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Biomedical subjects

R J Cadoret

Publications and source records attributed to R J Cadoret.

At least 19 recordsLinked to original sources
PubMed1991

Clozapine and norclozapine plasma concentrations and clinical response of treatment-refractory schizophrenic patients.

OBJECTIVE: Clozapine, an atypical antipsychotic, has been estimated to be effective in 30% of treatment-refractory schizophrenic patients. The authors hypothesized that if a dose-response relationship was obvious for this drug, the response rate could be significantly amplified. METHOD: Following an 8-24-day dose titration phase, 29 inpatients with treatment-resistant schizophrenia diagnosed according to DSM-III-R were given a clozapine dose of approximately 400 mg/day for 4 weeks; blood samples were obtained weekly during this period. RESULTS: A receiver operator curve demonstrated that the threshold clozapine plasma concentration for therapeutic response was 350 ng/ml. Sixty-four percent of the patients with clozapine plasma concentrations greater than 350 ng/ml responded, whereas only 22% of the patients with concentrations less than 350 ng/ml responded. CONCLUSIONS: Use of clozapine blood levels as a predictor for treatment response in treatment-refractory schizophrenic patients appears worthwhile, since the measurement's sensitivity for response was 64% and the specificity for nonresponse was 78%.

Adult↗
PubMed1990

Genetic and environmental factors in adoptee antisocial personality.

In a sample of 286 adult male adoptees 44 met criteria for antisocial personality (ASP). Two types of biologic parent background were associated with increased incidence of ASP in offspring: those with alcohol problem and those with a criminal conviction or adjudged delinquency. ASP adoptees were also significantly more likely to be alcoholic. Log linear modeling showed that alcohol problems in a biologic parent predicted increased alcohol abuse in the adoptee and that criminality/delinquency in a biologic parent predicted adult adoptee ASP. In the log-linear model two environmental factors significantly increased adoptee ASP: (1) placement in an adoptive home where there was an alcohol problem or antisocial behavior; and (2) placement in a lower socioeconomic home when the adoptee came from a background of criminality/delinquency in a biologic parent. When the adoptee did not have this biologic background socioeconomic level appeared to have little effect on ASP incidence. The results suggest the importance of genetic-environmental interaction in the genesis of adult ASP disorder.

Adoption↗
PubMed1988

Specific familial transmission in substance abuse.

In contrast to studies on alcoholism, there is little documentation on familial transmission of drug abuse. This study was designed to determine whether specific familial transmission of substance abuse occurs: a greater incidence of drug abuse in probands with a family history of drug abuse than in those with a family history of alcoholism. Probands were 305 consecutively admitted patients to an inpatient chemical dependency treatment center, whose substance abuse/dependence diagnoses were based on DSM-III criteria and a structured interview. Family history data were obtained from each proband. Log linear analysis investigated the association between family and proband substance abuse. As abuse of nonalcoholic substances was significantly greater in probands with family histories of drug abuse, specific familial transmission is suggested.

Adult↗
PubMed1988

The development of depressive symptoms in elderly following onset of severe physical illness.

This study followed a group of elderly patients (ill group) with recent onset of life-threatening or severely debilitating illness to determine development of depressive symptoms. Age- and sex-matched control patients were included for comparison. Depressive symptoms increased significantly in the group of ill male patients when compared with controls. Depressive symptoms did not show an increase in the group of ill female patients. Other variables also predicted increased depression: (1) an initial placement in nursing home, (2) a prior history of depression or higher initial level of depressive symptoms, (3) the presence of larger numbers of additional medical illnesses, and (4) following the occurrence of stressful life events. The increase in depression in the male test group was still present and significant when controlling for these additional four factors.

Aged↗
PubMed1985

Factors associated with suicide attempts in alcohol abusers.

