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Biomedical subjects

R A Weller

Publications and source records attributed to R A Weller.

At least 19 recordsLinked to original sources
PubMed1992

Depression and learning disabilities in children.

Occurrence of learning disabilities was determined in 30 inpatient children aged 6-12 with major depressive disorder (MDD). Learning disabilities (LD) occurred seven times more often compared to community base rates (33% v 4.7%). While rates of comorbid diagnoses, severity of depression, and children's and parents' reports (DICA-C, DICA-P) did not differ between groups, teachers' reports (TRS, TRF) indicated increased classroom problems and poorer adaptive functioning in MDD/LD subjects (P < 0.0001).

Child↗
PubMed1992

The Mania Rating Scale: can it be used in children? A preliminary report.

The Mania Rating Scale (MRS) was evaluated for use in prepubertal children. Eleven manic and 11 matched controls with attention-deficit hyperactivity disorder were examined. MRS scores were significantly higher in manic versus ADHD children (p less than 0.0001), while scores on hyperactivity rating scales (Conners-Parent and Teacher Forms) did not differ between groups. Most individual MRS item scores differed significantly between groups (p less than 0.05). MRS scores correlated significantly with severity of mania (Clinical Global Impression--Mania, r = 0.84; p less than 0.0001). Age, race, and sex were not correlated with MRS scores. The MRS may be useful in differentiating mania from ADHD and determining the severity of mania in prepubertal children.

Attention Deficit Disorder with Hyperactivity↗
PubMed1992

Comparison of fluorescent polarization immunoassay and radioimmunoassay in measuring cortisol levels in prepubertal depressed children.

Cortisol levels of 21 hospitalized prepubertal depressed children given the dexamethasone suppression test (DST) were measured by radioimmunoassay and by fluorescent polarization immunoassay, a new assay method. Correlation analyses demonstrated a highly significant linear relationship between the two methods of measuring cortisol. Thus, it may be possible to use fluorescent polarization immunoassay to measure cortisol levels in children undergoing the DST.

Age Factors↗
PubMed1991

Depression in recently bereaved prepubertal children.

OBJECTIVE: The purpose of this study was to ascertain depressive symptoms in recently bereaved prepubertal children and compare these symptoms with those of depressed prepubertal children. METHOD: The subjects were 38 children who had recently experienced the death of one but not both of their parents. They had to meet strict inclusion criteria so that the effects of bereavement per se, rather than other significant stressors, could be assessed. The comparison group consisted of 38 hospitalized, depressed children individually matched to each bereaved subject for age, sex, and socioeconomic status. All of the children underwent systematic and comprehensive evaluation. They and their parents were independently evaluated by trained interviewers using the parent and child versions of the Diagnostic Interview for Children and Adolescents. Family histories and basic demographic information were also obtained. RESULTS: The recently bereaved children endorsed many depressive symptoms. Thirty-seven percent of them met the DSM-III-R criteria for a major depressive episode. The depressed children, however, had more depressive symptoms on average than the bereaved children. The factors associated with increased depressive symptoms in the bereaved children were 1) the mother as the surviving parent, 2) preexisting untreated psychiatric disorder in the child, 3) family history of depression, and 4) high socioeconomic status. CONCLUSIONS: A considerable number of the bereaved children developed the clinical symptoms of a major depressive episode immediately after the death of a parent. The relation of these symptoms to the subsequent course of grief and to major depressive disorder remains unknown and should be studied further.

Adult↗
PubMed1990

Dexamethasone suppression test and depressive symptoms in bereaved children: a preliminary report.

Eighteen bereaved children and adolescents were assessed using the dexamethasone suppression test (DST) and the Diagnostic Interview for Children and Adolescents 4 weeks following parental death. Thirty-nine percent had a positive (nonsuppressed) DST. DST-positive subjects reported more DSM-III-R depressive symptoms (6.3 +/- 2.9 vs. 3.9 +/- 2.7, means +/- SD) than DST-negative subjects. Most frequently reported symptoms included dysphoria, loss of interest, sleep disturbance, appetite disturbance, psychomotor disturbance, and morbid and suicidal ideation. Post-dexamethasone cortisol levels were significantly correlated with the total number of depressive symptoms and suicidal ideation.

Adolescent↗
PubMed1989

DST status and blood chemistries in prepubertal children.

Cholesterol, sodium, potassium, and serum glucose were examined to determine if they could predict status on the dexamethasone suppression test (DST) in 59 depressed prepubertal psychiatric inpatients and 21 nondepressed psychiatric inpatients. Multivariate analyses found that none of these variables, alone or combined, were predictive of DST results.

Adolescent↗
PubMed1989

Plasma levels of imipramine and metabolites in 68 hospitalized children.

