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Biomedical subjects

D R Robbins

Publications and source records attributed to D R Robbins.

At least 19 recordsLinked to original sources
PubMed1995

Lung function development in young adults: is there a plateau phase?

Numerous population studies have reported that pulmonary function following the adolescent growth phase appears to be in a steady-state, where there is little or no growth occurring up to 40 yrs of age. We examined longitudinal forced expiratory volume in one second (FEV1), changes using three different statistical approaches to determine which subjects actually have significant trends during this period. Participants, who were employees at a metal processing plant, underwent quarterly spirometry for up to 10 yrs. Test results up to 33 yrs of age were included in the analysis. Each subject's FEV1 data was first analysed using simple linear regression (SLR) to test for a statistically significant linear slope. Next, each subject's data were fitted using bootstrap sampling (BSS) of their original data, to yield reduced estimates of the slope variances and increase the power of detecting a significant trend. And thirdly, we fitted a regression breakpoint (BKPT) model to the data to find those subjects who may have piecewise linear growth or decline in function. All analyses were stratified, based on smoking status. Subjects included 111 nonsmokers and 110 smokers. Among the nonsmokers, 34 subjects had significant slopes using SLR, an additional three using BSS, and only two with BKPT. Among the smokers, 36 had a significant trend using SLR, 7 were added using BSS, and no additional subjects with BKPT. We conclude that in young adult males lung function is not in a steady-state and that as many as 40% have a significant slope, either positive or negative.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1993

Smoking cessation and changes in respiratory symptoms in two populations followed for 13 years.

To investigate the relationship between persistence and incidence rates of respiratory symptoms, and the cessation of cigarette smoking, the data from longitudinal studies conducted in Cracow, Poland and Tucson, USA were analysed jointly. Among 1722 subjects smoking at the beginning of the study, 468 had given up smoking at the 13-year follow-up. The persistence and incidence rates of chronic cough, chronic phlegm, wheeze and attacks of breathlessness were reduced by 50% in ex-smokers compared to the subjects continuing to smoke. The beneficial effects of smoking cessation were decreased in subjects smoking more cigarettes per day in the past and starting to smoke at a younger age. The symptoms were less likely if smoking ceased before the onset of any respiratory disease. These results were similar in the Cracow and Tucson populations, confirming the universal nature of the observations.

Adult↗
PubMed1992

Panic disorder in children and adolescents.

Undiagnosed panic disorder may be a significant health problem in children and adolescents. Some of the adolescents and children who have presented for years with school refusal or psychogenic somatic complaints may suffer from this disorder and may benefit significantly from appropriate treatment.

Adolescent↗
PubMed1991

Death certificate reporting of confirmed airways obstructive disease.

Death certificate reporting of chronic airways disease was examined during 13 years of follow-up in the Tucson Epidemiologic Study of Airways Obstructive Disease. The Tucson study population is a geographically clustered stratified random sample of white, non-Mexican-American households in Tucson, Arizona. The initial survey was performed in 1972-1973. Using clinical and physiologic criteria from nine surveys to define airways obstructive disease in the population, the authors compared death certificate reporting with these criteria as the underlying cause and as reported anywhere on the death certificate. Reporting was related to the degree of antemortem airways obstruction. Sex differences in reporting were also noted. Females showed greater rates of reporting at low levels of impairment while males showed greater reporting at high levels of impairment. When airways obstructive disease was not the underlying cause of death, the type of underlying cause was found to affect reporting of airways obstructive disease on the death certificate.

Adult↗
PubMed1990

Panic disorder in children and adolescents.

Panic disorder is a common and well-known psychiatric disorder which commonly has its onset during adolescence. However, the disorder has only recently been described in children and adolescents. The clinical literature describing panic disorder in children and adolescents is reviewed, and six cases are presented. Future directions for research are suggested.

Adolescent↗
PubMed1989

Insulin misuse: a review of an overlooked psychiatric problem.

A number of forms of insulin misuse, other than the usual noncompliance, have been reported in the literature on the treatment of diabetes mellitus. These include attempted and completed suicide, factitious hypoglycemia, Munchausen syndrome by proxy, and the use of insulin by substance abusers. Such misuse has involved diabetic patients, their family members and medical staff, as well as others. The reports of suicide attempts reveal an equal distribution of misuse between the sexes (rather than the expected preponderance of females), underrepresentation of adolescents, and a high rate of recurrence. Recommendations for treatment are discussed for clinicians and investigators regarding this overlooked problem.

