Attenuation of response to serotonin reuptake inhibitors.
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1-Naphthylamine↗
Biomedical subjects
J F Goldberg
Publications and source records attributed to J F Goldberg.
Recurrent affective syndromes in bipolar and unipolar mood disorders at follow-up.
BACKGROUND: It is in dispute whether affective relapse disrupts psychosocial functioning to the same extent in depressed and manic patients. METHOD: A prospective, naturalistic, longitudinal follow-up of 84 unipolar and bipolar affectively disordered in-patients was conducted to examine the extent of recurrent affective syndromes and their relationship to overall outcome. Global adjustment relative to relapse was assessed at 2- and 4.5-year follow-ups. RESULTS: Nearly half of the bipolar patients had subsequent syndromes, which were often associated with uniformly poor psychosocial functioning. Fewer than one-quarter of those with recurrences had steady work performance. Bipolar patients taking lithium alone had fewer recurrences than those taking lithium as well as neuroleptics (P < 0.05). Bipolar and unipolar patients relapsed with equal frequency, but unipolar relapse was less often associated with readmission to hospital, work impairment, or uniformly poor functioning. CONCLUSION: Affective relapse in bipolar disorders was more detrimental to overall functioning than was recurrence in unipolar depression.
Antipsychotic Agents↗
Kindling in bipolar disorders: a longitudinal follow-up study.
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Adult↗
Outcome of schizoaffective disorder at two long-term follow-ups: comparisons with outcome of schizophrenia and affective disorders.
OBJECTIVE: This research assessed whether the outcome of schizoaffective disorder is more similar to that of schizophrenia or that of affective disorders. METHOD: The authors conducted a prospective follow-up study of 101 schizoaffective, schizophrenic, bipolar manic, and depressed patients assessed at three times: during hospitalization and 2 and 4-5 years later. The follow-up test battery involved detailed assessment of social functioning, work performance, symptoms, posthospital treatment, and rehospitalization. RESULTS: Outcome for schizoaffective patients 4-5 years after hospitalization differed significantly from that for patients with unipolar depression. However, the differences between schizoaffective and bipolar manic patients were more equivocal. Unlike the patients with bipolar disorder, only a limited number of patients with schizoaffective disorder showed complete recovery in all areas throughout the year preceding the 2-year follow-up and the year preceding the 4- to 5-year follow-up. The differences in outcome between schizoaffective and schizophrenic patients were also mixed. These two groups showed some similarities in outcome, but there were fewer schizoaffective than schizophrenic patients with uniformly poor outcome in all areas. CONCLUSIONS: Overall, schizoaffective patients showed some similarities to both schizophrenic and bipolar manic patients. Schizoaffective patients had somewhat better overall posthospital functioning than patients with schizophrenia, somewhat poorer functioning than bipolar manic patients, and significantly poorer functioning than patients with unipolar depression. The data suggest that when mood-incongruent, schizophrenic-like psychotic symptoms are present in the acute phase, they predict considerable difficulty in outcome, even when affective syndromes are also present, as in schizoaffective disorder. It is likely that schizoaffective disorder is not just a simple variety of affective disorder.
Adult↗
Outcome in manic disorders. A naturalistic follow-up study.
To study outcome in manic patients treated under routine clinical conditions, 73 manic and 66 unipolar depressed patients were followed up 1.7 years after hospitalization. A surprisingly large percentage of manic patients showed difficulty in post-hospital adjustment, and over 40% experienced a manic syndrome during the follow-up period. Manic patients showed poorer outcomes than did unipolar depressives. Manic patients taking lithium carbonate did not show better outcome than those not taking lithium carbonate. The results suggest (1) many hospitalized manic patients have a severe, recurrent, and pernicious disorder; and (2) in routine clinical practice, lithium carbonate treatment is an effective prophylaxis for fewer than the 70% to 80% of manic patients previously reported.
Adult↗
Rapid cycling in unipolar and bipolar affective disorders.
