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Biomedical subjects

A Frances

Publications and source records attributed to A Frances.

At least 19 recordsLinked to original sources
PubMed1992

Relationships over 1 year between lymphocyte subsets and psychosocial variables among adults with infection by human immunodeficiency virus.

To examine relationships between immune and psychosocial variables among adults infected with human immunodeficiency virus type 1, 221 subjects without acquired immunodeficiency syndrome were assessed for degree of depression, anxiety, psychiatric symptoms, social support, stressful life events, hardiness, hopelessness, bereavement, and intrusive and avoidant thoughts about acquired immunodeficiency syndrome. At entry, none of 22 psychosocial variables significantly correlated with lymphocyte subsets. Among subjects seen 6 and 12 months later, severity of physical symptoms was associated with greater emotional distress, but the CD4 cell count was predicted by neither clinical ratings of psychopathology and global functioning nor by standardized self-report measures of constructs used in psychoimmune research. We conclude that among our sample, physical symptoms contributed to emotional distress, but emotional distress did not contribute to the CD4 cell count, a marker of disease progression.

Adolescent↗
PubMed1992

Relationship of anxiety and depression.

There has been considerable controversy regarding the relationship between depression and anxiety. We review briefly the descriptive, longitudinal, genetic, biological, and treatment response data indicating that there is overlap between depression and anxiety. Several possible models are explored that provide different conceptions of how this relationship may best be understood: (1) that there are a variety of more or less discrete, but sometimes coexisting, syndromes within the spectrum of anxiety and depression; (2) that symptoms of depression and anxiety represent different external manifestations of a more basic underlying cause; (3) that one condition may predispose to the other; (4) that the association may be due to artifactual definitional overlap, particularly since the instruments used to measure depression and anxiety share so many items. All these propositions are supported. An important, practical question is discussed--should the mixed anxiety/depressive disorder that has been suggested by ICD-10 be included in DSM-IV?

Anxiety↗
PubMed1992

DSM-IV and new diagnostic categories: holding the line on proliferation.

The authors discuss aspects of the decision-making process for including "new" diagnostic categories in DSM-IV. They detail the different kinds of new categories proposed for inclusion in DSM-IV and discuss the risks and benefits of incorporating them. The authors comment on whether new diagnostic categories should be included in official nosologies as a stimulus for research or as a culmination of research. They also highlight problems with "sunsetting" diagnoses. The criteria for change in DSM-IV--a way to deal with the expanding array of proposals for additional diagnostic entities--are discussed. The authors also offer a series of specific examples of the different kinds of new categories being considered for inclusion in DSM-IV.

Anxiety Disorders↗
PubMed1992

Self-mutilation in personality disorders: psychological and biological correlates.

OBJECTIVE: The goal of this study was to determine whether self-mutilators with personality disorders differ from nonmutilators with personality disorders in impulsivity, aggression, and other psychopathology and whether serotonergic dysfunction contributes to self-mutilation. METHOD: Twenty-six self-mutilators with personality disorders were matched to 26 control subjects with personality disorders for gender, age, education, axis I diagnosis of affective disorder, and axis II diagnosis of personality disorder. Numerous indexes of psychopathology as well as CSF 5-hydroxyindoleacetic acid (5-HIAA) levels and platelet imipramine binding sites (Bmax) and affinity (Kd) were determined. RESULTS: Self-mutilators had significantly more severe character pathology, had greater lifetime aggression, and were more antisocial than the control subjects. The self-mutilators scored higher on the Hamilton Rating Scale for Depression but not on the Beck Depression Inventory or the Beck Hopelessness Scale. The two groups did not differ on the Buss-Durkee Hostility and Guilt Inventory or on the Sensation Seeking Scale. The degree of self-mutilation was significantly correlated with impulsivity, chronic anger, and somatic anxiety. Both self-mutilation and impulsivity showed significant negative correlations with Bmax, although the two groups did not differ in CSF 5-HIAA levels or in platelet imipramine binding. CONCLUSIONS: The results demonstrate the contribution of severe character pathology, aggression, impulsivity, anxiety, and anger to self-mutilation and provide preliminary support for the hypothesis of underlying serotonergic dysfunction facilitating self-mutilation.

Humans↗
PubMed1991

Effectiveness of psychoeducational interventions in reducing emotional distress after human immunodeficiency virus antibody testing.

To examine the effectiveness of three psychoeducational interventions in reducing emotional distress after voluntary serologic testing for human immunodeficiency virus-1,307 physically asymptomatic adults were randomly assigned to standard counseling, counseling plus a three-session interactive video program, or counseling plus six individual sessions of stress prevention training. Subjects were evaluated using five standardized distress measures at entry and 3 months later. Among the 204 human immunodeficiency virus-seronegative subjects, mean distress measures decreased significantly after all three interventions without differential treatment effects. Among the 103 human immunodeficiency virus-seropositive subjects, mean distress measures decreased significantly after the stress prevention training and did not significantly increase in the other two interventions. We conclude that stress prevention training is particularly helpful after notification of human immunodeficiency virus seropositivity.

Adult↗
PubMed1991

Cognitive-behavioral therapy for panic: an open study.

