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Biomedical subjects

L A Labbate

Publications and source records attributed to L A Labbate.

At least 37 records · Page 2Linked to original sources
PubMed1997

Bupropion treatment of serotonin reuptake antidepressant-associated sexual dysfunction.

Serotonin reuptake inhibitor (SRI)-induced sexual dysfunction is common, and a number of pharmacologic adjunctive strategies have been employed to treat this vexing problem. This open label study tested the efficacy of adjunctive bupropion across several measures of sexual function. Patients taking SRIs for various mood or anxiety disorders who reported prospective decline in sexual function after at least 2 months on SRIs were offered treatment with bupropion, 75 mg/day. Eight patients were treated, and sexual function was measured by use of a visual analog scale at 1 month of treatment. Four of eight patients experienced marked improvement in sexual dysfunction following adjunctive bupropion treatment. Bupropion may be a pharmacologic option for treating SRI-associated sexual dysfunction, though controlled clinical trials are needed.

1-Naphthylamine↗
PubMed1997

Salutary change after frontal brain trauma.

Adverse behavioral effects of frontal traumatic brain injury are well-known. Patients may suffer changes in personality ranging from disinhibition to apathy. Beneficial effects of traumatic brain injury are rarely described. We report three cases of patients who sustained frontal traumatic brain injury, one of whose social phobia resolved and the other two of whom had an improvement in impulsive and antisocial behavior. In one case the brain injury may have caused disinhibition of an inhibited state; in the other cases disinhibition associated with impulsivity was replaced by a more restrained state. This adds to the data on the integrative role of the frontal lobes in varied psychopathologic conditions.

Adult↗
PubMed1997

Tardive dyskinesia in older out-patients: a follow-up study.

Tardive dyskinesia (TD) is a long-term potential adverse effect of neuroleptic treatment, and older age has been correlated with the development of TD. We conducted a chart review of current out-patients and examined annual Abnormal Inventory Movement Scale (AIMS) evaluations for the period 1987-1995 for 43 patients who started neuroleptic treatment after the age of 35 years. Patients (mean age 67 years) began neuroleptic treatment at a mean age of 46 years and were taking neuroleptics for 18 years on average. A total of 18 patients (42%) met the research criteria for TD, of whom all cases were mild except for three, which were moderate. Although TD was common, it rarely progressed in this naturalistic setting, suggesting that even for older patients maintenance neuroleptic treatment may be feasible for chronic psychosis.

Adult↗
PubMed1997

Recidivism in major depressive disorder.

BACKGROUND: While recidivism has been well studied in psychotic disorders, little has specifically been done to determine what differences exist between patients admitted multiple times compared with once for major depressive disorder (MDD). METHOD: The records of patients admitted with MDD to a large military medical center were reviewed during the years 1991-1995. Recidivists were 46 consecutive patients admitted three or more times during the period. The comparison sample was 50 consecutive patients admitted for the first time in 1993 without subsequent admission to our hospital. Patient groups were compared for age, gender, comorbidity, and the presence of medical conditions contributing to their admission. RESULTS: Repeat hospital admissions for MDD were common. Recidivists were more likely to be older, suffer recurrent depression, receive a personality disorder diagnosis, receive ECT or have a medical condition contributing to their admission, than patients admitted once. Alcohol use disorders or other Axis I disorders did not predict recidivism. CONCLUSIONS: For some patients the morbidity of MDD in the form of frequent admissions is considerable, perhaps as severe as for patients with psychotic disorders. Frequent hospitalizations may result from recurrent MDD with or without personality disorder.

Adult↗
PubMed1997

Posttraumatic stress disorder in patients with traumatic brain injury and amnesia for the event?

Frequency of DSM-III-R posttraumatic stress disorder (PTSD) was studied in 47 active-duty service members (46 male, 1 female; mean age 27 = 7) with moderate traumatic brain injury and neurogenic amnesia for the event. Patients had attained "oriented and cooperative" recovery level. When evaluated with a modified Present State Examination and other questions at various points from study entry to 24-month follow-up, no patients met full criteria for PTSD or met criterion B (reexperience); 6 (13%) met both C (avoidance) and D (arousal) criteria. Five of these 6 also had organic mood disorder, depressed type, and/or organic anxiety disorder. Posttraumatic amnesia following moderate head injury may protect against recurring memories and the development of PTSD. Some patients with neurogenic amnesia may develop a form of PTSD without the reexperiencing symptoms.

Adult↗
PubMed1997

Incidence of HIV infection among patients with new-onset psychosis.

To assess the frequency of HIV testing and the incidence of HIV infection among patients with new-onset psychosis, the records of 811 patients referred to a military hospital for acute psychosis during a two-year period were reviewed. Records of 518 patients were excluded because they had known chronic psychotic illnesses, repeat admissions for recurrent affective disorders with psychotic features, delirium, dementia, or pre-existing HIV infection. Of the 293 patients with new-onset psychotic illness, 84 percent (N = 246) were tested for HIV antibodies. None were seropositive for HIV. Although patients with new-onset psychosis were commonly assessed for HIV infection to clarify their diagnosis, HIV infection was not associated with new-onset psychosis.

