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L A Labbate

Publications and source records attributed to L A Labbate.

54 records · Page 3Linked to original sources
PubMed1994

Sleep panic attacks: an association with childhood anxiety and adult psychopathology.

The authors examine whether the presence of sleep panic attacks identifies a subgroup of panic disorder patients. Subjects (n = 95) were consecutive patients with panic disorder participating in the MGH longitudinal study of panic disorder. Patients were evaluated with structured interviews to establish adult anxiety and affective disorders, and the presence of childhood anxiety disorders. Patients were queried whether they had ever experienced at least one panic attack during sleep. Patients with a history of sleep panic had significantly higher rates of comorbid generalized anxiety disorder (p < 0.01), social phobia (p < 0.03), and major depression (p < 0.005). The trend was toward longer length of illness (p < 0.09) and were more likely to have a history of an anxiety disorder during childhood (p < 0.005). The presence of sleep panic attacks may delineate a subgroup of panic disorder patients with early difficulties with anxiety, and comorbid mood and anxiety disorders as adults.

Adult↗
PubMed1994

Phototherapy for seasonal affective disorder: a blind comparison of three different schedules.

The authors investigated the outcome of an alternating time schedule versus two fixed schedules (either morning or evening) of bright light treatment for seasonal affective disorder. The subjects were 31 patients who met DSM-III-R criteria for major depression with a seasonal pattern. No statistically significant difference was observed among patients in the three groups for response criteria after 1 week of treatment. These results support the use of more flexible phototherapy schedules.

Adolescent↗
PubMed1994

Treatment of fluoxetine-induced sexual dysfunction with bupropion: a case report.

Antidepressant-induced sexual dysfunction is a common and significant cause of patient distress and noncompliance with treatment. A number of adjunctive pharmacologic strategies, including yohimbine, cyproheptadine, bethanechol, and amantadine, have been employed previously. We report a case of using bupropion to treat fluoxetine-induced sexual dysfunction in a 50-year-old man with a history of recurrent major depression. This is the first case of such treatment we know. Sexual dysfunction induced by fluoxetine is thought secondary to effects on the serotonin system. Bupropion is an antidepressant with minimal sexual side effects. The mechanism by which bupropion resolved this sexual dysfunction is unknown, but it may be related to its mild dopamine uptake blockade.

Bupropion↗
PubMed1994

The relationship of alprazolam and clonazepam dose to steady-state concentration in plasma.

This report addresses the correlation between dose and concentration of both alprazolam and clonazepam in plasma. Patients were 43 participants in a double-blind, placebo-controlled study of alprazolam and clonazepam for the treatment of panic disorder. The concentration of clonazepam in plasma was linearly related with dose, measured as milligrams per day (R = 0.724; F = 24.2; p = 0.0001) or milligrams per kilogram per day (R = 0.863; F = 58.3; p = 0.0001). The correlation between drug concentration and daily dose of alprazolam was also significant (R = 0.60; F = 9.5; p = 0.007), although the correlation between dose measured as milligrams per kilogram per day and drug level was not significant (R = 0.361; F = 2.4; p = 0.14). This replicates previous findings that, for each additional milligram per day dose of alprazolam, there is a corresponding increase of approximately 10 ng/ml in the plasma and presents preliminary data that, for each added 1 mg/day dose of clonazepam, there is approximately an increase of 12 ng/ml in the plasma. For both drugs, however, there may be considerable variation in level in plasma for a given dose. Weight-adjusted clonazepam concentration may be more predictable than weight-adjusted alprazolam concentration.

Adolescent↗
PubMed1994

Side effects induced by bright light treatment for seasonal affective disorder.

BACKGROUND: Bright light treatment has become an accepted treatment for seasonal affective disorder (SAD), but there have been few studies about adverse effects from using this treatment. We conducted a study to examine the frequency of adverse effects of bright light treatment for SAD. METHOD: Thirty patients meeting DSM-III-R criteria for major depression, recurrent, with seasonal pattern as determined by the Structured Clinical Interview for DSM-III-R were administered a structured interview, the 42-item Systematic Assessment for Treatment Emergent Events, to assess side effects from bright light treatment. RESULTS: Side effects were limited and mild. They remitted with time or decreased light. No patient discontinued treatment. One patient developed mild hypomania and 3 became agitated. Sleep disturbance occurred in 62% of patients (5 of 8) using evening light. Visual side effects occurred in 26% of patients (8 of 30). CONCLUSION: Except for one case of mild hypomania, no other clinically significant treatment-emergent adverse effects developed. Hypomania is an uncommon, but clinically important side effect. Mild visual complaints were common and remitted promptly. In this group of patients with SAD, bright light treatment was well tolerated and resulted in a limited number of adverse effects, none of which compromised treatment. The absence of a control group limits the specificity of these side effects to bright light treatment.

Adolescent↗
PubMed1992

Psychiatric hospitalization: treatment or triage?

We examined the outcome of active duty psychiatric inpatients (N = 101) 2 years after admission. Most patients were young with minor diagnoses (adjustment disorders), yet only 20% were still on active duty 2 years later. This compared poorly with national retention rates for all lengths of time in service (p < 0.0001). Longer time in service and low severity of diagnosis predicted a better outcome. We discuss implications of these findings.

