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D Stangl

Publications and source records attributed to D Stangl.

36 records · Page 2Linked to original sources
PubMed1986

Life events assessment of depressed patients: a comparison of self-report and interview formats.

Both self-report questionnaires and semi-structured interviews have been employed in past research on the association between life events and psychiatric disorder. We examined the comparability of these two approaches by giving both a self-report life events scale and semi-structured life events interview to 38 depressed patients. About 40% of the items noted on the interview were missed when using the questionnaire. Approximately 15% of the items noted on the questionnaire were errors since the events did not meet the definition or time criteria specified in the questionnaire. Twenty percent of the items noted on the questionnaire were not noted on the interview and may represent underinclusiveness on the part of the interview. The implications of these differences were examined by comparing the association between a variety of demographic and clinical variables and life events under each methodology. There were no significant differences between the two methods except when examining the association between life events and other subjective self-report measures.

Depressive Disorder↗
PubMed1986

An American validation study of the Newcastle scale. III. Course during index hospitalization and six-month prospective follow-up.

One hundred and fifty-two depressed inpatients were classified endogenous or neurotic according to the Newcastle Diagnostic Scale. Endogenous depressives were significantly more likely than neurotic depressives to be treated with electroconvulsive therapy (ECT). Newcastle subtyping was not associated with response to ECT; however, neurotic depressives not treated with ECT were more symptomatic at hospital discharge than endogenous depressives not treated with ECT. A prospective 6 month follow-up interview was completed with 85% of the patients. There was no association between Newcastle subtyping and follow-up outcome.

Depressive Disorder↗
PubMed1986

ECT response in depressed patients with and without a DSM-III personality disorder.

Twenty-five inpatients with DSM-III major depressive disorder received ECT and were interviewed with the Structured Interview for DSM-III Personality Disorders. Patients with and patients without a personality disorder had similar short-term responses to ECT. The results of a 6-month prospective follow-up showed that depressed patients with a personality disorder were significantly more symptomatic and eight times more likely to be rehospitalized.

Adult↗
PubMed1986

An American validation study of the Newcastle diagnostic scale. I. Relationship with the dexamethasone suppression test.

The Newcastle diagnostic index was completed on 159 depressed in-patients, who received the dexamethasone suppression test during their first week in hospital. Patients suffering from endogenous depression had a significantly higher rate of DST non-suppression, were older, were more frequently psychotic, and more frequently lost weight; even after controlling for these variables, DST non-suppression was significantly more frequent in the endogenous group. The relationship between Newcastle scores and the frequency of DST non-suppression was non-linear.

Adult↗
PubMed1986

Assessment of DSM-III personality disorders: the importance of interviewing an informant.

The Structured Interview for DSM-III Personality Disorders was used to interview 82 patients. In addition, a close relative or friend of the patient was interviewed regarding each patient's normal personality. After the informant interview, the diagnosis of the presence or absence of any personality disorder was changed in almost 20% of the sample. In general, the information given by the informants revealed additional pathology in the patients and was less frequently used to retract a diagnosis. Despite conflicting information from the patients and informants, the reliability of personality disorder assessment remained high.

Adult↗
PubMed1985

A structured interview for the DSM-III personality disorders. A preliminary report.

With few exceptions, published studies fail to indicate that the DSM-III personality disorders can be distinguished from each other with respect to etiology, prognosis, treatment response, or family history. The Structured Interview for the DSM-III Personality Disorders (SIDP) was developed to improve axis II diagnostic reliability, and hence allow validity testing of axis II. Sixty-three subjects were independently rated by two interviewers using the SIDP. The kappa coefficients for interrater agreement reached .70 or higher for histrionic, borderline, and dependent personalities. While it is impossible to separate the validity testing of the SIDP from validity testing of the DSM-III personality criteria themselves, preliminary results from 102 inpatient SIDP interviews suggest some criterion-based validity with respect to standard personality rating scales and some construct validity with respect to the dexamethasone suppression test.

Adolescent↗
PubMed1985

The research diagnostic criteria for endogenous depression and the dexamethasone suppression test: a discriminant function analysis.

Most studies examining the validity of the Research Diagnostic Criteria (RDC) for endogenous depression have been negative. RDC endogenous subtyping is not associated with short- or long-term treatment outcome, family history of affective disorder, or premorbid personality disorder. Studies examining its relationship to the dexamethasone suppression test (DST) are mixed; half report a significant association, and half do not. The RDC endogenous diagnosis may lack validity either because the criteria do not represent, or are not specific to, the endogenous subtype, or the diagnostic algorithm is inappropriate. In the present study, we conduct a discriminant function analysis on the 10 criteria for the endogenous subtype using DST results as the independent variable. We constructed a new diagnostic algorithm and cross-validated it on a second patient sample. In both samples the discriminant function classification was significantly associated with DST results, whereas the RDC algorithm was not.

Adult↗
PubMed1985

Iowa Discriminant Index for endogenous depression: family history correlates.

