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Biomedical subjects

E W Freeman

Publications and source records attributed to E W Freeman.

At least 55 records · Page 3Linked to original sources
PubMed1992

A placebo-controlled study of effects of oral progesterone on performance and mood.

1. Oral micronized progesterone (P) is proposed for the treatment of certain endocrine gynaecological disorders. To examine the effects of P on performance and mood, a randomized, placebo-controlled study of 24 healthy females ages 18-24 years on low-dose oral contraceptives was conducted. 2. Subjects were admitted to the Clinical Research Center on four occasions and received single doses of oral P (300, 600, 1200 mg) or placebo. Blood sampling, psychometric tests and mood scales were administered at baseline and at hourly intervals for 6 h. 3. P doses produced significant dose-related but highly variable increases in plasma P concentrations. Fatigue increased with P doses, although few subjects were objectively drowsy. Very high peak plasma P concentrations, achieved by some subjects at the 1200 mg dose, were associated with decreased information processing and verbal memory function as well as fatigue. 4. We conclude that oral P can safely be prescribed at higher than previously-reported doses, based on evidence of transient behavioural effects only at the highest doses in some subjects who achieved high plasma P concentrations.

Administration, Oral↗
PubMed1992

Late luteal phase dysphoric disorder in 670 women evaluated for premenstrual complaints.

OBJECTIVE: The American Psychiatric Association's DSM-IV Work Group on Late Luteal Phase Dysphoric Disorder (LLPDD) reanalyzed existing data from prospective, daily symptom ratings to evaluate the DSM-III-R criteria for LLPDD. The objectives were to 1) evaluate the individual symptoms presently required for the diagnosis and other symptoms, 2) determine the proportion of treatment-seeking women who meet the LLPDD criteria, and 3) explore the association between LLPDD and other mental disorders. METHOD: Data from over 1,000 women seeking evaluation for premenstrual complaints at five U.S. sites were examined. The data from 670 of these women were sufficiently complete to warrant evaluation by four different methods of assessing symptom change. RESULTS: Depending on the assessment method used, 14% to 45% of the women met the criteria for LLPDD. The current DSM-III-R symptoms were classified as positive for 7% to 54% of the women. Each of these symptoms was significantly more common among women with LLPDD regardless of the assessment method used. Five symptoms not presently included were also significantly more common. Women who had had mental disorders in the past, but not present, showed a significantly greater, but very small, relative risk of LLPDD. CONCLUSIONS: The variability in the frequency of LLPDD diagnosis according to method of assessing symptom change underscores the need for a uniform assessment method. The five additional symptoms with frequencies comparable to those of the DSM-III-R symptoms should be studied further for possible inclusion in the criteria.

Data Collection↗
PubMed1992

Course of premenstrual syndrome symptom severity after treatment.

OBJECTIVE: Patients from a randomized, double-blind, placebo-controlled study of progesterone suppository treatment for premenstrual syndrome (PMS) were followed up to determine poststudy PMS symptom levels and medication use. METHOD: An average of 1 year after the end of the treatment study, 129 subjects were contacted for telephone interviews. All subjects met criteria for PMS before the progesterone suppository treatment, and their symptoms were confirmed by daily symptom reports throughout the study. The outcome measure at follow-up was the patient's global assessment of symptom severity, which was also rated by the subjects during the treatment study. The ratings at enrollment, end of study, and follow-up were compared. RESULTS: Only 27% of the subjects (N = 35) were taking medications for PMS at follow-up. Symptom severity at follow-up was less than at enrollment but greater than at the end of the study. CONCLUSIONS: Some of the improvement gained during treatment was maintained, but overall the subjects remained moderately symptomatic. Validation of the PMS condition, education, and support and caring may account for the symptom decreases during treatment, and the end of treatment and withdrawal of these conditions may account for the moderate return of symptoms.

Double-Blind Method↗
PubMed1988

The next best thing to being there: conducting the clinical research interview by telephone.

This methodological commentary explores the utility of the telephone as a medium for collecting sensitive clinical research data. The nature of the clinical interview is discussed, clinical and research literature dealing with use of the telephone is reviewed, and a follow-up study conducted entirely by telephone is described. More rigorous study of this research approach is called for.

