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Biomedical subjects

J R Cornelius

Publications and source records attributed to J R Cornelius.

At least 37 records · Page 2Linked to original sources
PubMed1993

Fluoxetine trial in suicidal depressed alcoholics.

The selective serotonergic agonist fluoxetine has demonstrated efficacy in the treatment of depression and has suggested efficacy in the treatment of alcoholism. However, no trials with any selective serotonin agonist have been reported in patients who display both major depression and alcoholism. In this study, 12 patients with DSM-III-R diagnoses of major depressive disorder and alcohol dependence were treated openly with fluoxetine for 8 weeks, with doses ranging from 20 mg to 40 mg p.o. qAM. All 12 patients reported prominent suicidal ideation upon admission to our hospital; 6 had made serious suicide attempts shortly before admission. Statistically significant improvements were noted on measures of depression and postdischarge alcohol consumption. No paradoxical increases in suicidality were noted. These findings suggest that fluoxetine has potential for treating the depressive symptoms and the excessive alcohol intake of depressed alcoholics.

Adult↗
PubMed1993

Haloperidol vs. phenelzine in continuation therapy of borderline disorder.

We report the first double-blind, placebo-controlled continuation study comparison of a neuroleptic (haloperidol < or = 6 mg), monoamine oxidase inhibitor (MAOI) antidepressant (phenelzine < or = 90 mg), and placebo in 54 patients with borderline personality disorder. Continuation medication trials of 16 weeks followed 5 weeks of acute therapy. Haloperidol continued to be effective beyond the acute phase only for the treatment of irritability. Higher levels of depression, hypersomnia, and leaden paralysis were noted in the haloperidol group than in the phenelzine and placebo groups. The dropout rate during the first half (8 weeks) of the continuation study was significantly higher for the haloperidol group (64%) than for the placebo group (28%) (p < .05). Phenelzine demonstrated very modest efficacy beyond that noted in the acute phase for the treatment of depression and irritability. Phenelzine was shown to have an activating effect on measures of excitement and reactivity.

Borderline Personality Disorder↗
PubMed1991

Characterizing organic delusional syndrome.

We present a first comprehensive description of the clinical features of patients with organic delusional syndrome. This description is based on information from 39 patients with organic delusional syndrome among 14,889 patients who presented for initial evaluation over a 5-year period at our institution. This description includes an enumeration of the common clinical symptoms of this syndrome and the respective prevalence and mean severity of each symptom. The severity of the symptoms of organic delusional syndrome are compared with those of schizophrenia to determine which symptoms distinguish between these two diagnostic categories. Patients with organic delusional syndrome demonstrated significantly more symptoms of "acquired intellectual impairment," "impaired sensorium," and "hallucinations of smell, taste, or touch," while schizophrenic patients demonstrated more "flat affect," "emotional coldness," and "thought disorganization." In addition, associated factors are presented concerning demographics, modes of treatment, level of functioning, and current physical problems associated with organic delusional syndrome.

Delusions↗
PubMed1991

A preliminary trial of fluoxetine in refractory borderline patients.

Borderline personality disorder is characterized by many of the symptoms associated with serotonin dysregulation, including affective lability, suicidal behaviors, and impulsive aggression. These provide an ideal clinical model for studying the treatment of these serious symptom presentations. The recent development of selective serotonin reuptake inhibitors such as fluoxetine makes it possible to study the role of serotonin in the etiology of affective and behavioral dyscontrol in borderline personality disorder. In this preliminary medication trial, 5 borderline personality disorder patients with severe symptoms resistant to phenelzine and neuroleptics were treated openly with fluoxetine 20 to 40 mg for 8 weeks, with weekly ratings of symptoms. The findings from this work suggested efficacy for fluoxetine in treating the depressive and impulsive symptoms of refractory patients with borderline personality disorder.

Adult↗
PubMed1990

Fluoxetine trial in borderline personality disorder.

