Biomedical subjects

V J Grochocinski

Publications and source records attributed to V J Grochocinski.

36 records · Page 2Linked to original sources

PubMed1991

EEG sleep profiles and recurrent depression.

Earlier investigations have suggested that electroencephalographic (EEG) sleep may be altered as a function of the duration of an episode of depression. We compared the EEG sleep profiles in a group of recurrent depressives who had been depressed for less than 6 weeks with their sleep profiles as measured during their previous episode of depression. Findings in this sample of 32 patients point to the presence of specific rapid eye movement (REM) sleep abnormalities as being more pronounced earlier in the course of a depressive episode. Changes in REM latency and REM activity were also reflected in reductions in EEG spectral power in almost all bandwidths during the first REM period of the recurrent episode. These results are not easily explainable on the basis of traditional measures of clinical severity or the number of episodes.

Adult↗

PubMed1991

Fluvoxamine versus desipramine: comparative polysomnographic effects.

Electroencephalogram sleep measures over a 4-week period were obtained on 35 inpatients with major depression (unipolar) who received either fluvoxamine or desipramine in a randomized double-blind trial. Fluvoxamine showed immediate rapid eye movement (REM) sleep suppression and an alerting effect on sleep continuity measures. In contrast, desipramine administration was associated with REM suppression and sleep continuity improvement. The "alerting" quality of fluvoxamine, similar to other serotonergic antidepressants, appears to be unrelated to a lack of clinical efficacy, but may be related to persistent REM sleep suppression. However, it is premature to comment on the serotonin specificity for REM sleep.

Adult↗

PubMed1990

Three-year outcomes for maintenance therapies in recurrent depression.

We conducted a randomized 3-year maintenance trial in 128 patients with recurrent depression who had responded to combined short-term and continuation treatment with imipramine hydrochloride and interpersonal psychotherapy. A five-cell design was used to determine whether a maintenance form of interpersonal psychotherapy alone or in combination with medication could play a significant role in the prevention of recurrence. A second question was whether maintaining antidepressant medication at the dosage used to treat the acute episode rather than decreasing to a "maintenance" dosage would provide prophylaxis superior to that observed in earlier trials in which a maintenance dosage strategy was employed. Survival analysis demonstrated a highly significant prophylactic effect for active imipramine hydrochloride maintained at an average dose of 200 mg and a modest prophylactic effect for monthly interpersonal psychotherapy. We conclude that active imipramine hydrochloride maintained at an average dose of 200 mg is an effective means of preventing recurrence and that monthly interpersonal psychotherapy serves to lengthen the time between episodes in patients not receiving active medication.

Adult↗

PubMed1990

Delta sleep ratio. A biological correlate of early recurrence in unipolar affective disorder.

Slow wave sleep abnormalities have long been described in depression but were considered to be nonspecific indicators of psychopathology. Computerized techniques, including amplitude frequency measures and spectral analyses, are permitting new approaches to the examination of delta sleep. Early studies suggested that many depressed patients demonstrate lower delta wave intensity during the first non-rapid eye movement period than the second one. This finding, prominent in middle-aged depressed patients, has led to an examination of the ratio between the first and second non-rapid eye movement periods. This delta sleep measure seems to be a more robust predictor of recurrence than rapid eye movement latency. Analysis of data on 74 patients in a long-term maintenance treatment study for a minimum of 24 months demonstrates that the delta sleep ratio can predict survival time following discontinuation of drug treatment. Individuals with a high delta sleep ratio remain clinically remitted five times longer than those with a low delta sleep ratio.

Adult↗

PubMed1988

Electroencephalographic sleep in mania.

Electroencephalographic (EEG) sleep patterns were examined in nine unmedicated patients meeting DSM-III-R criteria for a current manic episode (four men and five women) for two to four consecutive nights. Compared with age- and sex-matched normal control subjects, manic patients exhibited significantly decreased total recording period, decreased time spent asleep, increased time awake in the last two hours of recording, shortened rapid eye movement (REM) latency, increased REM activity, and increased REM density. These results suggest that mania is associated with marked disturbances of sleep continuity and REM measures. Sleep continuity and REM sleep abnormalities of a similar nature and degree have been reported in major depression and psychotic depression. Thus, it is possible that various forms of affective disorders and psychotic disorders have pathophysiologic mechanisms in common.

Adolescent↗

PubMed1988

Electroencephalographic sleep profiles in recurrent depression. A longitudinal investigation.

The electroencephalographic sleep profile of a group of recurrent depressives who had been depressed for less than four weeks was compared with their sleep profile in a prior episode of depression. The findings in these 19 cases indicate that early in the episode, rapid eye movement (REM) sleep findings are more abnormal, including shortened REM latency, REM sleep percent, and REM activity. Other sleep variables, such as sleep continuity measures and decreased delta-wave sleep, are abnormal in a similar fashion in both episodes. The results are not explainable on the basis of clinical severity or number of episodes and call for increased attention to the potential relationships between the psychobiological pattern and duration and course of the depressive episode.