Steady-state plasma imipramine levels were measured in 68 hospitalized children. Interindividual variability (imipramine 12-fold; desipramine 72-fold; 2 hydroxyimipramine 33-fold; 2 hydroxydesipramine 3-fold) was not correlated with clinical or demographic variables. However, intraindividual levels were reproducible and were linearly correlated with dose (r = 0.76; p less than 0.005). Clinicians, by using plasma level monitoring, can rationally adjust dosages so that all patients will be in the optimum range, ensuring an adequate trial while avoiding supratherapeutic levels associated with cognitive toxicity.

Adolescent↗
PubMed1989

Imipramine treatment of trichotillomania and coexisting depression in a seven-year-old.

Trichotillomania is seen in normal children with a variety of psychiatric conditions (Krishnan, 1985). Although an association between depression and trichotillomania has been suggested in adults and adolescents (Krishnan, 1985), its association with DSM-III-R major depressive disorder in a prepubertal child has not been reported. Such a case of trichotillomania occurring with major depressive disorder is reported in this paper. In this prepubertal child, imipramine therapy led to remission of both disorders.

Child↗
PubMed1988

Improvement of tardive dyskinesia associated with electroconvulsive therapy.

This report describes a 54-year-old white woman who developed a persistent tardive dyskinesia after receiving neuroleptics for a manic episode. Although a variety of treatments were attempted, her tardive dyskinesia remained essentially unchanged for 5 years. It dramatically improved when she received electroconvulsive therapy for a depressive episode, however. This improvement has now been maintained for 14 months. Based on this observation, we suggest the use of electroconvulsive therapy in cases of persistent tardive dyskinesia that is unresponsive to treatment, if it is associated with a concurrent affective disorder requiring treatment.

Antipsychotic Agents↗
PubMed1988

Lithium treatment of manic episodes with psychotic features in prepubertal children.

The authors describe the manic symptoms, family psychiatric histories, and psychotic symptoms of 10 prepubertal children 6-12 years old who had a DSM-III diagnosis of manic episode with psychotic features. All of the children improved when treated with lithium alone. Improvement in both manic and psychotic symptoms was noted an average of 11 days after lithium administration was started.

Bipolar Disorder↗
PubMed1988

Neuroendocrine changes in affectively ill children and adolescents.

Depression in children has signs and symptoms similar to those observed in depressed adults. Neuroendocrine abnormalities have been consistently observed in depressed adults. Now, neuroendocrine abnormalities are beginning to be studied in depressed children and adolescents. Results of these studies should help clarify the relationship between depression in adults and in children. Careful psychiatric diagnosis is required for studies of the neuroendocrine concomitants of depression. When establishing a diagnosis of depression in children and adolescents, one must pay attention to differences in such variables as cognitive development. Studies of neuroendocrine functioning in depressed children are at an earlier stage than those in depressed adults. To date, most studies have centered on cortisol secretion, the DST, and GH. In general, studies of cortisol secretion (most of which utilize the DST) indicate that a majority of depressed children and adolescents have positive DSTs (that is, dexamethasone fails to suppress their cortisol secretion) and cortisol secretion appears to be increased. These findings are similar to those observed in adults. Results of GH studies are more mixed. Some studies found hypersecretion of GH in depressed children, whereas others found hyposecretion of GH in depressed children. The few studies of TRH stimulation of TSH and melatonin secretion have involved a small number of subjects and results must be considered preliminary.

Adolescent↗
PubMed1988

Neuroendocrine changes in affectively ill children and adolescents.

Depression in children has signs and symptoms similar to those observed in depressed adults. Neuroendocrine abnormalities have been consistently observed in depressed adults. Now, neuroendocrine abnormalities are beginning to be studied in depressed children and adolescents. Results of these studies should help clarify the relationship between depression in adults and in children. Careful psychiatric diagnosis is required for studies of the neuroendocrine concomitants of depression. When establishing a diagnosis of depression in children and adolescents, one must pay attention to differences in such variables as cognitive development. Studies of neuroendocrine functioning in depressed children are at an earlier stage than those in depressed adults. To date, most studies have centered on cortisol secretion, the DST, and GH. In general, studies of cortisol secretion (most of which utilize the DST) indicate that a majority of depressed children and adolescents have positive DSTs (that is, dexamethasone fails to suppress their cortisol secretion) and cortisol secretion appears to be increased. These findings are similar to those observed in adults. Results of GH studies are more mixed. Some studies found hypersecretion of GH in depressed children, whereas others found hyposecretion of GH in depressed children. The few studies of TRH stimulation of TSH and melatonin secretion have involved a small number of subjects and results must be considered preliminary.

Adolescent↗