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Biomedical subjects

Michael L Reed

Publications and source records attributed to Michael L Reed.

7 recordsLinked to original sources
PubMed2006

Validation of the Mood Disorder Questionnaire for bipolar disorders in adolescents.

OBJECTIVE: The study was designed to determine the validity of the Mood Disorder Questionnaire-Adolescent Version (MDQ-A) as a screening instrument for bipolar disorders (I, II, not otherwise specified, and cyclothymia) in an adolescent outpatient psychiatric population. METHOD: 104 adolescents and their parents completed the MDQ-A. Three versions of the MDQ-A were compared: (1) self report of symptoms by adolescent, (2) attributional report-how the adolescent believed teachers or friends would report his/her symptoms, and (3) parent report of adolescent's symptoms. DSM-IV diagnosis was made based upon the clinician-administered Schedule for Affective Disorders and Schizophrenia for School-Age Children-Present and Lifetime Version (K-SADS-PL), a semistructured diagnostic interview. MDQ-A items were summed, yielding a score for each adolescent ranging from 0 to 13 on each of the 3 MDQ-A versions. Each possible scoring threshold, in combination with co-occurrence of symptoms and behaviors and with moderate to serious problems caused by symptoms, was crossed with the results of the K-SADS-PL diagnostic interview to assess sensitivity and specificity. The study was conducted from April 2002 to September 2003. RESULTS: A score of 5 or more items on the parent version yielded a sensitivity of 0.72 and specificity of 0.81, which were superior to self and attributional versions. CONCLUSIONS: The MDQ-A completed by parents about their adolescents' symptoms may be a useful screening instrument for bipolar disorders in an adolescent psychiatric outpatient population.

Adolescent↗
PubMed2005

Prevalence of bipolar symptoms in epilepsy vs other chronic health disorders.

OBJECTIVE: To estimate the comparative prevalence of bipolar symptoms in respondents with epilepsy vs other chronic medical conditions. METHODS: The Mood Disorder Questionnaire (MDQ), a validated screening instrument for bipolar I and II symptoms, in conjunction with questions about current health problems, was sent to a sample of 127,800 people selected to represent the US adult population on selected demographic variables. A total of 85,358 subjects (66.8%) aged 18 or older returned the survey and had usable data. Subjects who identified themselves as having epilepsy were compared to those with migraine, asthma, diabetes mellitus, or a healthy comparison group with regard to relative lifetime prevalence rates of bipolar symptoms and past clinical diagnoses of an affective disorder. RESULTS: Bipolar symptoms, evident in 12.2% of epilepsy patients, were 1.6 to 2.2 times more common in subjects with epilepsy than with migraine, asthma, or diabetes mellitus, and 6.6 times more likely to occur than in the healthy comparison group. A total of 49.7% of patients with epilepsy who screened positive for bipolar symptoms were diagnosed with bipolar disorder by a physician, nearly twice the rate seen in other disorders. However, 26.3% of MDQ positive epilepsy subjects carried a diagnosis of unipolar depression, and 25.8% had neither a uni- nor bipolar depression diagnosis. CONCLUSION: Bipolar symptoms occurred in 12% of community-based epilepsy patients, and at a rate higher than in other medical disorders. One quarter were unrecognized.

Adolescent↗
PubMed2005

Use of health care services among persons who screen positive for bipolar disorder.

OBJECTIVE: This study examined patterns of diagnosis, consultation, and treatment of persons who screened positive for bipolar disorder. METHODS: An impact survey was mailed to a representative subset of 3,059 individuals from a large U.S.-population-based study that utilized the Mood Disorder Questionnaire (MDQ). RESULTS: Respondents who screened positive on the MDQ (reported the presence of seven of 13 symptoms of bipolar disorder, the co-occurrence of at least two symptoms, and moderate or severe symptom-related impairment) (N=1,167) had consulted a health care provider more often in the previous year than those who screened negative (reported six or fewer symptoms regardless of symptom co-occurrence or impairment) (N=1,283). Psychiatrists and primary care physicians failed to detect or misdiagnosed bipolar disorder among 53 percent and 78 percent of patients, respectively, who screened positive for bipolar disorder. The most commonly used psychotropic medications during the previous 12 months among those who screened positive were antidepressants alone (32 percent), followed by lithium and anticonvulsant mood stabilizers (20 percent), antidepressants in combination with other psychotropics (19 percent), hypnotics (19 percent), and antipsychotics (9 percent). In the preceding 12 months, respondents who screened positive on the MDQ had greater use of psychiatric hospitals, emergency departments, and urgent care centers and also had more outpatient visits to primary care physicians, psychiatrists, and alcohol treatment centers than those who screened negative. CONCLUSIONS: The results of this study suggest that bipolar disorder is an underdiagnosed and often inappropriately treated illness associated with significant use of health care resources.

