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Biomedical subjects

E F Donnelly

Publications and source records attributed to E F Donnelly.

17 recordsLinked to original sources

Sulcal prominence in young chronic schizophrenic patients: CT scan findings associated with impairment on neuropsychological tests.

Four of 17 chronic schizophrenic (or chronic schizoaffective) patients between the ages of 20 and 35, in partial remission, and living in the community were found to have mildly or moderately prominent sulci, as disclosed by computerized tomography (CT scan). These four patients were matched for sex and age with four chronic schizophrenic (or schizoaffective) patients without sulcal prominence. The Halstead-Reitan battery (HRB) of neuropsychological tests, including the Wechsler Adult Intelligence Scale (WAIS), was administered to these eight patients with the examiner blind to results of the CT scan. Each of the four patients with sulcal prominence considerably exceeded an established cutoff score for brain impairment on the HRB, whereas only one of the control schizophrenics performed in the impaired range, and that just beyond the cutoff. The WAIS Verbal IQ, mneasured concurrently, was in the normal range for all subjects and similar for the two groups. These findings suggest that mild or moderate sulcal prominence on CT scans among young chronic schizophrenics is associated with impaired neuropsychological functioning.

Adult

Prediction of antidepressant responses to imipramine.

45 patients hospitalized for depression who had received double-blind trials with imipramine were examined for possible associations between pretreatment responses to the Minnesota Multiphasic Personality Inventory (MMPI) and their behaviorally-rated responses to this drug. Each patient was randomly assigned to one of two groups with the restriction that the number of responders and nonresponders be balanced for sex. Results from the group A patients suggest that responders and nonresponders to imipramine were best identified by using two sex-specific, empirically-derived, MMPI scales. In contrast, 12 of 13 regular validity and clinical scales and all 49 of the selected special scales of the MMPI failed to separate responders from nonresponders. In the cross-validation study with the group B patients, we were able to predict female and male responders from nonresponders by the new imipramine response scale with accuracy rates of 93 and 100%, respectively. The implications of these results are discussed.

Depression

Psychological characteristics corresponding to low versus high platelet monoamine oxidase activity.

From an original sample of 375 college students and employees studied for platelet MAO activity, 66 subjects representing the lower and upper deciles of the sample were contacted for further study, including administration of the booklet form of the MMPI. We analyzed what psychological characteristics might be associated with differences in MAO activity and attempted to cross-validate these characteristics by using them to predict the separability of low vs. high MAO subjects. Each subject was randomly assigned to one of two groups in which the low and high MAO subjects were balanced for sex. For 16 women in group A, a MAO scale discriminated low and high subjects with 100% accuracy. For 18 men in group A, a separate MAO scale discriminated with 94% accuracy. To cross-validate these results, the two scales were applied to another population; both discriminated low and high MAO women and men with a combined 97% accuracy. The thematic content of the two scales is discussed in the light of other reports on the psychological characteristics of low and high MAO subjects, including the apparent relationship between the scale content and the clinical features of bipolar affective disorder.

Adolescent

Primary affective disorder: anxiety in unipolar and bipolar depressed groups.

A group of 50 patients (29 bipolar and 21 unipolar) hospitalized for depression were compared on the IPAT Anxiety Scale. The bipolar depressed group reported significantly less anxiety than the unipolar group. This finding supports the results of other studies that reported relatively less psychopathology in bipolar groups during the acute depressive state. It is suggested that test-taking defensiveness, especially denial, might account for relatively lower anxiety and MMPI scores in bipolar groups.

Anxiety

Prediction of antidepressant responses to lithium.

The authors studied 53 patients hospitalized for depression to evaluate possible associations between pretreatment responses to the Minnesota Multiphasic Personality Inventory and behaviorally rated responses to lithium. Patients were randomly assigned to two groups (A and B) in which responders and nonresponders were balanced for sex. For the 18 women in group A, a lithium response scale discriminated responders with 89% accuracy. For the 9 males, a separate scale discriminated responders with 100% accuracy. In a cross-validation, the two scales discriminated responders and nonresponders with 100% accuracy in group B. The empirical methodology of this study suggests an alternative to the theoretical-rational approach of predicting response to antidepressant drugs based on pretreatment depressive symptoms.

Adult

Inhibition of dopamine synthesis in chronic schizophrenia. Clinical ineffectiveness of metyrosine.

According to the dopamine (DA) hypothesis of schizophrenia, there is a functional excess of dopaminergic activity within unspecified areas of the brain in schizophrenic patients. As a clinical test of this hypothesis, we administered metyrosine for three weeks to symptomatic chronic male schizophrenic patients who were maintained on suboptimal doses of neuroleptic agents. Metyrosine inhibits tyrosine hydroxylase, the rate-limiting enzymatic step in the synthesis of DA. No clinical improvement was observed, using the National Institute of Mental Health Inpatient Behavioral Rating Scale or the Brief Psychiatric Rating Scale. Central inhibition of DA synthesis by metyrosine was suggested, however, by (1) the development of extrapyramidal side effects and (2) a significant increase in plasma prolactin concentrations. Plasma chlorpromazine concentrations remained unchanged during metyrosine treatment. There was, nevertheless, a significant improvement on the scores of the Wechsler Adult Intelligence Scale Comprehension subtest, which measures judgment and common sense. This finding suggests that DA may be involved in the regulation of subtle psychological processes. The results are discussed in light of the DA hypothesis of schizophrenia and previous reports suggesting that metyrosine potentiates the antipsychotic effect of neuroleptics in schizophrenia.

Adult

Perception and cognition in patients with bipolar and unipolar depressive disorders. A study in orschach responding.

The Rorschach was administered to 16 bipolar and 13 unipolar patients hospitalized during a depressive episode. Two contrasting styles of Rorschach responding differentiated the two patient groups. The bipolar style of response is characterized by selective attention to the more objective aspects of the inkblots, while the unipolar style of response is characterized by a more subjective approach. Primary response to color was found only in the protocols of bipolar patients. The styles of response were discussed in relation to other studies showing similar results based on self-assessment and clinical tests. It was suggested that perceptual-cognitive structuring of the external environment may be related to, or predispose, mood levels.

Adult