Adult↗
PubMed1987

Panic and depressive disorders among psychiatrically hospitalized adolescents.

Sixty-one adolescents hospitalized on an inpatient psychiatric unit were evaluated to determine whether they met criteria for panic and affective disorders according to Research Diagnostic Criteria. Ten (16%) and 15 (24%) met criteria for definite or possible panic disorder. Fifteen (24.5%) had major depressive disorder (MDD) endogenous subtype, 10 (16%) had MDD nonendogenous subtype, 8 (13%) had minor depressive disorder (mDD), and 27 (44%) had no diagnosable mood disorder. Four adolescents with definite panic disorders were diagnosed as having MDD endogenous subtype, three MDD, two mDD, and one had no diagnosable depressive disorder. The mean total score on the Hamilton Rating Scale for Depression (HRSD) was significantly higher among those subjects with definite panic attacks compared with those with either possible or no panic. Patients with definite panic disorder showed significant increases on the HRSD items of guilt, decreased work and interest, psychological and somatic anxiety, and weight loss compared to these samples.

Adolescent↗
PubMed1985

Use of the Hamilton Rating Scale for Depression and the Carroll Self-Rating Scale in adolescents.

The relationship of clinicians' ratings of depression in adolescents to self-rating is important to clinical research. The Hamilton Rating Scale for Depression (HRSD) and the Carroll Self-Rating Scale (CSRS) were compared in a study of 81 psychiatrically hospitalized adolescents. The correlation of CSRS and HRSD total scores in adolescents with melancholic major depression was 0.46, lower than the correlation reported in adults (0.80). Higher correlations were seen in females and in nonmelancholic and nondepressed subgroups. While the comparison of the two rating methods suggests some characteristics of depressed adolescents' presentation of their illness, it does not appear that the self-rating instrument can be used as an alternative to clinicians' ratings.

Adaptation, Psychological↗
PubMed1985

Depressive symptoms and suicidal behavior in adolescents.

Depressive symptoms and suicidal behavior in 64 adolescent psychiatric patients were assessed by a structured interview and the Schedule for Affective Disorders and Schizophrenia. The medical seriousness of suicidal behavior was associated with conscious intent to die and with the number of previous nonlethal suicide attempts. Suicidal behavior was associated with depressed mood, negative self-evaluation, anhedonia, insomnia, poor concentration, indecisiveness, lack of reactivity of mood, psychomotor disturbance, and alcohol and drug abuse. The results suggest that adolescents can be reliable reporters of their suicide potential and that clinicians need to be sensitive to symptoms of major depressive disorder in assessing potentially suicidal adolescents.

Adolescent↗
PubMed1984

Symptoms and subtypes of depression among adolescents distinguished by the dexamethasone suppression test: a preliminary report.

Twenty-three adolescents hospitalized on an inpatient psychiatric unit underwent a dexamethasone suppression test (DST) and were diagnosed as having major depressive disorder by interviewers blind to the DST results. These patients were divided into four categories according to whether they had major depressive disorders, endogenous ( MDDe ) or nonendogenous (MDD), and whether they were nonsuppressors (+) or suppressors (-) in response to the DST, i.e., MDDe (+), MDDe (-), MDD (+), or MDD (-). Psychomotor features significantly differentiated the MDDe group from the MDD group. Among symptoms this further differentiated the MDDe (+) from the MDD (-) group. The primary subtype of depression occurred significantly more frequently among the MDDe group than the MDD group. The primary subtype also occurred more frequently among the MDDe (+) group than the MDD (-) group, whereas the MDD (-) group had a greater frequency of secondary depression.

Adolescent↗
PubMed1983

The assessment of depression in normal adolescents--a comparison study.

This pilot study addressed two questions. The first was whether the combination of an observer scale (Hamilton Rating Scale) and a self-rating scale (Carroll Self-Rating Scale, modelled after the Hamilton) can make a valid distinction between the frequency and severity of depressive symptomatology in adolescents not referred for treatment, and psychiatric inpatients. The second was whether Major Depressive Disorder (MDD) could be recognized and diagnosed in "non-patient" adolescents using this interview and rating scale approach. The median Hamilton and Carroll scores of the school students differed significantly from those of the inpatients, though the scores alone did not correspond with the presence or absence of MDD. Only 1 of the 26 (3.8%) tenth grade students interviewed appeared to have MDD, compared with 9 of 33 (27%) adolescent inpatients studied previously with the same methodology. The strength and limitations of this interview and assessment approach are discussed.

Adolescent↗