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Biomedical subjects

S Checkley

Publications and source records attributed to S Checkley.

At least 19 recordsLinked to original sources
PubMed2003

Effect of neuroticism, response style and information processing on depression severity in a clinically depressed sample.

BACKGROUND: It is postulated that individuals who score high on neuroticism would ruminate when faced with stress. A ruminative response style to depression is associated with faulty attribution and higher dysfunctional beliefs, which in turn is associated with a higher level of depression and hopelessness. Distraction is associated with less severe depression. Evidence supporting these hypotheses mainly comes from a non-clinical population. Hence it is not clear if these theories apply to clinical depression. METHOD: One hundred and nine out-patients suffering from unipolar major depressive disorder were recruited to test these theories, using model-fitting analysis technique. RESULTS: Certain rumination responses to depression were associated with higher levels of depression and hopelessness, faulty attribution and dysfunctional attitudes when gender and the level of depression were controlled. Principal component analysis of the Rumination Scale yielded four factors: 'symptom-based rumination', 'isolation/introspection', 'self-blame' and 'analyse to understand'. Unlike the other factors, 'analyse to understand' did not correlate with the level of depression. Model fitting analysis, though not reflecting entirely the true model, captures most of the hypothesized relationships between important variables. Neuroticism was associated with stress. Rumination was associated with an increased level of dysfunctional beliefs and faulty attribution, which in turn was associated with increased severity of depression. Distraction, in contrast, was associated with lower levels of negative mood. CONCLUSION: The results of our study support the importance of teaching depressed patients to manage their depressive symptoms by avoiding rumination about their symptoms and engaging in distracting and pleasurable activities.

Affect↗
PubMed2002

Adrenocortical, autonomic, and inflammatory causes of the metabolic syndrome: nested case-control study.

BACKGROUND: The causes of metabolic syndrome (MS), which may be a precursor of coronary disease, are uncertain. We hypothesize that disturbances in neuroendocrine and cardiac autonomic activity (CAA) contribute to development of MS. We examine reversibility and the power of psychosocial and behavioral factors to explain the neuroendocrine adaptations that accompany MS. METHODS AND RESULTS: This was a double-blind case-control study of working men aged 45 to 63 years drawn from the Whitehall II cohort. MS cases (n=30) were compared with healthy controls (n=153). Cortisol secretion, sensitivity, and 24-hour cortisol metabolite and catecholamine output were measured over 2 days. CAA was obtained from power spectral analysis of heart rate variability (HRV) recordings. Twenty-four-hour cortisol metabolite and normetanephrine (3-methoxynorepinephrine) outputs were higher among cases than controls (+ 0.49, +0.45 SD, respectively). HRV and total power were lower among cases (both -0.72 SD). Serum interleukin-6, plasma C-reactive protein, and viscosity were higher among cases (+0.89, +0.51, and +0.72 SD). Lower HRV was associated with higher normetanephrine output (r=-0.19; P=0.03). Among former cases (MS 5 years previously, n=23), cortisol output, heart rate, and interleukin-6 were at the level of controls. Psychosocial factors accounted for 37% of the link between MS and normetanephrine output, and 7% to 19% for CAA. Health-related behaviors accounted for 5% to 18% of neuroendocrine differences. CONCLUSIONS: Neuroendocrine stress axes are activated in MS. There is relative cardiac sympathetic predominance. The neuroendocrine changes may be reversible. This case-control study provides the first evidence that chronic stress may be a cause of MS. Confirmatory prospective studies are required.

Adrenal Cortex↗
PubMed2002

Childhood Experience of Care and Abuse Questionnaire (CECA.Q). Validation of a screening instrument for childhood adversity in clinical populations.

