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Biomedical subjects

S D Targum

Publications and source records attributed to S D Targum.

At least 19 recordsLinked to original sources
PubMed1992

Variability of TRH test responses in depressed and normal elderly subjects.

Thyrotropin releasing hormone (TRH) tests were conducted in 33 elderly patients with Major Depressive Disorder and 99 normal elderly volunteers. A wide range of thyrotropin-stimulating hormone (TSH) responses to TRH injection was revealed. A gender effect was found such that men had significantly diminished TSH responses to TRH relative to women (p = 0.008). However, there were no significant differences noted between depressed patients and normal elderly subjects of either gender. It appears that the wide range of TSH responses to TRH found in normal elderly men and women blurs any measurable differentiation between depressed patients and normal subjects and thereby limits the usefulness of the TRH test in the study of depressive disorder in elderly patients.

Age Factors↗
PubMed1992

Cortisol response during different anxiogenic challenges in panic disorder patients.

The present study assessed the relation of cortisol response to anxiogenic reactivity during intravenous lactate infusion and oral fenfluramine in 12 panic disorder (PD) patients who responded positively to both challenges and in eight non-reactive control subjects. There was no significant cortisol response difference between the PD patients and the controls during lactate infusion, but there was s significant difference at 120 min during the fenfluramine challenge. These findings are consistent with the possibility that these challenges stimulate different neurobiologic mechanisms and that fenfluramine-precipitated anxiety is more akin to anticipatory or generalized anxiety than to true panic anxiety.

Administration, Oral↗
PubMed1991

Panic attack frequency and vulnerability to anxiogenic challenge studies.

Intravenous lactate infusion and 60 mg oral fenfluramine challenges were administered to 26 patients with panic disorder (PD) and 12 age- and sex-matched control subjects. PD patients had significantly greater anxiety responses to either challenge than controls. When a panic attack frequency index scale of 1-4 was used, PD patients with more recent and more frequent spontaneous panic attacks scored higher on either challenge. There was a significant correlation between increasing panic attack frequency and greater anxiogenic responses to lactate and fenfluramine. Nine of 12 patients (75%) with high attack frequency (defined as having one or more panic attacks per week) reacted positively to both challenges in contrast to 0 of 14 PD patients with low frequency (less than or equal to 1 attack/month). The findings suggest that the current heightened anticipatory state of the patient (influenced by recent spontaneous panic attacks) rather than putative underlying trait factors predominates in the evocation of experimentally induced anxiety reactions. Future studies must consider the frequency of recent spontaneous panic attacks in the evaluation of anxiogenic reactivity to provocative stimuli.

Administration, Oral↗
PubMed1990

Differential responses to anxiogenic challenge studies in patients with major depressive disorder and panic disorder.

Anxiogenic challenge studies (intravenous lactate infusion and oral fenfluramine challenge) were conducted in 17 patients with panic disorder (PD), 12 patients with major depressive disorder and a history of panic attacks (MDD-PD), 27 patients with major depression and no history of panic (MDD), and 12 normal controls. PD and MDD-PD patients revealed significantly greater anxiogenic responses to lactate infusion and fenfluramine administration than either MDD patients or controls. PD patients revealed the most robust anxiogenic responses to both challenges as well as associated significant prolactin and cortisol responses to fenfluramine. The findings suggest that the predisposition to panic attacks as seen in PD and MDD-PD patients may represent a distinct neurobiological diathesis which may coexist with a major depressive diathesis in some patients. The delineation of subgroups within the more heterogenous groups of patients with MDD and/or PD will lead to greater precision in the development of clinical treatment strategies. Thus, MDD-PD patients (better called panic-depressives) may have a more severe illness than patients with MDD alone which must be accounted for in the course of pharmacotherapy and psychotherapy.

Administration, Oral↗
PubMed1990

Measurement of cortisol and lymphocyte subpopulations in depressed and conduct-disordered adolescents.

Lymphocyte subpopulations were analyzed in 11 adolescents with major depressive disorder, 11 with conduct disorder, and eight normal age-matched subjects. No significant differences were noted on any T or B cell measure between the groups. Further, no significant correlations were found between any cortisol measure (baseline cortisol, post-dexamethasone cortisol, urinary free cortisol) and any lymphocyte measure in either depressed or conduct-disordered adolescents. The negative findings in this small sample contrast with those reported in adult patients and suggest that an aging effect may be associated with the immunological changes reported in older depressed patients.

Adolescent↗
PubMed1990

Prevalence of seasonal affective disorder at four latitudes.

The Seasonal Pattern Assessment Questionnaire (SPAQ) was mailed to a sample population balanced for sex and randomly selected from local telephone directories in four areas: Nashua, NH, New York, NY, Montgomery County, MD, and Sarasota, FL. On the basis of responses to this questionnaire, prevalence rates of winter seasonal affective disorder (winter SAD), summer seasonal affective disorder (summer SAD), and subsyndromal winter SAD were estimated for the four areas. Rates of winter SAD and subsyndromal SAD were found to be significantly higher at the more northern latitudes, while no correlation was found between latitude and summer SAD. The positive correlation between latitude and prevalence of winter SAD applied predominantly to the age groups over 35.

Adult↗
PubMed1989

Lymphocyte subpopulations in depressed elderly women.

