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Biomedical subjects

M Kovacs

Publications and source records attributed to M Kovacs.

At least 19 recordsLinked to original sources
PubMed1992

Difficulties in diagnosing manic disorders among children and adolescents.

Four factors are delineated that account for the difficulties in identifying and diagnosing manic disorders among children and adolescents. These factors are the low base rate of the disorder, its variable clinical presentation within and across episodes, its symptomatic overlap with more common disorders of childhood, and the constraints placed on symptom expression by the developmental stage of a child. Each of these factors is discussed in terms of its impact on the likelihood of recognizing mania, and strategies are proposed to improve diagnostic accuracy.

Adolescent↗
PubMed1992

Prevalence and predictors of pervasive noncompliance with medical treatment among youths with insulin-dependent diabetes mellitus.

School-age children were assessed longitudinally for up to 9 years, after the onset of their insulin-dependent diabetes mellitus (IDDM), to determine the time-dependent risk of the psychiatric diagnosis of noncompliance with medical treatment and to examine protective and risk factors. The cumulative risk for this diagnosis over the 9 years was .45. Noncompliance tended to emerge in middle adolescence and was found to be protracted. Social competence, self-esteem, and aspects of family functioning at IDDM onset and initial psychiatric status did not predict noncompliance. However, noncompliance was associated with having major psychiatric disorder later in the course of IDDM.

Adaptation, Psychological↗
PubMed1991

Cognitive and social cognitive development of depressed children and adolescents.

Depressed juveniles show evidence of functional impairment in various cognitive and social domains. Actual school performance seems to be more consistently affected by depression than cognitive and intellectual abilities. In addition, depressed youth appear to be less socially adept than nondepressed peers, although depression does not consistently impair social-cognitive abilities. Indications that depressed youth show mild declines in tested verbal performance over time and that residual problems in social functioning persist after symptomatic recovery suggest that major depression may have negative effects on development in childhood.

Adolescent↗
PubMed1990

Measurement of DNA and antigen expression of live cells using three fluorochromes and two detectors.

In a multiparameter flow cytometric study, the fluorescence from the two different dyes fluorescein and dansyl-lysine were detected in the same spectral interval on the same photomultiplier tube, using two lasers to excite the fluorochromes at two separate laser foci. The two signals were split by a T-cable at the output of the photomultiplier tube and synchronized by delaying the first signal. Dansyl-lysine binds to the membrane of heat-inactivated cells and was used to distinguish between live and dead cells after a hyperthermic treatment. By gating on the dansyl-lysine signal, the DNA distribution and surface antigen expression of live and dead cells were obtained separately, using Hoechst 33342 and a monoclonal antibody conjugated to fluorescein.

Animals↗
PubMed1990

Psychological functioning among mothers of children with insulin-dependent diabetes mellitus: a longitudinal study.

Mothers of children with newly diagnosed insulin-dependent diabetes mellitus (IDDM) were assessed repeatedly over a period of 6 years in order to determine the psychological correlates of managing this chronic illness. Both maternal depression and overall emotional distress after the 1st year of the IDDM increased slightly with illness duration and were also influenced by other factors. Mothers' adjustment shortly after their children were diagnosed with IDDM was a strong predictor of their long-term emotional symptomatology. However, mothers' symptoms over time were not related to medical aspects of IDDM (i.e., the extent of the children's metabolic control, number of rehospitalizations, or their compliance with the medical regimen) and were also unrelated to the levels of depression or anxiety reported by their children. Mothers generally found it easier to cope with the IDDM the longer their children had the illness. However, the degree to which mothers perceived the IDDM to be bothersome or difficult to manage at any given point in time was associated with their overall levels of emotional distress.

Adaptation, Psychological↗
PubMed1990

Psychological functioning of children with insulin-dependent diabetes mellitus: a longitudinal study.

Assessed school-age youth repeatedly over the first 6 years of their insulin-dependent diabetes mellitus (IDDM) to determine self-perceived psychological adjustment. After the first year of IDDM, Ss exhibited a mild increase in depressive symptoms. Anxiety decreased for boys but increased for girls over the duration of IDDM. In contrast, self-esteem remained stable regardless of rehospitalizations or degree of metabolic control. Ss' adjustment shortly after IDDM onset, as reflected by levels of depression, anxiety, and self-esteem, were predictors of later adjustment. In general, Ss found the implications of IDDM more upsetting and the regimen more difficult with time, and girls were more upset by their illness than boys. The degree to which children were upset by the implications and management of IDDM varied as a function of their anxiety and depression.

Adaptation, Psychological↗
PubMed1989

Depressive disorders in childhood. IV. A longitudinal study of comorbidity with and risk for anxiety disorders.

