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Biomedical subjects

D R Rubinow

Publications and source records attributed to D R Rubinow.

At least 145 records · Page 8Linked to original sources

Cortisol response to dexamethasone in women with premenstrual syndrome.

There were no significant differences in post-dexamethasone cortisol between the follicular and luteal phase of the menstrual cycle in both women with premenstrual syndrome (PMS) and control subjects tested on these two occasions. Within each menstrual cycle phase, there were also no differences in post-dexamethasone cortisol between the two groups. In a second group of control subjects tested on a single occasion, post-dexamethasone cortisol values were higher when subjects were tested in the middle 2 weeks of the menstrual cycle compared with the first and last weeks of the cycle. This phenomenon, possibly due to estrogen effects, suggests that post-dexamethasone cortisol should be assessed weekly in women with PMS to determine whether they also manifest this normally observed menstrual cycle phase-related pattern, or whether it is absent, reflecting a reproductive endocrine abnormality in this patient group.

Adult↗

Relation between plasma prolactin and plasma homovanillic acid in normal subjects.

The relation between fasting, a.m. plasma prolactin and plasma/homovanillic acid (HVA) was studied in 9 healthy males on one occasion and in 9 healthy females on two occasions (in the follicular and luteal phase of the menstrual cycle). There was a significant inverse correlation between plasma HVA and plasma prolactin in females in the follicular phase only. The correlation between these two measures, although also in the same direction, was not significant in females in the luteal phase or in males. The theoretical implications of these findings are discussed.

Adult↗

Reduced TSH and prolactin responses to TRH in patients with panic disorder.

The authors studied the TSH and prolactin responses to a standard 500-micrograms thyrotropin-releasing hormone (TRH) stimulation test in 12 patients with panic disorder and 10 control subjects. As a group, panic disorder patients had lower mean TSH and prolactin responses, and female patients accounted for the lower prolactin response. The clinical and theoretical implications of these findings are discussed.

Adult↗

Conditioning and sensitisation in the longitudinal course of affective illness.

Few biological theories of manic-depressive illness have focused on the longitudinal course of affective dysfunction and the mechanisms underlying its often recurrent and progressive course. The authors discuss two models for the development of progressive behavioural dysfunction--behavioural sensitisation and electrophysiological kindling--as they provide clues to important clinical and biological variables relevant to sensitisation in affective illness. The role of environmental context and conditioning in mediating behavioural and biochemical aspects of this sensitisation is emphasised. The sensitisation models provide a conceptual approach to previously inexplicable clinical phenomena in the longitudinal course of affective illness and may provide a bridge between psychoanalytic/psychosocial and neurobiological formulations of manic-depressive illness.

Behavior↗

Effects of carbamazepine on cerebrospinal fluid somatostatin.

This paper reports the reduction of the concentration of the neuropeptide somatostatin in the CSF of patients with affective illness during treatment with the anticonvulsant carbamazepine. None of the other psychotropic agents used in this study similarly affected CSF somatostatin, although zimelidine appeared to increase CSF somatostatin in a small number of patients. The potential mechanism and significance of the effects of carbamazepine on CSF somatostatin are discussed in relation to the psychotropic, anticonvulsant, and analgesic properties of carbamazepine.

Adrenocorticotropic Hormone↗

Effects of carbamazepine on noradrenergic mechanisms in affectively ill patients.

Noradrenergic mechanisms have been postulated to account for the anticonvulsant and psychotropic effects of carbamazepine. In order to assess this possibility in man, cerebrospinal fluid (CSF) was obtained from affectively ill patients before and during treatment with carbamazepine (average duration 29 days) at doses averaging 860 mg/day, achieving blood levels of 8.86 micrograms/ml. Neither plasma nor CSF norepinephrine (NE) nor CSF 3-methoxy-4-hydroxy-phenylglycol (MHPG) was significantly altered by carbamazepine. Baseline medication-free values in 21 depressed patients were not predictive of the degree of subsequent clinical antidepressant response. CSF NE decreased in four manic patients treated with carbamazepine. The many effects of carbamazepine on noradrenergic mechanisms in animals are discussed in relationship to these first studies of carbamazepine in man.

Affective Disorders, Psychotic↗

CSF substance P immunoreactivity in affective disorders.

CSF substance P immunoreactivity was determined in a group of inpatient controls and acutely manic, euthymic, or depressed unmedicated unipolar and bipolar subjects; a second outpatient group of euthymic bipolar patients (on and off lithium) and normal volunteers was also studied. No group differences and no lithium effects were detected. CSF that was allowed to stand at room temperature for brief periods and then was refrozen contained elevated levels of the immunoreactive substance P, an observation that may account for a previous report of elevated CSF substance P immunoreactivity in psychiatric disorders.

