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Biomedical subjects

E P Ahearn

Publications and source records attributed to E P Ahearn.

11 recordsLinked to original sources
PubMed2002

Thyroid function in mixed and pure manic episodes.

OBJECTIVES: Associations of both overt thyroid disease as well as subclinical thyroid abnormalities with affective disorders have been well established. Similar associations have been reported with mixed mania and rapid cycling bipolar disorder. We tested for differences in overt and subclinical thyroid disease and subclinical differences in a large series of bipolar patients examined during mixed or pure manic episodes. METHODS: Rates of previously diagnosed thyroid disease were compared by sex, race and manic subtype (mixed versus pure) in 443 patients. Serum thyroid stimulating hormone (TSH) and free thyroxine (FT4) concentrations obtained from patients with no clinical thyroid disease collected during manic and mixed bipolar episodes were compared using ANOVA statistics. Race was also included in the model and age was covaried. RESULTS: Rates of thyroid disease, in particular hypothyroidism, were higher in females and white people, and increased with advancing age. No differences were noted between subjects sampled during mixed or pure manic episodes. In patients with no history of thyroid disease, serum TSH and FT4 concentrations did not differ between manic subtypes or between sexes. TSH levels however, were significantly lower in African Americans. CONCLUSIONS: We did not confirm past reports of associations of overt or subclinical thyroid disease with mixed manic episodes. African Americans had significantly lower serum TSH concentrations than white people, while FT4 levels did not differ.

Adult↗
PubMed2001

MRI correlates of suicide attempt history in unipolar depression.

BACKGROUND: Suicide represents a major health problem in the United States, and prediction of suicide attempts is difficult. No structural neuroimaging studies have been done to specifically examine findings in patients who have attempted suicide. The objective of this study was to compare MRI findings in unipolar patients with and without a history of a suicide attempt. METHODS: In this post hoc analysis, 20 unipolar subjects with a history of a suicide attempt were matched by age and gender to unipolar subjects without a history of an attempt. Subjects were also matched on parameters such as cardiovascular history, electroconvulsive treatment history, and history of psychosis. Subjects with a history of any neurologic condition were excluded. There were no significant differences in age of onset of depression, number of episodes of depression, and Hamilton Depression scores between the two groups. T2-weighted magnetic resonance imaging (MRI) scans were rated using the Coffey and Boyko rating scales. RESULTS: Unipolar patients with a history of a suicide attempt demonstrated significantly more subcortical gray matter hyperintensities compared with patients without such a history. CONCLUSIONS: Patients with abnormal MRI findings may be at higher risk for mood disorders and suicide attempts because of disruption of critical neuroanatomic pathways. Gray matter hyperintensities in the basal ganglia may be especially associated with risk for suicide attempts.

Aged↗
PubMed2001

Substance abuse in bipolar disorder.

BACKGROUND: High rates of substance abuse have been reported in the general population, with males more often affected than females. Although high rates of substance abuse have also been reported in bipolar patients, the relationship between substance abuse and bipolar disorder has not been well characterized. METHODS: Substance abuse histories were obtained in 392 patients hospitalized for manic or mixed episodes of bipolar disorder and rates of current and lifetime abuse calculated. Analyses comparing sex, subtype (manic vs. mixed) and clinical history variables were conducted. RESULTS: Rates of lifetime substance abuse were high for both alcohol (48.5%) and drugs (43.9%). Nearly 60% of the cohort had a history of some lifetime substance abuse. Males had higher rates of abuse than females, but no differences in substance abuse were observed between subjects in manic and mixed bipolar states. Rates of active substance abuse were lower in older age cohorts. Subjects with a comorbid diagnosis of lifetime substance abuse had more psychiatric hospitalizations. CONCLUSIONS: Substance abuse is a major comorbidity in bipolar patients. Although rates decrease in older age groups, substance abuse is still present at clinically important rates in the elderly. Bipolar patients with comorbid substance abuse may have a more severe course. These data underscore the significance of recognition and treatment of substance abuse in bipolar disorder patients.

Adult↗
PubMed1999

A neuroanatomic model for depression.

1. Emotion and mood, once thought to be governed solely by the limbic system of the brain, now are thought to be influenced by numerous nonlimbic central nervous system structures as well. 2. The present review discusses several important brain structures and neuroanatomic pathways thought to be involved in affect and mood disorders, including the amygdala, frontal neocortex, cingulate gyrus, basal ganglia, and the monoamine systems. 3. The authors propose a specific neuroanatomic model for depression that emphasizes that a distributed system of extensively interconnected CNS structures mediates emotion and affect.

Affect↗
PubMed1998

Familial leukoencephalopathy in bipolar disorder.

OBJECTIVE: Imaging studies of patients with bipolar disorder demonstrate changes in deep white matter and subcortical gray nuclei that are seen as focal hyperintensities on T2-weighted magnetic resonance imaging (MRI). The objective of this study was to examine MRIs in a family with a strong history of bipolar disorder to look for possible MRI abnormalities in members with and without affective illness. METHOD: The authors obtained MRIs of 21 members of a family with a strong history of bipolar disorder. Eight of the family members studied had bipolar illness, one had symptoms of bipolar disorder but did not meet full DSM-III-R criteria, two had unipolar disorder, and 10 did not have bipolar disorder. RESULTS: Fifteen of the 21 family members had MRI findings, including six of 10 family members who had no affective disorder and all of those with bipolar disorder. Lesions of both white matter and subcortical gray nuclei were found. CONCLUSIONS: Although the clinical significance of these MRI findings is unknown, the high prevalence of MRI findings in both affected and unaffected family members suggests that MRI findings may potentially serve as a biological marker for bipolar disorder. Recent genetic studies have established a link between familial leukoencephalopathy and chromosome 19. If leukoencephalopathy appears to be related to bipolar disorder, it may allow clearer characterization of the genetics of the disorder.

