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Biomedical subjects

E S Paykel

Publications and source records attributed to E S Paykel.

At least 19 recordsLinked to original sources
PubMed1991

Platelet alpha 2-adrenoceptors, defined with agonist and antagonist ligands, in depressed patients, prior to and following treatment.

Saturation binding of the alpha 2-adrenoceptor antagonist, 3H-yohimbine, and displacement of 3H-yohimbine with the alpha 2-adrenoceptor agonist, UK-14,304, were performed concurrently in platelet membranes obtained from drug-free depressed patients and healthy volunteers. Where possible platelet binding was repeated in depressed patients following treatment. The number and affinity of 3H-yohimbine binding sites did not differ between controls and depressed patients, or when depressed patients were divided on the basis of endogenicity (Newcastle or RDC criteria) or dexamethasone test result. The proportion of alpha 2-adrenoceptor binding sites with high affinity for UK-14,304 and KD values for the two states of the receptor did not differ in the total sample of depressed patients compared to controls. The KD for both states of the receptor and the proportion of sites with high affinity for UK-14,304 was lower in RDC non-endogenous patients than RDC endogenous patients. Treatment did not alter the total number of alpha 2-adrenoceptors or the proportion of sites with high affinity for UK-14,304, but reduced the KD for 3H-yohimbine and the KD of UK-14,304 for the low affinity state of the alpha 2-adrenoceptor.

Adrenergic alpha-Agonists↗
PubMed1991

Care of chronic neurotic out-patients by community psychiatric nurses. A long-term follow-up study.

Ninety-nine neurotic patients from a controlled trial of CPN v. psychiatric out-patient aftercare were followed up seven years later. Of the 92 survivors, 76 were successfully interviewed. Few differences were found between the groups. Chronic mild symptoms and moderate social disability persisted, and tended to worsen a little. Treatment patterns persisted for one to two years beyond the original study; the CPN group had more CPN contacts, fewer psychiatric out-patient contacts and less psychiatric care. Thereafter, more out-patients were discharged from psychiatric care and care patterns for the two groups became similar. Out-patients attended more non-psychiatric out-patient clinics than the CPN group, but it is possible that this reflected pre-existing differences. About a third of patients remained in contact with the psychiatric service during follow-up.

Activities of Daily Living↗
PubMed1991

Neuroendocrine challenge studies in puerperal psychoses. Dexamethasone suppression and TRH stimulation.

Subjects admitted to hospital with post-partum psychoses were compared with matched normal post-partum controls using two neuroendocrine challenge tests: dexamethasone suppression of cortisol and TRH stimulation of TSH. Post-dexamethasone cortisol levels were significantly elevated. There were less-clear hints of blunting of TSH response. In the small samples there was no obvious association of abnormalities with any particular diagnoses within the range of mania, psychotic depression and schizoaffective disorders.

Adult↗
PubMed1991

Depression in women.

Depression in treated samples shows an approximately 2:1 female predominance. The sex ratio is not due simply to more help-seeking behaviour in women, for it applies equally in studies of community prevalence. Differential acknowledgement and direction of distress may be a partial explanation, supported by male predominance of alcoholism and completed suicide, and by a possible recent increase in depression in young men. Biological mechanisms acting through hormonal effects on the brain are plausible, but hard to test. Epidemiological studies indicate that much of the excess occurs in married women aged 25-45 years with children. This strongly suggests social causation and highlights the vulnerable situation of young mothers. The full explanations for the sex difference are not yet clear, but are likely to combine factors related to expression of distress, biology and social situation.

Adult↗
PubMed1991

Platelet [3H]imipramine and alpha 2-adrenoceptor binding in normal subjects during desipramine administration and withdrawal.

The effect of desipramine 150 mg daily on platelet [3H]imipramine and alpha 2-adrenoceptor binding sites was studied over a 6-week period and for 6 weeks after withdrawal. Modest (10%) increases in [3H]imipramine binding site densities during treatment were noted with a decrease between 1 and 4 weeks after withdrawal. No effect was found on alpha 2-adrenoceptors. Time of day appeared to have some effect on the results found. None of the [3H]imipramine binding site effects of desipramine, on treatment or following withdrawal, was comparable in magnitude to trait differences that were also found between subjects.