Adaptation, Psychological↗
PubMed1988

Effects of medical history factors on symptom severity in women meeting criteria for premenstrual syndrome.

Medical history variables were examined to identify their effects on the severity of premenstrual syndrome (PMS) in women seeking medical treatment. Symptoms were monitored daily for two untreated cycles and two placebo-treated cycles to establish the diagnosis of PMS. Data from 60 women who reported moderate to severe premenstrual mood changes and met criteria for PMS were analyzed statistically. Step regression analysis showed that 34% of the variance in symptom severity was explained by four variables: PMS in the patient's mother, low level of exercise, younger age, and more children. These significant relationships with severity of PMS have not previously been identified and suggest a role of familial and daily stress factors in this complex syndrome.

Adult↗
PubMed1987

Emotional and psychosocial factors in follow-up of women after IVF-ET treatment. A pilot investigation.

One hundred and fifty-six women who enrolled for treatment in an in vitro fertilization (IVF-ET) program were interviewed, 15 months (mean interval) after the last program contact. Perceptions of treatment stress, decisions about further treatment and the extent of resolution of the infertility crisis were investigated. Standard self-report instruments were used to assess emotional status, self-esteem and marital adjustment. The results showed that only about half the couples who did not achieve pregnancy had decided to terminate treatment. Resolution of infertility was significantly correlated with coping with infertility and with the decision to abandon treatment. Although most patients described treatment as extremely stressful, this did not itself result in emotional distress or dysfunction following treatment, and psychiatric syndromes were infrequent. A deeper understanding of the interactions of these identified factors would help all couples who confront unwanted infertility.

Adult↗
PubMed1987

Serum progesterone levels following vaginal administration of progesterone during the luteal phase.

We measured serum progesterone (P) levels after administration of 400 mg P vaginal suppositories to women during the luteal phase of the menstrual cycle. Blood samples were obtained before suppository insertion and at five intervals up to 8 hours after insertion. On the first day of treatment with P suppositories, there was a substantial elevation in serum P above baseline after insertion. However, on subsequent days of administration a smaller increment in serum P was observed. In 4 women studied on days 1 and 8 of the same treatment cycle in the luteal phase, a smaller rise in serum P following suppository administration on day 8, compared with day 1, was found. Overall, a highly significant negative correlation between change in serum P from baseline and duration of vaginal suppository treatment was found. This observation does not appear to be related to the achievement of a pharmacokinetic steady state. Possible mechanisms for this observation are discussed.

Administration, Intravaginal↗
PubMed1985

Psychological evaluation and support in a program of in vitro fertilization and embryo transfer.

This report describes the psychological evaluation of 200 couples consecutively seen at a pretreatment consultation in an in vitro fertilization and embryo transfer program. Attitudinal and emotional characteristics of the sample are also described. Half the women and 15% of the men reported that infertility is the most upsetting experience of their lives. On the Minnesota Multiphasic Personality Inventory (MMPI), approximately 20% of the males and females had one or more elevated scale scores, suggesting dysfunctional emotional distress or personality difficulties. Half the sample had high scores on the MMPI Ego Strength scale, which indicated effective functioning and ability to withstand stress. T scores for the Taylor Manifest Anxiety Scale were in the normal range before treatment. Further longitudinal study is needed to define the emotional impact of procedures and reactions to treatment outcomes.

Adult↗
PubMed1985

Behavioral and emotional factors and treatment responses in a study of anovulatory infertile women.

In a controlled treatment study of 49 anovulatory infertile women, responses to clomiphene citrate (CC) and placebo treatments were compared and associations of behavioral and emotional factors with treatment responses were investigated. In the first treatment series, ovulation occurred in 20 of 24 women in the CC group and 8 of 22 women in the placebo group. Pregnancy was achieved by 11 women during CC treatment and 3 women during placebo treatment. Overall, 28 women completed the protocol and 21 withdrew. Those who achieved pregnancy (n = 14) did not differ significantly from the ovulation-only group (n = 22) on pretreatment measures of emotional, behavioral, and personality factors including the Hopkins Symptom Checklist (HSCL-90), Eysenck Personality Inventory, Langner Screening Scale, Mood Analog Scale, Social Adjustment Scale, Mooney Problem Checklist, and the Minnesota Multiphasic Personality Inventory (MMPI). Conclusions were that a placebo response was observed in both ovulation and pregnancy, but psychologic factors as measured in this sample were not associated with these treatment outcomes.