As part of a longitudinal nosologic study of major depressive disorder (MDD), dysthymic disorder (DD), and adjustment disorder with depressed mood (ADDM) in a school-age cohort, we examined the prevalence and clinical consequences of comorbid anxiety disorders. We also estimated the risk of a first anxiety disorder and examined its predictors. Of 104 cases, 41% had anxiety disorders in conjunction with their index depression, which was more likely with MDD and DD than with ADDM. The age-corrected risk of a first anxiety disorder was 0.47 up to age 18 years. Separation-anxiety disorder was the most frequent diagnosis of anxiety, followed by overanxious disorder of childhood. Among the MDD cases with comorbidity, the anxiety disorder preceded the depression about two thirds of the time and often persisted after the depression remitted. The effect of comorbid anxiety disorder on the length of index MDD depended on the presence of other clinical features, but it did not seem to affect the risk of subsequent MDD or the course of DD or ADDM. Concurrent maternal psychopathology and poor physical health increased the risk of anxiety disorder in the children, but a history of prior separation from parental figures did not seem to have an effect.

Adjustment Disorders↗
PubMed1989

Affective disorders in children and adolescents.

Recent developments in the classification, description, and empiric study of affective disorders and related syndromes in the preadult years are highlighted. Because the bulk of extant work concerns the depressions, manic disorders are discussed only briefly. Major trends are summarized under three headings: psychiatric and diagnostic (nonbiologic) studies; hypothesis-testing and causal-explanation studies; and studies of developmental psychopathology. There is compelling evidence from a variety of sources that affective disorders among children and adolescents are more persistent than hitherto thought and have numerous negative associated features and consequences. The findings are discussed in light of the methodologic and conceptual problems that beset research in this area. Future research directions are indicated, among which the following deserve particular consideration: investigations of the long-term consequences of juvenile-onset affective disorders, further work on the logic of psychiatric classification to facilitate resolution of diagnostic dilemmas, expansion or revision of theories of depression to take into account issues and psychologic mechanisms specific to children and adolescents, further psychometric work with attention to developmental processes that constrain methods of assessment, and design and testing of innovative treatment and remediative approaches to juvenile-onset affective disorders.

Adolescent↗
PubMed1989

Family functioning and metabolic control of school-aged children with IDDM.

The relationship of two aspects of family life to metabolic control were examined as part of a longitudinal study of school-aged children with newly diagnosed insulin-dependent diabetes mellitus (IDDM). Glycosylated hemoglobin level was the primary index of metabolic control; weight-adjusted insulin dosage served as an indirect index. Neither the quality of family life nor aspects of the parents' marriage predicted the child's metabolic control over the next 3-4 mo, and they were also unrelated to concurrent weight-adjusted insulin dosage. Longitudinal data spanning a 6-yr period of the child's diabetes also failed to reveal an association between aspects of family life and metabolic control. The significance of the findings are discussed in light of the sample's characteristics and possible methodological constraints.

Adult↗
PubMed1988

An evaluation of intravenous, subcutaneous, and in vitro activity of new agmatine analogs of growth hormone-releasing hormone hGH-RH (1-29)NH2.

The effects of new Agmatine (Agm) analogs of human growth hormone-releasing hormone (GH-RH) were compared to GH-RH (1-29)NH2 and to (D-Ala2)GH-RH(1-29)NH2 after intravenous (IV) and subcutaneous (SC) administration to pentobarbital-anesthetised male rats and in vitro using superfused rat pituitary cell system. After IV administration, the analogs: (D-MeAla2,Nle27)GH-RH(1-28)Agm(JG-75), (desamino-Tyr1,D-Ala2,Nle27)GH-RH(1-28)Agm(JG-77), (D-Ala2,Nle27)GH-RH(1-28)Agm(JG-73) and (D-Ala2)GH-RH(1-29)NH2 showed a potency 2.6-3.9 times greater than GH-RH(1-29)NH2 at 5 min and 1.6-2.7 times higher at 15 min. After SC administration these analogs were 30-74 times more potent than GH-RH(1-29)NH2. The ratio between the IV and SC GH-releasing activity of the analogs ranged from 2 to 5, while GH-RH(1-29)NH2 was about 50 times more active IV than SC. This indicates that 20-50% of the analogs can be absorbed from SC tissues, but only 2% of GH-RH(1-29)NH2. The in vitro activity of the agmatine analogs on GH release closely paralleled their IV potency and was 2.8-3.9 times greater than that of GH-RH(1-29)NH2. No significant difference in potency was found between (D-Ala2)GH-RH(1-29)NH2 and JG-75 after IV administration and in vitro, although JG-75 contained only 28 amino acids. We conclude that the reason for the large discrepancies between the previously reported activities of (D-Ala2)GH-RH(1-29)NH2 was simply due to the different ways of administration of this analog, SC vs IV, and not to species specificity. The replacement of Arg29 by Agmatine in (D-Ala2,Nle27)GH-RH(1-29)NH2 causes a 3 fold increase in SC potency, but the replacement of D-Ala2 with D-MeAla2 reduces the SC, but not the IV and in vitro activity in half.