Adolescent↗
PubMed1997

Adjunctive use of olanzapine in mood disorders: five case reports.

Olanzapine has emerged as an atypical antipsychotic with few side effects and potentially superior efficacy in the treatment of schizophrenia. To our knowledge there have been few published reports of olanzapine in the treatment of mood disorders. We report on the adjunctive use of this medication in three subjects with mania and two with depression. Response occurred rapidly and patients tolerated the medication. Olanzapine offers promise in the treatment of mood disorders.

Adult↗
PubMed1996

Short-term variability of mood ratings in unipolar and bipolar depressed patients.

The ability of depressed patients to assess their mood states is controversial. We devised a scale consisting of a global item and 23 multiple visual analog items based on the Carroll/Klein model of depression. Short-term reliability of self-ratings in 13 unipolar and 11 bipolar depressed patients was tested. Subjects completed the scale and were retested 1 h later. Global clinician and self-ratings demonstrated similar episode severity between the groups and global self-ratings were highly reliable at retest for both groups. Unipolar depressed patients demonstrated high retest reliability on individual items of the MVAS. Bipolar patients demonstrated greater variability of responses suggesting greater short-term mood fluctuation in bipolar patients.

Adult↗
PubMed1995

Fetal bifid sacrum artifact: normal developmental anatomy simulating malformation.

PURPOSE: To determine the clinical importance and origin of a bifid configuration of the fetal sacrum seen during routine fetal sonography. MATERIALS AND METHODS: An apparent bifid malformation of the sacral spine was seen in 24 fetuses at antenatal sonography. An attempt was made to recreate this configuration prospectively in 111 consecutive second- and third-trimester fetuses. Three cadavers were also imaged to determine the origin of this configuration. RESULTS: Outcome information was available for 22 of the 24 fetuses; all fetuses were normal. In the prospective study, the bifid sacrum configuration was recreated in 75 of the 111 fetuses studied. The configuration could never be produced earlier than 20 weeks gestational age, was seen in some fetuses at 20-25 weeks, and could always be seen after 25 weeks. Findings from imaging studies of the three cadavers revealed that this configuration was dependent on the demonstration of the alar ossification centers of the sacral vertebra. CONCLUSION: The bifid sacrum artifact is a skewed representation of normal anatomy and should not be interpreted as a true anomaly.

Artifacts↗
PubMedDate not supplied

The use of visual analog scales in mood disorders: a critical review.

Patient-rated visual analog scales are a useful tool in the measurement of mood. The historical development of such scales and their design are reviewed. The simplicity of these scales promotes high compliance and, in addition, they have been shown to be both reliable and valid. While clinician-rated measurements of mood are an accepted standard, self-report of symptoms provides complementary and important information about the course and variability of illness from the patient's perspective.

Humans↗
PubMedDate not supplied

Dimensions of self-rated mood in depressed, manic, and normal subjects.

Self-rated scales allow the comparison of subjective mood across the spectrum of manic, depressive, and euthymic states. This study examined the self-reported mood of manic, depressed, and normal subjects using a 23-item research instrument based on the Carroll-Klein model of bipolar disorder. The Multiple Visual Analog Scale (MVAS) measures the following dimensions: consummatory reward (seven items), incentive reward (two items), psychomotor speed (seven items), and central pain (seven items). The MVAS was completed by 31 manic inpatients, 43 depressed inpatients, and 29 normal volunteer subjects. Total scores, average item scores, and total dimension scores were obtained. Subjects also completed a global mood VAS and the Carroll Depression Scale (CDS). Groups were compared by analysis of variance (ANOVA) and post hoc Bonferroni-Dunn methods. In a separate post hoc analysis, the group of manic patients was divided at the median CDS score into "pure" and "dysphoric" manic subgroups. We found excellent congruence of average 23-item total MVAS scores with global VAS and CDS scores. Dimension scores on the MVAS conformed to the predictions of the Carroll-Klein model. Depressed patients differed significantly from both manic and normal subjects on each dimension. MVAS dimension scores of normal subjects did not differ significantly from those of manic patients. On the dimension of central pain, normal subjects had significantly less inhibited scores than the "pure" subgroup of manics. The results confirmed that the dimensions of the Carroll-Klein model are bipolar and orthogonal. By the MVAS technique, the self-reported mood of normal subjects is similar to the self-reported mood of manic patients on all dimensions of the Carroll-Klein model of bipolar disorder. The positive scores of both groups are clearly distinguished from the negative scores of depressed patients. Average MVAS scores of normal subjects approximated the conventional zero score only on the dimension of central pain. Normal subjects exhibit megalothymic (hyperthymia) on most dimensions of subjective mood. The negative MVAS scores of depressed patients are even more deviant from normal than the conventional scoring system would suggest.

Adult↗