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Biomedical subjects

J Croughan

Publications and source records attributed to J Croughan.

17 recordsLinked to original sources
PubMed1993

Specificity of mixed affective states: clinical comparison of dysphoric mania and agitated depression.

To investigate the clinical specificity of mixed affective states, we compared clinical characteristics of mixed (dysphoric) manics to those of agitated depressed patients. The subjects were inpatients studied in the NIMH Clinical Research Branch Collaborative Study on the Psychobiology of Depression, Biological Studies. Behavior and symptom ratings for depressive and manic symptoms were obtained during a 15-day placebo washout period. Patients with agitated depression were compared to those in acute manic episodes with and without prominent depressive symptoms. Mania ratings clearly distinguished agitated depressed from mixed manic patients. Concerning depression and general psychopathology, mixed manics had more severe agitation, hostility and cognitive impairment than did agitated depressed patients. Depressed mood and anxiety did not differ significantly between the two groups. Nurse ratings for depression and anxiety, based on ward behavior, were similar for mixed manics and agitated depressed patients, while physician-interview rated depression and anxiety were higher in agitated depressed patients. These data support the existence of superimposed depressive and manic syndromes in mixed manics.

Anxiety Disorders↗
PubMed1990

Stress, depression, and mania: relationship between perceived role of stressful events and clinical and biochemical characteristics.

We investigated the perceived role of stressful events in episodes of major affective disorder in patients studied in the NIMH Clinical Research Branch Collaborative Program on the Psychobiology of Depression (Biological Studies). Using items from the Schedule for Affective Disorders and Schizophrenia (SADS), episodes were divided into environment-sensitive (high perceived role of stressful events) and autonomous (minimal or no perceived role of stressful events). Patients with environment-sensitive episodes had fewer previous episodes and a longer index episode. The groups did not differ with respect to age, gender, education, socioeconomic group, diagnosis, severity of illness, or eventual response to treatment. Unipolar depressed patients with environment-sensitive episodes had lower CSF 5-HIAA than those with autonomous episodes. Among bipolar depressed patients, those with autonomous episodes had elevated excretion of O-methylated catecholamine metabolites and of epinephrine, while those with environment-sensitive episodes had normal excretion of catecholamines and metabolites. Manic subjects with environment-sensitive episodes had elevated norepinephrine excretion, while this was normal in manics with autonomous episodes. Relationships between environmental sensitivity of affective episodes and neurotransmitter function therefore appear to be related to the type of episode.

Adaptation, Psychological↗
PubMed1987

The timing, specificity and clinical prediction of tricyclic drug effects in depression.

This research was aimed at studying the rate of action of tricyclic drugs in depressive disorders, specifying the behavioural effects associated with recovery, and predicting clinical response. The research design involved comparison of a recovered group with a group treated for the equivalent four weeks, who showed minimal to no response. The findings indicated significant differences in baseline characteristics between responders and non-responders. Further, the drugs were found to act early in the responders, within the first week of treatment. Specific changes at one week which distinguished responder and non-responder groups occurred in the disturbed affects, and in cognitive functioning. Improvements also occurred in somatic symptoms, but these latter changes were general and not associated with later recovery. At 2 1/2 weeks, all facets of the depressed condition showed positive change in the responders. Implications of the results for assessing rate of tricyclic drug actions, their effects on the interaction of affect and neurochemistry, and the practical application of the results for the clinical situation, are discussed.

Adult↗
PubMed1987

Diagnosis and treatment of mixed mania.

In a study of 19 manic patients, the authors found that eight suffered from mixed mania, a condition in which depressive symptoms are found in the context of classic manic features. The presence of a mixed manic state predicted at least a slower and possibly a poor response to lithium therapy. The authors suggest that the delineation of a subgroup of mixed manic patients might help to identify potential lithium-resistant patients.

Adult↗
PubMed1982

Is the major histocompatibility complex linked to genes that increase susceptibility to affective disorder? A critical appraisal.

The evidence implicating genes linked to the major histocompatibility complex in the pathogenesis of affective disorder is reviewed, and 10 new multiplex families containing 26 affected siblings are presented. It is shown that when the data are properly analyzed by not dismantling multiplex sibships into all possible sib pairs, no individual data set presents compelling evidence of linkage. The present study is also negative. However, pooling all published families results in moderate evidence for nonrandom assortment.

Adolescent↗
PubMed1982

Behavioural measurement and drug response characteristics of unipolar and bipolar depression.

