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Biomedical subjects

E B Weller

Publications and source records attributed to E B Weller.

At least 55 records · Page 3Linked to original sources
PubMed1988

Neuroendocrine changes in affectively ill children and adolescents.

Depression in children has signs and symptoms similar to those observed in depressed adults. Neuroendocrine abnormalities have been consistently observed in depressed adults. Now, neuroendocrine abnormalities are beginning to be studied in depressed children and adolescents. Results of these studies should help clarify the relationship between depression in adults and in children. Careful psychiatric diagnosis is required for studies of the neuroendocrine concomitants of depression. When establishing a diagnosis of depression in children and adolescents, one must pay attention to differences in such variables as cognitive development. Studies of neuroendocrine functioning in depressed children are at an earlier stage than those in depressed adults. To date, most studies have centered on cortisol secretion, the DST, and GH. In general, studies of cortisol secretion (most of which utilize the DST) indicate that a majority of depressed children and adolescents have positive DSTs (that is, dexamethasone fails to suppress their cortisol secretion) and cortisol secretion appears to be increased. These findings are similar to those observed in adults. Results of GH studies are more mixed. Some studies found hypersecretion of GH in depressed children, whereas others found hyposecretion of GH in depressed children. The few studies of TRH stimulation of TSH and melatonin secretion have involved a small number of subjects and results must be considered preliminary.

Adolescent↗
PubMed1988

Neuroendocrine changes in affectively ill children and adolescents.

Depression in children has signs and symptoms similar to those observed in depressed adults. Neuroendocrine abnormalities have been consistently observed in depressed adults. Now, neuroendocrine abnormalities are beginning to be studied in depressed children and adolescents. Results of these studies should help clarify the relationship between depression in adults and in children. Careful psychiatric diagnosis is required for studies of the neuroendocrine concomitants of depression. When establishing a diagnosis of depression in children and adolescents, one must pay attention to differences in such variables as cognitive development. Studies of neuroendocrine functioning in depressed children are at an earlier stage than those in depressed adults. To date, most studies have centered on cortisol secretion, the DST, and GH. In general, studies of cortisol secretion (most of which utilize the DST) indicate that a majority of depressed children and adolescents have positive DSTs (that is, dexamethasone fails to suppress their cortisol secretion) and cortisol secretion appears to be increased. These findings are similar to those observed in adults. Results of GH studies are more mixed. Some studies found hypersecretion of GH in depressed children, whereas others found hyposecretion of GH in depressed children. The few studies of TRH stimulation of TSH and melatonin secretion have involved a small number of subjects and results must be considered preliminary.

Adolescent↗
PubMed1986

Clinical aspects of childhood depression.

Currently, major depressive episodes in children can be diagnosed using criteria similar to those for adult depression. Although symptoms appear similar to those seen in adult depression, differences in cognitive and language functioning compared to adults must be taken into account when assessing children. Recognition of depression and its presentation in children is essential in making an accurate diagnosis. Increased interest and improved methods of assessment and treatment should result in better care for depressed children and their families.

Child↗
PubMed1986

Tricyclic antidepressants in prepubertal depressed children: review of the literature.

Other studies have reported the use of TCA antidepressants in the treatment of depressed children (Frommer 1967; Ossofsky 1974; Stack 1972; Polvan and Cebiroglu 1972). However, these studies did not meet criteria for inclusion in this review. In studies, other medicines were given concurrently with TCAs. Several did not specify the number of subjects and/or the number who responded. Sometimes subjects who were not diagnosed as depressed were included. Also studies of childhood depression tend to include adolescents; thus many samples were a mixture of adolescents and prepubertal children with the adolescents frequently predominating. As the purpose of this review was depression in prepubertal children, only studies comprised predominantly of prepubertal children were included. Although not included in this review, many such studies reported TCAs were useful in treating depression in children. After reviewing these studies, it is obvious that their sophistication has improved dramatically in recent years. Standard diagnostic criteria such as Feighner's Research Diagnostic Criteria, the Research Diagnostic Criteria, and more recently DSM-III (all of which are similar) have permitted a more objective and standardized diagnosis of depression. Likewise, the development of the Children's Depression Inventory and the Childhood Depression Rating Scale have allowed more objective measurement of severity of depression and of improvement in depression in children. Plasma drug level monitoring has allowed for pharmacokinetic studies of TCAs, more precise dose adjustment and equivalent drug treatment of subjects involved in clinical research studies. Studies to date indicate TCAs were helpful in treating depressed prepubertal children. However, double-blind placebo/control studies of tricyclic antidepressants in depressed prepubertal school-aged children have not been published. Ideally a study of antidepressants in children should include: objective standardized diagnostic criteria for diagnosing depression; objective rating of severity of depression; explicit exclusion criteria; steady-state plasma blood level monitoring; assured compliance; adequate duration of treatment so sufficient time is allowed for response to occur; a double-blind study design. Unfortunately the ideal study has not been done. TCAs may be an effective treatment for prepubertal major depressive disorder. However, further study is necessary to clearly establish their efficacy.

