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Biomedical subjects

F R Frankenburg

Publications and source records attributed to F R Frankenburg.

At least 55 records · Page 3Linked to original sources
PubMed1988

Long-term response to carbamazepine: a retrospective study.

Carbamazepine is now used by many clinicians in the treatment of bipolar disorder (BD) refractory to standard treatments, including lithium and neuroleptics. Little information is yet available about the utility and efficacy of this novel treatment during long-term use. We carried out a retrospective study of 50 patients (34 with BD) who had received carbamazepine for the treatment of a psychotic disorder. Two-thirds (22) of the BD patients and two of the 16 patients with other diagnoses appeared to respond to carbamazepine acutely. However, follow-up 3 to 4 years later revealed that only eight patients (seven with BD) were still receiving the drug. In only two cases was the treating psychiatrist convinced that carbamazepine was clearly beneficial. Side effects, particularly hematological abnormalities, during both short- and long-term treatment were troublesome. Carbamazepine may only infrequently be useful in the long-term care of patients who fail to respond to standard treatment.

Adult↗
PubMed1987

A controlled family history study of bulimia.

Using the family history method, we assessed the morbid risk for psychiatric disorders in the first-degree relatives of 69 probands with bulimia, 24 probands with major depression, and 28 nonpsychiatric control probands. The morbid risk for major affective disorder among the first-degree relatives of the bulimic probands was 32%, significantly greater than that found in the nonpsychiatric control probands. The rate of familial major affective disorder was significantly greater in bulimic probands who had a history of major affective disorder themselves than in bulimic probands without such a history - but the latter group, in turn, displayed significantly higher rates than the nonpsychiatric control probands. Eating disorders were slightly, but not significantly, more prevalent in the families of bulimic probands than nonpsychiatric control probands. We present two alternative hypotheses which might explain these findings.

Adolescent↗
PubMed1987

A controlled study of lifetime prevalence of affective and other psychiatric disorders in bulimic outpatients.

The authors used structured diagnostic interviews to assess the lifetime prevalence of psychiatric disorders, by DSM-III criteria, among 70 women: 51 outpatients with active bulimia and 19 nonpatient subjects with remitted bulimia. Comparison groups consisted of 24 female outpatients with major depression and 28 nonpsychiatric control subjects. The active and remitted bulimic subjects closely resembled each other, with high lifetime rates of major affective disorder, anxiety disorders, and substance use disorders. Atypical depression was equally common among subjects with major affective disorder in all groups. These results are consistent with previous studies suggesting a phenomenologic relationship between bulimia and major affective disorder.

Adolescent↗
PubMed1987

Is bulimia associated with borderline personality disorder? A controlled study.

To test the hypothesis that bulimia may be associated with borderline personality traits or frank borderline personality disorder, the authors administered the Diagnostic Interview for Borderlines (DIB) under blind conditions to 52 bulimic subjects, 22 outpatient controls with a history of major depression but no history of an eating disorder, and 13 nonpsychiatric controls. Only 1.9% of bulimic subjects met revised DIB criteria for borderline personality disorder, and mean DIB scores were almost identical in bulimic subjects and controls with major depression. These results argue against a relationship between bulimia per se and borderline personality disorder or traits.

Adolescent↗
PubMed1987

Psychosis and prenatal exposure to diethylstilbestrol.

Over the past 10 years, increasing evidence has demonstrated mammalian brain development to be influenced by prenatal exposure to sex hormones. It seems possible that human behavioral abnormalities may be associated with prenatal exposure to diethylstilbestrol (DES). Relevant basic science and clinical reports are reviewed and four case reports of psychotic patients who were prenatally exposed to DES are presented.

Adult↗
PubMed1985

Issues in the therapy of hearing children with deaf parents.

The psychiatric literature on deaf children is sparse. Even less attention has been paid to the more common situation of the hearing child raised by deaf parents. Such a child is deprived of the parents' hearing and often the parents' speech. The oldest hearing child in the family often takes on the role of family interpreter which may be a source of both pride and resentment. This can contribute to role reversal leading to a frustration of the child's dependency needs and bitter sibling rivalry. Other problems may result from the parents' ambivalence towards their child. The available literature is surveyed and case illustrations are provided. Suggestions to therapists working with similar families are made.

Adolescent↗
PubMed1984

Hoarding in anorexia nervosa.

A case study of hoarding in a woman with anorexia nervosa is reported. Obsessional and borderline personality characteristics, exacerbated by starvation, may be determinants of hoarding in anorexia nervosa.

Adult↗
PubMed1983

Preparation for the certification examination.

The authors present their view of the oral certification examination of the Royal College. They found that preparation for the examination was educational, and that the examination itself was fair. Some suggestions to prospective candidates are offered.

Canada↗
PubMedDate not supplied

Pharmacotherapy of borderline outpatients.

The charts of 50 outpatients meeting both Diagnostic Interview for Borderlines (DIB) and DSM-III criteria for Borderline Personality Disorder (BPD), 29 outpatients meeting DSM-III criteria for Antisocial Personality Disorder (APD), and 26 outpatients meeting DSM-III criteria for Dysthymic Disorder, as well as DSM-III criteria for some other type of Axis II disorder (dysthymic other personality disorder [OPD]) were reviewed blind to proband diagnosis to determine both the percentage of those in each group who had adequate medication trials and the efficacy of those trials. Borderlines were significantly more likely than antisocial controls to have received an adequate trial of some form of medication. They were also significantly more likely than antisocial controls to have received an adequate trial of anxiolytics and antidepressants. However, they were distinguished at the trend level or better from both antisocial and dysthymic OPD controls by their greater likelihood of having received an adequate trial of neuroleptics, lithium, and polypharmacy. The percentage of adequately treated borderlines who experienced some degree of symptom relief was not significantly different than that found in either control group. However, adequately treated borderlines were significantly less likely than adequately treated dysthymic OPD controls to have had a definite response to pharmacotherapy (i.e., shown marked improvement of target symptoms).

