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Biomedical subjects

Michael Serby

Publications and source records attributed to Michael Serby.

10 recordsLinked to original sources
PubMed2005

A 10-item smell identification scale related to risk for Alzheimer's disease.

University of Pennsylvania Smell Identification Test data from control subjects (n = 63), patients with mild cognitive impairment (n = 147), and patients with Alzheimer's disease (n = 100) were analyzed to derive an optimal subset of items related to risk for Alzheimer's disease (ie, healthy through mild cognitive impairment to early and moderate disease stages). The derived 10-item scale performed comparably with the University of Pennsylvania Smell Identification Test in classifying subjects, and it strongly predicted conversion to Alzheimer's disease on follow-up evaluation in patients with mild cognitive impairment. Independent replication is needed to validate these findings.

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PubMed2004

Depression in autopsy-confirmed dementia with Lewy bodies and Alzheimer's disease.

Depression has frequently been cited as a manifestation of dementia with Lewy bodies (DLB). Previous studies have suggested an increase of depression in patients with DLB, compared to those with Alzheimer's disease (AD). The purpose of this study was to examine depressive symptomatology in nursing home residents, from a consecutive series of DLB (n=16) and AD (n=39) autopsy-confirmed cases. Subjects received standard neuropathological analysis and postmortem chart review for clinical assessment of depression. Depressive symptomatology did not differ between the AD and DLB groups, and there was no significant relationship between depression and cortical or subcortical Lewy body (LB) count in the locus ceruleus or substantia nigra. This study suggests that the presence or absence of depression cannot be used to distinguish between AD and DLB. Furthermore, depressive symptomatology in DLB does not appear to be related to severity of cortical or subcortical LB pathology.

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PubMed2003

Methylphenidate-induced obsessive-compulsive symptoms in an elderly man.

An 82-year-old man with treatment-resistant depression and early Alzheimer's disease was started on methylphenidate. Significant obsessive-compulsive behavior ensued but diminished over several weeks when methylphenidate was replaced by fluvoxamine. The patient had no prior psychiatric history, but he had a sister with obsessive-compulsive disorder. It appears that methylphenidate precipitated the patient's pathological behavior.

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PubMed2003

Psychiatric resident conceptualizations of mood and affect within the mental status examination.

OBJECTIVE: To explore the ways in which psychiatry residents conceptualize the terms "mood" and "affect," a 14-item questionnaire was sent to residency programs in New York. METHOD: The questions consisted of possible definitions of mood and affect; all questions required a "true" or "false" response. Residents (N=99) were asked how they viewed mood and affect from a temporal perspective (i.e., sustained versus momentary) and in terms of an objective-subjective (or external-internal) dichotomy. RESULTS: There were inconsistencies in the temporal view of mood (said to be sustained by 60.6% and momentary by 50.5%) and affect ("pervasive" by 26.3% and "momentary" by 66.3%). Residents overwhelmingly defined mood as being subjective and internal and affect as being objective and external. CONCLUSIONS: If mood and affect are to be viewed from both perspectives, psychiatrists must infer the enduring internal emotional tone (mood) of a patient over an entire interview.

Affect↗
PubMed2003

Overview: depression in the elderly.

Depression in the elderly population is a major public health problem. It has a high prevalence, is frequently co-morbid with medical illnesses, impacts negatively on quality of life, increases the number of visits to different medical services, and carries a high risk of suicide, especially in men. Imaging studies have increased our understanding of the biological mechanisms of depression in the elderly. Depression is sometimes difficult to diagnose in the elderly. It should be differentiated from apathetic states ( negative syndrome ), and its treatment requires knowledge of specific physiological changes that occur in this age group. Geriatric depression is more somatic and less ideational than depression in other age groups. Acute treatments with various antidepressant medications, augmentation strategies, electroconvulsive treatments, and psychotherapy must be coupled with maintenance strategies to prevent recurrences, which are common.

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PubMed2002

Characterizing affective instability in borderline personality disorder.

OBJECTIVE: This study sought to understand affective instability among patients with borderline personality disorder by examining the degree of instability in six affective domains. The authors also examined the subjective intensity with which moods are experienced and the association between instability and intensity of affect. METHOD: In a group of 152 patients with personality disorders, subjective affective intensity and six dimensions of affective instability were measured. The mean scores for lability and intensity for each affective domain for patients with borderline personality disorder were compared with those of patients with other personality disorders through analyses that controlled for other axis I affective disorders, age, and sex. RESULTS: Greater lability in terms of anger and anxiety and oscillation between depression and anxiety, but not in terms of oscillation between depression and elation, was associated with borderline personality disorder. Contrary to expectation, the experience of an increase in subjective affective intensity was not more prominent in patients with borderline personality disorder than in those with other personality disorders. CONCLUSIONS: By applying a finer-grained perspective on affective instability than those of previous personality disorder studies, this study points to patterns of affective experience characteristic of patients with borderline personality disorder.

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PubMed2002

Length of psychiatry clerkships: recent changes and the relationship to recruitment.

The authors assessed the extent of change in the length of psychiatry clerkships in U.S. medical schools from 1995-1996 to 1998-1999 and explored the relationship between clerkship length and percentage of medical students choosing psychiatry as a career. Data from 124 U.S. medical schools over 4 years included clerkship length in weeks and percentage of graduating students entering psychiatry residencies. Fifteen schools sustained reductions in rotation length; the mean clerkship measured in weeks decreased for the entire sample from 6.27 to 6.04 (t=3.086, P<0.003). There was no significant correlation between clerkship length and recruitment into psychiatry. There appears to be a trend toward shorter psychiatry clerkships in recent years; however, there is no demonstrable relationship between length of clerkship and medical student interest in psychiatry as a career.

Journal Article↗
PubMedDate not supplied

Cognitive burden and excess Lewy-body pathology in the Lewy-body variant of Alzheimer disease.

OBJECTIVES: Authors compared the degrees of cognitive deficit among individuals with Alzheimer disease (AD), the Lewy-body variant of AD (LBV), and "pure" dementia with Lewy bodies (DLB); and compared cortical Lewy body (LB) counts in LBV versus DLB and neuritic plaque and neurofibrillary tangle severity in LBV versus AD. METHODS: Authors examined brain specimens from consecutive autopsies of elderly nursing home subjects. Numbers and densities of plaques, Lewy bodies, and tangle severity were determined in multiple cortical regions, and demographic and clinical variables were compared among the three groups. RESULTS: The three groups did not differ in demographic or clinical variables. The LBV group was significantly more impaired than the other groups. Cortical LB counts were significantly higher in LBV than in DLB. There was no evidence of increased plaque or tangle severity in LBV than in AD. CONCLUSION: The co-occurrence of AD and LB pathology is associated with higher numbers of LBs and more severe dementia than when classical AD or LB lesions occur alone.

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