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Biomedical subjects

P Stokes

Publications and source records attributed to P Stokes.

17 recordsLinked to original sources
PubMed1991

Suicidal behavior and hypothalamic-pituitary-adrenocortical axis indices in child psychiatric inpatients.

Studies of adults have reported associations between suicidal behavior and hypothalamic-pituitary-adrenocortical (HPA) axis functioning, but these associations were inconsistent. Very few studies of prepubertal children evaluating these relations exist. This study of 49 prepubertal psychiatric inpatients evaluates associations between suicidal behavior and predexamethasone and postdexamethasone plasma cortisol levels shortly after hospital admission and 7 weeks later. Results suggest that associations between suicidal behavior and plasma cortisol levels are independent of diagnosis. Covariation of predexamethasone and postdexamethasone plasma cortisol levels with major depression was associated with severity of suicidal behavior. Implications of these results for childhood suicidal risk are discussed.

Child↗
PubMed1989

Psychopathology and plasma cortisol responses to dexamethasone in prepubertal psychiatric inpatients.

This study of 51 prepubertal psychiatric inpatients evaluates plasma cortisol measurements at 8 AM, 4 PM, and 11 PM before and after dexamethasone was administered in counterbalanced order at doses of 0.5 mg and 1.0 mg. Approximately 76.5% of the children had an affective disorder. Major depressive disorder was associated with higher plasma cortisol levels than other disorders. Pre- and postdexamethasone plasma cortisol levels using 0.5 mg dexamethasone exhibited a circadian variation. The optimal criterion for cortisol nonsuppression was 5 micrograms/dl measured at 8 AM after administration of 0.5 mg dexamethasone.

Child↗
PubMed1989

Cognitive functioning in depression.

Verbal learning and memory, and recognition of famous faces, were assessed in 21 non-demented inpatients with RDC endogenous depression. Severity of depression was related to attention span, and patient age was related to measures of learning and recall. However, even in this severely depressed sample, verbal learning/memory measures were not below normative values. Facial recognition was significantly impaired relative to test norms. The results suggest that mild impairment in the early stages of verbal information encoding, and more marked impairment in the recognition of famous faces, may be associated with depression. These impairments differ from the cognitive changes associated with aging.

Age Factors↗
PubMed1987

Catecholamine metabolism and disposition in healthy and depressed subjects.

Depressed patients as a group have been found to excrete greater amounts of catecholamines (CAs) and metabolites than healthy control subjects, but these differences were not uniform for all metabolites. Patients may differ from controls in the metabolism and/or disposition of CAs. We analyzed the suggested metabolic-dispositional differences by determining 24-hour urine values for norepinephrine (NE), epinephrine (E), normetanephrine (NM), metanephrine (M), vanillylmandelic acid (VMA), and 3-methoxy-4-hydroxyphenylglycol (MHPG). For each subject, we calculated ratios of CAs or metabolites to an estimate of CA synthesis and determined ratios of CAs and metabolites to each other based on a precursor-product paradigm. The results indicate that as a group, patients have modestly but significantly greater CA synthesis rates than controls; patients excrete disproportionately more NE and E and disproportionately less MHPG relative to estimated CA synthesis, as well as other metabolites, than do controls; in contrast to NE, E, and MHPG, the increased NM, M, and VMA excretion rates by patients are proportional to each other as well as to the increase in CA synthesis; and the differences in NE, E, and metabolite excretion in the patients as a group are due principally to unipolar rather than bipolar depressives. The differences would be expected if patients, relative to controls, released more NE and E into the circulation. These data indicate the need to measure several CAs and metabolites when evaluating differences between groups since the significance of any given metabolite value needs to be examined in the context of total CA and metabolite production and excretion.

Adult↗
PubMed1986

Patterns of melatonin rhythms in depression.