Alcoholics with and without previous suicide attempts were compared on a variety of clinical variables. Drug abuse and major depression especially if accompanied by crying spells, hopelessness, or seeking psychiatric help were found more frequently in the suicide attempter group. Additionally, total psychiatric symptoms were found to be higher in the suicide attempters in various categories including somatic, obsessive-compulsive, and total number of psychiatric symptoms reported on the structured interview. These results indicate that certain psychopathological symptoms are associated with suicide attempts in alcoholics and may be predictive of completed suicide.

Aggression↗
PubMed1985

Genetic and environmental factors in major depression.

A study of 48 individuals with major depression in a sample of 443 adoptees has shown that depression is positively but not significantly correlated with a biologic background of affective disorder. Both primary and secondary depression was positively and significantly correlated with several environmental factors. In males, an adoptive home where another individual had an alcohol problem increased depression; in females, death of an adoptive parent prior to adoptee age 19 and an adoptive family where another individual had a behavior disturbance increased depression. Results suggest that the environmental factors occurring prior to adoptees age 18 predisposed to depression.

Adolescent↗
PubMed1979

Depression in family practice: changes in pattern of patient visits and complaints during subsequent developing depressions.

This study was done to characterize changes in patient behavior during specific time periods immediately before first, second, third, and fourth episodes of depression. Forty-three patients from a group of 154 depressed patients examined in an earlier study developed 59 subsequent episodes of depression, and these were the patients used in this study. Suitable age and sex matched controls were also examined for the same time periods. The depressed patients and controls were patients in a rural solo practice. The depressed patients showed increased number of patient initiated visits, increased incidence of hospitalization, increased number of functional complaints, increased number of pain complaints, and increased feelings of tension as compared to controls during the seven months prior to the diagnosis date of the first and each succeeding episode of depression. The study results indicate that increased numbers of office visits, functional complaints, pain complaints, and anxiety complaints can be harbingers of a clinical depression, whether it be the index (first) or a subsequent depressive illness.

Depression↗
PubMed1978

Psychopathology in adopted-away offspring of biologic parents with antisocial behavior.

A study of 246 adoptees aged 10 to 37 years separated at birth from biologic parents is used to study genetic heritability of antisocial behavior and to delineate the extent and quality of "antisocial spectrum" conditions. Evidence is presented for a genetic factor in adoptee antisocial behavior and for the following as "spectrum" conditions: (1) hysteria in adult females (Briquet's syndrome) or multiple somatic complaints without medical explanation in younger female subjects and (2) mood swings possibly associated with the symptom of audible thoughts.

Adolescent↗
PubMed1978

Evidence for genetic inheritance of primary affective disorder in adoptees.

Offspring of psychiatrically disturbed and normal biologic parents, adopted away at birth, were followed up as adults. The psychiatric status of the adoptees was determined by adoptive parent and adoptee interviews. The incidence of depression was significantly higher in the affective-parented adoptees (3 depressed of 8 adoptees) than in the remaining adoptees whose biologic parents had other psychiatric conditions or were apparently psychiatrically well (8 depressed of 118). The results suggest a genetic factor in affective disorders.

Adolescent↗
PubMed1978

Depression in primary care: changes in pattern of patient visits and complaints during a developing depression.

The purpose of this study was to characterize changes in patient behavior associated with a developing depression. The records of 154 depressed patients from a solo family practice were examined for type and number of complaints, number of visits, and amount of hospitalization during two periods of time. In addition, 154 patients were used as controls and matched to the depressive patients by age, sex, and season of year seen. Two similar time periods were examined in the controls. The depressed group in comparisons both with itself and with the control group showed, in the seven months prior to the diagnosis of depression, these changes: (1) increase in number of patient-initiated office and home visits; (2) increased incidence of hospitalization; and (3) increased number of presenting complaints of three types: ill-defined "functional" complaints; pain of undetermined etiology in a wide variety of sites: head, chest, abdomen, and extremities; and "nervous" complaints, mainly increased tension and feelings of anxiety. The study results indicate that increased number of office visits and "functional" somatic complaints or anxiety-tension feelings should suggest depression.

Adolescent↗
PubMed1977

Genetic aspects of manic-depressive disease in family practice.