This paper reports results of an open prospective study of 26 patients who met DSM-III criteria for panic disorder or agoraphobia with panic attacks. Cognitive-behavioral treatment alone produced clinically and statistically significant improvement in panic symptoms, including both full-blown and limited symptom episodes. In addition, the treatment produced improvement in associated symptoms of phobic avoidance and generalized anxiety. This work provides further preliminary indication of the usefulness of cognitive-behavioral strategies as an alternative to medication in symptom-oriented treatments.

Adult↗
PubMed1991

Vulnerability to sodium lactate in panic disorder patients given cognitive-behavioral therapy.

Six patients with panic disorder who had panicked during sodium lactate infusion were given cognitive-behavioral treatment for 12-24 weeks. After treatment they underwent another lactate infusion, and four patients were rates as having no panic, suggesting that reduced vulnerability to lactate accompanies remission of panic. Controlled trials of cognitive-behavioral therapy and use of lactate infusion as a measure of remission are recommended.

Adolescent↗
PubMed1990

Acute effects of drug abuse in schizophrenic patients: clinical observations and patients' self-reports.

Substance abuse among schizophrenic patients is an increasingly recognized clinical phenomenon. The authors review experimental and observed clinical effects of drug abuse and patients' subjective experiences of acute intoxication. Though drug abuse may exacerbate psychotic symptoms, abused drugs may also lead to transient symptom reduction in subgroups of schizophrenic patients. Some patients report feeling less dysphoric, less anxious, and more energetic while intoxicated. Models of the relationship of drug abuse and schizophrenia, particularly the self-medication hypothesis, are discussed in reference to these data.

Humans↗
PubMed1990

The definition of dependence and behavioural addictions.

DSM-III-R and ICD-10 have incorporated a much broader definition of chemical dependence than was included in DSM-III. This broader definition no longer requires the presence of tolerance and withdrawal, and places greater emphasis on aspects of compulsive use. Using this broader definition, a number of behavioral syndromes, especially compulsive and impulse disorders, appear to share descriptive similarities with chemical dependence. Although these similarities in overt presentation may reflect underlying similarities in pathogenesis and treatment response, such a non-specific definition may also obscure important differences. Given the available knowledge, it is unclear if it is more useful to highlight the similarities among chemical dependencies and other behavioral syndromes or to maintain their distinction.

Drive↗
PubMed1990

Psychiatric diagnosis before serological testing for the human immunodeficiency virus.

To identify the diagnostic characteristics and counseling needs of individuals at risk for acquired immune deficiency syndrome (AIDS), standardized DSM-III-R diagnoses were given to 207 physically asymptomatic adults when they sought serological testing for the human immunodeficiency virus (HIV). The subjects had high lifetime rates of mood disorders. Even after the 20 subjects with intravenous drug use as a risk factor were eliminated, lifetime rates of nonalcohol substance dependence were also high. These findings suggest that even before they are notified of HIV test results, many individuals at perceived risk for AIDS may be vulnerable to future depression and nonintravenous drug abuse.

AIDS Serodiagnosis↗
PubMed1990

DSM-IV: work in progress.

The authors present an overview of the work in progress on DSM-IV. After a brief historical review, they discuss the principles and multiple purposes of the DSM-IV effort and outline the three stages of its empirical documentation: systematic literature reviews, analysis of unpublished data, and field trials. Next, they discuss several of the basic conceptual issues that are implicit in revising a nomenclature. These include the definition of mental disorder, the balance between multiple diagnosis and differential diagnosis, the use of categorical and dimensional models of classification, and issues involved in the construction of criteria. Finally, they summarize the most important specific questions being reviewed by each of the DSM-IV work groups.

Humans↗
PubMed1990

Diagnosis and clinical course of erotomanic and other delusional patients.

Twenty-eight patients with erotomanic delusions were compared with 80 patients with other delusions to clarify questions about diagnosis and course of illness in erotomania. The erotomanic patients were a heterogeneous group with respect to both diagnosis and course. They had significantly more manic symptoms than the comparison group and more affective diagnoses than would be expected from the literature; 25% (N = 7) had schizoaffective disorder and 7% (N = 2) had bipolar disorder. A subgroup of monodelusional erotomanic patients was identified who met the DSM-III-R criteria for delusional disorder, thus supporting the decision to include erotomanic delusions in this diagnostic category in the revision of DSM-III.

Adolescent↗
PubMed1989

Changes in eye tracking during clinical stabilization in schizophrenia.

Eye tracking abnormalities have been proposed as a trait marker for schizophrenia on the basis of their familial prevalence and the consistency of tracking over time in clinically stable patients. However, few studies have examined stability through acute episodes of illness, and most studies have not analyzed changes in different forms of eye movements. Therefore, the authors examined eye tracking, clinical state, and neuroleptic dose during 4 consecutive weeks in nine recently hospitalized schizophrenic patients. For the patients and controls, qualitative ratings of pursuit accuracy remained relatively stable over time. In contrast, saccade frequency increased significantly, with a 57% increase in small saccades and a 77% reduction in larger saccades. In comparison with cross-sectional studies which have found no correlation between neuroleptic dose and tracking performance, a reduction in large saccades was strongly correlated with increase in neuroleptic dose. The findings suggest that pursuit accuracy may be a trait characteristic of schizophrenia, while the frequency and size of saccades are state dependent characteristics.

Adult↗