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S Greenwald

Publications and source records attributed to S Greenwald.

At least 37 records · Page 2Linked to original sources
PubMed1995

Low parental care as a risk factor to lifetime depression in a community sample.

A number of studies have reported links between experiencing low parental care and subsequent depressive experience. As the majority have involved patient samples, links may reflect anomalous parenting disposing to help-seeking behaviour (and patient status) rather than directly to depression. We, therefore, report a community study, so redressing any such artefact emerging from a patient sample and, additionally, quantify the relevance of low parental care to depression in comparison to several other risk factors (i.e., age, gender, educational level, socioeconomic status and marital status). Subjects were drawn from the ECA study and comprised those assessed at the 1-year follow-up interview undertaken at the New Haven site, with parental care being assessed by a key item from the Parental Bonding Instrument (PBI). Those reaching criteria for a lifetime episode of major depressive disorder were significantly more likely to report low care from both parents as well as to be female, divorced or separated, and younger. Low parental care (along with age and mental status but not female sex) appeared pathoplastic in being linked with an increased chance of psychopathology in general, rather than demonstrating specificity to major depressive disorder.

Adult↗
PubMed1995

Growth in utero, adult blood pressure, and arterial compliance.

OBJECTIVES: To examine the relation between disproportionate fetal growth and adult blood pressure and to investigate whether arterial compliance in adult life is related to early development. DESIGN: A follow up study of a group of men and women whose birth weights and other measurements of body size had been recorded at birth. SETTING: Home and outpatient study. SUBJECTS: 337 men and women born in the Jessop Hospital, Sheffield, between 1939 and 1940. MAIN OUTCOME: Adult systolic and diastolic blood pressures and arterial compliance as measured by pulse wave velocity in two arterial segments. RESULTS: Both systolic and diastolic blood pressures were higher in people whose birth weight was low, who were short or who had small abdominal or head circumferences at birth. Systolic blood pressure decreased by 2.7 mm Hg (95% CI 0.8 to 4.6) for each pound (454 g) gain in birth weight and by 3.4 mm Hg (95% CI 1.4 to 5.4) for each inch (2.54 cm) increase in crown-heel length. Diastolic pressure fell by 1.9 mm Hg (95% CI 0.9 to 2.9) for each pound (454 g) gain in birth weight and by 2.4 mm Hg (95% CI 1.4 to 3.5) for each inch (2.54 cm) increase in length. Systolic blood pressure was also higher in individuals whose mother's intercristal pelvic diameter was small or whose mother's blood pressure had been raised during pregnancy but these effects were statistically independent of the effects of low birth weight and other measurements that indicate fetal growth retardation. Arterial compliance was lower in those who had been small at birth. CONCLUSION: Impairment of fetal growth is associated with raised blood pressure in adult life and decreased compliance in the conduit arteries of the trunk and legs.

Arteries↗
PubMed1994

Panic disorder and gastrointestinal symptoms: findings from the NIMH Epidemiologic Catchment Area project.

OBJECTIVE: Clinical experience and recent reports suggest that there is a high prevalence of gastrointestinal symptoms in patients with panic disorder and that there is a high prevalence of panic disorder in patients with irritable bowel syndrome, a functional gastrointestinal disorder. To assess gastrointestinal symptoms in a nonpatient, community-based sample, the authors surveyed the prevalence of gastrointestinal symptoms in individuals with panic disorder and other or no psychiatric disorders obtained in a national community survey. METHOD: Subjects were 13,537 respondents at four sites of the National Institute of Mental Health (NIMH) Epidemiological Catchment Area project. DSM-III diagnoses were determined by using the NIMH Diagnostic Interview Schedule (DIS). Gastrointestinal symptoms were assessed from the somatization disorder section of the DIS. RESULTS: Individuals with panic disorder had a significantly higher rate of endorsing gastrointestinal symptoms, including those typically associated with irritable bowel syndrome, than those with other or no psychiatric diagnosis. CONCLUSIONS: Findings suggest a diagnostic overlap between panic disorder and irritable bowel syndrome, with similar demographic and clinical characteristics of patients. Limitations of the study are discussed in terms of medical assessment and self-report inventories. Practical and theoretical implications are discussed.

Adolescent↗
PubMed1994

The cross national epidemiology of obsessive compulsive disorder. The Cross National Collaborative Group.

