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Biomedical subjects

A W Clare

Publications and source records attributed to A W Clare.

At least 19 recordsLinked to original sources
PubMed1992

Buspirone induced prolactin responses in obsessive-compulsive disorder (OCD): is OCD a 5-HT2 receptor disorder?

Buspirone (BUSP) is a serotonergic (5-HT) agonist with activity at the 5-HT1A receptor. The BUSP induced prolactin (PRL) response was examined in 10 patients with a DSM IIIR diagnosis of obsessive-compulsive disorder (OCD). The results were compared with PRL responses to BUSP found in 10 age and sex matched healthy controls. The results suggest that the 5-HT1A receptor dysfunction may not be involved in the pathophysiology of OCD. The authors review the literature and consider the hypothesis that in OCD a complex interaction of other 5-HT receptor sub-types may be occurring, possibly with dysfunction primarily of the 5-HT2 receptors.

Adult↗
PubMed1992

Prevalence and characteristics of at-risk drinkers among elderly acute medical in-patients.

Three-hundred-and-twenty-seven male and 323 female medical and geriatric admissions over the age of 65 were interviewed about their drinking habits. Thirty (9%) of the men were found to drink in excess of the Royal College of Psychiatrists' recommended safety limits. The majority of these were lifelong heavy drinkers. Another 33 (10%) had previously drunk heavily over the age of 65, but had cut down, the majority spontaneously. Alcohol usage among women was less, although there was strong circumstantial evidence of heavy usage in a few. Twenty-five of the 30 men identified above as 'at risk' were interviewed in greater depth. These were compared with 25 age-matched light drinkers or non-drinkers. Forty-eight per cent of the men admitted to one or more alcohol related problem and if the admission diagnosis were included the number rose to 60%. The 'at risk' drinkers were significantly more likely to smoke, not to be married and to have some impairment of mobility.

Aged↗
PubMed1992

Effect of metyrapone on the pituitary-adrenal axis in depression: relation to dexamethasone suppressor status.

It has been suggested that the well-documented hypercortisolaemia found in a proportion of patients with severe depression occurs either in response to excessive secretion of corticotrophin-releasing hormone-41 (CRH-41) from the hypothalamus, or as a consequence of up-regulation of pituitary CRH-41 receptors. The attenuation of the normal ACTH response to CRH-41 in these subjects is thought to result from inhibition of corticotrophin secretion by elevated cortisol levels. We tested these hypotheses by examining ACTH responses to metyrapone, an 11 beta-hydroxylase inhibitor which blocks the formation of cortisol, followed by CRH-41 in 15 severely depressed in-patients diagnosed according to DSM-IIIR criteria. Patients were assigned to two groups according to their response to overnight administration of 1 mg dexamethasone: suppressors (8) and nonsuppressors (7). A third group consisted of 6 healthy matched controls. Metyrapone 750 mg was given 4-hourly for 24 h and samples were taken for cortisol and ACTH. Six of the original 15 patients (3 from each group) were given a bolus dose of 100 micrograms human CRH-41 intravenously after 24 h of metyrapone, and ACTH levels were measured over 2 h. Falls in circulating cortisol in response to metyrapone were similar in all three groups. However, we found exaggerated rises in ACTH amongst the nonsuppressors, as compared to the suppressors and the control group, after metyrapone.(ABSTRACT TRUNCATED AT 250 WORDS)

Adrenal Cortex Hormones↗
PubMed1992

Cortisol and prolactin responses to d-fenfluramine in non-depressed patients with obsessive-compulsive disorder: a comparison with depressed and healthy controls.

Cortisol and prolactin responses to d-fenfluramine were measured in 10 drug-free normothymic patients with obsessive-compulsive disorder (OCD). The results were compared with these responses in 10 healthy controls and in 10 major depressives. The endocrine responses in OCD were significantly attenuated when compared to the healthy controls; however, the results were not specific to OCD as the depressives' responses were similarly blunted.

Adult↗
PubMed1991

Serum thyrotropin responses to thyrotropin-releasing hormone in alcohol-dependent patients with and without depression.

