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Biomedical subjects

T B Mackenzie

Publications and source records attributed to T B Mackenzie.

At least 19 recordsLinked to original sources
PubMed1996

The effects of alcohol consumption on laboratory-induced panic and state anxiety.

BACKGROUND: This study tested whether alcohol consumption reduces anxiety and panic associated with a panic-challenge procedure. METHODS: Subjects with panic disorder were randomly assigned to consume either a moderate dose of alcohol or a nonalcoholic placebo. All subjects were told that they were drinking alcohol to control beverage expectancies. Following the beverage administration, subjects underwent a panic challenge (35% carbon dioxide) and a series of anxiety symptom assessments. RESULTS: Subjects who consumed alcohol reported significantly less state anxiety both before and after the challenge. In response to the challenge, subjects who consumed alcohol experienced significantly fewer panic attacks when applying liberal panic criteria; however, this effect only approached significance when applying conservative panic criteria. CONCLUSIONS: These findings suggest that alcohol acts acutely to reduce both panic and the anxiety surrounding panic, and they lend support to the view that drinking behavior among those with panic disorder is reinforced by this effect. We suggest that this process may contribute to the high rate at which alcohol-use disorders co-occur with panic disorder.

Adult↗
PubMed1996

Placement of an implantable venous access device for use in maintenance ECT.

Achieving intravenous (i.v.) access prior to electroconvulsive therapy (ECT) can be painful and time consuming. It may contribute to premature discontinuation of therapy. The authors report a novel method of ensuring i.v. access in a patient receiving maintenance ECT who developed an aversion to needle sticks. A Port-A-Cath P.A.S. vascular access catheter, placed in her left forearm, has been used for > 30 treatments without complication.

Adult↗
PubMed1995

Identification of cues associated with compulsive, bulimic, and hair-pulling symptoms.

Subjects with obsessive compulsive disorder, bulimia nervosa, or trichotillomania selected cues which elicited or worsened their symptoms from a 339 item list. Principal components analysis suggested a four-component solution. Each disorder was significantly associated with one of these components. Diagnostic assignment based on component scores yielded 85% correct classification. The diagnostic groups did not differ on a negative feeling state component. The results indicate that both disorder-specific and generic components exist. This approach has potential for defining clinical subtypes, studying the interaction of feeling states and environmental cues in evoking symptoms, and designing treatment strategies.

Adolescent↗
PubMed1994

Compulsive buying: descriptive characteristics and psychiatric comorbidity.

BACKGROUND: Compulsive buying is infrequently described in the psychiatric literature despite suggestions that it may be prevalent. The authors investigated the demographics and phenomenology of this syndrome and assessed psychiatric comorbidity via interviews of both compulsive buyers and normal buyers. METHOD: Twenty-four compulsive buyers were compared with 24 age- and sex-matched normal buyers using (1) a semistructured interview for compulsive buying and impulse control disorders, (2) a modified version of the Structured Clinical Interview for DSM-III-R, and (3) scales measuring compulsiveness, depression, and anxiety. RESULTS: The typical compulsive buyer was a 36-year-old female who had developed compulsive buying at age 17 1/2 and whose buying had resulted in adverse psychosocial consequences. Purchases were usually of clothes, shoes, jewelry, or makeup, which frequently went unused. Compared with normal buyers, compulsive buyers had a higher lifetime prevalence of anxiety disorders, substance use disorders, and eating disorders and were more depressed, anxious, and compulsive. Among compulsive buyers, 16 (66.7%) described buying that resembled obsessive compulsive disorder, whereas 23 (95.8%) described buying that resembled an impulse control disorder. CONCLUSION: Compulsive buying is a definable clinical syndrome that can result in significant psychosocial impairment and which displays features of both obsessive compulsive disorder and the impulse control disorders.

Adult↗
PubMed1993

Cues to obsessive-compulsive symptoms: relationships with other patient characteristics.

The waxing and waning of symptoms in obsessive-compulsive disorder (OCD) suggests that environmental cues may impact on exacerbations of this disorder. Eighty-one Ss with OCD completed the Cues Checklist (CCL; Mackenzie, Ristvedt, Christenson, Lebow & Mitchell, 1992), a 339-item checklist of rationally-derived cues and circumstances that might be expected to elicit or worsen symptoms. Principal components analysis revealed four components: household order and organization, contamination and cleaning, negative affect, and prevention of harm and checking. Total number of cues endorsed and component scores were correlated with other characteristics of the disorder, and with the presence of other Axis I and II disorders. Patterns of cue endorsement related to standard measures of obsessive-compulsive content but not to symptom severity. Early-onset Ss endorsed a greater number of cues. History of depression, anxiety disorders and Axis II pathology related most strongly to scores on the negative affect component. The values and limitations of this approach are discussed.

Adolescent↗
PubMed1993

Identification of trichotillomania cue profiles.

To explore the usefulness of emotional and environmental cues in distinguishing different patterns and potential subtypes of hair pulling in trichotillomania, we looked at the responses of 75 chronic hair pullers who had identified relevant cues for hair pulling from a 339 item list. Principal components analysis suggested two independent components which were important to hair pulling, one distinguished by negative affective states (NA), and the other by sedentary activities and contemplative attitudes (S). High NA scores were related to hair pulling which was the focus of the Ss' attention, as well as with increased prevalence of lifetime obsessive compulsive disorder, other anxiety disorders, current and past depression, and obsessive compulsive personality disorder. High SA scores were related to a history of major depression only. Weighted scores on these components may be useful in further elaborating the phenomenology of trichotillomania and designing appropriate treatment interventions.

Adult↗
PubMed1993

Depression in Alzheimer patients: discrepancies between patient and caregiver reports.