This research is part of the NIMH--CRB Collaborative Study on the psychobiology of depression. The main objective of the research programme is to test hypotheses concerning the interaction of neurobiological mechanisms and behaviour in the depressive disorders. Part I of the report describes the rationale and the overall approach to measuring behavioural state and outcome in the research programme. Part II reports on the results of applying the behavioural methods to a comparison of the clinical phenomenology of unipolar and bipolar depression. The behavioural patterns expressed during the episode by the two groups are different. Further, the two types are shown to react differently to treatment with tricyclic drugs, reinforcing the thesis that they are qualitatively distinct forms of the depressive disorders.

Antidepressive Agents, Tricyclic↗
PubMed1981

National Institute of Mental Health Diagnostic Interview Schedule. Its history, characteristics, and validity.

A new interview schedule allows lay interviewers or clinicians to make psychiatric diagnoses according to DSM-III criteria, Feighner criteria, and Research Diagnostic Criteria. It is being used in a set of epidemiological studies sponsored by the National Institute of Mental Health Center for Epidemiological Studies. Its accuracy has been evaluated in a test-retest design comparing independent administrations by psychiatrists and lay interviewers to 216 subjects (inpatients, outpatients, ex-patients, and nonpatients).

Humans↗
PubMed1981

Reliability of lifetime diagnoses and symptoms in patients with a current psychiatric disorder.

In this study we assess the reliability of rating past psychiatric symptoms and lifetime diagnoses in a currently ill population using the SADS and RDC. Five raters from different centers interviewed 25 subjects in a short-interval test-retest design. Subjects had a wide diversity of affective and non-affective diagnoses and high levels of manifest psychopathology. Our results demonstrate that it is possible for raters from different research centers to reliably rate lifetime diagnoses and previous symptoms. Two important exceptions to the high reliability are the lifetime diagnoses of hypomania and the recurrent unipolar subtype of major depressive disorder, and we alert clinicians and researchers to be cautious when diagnosing these conditions. We conclude that the next step in measuring reliability should be a long-interval test-retest design with separate interviews conducted at the later assessment, one by the original rater and the other by a blind rater.

Affective Disorders, Psychotic↗
PubMed1980

Biological component of the NIMH clinical research branch collaborative program on the psychobiology of depression: II. Methodology and data analysis.

A preceding paper has reviewed the history, background, and rationale for this collaborative effort exploring the biologic basis of the affective disorders. This paper details the "flow" of a subject through the experimental protocol, the instrumentation used to obtain the clinical and behavioural data, and the biologic methodologies employed in the analysis of the body fluids. Data management and analysis techniques developed for this study are also examined.

Adrenocorticotropic Hormone↗
PubMedDate not supplied

Mania. Diagnosis, state measurement and prediction of treatment response.

The phenomenology of the manic state and its response to lithium drug treatment were intensively studied as part of a larger NIMH Clinical Research Branch Collaborative Program on the Psychobiology of Depression. In view of the weaknesses in current methods for measuring the components of the manic state, a new instrument was developed, the Manic Diagnostic and Severity Scale (MADS). Its sensitivity in diagnosis and in measuring change was compared to other scales already in use. Finally baseline clinical data is presented that suggests that the presence of a "mixed" manic state is a predictor of lack of clinical response to lithium treatment.

Adult↗
PubMedDate not supplied

Cortisol measures in primary major depressive disorder with hypersomnia or appetite increase.

Morning plasma cortisol response to the 1 mg dexamethasone suppression test along with cortisol levels in blood, cerebrospinal fluid (CSF), and urine were measured in hospitalized male and female patients with primary major depressive disorder who reported hypersomnia (n = 23), or increase in appetite (n = 22). Comparisons were drawn to cortisol levels in patients with primary major depressive disorder who did not report hypersomnia or appetite increase (n = 23) and to normal controls (n = 23), all age- and sex-matched. Depressives with hypersomnia or increased appetite showed higher than normal 24-h urinary free cortisol concentrations. Depressed patients without hypersomnia or appetite increase had in addition to elevated free urinary cortisol concentrations higher than normal morning plasma cortisol levels before and after dexamethasone administration and a higher incidence of cortisol non-suppression after dexamethasone compared to normal subjects. The findings provide preliminary evidence that HPA activation in depression is diminished in the presence of hypersomnia and/or an increased appetite. Studies of the hypothalamic-pituitary-adrenal axis may be useful for differentiating subtypes of depression characterized by hypersomnia or enhanced appetite.

Adult↗