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Biomedical subjects

G Molnar

Publications and source records attributed to G Molnar.

At least 37 records · Page 2Linked to original sources
PubMed1990

Prodromal symptoms in primary major depressive disorder.

Prodromal symptomatology was investigated, by means of a modified version of Paykel's Clinical Interview for Depression, in 15 outpatients at their first episode of primary major depressive disorder. Compared to normals, generalized anxiety and irritability were significantly more frequent. Impaired work and interests, fatigue, initial and delayed insomnia were also reported. Four patients who relapsed upon discontinuation of antidepressant treatment displayed the same prodromal symptomatology as in the initial episode.

Adult↗
PubMed1988

Duration and symptoms of bipolar prodromes.

The duration and symptoms of manic and depressive prodromes of 20 bipolar patients showed much interindividual variation. However, these features were consistent in successive episodes of the same type in the same patient. Manic prodromes were longer than depressive prodromes.

Adolescent↗
PubMed1988

Multiple-dose pharmacokinetics of imipramine and its major active and conjugated metabolites in depressed patients.

Imipramine (IMI) and its active metabolites, desipramine (DMI), 2-hydroxyimipramine (2-OH-IMI), and 2-hydroxydesipramine (2-OH-DMI), were assayed by high pressure liquid chromatography in the serum and urine of 14 depressed patients after 1 week of twice-daily treatment with 100 mg of IMI. The concentrations of the glucuronide conjugates of 2-hydroxyimipramine (GA-O-IMI) and 2-hydroxydesipramine (GA-O-DMI) were assessed via enzyme hydrolysis. The range of serum concentrations of IMI and DMI was 65 to 1,064 ng/ml with slight elevation in total active components caused by inclusion of the unconjugated hydroxy metabolites. The average of total active compounds in smokers (239 ng/ml) was less (p less than 0.1) than in nonsmokers (524 ng/ml). The mean serum concentration ratios were 0.24 for 2-OH-IMI/IMI and 0.50 for 2-OH-DMI/DMI ratios, whereas the DMI/IMI ratio was 1.88, indicating more extensive accumulation of DMI. Appreciable glucuronide conjugate accumulation occurred with average serum concentration ratios of 8.13 for GA-O-IMI/2-OH-IMI and 6.22 for GA-O-DMI/2-OH-DMI. Covariance occurred in metabolite/precursor ratios indicating intrapatient similarities in formation/disposition rates of the hydroxy pairs and the conjugate metabolite pairs. Renal clearances of 2-OH-DMI were 35 to 267 ml/min, whereas those of the conjugates were only 10 to 110 ml/min. Total urinary recovery of these metabolites was similar to that reported previously for single IMI doses. The data indicate accumulation of substantial serum concentrations of glucuronide conjugates after therapeutic doses of IMI in depressed patients and similarities within patients in disposition of metabolite pairs.

Adult↗
PubMed1987

Measurement of subclinical changes during lithium prophylaxis: a longitudinal study.

Psychological distress was observer-rated with the Brief Psychiatric Rating Scale (BPRS) and self-rated with the Symptom Questionnaire (SQ) every other week for a 6-month period in 9 apparently remitted bipolar patients attending a lithium clinic. Substantial clinical fluctuations in psychopathology were observed with both rating methods. Compared to normal control subjects, patients suffering from bipolar disorder displayed significantly higher BPRS and SQ anxiety, somatization and total distress scores.

Adult↗
PubMed1987

Health attitudes of psychiatric inpatients.

Despite the high prevalence of medical illness in the mentally ill population, little is known about the health attitudes of patients with combined medical and psychiatric disorders. We compared the health attitudes of a group of inpatients with concomitant medical and psychiatric illness, a group of physically healthy psychiatric inpatients, and a group of normals. The instrument used was the Illness Attitude Scales, a self-rating scale designed to explore beliefs which can be responsible for hypochondriacal attitudes. A self-rating scale of psychological distress, the Symptom Questionnaire, was administered as well. Compared to normals, psychiatric patients displayed more hypochondriasis. There were no significant differences in psychological distress or health attitudes between patients with concomitant physical and psychiatric disorder and physically healthy psychiatric patients.