Borderline personality disorder (BPD) is defined by many of the symptoms associated with serotonin dysregulation, including affective lability, suicidal behaviors, and impulsive aggression, providing an ideal clinical model for studying the treatment of these serious disorders. The recent development of selective serotonin re-uptake inhibitors such as fluoxetine makes it possible to study the role of serotonin in the etiology of affective and behavioral dyscontrol in BPD. In this preliminary medication trial, 5 patients with BPD were treated openly with 20 mg to 40 mg of fluoxetine for 8 weeks, with weekly ratings of symptoms. The findings from this work suggested efficacy for fluoxetine in treating the depressive and impulsive symptoms of patients with BPD. The findings were mixed concerning the efficacy of fluoxetine in treating the hostility and psychotic symptoms of BPD. No evidence for effectiveness was found in the treatment of the anxiety, phobic anxiety, or interpersonal sensitivity of BPD.

Adult↗
PubMed1989

Amitriptyline versus haloperidol in borderlines: final outcomes and predictors of response.

The authors report the final results of a 4-year study of amitriptyline and haloperidol in 90 symptomatic borderline inpatients. Medication trials were double-blind and placebo controlled and lasted 5 weeks. Haloperidol (4-16 mg/day) produced significant improvement over placebo in global functioning, depression, hostility, schizotypal symptoms, and impulsive behavior. Significant effects of amitriptyline (100-175 mg/day) were generally limited to measures of depression. Factor analysis identified three symptom change patterns: a global depression, hostile depression, and schizotypal symptom pattern. Medication effects favoring haloperidol were most prominent for hostile depression. Variables predicting favorable response to haloperidol included severity of schizotypal symptoms, hostility, and suspiciousness. Schizotypal symptoms and paranoia predicted poor outcome on both depression patterns with amitriptyline. Placebo effects were most prominent on acute state symptoms, with severe character traits predicting poor response.

Amitriptyline↗
PubMed1988

Changes in EEG mean frequency associated with anxiety and with amphetamine challenge in BPD.

Recent authors have hypothesized that cerebral dysfunction, as reflected in an abnormal EEG, may play an important role in the behavioral symptoms of patients with borderline personality disorder (BPD). Spectral analysis and amphetamine challenge testing are two promising methods for probing the clinical symptomatology of this disorder. In this study, we evaluated the relationship between clinical symptoms and computerized EEG spectral analysis in BPD patients both before and after amphetamine challenge. We found that mean frequency values on spectral analysis consistently correlated with anxiety levels in our patients, but did not correlate with a wide variety of other important symptoms, such as depression or transient psychosis. This result, coupled with our previous negative findings concerning EEG abnormalities in patients with BPD, casts doubt on the etiological relationship of cerebral dysrhythmias to the behavioral pathology of this disorder, but raises interesting questions concerning the relationship of anxiety and mean frequency.

Adult↗
PubMedDate not supplied

Characterizing organic hallucinosis.

A first comprehensive description of the clinical features of patients with the rare diagnosis of organic hallucinosis (OH) is presented, based on information from 11 OH patients among 14,889 patients who presented for evaluation over a 5-year period at our institution. This characterization is of particular current relevance to diagnosticians and clinicians because of the proposed major changes in the diagnostic system for OH in the upcoming DSM-IV and because of the virtual total lack of published information concerning this syndrome. This description includes a listing of the prevalence and mean severity of each symptom. The severity of the symptoms of OH are then compared with those of its crude "functional" equivalent of schizophrenia to determine which symptoms distinguish between these categories. Associated factors are also presented concerning demographics, modes of treatment, level of functioning, and current physical problems associated with OH.

Adult↗
PubMedDate not supplied

Characterizing organic mood syndrome, depressed type.