BACKGROUND: Interview measures for investigating adverse childhood experiences, such as the Childhood Experience of Care and Abuse (CECA) instrument, are comprehensive and can be lengthy and time-consuming. A questionnaire version of the CECA (CECA.Q) has been developed which could allow for screening of individuals in research settings. This would enable researchers to identify individuals with adverse early experiences who might benefit from an in-depth interview. This paper aims to validate the CECA.Q against the CECA interview in a clinical population. METHODS: One hundred and eight patients attending an affective disorders service were assessed using both the CECA interview and questionnaire measures. A follow-up sample was recruited 3 years later and sent the questionnaire. The questionnaire was also compared with the established Parental Bonding Instrument (PBI). RESULTS: Agreement between ratings on the interview and questionnaire were high. Scales measuring antipathy and neglect also correlated highly with the PBI. The follow-up sample revealed the questionnaire to have a high degree of reliability over a long period of time. CONCLUSIONS: The CECA.Q appears to be a reliable and valid measure which can be used in research on clinical populations to screen for individuals who have experienced severe adversity in childhood.

Adult↗
PubMed2001

Acquired mind-blindness following frontal lobe surgery? A single case study of impaired 'theory of mind' in a patient treated with stereotactic anterior capsulotomy.

Social insight, specifically the ability to represent thoughts and feelings ('theory of mind'), may have a circumscribed and dedicated neurological substrate. Evidence of deficits in 'theory of mind' following acquired lesions would support this idea. Previous studies of lesions resulting from stroke or head injury have been hampered by lack of detailed lesion information and pre-lesion documentation. We report the case of a 76-year-old man who, following a standard surgical procedure to treat bipolar affective disorder, showed evidence of impaired 'theory of mind'. This case, which is the first of its type, may contribute to the search for the brain basis of social insight.

Aged↗
PubMed1999

Neurodevelopmental antecedents of early-onset bipolar affective disorder.

BACKGROUND: Developmental impairments have been identified as a risk factor for early-onset schizophrenia. Affective symptoms are more common in children and adolescents with disordered neurodevelopmental than in healthy controls. AIMS: To test the hypothesis that severe early-onset mood disorders are associated with developmental antecedents. METHOD: We retrospectively identified 38 adolescent cases (15 female, 23 male; mean age 14.4 years, range 11-18) who met ICD-10 Research Diagnostic Criteria for a manic episode, bipolar affective disorder or psychotic depression, and 41 controls (25 female, 16 male, mean age 14.2 years, range 11-18) with depression but without psychotic features. RESULTS: Cases were significantly more likely to have experienced delayed language, social or motor development (OR 5.5, 95% CI = 1.4-21.6, P = 0.01), in particular those who develop psychotic symptoms (OR 7.2, 95% CI = 1.8-28.6, P = 0.003). CONCLUSIONS: Compared to early-onset unipolar depression, neurodevelopmental antecedents are over-represented in early-onset bipolar disorder. The validity of this finding was supported by contemporaneous IQ scores that are not subject to the same potential biases as case-note ratings.

Adolescent↗
PubMed1998

Salivary cortisol profiles in chronic fatigue syndrome.

Salivary cortisol profiles (hourly sampling over a 16-hour period) of 10 patients with chronic fatigue syndrome (CFS) but without concurrent depressive disorder were compared with those of 10 healthy volunteers matched for age, sex and menstrual cycle. The mean saliva cortisol concentration over the 16-hour period was slightly but significantly greater in the patients than the controls (p < 0.05). These findings are at variance with earlier reports that CFS is a hypocortisolaemic state and suggest that in CFS the symptom of fatigue is not caused by hypocortisolaemia.

Adolescent↗
PubMed1996

Dependency, matching adversities, length of survival and relapse in major depression.