AIDS Serodiagnosis↗
PubMed1996

Bedside stuffed animals and borderline personality.

We explored the relationship between psychiatric diagnosis and the presence of stuffed animals at the bedside in a population of adult female psychiatric inpatients. One of the authors made approximately weekly surveys of the wardrooms of adult psychiatric inpatients over twelve months for the presence of displayed stuffed animals. The observer was blind to the diagnosis of 80% of the patients, and the study or its hypothesis was not known to other physicians. The discharge diagnoses of patients displaying stuffed animals were recorded and compared with those of the ward population in general. Among 36 female patients who displayed stuffed animals in their rooms, Borderline Personality Disorder was diagnosed in 22 (61%) of these patients. Of 447 adult female patients admitted to the same unit over the same period, only 17% were noted to be diagnosed Borderline Personality Disorder. Stuffed animals as a bedside clinical clue may suggest evaluation for Borderline Personality Disorder.

Adolescent↗
PubMed1995

Influence of phototherapy treatment duration for seasonal affective disorder: outcome at one vs. two weeks.

Most previous phototherapy research has been conducted on trials of 1 week duration. This study compares response to phototherapy at weeks 1 and 2. All subjects (n = 26) were between 18 and 65 years and met Diagnostic and Statistical Manual of Mental Disorders, 3rd ed, revised, (DSM III-R) criteria for major depression, recurrent, seasonal pattern and had a Hamilton Depression Rating Scale score (HAM-D) > or = 20. A rater blinded to treatment schedule and study hypothesis repeated the HAM-D-31 1 and 2 weeks after baseline to assess treatment response to bright light. Response rates at week 1 defined by 50% reduction in HAM-D-31 and HAM-D-31 score < 8 were 62% and 27%, respectively. At week 2, however, 65% had a 50% reduction in HAM-D-31 and 62% had a HAM-D-31 < score 8 (chi-square = 6, p = 0.01). Four patients (15%) who were nonresponders at week 1 responded after 2 weeks. The results show a statistically different outcome after 2 weeks of treatment and suggest the necessity of longer trials of phototherapy.

Adolescent↗
PubMed1995

Routine screening of thyroid function in patients hospitalized for major depression or dysthymia?

Our objective was to examine the clinical practice of testing thyroid function in a mixed community and referral psychiatry inpatient unit. We evaluated (1) the frequency of ordering screening, (2) the type of test, and (3) the incidence of thyroid function abnormality among those tested. We reviewed thyroid function tests obtained on 277 consecutive first time adult admissions to the psychiatric wards at Walter Reed Army Medical Center, from 1992 through 1993, who met the DSM-III R diagnostic criteria for major depression or dysthymia. Of the 277 subjects, 260 (94%) had thyroid function tests performed which included evaluation of thyroid stimulating hormone (TSH). Seventeen patients (6.5%) had a TSH outside the normal range. Of these, there were two cases (0.4%) suggestive of hyperthyroidism and no overt cases of hypothyroidism. Eight patients had subclinical hypothyroidism (elevated TSH, normal T4). Although screening thyroid tests are often routine for depressed inpatients, our data suggest that thyroid screening may add little to diagnostic evaluation. Overt thyroid disease is rare among depressed inpatients.

Adolescent↗
PubMed1995

Hypothyroidism and hyperthyroidism in major depression revisited.

BACKGROUND: The aim of our study was to evaluate the prevalence of thyroid abnormalities among depressed outpatients and to examine the response to treatment of those subjects with relatively low or high thyroid hormone levels. METHOD: Outpatients (N = 200) 18 to 65 years of age who met DSM-III-R criteria for major depression were screened for the presence of thyroid abnormalities using a number of thyroid indices. Of these patients, 166 were then treated openly with the antidepressant fluoxetine for 12 weeks. We assessed whether patients with relatively low or high thyroid hormone levels had a different response to treatment compared with other patients. The 17-item Hamilton Rating Scale for Depression (HAM-D-17) was administered during the study to assess changes in depressive symptoms. Thyroid function was assessed by measuring T3, T4, free T4 index (FT4I), T3 uptake (T3U), and serum thyroid-stimulating hormone (TSH) levels. RESULTS: No clinical cases of hyperthyroidism or hypothyroidism were detected. Of the patients examined, 5 (2.6%) had slightly elevated TSH levels (range, 4.7-8.2); none of these had T4 or FT4I levels below the normal range. Subnormal levels of T4 or FT4I were found in 1 subject (0.5%). T3 and T3U levels were below the normal range in a larger number of patients (7.6% and 15.0% respectively), but only 1 of these patients had elevated TSH levels. None of the patients had levels of TSH below the normal range, and only 3 subjects (1.5%) had T4 levels above the normal range. No relationship was found between response rate (assessed as either change in HAM-D-17 score or as remission of depressive symptoms with a HAM-D-17 score < or = 7 for 3 consecutive weeks) and each of the thyroid tests, even after adjusting for baseline severity of depression. CONCLUSION: In depressed outpatients, it appears that hypothyroidism and hyperthyroidism are extremely uncommon and that the presence of subtle thyroid function abnormalities does not have an impact on treatment outcome.

Adolescent↗