Bipolar affective disorder (manic-depressive disease) is a mental disturbance characterized by phases of both depression and mania. Mania is essential to the diagnosis and is characterized by elevated mood, flight of ideas, and increased psychomotor activity. Current psychiatric literature not only shows that this disease is familial but has also demonstrated, through linkage studies, that an X-linked dominant mode of inheritance adequately explains the strong prevalence of bipolar affective disorder in some families. The family discussed here shows many of the known clinical aspects of bipolar affective disorder. It serves as an example consistent with the X-linked dominant mode of inheritance. Knowledge of the genetic background of this disease aids the family physician by helping to identify members of the family likely to have acquired this condition. The family physician can then look for future problems in them and in their offspring, leading to earlier diagnosis and more effective management. Thus, a member of a bipolar family with supposed unipolar illness (depression only) might be better served with the prophylactic use of lithium carbonate because of his likelihood of possessing a bipolar genotype. The prophylactic use of this drug has been shown effective in reducing the frequency, duration, and intensity of both manic and depressive mood swings.

Adult↗
PubMed1976

Studies of adoptees from psychiatrically disturbed biological parents. III. Medical symptoms and illnesses in childhood and adolescence.

Analysis of data gathered from interviews with adoptive parents supports the hypothesis that female adoptees of antisocial biological backgrounds might have higher percentages of somatic symptoms. The authors compared female adoptees of antisocial parentage with male and female controls, male adoptees of antisocial parentage, and male and female adoptees whose biological parents had other psychiatric conditions. They stress the importance of this hypothesis in the diagnosis and management of childhood and adolescent "medical" and behavioral problems.

Adolescent↗
PubMed1975

Studies of adoptees from psychiatrically disturbed biologic parents. II. Temperament, hyperactive, antisocial, and developmental variables.

Temperament, hyperactivity, antisocial behavior, and developmental milestones were assessed in two groups of adoptees by interviewing the adoptive parents. One group, the "experimental," was born of psychiatrically disturbed biologic parents (N = 59). The second group, the "control," had psychiatrically "normal" parents (N = 54). Infants in each group were separated from their biologic parents at birth and had no further contact with them. Male "experimental" adoptees had excess number of temperament traits characteristic of the "difficult" child, as well as an excess of antisocial behaviors when contrasted with male control subjects. No differences between control and experimental females were found for these variables. Hyperactive behavior in the adoptees of each sex was associated more with antisocial parentage than in those of "normal" parentage.

Adolescent↗
PubMed1975

Non-psychotic disorders in the families of process schizophrenics.

The present study was designed to test the hypothesis of "schizophrenic spectrum" disorders. The families of 60 process schizophrenics were systematically interviewed with structured interview forms, and evaluated for psychiatric illness according to strict diagnostic criteria. The interviewed persons were then separated into two groups for comparative analysis according to a positive (FH+) or negative (FH-) family history for schizophrenia. The frequencies of affective disorder and all non-psychotic conditions did not differ to a convincingly significant degree between the two groups. Our data thus fail to support the "schizophrenic spectrum" hypothesis in which neurosis and sociopathy occur as a consequence of a genetic loading for schizophrenia.?

Adult↗
PubMed1975

Studies of adoptees from psychiatrically disturbed biological parents: psychiatric conditions in childhood and adolescence.

Psychiatric problems were assessed in two groups of adoptees by interviewing the adopting parents. One group of 59 adoptees, the "experimental', were born of psychiatrically disturbed biological parents; the other group, the "control' of 54 adoptees, had psychiatrically "normal' biological parents. Both groups had been separated from biological parents at birth. The incidence of psychiatric conditions requiring professional care was significantly higher in the experimental than in the controls (37 per cent vs. 14 per cent). In the experimental group more males than females were disturbed (59 per cent vs. 30 per cent). Most of the excess of disordered males were diagnosed hyperactive. There was some evidence of correlation of the type of psychiatric diagnosis of the biological parent with that of the adoptee.

Adolescent↗