PubMed Health⌕ Search

Biomedical subjects

S D Targum

Publications and source records attributed to S D Targum.

At least 55 records · Page 3Linked to original sources
PubMed1983

Segregation and linkage analyses in families of patients with bipolar, unipolar, and schizoaffective mood disorders.

Hypotheses of single major locus transmission (autosomal and X chromosome) of major affective disorder (i.e., bipolar, unipolar, and schizoaffective) are tested using the Elston-Stewart likelihood method of pedigree segregation analysis. The sample consists of families of varying size ascertained through patients treated at the National Institute of Mental Health in Bethesda, Maryland. We test hypotheses on subsamples of families according to: (1) diagnosis of proband (75 bipolar I, 22 bipolar II, 18 unipolar, and six schizoaffective); (2) extreme value of a biological trait in the proband ("low" monoamine oxidase, "low" cerebrospinal fluid serotonin metabolite 5-HIAA); and (3) positive response to lithium in the proband. We cannot find evidence for single major locus transmission of major affective disorder from segregation analysis in any subsample of family even when the diagnostic classification of ill phenotypes is widened to include possible affective "spectrum" diagnoses. In addition, linkage studies of 21 autosomal markers do not provide evidence for single major locus transmission of illness. The maximum lod score, found for 30 families at the MNS locus, was 1.39 at 20% recombination.

Alleles↗
PubMed1982

A family study of schizoaffective, bipolar I, bipolar II, unipolar, and normal control probands.

In a family study of 1,254 adult relatives of patients and controls, lifetime prevalences of major affective disorder (including schizoaffective) were 37%, 24%, 25%, 20% and 7% in relatives of probands with schizoaffective, bipolar I, bipolar II, and unipolar disease, and normal controls. These data were compatible with the different affective disorders representing thresholds on a continuum of underlying multifactorial vulnerability. In this model, schizoaffective illness represents greatest vulnerability, followed by bipolar I and bipolar II, then unipolar illnesses. Alcoholism, drug abuse, and sociopathy were not more frequent in relatives of patients v relatives of controls. Sex-related transmission of morbid risk was not present. Morbid risk was 74% to offspring of two III parents, and 27% to offspring of one III parent. Nationality and age at time of interview seem to be nongenetic factors that affect frequency of diagnosis.

Adult↗
PubMed1982

Subtypes of unipolar depression distinguished by the dexamethasone suppression test.

The dexamethasone suppression test (DST) was administered to 54 primary unipolar depressed patients and 19 non-depressed hospitalized inpatients. Abnormal DST were found in 23 depressed patients (43%) in contrast to 2 (11%) non-depressed patients (P less than 0.05). Within the endogenously depressed group, 69% of patients categorized as familial pure depressive disease (FPDD) in contrast to 13% of depressive spectrum disease (DSD) patients had abnormal DST results (P less than 0.02). The DSD group had significantly fewer abnormal DST results than all other subtypes of unipolar depression (P less than 0.05). The distinction revealed between DSD patients and other endogenously depressed patients may be due to biological factors or due to the heterogeneous nature of the DSD subtype group.

Adult↗
PubMed1982

The TRH stimulation test in subtypes of unipolar depression.

The thyrotropin releasing hormone (TRH) stimulation test was administered to 54 primary unipolar endogenously depressed and 19 non-depressed hospitalized inpatients. Blunted TSH responses to TRH infusion (delta max TSH less than 7 microunits/ml) were revealed in 18 depressed and no non-depressed patients (P less than 0.01). Augmented TSH responses (delta max TSH greater than 23 microunits/ml) were noted in 8 depressed and no non-depressed patients (P = n.s.). The TRH stimulation test did not distinguish between subtypes of unipolar depression using the familial subtyping criteria of Winokur. These findings are discussed in light of previously reported dexamethasone suppression test subtype distinctions.

Adult↗
PubMed1982

Dysregulation of hypothalamic-pituitary-adrenal axis function in depressed alcoholic patients.

Hypothalamic-pituitary-adrenal (HPA) axis function was examined in 28 hospitalized, withdrawing alcoholic patients. Fourteen patients met DSM-III criteria for Major Depressive Disorder. Elevated 8 a.m. basal cortisols were noted in 7 depressed alcoholic patients (50%) and no non-depressed alcoholics (P less than 0.01). Escape from dexamethasone suppression was noted in 9 depressed alcoholics (64%) and no non-depressed alcoholics (P less than 0.005). The measurement of HPA axis function may be a useful marker for endogenous depression in an alcoholic population.

Adult↗
PubMed1982

Compensatory pituitary-thyroid mechanisms in major depressive disorder.

The thyrotropin-releasing hormone (TRH) stimulation test was administered to 47 patients meeting DSM-III criteria for major depressive disorder (with melancholia) and to 19 nondepressed patients. The wide variability of pituitary responses to TRH stimulation noted in the depressed patients provides evidence for the dysregulation of compensatory hypothalamic-pituitary-thyroid function in acute depression. Blunted thyroid-stimulating hormone (TSH) responses to TRH injection were found in 16 depressed (34%) and no nondepressed patients (p less than 0.01). Depressed patients who revealed blunted TSH responses also had blunted prolactin responses to TRH relative to other depressed and nondepressed patient groups (p less than 0.01). These patients (with blunted TSH and prolactin responses) may represent a psychobiologically distinct subgroup of endogenously depressed patients. Augmented (high normal) TSH responses to TRH stimulation were found in eight depressed patients (all women), in contrast to no nondepressed patients. These patients may have a subtle thyroidal dysfunction affecting the underlying endogenous depressive diathesis.

