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Biomedical subjects

B J Carroll

Publications and source records attributed to B J Carroll.

At least 163 records · Page 9Linked to original sources
PubMed1981

The Carroll rating scale for depression. II. Factor analyses of the feature profiles.

Factor analyses were conducted for the Hamilton depression rating scale (HRS) and the self administered Carroll counterpart (CRS). The factor loadings for the respective first factors were similar; those for the respective second factors showed strict sign consistency but only moderate consistency of magnitude; the loadings for the respective third factors showed no particular consistency. The first three CRS and first three HRS factor scores were computed for each individual and correlations were computed from these factor scores. The first and second factors were highly correlated but the third factors were negatively correlated indicating that they were not measuring the same thing. The first factors of the CRS and HRS correlated highly with their respective raw total scores and were indices of the severity of illness. The self-administered CRS (with matching weights) is a credible alternative to the HRS for routine clinical assessment of the severity of depression.

Adult↗
PubMed1981

The Carroll rating scale for depression. III. Comparison with other rating instruments.

Patients in an effective disorders out-patient clinic were studied with four depression rating scales: the Hamilton rating scale (HRS) the Carroll rating scale (CRS) a clinical global rating of depression (CGRD) and the visual analogue scale (VAS). The overall correlations between the self ratings (CRS, VAS) and the observer ratings (HRS, CGRD) were highly significant. Both the HRS and the CRS distinguished mild from moderate, and moderate from severe depression. CRS scores increased more rapidly than HRS scores with increasing severity of depression. The concordance of self ratings and observer ratings was highest for the two structured instruments (HRS and CRS), and was lowest for the two global scales (CGRD and VAS). The global scales have the advantages of speed and simplicity, but at the cost of some reliability. Patients with non-endogenous depression had significantly increased self rating scores in comparison to patients with unipolar or bipolar endogenous depression. The correlations between the self ratings and the observer ratings were notably lower in patients with non-endogenous depression than in patients with endogenous depression. Euthymic bipolar patients rated themselves on the VAS as significantly less well than euthymic unipolar patients. The clinical and research implications of these findings are discussed.

Depressive Disorder↗
PubMed1981

Changes in serial dexamethasone suppression tests among unipolar depressive receiving electroconvulsive treatment.

An abnormal dexamethasone suppression test (DST) identifies endogenous depressive with 95% confidence. The DST normalizes with successful treatment. Serial DSTs throughout treatment could provide useful information on (i) whether they biologically monitor clinical response, (ii) when DST normalization does occur, and (iii) whether early normalization predicts clinical outcome. We studied six inpatients who had abnormal DSTs on admission and serial DSTs during and after a course of ECT. All were diagnosed as unipolar major depressive disorder, endogenous (RDC). Clinical improvement was monitored with weekly Hamilton Rating Scales. Five of six abnormal DST patients converted to a normal test and showed significant clinical improvement. On patient failed to normalize and also had a poor outcome. All DST normalizations occurred by the fourth to sixth ECT. Additional ECTs resulted in further reduction in DST plasma cortisol values. All normalizers experienced progressive clinical improvement, and the DST successfully monitored these changes. DST conversion occurred early in treatment. Early DST normalization may have predictive value for good treatment response.

Depressive Disorder↗
PubMed1981

Speech pause time: a marker of psychomotor retardation among endogenous depressives.

Speech pause time (SPT)-the silent interval between phonations during automatic speech-is elongated during depressive episodes among endogenous depressives. Phonation time is unchanged. To follow up and expand earlier small-scale studies of these psychomotor findings we conducted a prospective determination of SPT among 24 unipolar (UP) depressives, 12 bipolar (BP) depressives, and 19 nondepressed controls. SPT was lengthened among both UP and BP depressives during their episodes. This elongation disappeared with clinical improvement. Nondepressed controls did not have longer SPT. During states of clinical remission, depressives and controls had comparable SPT values. Replications are required, but the measurement of SPT appears to be a useful, objective technique for identifying and monitoring psychomotor deceleration among depressives.

Bipolar Disorder↗
PubMed1980

Behavioral effects of dopamine agonists across the estrous cycle in rats.

The effects of apomorphine upon stereotypy and bromocriptine upon wheel running and intracranial reward were examined across the estrous cycle of female rats. Apomorphine elicited sterotypy in a dose-related fashion, but sterotypy was not reliably or systematically altered by estrous conditions. On the other hand, wheel running was augmented by bromocriptine in an estrous-specific fashion. Self-stimulation was increased by bromocriptine but this was not related to estrous cyclicity. These findings provide evidence for possible behavioral and motivational specificity of dopamine (DA) receptor-related estrous changes.

Animals↗
PubMed1980

Diagnosis of endogenous depression. Comparison of clinical, research and neuroendocrine criteria.