Data on the epidemiology of psychiatric disorders from different parts of the world using similar methods and diagnostic criteria have previously not been available. This article presents data on lifetime and annual prevalence rates, age at onset, symptom profiles, and comorbidity of obsessive compulsive disorder (OCD), using DSM-III criteria, from community surveys in seven countries: the United States, Canada, Puerto Rico, Germany, Taiwan, Korea, and New Zealand. The OCD annual prevalence rates are remarkably consistent among these countries, ranging from 1.1/100 in Korea and New Zealand to 1.8/100 in Puerto Rico. The only exception is Taiwan (0.4/100), which has the lowest prevalence rates for all psychiatric disorders. The data for age at onset and comorbidity with major depression and the other anxiety disorders are also consistent among countries, but the predominance of obsessions or compulsions varies. These findings suggest the robustness of OCD as a disorder in diverse parts of the world.

Adolescent↗
PubMed1992

Jewish Americans and mental health: results of the NIMH Epidemiologic Catchment Area Study.

Data from the Epidemiologic Catchment Area Study showed that the overall lifetime rate of psychiatric disorder among Jews did not differ from the rate among non-Jews. However, there was a significant difference between Jewish and non-Jewish samples when comparing the distribution of specific psychiatric disorders. Compared with Catholics and Protestants, Jews had significantly higher rates of major depression and dysthymia, but lower rates of alcohol abuse. Jews were more likely than Catholics or Protestants to seek treatment with mental health specialists and general practitioners. These differences remained statistically significant after adjusting for sex, age, race and socioeconomic status.

Adolescent↗
PubMed1992

Axonal injury in closed head injury by assault: a quantitative study.

Due to the controversy in the literature regarding the time course of axonal balloon formation in human material, we wished to determine if it was possible to diagnose axonal injury before the development of axonal balloonings. The hypothesis was that the presence of axonal swellings or axonal enlargements associated with a glial reaction could be used as a diagnostic aid in human axonal injury before 12 hours. The brains of eight individuals that survived for less than 48 hours following head injury, and also had evidence of axonal injury using the criteria of Vanezis et al. (1987), were systematically studied by looking at axonal swellings, axonal balloonings, reactive astrocytes, maximum diameter of axonal enlargements and density of axonal enlargements. Controls were eight selected cases without neurological disease. The variables studied were assessed in 25 fields from ten different areas of the brain, using silver stains and immunoperoxidase for glial fibrillary acidic protein (GFAP). Logarithms of one plus the count of each variable were taken from the raw data and these were analysed using percentile distribution and the median, the t-test, Mann-Whitney U test and the Wilcoxon signed rank test. We conclude that quantitation of axonal damage allows the detection of mild degrees of axonal injury that could be overlooked on routine examination, and that the criteria of axonal enlargements, rather than axonal balloonings, are indications of axonal damage, cannot be endorsed with the evidence provided.

Axons↗
PubMed1992

Calcium phosphate crystal distribution in the superficial zone of human femoral head articular cartilage.

The distribution of cuboid crystals in articular cartilage was examined by image analysis of electron micrographs. The specimens were considered to be functionally normal articular cartilage from femoral heads resected either because of femoral neck fracture or tumour in the distal femur. The study was restricted to the superficial region between 0 and 50 microns depth. Crystals were present in all specimens regardless of the age of the patient. The crystal profile area density was significantly greater in superior region samples than inferior region samples and this difference was less in older specimens. A band of microcrystals 10-20 microns below the articular surface was observed in superior samples. A significant correlation between mean individual crystal profile area and age was observed. It is noted that crystals are present in regions of cartilage subject to high mechanical stress.

Adolescent↗
PubMed1992

A double-blind clinical trial of alprazolam, imipramine, or placebo in the depressed elderly.

The efficacy and safety of alprazolam as compared to imipramine or a placebo added to weekly interpersonal psychotherapy was compared in a 6-week double-blind randomized clinical trial of 35 ambulatory elderly patients with major depression. The average maximum dosage of alprazolam was 2.2 mg and the average maximum dosage of imipramine was 97.5 mg. The findings showed a rapid onset of action of alprazolam within 1 week on symptoms of depression and anxiety. The effects for imipramine were seen later in the study. There were no serious side effects that interfered with treatment. The anticholinergic effects of imipramine were the ones that most commonly interfered with treatment. Alprazolam produced the greatest number of symptoms with discontinuation, most of which were alleviated within a week. We conclude that alprazolam may be useful as an antidepressant for the elderly. More clinical trials are needed to test its efficacy in the depressed elderly with concomitant medical problems, using plasma levels. A double-blind discontinuation study of alprazolam is needed to determine the degree of symptom return.

Aged↗
PubMed1991

Panic attacks in the community. Social morbidity and health care utilization.

