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Biomedical subjects

E M Gruenberg

Publications and source records attributed to E M Gruenberg.

At least 19 recordsLinked to original sources
PubMed1992

The epidemiology of psychiatrist-ascertained depression and DSM-III depressive disorders. Results from the Eastern Baltimore Mental Health Survey Clinical Reappraisal.

Psychiatrists used a semi-structured Standardized Psychiatric Examination method to examine 810 adults drawn from a probability sample of eastern Baltimore residents in 1981. Of the population, 5.9% was found to be significantly depressed. DSM-III major depression (MD) had a prevalence of 1.1% and 'non-major depression' (nMD), our collective term for the other depressive disorder categories in DSM-III, had a prevalence of 3.4%. The two types of depression differed by sex ratio, age-specific prevalence, symptom severity, symptom profiles, and family history of suicide. Analyses using a multiple logistic regression model discerned that both types of depression were influenced by adverse life events, and that nMD was influenced strongly by gender, marital status, and lack of employment outside the home. Neither type of depression was influenced by income, education, or race. This study validates the concept of major depression as a clinical entity. Future studies of the aetiology, mechanism, and treatment of depression should distinguish between these two types of depression.

Adult↗
PubMed1991

DSM-III compulsive personality disorder: an epidemiological survey.

A two-stage probability sample of community subjects was developed with a full psychiatric examination employing DSM-III criteria in conjunction with the Epidemiological Catchment Area (ECA) survey conducted in Baltimore, MD. This report details the observation on those subjects diagnosed with compulsive personality disorder and compulsive personality traits. The results indicate that this condition has a prevalence of 1.7% in a general population. Male, white, married and employed individuals receive this diagnosis most often. Our data suggest a dimensional rather than categorical character for this disorder. The disorder imparts a vulnerability for the development of anxiety disorders.

Adolescent↗
PubMed1990

An epidemiological study of histrionic personality disorder.

In conjunction with the Epidemiological Catchment Area (ECA) survey conducted in Baltimore, MD, a two-stage probability sample of community subjects was developed with a full psychiatric examination employing DSM-III criteria. This report details the observations on those subjects diagnosed with the DSM-III diagnosis Histrionic Personality Disorder. The results indicate that this condition can be diagnosed reliably and that it is a valid construct. It has a prevalence of 2.1% in a general population. Males and females are equally affected, suggesting that prior reports of an increased prevalence in females was an expression of ascertainment bias found in hospital-based studies. The diagnosis is associated with clear evidence of disturbance in the emotional, behavioural, and social realms. Individuals with this disorder tend to use health care facilities more frequently than others.

Adolescent↗
PubMed1988

Interobserver reliability of a "Standardized Psychiatric Examination" (SPE) for case ascertainment (DSM-III).

The authors describe the Standardized Psychiatric Examination (SPE), a new method for conducting psychiatric examinations in both clinical and research settings that preserves the clinical method. The SPE provides a consistent replicable format for eliciting and recording psychiatric history, signs, and symptoms without perturbing the patient-clinician interaction. By means of the SPE, the clinician can formulate diagnoses using DSM-III or ICD-9 criteria and yet generate CATEGO profiles derived from the Present State Examination, 9th edition. Psychiatrists using the SPE demonstrated high interrater reliability in ascertaining individual psychopathological symptoms (Kappa range, 0.55 to 1.0) and in making DSM-III diagnoses (Kappa range, 0.79 to 1.0) among a sample of study subjects (N = 43) drawn from both a psychiatric inpatient population and a large community sample of nonpatients from the Epidemiological Catchment Area (ECA) study. The implications of the SPE for clinical practice and for research are discussed.

Catchment Area, Health↗
PubMed1987

The Social Breakdown syndrome in the elderly population living in the community: the Helping Study.

A representative sample of elderly people residing in the community was examined to establish their psychiatric status. An interview with a close friend or relative, focusing on a one-week period in 1981, was used to investigate each subject's functional limitations and troublesome behaviour, these being the two components of the Social Breakdown Syndrome. The data from the sample were weighted to allow estimates of the characteristics of the general population. No cases of SBS at its most extreme were identified, and almost the entire population was found to be functioning at an adequate or near-adequate level: all cases of severe SBS were attributable to troublesome behaviour. Severe SBS was shown to increase with age and to be most common in non-white males. Persons with dementing disorders were more likely than their non-demented counterparts to show severe/moderate SBS, but in the majority of cases of SBS there was no mental disorder.

Age Factors↗
PubMed1985

Brief report on the clinical reappraisal of the Diagnostic Interview Schedule carried out at the Johns Hopkins site of the Epidemiological Catchment Area Program of the NIMH.

A psychiatric examination was conducted on 810 community dwelling subjects previously given a diagnosis derived from the Diagnostic Interview Schedule (DIS). The agreement in allocating subjects to a particular disorder was never high enough to encourage the confident replacement of a psychiatric diagnosis with a DIS diagnosis.

Alcoholism↗
PubMed1985

The meaning of cognitive impairment in the elderly.

In order to determine the meaning of cognitive impairment in community dwelling elderly, 3,481 adults were interviewed in their homes using the Mini-Mental State Examination. Ninety-six per cent of the population aged 18-64 scored 23 or higher, whereas 80 per cent of the population 65 and over scored 23 or higher. Individuals with low scores were suffering from a variety of psychiatric disorders including dementia. Thirty-three per cent of the elderly population scoring in the range of 0-23 had no diagnosable DSM-III condition. Prevalence of dementia from all causes was 6.1 per cent of the population over age 65. Two per cent of the population over age 65 were diagnosed as having Alzheimer's disease.

Adolescent↗
PubMed1982

Distribution of focal signs in a group of demented men.

The distribution of signs indicative of localized brain damage important in the diagnosis of multi-infarct dementia (MD) has not been specified. The demented members of a longitudinally examined research panel (n = 519) were identified. Differential diagnosis of the probable causes of the dementias was made. Focal signs were found to occur in both the cases diagnosed as MID (n = 13) and the case diagnosed as senile dementia - Alzheimer's type (n = 27). It is important for the clinician in the evaluation of focal signs in dementing illness to consider the developmental sequence and the total clinical context of the disorder.

Alzheimer Disease↗
PubMed1979

Abandonment of responsibility for the seriously mentally ill.

The road leading to the demise of state responsibility for the seriously mentally ill and the current crisis of abandonment was paved with all the best intentions. Tragically, policies underlying the pattern of abandonment are based on erroneous interpretations of what patients need and what our current techniques can produce to help them. An index of declining hospital census must not be mistaken for the goal of care.

Community Mental Health Services↗
PubMed1976

6. Limitations of the mental health data base.

Mental health research illustrates the value and limitations of data derived from the records of long-term care institutions. Social and other nondisease factors like distance have been shown to play a significant role in determining who gets care; however, patient-related data are not sufficient to measure the prevalence, distribution, and outcome of psychiatric conditions. Rapid changes in treatment over the past 25 years have far outstripped the ability of mental health data systems to inform decision makers or evaluate new approaches. It is recommended that the long-term care basic data set include 1) adequate descriptors of the reasons other than diagnoses that explain the use of services; 2) recording of the increasingly prevalent adverse reactions resulting from treatment; and 3) sufficient identification data to link patient records from different sources and to permit follow-up studies.

Age Factors↗