This paper reports the 1-year follow-up of a sample of depressed patients. Social cognitive variables obtained during the index episode, including ideal emotional support, roles and goals investment in various domains and dysfunctional attitudes were used to predict subjects' likelihood for subsequent relapse. More subjects who experienced severe life events in the year were found to have relapsed. However, the predictive value of life events was improved if adversity was in the most invested domain according to the roles and goals questionnaire that subjects filled in during their index episode (matching adversity). Subjects who experienced matching adversity had a 3-fold chance of relapse compared with subjects with nonmatching adversity. The majority of the matching events were in the interpersonal domain. Levels of dysfunctional attitudes alone did not predict relapse. However, matching adversity and the dependency subscale of the dysfunctional attitude scale contributed significantly both to whether or not subjects relapsed and to the number of weeks subjects survived before they relapsed. The higher the level of dependency dysfunctional attitudes, the sooner subjects relapsed. The findings of the follow-up study supported the importance of psychological and social factors in determining relapse.

Adaptation, Psychological↗
PubMed1996

The neuroendocrinology of depression and chronic stress.

This chapter will review basic and clinical studies of the social, genetic and developmental influences upon the reactivity of the hypothalamic pituitary adrenal (HPA) axis and the relationship of these to depression. Significant advances have taken place in each of these areas and it is now possible to interlink many of these areas of work. In order to do so, this chapter will be organised into five sections. The first section will show how the neuroendocrinology of chronic stress is characterised by an up-regulation of the central drive to the HPA axis in conjunction with down-regulation of its negative feedback control. The second will show that very similar processes occur in depressive illness. The third section will describe social, developmental and genetic influences on the HPA axis both in experimental animals and in man. The fourth will show how activation of the HPA axis can influence the development of animal models of depression as well as the onset and perpetuation of clinical depression. The final section will draw together an overall hypothesis and indicate the potential for new treatments for depression that arise from this work.

Chronic Disease↗
PubMed1996

How does marriage protect women with histories of affective disorder from post-partum relapse?

Interviews were carried out at 36 weeks antenatal with 63 married couples, in 36 of which the woman had a history of affective disorder and in 27 the woman had no previous psychiatric history. The men's attitudes to their wives were assessed using expressed emotion methodology. Also assessed were psychiatric history, neuroticism, satisfaction with the marital relationship and attitudes to sex, pregnancy and parenthood in both the woman and her partner. Women with psychiatric histories who did not relapse in the six months following delivery had partners who were more positive about them than partners of high-risk women who remained well and control women. This effect is explored further by examining which characteristics of the man and which of the woman contributed to his critical and positive comment score. Criticism of his wife was associated with each partner reporting less marital satisfaction and also with the man's psychiatric history. No characteristic of the woman contributed to her partner's criticism. In contrast, the men's positive comments about their wives were associated with the woman's satisfaction with key aspects of her femaleness. Positive husbands had wives were pleased to be pregnant, happy with their pregnant bodies and enjoying the sexual aspect of the marital relationship. In women with psychiatric histories the time which had elapsed since her last psychiatric admission also influenced his positive comments.

Case-Control Studies↗
PubMed1995

Continuous administration of human corticotropin-releasing hormone in the absence of glucocorticoid feedback in man.

Continuous 24-hour infusions of a maximally stimulating dose (1 microgram/kg/h) of corticotropin-releasing hormone (CRH) have been shown to cause elevations of plasma cortisol and ACTH, but the pattern of results were confounded by serum cortisol causing feedback changes. We have looked at ACTH responses to saline or CRH infusions over 24 h in 6 normal subjects who, in addition, received either placebo or metyrapone, an 11 beta-hydroxylase inhibitor which blocks the formation of cortisol and thus abolishes glucocorticoid feedback. Cortisol and ACTH levels were measured by radioimmunoassay. Before metyrapone, CRH infusion resulted in exaggerated ACTH peaks throughout the day, as compared with normal saline: there was no influence on the noctural rise in ACTH. Following metyrapone alone, absolute cortisol levels were lower but circadian rhythmicity was preserved. Circadian rhythm of ACTH was maintained, with a fall in the evening to 14.5 +/- 4 pg/ml (mean +/- SE) at midnight and an exaggerated rise overnight, reaching a peak level of 90 +/- 33 pg/ml at 07:00 h. Subjects receiving CRH with metyrapone showed a similar pattern of responses, but with further enhanced ACTH levels. The evening fall reached a nadir of 30 +/- 6 pg/ml at 01:00 h. With diminished glucocorticoid feedback the nocturnal rise in ACTH was augmented by CRH infusion, with a morning peak of 193 +/- 21 pg/ml at 07:00 h. Thus, continuous infusion of CRH in the absence of steroid feedback leads to a retention of the circadian rhythmicity in ACTH secretion, reset at a higher absolute level.(ABSTRACT TRUNCATED AT 250 WORDS)