Dexamethasone Suppression Tests (DST) and measurement of lymphocyte subpopulations were conducted in 21 medically healthy elderly women with major depressive disorder and 77 healthy elderly women volunteers. Depressed women revealed significantly reduced absolute lymphocytes (p less than 0.01), T cells (p less than 0.01), and T helper cells (p less than 0.02) compared to normal elderly women. Of the depressed women, 50% had positive DSTs (postdexamethasone cortisols greater than 5 micrograms/dl) compared to 5.4% of the normal women (p less than 0.0001). Within the depressed group, patients with positive DSTs had significantly reduced absolute lymphocytes (p less than 0.05) and T helper cells (p less than 0.025) compared with depressed women who had normal DSTs. Further, a significant negative correlation was found between postdexamethasone cortisols (at both 4:00 and 11:00 PM) and absolute lymphocyte count and T helper cells. These data suggest that the hypercortisolemia seen in some patients with major depressive disorder is sufficient to alter leukocyte distribution in the peripheral circulation, particularly that of the T helper cell subset. The association between cortisol and lymphopenia appears to be more pronounced in an elderly population than in younger depressed patients.

Aged↗
PubMed1989

Fenfluramine provocation of anxiety in patients with panic disorder.

Fenfluramine, and indirect serotonergic agonist, was administered to nine women with panic disorder, nine women with major depressive disorder, and nine women controls. Panic disorder patients revealed significantly greater anxiogenic responses to fenfluramine administration at all 5 hourly measurement points than either depressed patients or control subjects. Prolactin and cortisol responses to fenfluramine were also significantly greater in panic disorder patients than in either depressed patients or control subjects. Placebo administration did not elicit robust or significantly different anxiety or hormonal responses in panic disorder patients or control subjects. These data offer evidence that serotonergic hyperresponsivity must be considered as an important factor in the mechanism of events provoking overt panic attacks.

Adult↗
PubMed1989

TRH tests in a healthy elderly population. Demonstration of gender differences.

Thyrotropin releasing hormone (TRH) tests were conducted in 99 healthy elderly men and women between the ages of 65 and 89. The TRH test identified elderly patients with subclinical thyroid dysfunction not recognized by basal TSH values alone. Men revealed significantly diminished TSH responses to TRH injection relative to women. Mean delta max TSH was 9.0 +/- 8.3 microIU/mL in men vs 15.7 +/- 14.8 microIU/mL in women (P less than .01) reflecting the need to consider gender effect in the interpretation of TRH test responses.

Age Factors↗
PubMed1979

Effect of lithium carbonate on memory processes of bipolar affectively ill patients.

The effect of long-term lithium carbonate treatment on parameters of immediate, short-, and long-term memory was examined in a group of bipolar affectively ill patients. The lithium treatment group recalled significantly fewer words across trials on a verbal learning task than a group of bipolar affectively ill patients receiving no medication. The ability to consistently recall material for which prior learning had been demonstrated was also decreased and accounted for most of the variance in total number of words recalled. Possible mechanisms of effect are discussed.

Adult↗
PubMed1979

Color blindness not closely linked to bipolar illness. Report of a new pedigree series.

A new pedigree series of bipolar manic-depressive patients admitted to the National Institute of Mental Health intramural research program was evaluated for linkage between bipolar illness and red-green color blindness, since previous studies had indicated that close linkage was generally present. Using family study methods, six informative pedigrees were investigated. Analysis was performed using a multigenerational procedure and taking into account variable penetrance. Close linkage could be definitively ruled out as a general finding. Bipolar and related illnesses are thus not generally transmitted by a single major gene close to the protan/deutan region of the human X-chromosome.

Bipolar Disorder↗
PubMed1979

New data do not suggest linkage between the Xg blood group and bipolar illness.

The Xg blood group antigen (a genetic marker of a region of the X chromosome at a considerable distance from protan/deutan color blindness) was studied for linkage to bipolar manic-depressive illness. A multigenerational analytic method, taking variable penetrance into account, was used. In our series of six informative pedigrees, very close linkage could be definitively ruled out, and the likelihood of less tight linkage was consistently less than the likelihood of nonlinkage.

Bipolar Disorder↗
PubMed1979

Postpartum mania in bipolar manic-depressive patients withdrawn from lithium carbonate.

Three women, previously diagnosed as bipolar I manic-depressive, were withdrawn from lithium carbonate prophylaxis immediately prior to their pregnancies. The patients had been euthymic while on lithium carbonate for at least 3 1/2 years prior to their pregnancies. Two of the three patients developed a manic syndrome within 2 weeks postpartum. The use of lithium carbonate during pregnancy, and particularly in the postpartum period, requires reassessment. We advocate an ongoing clinical relationship and the reinstitution of lithium in the third trimester in most cases.

Adult↗
PubMed1979

Human leukocyte antigen system not closely linked to or associated with bipolar manic-depressive illness.

An association and linkage study of the HLA system and bipolar affective illness is reported. HLA B-14 showed an increased frequency and HLA-Bw27 a decreased frequency in 92 bipolar patients compared to 210 controls, but significance is not reached when appropriate statistical corrections are made. It is shown that ethnological differences can lead to sampling biases; a purported increased frequency of HLA-Bw 16 in Ashkenazi Jewish bipolar patients is negated when ethnologically similar controls are used. The transmission of HLA alleles in nine families with at least two generations of affective illness revealed independent assortment, and nonlinkage to either locus A or B was demonstrated using a multigenerational method of linkage analysis. The nonreplicability of the HLA association studies, and the failure to demonstrate linkage of the HLA loci with afe development of affective illness, although further analyses are necessary.

Adult↗
PubMed1979

Screening for PKU heterozygosity in bipolar affectively ill patients.

There were no significant differences noted between bipolar manic-depressive patients and normal controls for plasma phenylalanine or tyrosine following an L-phenylalanine loading test given to determine if some affective illness may be related to the heterozygous phenotypic expression of phenylketonuria (reduced liver phenylalanine hydroxylase). The test was able to distinguish known PKU heterozygotes from the other subjects. It is possible that other heterozygous states may be implicated in the development of some psychiatric disorders.

Bipolar Disorder↗