Adolescent↗
PubMed2004

CD34-reactive trichodiscoma.

BACKGROUND: Trichodiscomas are rare hamartomas of the dermal portion of the hair disc, a specialized component of the perifollicular mesenchyme. They are usually found as asymptomatic multiple skin-colored papules on the face and extremities and may have an autosomal dominant inheritance pattern. However, a solitary variant has been described. CASE REPORT: A 78-year-old woman presented with a single, non-pigmented, firm papule on the left tip of the nose, measuring 3.5 mm in diameter. RESULTS: The histological examination revealed the previously described features of a trichodiscoma. The immunohistochemical analysis showed strong immunoreactivity for CD34 in the spindle cell component. Spindle cells were negative for S-100, HMB-45, Melan-A, EMA, neurofilament, desmin, and Factor XIIIa by immunohistochemistry. CONCLUSIONS: We report strong reactivity for CD34 in the spindle cell component of a trichodiscoma. We suggest that this lesion be considered in the differential diagnosis of any CD34+ dermal spindle cell proliferation, in which an adjacent epithelial component cannot be entirely excluded.

Aged↗
PubMed2004

Impact of depressive symptoms compared with manic symptoms in bipolar disorder: results of a U.S. community-based sample.

OBJECTIVE: In the present study, we assessed the functional impact of depressive versus manic symptoms in bipolar disorder. METHOD: A survey comprising the Sheehan Disability Scale (SDS), the Social Adjustment Scale Self-Report (SAS-SR), the Mood Disorder Questionnaire (MDQ), and other questions was mailed to a representative subset of 4810 individuals (with or without bipolar disorder) from a U.S. population-based epidemiologic study conducted in 2001. RESULTS: Of the 3191 evaluable surveys returned, 593 respondents screened positive for bipolar disorder on the MDQ and/or reported a physician diagnosis of bipolar disorder. In the 4 weeks prior to the survey, subjects reported a mean of 12.4 days of depressive symptoms and 7.0 days of manic symptoms (p < .0001). The majority of days with depressive (79.8%) and manic (77.1%) symptoms were disruptive. Both total and mean scores on each domain of the SDS (work, social life, family life) reflect significantly greater impairment because of depressive versus manic symptoms during the 4 weeks prior to the survey (p < .0001). Among the 118 employed subjects who missed at least 1 day of work in the past month, more workdays were missed because of depressive versus manic symptoms (0.78 vs. 0.15, p < .004). For each domain of the SAS-SR, functional impairment was attributed significantly more often to depressive symptoms than manic symptoms (p < .0001). Similar results were observed for the 12 months preceding the survey. CONCLUSIONS: Self-reported depressive symptoms are more frequent than manic symptoms and cause greater disruption of occupational, family, and social functioning. These findings underscore the need to improve the recognition and management of bipolar depression.

Adolescent↗
PubMed2002

Vitrification of human blastocysts using the cryoloop method: successful clinical application and birth of offspring.

PURPOSE: The purpose was to investigate vitrification of human blastocysts using the cryoloop. METHODS: Thirteen couples elected to have blastocysts cryopreserved via vitrification (N = 54 blastocysts). Embryos were exposed to two vitrification solutions, pipetted onto the cryoloop then plunged into liquid nitrogen. On the day of embryo replacement, blastocysts were warmed by passage through three dilution media, and rinsed into culture medium. RESULTS: Four couples returned for cryopreserved embryo replacement. Fifteen blastocysts were warmed; all 15 (15/15; 100%) were recovered. Fifteen (15/15; 100%) blastocysts were deemed viable, and 13 were replaced. Two replacements did not result in pregnancy; one resulted in clinical pregnancy with a blighted ovum; one resulted in clinical pregnancy with the live, term birth of a healthy male infant. Two of 13 embryos implanted yielding an implantation rate of 15.4%. CONCLUSIONS: These preliminary data suggest that blastocysts can be successfully vitrified using the cryoloop method.

Blastocyst↗