Adolescent↗
PubMed1982

Patient and family attitudes about schizophrenia: implications for genetic counseling.

Psychiatrists are giving increased attention to genetic counseling for mental illness. However, the burden of these illnesses are perceived by families and the degree to which families feel a need for genetic counseling have yet to be established. Attitudes and perceptions measured in this study focus on etiology, familial risk, and socioeconomic burden of schizophrenia, as well as childbearing plans and the acceptability of genetic counseling. Members of 17 families, each with a child diagnosed schizophrenic, were studied using the Family Attitudes Questionnaire. The results demonstrate that the well family members view schizophrenia as a severe and debilitating illness. The results also show that there is a disparity between the attitudes of well family members and patients: 92 percent of parents compared to 25 percent of patients identified schizophrenia as a disorder associated with extreme burden. Regarding childbearing decisions, 29 percent of parents compared to 66 percent of patients say they would have children (in hindsight or in future) based on what they now know about schizophrenia in their family. This result corroborates reports from genetic counselors for other illnesses: the wish for children appears to override considerations of risk and burden for those potentially genetically affected persons who have not reached their desired family size.

Adolescent↗
PubMed1982

Neuroendocrine interrelationships in major depressive disorder.

The authors administered the thyrotropin-releasing hormone (TRH) stimulation test and the dexamethasone suppression test (DST) to 54 patients who met DSM-III criteria for major depressive disorder and to 19 nondepressed patients. A blunted thyrotropin (TSH) response to TRH injection was noted in 18 depressed patients (33%) but in no nondepressed patients. An escape from dexamethasone suppression was noted in 23 depressed patients (43%) but in only 2 nondepressed patients (11%). The combined sensitivity of the DST and the TRH test in identifying major depressive disorder was 67% with 92% specificity. Only 6 depressed patients (11%) had abnormal responses to both the DST and the TRH test, suggesting that the hypothalamic-pituitary-adrenal axis dysregulation and hypothalamic-pituitary-thyroid axis dysregulation are independent phenomena. These findings support the combined use of these neuroendocrine tests in clinical practice.

Adolescent↗
PubMed1982

An intervention to reduce the rate of hospital discharges against medical advice.

The initiation of a patient advocacy program in a private psychiatric hospital in 1980 was effective in significantly reducing the rate of hospital discharges against medical advice relative to the rate in 1979 and in 1978. There was also a concomitant increase in the rate of clinically approved discharges relative to that in 1979 and in 1978. The authors view the patient advocate as an objective intermediary who represents an acknowledgment of patients' rights and affords patients an opportunity to have some autonomy and an impact on the hospital system.

Attitude↗
PubMed1981

The Family Attitudes Questionnaire. Patients' and spouses' views of bipolar illness.

A newly devised Family Attitudes Questionnaire has been employed to quantify the perceptions of 19 bipolar manic-depressive patients and their well spouses about the etiology, familial risk, and long-term burden of bipolar illness, and to assess their abilities about marriage and childbearing. In this study, 53% of well spouses compared with 5% of patients (P less than .01) would not have had children if they had known more about bipolar illness prior to making these decisions. The overall data suggest that the bipolar patients, compared with his or her spouse, minimizes the burden and denies the heritable/familial nature of affective illness. These findings should be borne in mind for genetic counseling as well as for psychotherapy.

Adult↗
PubMed1981

Psychotherapeutic considerations in genetic counseling.

It is essential to consider the psychodynamic aspects of genetic counseling to attain the best outcome for the family. Narcissistic injury (reduced self-esteem), excessive defensiveness, and depressive reactions may impede an effective resolution of feelings and preclude the necessary adaptation to genetic diseases and the new realities that have developed. Most parents of genetically affected children are capable of dealing with these conflicts. However, some individuals need help during the adaptation process by assisting them to grieve for their disappointments and to help them develop new goals for themselves and for the baby that was born. This paper describes psychodynamic concepts that might be explored to facilitate conflict-resolution resulting from the occurrence of genetic disease.

Adaptation, Psychological↗
PubMed1981

A comparison of nonpatient and bipolar patient-well spouse couples.

The authors compared responses of 16 couples, in which one partner had a diagnosis of remitted bipolar illness, to a lengthy self-report questionnaire (KDS-15) designed to assess many aspects of marital adjustment with those of 16 matched nonpatient couples. The bipolar patient-well spouse couples had marital adjustments closely resembling those of the nonpatient couples; three of four global ratings of satisfaction failed to discriminate between the two groups. Perceptions of the courtship, first year of marriage, and the degree to which the marriage had met expectations were also similar for both groups.

Adjustment Disorders↗
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↗