Adult↗

PubMed1987

Methodology in psychiatric research. Report on the 1986 MacArthur Foundation Network I Methodology Institute.

This report discusses many of the issues raised during a two-day institute that focused on methodological problems encountered in psychiatric research. The topics range from the problems with psychiatric diagnosis and measurement to sampling issues and biases to specific statistical concerns. Attention is given to the need for improved communication and collaboration between psychiatric researchers and biostatisticians.

Biometry↗

PubMed1986

Comparison of automated REM and slow-wave sleep analysis in young and middle-aged depressed subjects.

A comparison of electroencephalographic sleep measures between young and middle-aged groups of depressed inpatients was conducted with specific interest in the application of automated measures of REM and delta wave sleep. Aside from the expected differences in sleep continuity, increased Stage 1 percent, decreased Stage 2 percent, and decreased REM latency in the middle-aged depressives as compared to the younger depressives, distinct findings from automated analyses were noted in the distribution of REM and delta sleep throughout the night. Although the younger depressed patients showed increased numbers of delta waves, the middle-aged depressives showed greater average REM count. Such changes were more pronounced in the first third of the night. Finally, in the middle-aged depressives, little statistical relationship between manual measures of slow-wave sleep and automated measures of delta sleep was found.

Adult↗

PubMed1986

Aspects of short REM latency in affective states: a revisit.

Electroencephalographic (EEG) sleep changes in affective disorders have been characterized by sleep continuity, slow wave sleep, and rapid eye movement (REM) abnormalities. The most commonly cited feature, however, has been shortened REM latency. Because the diagnostic and prognostic significance of shortened REM latency has been debated, this issue was reexamined in a group of 186 psychotic and nonpsychotic depressed inpatients and outpatients. The analyses suggest an increased frequency of sleep onset REM periods in psychotic depression and in elderly depressed patients (psychotic or nonpsychotic).

Adolescent↗

PubMed1986

Relationship of awakening and delta sleep in depression.

It has been demonstrated that deficiencies in slow-wave sleep occur in the sleep profiles of depressed patients. Recent theories of sleep regulation link a deficiency in the so-called "Process S" to these slow-wave sleep alterations. However, the degree of wakening during sleep has been suggested as the explanation for reduced slow-wave sleep. In the present study, the extent of this relationship was examined in both depressed patients and normal subjects. Only a relatively low level of correlation between the degree of wakening and reduction in slow-wave sleep was noted in depressed patients. This finding on 38 unipolar depressed patients is similar to the findings on a smaller sample of depressed individuals.

Adult↗

PubMed1985

Electroencephalographic sleep of younger depressives. Comparison with normals.

The electroencephalographic sleep of younger depressives (aged 20 to 44 years) was compared with that of an age-matched group of normals. The patients demonstrated many of the typical sleep changes reported for older depressed populations: shortened rapid-eye-movement (REM) latency; REM sleep activity alterations, with a shift to the early portion of the night (first REM period); reduced delta sleep; and sleep efficiency reductions marked by sleep-onset difficulties. The traditional scoring procedures were supplemented by automated REM and delta-sleep analyses that provided more precise delineation of these differences between patients and normals, particularly the distributions of REM activity and delta-wave patterning.

Adult↗

PubMed1985

Comparison of effects of desipramine and amitriptyline on EEG sleep of depressed patients.

Despite their widespread use, there are few data concerning the effects of tricyclic antidepressants on EEG sleep in depression. The present study documented the effects of desipramine (DMI, n = 17) and amitriptyline (AT, n = 16) upon EEG sleep in hospitalized depressed patients as part of a double-blind protocol involving 28 days of active treatment. Compared to placebo, patients receiving DMI showed somewhat worsened sleep continuity, particularly after 1 week of administration when the dose was 150 mg/day. On the other hand, sleep architecture and REM measures showed a rapid suppression of REM sleep, and then partial tolerance for this effect was observed with continued administration of DMI for 3 weeks. DMI was a more potent suppressor of REM sleep, while AT was more sedative. Based on these differences in effects upon EEG sleep, a discriminant function was derived and resulted in a correct classification of 87.5% of AT cases and 76.5% of DMI cases. These results are discussed in terms of the differences in pharmacological profiles for uptake blockade and anticholinergic potency for these two compounds.

Adult↗

PubMed1985

Slow wave sleep in elderly depressed, demented, and healthy subjects.

The application of automated analysis in the measurement of sleep electroencephalogram delta activity allows a more precise temporal description of slow wave sleep changes in normal and pathological aging than do standard, all-night, slow wave sleep measures. Thus, with a baseline crossing technique, elderly depressives were shown to have a higher delta count per minute during the second NREM sleep period than did controls or demented subjects. This difference reflected greater activity per minute in the 2-3 Hz frequency band (75-200 microV).

