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Biomedical subjects

M J Garvey

Publications and source records attributed to M J Garvey.

At least 19 recordsLinked to original sources
PubMed1995

Relationship of generalized anxiety symptoms to urinary 5-hydroxyindoleacetic acid and vanillylmandelic acid.

Urinary levels of the serotonin metabolite 5-hydroxyindoleacetic acid (5-HIAA) and the norepinephrine metabolite vanillylmandelic acid (VMA) were measured in 45 patients with generalized anxiety disorder. Multiple regression analysis demonstrated that the severity of several anxiety symptoms was predicted by levels of 5-HIAA and VMA. These data are consistent with the proposal that serotonin and norepinephrine may be involved in the pathophysiology of anxiety.

Adult↗
PubMed1995

The association of urinary 5-hydroxyindoleacetic acid and vanillylmandelic acid in patients with generalized anxiety.

There is evidence that serotonin and norepinephrine are in some way involved in the pathophysiology of anxiety disorders. Urinary levels of the serotonin metabolite 5-hydroxyindoleacetic acid (5-HIAA) and the norepinephrine metabolite vanillylmandelic acid (VMA) were measured in 46 patients with generalized anxiety disorder. There was a significant association between urinary levels of 5-HIAA and VMA: r = 0.79; p = 0.0001. Possible implications of this finding are discussed.

Anxiety Disorders↗
PubMed1995

The association of the serotonin metabolite, 5-HIAA, to the lysosomal enzyme N-acetyl-beta-glucosaminidase.

Twenty-one medication-free patients with generalized anxiety disorder (GAD) collected urine samples for 5-hydroxyindoleacetic acid (5-HIAA) and N-acetyl-beta-glucosaminidase (NAG). Nine patients with no comorbid psychiatric diagnosis showed a significant association between 5-HIAA and NAG, r = -0.683, p = 0.04. The possibility that NAG could be a marker for serotonin metabolism is discussed.

Acetylglucosaminidase↗
PubMed1995

Association of NAG levels with specific psychiatric symptoms in unipolar patients.

The levels of N-acetyl-beta-glucosaminidase (NAG) from 57 unipolar patients were compared to the scores of symptom severity for nine symptom clusters derived from the Symptom Check List (SCL-90). The depression and hostility clusters were significantly associated with NAG levels. In a separate study of 21 unipolar patients, six out of 31 mood symptoms were significantly associated with NAG levels, as were two out of seven tested RDC depression subtypes. Serotonin abnormalities may play a role in the production of many of these symptoms. A hypothesis that NAG could be a marker for serotonin activity is discussed.

Acetylglucosaminidase↗
PubMed1994

Do depressed patients with higher pretreatment stress levels respond better to cognitive therapy than imipramine?

Forty-eight unipolar depressed patients were randomly assigned to 12 weeks of treatment with either imipramine (IMI) (n = 32) or cognitive therapy (CT) (n = 16). Prior to treatment assignment, all patients were rated for severity of a variety of psychosocial stressors. The interaction effect between pretreatment stress and type of treatment, CT or IMI, on symptom improvement was evaluated. We hypothesized that patients with greater pretreatment stress would respond better to cognitive therapy. Patients treated with either CT or IMI showed equivalent reductions of depressive symptoms. There was no interaction effect between pretreatment stress and type of treatment on improvement of depressive symptoms. Based on this preliminary study it does not appear that depressed patients with higher pretreatment levels of stress respond better to cognitive therapy than they do to imipramine.

Adult↗
PubMed1994

Are some symptoms of depression age dependent?

177 depressed patients were examined to see whether age was associated with the presence of specific symptoms or symptom clusters. 14 of the 39 tested variables were significantly associated with age. Patients age > or = 40 were more likely to have terminal insomnia, agitation, diurnal variation with lower mood in the morning and the RDC subtype diagnoses endogenous, incapacitated or agitated. Patients age < or = 39 were more likely to have hypersomnia, increased appetite, weight gain, decreased libido, headaches, diurnal variation with worsening of mood in the afternoon and a mood characterized as sad not anxious.