Bipolar Disorder↗

CSF somatostatin in affective illness and normal volunteers.

Somatostatin is a hypothalamic tetradecapeptide with many central nervous system actions. We investigated a potential role for altered somatostatin activity in affective disorder by measuring somatostatin in the cerebrospinal fluid (CSF) of 47 patients with affective disorder and of 39 normal volunteers. Medication-free depressed patients showed significantly lower levels of CSF somatostatin than normal volunteers (p less than .001) or patients during the improved state (p less than .01). Somatostatin levels were significantly and inversely correlated with duration of sleep on the night of the lumbar puncture (p less than .05). Treatment with carbamazepine reduced CSF somatostatin (p less than .01) in contrast to the absence of effect of imipramine, desmethylimipramine, and lithium carbonate and the significant increase in CSF somatostatin seen in a small group of patients treated with zimelidine. The implications of these findings with respect to attempts to explore the neurobiology of depression are discussed.

Bipolar Disorder↗

Relationship between cerebrospinal fluid somatostatin and peripheral thyroid hormones with carbamazepine treatment.

The relationship between CSF somatostatin and peripheral thyroid hormones was assessed in 11 affectively ill patients before and during carbamazepine treatment. A direct relationship between CSF somatostatin and plasma thyroxine and free thyroxine, but not triiodothyronine, was observed both while patients were medication-free and during carbamazepine treatment. These first data in man are consistent with those in animals, suggesting a close interrelationship between somatostatin and thyroid regulation.

Adult↗

Premenstrual mood disorder and psychiatric illness.

The results of several studies suggest that a special relationship exists between premenstrual syndromes and major psychiatric disorders, particularly affective illness. These studies in general have not employed prospective criteria to diagnose premenstrual syndrome. In this paper the authors report a significant difference in the lifetime history of psychiatric illness between women with prospectively confirmed menstrually related mood disorder and those without it.

Adult↗

Premenstrual syndromes: past and future research strategies.

Premenstrual Syndrome remains a poorly understood controversial disorder largely because of the errors in design found in research into this subject. The first task is to clearly define the entity to be studied. It is necessary to look at the nature, intensity and time of occurrence of symptoms in relation to menstruation. One must further differentiate the appearance of symptoms premenstrually from the premenstrual exacerbation of symptoms present throughout the menstrual cycle. Research has clearly shown the superiority of prospective versus retrospective data in establishing a linkage between symptoms and menstruation. Premenstrual Syndrome research offers a unique opportunity to study classical psychiatric disorders. A relationship appears to exist between this syndrome and major affective disorders. Studies of the appearance or exacerbation of mood disturbances in relation to the menstrual cycle may inform us about the development, course and vicissitudes of psychiatric illness.

Affect↗

Cortisol hypersecretion and cognitive impairment in depression.

We attempted to investigate the relationship between hypothalamic-pituitary-adrenal axis activity and cognitive function by measuring mean urinary free cortisol (MUFC) excretion and performance on the Halstead Category Test in depressed patients and normal controls. We observed a significant relationship between category test errors and MUFC in the depressed patients, but not in the controls. While an even more robust correlation was observed between age and category test errors in the patients, it appeared that age and depression interacted to produce severe cognitive impairment. Depression-related cortisol hypersecretion or its underlying determinants may contribute to depression-related cognitive dysfunction.

Adult↗

Premenstrual syndromes: overview from a methodologic perspective.

The authors review the available evidence regarding the nature, cause, and treatment of the premenstrual syndromes. They attribute the contradictory results of various studies and the current theoretical confusion in the area to the failure of investigators to carefully define the syndromes, formulate a set of answerable questions, and select a homogeneous population before initiating their studies. The relationship between premenstrual syndromes and major psychiatric disorders, as well as the clinical and theoretical relevance of the menstrual cycle to major psychiatric disorders, is discussed. The authors offer recommendations to both investigators and clinicians for more careful observation and documentation of the relationship between mood disorders and the menstrual cycle.

Androgens↗

Prospective assessment of menstrually related mood disorders.

For prospective longitudinal confirmation of menstrually related mood changes, the authors selected a 100-mm visual analogue scale for twice-daily self-rating of mood. The advantages of this method are simplicity; increased compliance; ease of graphic presentation, allowing evaluation of severity and relationship to menstruation; and greater uniformity among studies of menstrually related syndromes. In a preliminary application of this measure to 20 women with self-diagnosed premenstrual syndrome, eight (40%) had a mean depression rating during the week before menstruation that was 30% higher than during the week after cessation of menstruation.

Adult↗