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N Andreasen

Publications and source records attributed to N Andreasen.

49 records · Page 3Linked to original sources
PubMed1989

Bipolar affective disorder and high achievement: a familial association.

The authors studied 442 probands with nonbipolar major depression, 64 with bipolar II disorder, and 88 with bipolar I disorder. Although the proband groups did not differ in occupational or educational achievement, the first-degree relatives of probands with bipolar disorders had significantly higher mean levels of achievement than did those of probands with nonbipolar disorder. This pattern applied whether or not the relatives themselves had bipolar illness. The authors conclude that the socioeconomic advantage previously associated with affective disorder in general may be limited to the bipolar forms.

Achievement↗
PubMed1987

The antisocial and the nonantisocial alcoholic: clinical distinctions in men with major unipolar depression.

Depressed, alcoholic men were divided into those with and those without antisocial personality (ASP). The ASP alcoholics had a more severe, cross-sectional clinical picture; they had a higher rate of drug use disorder and more alcohol-related symptomatology. The medical complications of alcoholism were related to the duration of heavy drinking whereas the nonmedical complications (the psychosocial and pathologic-intake problems) were related to ASP, duration of heavy drinking, and their interaction.

Adult↗
PubMed1986

Structural abnormalities in the frontal system in schizophrenia. A magnetic resonance imaging study.

Thirty-eight schizophrenics and 49 normal controls underwent magnetic resonance imaging. Midline sagittal cuts indicated that the schizophrenics had significantly smaller frontal lobes, as well as smaller cerebrums and craniums. The findings are consistent with some type of early developmental abnormality that might retard brain growth and therefore skull growth. These findings are confirmed on a smaller sample of patients on whom we have coronal cuts. Decreased cerebral and cranial size are associated with prominent negative symptoms, although decreased frontal size is not. Decreased cranial and cerebral size was also associated with impairment on some cognitive tests. These findings are consistent with the hypothesis that some schizophrenics may have a type of early developmental abnormality associated with prominent negative symptoms and cognitive impairment. Further, the results suggest that schizophrenics may have a type of structural frontal system impairment. Thus, they provide anatomic evidence for the "hypofrontality hypothesis."

Adult↗
PubMed1985

Alcoholism in antisocial and nonantisocial men with unipolar major depression.

Men with primary and secondary unipolar major depression were divided into those with and without antisocial personality (ASP). The ASP depressives had a higher rate of alcoholism than the nonASP depressives, and among the nonASP depressives, those with drug abuse had a higher rate of alcoholism than those without drug abuse. The course of depression appeared to be related to the presence of nonaffective psychopathology. Depressed men with additional nonaffective disorders had fewer, but larger episodes than depressed men without, and depressed men with alcoholism had a higher risk of suicide. Our results confirm the close association of alcoholism and ASP and highlight the importance of recognizing nonaffective syndromes in the depressed patient.

Adult↗
PubMed1985

Bipolar I, bipolar II, and nonbipolar major depression among the relatives of affectively ill probands.

An earlier report described symptoms and background features in depressed probands grouped by polarity: bipolar I, bipolar II, and nonbipolar. The present study made similar comparisons among relatives with a lifetime history of major depression. The 73 relatives with bipolar II disorder had the highest rates of marital disruption, psychopathology in the previous month, nonserious suicide attempts, and nonaffective syndromes and were the youngest when first treated.

Adult↗
PubMed1984

A family study of bipolar II disorder.

Professional raters who were blind to proband diagnosis used the schedule for affective disorders and schizophrenia (SADS-L) and the Research Diagnostic Criteria (RDC) to evaluate 1,210 first-degree relatives of 327 probands with primary major depression, participating in the family sub-study of the NIMH Collaborative Study of the Affective Disorders--Clinical Branch. Bipolar II probands were significantly more likely to have bipolar II relatives than were non-bipolar or bipolar I probands. Bipolar II probands were slightly more likely than non-bipolar probands and slightly less likely than bipolar I probands to have relatives with bipolar I illness. Similar patterns have emerged in two other recently reported family studies of bipolar II illness. Taken together, these data suggest heterogeneity among patients with bipolar II depression. Some appear to be genotypes for bipolar I illness, while a small proportion may be genotypes for non-bipolar illness. A third group, of undetermined size, may breed true.

Adult↗
PubMed1983

The reliability of retrospective treatment reports.

High levels of agreement are reported for retrospective assessment of treatment history using the Longitudinal Interval Followup Evaluation Baseline (LIFE Base), a recently developed structured psychiatric interview, in a sample of 47 subjects with a moderate to severe affective disorder. In a paired rater/observer design with interviews conducted at five different research centers, most coefficients of reliability (Kappa) were above 0.91. This is the first published reliability study of treatment data and should be encouraging to practitioners and researchers. Future research aimed at assessing the validity of treatment information obtained from patient records and clinical interviews is recommended.

Adolescent↗
PubMedDate not supplied

Bipolar II. Combine or keep separate?

Data on prior course, characteristics of index episode, and familial aggregation of patients with bipolar II disorder is discussed. The data supports the separation of this condition from both bipolar I and recurrent unipolar disorder.

Adult↗
PubMedDate not supplied

The reliability of distinguishing primary versus secondary negative symptoms.

The objective appearance of negative symptoms in schizophrenia and other psychotic disorders may be a direct reflection of a primary neural abnormality or may be secondary to a variety of factors such as neuroleptic side effects, depression, positive symptoms, or environmental understimulation. Although there is a consensus that it is important to be able to disentangle "primary" versus "secondary" negative symptoms, optimal strategies for doing so remain unclear. Concerns have been raised about making this distinction based on clinical judgment because of potential low reliability in the absence of extensive training and/or highly specialized rating scales. This is particularly important in terms of the application of DSM-IV criteria for schizophrenia, in which negative symptoms play a prominent role. In the context of the DSM-IV schizophrenia field trial project, we examined the reliability of making the primary versus secondary distinction in a multicenter sample of 462 subjects with nonorganic psychotic disorders. Each subject was assessed by two raters, half in an interrater design (i.e., conjoint interviews) and half in a test-retest design (i.e., independent interviews by two raters conducted 1 day apart). All raters used the same semistructured interview instrument, which included an abbreviated version of the Scale for the Assessment of Negative Symptoms (SANS). In addition to the usual SANS ratings, raters were asked to indicate their judgment as to whether the symptom was primary, secondary, or unknown (inadequate information to assess). No formal training was provided. Reliability, as quantified by kapp, indicated only a fair degree of agreement ranging from 0.48 to 0.68 for interrater reliability (median, 0.50) and 0.34 to 0.66 for test-retest reliability (median, 0.38). Negative symptoms were rated as primary approximately twice as often as secondary, and raters believed they had adequate information to make this distinction based only on cross-sectional evaluation in all but 10% of the cases. These data suggest that the primary versus secondary distinction should not be incorporated into the application of operationalized diagnostic criteria. Implications are discussed in terms of balancing reliability and validity in the assessment of negative symptoms.

Adult↗