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Biomedical subjects

S Kuperman

Publications and source records attributed to S Kuperman.

18 recordsLinked to original sources
PubMed1991

Treatment of ADHD with fluoxetine: a preliminary trial.

Nineteen children and adolescents with attention-deficit hyperactivity disorder were treated with fluoxetine hydrochloride. The drug was administered in an open-label fashion for 6 weeks. At completion of the study, nearly 60% were judged to be at least moderately improved. No effects on appetite or weight were observed, and side effects were minimal. These findings suggest that fluoxetine may prove to be an alternative treatment for some attention-deficit hyperactivity disorder patients.

Adolescent↗
PubMed1990

Neuroimaging in child and adolescent psychiatry.

Although less well studied in child and adolescent psychiatry than in adult psychiatry, brain imaging has significantly altered psychiatric research and practice. This review focuses on the modalities that are used to image the brain. These include structural imaging techniques of computer tomography (CT) and magnetic resonance imaging (MRI), as well as functional imaging techniques of computed electroencephalography (CEEG), positron emission tomography (PET), and single photon emission computed tomography (SPECT). The technologies are reviewed, strengths and weaknesses of modalities discussed, and research progress reported.

Adolescent↗
PubMed1990

Bipolar disorder in a prepubescent child.

Early onset bipolar affective disorder (BAD) is a relatively rare psychiatric disturbance in childhood and early adolescence. Its diagnosis is difficult due to the presentation of symptoms suggestive of other psychiatric illnesses. The literature on BAD in children is reviewed with emphasis on the clinical picture, predictive factors, and pharmacotherapy. Illustrations of these points are made through the use of a case report of a boy who first presented with symptoms at age 7.

Adolescent↗
PubMed1989

Forebrain structure in infantile autism.

Researchers implicate central nervous system dysfunction in infantile autism, but postmortem examinations and in vivo brain imaging studies have produced conflicting results concerning the neuronal systems involved. Magnetic resonance imaging--a new modality of in vivo brain imaging--was used to investigate the cerebral and thalamic structure of 105 autistic patients. Compared with the control group, there was an overall difference in the forebrain morphology of the autistic subjects due to subtle but statistically significant differences in the anterior ventricular horns, lateral ventricles, and the right lenticular nucleus. These results, when considered with previous studies of cerebral structure, suggest that there are subtle alterations in the forebrain of autistic patients.

Adolescent↗
PubMed1988

Excess mortality among formerly hospitalized child psychiatric patients.

Mortality was investigated in 881 male and 450 female formerly hospitalized child psychiatric patients in a four- to 15-year follow-up. Death from natural causes was not increased, but death from unnatural causes occurred at a rate more than twice as high as expected based on age- and sex-matched comparisons with the general population of the state of Iowa. Increased risk of unnatural death was found in five of eight psychiatric diagnostic categories but was significant only for Mental Reasoning, a category that combined patients with organic mental disorders, schizophrenia, or mental retardation. Clinical variables associated with an excess rate of unnatural death included age 15 years or older at the time of admission, the absence of a second psychiatric diagnosis, the presence of previous psychiatric hospitalizations, and the presence of a seizure disorder. Among the 23 unnatural deaths, the 11 (47.8%) suicides were excessive, but accidents and homicides were not.

Accidents↗
PubMed1988

Morphological evidence for brainstem involvement in infantile autism.

Previous neurophysiological and neuroanatomic studies suggest brainstem dysfunction in infantile autism. Therefore, we investigated the brainstem structure of autistic patients by planimetric analysis of midsagittal magnetic resonance imaging scans. We found the entire brainstem and one component--the pons--to be statistically significantly smaller in the autistic group when compared with medical controls. We also noted no correlation between brainstem size and age in the autistic group--a correlation that was found in the control group. These data present morphological evidence of brainstem involvement in the infantile autism syndrome.

Adolescent↗
PubMed1988

Enzyme activity and behavior in hyperactive children grown up.

Thirty-one men, originally seen as children for problems with overactivity, distractibility, and impulsiveness, were reevaluated at ages 21-23 years. Subjects were interviewed and tested and provided a blood sample for analyses of dopamine-beta-hydroxylase (DBH), monoamine oxidase (MAO), and catechol-O-methyl-transferase (COMT). A series of Pearson correlations between the biological variables and psychological measures revealed that MAO levels were negatively associated with measures of drug involvement, cigarette use, fire-setting, and sensation seeking; DBH levels were positively associated with measures of sensation-seeking; and COMT levels were negatively associated with a measure of hostility and positively correlated with a measure of impulsiveness.

Adult↗
PubMed1988

Excess suicide among formerly hospitalized child psychiatry patients.