Adrenal Cortex Hormones↗
PubMed1994

The impact of social cognitive variables on the initial level of depression and recovery.

Thirty-seven patients who fulfilled DSM-III-R criteria for Major Depressive Disorder were recruited for a double-blind controlled trial of Desipramine and placebo for 6 weeks. Data about social cognitive variables, including social adversities, investment in roles and goals, general social support and crisis support were collected. Crisis support had a moderating effect on the initial level of depression: the more crisis support the subjects had, the less depressed they were on recruitment. Initial level of depression, the experience of adversity and drugs all contributed significantly to recovery defined as Hamilton Rating for Depression less than 10 at week 6. When recovery was defined as Hamilton score halved or more than halved between week 2 and week 6, subjects' level of ideal emotional support, and whether they had experienced adversity in their most invested domains, contributed significantly to recovery, independent of any drug effects or the initial level of depression. The higher their level of ideal emotional support, the less was the chance of these subjects recovering. The findings of this study pointed to the importance of controlling for psycho-social variables in studies of response to treatment.

Adult↗
PubMed1993

Neuroendocrine and psychosocial mechanisms in post-partum psychosis.

(1) Results from a study investigating psychosocial and neuroendocrine influences on post-partum psychosis are presented. Subjects were 43 pregnant women with histories of affective disorder (bipolar or schizoaffective disorder, n = 26; major depressive disorder, n = 17), together with 45 pregnant women without any psychiatric history. (2) At 36 weeks antenatal assessments were carried out of the women's psychiatric histories, current psychiatric state and also the occurrence of life events in the preceding year. They were then monitored for 6 months after delivery during which time psychiatric state and any further life events were recorded. Illness was defined according to Research Diagnostic Criteria (RDC); 22 high risk women and 3 control women were categorised as RDC 'cases' during the post-partum follow-up period. Fifteen of the bipolar/schizoaffective women (8 of whom subsequently became ill within 3 months of delivery) and 15 controls (all of whom remained well) also participated in a neuroendocrine test at 4 days post-partum when their growth hormone response to a challenge dose of the dopamine agonist, apomorphine, was measured. (3) The results showed that women with histories of depression and control women who became ill after delivery were three times more likely to have had a life event in the year preceding onset of illness than women from these subgroups who remained well. In contrast, for women with histories of bipolar or schizoaffective disorder, life events appeared to be unimportant. Instead bipolar/schizoaffective women who became ill showed an enhanced growth hormone response to the apomorphine challenge test compared to those who remained well and controls.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1992

Neuroendocrine mechanisms and the precipitation of depression by life events.

It is now generally accepted that stressful life events and chronic difficulties can trigger the onset of depression in predisposed individuals. However, although much is known of the neurobiology of stress, few attempts have been made to provide a biological explanation for the mechanisms whereby life events might trigger depression. Enough is now known of the central control of hypothalamic pituitary adrenal (HPA) function and its response to stress to permit an examination of its role in the neurobiology of the triggering of depression by stress. This evidence is reviewed, and the proposal explored that stress triggers depression by a genomic action of corticosteroids.

Adjustment Disorders↗
PubMed1989

Seasonal affective disorder.

Depression during winter has been found to respond to treatment with simulated daylight. Seasonal affective disorder should be distinguished from other forms of depression which can also occur in winter before prescribing light therapy.

Diagnosis, Differential↗