Adult↗
PubMedDate not supplied

Axis I phenomenology of borderline personality disorder.

The Axis I phenomenology of 50 outpatients meeting both Diagnostic Interview for Borderlines (DIB) and DSM-III criteria for Borderline Personality Disorder (BPD), 29 outpatients meeting DSM-III criteria for Antisocial Personality Disorder (APD), and 26 outpatients meeting DSM-III criteria for Dsythymic Disorder as well as DSM-III criteria for some other type of Axis II disorder (dysthymic OPD) was assessed blind to clinical diagnosis using the Structured Clinical Interview for DSM-III (SCID). Borderlines were significantly more likely than antisocial controls to have met DSM-III criteria for an affective disorder, particularly Dysthymic Disorder, and an anxiety disorder. They were also significantly more likely than dysthymic OPD controls but significantly less likely than antisocial controls to have met DSM-III criteria for alcohol abuse/dependence and drug abuse/dependence. The authors conclude that: (1) the link between BPD and unipolar affective disorders is less specific than previously suggested, and (2) there is a link between BPD and impulse disorders that may be of equal, if not greater, importance.

Adult↗
PubMedDate not supplied

Childhood experiences of borderline patients.

The childhood histories of 50 outpatients meeting both Diagnostic Interview for Borderlines (DIB) and DSM-III criteria for Borderline Personality Disorder, 29 outpatients meeting DSM-III criteria for Antisocial Personality Disorder, and 26 outpatients meeting DSM-III for Dysthymic Disorder as well as DSM-III criteria for some other type of Axis II disorder were assessed, blind to proband diagnosis, using a semistructured interview. Borderlines were significantly more likely than those in either control group to report a history of abuse, particularly verbal and sexual abuse. They were also significantly more likely than antisocial controls to report a history of neglect, particularly emotional withdrawal, and significantly more likely than dysthymic other personality disorder controls to report a history of early separation experiences. The authors conclude that the development of Borderline Personality Disorder is more strongly associated with (1) exposure to chronically disturbed caretakers than prolonged separations from these same adults and (2) a history of abuse than a history of neglect.

Adolescent↗
PubMedDate not supplied

Axis II comorbidity of normal-weight bulimia.

The axis II comorbidity of 34 women with active bulimia, 18 women with remitted bulimia, and 20 women with a history of major depression was assessed blind to axis I diagnosis using the Diagnostic Interview for Personality Disorders (DIPD), a semistructured interview of demonstrated reliability. Fifty percent of the active bulimic subjects, 44% of the remitted bulimic subjects, and 35% of the depressed controls met DSM-III criteria for at least one axis II disorder. Despite the generally higher prevalence of axis II pathology in both bulimic groups than depressed controls, these between-group differences did not reach significance. The clinical implications of these findings are discussed.

Adolescent↗
PubMedDate not supplied

Clozapine treatment of borderline patients: a preliminary study.

Clinicians frequently encounter patients who present with borderline personality disorder (BPD) and prolonged and/or pronounced psychotic symptoms of an atypical nature. Fifteen such patients were treated with clozapine and rerated blind to baseline symptomatology and functional level from 2 to 9 months after beginning treatment (mean = 4.2 +/- 2.1). The overall symptomatology of these patients as rated on the Brief Psychiatric Rating Scale (BPRS) decreased significantly from a mean of 57.0 +/- 10.4 to a mean of 37.8 +/- 7.7 (t = 7.03, df = 14, P = .001). Their positive, negative, and general symptoms as rated by the BPRS also decreased significantly. Additionally, their Global Assessment Scale (GAS) score increased significantly from a mean of 30.8 +/- 4.7 to a mean of 43.1 +/- 8.6 (t = 5.19, df = 14, P = .001). These results suggest that clozapine may be an effective antipsychotic agent for this subset of BPD patients. However, double-blind, placebo-controlled studies are necessary to confirm these preliminary results.

Adolescent↗
PubMedDate not supplied

The dissociative experiences of borderline patients.

The study objective was to assess the severity and quality of dissociative experiences reported by borderline patients. Two hundred ninety criteria-defined borderline patients and 72 axis II controls completed the Dissociative Experiences Scale (DES), a 28-item self-report measure with demonstrated reliability and validity. Thirty-two percent of borderline patients had a low level of dissociation, 42% a moderate level, and 26% a high level similar to that reported by patients meeting criteria for posttraumatic stress disorder (PTSD) or dissociative disorders. The controls had a significantly different distribution of overall DES scores: 71% reported a low level of dissociation, 26% reported a moderate level, and only 3% reported a high level. In addition, borderline patients had a significantly higher score than the controls on 21 of 28 DES items and a significantly higher overall DES score, as well as the score on the 3 factors that have been found to underlie the DES, absorption, amnesia, and depersonalization. The results of this study suggest that the severity of dissociation experienced by borderline patients is more heterogeneous than previously reported. They also suggest that borderline patients have a wider range of dissociative experiences than are commonly recognized, including experiences of absorption and amnesia, as well as experiences of depersonalization.

Adolescent↗