Forty-one patients with DSM-III alcohol dependence syndrome were studied, as were 30 patients with major depression and 20 healthy controls. Nineteen of the alcohol-dependent patients had depressive symptoms. All subjects underwent a TRH/TSH stimulation test. Fifty percent of the alcohol-dependent patients without depression had a blunted response, while 52% of patients with depression were similarly blunted. The overall rate of blunting in the non-alcoholic major depressives was 26%. Blunting in the alcoholics was not associated with a personal or family history of affective disorder. Furthermore the blunted response in recently detoxified alcoholics was of no prognostic significance.

Adult↗
PubMed1991

Gender and age differences in the growth hormone response to pyridostigmine.

Thirty healthy subjects 12 males and 18 females were given the acetylcholinesterase inhibitor pyridostigmine (120 mg) orally. The growth hormone (GH) response was measured as the maximum GH level post-pyridostigmine relative to baseline. Twenty-six subjects increased their GH level in response to pyridostigmine. Responses in females were considerably greater than those in males and correlated closely with serum oestradiol levels. Overall there was a significant negative correlation between GH response and age.

Adult↗
PubMed1990

The alcohol problem in universities and the professions.

Over the past few decades the belief has grown that the drinking habits of medical students and doctors are abnormal. The literature on the subject is, however, equivocal. Some studies suggest that medical drinking is not particularly excessive. Others indicate that it is when compared with the general population but not when compared with the drinking rates and patterns of comparable professional groups. Medical student drinking is often analysed without reference to that of other young adult groups and university students. However, the growing concern about medical drinking has stimulated a number of 'impaired physician' treatment programmes designed, implemented and monitored by the profession itself. Preliminary results suggest that such programmes achieve impressive therapeutic results and contain useful indicators relating to therapeutic efficacy which may well have wider application.

Alcoholism↗
PubMed1990

Symptoms and social adjustment in Jewish depressives.

In 25 Jewish and 26 non-Jewish depressives resident in Hackney, the PSE revealed that 'hypochondriasis' and 'tension' were more common in the Jewish group, and special features of depression, containing symptoms connected with guilt, was less common. These differences could not be explained by variation in severity of illness as both groups had similar scores on the HRSD. The 'social maladjustment' scores were similar, very probably reflecting an elderly, deprived, inner-city population.

Depressive Disorder↗
PubMed1989

The treatment of premenstrual syndrome.

Premenstrual syndrome is commonly found among GP female attenders of childbearing age. This article discusses the main types of drug therapies used to treat premenstrual syndrome. Guidelines are also given on the management of these patients incorporating nondrug treatments such as behavioural methods and supportive counselling for associated psychosocial difficulties.

Adult↗
PubMed1989

Psychotic illness following termination of pregnancy.

A case of a psychotic illness following an induced termination of pregnancy is described; this is discussed in relation to the literature on the subject, and possible aetiological factors in the case are reviewed.

Abortion, Induced↗
PubMed1987

Depressive disorder in primary care.

Since the pioneering study of psychiatric morbidity in primary care by Shepherd et al in 1966, it has become increasingly apparent that a substantial proportion (between 20% and 25%) of patients consulting their GP are suffering from some form of psychiatric disturbance (Goldberg & Blackwell, 1970; Hoeper et al, 1979). The composition of this psychiatric morbidity has been shown to be almost wholly affective in nature and largely mild in degree. In their important review Jenkins & Shepherd (1983) recently summarised the now extensive findings relating to overall minor psychiatric morbidity in primary care. However, recent collaborative studies between psychiatrists and GPs have identified that within this dilute pool of minor disorders, lurks a significant but poorly served population of patients suffering from depressive disorders which are by no means minor in degree. A number of crucial issues regarding this depression in primary care emerge which the present paper aims to review. In particular, how common is it, and how severe? How does it present and what, if any, are its special characteristics? What is the precise relationship between depressive symptoms and depressive illness presenting to the GP and what is the relationship between physical illness and depression? And finally, what is the course and outcome of depression in this setting and what are the indications for and effect of treatment?

Adult↗