Estimates of the prevalence of depression in dementia patients vary widely. One problem in accurate identification of such depression is determining whether to rely on demented patients' reports or second-party caregivers' reports of symptoms. To further explore this problem, 31 outpatients with probable Alzheimer disease and their 31 caregivers were interviewed separately with depressive symptom questionnaires. Caregivers reported more depressive symptoms in dementia patients than patients reported for themselves. Correlations between caregivers' and patients' reports of individual symptoms ranged between -0.23 to 0.76, with lowest correlations found for intrapsychic distress, cognitive impairment, and hallucinations. Patients' responses were not necessarily affected by stereotypic responding or severity of impairment, but patients appeared to under-report symptomatology. Caregivers' responses were associated with the extent of contact with the patients, familial relationship, and sources of information used to determine patients' mood but were not correlated with caregivers' depression or ratings of how they would feel if they were "in the patient's shoes."

Aged↗
PubMed1991

A placebo-controlled, double-blind crossover study of fluoxetine in trichotillomania.

OBJECTIVE: It has been proposed by some investigators that trichotillomania, a disorder of chronic hair pulling, is a variant of obsessive-compulsive disorder, and some studies have suggested that the antiobessional agents clomipramine and fluoxetine are useful in treating this disorder. The authors investigated the efficacy of fluoxetine in the treatment of trichotillomania. METHOD: Twenty-one adult chronic hair pullers were recruited into an 18-week placebo-controlled, double-blind crossover study of fluoxetine, in doses up to 80 mg/day. The fluoxetine and placebo treatment phases consisted of 6-week trials of each agent separated by a 5-week washout period. Fifteen subjects (14 female and one male) completed the study; an additional female subject dropped out at 16 weeks after developing a drug reaction. RESULTS: No significant Drug by Period interactions were found in weekly subject ratings of hair pulling, weekly subject ratings of the urge to pull hair, weekly assessments of the number of hair-pulling episodes, or the estimated amount of hair pulled per week. CONCLUSIONS: The short-term efficacy of fluoxetine in the treatment of trichotillomania was not demonstrated in this study.

Adult↗
PubMed1991

Characteristics of 60 adult chronic hair pullers.

OBJECTIVE: This study was constructed to detail the demographic and phenomenological features of chronic hair pullers as well as to assess psychiatric comorbidity in a sizable study group. METHOD: Subjects were drawn from an outpatient population of chronic hair pullers who had been referred to a trichotillomania clinic or had responded to a newspaper advertisement announcing a treatment study of adults who pull out their hair. Sixty adult chronic hair pullers completed a semistructured interview that focused on their hair-pulling behavior and demographic characteristics and that incorporated screening questions for DSM-III-R axis I disorders. The data were tabulated to derive a comprehensive picture of this group. RESULTS: The typical subject was a 34-year-old woman who had pulled hair from two or more sites for 21 years. All subjects described either tension before or relief/gratification after pulling hair from the primary site, but 17% (N = 10) failed to describe both of these characteristics and thus failed to fulfill the DMS-III-R criteria for trichotillomania. Forty-nine subjects (82%) qualified for past or current axis I diagnoses other than trichotillomania. Several characteristics of the study group suggested phenomenological differences between obsessive-compulsive disorder and trichotillomania. CONCLUSIONS: Adult trichotillomania is a chronic disorder, frequently involving multiple hair sites, and is associated with high rates of psychiatric comorbidity. Its relation to obsessive-compulsive disorder requires further clarification. The tension-reduction requirement in DSM-III-R for the diagnosis of trichotillomania may be overly restrictive.

Adult↗
PubMed1991

Lithium treatment of chronic hair pulling.

Ten patients with chronic hair pulling received trials of lithium carbonate of 2 to 14 months' duration. Eight patients demonstrated decreased hair pulling and mild to marked hair regrowth. Three responders experienced increased hair pulling subsequent to discontinuation of lithium treatment. Lithium's effect on hair pulling may be related to its observed benefits in treating aggressivity, impulsivity, and mood instability.

Adolescent↗
PubMed1989

Social phobia. Recognizing the distress signals.

Social phobia is a distinct clinical entity that accounts for significant morbidity. It is often linked to depression and other anxiety disorders and may be a risk factor for alcohol abuse. Primary care physicians can more easily recognize the disorder if they carefully question patients about anxiety in social situations. Effective behavioral and pharmacologic therapies for social phobia are available. However, primary care physicians may prefer to refer patients to a specialist because of inherent difficulties in treatment that may require the experience of a clinician more familiar with the disorder.

Alcoholism↗
PubMed1989

Differences between patient and family assessments of depression in Alzheimer's disease.

A structured interview covering the DSM-III criteria for major depression was adapted for separate use with Alzheimer's disease patients and with their families. Data from 36 patients yielded a depression rate of 13.9%, whereas information from their families indicated that the rate was 50.0%. This disagreement reflected greater family endorsement of patients' loss of interest or pleasure, irritability, fatigue, and feelings of worthlessness. Use of DSM-III-R criteria narrowed but did not eliminate the discrepancy between patients' and families' assessments of the patients' depression. Uniform procedures for gathering and integrating data from the family that are relevant to diagnosis in this group are indicated.

Aged↗
PubMed1988

Memory and awareness in a patient with multiple personality disorder.

We studied an individual with multiple personality disorder in whom each of several personalities claimed to have no direct awareness of the others and to be unable to consciously remember the experiences of other personalities. A broad selection of implicit and explicit memory tests was used to determine the extent to which one personality had access to knowledge acquired by another and the circumstances in which that knowledge would be expressed. The implicit assessment of memory was a necessary but not sufficient condition for demonstrating interpersonality access. The degree of compartmentalization of knowledge in this patient depended largely on whether the interpretation of presented information was likely to differ across personalities.

Awareness↗