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Biomedical subjects

R A Weller

Publications and source records attributed to R A Weller.

At least 55 records · Page 3Linked to original sources
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↗
PubMed1986

Clinical aspects of childhood depression.

Currently, major depressive episodes in children can be diagnosed using criteria similar to those for adult depression. Although symptoms appear similar to those seen in adult depression, differences in cognitive and language functioning compared to adults must be taken into account when assessing children. Recognition of depression and its presentation in children is essential in making an accurate diagnosis. Increased interest and improved methods of assessment and treatment should result in better care for depressed children and their families.

Child↗
PubMed1986

Tricyclic antidepressants in prepubertal depressed children: review of the literature.

Other studies have reported the use of TCA antidepressants in the treatment of depressed children (Frommer 1967; Ossofsky 1974; Stack 1972; Polvan and Cebiroglu 1972). However, these studies did not meet criteria for inclusion in this review. In studies, other medicines were given concurrently with TCAs. Several did not specify the number of subjects and/or the number who responded. Sometimes subjects who were not diagnosed as depressed were included. Also studies of childhood depression tend to include adolescents; thus many samples were a mixture of adolescents and prepubertal children with the adolescents frequently predominating. As the purpose of this review was depression in prepubertal children, only studies comprised predominantly of prepubertal children were included. Although not included in this review, many such studies reported TCAs were useful in treating depression in children. After reviewing these studies, it is obvious that their sophistication has improved dramatically in recent years. Standard diagnostic criteria such as Feighner's Research Diagnostic Criteria, the Research Diagnostic Criteria, and more recently DSM-III (all of which are similar) have permitted a more objective and standardized diagnosis of depression. Likewise, the development of the Children's Depression Inventory and the Childhood Depression Rating Scale have allowed more objective measurement of severity of depression and of improvement in depression in children. Plasma drug level monitoring has allowed for pharmacokinetic studies of TCAs, more precise dose adjustment and equivalent drug treatment of subjects involved in clinical research studies. Studies to date indicate TCAs were helpful in treating depressed prepubertal children. However, double-blind placebo/control studies of tricyclic antidepressants in depressed prepubertal school-aged children have not been published. Ideally a study of antidepressants in children should include: objective standardized diagnostic criteria for diagnosing depression; objective rating of severity of depression; explicit exclusion criteria; steady-state plasma blood level monitoring; assured compliance; adequate duration of treatment so sufficient time is allowed for response to occur; a double-blind study design. Unfortunately the ideal study has not been done. TCAs may be an effective treatment for prepubertal major depressive disorder. However, further study is necessary to clearly establish their efficacy.

Amitriptyline↗
PubMed1986

Assessing depression in prepubertal children.

Although symptoms of major depression are the same in adults and prepubertal children, diagnosing depression in children presents special problems not encountered with adults. In addition to the standard clinical interview, methods of assessing childhood depression include diagnostic interviews, self-report inventories, projective tests, peer ratings, and biological markers. Unfortunately many of these methods currently lack detailed reliability and validity studies. Despite their limitations these techniques can be helpful in making a diagnosis. However, accurate diagnosis still requires careful evaluation and individualized clinical judgement.

Child↗
PubMed1985

Marijuana use and psychiatric illness: a follow-up study.

In 1970, 100 regular marijuana users and 50 of their nonuser friends underwent a psychiatric evaluation. Of these, 97 users and all 50 nonusers were reinterviewed 6-7 years later. At follow-up, 60% of both groups had a psychiatric diagnosis. Antisocial personality was more prevalent in users; otherwise, there were no significant differences in diagnosis. Depression, alcohol abuse, and antisocial personality increased in users. However, these increases occurred in subjects who had reported problems in these areas in the initial interview but did not then meet diagnostic criteria. There was not a significant increase in the total number with a diagnosable illness.

Adolescent↗
PubMed1985

A longitudinal study of marijuana effects.

One hundred regular marijuana users volunteered to be extensively interviewed in 1968-1970, and 97 were located and reinterviewed 6 to 8 years later. As part of each interview the subjects filled out a checklist review of 105 effects of marijuana. This report focuses on the differential patterns of effects found at the two time intervals. Scores on groupings of items were examined for changes over time. Reports of sensory and hallucinatory items dropped substantially. Reports of appetite effects, sex effects, and intoxication effects on sleep remained stable. Reports of cognitive effects, mood effects, and aftereffects on sleep appeared to be shifting from desirable to undesirable, with the frequency of desirable effects dropping while frequency of undesirable effects remained the same.

Adolescent↗