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Biomedical subjects

M Jenike

Publications and source records attributed to M Jenike.

8 recordsLinked to original sources

Long-term outcome of pediatric obsessive-compulsive disorder: a meta-analysis and qualitative review of the literature.

OBJECTIVE: To review the extant literature on the long-term outcome of child/adolescent-onset obsessive-compulsive disorder (OCD). METHOD: Medline and Psychlit databases were systematically searched for articles regarding long-term outcomes of child/adolescent-onset OCD. Meta-analysis regression was applied to evaluate predictors and persistence of OCD. RESULTS: Sixteen study samples (n = 6-132; total = 521 participants) in 22 studies had follow-up periods ranging between 1 and 15.6 years. Pooled mean persistence rates were 41% for full OCD and 60% for full or subthreshold OCD. Earlier age of OCD onset (z = -3.26, P = 0.001), increased OCD duration (z = 2.22, P = 0.027) and in-patient vs. out-patient status (z = 2.94, P = 0.003) predicted greater persistence. Comorbid psychiatric illness and poor initial treatment response were poor prognostic factors. Although psychosocial function was frequently compromised, most studies lacked comprehensive outcome measures. CONCLUSION: Long-term persistence of pediatric OCD may be lower than believed. Future studies should include broader measures of outcome including symptomatic persistence and functional impairment in multiple domains.

Adolescent↗

Women's strategies to alleviate nutritional stress in a rural African society.

Many agricultural populations are subject to chronic or seasonal undernutrition, reproductive women and children often being most vulnerable. This paper presents quantitative and qualitative data on food consumption, food distribution practices, food taboos, garden sizes and work effort to show how Lese horticulturalist women living in the Ituri Forest of northeast Democratic Republic of Congo attempt to alleviate nutritional stress. The Lese experience an annual hunger season when approximately one quarter of the population suffer from energy deficiency. Nutritional intake is also compromised by a complex system of food taboos against meat from wild forest animals. Anthropometric data collected over several years suggest that Lese women suffer from nutritional stress more than men during the hunger season. They also have more food taboos particularly during pregnancy and lactation. Their low fertility is compounded by nutritional stress. Despite these inequities, Lese women use several strategies to improve their food intake. Since they are responsible for all household cooking, they manipulate food portions. During the hunger season, they snack frequently, and increase their consumption of palliative foods. Women with more food taboos plant larger gardens to supplement their diet with vegetable foods. Although this results in their consumption of more daily protein, they work harder compared to women with smaller gardens. Women cheat in their adherence to specific food taboos by actively discounting them, or by eating prophylactic plants that supposedly prevent the consequences (usually illness) of eating tabooed foods. In addition, women resort to subterfuge to access desirable resources. Lese women do not reduce work effort during the hunger season, but adapt physiologically by reducing resting metabolic rates during periods of weight loss. These results point to the ability of Lese women to minimize the ecological and cultural constraints on their nutrition. More data, however, are required to assess the long-term effectiveness of these strategies.

Adult↗

Thyrotropin response to thyrotropin-releasing hormone in patients with dementia of the Alzheimer type.

Eleven patients with senile dementia of the Alzheimer type and 11 age-matched control subjects were given the thyrotropin-releasing hormone (TRH) test. The two groups did not differ with respect to peak thyrotropin (TSH) response or TSH levels at baseline, 20, 30, and 45 min after TRH injection. There were significant differences between the groups on Hamilton Depression Rating Scale scores (p < 0.03), although neither group met clinical criteria for depression. Items that were significantly different pertained to depressed mood, loss of interest, loss of insight, suicidal ideation, and obsessional symptoms.

Aged↗

Results of a double-blind placebo controlled trial of a new serotonin uptake inhibitor, sertraline, in the treatment of obsessive-compulsive disorder.

Eighty-seven patients with a DSM-III diagnosis of obsessive-compulsive disorder (OCD) without depression were entered into a double-blind, placebo-controlled study of the efficacy of sertraline, a new serotonin uptake inhibitor. After a 1-week washout period, patients were randomly assigned to receive either placebo or sertraline. After a 2-week titration period in which the once-daily sertraline dose was increased from 50 mg/day to a maximum of 200 mg/day, dosage was maintained until the end of the eighth week, then patients were titrated off medication over the next 2 weeks. Efficacy was measured by the Yale-Brown Obsessive-Compulsive Scale (Y-BOCS), NIMH General Obsessive-Compulsive Scale, Maudsley Obsessive Compulsive (MOC) Inventory, and Clinical Global Impressions (CGI) Severity and Improvement scales. Results on the MOC Inventory showed trends in favor of active drug that were not statistically significant compared with placebo. Results of the Y-BOCS total score, the NIMH score, and the global severity and improvement scores demonstrated a statistically significant superiority of sertraline compared with placebo.

1-Naphthylamine↗

Ergoloid mesylates and ECT.

Amnesia is the most common adverse effect among patients receiving electroconvulsive therapy. In a double-blind pilot study, patients receiving bilateral ECT were pretreated with ergoloid mesylates (N = 5) or placebo (N = 5). Consistent with the hypothesis that ergoloid mesylates might protect against ECT-associated amnesia, nonsignificant trends on some memory tests showed better performance for patients receiving active treatment. Unexpectedly, patients treated with ergoloid mesylates had a significantly better antidepressant response.

Amnesia↗

Physostigmine-induced myoclonus in Alzheimer's disease.

Physostigmine caused myoclonus in two patients with Alzheimer's disease during a clinical trial. Neither patient had myoclonus before or after physostigmine treatment. We hypothesize that physostigmine reduced the sensitivity of the remaining muscarinic receptors in these two patients, altering the interaction between cholinergic and either serotoninergic or dopaminergic neurotransmitter systems.

Acetylcholine↗

Use of psychostimulants in medically ill patients with neurological disease and major depression.

The effective therapeutic response to dextroamphetamine and methylphenidate by five depressed patients with neurological disease is described. In four of these patients tricyclic antidepressants had to be discontinued due to the concomitant deterioration of their cognitive functions, and in one case they were not used due to cardiovascular complications. There was a rapid remission of depressive symptomatology with no adverse side effects, consistent with the findings of other investigators. The possible association of right hemisphere strokes and depression is also discussed. Further evaluation of the therapeutic role of psychostimulants in the treatment of depressed patients with structurally-compromised brain function is recommended.

Aged↗