Adolescent↗
PubMed1994

Fine T-cell subsets in alcoholics as determined by the expression of L-selectin, leukocyte common antigen, and beta-integrin.

Alcoholics admitted to the hospital solely for detoxication have been studied by flow cytometry to evaluate changes in the surface markers of peripheral blood leukocytes. As we have shown previously, such patients have an elevated percentage of CD8hi lymphocytes that are HLA DR+; we now demonstrate that they also have striking alterations in the quantitative relationships of the fine T-cell subsets. Both CD4+ and CD8hi lymphocytes have a sharply reduced percentage of the L-selectin+ CD45RA+ subset, increased percentages of the CD45RA- subsets, and several other fine subset alterations. The fine subset profile suggests, according to current correlations of phenotype and function, that both CD4+ suppressor inducer and CD4-dependent CD8+ suppressor effector cells are reduced, whereas other subsets, including CD8+ CTL or their precursors, are increased in relative percentages. Some of the phenotypic changes are reversible over the several days following withdrawal. In other results, the percentage of CD8hi lymphocytes epxressing CD11b (beta-integrin) is shown to be reciprocal with the percentage expressing L-selectin both in normals and alcoholics. However, the regression function of CD11b vs. L-selectin on CD8hi cells is different for the alcoholics than for the normals, indicating an abnormality in the regulation of the expression of these two adhesion markers. Taken together, this abnormality of adhesion molecules and the fine subset alterations previously described indicate widespread changes in the peripheral lymphocytes of currently drinking alcoholics. These changes suggest functional deficiencies that may include alterations of lymphocyte traffic and other adhesion-dependent functions, and a shift in the balance of regulatory interactions.

Adult↗
PubMed1994

Relationship between 3-methoxy-4-hydroxyphenylglycol and suicide.

Urinary 3-methoxy-4-hydroxyphenylglycol (MHPG) levels in 53 depressed women were compared to current suicidal thoughts or activity. Comparisons were also made between MHPG and past suicide attempts, number of past attempts, and seriousness of the worst attempt. There was a weak trend for current but not past suicidality to be associated with decreased MHPG levels.

Adult↗
PubMed1994

The reliability of urinary 5-HIAA levels.

Examination of the serotonin metabolite, 5-hydroxyindoleacetic acid (5-HIAA), in the urine of psychiatry patients has generally not been used because the reliability of urinary 5-HIAA levels has been questioned. Thirty-seven generalized anxiety disordered patients collected two consecutive urines for measurement of 5-HIAA. The correlation of the 5-HIAA collections was r = 0.82, p = 0.0001.

Adult↗
PubMed1993

Association of levels of N-acetyl-beta-glucosaminidase with specific psychiatric symptoms in bipolar patients.

The levels of N-acetyl-beta-glucosaminidase (NAG) in urine from 35 patients with bipolar affective disorder were compared with scores for the 90 items (symptoms) of the Symptom Checklist (SCL-90). There were significant negative correlations between NAG levels and 23 of the SCL-90 variables (symptoms). These symptoms could be grouped into the following categories: anxiety, unusual or psychotic thinking, suicidal thinking, dysphoria, irritability, nausea, headaches, memory problems, and loss of interest. Serotonin abnormalities may play a role in the production of many of these symptoms. The hypothesis that NAG could be a marker for a serotonin activity is discussed.

Acetylglucosaminidase↗
PubMed1993

Identification of treatment-resistant depressives who respond favorably to carbamazepine.

Thirteen depressed patients with documented histories of failure to respond to tricyclic antidepressant medications who reported multiple partial seizure like symptoms were given open trials of carbamazepine. Eleven of the 13 showed moderate to substantial improvement in affective status that was accompanied by significant mean changes on the Beck or Hamilton depression scales. In addition, the mean number of reported partial seizure-like symptoms decreased significantly with treatment. Dichotic word listening performance was the only neuropsychological variable that was impaired at baseline and was also the only cognitive performance that improved following treatment. These preliminary observations suggest that there is likely to be a subgroup of treatment-resistant, carbamazepine-responsive depressives who can be identified by evaluating for the presence of multiple partial seizure-like symptoms.