Agmatine↗
PubMed1979

Drug abuse, hopelessness, and suicidal behavior.

This study focused on assessing variables which may differentiate suicidal drug abusers from nonabusers. Data from a sample of drug abusing (n = 86) and nonabusing (n = 298) suicide attempters were subjected to a stepwise multiple regression analysis to identify factors related to suicidal intent. The analysis revealed that in our sample of suicide attempters, drug abuse status was not a significant contributor to the severity of suicidal intent. However, it was found that hopelessness accounted for a significant proportion of the variance of intent. The findings suggest that hopelessness among drug abusers, an important determinant of suicidal behavior, presents an important target for therapeutic intervention.

Adolescent↗
PubMed1978

Maladaptive cognitive structures in depression.

According to the cognitive view, the individual's negative and distorted thinking is the basic psychological problem in the depressive syndrome. The distorted cognitions are supported by maladaptive cognitive schemata, which involve immature "either-or" rules of conduct or inflexible and unattainable self-expectations. These schemata are probably acquired early in development and, if uncritically carried into adulthood, serve to predispose the individual to depression. Since these schemata are long-term identifiable psychological patterns that influence attitude and behavioral responses, they may constitute a cognitive dimension of the depression-prone individual's personality. The authors discuss the treatment implications of the cognitive approach to depression.

Attitude↗
PubMed1977

The wish to die and the wish to live in attempted suicides.

The internal struggle hypothesis of suicidal behavior suggests that suicidal individuals wish both to die and to live. To test this hypothesis, spearate self-ratings of the Wish to Die and the Wish to Live were obtained from 64 women and 42 men hospitalized for suicide attempts. The dependent variable was the severity of suicidal intent assessed by a quantitative instrument. The results indicate that 50% of the sample experienced internal debates over death and life, 40% wanted to die, and 9% wanted to live. Internal struggle over the issues of death and life was related to lower suicidal intent scores than a unidirectional motivation toward death. It also appeared that the actual magnitudes of death and life wishes were not as crucial to suicidal intent as the degree of congruence between them. However, two-way analysis of variance yielded only a significant Wish to Die main effect. The discussion centers on the heterogeneity of the sample's motivational stance and the therapeutic and empirical usefulness of the scales to identify ambivalent and monambivalent patients.

Adolescent↗
PubMed1976

The communication of suicidal intent. A reexamination.

Verbal expressions and nonverbal indicators of suicidal intent have been frequently regarded as pleas for rescue and help. We investigated the clinical and empirical significance of verbalizations of suicidal ideas, putting one's affairs in order, and previous suicide attempts as forms of "communication of suicidal intent." The patient sample consisted of 211 suicide attempters: 71 "communicators" and 140 "noncommunicators." The results indicated the following: (1) there is no clear evidence that verbal communication, final acts, and previous suicide attempts are justifiably labeled together as ways of communicating suicidal intent; (2) prior verbalization of suicidal ideation or intent bears little relationship to the extent of the wish to die experienced at the time of the suicide attempt; and (3) "talking" or "not talking" about suicidal plans may be a manifestation of personal style rather than an index of despair or hidden motives.

Communication↗
PubMed1975

Hopelessness and suicidal behavior. An overview.

The relation of hopelessness to levels of depression and suicidal intent was explored both psychometrically and clinically. The results of an investigation of 384 suicide attempters support previous reports that hopelessness is the key variable linking depression to suicidal behavior. This finding has direct implications for the therapy of suicidal individuals. By focusing on reducing the sources of a patient's hopelessness, the professional may be able to alleviate suicidal crises more effectively than in the past.

Adolescent↗
PubMed1975

Classification of suicidal behaviors: I. Quantifying intent and medical lethality.

Previous studies of attempted suicide have cast doubt on the value of assessing psychological intent. By identifying a moderating variable, namely, the attempter's preconceptions about the lethality of his act, the authors were able to solve the puzzle of the low correlations between intent and lethality. Suicidal intent correlates highly with medical lethality when the attempter has sufficient knowledge to assess properly the probable outcome of his attempt. The authors conclude that suicidal intent and medical lethality are useful dimensions in classifying suicidal behavior.

Attitude to Death↗