Eighty-nine depressed outpatients were studied by clinical criteria, Research Diagnostic Criteria (RDC), and the dexamethasone suppression test (DST) of neuroendocrine regulation. A simple outpatient version of the DST, requiring only one blood sample, correctly identified 40% of patients diagnosed clinically as endogenous depression (ED), with a specificity of 98% and a diagnostic confidence of 95%. Differences in age, sex, or severity of symptoms between endogenous and non-endogenous depressives did not account for these results. By comparison, the diagnostic performance of the DST was weaker for the RDC categories Major Depressive Disorder (MDD) and primary MDD. These were less selective and more heterogeneous than the clinical category ED. The clinical diagnoses of ED were supported in 98% of cases by the RDC, but 22% of RDC endogenous MDD diagnoses were not supported by the clinical diagnoses. Abnormal DST results were found only in patients with both the clinical diagnosis of ED and the RDC diagnosis of endogenous MDD. Patients with definite endogenous MDD had a significantly higher frequency of abnormal DST results (42%) than those with probable endogenous MDD (14%), or those with other RDC diagnoses (3%). A significant association was found between positive DST results and a positive family history of depression. These results support other evidence for use of a positive DST result as an external validating criterion for ED. The category MDD contained all cases diagnosed clinically as ED, but was diluted by cases diagnosed clinically as non-endogenous depression who had no neuroendocrine disturbance. The results also confirmed that the endogenous/non-endogenous and primary/secondary classifications of depression are not identical. We conclude: (1) that the DST can be used in the differential diagnosis of depressed outpatients as well as inpatients; (2) that the RDC category primary MDD and the Washington University category primary depression are more heterogeneous and probably less valid than the clinical category ED; (3) that the RDC for endogenous MDD have only moderate validity; (4) that RDC diagnoses cannot substitute for careful clinical diagnoses in research studies; (5) that the best use of the RDC is to support clinical diagnoses, but not to generate diagnoses independently as a free-standing system; (6) that the concept of endogenous or endogenomorphic depression has validity and should be retained in research studies of depression.

Adult↗
PubMed1980

Neuroendocrine dysfunction in genetic subtypes of primary unipolar depression.

Disinhibited activity of the hypothalamic-pituitary-adrenocortical (HPA) neuroendocrine system, characterized most specifically by abnormal responses to the dexamethasone suppression test (DST), is observed in 40-50% of patients with endogenous depression. The heterogeneity of endogenous depressives with respect to this neuroendocrine marker is so far unexplained. A recent report from Iowa suggested that genetic factors could account for this heterogeneity, since abnormal DST reponses were found with widely differing frequencies among primary unipolar depressives subtyped by the genetic criteria of Winokur. We studied 14 patients with primary endogenous delusional unipolar depression. Abnormal DST responses were found in 79% of the entire group, and with similar frequencies among each of the Winokur subtypes. In particular, five of six patients (83%) with depression spectrum disease had abnormal DST results. This contrasts with a frequency of 4% reported by the Iowa group. We conclude that disinhibited HPA activity does occur in depression spectrum disease when a delusional endogenous depression is present. Our results and those of the Iowa study could both be consistent with a threshold model of HPA activation. The high frequency of positive DST results in delusional endogenous depressives may be determined by disinhibited central pain mechanisms. Variations in this clinical dimension, combined with variations in threshold for HPA activation by pain mechanisms, could account for the heterogeneity of DST responses among endogenous depressives.

Delusions↗
PubMed1980

Dissociation of TSH adrenocortical disturbances in endogenous depression.

To evaluate a possible interaction between the pituitary-thyroid axis and the pituitary-adrenal axis, we measured serum levels of thyrotropin (thyroid stimulating hormone; TSH), the maximal TSH response (delta max TSH) to thyrotropin releasing hormone (TRH), serum and cerebrospinal fluid (CSF) levels of cortisol, urinary excretion of cortisol, and the plasma levels of adrenocorticotropic hormone (ACTH) in 20 patients with endogenous depression before and after electroconvulsive therapy. No significant correlations were found between serum TSH or delta max TSH on the one hand, and serum and CSF cortisol or urinary excretion of cortisol on the other hand. A direct correlation was found between serum cortisol and plasma ACTH.

Adrenocorticotropic Hormone↗
PubMed1980

Multimodal treatment of a case of obsessive-compulsive neurosis.

A severe incapacitating case of obsessive-compulsive neurosis was treated in hospital with an intense multimodal approach including individual, conjoint marital, and group psychotherapy, behavioral therapy, occupational and recreational therapy, milieu therapy, and medications. The separate treatments appeared to have a synergistic effect. The patient's symptoms decreased dramatically, and he resumed his normal occupational and family functions and responsibilities. At 2-year follow-up, the patient remained well.

Adult↗
PubMed1980

Treatment of premenstrual tension with lithium carbonate. A pilot study.

Some previous reports have suggested that lithium treatment is of benefit to women with the premenstrual tension syndrome (PMTS). In this study 15 women carefully selected for severe PMTS were given lithium carbonate (600-900 mg/day) continuously for three menstrual cycles. Lithium did not affect physical premenstrual symptoms and was ineffective in most women against behavioral premenstrual symptoms. Despite the low dosage most women also experienced significant drug-related side effects. Although a statistically significant improvement was recorded by several symptom rating instruments, this benefit was of no practical clinical value. The three women who responded best to lithium, and who requested continued treatment beyond 3 months, met diagnostic criteria for subsyndromal affective (cyclothymic) disorder. Lithium is not recommended for the average woman with PMTS.

Adult↗
PubMed1980

Premenstrual tension syndrome: the development of research diagnostic criteria and new rating scales.

Research diagnostic criteria for premenstrual tension syndrome (PMTS) are developed using data collected from a study of 42 women who were suffering from severe PMTS but were well at other times. Two specific scales are also devised for rating the severity of PMTS, a 36-item self-report questionnaire and a 10-item scale for use by therapist/researcher. It is proposed that after further evaluation and validation, these instruments may permit more useful comparisons of data on the etiology and treatment of this disorder.

Adult↗
PubMed1980

Affective illness and HLA frequencies: no compelling association.

114 patients suffering from an endogenomorphic affective illness were typed for HLA antigens at the A and B loci, and the frequencies were compared with those of a control panel numbering 439 individuals. Using new analytical procedures, a large number of tests were conducted, but no convincing evidence for an association of HLA types with affective disorders was obtained. A reanalysis of the same data, where patients are classified according to Danish diagnostic criteria, yields a marginally significant association of the B locus alleles. The sample sizes for this latter analysis were small, the test criteria are undoubtedly inflated, and no compelling case can be made for a useful association.

Alleles↗