Adult↗
PubMed1993

Panic disorder: guidelines to safe use of benzodiazepines.

Panic disorder is relatively common in older patients and may have serious consequences. The diagnosis is based on an accurate history of symptom onset and intensity. Symptoms include shortness of breath, dizziness, increased heart rate, trembling, and sweating. Effective treatment can be achieved with several kinds of medication, including benzodiazepines. Although physician and patient fears about benzodiazepines persist, panic-disordered patients with no history of drug abuse rarely develop substance dependence problems. Physical dependence occurs in a minority of patients and can be minimized by a slow tapering schedule. As with most medications, benzodiazepines need to be used with caution in older patients, who are more susceptible to adverse effects.

Aged↗
PubMed1992

Cognitive therapy and pharmacotherapy for depression. Singly and in combination.

Cognitive therapy and imipramine hydrochloride tricyclic pharmacotherapy, each singly and in combination, were compared in the treatment of nonpsychotic, nonbipolar depressed outpatients. One hundred seven patients were randomly assigned to 12 weeks of active treatment; 64 patients completed the full course of treatment. Rates of attrition were high but not differential. Cognitive therapy and pharmacotherapy did not differ in terms of symptomatic response, either in the primary analyses or in secondary analyses restricted to more severely depressed outpatients. Initial severity did predict response within pharmacotherapy alone, but not within cognitive therapy. Combining cognitive therapy with pharmacotherapy did not markedly improve response over that observed for either modality alone, although such nonsignificant differences as were evident did favor the combined treatment. Two patients died as a consequence of suicide attempts, both of which involved study medication.

Adolescent↗
PubMed1992

Differential relapse following cognitive therapy and pharmacotherapy for depression.

Patients successfully treated during a 3-month period with either imipramine hydrochloride pharmacotherapy, cognitive therapy, or combined cognitive-pharmacotherapy were monitored during a 2-year posttreatment follow-up period. Half of the patients treated with pharmacotherapy alone continued to receive study medications for the first year of the follow-up. All other patients discontinued treatment at the end of the acute treatment phase. Patients treated with cognitive therapy (either alone or in combination with medication) evidenced less than half the rate of relapse shown by patients in the medication--no continuation condition, and their rate did not differ from that of patients provided with continuation medication. It appears that providing cognitive therapy during acute treatment prevents relapse. Whether this preventive effect extends to recurrence remains to be determined.

Adolescent↗
PubMed1992

Generalized anxiety disorder vs. panic disorder. Distinguishing characteristics and patterns of comorbidity.

In order to examine the validity of the distinction between generalized anxiety disorder (GAD) and panic disorder (PD) we compared 41 subjects with GAD and 71 subjects with PD. The GAD subjects had never had panic attacks. In contrast to the symptom profile in PD subjects suggestive of autonomic hyperactivity, GAD subjects had a symptom pattern indicative of central nervous system hyperarousal. Also, subjects with GAD had an earlier, more gradual onset of illness. In terms of coexisting syndromes, GAD subjects more often had simple phobias, whereas PD subjects more commonly reported depersonalization and agoraphobia. GAD subjects more frequently had first-degree relatives with GAD, whereas PD subjects more frequently had relatives with PD. A variety of measures indicated that our GAD subjects had a milder illness than those with PD. Also, fewer GAD subjects gave histories of major depression than did PD subjects. Among GAD subjects, coexisting major depression was associated with simple phobia and thyroid disorders and among PD subjects, comorbid depression was associated with social phobia and hypertension. Our findings indicate that the separation of GAD from PD is a valid one. They also indicate that, within disorders, unique patterns of comorbidity may exist that are important both clinically and theoretically.

Adult↗
PubMed1992

Examination of pre- and posttreatment MHPG during cognitive therapy.

Sixteen unipolar depressed patients were treated with cognitive therapy for 12 weeks. Pretreatment 24-hour urinary MHPG levels were unable to predict treatment response. There was a nonsignificant trend for cognitive therapy responders to show a decrease in MHPG during treatment when compared to nonresponders.

Adult↗