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Biomedical subjects

R K Hornstra

Publications and source records attributed to R K Hornstra.

13 recordsLinked to original sources
PubMed1990

Evaluation of the interaction of lithium and alprazolam.

A potential pharmacokinetic interaction between lithium and alprazolam was studied in 10 normal subjects. Pharmacokinetic parameters were determined from the following regimens: single-dose alprazolam, multiple-dose lithium, and multiple-dose alprazolam with lithium. Steady-state alprazolam clearance during multiple dosing with lithium was not different from that with the single dose of alprazolam. Lithium renal clearance decreased when it was coadministered with alprazolam (31.2 vs. 22.4 ml/minute, p less than 0.05). There was a small but significant increase in the steady-state area under the curve for lithium in the presence of alprazolam (10.3 vs. 11.1 mEq/hour/liter). The small increase in the serum lithium concentrations and decrease in lithium renal clearance was probably the result of lower urine flow rates (1.46 vs. 0.98 ml/minute, p less than 0.05) with the combination of the drugs. This is supported by a weak but significant linear relationship between urine flow rates and lithium renal clearance (N = 57, r = 0.353, p = 0.007). The percent of daily lithium dose recovered at steady-state from the 24-hour urine collection decreased significantly from 93.6% to 78.2% in the presence of alprazolam. This suggests that alprazolam may decrease lithium absorption. The results of this study do not support a definitive interaction of lithium and alprazolam and there is little clinical significance to the small rise in serum lithium concentrations.

Adult↗
PubMed1979

Depressed mood and subsequent physical illness.

The authors describe the results of a matched case-control analysis in which 82 pairs of subjects were selected from a large-scale community study carried out in two general populations. Cases were those of persons hospitalized during an interval between two interviews for an illness starting during that interval or persons who died during the interval. Controls were persons with no new illnesses or hospitalizations during the interval. No relationship between measures of depressive symptomatology or depressed mood and subsequent physical illness was shown. This result corroborates the findings of prospective studies in more selected populations and suggests that it is unlikely that depressed mood is related to subsequent physical illness.

Adolescent↗
PubMed1978

Correlates of depressive mood among normals.

In order to determine the correlates of depressive mood, members of a women's volunteer organization were surveyed by a mailed questionnaire that included the Depression Adjective Check List (DACL) Form E and 14 depression-related measures. Correlations are presented and discussed. Highest correlations are with measures whose relationship to depressive mood are most clear.

Adult↗
PubMed1977

Three utilization styles at an urban mental health center.

The authors report a study of utilization of services based on data obtained on two patient groups at an urban mental health center: a one-year applicant population, consisting of an unduplicated count of all adults applying for psychiatric care during a one-year period; and a one-day prevalence population, consisting of all persons on a psychiatric roster on a single selected day. Juxtaposing diagnosis, applicant-to-prevalence ratios, and treatment or services used, they found three styles of utilization of services--the intensive user, as exemplified by the neurotic in psychotherapy, the casual user (the schizophrenic attending medication clinic), and the pseudo user (the alcoholic using detoxification services). The intensive user represents a minority utilization style, while the last two styles are predominat at the center. Taken together they characterize the typical patient as a therapeutically passive user of services.

Alcoholism↗
PubMed1976

A comparative study of neurotics seen in a community mental health center and in private practice.

Differences that emerge in comparisons of persons applying for psychiatric care at a mental health center with those applying to the private sector are comfounded by marked diagnostic differences beyond obvious social class differences. To circumvent that problem and to ascertain what differences, if any, persist after diagnosis is held constant, the authors examined demographic and psychosocial characteristics of neurotics in a one-year adult applicant population, the only major diagnostic group treated in large numbers and similar proportions by the center and the private sector. Findings showed that significantly more neurotic applicants in the private sector are medical referrals, are members of intact nuclear families, and do not have previous inpatient experience.

Adjustment Disorders↗
PubMed1975

Good patients and bad. Therapeutic assets and liabilities.

This is an extension of an earlier article that identified three utilization styles at an urban mental health center where, apart from a minority of intensive users, casual users, and pseudousers predominate and, combined, characterize the therapeutically passive user. The present article compares center data to added data from the private sector, where the intensive user predominates. Center/private differences are examined, and correlates of differing utilization styles are identified, such as sex, diagnosis, marital/living arrangements, referral source, and social engagement factor. The later is associated with differences not attributable to diagnostic severity of social impairment. The growing division of labor, wherein the privates sector is engaged in intensive psychiatric treatment while the center increasingly operates an emergency/crisis/maintenance service, is shown to reflect a gross public/private maldistribution of therapeutic assets and liabilities.

Alcoholism↗