Differentiating anxiety and depression in anxiety disorders: use of rating scales.
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Biomedical subjects
Publications and source records attributed to R S Lipman.
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A factor analysis of the 90-item version of the Hopkins Symptom Checklist, performed on the pretreatment self-ratings of nonpsychotic outpatients with symptoms of depression and anxiety, revealed the presence of 8 clinically meaningful factors. These eight orthogonal factors each contained at least 5 items with loadings above 0.40 and explained 4.5% or more of the matrix variance. They were labeled Somatization, Phobic-Anxiety, Retarded Depression, Agitated Depression, Obsessive-Compulsive, Interpersonal Sensitivity, Anger-Hostility and Psychoticism.
1. Symptomatic volunteers were recruited at two collaborating institutions for anti-anxiety and antidepressant drug trials. Advertisements were placed for volunteers with significant symptoms of anxiety, depression, or both, and who were not currently in treatment. 2. It was possible to recruit adequate numbers of volunteers who met the numerous criteria for severity of distress; and who were not ruled out by various exclusion criteria, such as medical contraindications, etc. 3. Acceptable homogeneity across the samples at the collaborating institutions was found for demographic characteristics, level of distress, duration of symptoms, etc. 4. Attrition rates for these volunteers were lower than for the typical anxiolytic and antidepressant trials using outpatients. 5. Symptomatic volunteers appear to present a feasible alternative to the increasingly diminishing pool of outpatients.
This article reviews the literature on possible growth-suppressing effects of stimulant medications in the long-term treatment of children with the hyperkinetic behavior syndrome. The evidence clearly indicates a temporary retardation in the rate of growth in weight and suggests a temporary slowing of growth in stature, but no effect on adult stature or weight. This temporary effect on growth is present during the first few years of treatment and seems related to drug dosage and to the presence or absence of drug holidays. These conclusions related specifically to treatment during the prepubertal period; little is known of the growth-related effects of treatment extending through pubescence.
Rapid growth in the production and prescription of minor tranquilizers has stimulated increasing concern that we live in an "overmedicated" society. Data regarding drug use from a health survey in Oakland, Calif, show that (1) 20% took a minor tranquilizer or sedative during the previous year, 10% daily for a week or more; (2) use was related directly to the amount of distress and dysfunction, to psychologic more than to other types of disturbance, but not to situational stress alone; and (3) taking tranquilizers was only one aspect of a complex pattern of coping behaviors including the almost universal use of some medication, most often a "nonpsychotropic" type.
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The authors conducted a series of multiple regression analyses of data from depressed patients. They found that 8 factors consistently predicted treatment response: a lower initial level of distress, imipramine treatment, a positive attitude toward group psychotherapy, and a good employment history predicted lower posttreatment distress levels; estrogen maintenance treatment was related to better response to diazepam, and a low level of intelligence predicted better response to both diazepam and imipramine; and a low initial level of interpersonal sensitivity and a significant other's having an unfavorable attitude toward psychiatric treatment were associated with better response to group psychotherapy.
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