Aged↗

PubMed1984

Biological and clinical predictors of response in recurrent depression: a preliminary report.

Electroencephalographic (EEG) sleep and selected hormone measurements were investigated in a group of 34 recurrent depressives receiving both pharmacotherapy and psychotherapy. These biological variables were examined to determine whether such measures could predict the rapidity of treatment response. While the EEG measures of sleep onset difficulty and degree of rapid eye movement (REM) density provided some level of discrimination, the serum cortisol measure, particularly the cortisol nadir, significantly discriminated between normal responders and slow or nonresponders. These data support the notion that biological factors measured before treatment might relate to the rapidity and extent of clinical response achieved by the patient.

Adult↗

PubMed1984

Differential effects of amitriptyline and of zimelidine on the sleep electroencephalogram of depressed patients.

The effects of amitriptyline (n = 14) or zimelidine (n = 13) on the sleep electroencephalogram of hospitalized depressed patients were assessed in a double-blind protocol involving 28 days of active dosing. Zimelidine induced no immediate improvement in sleep continuity, and even after 3 wk on zimelidine subjects tended to have longer sleep latency, more awakenings, and lighter non-rapid eye movement (REM) sleep than before taking the drug. Zimelidine did, however, induce a rapid and persistent alteration of sleep architecture and selected REM measures. REM sleep, which was suppressed over the first two nights on zimelidine, was maximally suppressed after 1 wk, but by 3 wk there was some tolerance for selected REM measures. While zimelidine induced none of the sedative effects of amitriptyline, both were equivalent in their REM-suppressant effects. These findings are discussed in terms of the differences in uptake blockade and anticholinergic potency in these two drugs.

Adult↗

PubMedDate not supplied

Sleep-related growth hormone secretion is persistently suppressed in women with recurrent depression: a preliminary longitudinal analysis.

Growth hormone secretion was monitored during sleep in a group of 43 women with recurrent major depression who were participating in a 3-year maintenance therapy program. Patients were studied before acute treatment, after complete remission, and at 3-month intervals during maintenance treatment and the data generated were compared to those obtained in a control group of 14 age-matched healthy women studied once under identical conditions. When compared to the control group, the depressed patients secreted significantly less growth hormone before treatment. This reduction in growth hormone secretion, which was confined to the first half of the sleep period, persisted across the length of the maintenance study regardless of whether the subjects completed three years of therapy or experienced a recurrence.

Adult↗

PubMedDate not supplied

Panic-agoraphobic spectrum: reliability and validity of assessment instruments.

DSM IV is a simple, reliable diagnostic system with many advantages. However, DSM diagnostic criteria may not provide sufficient characterization of clinically significant symptoms. We have undertaken a project to assess an array (spectrum) of clinical features associated with different DSM Disorders. The purpose of this paper is to report on reliability of assessment instruments for Panic-Agoraphobic Spectrum (PAS), to document convergent validity of PAS symptom groupings, and to confirm the relationship between PAS and DSM IV Panic Disorder (PD). We studied 22 normal controls and 95 outpatients who met criteria for Panic Disorder with and without lifetime Major Depression, and Major Depression or Obsessive Compulsive Disorder without lifetime Panic Disorder. Assessment instruments had excellent reliability and there was good concordance between interview and self-report formats. PAS scores were highest in subjects with PD, followed by outpatients without PD, and were lowest in normal controls. PAS scores varied among PD patients, and a subgroup of patients without PD scored high on PAS. We conclude that PAS can be reliably assessed, and that it describes a valid, coherent constellation of features associated with DSM IV Panic Disorder, but providing additional important clinical information.

Agoraphobia↗

PubMedDate not supplied

Insulin-like growth factor 1 and growth hormone binding protein in depression: a preliminary communication.

This study was undertaken in order to advance our understanding of the distal growth hormone axis in depression. Insulin-like growth factor 1 (IGF-1) and growth hormone binding protein (GHBP) were measured in a group of 19 depressed women and a group of 16 healthy women. Using a generalized linear model, IGF-1 levels were negatively correlated with age (p = 0.0001), influenced by menstrual phase (p = 0.016), and significantly increased in the depressed group (p = 0.02). Using the same type of analysis, GHBP was significantly related to menstrual phase (p = 0.0001) and body mass index (p = 0.0001), but was not significantly different in patients and controls. IGF-1 and GHBP were positively correlated among healthy subjects (r = 0.46, p = 0.08), but not among depressed patients (r = -0.16, p = 0.51), although these correlation coefficients were not statistically significantly different from each other. These findings confirm the importance of several physiological factors in the regulation of IGF-1 and GHBP, and suggest that depression further influences this regulation.

Adult↗