Adult↗
PubMed1990

Life events and social stress in puerperal psychoses: absence of effect.

Thirty-three patients admitted to hospital with severe early onset puerperal psychiatric disorders were compared with matched normal puerperal controls. Interviews, which were administered after recovery, covered life events in the previous thirteen months and detailed assessment of previous and personal history, pregnancy and labour, other aspects of stress, social support, and marital relationships. No differences, except for previous history of psychiatric disorder, were found between patients and controls or between patients with depressive and with other diagnoses. These findings of absence of social stress contrast with previous studies of milder post-partum depression and of disorders with onset during pregnancy, and suggest that the aetiology of severe post-partum disorders is predominantly biological.

Adult↗
PubMed1990

Dysfunctional attitudes and vulnerability to persistent depression.

Forty-four patients who met criteria for major depressive disorder were assessed for presence of dysfunctional attitudes and negative self-schema on admission. After six weeks, of sixteen patients who had shown high dysfunctional attitudes, six (35%) had not recovered. By contrast, of seventeen patients who had been equally severely depressed at the outset, but had low dysfunctional attitudes, only one (6%) had not recovered. The rating by the patients of themselves, as opposed to their attitudes, did not however predict. Thirty-one patients were tested six months later. Twenty-one (68%) remained asymptomatic, ten patients had relapsed or not responded to treatment, but neither type of admission measure predicted the state at this point. This is consistent with previous evidence which suggests that vulnerable attitudes assessed when symptomatic predict recovery, but that for prediction of relapse, cognitive measures need to be used when the patient is asymptomatic.

Adult↗
PubMed1990

3H-imipramine binding to previously frozen platelet membranes from depressed patients, before and after treatment.

3H-imipramine binding in 39 drug-free patients with major depression and 44 healthy controls did not differ significantly between the two groups, in male or female subjects or in subgroups of depressed patients divided by endogenicity or dexamethasone suppression test result. 3H-imipramine binding in depressed patients drug-free for less than three weeks did not differ from those drug-free for longer intervals or from controls. A significant seasonal variation of 3H-imipramine Bmax was found, with lower values in summer and autumn. Treatment of depressed patients with imipramine or lofepramine for six weeks increased KD and Bmax. Methodological modification (in preparation and storage of platelets) does not explain the major differences in results between this study (using frozen platelets), a previous one (using freshly prepared platelets) and others in general, although it might contribute to the range of values reported.

Adult↗
PubMed1979

Factor patterns in depression. A replication study.

A principal component analysis was carried out on symptom ratings and selected history items from 79 depressed patients. Three interpretable factors were obtained. The first was a general factor reflecting severity. The second a bipolar factor contrasting endogenous and neurotic depression, the third a bipolar contrasting anxiety and depressive symptoms. These replicate similar factors found previously in a different sample. The stability and predictive value are emphasized of other factors as well as the endogenous-neurotic dimension.

Adult↗
PubMed1979

Depressive classification and prediction of response to phenelzine.

A variety of depressive classifications were used to predict response to four weeks' treatment with phenelzine. Better response was found in outpatients rather than inpatients, in atypical depressives, in less severe depressives with a pattern of anxiety and other neurotic symptoms, and in groups characterized as hostile and agitated. The findings, although a little patchy, gave clear support to the concept of a specific clinical group responsive to MAO inhibitors.

Adolescent↗
PubMed1978

Contribution of life events to causation of psychiatric illness.

This paper discusses the magnitude of the effect of life events in the causation of psychiatric illness. It is argued that an established epidemiological concept, relative risk, provides a useful measure of association which can be approximately adapted for retrospective controlled studies. Examination of studies employing general population controls consistently indicates effects of some importance, with risks of illness increased by factors of between 2 and 7 in the 6 months after an event. Risks are greater for the more stressful types of events, greater for depression and neuroses than schizophrenia, and even greater for suicide attempts. However, similar events occur commonly and a large proportion of event occurrences are not followed by illness. Events must interact with a wide variety of background factors, and the appropriate model is one of multifactorial causation.

Depression↗