Adjustment Disorders↗
PubMed1987

Criteria for diagnosing depression in the setting of medical disease.

The evaluation of depression in the setting of medical disease is a complex task that requires considerable clinical skills. Physical illness is a common cause of psychopathology and this should alert the physician to vigorously search for possible organic explanations of depressive symptoms, especially in the elderly, where organic affective syndromes seem to be most prevalent. The multifactorial determinants and modes of expression of depression in the medically ill require further psychosomatic studies.

Adjustment Disorders↗
PubMed1985

The dexamethasone suppression and metyrapone tests in depression.

The dexamethasone suppression test (DST) and the metyrapone test (MT), a useful and reliable procedure for assessing the integrity of the hypothalamic-pituitary-adrenal (HPA) axis, were performed in 28 patients suffering from major depressive illness with melancholia. The relationship between the DST and MT appeared to be complex. Patients who failed to suppress cortisol secretion after dexamethasone administration had higher postmetyrapone cortexolone levels and cortexolone/cortisol ratios than suppressors. However, there was a wide range of metyrapone responses in patients exhibiting abnormal DST results. This suggests that failure of adequate suppression after 1 mg of dexamethasone in depressed patients does not necessarily reflect homogeneity in the HPA axis disturbances of such patients.

17-Hydroxycorticosteroids↗
PubMed1985

The metyrapone test in depressed males.

Hyperactivity of the hypothalamic-pituitary-adrenocortical (HPA) axis in depression has received considerable attention, particularly in the now numerous studies utilizing the dexamethasone suppression test. The possibility of HPA axis hypoactivity in this population however has not been similarly explored. To examine this latter possibility, the metyrapone test, a well-established neuro-endocrine assay for determining pituitary reserve, was administered to ten endogenously depressed males and ten matched controls. Consistent with the findings of an earlier study on ten female depressives, one of the depressed males but none of the controls showed clear evidence of HPA axis hypoactivity. This suggests that HPA axis dysfunction in depressives may be more complex than originally anticipated. This finding also has implications for the psychiatric symptomatology classically associated with such illnesses as Addison's disease.

Addison Disease↗
PubMed1985

Case report of prolactin and bipolar illness: a longitudinal study.

A longitudinal and naturalistic study of nine bipolar patients attending a lithium clinic during a six-month period was undertaken. Prolactin plasma levels and psychiatric symptoms were evaluated bi-weekly. Wide interindividual and intraindividual fluctuations were observed both in prolactin levels and psychiatric symptoms. The relationship between prolactin and affective episodes was found to be complex. In a few instances, sharp prolactin changes preceded behavioral modifications. Bipolar disorders, even if treated, appeared to be unstable conditions, from both the phenomenological and neuroendocrinological viewpoints.

Adult↗
PubMed1985

The metyrapone test in schizophrenic patients and healthy subjects.

The metyrapone test, a useful and reliable procedure for assessing hypothalamic-pituitary-adrenocortical (HPA) axis function, was applied to schizophrenic patients and healthy controls. 4 out of 18 patients had subnormal responses to metyrapone whereas there were no such cases in the 22 control subjects. 1 schizophrenic patient and 3 control subjects had high normal responses to metyrapone. The relationship with the dexamethasone suppression test was found to be complex. These preliminary results suggest that the HPA axis activity patterns in psychiatric illness may be more complicated than previously reported.

Adult↗
PubMed1985

The medical-psychiatric unit: a novel psychosomatic approach.

A retrospective chart review of 600 general hospital patients, of whom 200 had been admitted to a medical-psychiatric unit, 200 to a conventional psychiatric unit and 200 to medical-surgical units, and for whom psychiatric consultation had been requested, disclosed significant differences in the patient populations of these services. The data suggest that consultation psychiatry and medical-psychiatric units serve two different subgroups of patients with combined physical and psychiatric illness. A comprehensive model of clinical psychosomatic medicine encompassing consultation psychiatry, liaison psychiatry, medical-psychiatric units and after-care medical-psychiatric clinics, is proposed.

Adult↗