Amitriptyline↗
PubMed1986

Assessing depression in prepubertal children.

Although symptoms of major depression are the same in adults and prepubertal children, diagnosing depression in children presents special problems not encountered with adults. In addition to the standard clinical interview, methods of assessing childhood depression include diagnostic interviews, self-report inventories, projective tests, peer ratings, and biological markers. Unfortunately many of these methods currently lack detailed reliability and validity studies. Despite their limitations these techniques can be helpful in making a diagnosis. However, accurate diagnosis still requires careful evaluation and individualized clinical judgement.

Child↗
PubMed1985

Absorption and metabolism of hexamethylmelamine and pentamethylmelamine in rat everted perfused gut segments: correlation with in-vivo data.

The intestinal oxidative metabolism of hexamethylmelamine (HMM) and pentamethylmelamine (PMM) has been studied in microsomes, isolated mucosal cells and intestinal perfused segments. (sub) Cellular systems revealed an almost equal Km (53-65 microM) and Vmax (5.6-7.0 nmol min-1 g-1 intestine) for both compounds. Detailed studies in everted intestinal perfused segments, showed that HMM is metabolized to a far greater extent than PMM (e.g. 11-times, at 80 microM substrate concentration) while PMM transport was 3 times greater than the transport of unchanged HMM. Only when perfused segments were used as an in-vitro tool was a good correlation observed between the in-vivo and in-vitro rate of intestinal metabolism of HMM and PMM. It is concluded that this is due to preservation of structural integrity of the mucosa for both absorptive and metabolic processes.

Altretamine↗
PubMed1985

The dexamethasone suppression test in prepubertal depressed children.

The dexamethasone suppression test (DST) was performed in 50 hospitalized prepubertal children who met DSM-III criteria for major depressive episode, 18 hospitalized controls with a psychiatric disorder, and 18 nonhospitalized normal controls. Baseline and post-DST cortisol levels were measured at 8 a.m. and 4 p.m. The depressed children had consistently higher cortisol levels than the controls at baseline and post-DST. The DST was positive in 82% of depressed children, 28% of psychiatric controls, and 11% of normal controls. The results indicate that prepubertal depressed children may have abnormalities in the hypothalamic-pituitary-adrenal axis similar to those in adults with a major depressive illness.

Age Factors↗
PubMed1983

Plasma levels of imipramine and adverse effects in children.

In 22 prepubertal depressed children, the total plasma concentration of imipramine and its major metabolite, desipramine, varied by more than sevenfold. The plasma drug concentrations correlated with slowing of intracardiac conduction, elevation of diastolic blood pressure, and increase in heart rate. These drug-induced changes were uniformly observed when the total tricyclic level exceeded 225 ng/ml. However, subjective reporting of nuisance side effects was not related to plasma drug concentration. These findings suggest that children can be safely treated when their plasma levels are below 225 ng/ml. If higher plasma levels are attained, closer monitoring is warranted.

Blood Pressure↗
PubMed1983

Adult psychiatric disorders in psychiatrically ill young adolescents.

Adolescents aged 12-15 years, randomly selected from a psychiatric outpatient clinic, psychiatric consultation service, and general pediatric outpatient clinic, were given a complete psychiatric evaluation and structured diagnostic interview. Of 121 subjects studied, 100 satisfied Rutter and associates' criteria for a childhood psychiatric disorder. When these subjects were rediagnosed according to Feighner and associates' research diagnostic criteria (similar to DSM-III criteria), 52 fulfilled the criteria for an adult disorder. Diagnoses included antisocial personality, hysteria, schizophrenia, depression, mental retardation, anxiety neurosis, and undiagnosed psychiatric illness. There was a correlation between diagnosis according to Rutter and associates' criteria and adult diagnosis.

Adolescent↗