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Biomedical subjects

E Lepkifker

Publications and source records attributed to E Lepkifker.

At least 19 recordsLinked to original sources
PubMed1998

Lithium carbonate therapy is not a risk factor for osteoporosis.

Lithium carbonate is a widely used drug for affective disorders. It may effect calcium metabolism and alter parathyroid physiology by causing hypersecretion of parathyroid hormone. Patients treated with this medication might therefore be predisposed to osteoporosis. The purpose of this study was to evaluate the effect of either short- or long-term lithium carbonate therapy on parameters of bone metabolism. Parathyroid function and indices of bone metabolism were assessed in 23 patients treated for affective disorders. 10 patients were treated for 0.4-1.0 year (Group 1), and 13 patients were treated for more than 3 years (Group 2). In all subjects, bone mineral density measurements in the hip and lumbar spine regions were performed using dual energy X-ray absorptiometry. Serum thyroid hormone, PTH, LH, testosterone and urine OH-proline, free cortisol, calcium and phosphate excretion were measured. The two groups were well matched for sex, weight, calcium intake, lithium levels and smoking habits, although Group 2 was slightly older. No differences between the two groups were noted in either bone mineral density or other parameters that were assessed. Urinary OH-proline was elevated similarly in both groups. Our results did not detect any effect on bone density after short- or long-term lithium carbonate therapy, although the data does suggest an increase in bone turnover associated with this treatment. Thus, short- or long-term treatment with lithium is not associated with increased risk for osteoporosis.

Absorptiometry, Photon↗
PubMed1997

Vitamin E treatment in tardive dystonia.

Tardive dystonia is a disorder characterized by abnormally sustained posturing associated with the use of dopamine-receptor blocking agents such as antipsychotic drugs. However, the structural pathologic and pathophysiologic features of this disorder are unknown, and no consistently effective pharmacologic treatment is available. Patients with tardive dystonia mostly are young men. We present the case of one substantially improved with treatment by 1200 mg/d (IU) of vitamin E.

Adult↗
PubMed1997

Anger, impulsivity and suicide risk.

BACKGROUND: To examine the relationship between anger, impulsivity and suicidality. METHODS: Thirty psychiatric inpatients admitted for suicidal behavior were compared with 30 nonsuicidal psychiatric inpatients and 32 healthy controls on measures of anger, impulsivity and suicide risk. RESULTS: The three groups were similar on demographic variables, but the suicidal group scored higher on the suicide risk scale, impulsivity scale and anger scale. Anger and impulsivity correlated significantly with suicide risk. High anger and impulsivity contributed synergistically to the suicide risk. Whereas anger was specific to both psychiatric groups, suicidals and nonsuicidals, only impulsivity was specific to the suicidal group. CONCLUSIONS: These findings may have important implications for therapists and primary prevention workers, and may pave the way for the recognition of risk factors and for effective intervention in patients with a high suicide risk.

Adult↗
PubMed1996

Abnormal psychosocial situations and eating disorders in adolescence.

OBJECTIVE: To assess the relationship between abnormal psychosocial situations and eating disorders in adolescents. METHOD: Twenty girls with eating disorders, 20 girls with major psychiatric conditions, and 20 healthy controls took part in the study. They were interviewed using a semistructured interview designed by the World Health Organization to diagnose the psychosocial situations included in the International Classification of Disease Axis 5 classification for child and adolescent psychiatry. All subjects were also given the Eating Attitudes Test. RESULTS: Many life events and psychosocial adversities differentiated significantly between the patients and controls. Inappropriate parental pressure was specific only for the subjects with eating disorders compared with the other psychiatric patients. In addition, Eating Attitudes Test scores correlated significantly with hostility toward child, sibling disability, parental overprotection, inappropriate parental pressures, and negative changes in family relationships. CONCLUSION: These results support the growing literature on the interrelationship between disordered family relationships and eating disorders. They point the way for developing treatment programs dealing with these issues.

Adolescent↗
PubMed1996

Coping styles and suicide risk.

A total of 30 psychiatric in-patients admitted because of suicidal behaviour were compared with 30 non-suicidal psychiatric in-patients and 32 healthy controls on measures of suicide risk and coping styles. The three groups were similar with regard to demographic variables, but the suicidal group scored higher on the suicide risk scale. Suicidal patients were significantly less likely to use the coping styles of minimization and mapping. They were unable to de-emphasize the importance of a perceived problem or source of stress. They also lacked the ability to obtain new information required to resolve stressful life events. Four coping styles correlated negatively with the suicide risk (minimization, replacement, mapping and reversal), while another three (suppression, blame and substitution) correlated positively. These findings may have important implications for therapists and primary prevention workers, and might pave the way towards recognition of the role played by coping styles in predicting suicide and its use for cognitive intervention in these high-risk patients.

Adaptation, Psychological↗
PubMed1995

Valproic acid in ultra-rapid cycling: a case report.