In this report, a first comprehensive description of the clinical features of patients with organic mood syndrome, depressed type (OMS-D), in a psychiatric hospital population is presented. This description is based on information from 130 OMS-D patients among 14,889 patients who presented for initial evaluation over a 5-year period. This description includes an enumeration of the common clinical symptoms of this syndrome. Following this, the severity of the symptoms of OMS-D are compared with those of its crude "functional" equivalent of major depressive disorder, single episode (MDD-SE). In addition, associated factors are presented concerning demographics, level of functioning, comorbidity, electroencephalographic and computed tomographic abnormalities, and current physical problems. These findings provide preliminary support for the validity of this diagnostic category, and provide relevant information concerning proposed changes in this category as listed in the DSM-IV Options Book.

Adult↗
PubMedDate not supplied

Characterizing organic mood syndrome, manic type.

The purpose of this study is to provide the first empirically based description of the clinical features of organic mood syndrome, manic type (OMS-M). During a recent 5-year period, 14,889 new patients presented for initial evaluation and care at our institute. Of these patients, a total of 12 cases of OMS-M were diagnosed. Evaluations were conducted using the Initial Evaluation Form, which was developed to be compatible with the DSM-III. The symptom profile of OMS-M was compared with that of "functional" manics (bipolar disorder, manic type [BD-M]). A variety of associated clinical factors were also assessed. The OMS-M patient demonstrated somewhat less severe acute symptomatology but more longstanding functional impairment than in BD-M. OMS-M patients also displayed a lower age at onset of illness and a higher level of perinatal problems and developmental delays compared with BD-M patients. The OMS-M group displayed a low family burden of mania. The most striking distinguishing feature of OMS-M was the prevalence of neurological disorders, with a surprisingly high prevalence of seizure disorders. Seizure disorders were more prevalent in OMS-M than in other organic brain syndromes (OBS).

Adult↗
PubMedDate not supplied

Gender effects on the clinical presentation of alcoholics at a psychiatric hospital.

Despite the clinical importance of gender effects on symptom patterns and comorbidity patterns in alcoholics, little is known about such effects in treatment facilities other than alcoholism treatment centers. This study evaluated the effect of gender on the clinical profile of 604 alcoholics who presented for initial evaluation and treatment at a psychiatric hospital. It demonstrated that major depression and accompanying depressive and anxiety-related symptoms are more prominent in female alcoholics than in male alcoholics, whereas antisocial personality disorder and antisocial symptoms are more prominent in male alcoholics presenting to a psychiatric hospital. The study also demonstrated that reversed neurovegetative symptoms are more severe in female than in male alcoholics.

Adult↗
PubMedDate not supplied

Racial effects on the clinical presentation of alcoholics at a psychiatric hospital.

Despite the clinical importance of race effects on comorbidity and symptom patterns in recent community studies, little is known about such effects in various treatment facilities. This study evaluated the effect of race on the clinical profile of 604 alcoholics who presented for initial evaluation and treatment at a psychiatric hospital. The factor that most strongly distinguished the racial groups was socioeconomic status (SES). After controlling for SES and other factors, no significant difference was noted between ethnic groups in the prevalence of major depressive disorder (MDD) or antisocial personality disorder. However, after controlling for SES and other factors, alcohol and drug use were more severe in African-American alcoholics, along with four symptoms associated with alcohol and drug use. In contrast, reversed neurovegetative symptoms, anxiety-related symptoms, and some personality-related symptoms were more severe in white alcoholics.

Adult↗
PubMedDate not supplied

Age effects on the clinical presentation of alcoholics at a psychiatric hospital.

Little is known about the effects of age on the clinical presentation of alcoholism in various treatment settings, despite the clinical importance of this factor. This study evaluates the effects of age on the clinical profile of 604 alcoholics who presented for initial evaluation and treatment at a psychiatric hospital. Young alcoholics displayed the most prominent substance use, antisocial behavior, depressive symptoms (including suicidality), and impulsivity. Early middle-aged alcoholics displayed the highest levels of drinking. Elderly alcoholics displayed the highest levels of cognitive dysfunction, although some level of cognitive dysfunction was present among even the youngest alcoholics. These findings confirm and clarify the effects of age on the clinical profile of alcoholics presenting for initial evaluation at a psychiatric hospital.

Adult↗