Potential danger associated with stuck capsules.
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Adult↗
Biomedical subjects
S E Luty
Publications and source records attributed to S E Luty.
A differential response to nortriptyline and fluoxetine in melancholic depression: the importance of age and gender.
OBJECTIVE: To consider the impact of age and gender on the antidepressant response to nortriptyline and fluoxetine in melancholic depression. METHOD: Of 191 depressed patients, 113 met study criteria for melancholia. All patients were randomized to receive either fluoxetine or nortriptyline. Response rates, defined as an improvement of 60% or more on the Montgomery Asberg Depression Rating Scale over 6 weeks of antidepressant treatment on an intention to treat basis, were examined by age, and by age and gender. RESULTS: Melancholic depressed patients 40 years or older, especially men, had a markedly superior response to nortriptyline compared with fluoxetine. Conversely, melancholic depressed patients, age 18-24 years, especially women, had a markedly superior response to fluoxetine. CONCLUSION: Age and gender appear to be critical variables in understanding differential antidepressant responses to tricyclic antidepressants and selective serotonin reuptake inhibitors in melancholic depression.
Adolescent↗
Comparison between noradrenergic and serotonergic medications using the social adjustment scale: is drive enhancement necessary for recovery of social functioning?
The Social Adjustment Scale (SAS) was used to assess social functioning sequentially over 13 weeks in a group of 188 depressed outpatients randomized to either the noradrenergic antidepressant, nortriptyline, or the selective serotonin reuptake inhibitor, fluoxetine. Over the period of 13 weeks, there were no differences in total SAS scores between the nortriptyline and the fluoxetine group. In comparing the SAS subscale scores, which may measure different areas of motivation and behaviour (drive), there were differences between the two groups in only two subscales. At 13 weeks, the group randomized to fluoxetine were more impaired in marital role (p = 0.026) whereas, at 6 weeks, the group randomized to nortriptyline were more impaired in friction scores (p = 0.012). These results do not support the concept of specific augmentation of drive-related behaviour by noradrenergic medication. This challenges the earlier findings relating to drive enhancement and social adjustment using such medication.
Adrenergic Agents↗
The contribution of temperament, childhood neglect, and abuse to the development of personality dysfunction: a comparison of three models.
We examined the contribution of temperament, childhood neglect, and abuse to the development of personality dysfunction as postulated in three different but correlated models of personality: the psychobiological, Vaillant's psychoanalytic, and DSM psychopathology models. Character, defense style, and personality disorder symptomatology (the dependent variables), and temperament, childhood neglect, and abuse (the independent variables) were assessed in 168 depressed outpatients. High harm avoidance (temperament) tended to be the strongest and most consistent risk factor across the three models. Deficient parental care predicted personality dysfunction, however low care was not consistently predictive across all three models. Emotional/psychological abuse and actual physical abuse were risk factors for increasing personality disorder symptomatology only. Childhood sexual abuse was not as predictive of personality dysfunction as might be expected, thereby raising questions as to the importance placed on child sexual abuse as a general risk factor for personality psychopathology.
Adult↗
Interpersonal psychotherapy for anorexia nervosa.
OBJECTIVE: This paper outlines the rationale for treating individuals with anorexia nervosa using interpersonal psychotherapy. METHOD: We review theoretical, empirical, and psychotherapy literature relating to interpersonal functioning in anorexia nervosa. RESULTS: Etiological theories emphasize interpersonal and family dysfunction in the development of anorexia nervosa. Research supports the notion that families of individuals with anorexia nervosa have dysfunctional patterns of communication. The history of treatment for anorexia nervosa emphasizes the need for resolution of interpersonal dysfunction, within the traditions of psychodynamic, family therapy, and multidimensional therapies. DISCUSSION: Interpersonal psychotherapy is a time-limited psychotherapy based on the notion that regardless of etiology, interpersonal relationships are intertwined with symptomatology. The goals of the therapy are to improve interpersonal functioning and thereby decrease symptomatology. Factors identified as important in the development of anorexia nervosa are readily conceptualized within the interpersonal psychotherapy problem areas of grief, interpersonal disputes, interpersonal deficits, and role transitions.
Anorexia Nervosa↗
Gender differences in the presentation of depressed outpatients: a comparison of descriptive variables.
BACKGROUND: Gender differences in the clinical manifestation of depression and related variables were examined in 170 depressed outpatients. METHOD: Age of onset of depression, chronicity, recurrence, subtype of depression, self-harm history and prior treatment history were assessed with structured clinical interviews. Depression symptom profile, family psychiatric history and social, occupational and interpersonal functioning were assessed with self-report and clinician ratings. RESULTS: Overall, males and females were remarkably similar. Significant findings were that depressed females reported significantly more appetite increase, weight gain and carbohydrate craving, and in general, expressed their depression in a more emotional manner, than depressed males. CONCLUSION: Psychosocial and biological explanations for these results are explored. LIMITATIONS: Descriptive study and multiple testing
Adult↗
Gender differences in the rate of comorbid axis I disorders in depressed outpatients.