We examined the risk of psychiatric illness in the first-degree relatives of the 257 depressed inpatients upon whom we constructed the Iowa Discriminant Index (IDI) for endogenous depression. Nonendogenous depressives had a higher rate of alcoholism and antisocial personality in their families. IDI endogenous subtyping was not associated with a family history of depression. These results provide additional support for the validity of the empirically derived IDI.

Adult↗
PubMed1985

The validity of DSM-III axis IV (severity of psychosocial stressors).

One hundred thirty depressed inpatients were rated on DSM-III axis IV on the basis of information collected from a comprehensive life events interview. Axis IV scores were more highly correlated with undesirable than desirable events, with exits than entrances, and with time-limited than chronic events. Higher axis IV scores were associated with a lower rate of abnormal dexamethasone suppression test results, a higher morbid risk for alcoholism, a greater frequency of personality disorders, and a greater likelihood of attempted suicide during the index episode.

Adolescent↗
PubMed1984

The implications of DSM-III personality disorders for patients with major depression.

We studied 78 inpatients with DSM-III major depression. Forty-one (53%) had a concurrent personality disorder (PD) according to a detailed structured interview for DSM-III personality disorders. The patients with depression plus PD differed from patients with depression alone on numerous measures. The PD patients had earlier onset; higher HRS scores; poorer social support; more life stressors; more frequent separation and divorce; more frequent nonserious suicide attempts, less frequent dexamethasone nonsuppression; poorer response to antidepressant medication; and higher risk for depression, alcoholism and antisocial personality among first-degree relatives. The PD subgroup shares many attributes with Winokur's subtype of depression spectrum disorder and Akiskal's character spectrum disorder. An attempt to identify a subgroup of personality disorders which might be an atypical affective disorder was inconclusive. However, patients in DSM-III cluster III were similar to the patients with no-PD on the dexamethasone suppression test, response to treatment, and familial risk for depression and antisocial personality.

Adult↗
PubMed1983

The association between early parental loss and diagnosis in the Iowa 500.

While a number of studies have found an association between the experience of death of a parent during childhood and the later development of depression as an adult, few of these studies have controlled for possible confounders such as social class, sibship size, parental age at birth, and the patient's age at admission. The results of several studies that do control for such confounders have been negative. The authors investigated the frequency of parental loss and parental death among 129 depressives, 155 schizophrenics, and 63 manics from the Iowa 500 data base. Using a logistic regression to control for confounders, depressives are found to experience early maternal death 3.4 times more frequently than the schizophrenics and 2.1 times more frequently than the bipolars. The failure to confirm other hypotheses and possible implications are discussed.

Adult↗
PubMedDate not supplied

Four definitions of endogenous depression and the dexamethasone suppression test.

We examined the relationship between the DST and 4 definitions of endogenous depression: DSM-III, Feinberg and Carroll, Newcastle and RDC. Endogenous patients had a significantly higher rate of nonsuppression than nonendogenous patients according to the DSM-III and Newcastle definitions but not according to the RDC and Feinberg and Carroll criteria. Moreover, the relationship between the DST and the DSM-III and Newcastle definitions was significant even after individually controlling for age, psychosis and weight loss. We review the literature on the relationship between the DST and the RDC definition of endogenous depression and suggest that interstudy differences in criteria application may be partially responsible for the inconsistent results across studies.

Adult↗
PubMedDate not supplied

The relationship between age and post-dexamethasone cortisol: a test of three hypotheses.

Previous studies report that DST nonsuppressors are older than normal suppressors. Data are presented on 188 primary unipolar major depressive inpatients and 35 healthy controls. In males, age appeared to correlate positively with post-dexamethasone cortisols in depressed patients and normal controls, although mean levels were higher in depressives. Female controls showed no consistent relationship between age and post-dexamethasone cortisol. A positive relationship did exist for depressed women. However, the association disappeared when age-of-onset was entered into the model, suggesting that in females early onset may identify a subtype of depression with normal DST suppression.

Adult↗
PubMedDate not supplied

Validity of an operational definition for neurotic unipolar major depression.

After we reviewed the literature to identify the clinical and phenomenologic correlates of neurotic depression, we constructed a 6-item operational definition to distinguish neurotic unipolar major depressive disorder from non-neurotic major depression. The neurotic depressives were characterized by a low rate of abnormal dexamethasone suppression test (DST) results and a strong family history of alcoholism. Neurotic depressives improved less than non-neurotic depressives during the index hospitalization, and were more frequently rehospitalized during a 6-month prospective follow-up. Neurotic subtyping was significantly negatively associated with DSM-III melancholia. Neurotic classification remained significantly associated with the above validating variables after melancholic status was held constant, whereas melancholic subtyping did not predict DST results, familial alcoholism rates, or outcome when neurotic status was controlled.

Depressive Disorder↗
PubMedDate not supplied

Past loss as a symptom formation factor in depression.

We examined the relationship between past loss and endogenous subtyping of depressed patients. In a sample of 124 female depressed inpatients there was no association between past loss and RDC endogenous or DSM-III melancholic subtyping. We thus failed to replicate Brown and colleagues' finding that past loss is a symptom formation factor.

Depressive Disorder↗