The nocturnal rise of melatonin in serum of humans is the result of endogenously released norepinephrine (NE) acting upon beta-adrenergic receptors of the pineal gland. As there is much interest in the possibility of there being changes in the function of beta-receptors in depressed patients, the nocturnal rise of melatonin was measured in depressives and healthy control subjects. In one study, multiple serum samples were taken between 4.30 p.m. to 7.30 a.m. in seven male depressed patients with melancholia and five healthy male control subjects. The melancholic patients had a significantly reduced nocturnal elevation of melatonin. In a separate study, serum samples were taken at 8 a.m. and 11 p.m. in melancholic depressives, non-melancholic depressives and healthy control subjects. The melancholic patients had a significantly lower concentration of melatonin at 11 p.m., but not at 9 a.m., than that measured in either the control subjects or the non-melancholic depressed patients. These results are similar to those found recently by several other groups of investigators. Further research is indicated to elucidate mechanism(s) responsible for this phenomenon.

Adult↗
PubMed1979

Dissimilar effects of lithium isotopes on motility in rats.

Male Wistar rats were injected twice daily with chlorides of pure lithium isotopes, either Li-6 or Li-7. While both salts decreased mobility, the salt of Li-6 initially produced a more profound effect than the salt of Li-7. This differential effect of the isotopes proved to be time dependent and was most evident on the third day of treatment. Li-6 is likely to become a valuable tool in basic psychopharmacological research. It may possess therapeutic and/or toxic properties that are different from those of lithium salts currently used in treatment of mania.

Animals↗
PubMedDate not supplied

The usefulness of DST in predicting response to antidepressants: a placebo-controlled study.

Seventy-two out-patients, 55 years or older, suffering from major depression were treated with either nortriptyline or phenelzine for seven weeks under placebo-controlled double-blind conditions. The dexamethasone suppression test (DST) was administered at baseline and at weeks 3 and 7 of treatment, and its usefulness in predicting and/or paralleling clinical response was examined. No correlation was found between baseline DST results and treatment response with antidepressants. Of 13 patients whose abnormal baseline DSTs normalized during treatment, six were responders and seven were nonresponders (P = 0.24). However, all (seven) patients whose DSTs persisted to be abnormal throughout the seven weeks did not respond. The authors conclude that the DST has not been shown to have practical value as an indicator of impending recovery from major depression in the elderly, but its failure to normalize may have ominous prognostic significance.

Aged↗
PubMedDate not supplied

Cortisol measures in primary major depressive disorder with hypersomnia or appetite increase.

Morning plasma cortisol response to the 1 mg dexamethasone suppression test along with cortisol levels in blood, cerebrospinal fluid (CSF), and urine were measured in hospitalized male and female patients with primary major depressive disorder who reported hypersomnia (n = 23), or increase in appetite (n = 22). Comparisons were drawn to cortisol levels in patients with primary major depressive disorder who did not report hypersomnia or appetite increase (n = 23) and to normal controls (n = 23), all age- and sex-matched. Depressives with hypersomnia or increased appetite showed higher than normal 24-h urinary free cortisol concentrations. Depressed patients without hypersomnia or appetite increase had in addition to elevated free urinary cortisol concentrations higher than normal morning plasma cortisol levels before and after dexamethasone administration and a higher incidence of cortisol non-suppression after dexamethasone compared to normal subjects. The findings provide preliminary evidence that HPA activation in depression is diminished in the presence of hypersomnia and/or an increased appetite. Studies of the hypothalamic-pituitary-adrenal axis may be useful for differentiating subtypes of depression characterized by hypersomnia or enhanced appetite.

Adult↗
PubMedDate not supplied

Beneficial effects of fasting and low carbohydrate diet in D-lactic acidosis associated with short-bowel syndrome.

A case of D-lactic acidosis in an 18-yr-old man with a short bowel is reported. The diagnosis, suspected on clinical grounds, was confirmed by serum and urine levels of D-lactate. Our studies revealed that an ad libitum diet was associated with elevated D-lactate levels and "nothing per oral" and 10% carbohydrate diet regimens caused a drop in D-lactate levels. We recommend npo and low carbohydrate diet as preferred alternatives to antibiotics in some patients with D-lactic acidosis. The literature is reviewed.

Acidosis↗