We examined gender differences in comorbid Axis I disorders in 236 outpatients with major depression. Axis I comorbidity, age of onset of depression and comorbid disorder were assessed with the SCID-P. Depression severity was assessed with the HAM-17. The results indicated that males had a higher rate of comorbid substance abuse/dependence, while females had a higher rate of comorbid bulimia nervosa. These results are consistent with previous research, with the marked exception that females did not have higher rates of anxiety disorders in general, and in particular, panic disorder, simple and social phobia, obsessive-compulsive disorder and agoraphobia. It is concluded that the female predominance in anxiety disorders found in general population studies may be due to comorbidity with depression.
Adult↗
Early deficient parenting in depressed outpatients is associated with personality dysfunction and not with depression subtypes.
BACKGROUND: We investigated the associations between recollected levels of parental care and current symptomatology, axis I and axis II comorbidity and family psychiatric history in 248 depressed outpatients. METHODS: The sample was divided into three approximately equal groups according to PBI scores. Current symptomatology was assessed with the SCL-90, SAS and HAM-17. Axis I and axis II comorbidity were assessed with the SCID-P and SCID-II respectively. RESULTS: Deficient parenting was not associated with melancholia, age of onset or severity of depression. Significant linear associations were found for recurrent depression, comorbid substance disorder, current symptomatology and, of most significance, personality disorders. CONCLUSION: Personality dysfunction may mediate the relation between early parental deprivation and adult psychopathology. LIMITATIONS: Possible limitations include retrospective recall of parental care and the state effects of depression on assessment.
Adolescent↗
The relationship of dysfunctional attitudes to personality in depressed patients.
AIM: To examine the relationship between dysfunctional attitudes and personality in depressed patients. METHOD: One hundred depressed patients completed both the Dysfunctional Attitudes Scale (DAS) and the Temperament and Character Inventory (TCI). RESULTS: Scores on the DAS correlated with duration of depression, age of onset of depression, age, harm avoidance and self-directedness. In a multiple regression analysis three measures explained 45% of the DAS score. These were duration of depression, reward dependence and self-directedness. In both the univariate analyses and multiple regression the strongest predictor of dysfunctional attitudes was the character dimension of self-directedness. CONCLUSION: The character dimension of self-directedness in the TCI which assesses an individuals' self-concept, relates highly with the dysfunctional attitudes score on the DAS. Given that the TCI assesses personality within a broader framework of a psychobiologic and developmental model, self-directedness may have a wider application as a measure of self-concept than the DAS.
Adult↗
Gender differences in the frequency of personality disorders in depressed outpatients.
We examined gender differences in the frequency of DSM-III-R personality disorder diagnoses and symptomatology in a sample of 225 depressed outpatients. This research partially replicates and extends one of the first studies in this area by Golomb et al. (1995). Males were significantly more likely than females to meet diagnoses for schizotypal, paranoid, narcissistic, antisocial, obsessive compulsive, and borderline personality disorder. Compared to females, males were also significantly more likely to have schizoid, schizotypal, narcissistic, antisocial, and obsessive-compulsive personality disorder symptomatology. Females did not predominate in any personality disorder symptomatology or diagnoses. A possible explanation for these findings is discussed. The results of this study challenge traditional assumptions about gender differences in the frequency of personality disorders, and confirm the need for future studies to investigate the relation between gender and personality disorders in specific Axis I samples.
Adult↗
Relationship between interpersonal psychotherapy problem areas with temperament and character: a pilot study.
OBJECTIVE: To examine the relationships between dimensions of personality assessed by using the Temperament and Character Inventory and presenting problem areas in Interpersonal Psychotherapy. METHOD: One hundred two depressed patients completed the Temperament and Character Inventory (TCI), and Interpersonal Psychotherapy (IPT) problem areas were assessed using a clinician-rated questionnaire. RESULTS: Following multiple regression analysis, patients rated as having problems with grief scored low on self transcendence, those with disputes had low cooperativeness, those with role transitions had low novelty seeking, and those with deficits had low reward dependence. CONCLUSIONS: Both temperament and character may be relevant to the nature of presenting problems related to Interpersonal Psychotherapy. An understanding of how personality is relevant to presenting interpersonal problems may provide both a framework and a focus with which to work in this form of psychotherapy.
Adult↗