The authors report suicide risk among 1331 child psychiatry inpatients followed up for 4 to 15 years in a record-linkage study. Age- and sex-matched comparisons were made with the general population of Iowa (the state from which most of the subjects were selected). Suicide rates were higher than expected for both sexes, but the excess (9 suicides) was significant only for males. No suicides occurred earlier than age 17. The risk of suicide was 80 times that expected for schizophrenic patients and 25 times that expected for patients with organic mental disorders. Unlike follow-up studies of adult inpatients, a significant excess of suicide was not associated with affective disorder, substance abuse, neurosis, or anorexia nervosa. Clinical variables indicating more complicated psychiatric disturbance were associated with an even greater rate of suicide; these variables included multiple hospitalizations, a hospital stay of more than 15 days, and the presence of a medical diagnosis.

Adolescent↗
PubMed1987

Cerebellar structure in autism.

Several recent reports suggest cerebellar abnormalities in patients with autism. To further investigate the posterior fossa in vivo, we analyzed axial (transverse) and coronal magnetic resonance imaging (MRI) scans of autistic patients. The MRI scans were measured at life-size by planimetry. Axial MRI scans of "high level" autistic patients were compared with control scans; there were no differences in the fourth ventricles, vermes, cerebella, and cerebellar-pontine "complexes" between the groups. Coronal MRI scans were also studied. In the coronal scans, the cerebella of autistic patients were proportionally smaller and the fourth ventricles proportionally larger. This suggests that there are morphologic changes in cerebella of autistic children; such alteration may best be viewed in the MRI coronal plane.

Adolescent↗
PubMed1987

Fenfluramine treatment of autism: relationship of treatment response to blood levels of fenfluramine and norfenfluramine.

Nine children meeting DSM-III criteria for infantile autism were treated with fenfluramine hydrochloride or inactive placebo in a double-blind crossover trial that followed the protocol for the fenfluramine multicenter study. Parents of the two children who had had the highest fenfluramine blood levels wished to have their children continue on fenfluramine, although the improvement they saw could not be demonstrated on the various rating instruments employed. The results of the study, while providing minimal support in themselves for the effectiveness of fenfluramine, do raise the possibility that fenfluramine blood levels might be related to treatment response.

Adolescent↗
PubMed1987

Association of serotonin concentration to behavior and IQ in autistic children.

Twenty-five boys meeting DSM-III criteria for infantile autism were evaluated for IQ, age, and behavior score on the Autism Behavior Checklist (ABC), in order to determine the ability to predic platelet-rich plasma (PRP) serotonin concentrations. Multiple regression techniques were used to adjust the PRP serotonin concentration for medication and whole blood platelet count to allow meaningful comparisons of serotonin concentrations among the autistic children. Though we found no significant correlation between the adjusted serotonin concentration and the IQ, or between the adjusted serotonin concentration and the various ABC scale scores, four individual items of the ABC did correlate with the adjusted serotonin concentration. Individuals with all of these items appear to be more severely affected with the disorder of autism and have a tendency to higher adjusted PRP serotonin concentration.

Adolescent↗
PubMed1987

Desipramine: a possible treatment for depersonalization disorder.

Primary depersonalization disorder is believed to be resistant to treatment. However, we report the successful treatment of a case with desipramine and suggest that, because there is a link between depersonalization and anxiety disorders, tricyclic antidepressants may prove effective for depersonalization.

Adolescent↗
PubMed1987

Midsagittal magnetic resonance imaging of autism.

Since recent reports suggest structural brain abnormalities in autistic patients, we analysed magnetic resonance imaging (MRI) scans of autistic children. Planimetric measurements were done on midsagittal MRI scans, produced with a 0.5 T superconducting magnet. Scans of 13 'high-level' autistic subjects were compared with 35 control MRI scans, read as anatomically normal by a neuroradiologist. Corpus callosal, fourth ventricular, cerebellar, cerebral, and cranial areas were measured. The fourth ventricle was found to be significantly larger in the autistic group. No other areas in the midsagittal scans differed statistically between groups. Results suggest that structures defining the fourth ventricle are anatomically altered in autistic patients.

Adolescent↗
PubMed1979

The diagnosis of depression in children.

Operational criteria for depression in children were derived from diagnostic criteria designed for adults. These criteria were applied to a series of outpatients and inpatients on a Child Psychiatry Service. Thirteen per cent of girls and 5% of boys admitted to the clinic met the criteria for depression. (For this calculation autistic, brain-damaged and seriously retarded were excluded from the clinic population.) The frequencies of criterion symptoms and some related symptoms are reported. Generally the data suggest that the significant depression does occur as an independent syndrome in children, it is relatively common in a clinic population and it does not differ obviously from depression in adults.

Adolescent↗
PubMed1977

Depersonalization in accident victims and psychiatric patients.

A transient depersonalization syndrome was identified in nearly one third of persons exposed to life-threatening danger (accident victims) and close to 40% of a group of hospitalized psychiatric patients. Although the syndrome was similar in these populations, mental clouding developed more commonly among patients and alertness was more prominent among accident victims. Anxiety was significantly associated with the development of depersonalization among psychiatric patients and was almost certainly a factor in its appearance among accident victims. The findings suggest that this syndrome is a specific response to extreme danger or its associated anxiety.

Accidents, Traffic↗