This article focuses on social morbidity and health care utilization in persons with panic attacks not meeting full diagnostic criteria for panic disorder. The findings are based on data from a random sample of over 18,000 adults drawn from five US communities. Panic attacks not meeting full criteria for panic disorder have a relatively high lifetime prevalence (3.6% of the adult population). Persons with panic attacks had impairment in perceived physical and emotional health, and in occupational and financial functioning, increased use of health care facilities, emergency departments, and psychoactive drugs. Persons with panic attacks were intermediate in severity between those with panic disorder and those with other psychiatric disorders. The findings could not be explained by comorbidity with other psychiatric disorders. We conclude that panic attacks have clinical significance and are associated with substantial morbidity.

Adolescent↗
PubMed1991

Language change in child psychotherapy: a meta-analytic review.

Eighteen child therapy outcome studies, containing 26 treatment/control comparisons on at least one language measure, were evaluated. Four questions were addressed: (a) Does child therapy positively impact children's language proficiencies, and are its effects comparable to those obtained on nonlanguage outcome measures? (b) Do outcome effects vary across individual versus group treatment? (c) Does the type of emphasis on verbal process in treatment affect the degree of gain in the children's language proficiencies at outcome? and (d) Do effect sizes on language measures differ depending on type of presenting problem? Results indicate that child therapy has a significant positive impact on children's language proficiencies and that individual is superior to group treatment. Several trends emerged suggesting relationships between the magnitude of language change and type of emphasis on verbal processes in therapy and the childs' presenting problems. Further research on language variables is recommended.

Child↗
PubMed1991

The glial reaction in closed head injuries.

The development of the glial reaction in human closed head injury has been investigated using morphometry and statistical analysis. The brains of eight individuals that survived less than 48 h following closed head injury were analysed using immunoperoxidase for glial fibrillary acidic protein (GFAP). Controls were eight patients without neurological disease. The density of reactive astrocytes was estimated in 25 fields in each of 10 different areas sampled bilaterally avoiding the subpial and subependymal zones, and the perivascular white matter. There was great variation between the zones within and between groups, and considerable variation between individuals. The raw data were expressed as logarithms averaged and analysed using the median and non-parametric statistics. The corpus callosum in the head injury group showed the highest densities of reactive astrocytes, particularly in the splenium which achieved statistical significance using the non-parametric tests. This pattern was not reproduced in the control group. Although there was overlap between the head injured and control individuals, the head injury group had relatively higher densities in all zones, and showed an overall increase in the density of reactive astrocytes. This achieved statistical significance in the corpus callosum, the occipital subcortical white matter, and the cerebellum. This study has shown that the glial reaction is often prominent in the corpus callosum irrespective of the presence of a primary lesion although the pattern varies from case to case.

Adult↗
PubMed1990

Panic disorder and cardiovascular/cerebrovascular problems: results from a community survey.

Follow-up studies of psychiatric patients with panic disorder have shown an abnormally high mortality rate in men due to cardiovascular and cerebrovascular events. The authors report that in the New Haven portion of the Epidemiologic Catchment Area program the risk for stroke in persons with lifetime diagnoses of panic disorder was over twice that in persons with other psychiatric disorders or no psychiatric disorder. After adjustments for demographic differences between groups, the risk was even higher. While the results should be interpreted cautiously because of the small sample and absence of medical examinations, these findings are consistent with clinical studies showing an association between panic disorder and cardiovascular/cerebrovascular events.

Adolescent↗
PubMed1983

The Tay-Sachs disease gene in North American Jewish populations: geographic variations and origin.

From data collected in a North American Tay-Sachs disease (TSD) heterozygote screening program, the TSD carrier frequency among 46,304 Jewish individuals was found to be .0324 (1 in 31 individuals). This frequency is consistent with earlier estimates based on TSD incidence data. TSD carrier frequencies were then examined by single country and single region of origin in 28,029 Jews within this sample for whom such data were available for analysis. Jews with Polish and/or Russian ancestry constituted 88% of this sample and had a TSD carrier frequency of .0327. No TSD carriers were observed among the 166 Jews of Near Eastern origins. Relative to Jews of Polish and Russian origins, there was at least a twofold increase in the TSD carrier frequency in Jews of Austrian, Hungarian, and Czechoslovakian origins (P less than .005). These findings suggest that the TSD gene proliferated among the antecedents of modern Ashkenazi Jewry after the Second Diaspora (70 A.D.) and before their major migrations to regions of Poland and Russia (before 1100 A.D.).

Female↗