Adult↗
PubMed1985

Evaluating premenstrual symptoms in medical practice.

Essential diagnostic criteria for evaluating premenstrual syndrome (PMS) symptoms are marked change in intensity of symptoms measured on postmenstrual and premenstrual days and documentation of changes for at least two cycles. Four symptom evaluation methods in a PMS treatment program are compared and discussed: physician interview, menstrual symptom questionnaire, daily symptom ratings, and the Hopkins symptom checklist. Data from 241 patients who met the criteria for marked change in symptoms show that premenstrual symptom levels are severe, a subgroup has moderate symptoms continuing in the follicular phase, and that emotional symptoms are predominant. Diagnostic evaluation needs to distinguish menstrually related disorder from undiagnosed physical or psychiatric illness. Further research is needed to identify a classification system of multiple subtypes of menstrual disorders.

Adult↗
PubMed1984

Urban black adolescents who obtain contraceptive services before or after their first pregnancy. Psychosocial factors and contraceptive use.

This paper compares three groups of urban black teenagers at their enrollment in a contraceptive program and at a one-year follow-up. The groups comprise 263 never-pregnant, postabortion, and postpartum teens ages less than or equal to 17 years at their initial family planning visit. Self-report questionnaires examined attitudes and information about pregnancy and contraceptive use, sources of contraceptive information, sexual and contraceptive experience, family and partner support for contraceptive use, and demographic background factors. Emotional, personality, and psychosocial factors were assessed with standard measures. Age, partner relationships, and items relating to the mother's communication about contraception and pregnancy were significant variables in the outcome of never-pregnant and delivery of pregnancy. Self-esteem was highest in the never-pregnant group. Personality factors, emotional distress, and social adjustment scores were in the normal ranges and did not differ between the groups. Contraceptive use at follow-up was most consistent in the never-pregnant group. These data suggest the need for earlier family involvement in educating and guiding teens together with access to contraceptive services in preventing unwanted adolescent pregnancies.

Abortion, Induced↗
PubMed1983

Physiologic and psychologic profiles in a survey of women runners.

The purpose of the present study is to report physiologic and psychologic factors in a survey of women runners. Psychologic factors were used in an investigation of differences in perceived emotional distress within a group of women runners. The psychologic information was compared with the results of two groups of infertility patients and a group of fertile control subjects. Among the physiologic factors, there was a significant difference in the mean weight and the height/weight ratio between amenorrheic and regularly cycling runners (P less than 0.001) and amenorrheic runners and runners with irregular cycles (P less than 0.01). The psychologic data showed no difference between runners and fertile control subjects. When runners were divided according to menstrual intervals or miles run per week, there were differences in perceived emotional distress.

Body Composition↗
PubMed1983

Behavioral and emotional factors: comparisons of anovulatory infertile women with fertile and other infertile women.

This controlled study compared behavioral and emotional factors in a group of anovulatory infertile women requesting treatment to achieve pregnancy. The sample comprised 49 women with secondary amenorrhea or oligomenorrhea in the treatment group, 141 women in the fertile comparison group, and 104 women with diagnoses other than anovulation in an infertile comparison group. Scores on the Hopkins Symptom Checklist (HSCL-90), the Eysenck Personality Inventory, the Langner Screening Scale, a Mood Analog Scale, and the Minnesota Multiphasic Personality Inventory (MMPI) were in the normal range and did not differ significantly between the groups. On other measures, the treatment group rated itself significantly less potent than to partner, mother, or father and reported more inhibited sexual attitudes than the comparison groups. Conclusions were that neurotic personality structure or psychopathology were not significantly greater in the treatment group than in the comparison groups. Whether the lower self-esteem and inhibited sexual attitudes of the treatment group resulted from or preceded infertility could not be determined.

Anovulation↗