Female↗
PubMedDate not supplied

Physical fitness and perceived stress. Relationships with coronary artery disease risk factors.

This study evaluated the relationship between two biochemical risk factors for coronary artery disease, serum lipids and dehydroepiandrosterone-sulfate (DHEA-S), and both fitness and perceived stress among a cohort of senior male Army officers (N = 331). The participants underwent a number of assessments gauging their fitness [exercise tolerance as measured by maximum ventilatory oxygen uptake (MVO2)], psychological well-being, and biochemical cardiovascular risk factors. Perceived stress was significantly and inversely related to DHEA-S levels, even after adjusting for age, though no relationship was found between perceived stress and serum lipids. Significant correlations were found between MVO2 and high-density lipoprotein cholesterol and inversely between MVO2 and triglycerides. Overall, the study's findings are generally consistent with the view that psychological stress and physical activity have opposite effects on parameters that affect cardiovascular status.

Adaptation, Psychological↗
PubMedDate not supplied

Sexual dysfunction induced by serotonin reuptake antidepressants.

Serotonin reuptake inhibitor (SRI) antidepressants have been associated with sexual dysfunction, though there have been few prospective reports specifically examining this problem. The purpose of this study was to determine if three SRIs affected sexual function in patients with an anxiety disorder or major depressive disorder over a 3-month period. Sixty-one patients were evaluated for at least 2 months in a prospective study of the effects of fluoxetine, sertraline, and paroxetine on five aspects of sexual function: libido, erection/lubrication, orgasm quality, orgasm delay, and sexual frequency. Measurements were made at baseline and at each month on visual analog scales. For men and women, orgasm quality was lower and orgasm delay longer at Months 1, 2, and 3 compared with baseline (p < .001). Erection scores were lower over time (p < .02) but this change was less dramatic. Lubrication, libido, and sexual frequency were not appreciably changed over 3 months. Anorgasmia was significantly more common in women than men at Months 1 and 2. Orgasm appears to be a primary sexual function affected by SRIs.

1-Naphthylamine↗
PubMedDate not supplied

Psychiatric syndromes in Persian Gulf War veterans: an association of handling dead bodies with somatoform disorders.

BACKGROUND: Traumatic combat experience has been associated with the development of posttraumatic stress disorder, but there have been few studies about the association of military combat experience and the development of somatoform disorders. METHODS: The authors evaluated 131 referred Gulf War veterans for medical and psychiatric syndromes thought related to their involvement in the Gulf War. Patients completed questionnaires regarding their traumatic experiences and were interviewed using the Structured Clinical Interview for DSM III-R. RESULTS: For the sample, 69% had axis I conditions. Major depression, undifferentiated somatoform and posttraumatic stress disorders were the most common diagnoses. Reports of traumatic events were associated with both posttraumatic stress disorder (p < 0.05) and somatoform diagnoses (p < 0.05). Veterans who handled dead bodies had a 3-fold risk of receiving a somatoform diagnosis (p < 0.05). CONCLUSIONS: Psychiatric syndromes may explain some medical complaints following involvement in the Persian Gulf War. The results suggest that some psychological and nonspecific somatic symptoms persisting since the Gulf War may be related to exposure to psychological trauma.

Adult↗
PubMedDate not supplied

Sexual dysfunction in male psychiatric outpatients: validity of the Massachusetts General Hospital Sexual Functioning Questionnaire.

BACKGROUND: The purpose of this study was to determine the frequency of sexual dysfunction in male outpatients with concomitant psychiatric and medical conditions and to establish the validity of the Massachusetts General Hospital Sexual Function Questionnaire (MGH). METHODS: Male VA outpatients were given two sexual function questionnaires, a 36-item Changes in Sexual Functioning Questionnaire (CSFQ) and the 5-item MGH. Medical records were evaluated for diagnosis, medications and illnesses that might affect sexual functioning. RESULTS: Among 100 outpatient respondents, the CSFQ showed that 90% and the MGH showed that 77% experienced sexual dysfunction. Forty percent of patients reported total absence of sexual function. Good concurrent validity was established between the MGH and CSFQ. CONCLUSIONS: Sexual dysfunction is highly prevalent in psychiatric outpatients. The MGH is a valid clinical measure to determine sexual dysfunction.

Adult↗
PubMedDate not supplied

The construct validity and clinical utility of the Frank Jones story as a brief screening measure of cognitive dysfunction.

The use of quick and easily administered screening measures of cognitive functioning has become increasingly important in clinical settings. A number of brief screening instruments are available, but few have been thoroughly examined for their validity and clinical utility. The Frank Jones Story is a 2-minute screening procedure proposed to measure problem solving by asking patients to explain an absurd proposition. The authors used this screen to help them classify 155 patients as cognitively impaired or unimpaired based on a full neuropsychological evaluation. Overall, the total score on the Frank Jones Story was a good predictor of intact functioning for patients that were unimpaired but was poor at predicting cognitive dysfunction. However, various subscores of the test reflected differing patterns of sensitivity and specificity for cognitive impairment. These data suggest that the Frank Jones Story might have some utility for initial screening for cognitive dysfunction.

Adult↗