To characterize the nature of rapid cycling affective disorders, the authors analyzed mood fluctuation patterns in 570 patients with affective disorders hospitalized in 1960, 1975, or 1985. Patients' records were rated for the frequency, duration, and complexity of distinct affective states. Very rapid mood fluctuations were absent among bipolar patients in 1960 but were evident in 1975 and 1985. In each year, bipolar patients displayed more frequent, complex, and mixed episodes than did unipolar patients. The results suggest that more frequent episodes occur among bipolar than unipolar patients and that very rapid switch processes have become more widespread for some bipolar patients.
Adult↗
Neuronal overload in the developing anuran lateral motor column in response to limb removal and thyroid hormone.
The lateral motor column (LMC) in the anuran spinal cord normally undergoes a dramatic reduction in motor neuron number during development. At least two factors influence this process: the limb target which is required for the progression of cell loss, and thyroid hormone, a requisite for metamorphosis. This study has examined the relative and combined effects of limb amputation and exogenous thyroxine, initiated at the onset of normal rapid cell loss in Rana pipiens tadpoles, in regulating neuron number in the lumbosacral LMC. Thyroxine treatment or unilateral limb amputation temporarily resulted in significantly more LMC neurons than in untreated controls. Extraordinary numbers of motor neurons persisted through metamorphic climax when both treatments were combined. Population sizes frequently exceeded the maximum number of neurons observed prior to the onset of natural cell loss. Moreover, thyroxine-treated tadpoles contained increased numbers of mitotic figures in the ventricular zone of the spinal cord and significantly more newly generated cells in the LMC, as revealed by 3H-thymidine autoradiography. These findings suggest that thyroxine-potentiated mitogenesis promotes greater numbers of new motor neurons to the LMC while, simultaneously, target removal delays the loss of extant cells. It is proposed that this interaction effectively maintains an immature state in the LMC so that neuronal "decisions" for survival and the consequent loss of target-deprived neurons are postponed far longer than previously reported.
Animals↗
Cyclothymic mood swings in the course of affective disorders and schizophrenia.
The authors assessed cyclothymic mood swings and psychosocial adjustment in 38 unipolar depressed, 27 bipolar, 35 schizophrenic, and 27 other psychiatric patients 4 years after hospital discharge and in 153 normal control subjects. The patients were significantly more cyclothymic at follow-up than the control subjects, but there were no differences in cyclothymia between the diagnostic groups. Cyclothymic patients showed significantly poorer posthospital functioning than noncyclothymic patients. These findings raise questions concerning the scope of the hypothesized cyclothymic-bipolar spectrum. Minor mood swings in a variety of patients with poor posthospital adjustment may reflect persistent vulnerability to psychopathology.
Adaptation, Psychological↗
Qualitative differences in manic symptoms during mixed versus pure mania.
Previous studies have compared demographic and clinical-outcome features of bipolar patients with mixed or pure mania. However, little is known about the potential differences in the nature and extent of manic symptoms in mania either with or without an accompanying depression. This study examined DSM-III-R manic symptoms in a cohort of 183 bipolar I inpatients hospitalized for mixed mania (diagnosed by broad or narrow criteria) or pure manic episodes. Inpatient charts were reviewed to determine the presence of individual affective symptoms. The results indicate that clinicians were more likely to diagnose a pure mania from the beginning to end of an episode than to diagnose a mixed mania from its beginning to end. Mixed-manic patients had significantly fewer manic symptoms than pure manic patients. Grandiosity, euphoria, pressured speech, and a decreased need for sleep were more prevalent during pure versus mixed mania. Grandiosity and a diminished need for sleep were especially notable during pure mania compared with mixed mania as defined by narrow criteria for mixed states. The observed differences in manic symptom profiles between mixed and pure mania may aid in the clinical assessment of dysphoric states among bipolar patients. The data also lend support to the use of broad diagnostic criteria for defining mixed mania as an entity phenomenologically distinct from pure mania.
Acute Disease↗