Valproic acid has been proven to be efficient in the treatment of bipolar affective disorders as an adjunctive agent to lithium and carbamazepine. Recently, its efficacy in rapid cycling states has attracted interest. We present the case of a male patient with bipolar affective disorder who developed an extreme state of ultra-rapid cycling (48-h cycles). Only the addition of valproic acid therapy to prior lithium treatment succeeded in curtailing the ultra-rapid cycling. Several issues regarding ultra-rapid cycling and valproate's efficacy in bipolar disorder are discussed.

Bipolar Disorder↗
PubMed1995

Nightmares related to fluoxetine treatment.

Sleep disturbances are found in most depressive patients. Serotonin reuptake inhibitors, such as fluoxetine hydrochloride, seem to improve sleep by changing the depressive affect and the underlying biological mechanisms. Insomnia is an occasional adverse effect of the medication, but it was shown that only 2-3% of the patients with fluoxetine-induced insomnia discontinued the drug for this reason. We could not find any report of nightmares or night terrors under fluoxetine treatment. We report on four patients who experienced nightmares on fluoxetine monotherapy.

Adult↗
PubMed1995

Life events and severe anorexia nervosa in adolescence.

The purpose of the study was to study the influence of life events on adolescent patients suffering from anorexia nervosa. Twenty one hospitalized adolescent inpatients with severe anorexia nervosa were compared with 79 adolescent nonanorectic psychiatric inpatients and 40 healthy adolescents for stressful life events throughout their lives. The nonanorectic patients suffered from schizophrenia, affective disorders, anxiety disorders, borderline personality disorder or conduct disorder. The assessment of the contribution of life events to the development of anorexia and the control mental disorders was based on semistructured interviewing of the patients, their parents and the patients' therapists. The instrument used was that developed by Pfeffer. The anorectic patients showed significantly higher negative life event scores than healthy controls in all the areas of life events examined. In addition, they showed significantly more negative life events concerning parents than patients in the other psychiatric diagnostic categories. These findings have relevance for the growing literature on the association between eating disorders and certain forms of child abuse.

Adolescent↗
PubMed1995

Obsessive-compulsive disorder limited to pregnancy.

The relationship between obsessive-compulsive disorder and pregnancy is reviewed in the light of recent reports concerning the frequent onset and exacerbation of obsessive-compulsive disorder during pregnancy. We present the case of a young woman who developed obsessive-compulsive disorder during a pregnancy and recovered completely after delivery. Five years afterwards she is still symptom-free. Several possible explanations for this unusual occurrence are discussed.

Adult↗
PubMed1988

Life satisfaction and adjustment in lithium-treated affective patients in remission.

The aim of this study was to assess life satisfaction and adjustment of lithium-treated affective patients in remission. Scores of life satisfaction and adjustment in four areas were obtained for two experimental groups of 50 unipolars and 50 bipolars and for two control groups of 50 healthy individuals and 50 patients with personality disorders. Subjects' self-assessments and psychiatrists' evaluation were rated using a modification of Cantril's ladder device. No significant differences were found between affective patients and healthy controls regarding life satisfaction and adjustment, whereas psychiatric controls scored significantly less on most indices. Moreover, the treating psychiatrists rated affective patients significantly higher than psychiatric controls and perceived them as actualizing their potential to a greater degree. Thus, it is concluded that neither the affective illness nor lithium as a prophylactic agent interfered with the patients' feelings of satisfaction or with manifest functioning while in remission.

Adaptation, Psychological↗
PubMed1976

Elevated myo-inositol concentrations in cerebrospinal fluid of neonates and of patients with an impaired state of consciousness.

A simple, semiquantitative paper chromatographic method was used to identify samples of cerebrospinal fluid containing elevated concentrations of myo-inositol. All patients whose CSF inositol concentrations were greater than 70 mug/ml (as determined by S. carlsbergensis microbiological assay) showed disturbances of the state of consciousness, reported as stupor, coma or confusion in adults, or apathy and stupor in infants. An elevated level of inositol in cerebrospinal fluid appeared to be a characteristic finding in infants under one year of age. Among other age groups no common etiology was correlated with high inositol concentration.

Adolescent↗
PubMedDate not supplied

Relationship between self-disclosure and serious suicidal behavior.

The ability to predict which suicidal patient is at high risk for a serious attempt is an important clinical problem. On the basis of our clinical research, we hypothesized that self-disclosure may be an important personality variable differentiating suicide attempters and completers. We assessed 80 patients with depressive disorder, divided into four groups of 20 each: suicidal ideation only, nonserious suicide attempts, severe suicide attempts, and no suicidal behavior. Comparisons were also made with 20 healthy controls. All subjects completed Jourad's Self-Disclosure Questionnaire (JSDQ), as well as scales measuring depression/anxiety and hopelessness. The lack of willingness for self-disclosure significantly differentiated the serious attempters from the suicide ideators and mild attempters. The relationship of self-disclosure and more lethal suicide attempts did not appear to be mediated by depression, anxiety, or hopelessness. This preliminary study indicates that self-disclosure may be a promising field for assessment, therapy, and prevention in suicidal patients. Further studies are needed to investigate related variables, wider patients groups, and the use of different instruments.

Adult↗