopathology was observed. In conclusion, when comprehensively assessed, BPD patients can be discriminated from APD patients based on certain dimensions of psychopathology and differences in the direction of their hostility. Moreover, the relationship between psychopathology and hostility patterns suggests that the direction of patients' hostility plays an important role in the development of disorder-specific symptomatology.

Adult↗
PubMed1995

Low and high melatonin excretors among healthy individuals.

To meet the need of establishing firm normative data regarding the secretion/excretion of human melatonin, nighttime urinary melatonin of 16 healthy volunteers was measured in samples collected monthly over a period of 1 year. Low melatonin excretors (N = 8) were distinguished from high melatonin excretors (N = 8), based on a cut-off mean melatonin value of 0.25 nmol/l. There was no overlap in any of the monthly melatonin values between the two groups, while their annual rhythms of melatonin excretion were not different in shape. Since no obvious factors (age, sex, height, weight, etc.) were responsible for the observed differences, the distinction between low and high nocturnal excretion and by inference secretion of melatonin most likely reflects genetically determined variable levels of the noradrenergic secretory drive and/or variable N-acetyltransferase/hydroxyindole-O-methyltransferase enzymatic activity during the night.

Adult↗
PubMed1994

Insomnia in relation to depression and anxiety: epidemiologic considerations.

Epidemiologic studies show that psychopathology is a very powerful risk factor for the occurrence of insomnia. Depression and/or anxiety are quite prevalent among insomniacs, while insomnia is more than twice as prevalent in depressed than in non-depressed individuals. Moreover, recent data support a strong causal link of insomnia to both depression and anxiety. An exact cause-and-effect relationship between insomnia and psychopathology, however, has not as yet been definitively established. This is probably due to methodological differences across studies, related to design characteristics and the ways insomnia as well as various dimensions of psychopathology have been defined and detected. Thus, more refined psychometric techniques and multivariate methods of analysis should be utilized to elucidate the etiologic interface of insomnia and psychopathology.

Anxiety Disorders↗
PubMed1994

Suicide and violence risk. I. Relationship to coping styles.

Thirty suicidal psychiatric inpatients were compared with 30 nonsuicidal psychiatric inpatients. A battery of self-report tests was administered measuring suicide risk, violence risk and coping styles. The suicidal patients scored higher on both the suicide risk and violence risk. They also used almost all coping styles less frequently than the nonsuicidal patients. Among suicidal patients, suicide risk was negatively correlated with the coping styles of minimization, replacement and blame. Further, suicide risk and violence risk in suicidal patients were shown to be predicted by coping styles. These data indicate that suicidal patients have inadequate mental resources to deal with life problems. Besides their significance for assessing suicide risk, the findings may have possible clinical implications for case detection and early intervention with potential preventive value.

Adaptation, Psychological↗
PubMed1988

An experimental antidepressant increases REM sleep.

1. An experimental antidepressant was studied through sleep laboratory recordings, psychoendocrinological tests and clinical measurements in terms of its efficacy, side effects and effects on sleep. 2. The design included a four-week drug administration period, preceeded and followed by a one week placebo period. 3. In the presence of antidepressant efficacy, the drug did not disturb sleep induction and maintainance. 4. The only effect on sleep stages was an increase of REM sleep during the short-term drug administration period which is contrary to the REM supressant effect of most antidepressants. 5. This finding suggests that REM supression and antidepressant efficacy are not necessarily related. 6. Further, given that the only known action of the drug is its inhibitory effect on GABAergic transmission, one can speculate that GABA mechanisms may be involved in REM sleep modulation.

Antidepressive Agents↗
PubMed1988

Nocturnal sleep and blood pressure in essential hypertension.

Blood pressure and sleep-wakefulness patterns were monitored in the sleep laboratory over four consecutive nights in six patients with mild hypertension and six age- and sex-matched controls. In both hypertensives and normals, blood pressure levels decreased during sleep compared with presleep levels by 16.6 and 8.4%, respectively; levels for hypertensives, however, remained significantly above those for the normals. The nocturnal drop in blood pressure for both groups appeared to be related primarily to the general state of sleep rather than to any specific sleep stage. Nocturnal patterns of sleep stages and sleep cycling were almost identical for the two groups. Nocturnal blood pressure fluctuation was correlated positively with the distribution of nocturnal wakefulness in hypertensives but not in normotensives. This suggests that with hypertension there is some diminution of the dampening effect of sleep itself upon blood pressure which normally carries over into periods of nocturnal wakefulness. This alteration in patients with mild hypertension may reflect a decrease in the sensitivity of the baroreceptor reflex or some other pathophysiological process.

Adult↗
PubMed1988

Diazepam: effects on sleep and withdrawal phenomena.

Diazepam 10 mg was evaluated in a sleep laboratory study of six insomniac subjects. The protocol, which lasted for 18 consecutive nights, including four placebo-baseline, seven drug, and seven placebo-withdrawal nights, allowed for assessment of initial and short-term drug effects, side effects, and any withdrawal effects. With initial drug use, there was a significant improvement in sleep. Further, there was little evidence of tolerance developing at the end of the 1-week drug administration period. During drug administration there was a mild degree of daytime sedation reported. After abrupt termination of diazepam, there was a moderate degree of sleep difficulty on the sixth withdrawal night when total wake time was increased by 34% above baseline (not significant). On other nights, mild withdrawal changes were noted. These findings for the short-term administration and withdrawal of diazepam contrast with those for rapidly eliminated benzodiazepine drugs. The latter are characterized by a rapid development of tolerance and more frequent and intense withdrawal sleep disturbances.

Adult↗
PubMed1987

Alprazolam: effects on sleep and withdrawal phenomena.

Alprazolam was evaluated in chronic insomniacs in a 1-mg bedtime dose. The 16-night sleep laboratory protocol included four placebo-baseline nights followed by seven nights of drug administration and five placebo-withdrawal nights. On the first three drug nights (nights 5 to 7), the drug was highly effective in inducing and maintaining sleep with this short-term use. By the end of the one week of administration (nights 9 to 11), however, the drug had lost about 40% of its efficacy. During drug use, one subject reported some difficulty in controlling expression of inappropriate emotions when interacting with others, which suggested the presence of disinhibition. On the third night following drug termination, there was a significant increase in sleep difficulty above baseline levels (rebound insomnia). This worsening was of comparable magnitude to the peak improvement of sleep with drug administration. Thus, the clinical utility of alprazolam when administered to insomniac patients appears to be limited because of a relatively rapid development of tolerance and possible disinhibitory reactions during drug use and the occurrence of rebound insomnia following withdrawal.

Adult↗