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David Lehman

Publications and source records attributed to David Lehman.

4 recordsLinked to original sources
PubMed2006

Depressive symptom patterns in patients with chronic schizophrenia and subsyndromal depression.

BACKGROUND: Since subsyndromal depressive symptoms (SDS) are prevalent, under-recognized and clinically important problems in patients with schizophrenia, as well as in the elderly, the association and correlates of SDS in mid-life and older age patients with schizophrenia deserves more investigation. The purpose of this study is to learn more about the occurrence, pattern of symptoms and associated features of subsyndromal depressive symptoms in patients with chronic schizophrenia or schizoaffective disorder. METHOD: The first 165 participants from the "Citalopram Augmentation in Older Adults with Psychoses" (NIH RO1 # 63931) study comprised the sample. Inclusion criteria included: age > or =40, DSM-IV diagnosis of schizophrenia or schizoaffective disorder, outpatient status, >2 DSM-IV symptoms of MDE and Hamilton Depression Rating Scale (HAM-D) score > or =8. Depressive symptoms were assessed using the 17-item version of the HAM-D and the Calgary Depression Rating Scale (CDRS). RESULTS: The most prevalent symptoms cut across several domains of the depressive syndrome: psychological (e.g., depressed mood, depressed appearance, psychic anxiety); cognitive (e.g., guilt, hopelessness, self depreciation, loss of insight); somatic (insomnia, anorexia, loss of libido, somatic anxiety); psychomotor (e.g., retardation and agitation) and functional (diminished work and activities). Participants diagnosed with schizoaffective disorder appeared more depressed, endorsed more intense "guilty ideas of reference" and had higher total CDRS scores than patients diagnosed with schizophrenia. CONCLUSION: This study confirms the high prevalence of depressive symptoms in middle-aged and older persons with schizophrenia and schizoaffective disorder who were selected on the basis of having subsyndromal symptoms of depression.

Adult↗
PubMedDate not supplied

Bone mineral density in male schizophrenia patients: a review.

BACKGROUND: Decreased bone mineral density (BMD) has been documented frequently in female patients with schizophrenia receiving antipsychotic therapy with potent dopamine D(2) antagonists, but there has been much less coverage of this issue in male patients with schizophrenia despite the fact that older males who sustain osteopenia-related hip fractures have subsequently greater mortality than females. METHODS: A Medline search was performed for the years 1966-2004 using the following search terms: "osteopenia or osteoporosis or bone density or bone mineral density," combined with "schizophrenia or psychosis or antipsychotic." RESULTS: The search yielded 8 studies which provided data on bone mineral density in male patients with schizophrenia, of which 2 were case reports, and 3 were controlled studies. Hormonal measures were present in 6 studies. In every study where such information was provided, the patients with schizophrenia had significantly lower BMD than nonschizophrenic controls or population norms, with the prevalence of osteopenia ranging from 40-72%. CONCLUSIONS: Low BMD and corresponding osteopenia or osteoporosis may be a highly prevalent but significantly underdiagnosed medical condition among male schizophrenia patients. Psychiatrists should consider BMD screening among older males who have received chronic antipsychotic therapy with antipsychotics expected to achieve high levels of postsynaptic D(2) antagonism.

Absorptiometry, Photon↗