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Biomedical subjects

C Gorenstein

Publications and source records attributed to C Gorenstein.

At least 19 recordsLinked to original sources
PubMed2005

Validation of the Beck Depression Inventory for a Portuguese-speaking Chinese community in Brazil.

The objective of the present study was to investigate the psychometric properties and cross-cultural validity of the Beck Depression Inventory (BDI) among ethnic Chinese living in the city of São Paulo, Brazil. The study was conducted on 208 community individuals. Reliability and discriminant analysis were used to test the psychometric properties and validity of the BDI. Principal component analysis was performed to assess the BDI's factor structure for the total sample and by gender. The mean BDI score was lower (6.74, SD = 5.98) than observed in Western counterparts and showed no gender difference, good internal consistency (Cronbach's alpha 0.82), and high discrimination of depressive symptoms (75-100%). Factor analysis extracted two factors for the total sample and each gender: cognitive-affective dimension and somatic dimension. We conclude that depressive symptoms can be reliably assessed by the BDI in the Brazilian Chinese population, with a validity comparable to that for international studies. Indeed, cultural and measurement biases might have influenced the response of Chinese subjects.

Asian People↗
PubMed2002

Validation of the Portuguese version of the Social Adjustment Scale on Brazilian samples.

BACKGROUND: Social dysfunction is reported in several psychiatric diseases and its evaluation is becoming an important measure of treatment outcome. The aim of this study was to obtain normative data, to test the validity and the ability of the Portuguese version of the Self-Report Social Adjustment Scale (SAS-SR) to detect different clinical conditions. METHODS: The Portuguese version of the SAS-SR was applied to a carefully selected non-psychiatric sample, and to depressed, panic, bulimic and cocaine-dependent patients. Depressed and panic patients were evaluated in two different clinical conditions: acutely symptomatic and in remission. RESULTS: SAS overall and sub-scale scores of the normal sample were consistently lower than all patient groups, indicating better social adjustment in all areas. Panic patients were impaired to a lower level than depressed and cocaine-dependent patients in overall adjustment. Depressed patients in remission, although in better condition, were still impaired in relation to normal subjects in overall social functioning, leisure time and marital areas. In panic patients in remission, normalization was not achieved in overall functioning, work and marital areas. LIMITATIONS: Sample size was small in some groups and the evaluation was cross-sectional. CONCLUSIONS: The Portuguese version of SAS-SR is a useful instrument for detecting differences between psychiatric patients and normal subjects and for the evaluation of different clinical conditions, recommending its use in outcome studies.

Adult↗
PubMed2002

Social adjustment in depressed patients treated with venlafaxine and amitriptyline.

Social dysfunction is often associated with depressive disorders and its evaluation is an important measure of treatment outcome. The aim of this study was to assess the effect of two treatments, venlafaxine and amitriptyline, on the social functioning of depressed patients. Twenty-eight outpatients, meeting criteria for recurrent or single major depressive episodes, took part in a double-blind, 8-week trial with amitriptyline or venlafaxine (maximum of 150 mg/day) and were assessed by the Self-Report Social Adjustment Scale (SAS-SR) before and at the end of treatment. The scale was also applied to a carefully selected non-psychiatric sample. Both drugs showed the same efficacy on a clinical scale, but venlafaxine improved social functioning more than amitriptyline as only venlafaxine-treated patients reached SAS-SR values estimated for normal subjects. This effect might be linked to the higher rate of side-effects observed with amitriptyline.

Adult↗
PubMed2001

A dose-finding and discontinuation study of clomipramine in panic disorder.

Eighty-one panic disorder patients with or without agoraphobia were treated with flexible doses of clomipramine under single-blind conditions. Fifty-seven (70.3%) reached operational criteria for full remission in 16.2 +/- 6.5 weeks, with a mean dose of 89.1 +/- 8.2 mg/day. Fifty-four (81%) of them received a continuous post-remission maintenance treatment at full doses of clomipramine for 4-6 months. No patient relapsed during the clomipramine maintenance phase. Their medication was then tappered and discontinued with placebo substitution under double-blind conditions. Fifty-one (63%) patients were followed-up until relapse or recurrence for up to 3 years, with periodic assessments. Three different outcome groups were identified: the first (n = 19, 19; 37.2%) experienced an early/immediate relapse (5.2 +/- 4.9 weeks after drug discontinuation); the second group (n = 22, 22; 43.1%) experienced recurrence after 42.9 +/- 35 weeks following discontinuation; and the third group (n = 10, 10; 19.6%) remained assymptomatic and functionally well throughout the follow-up. Predictors of early relapse were: (1) higher baseline score in the Beck Depression Inventory; (2) higher global score on the phobic avoidance scale after the full remission criteria; and (3) the need for higher clomipramine doses to reach full remission. The need for long-term or intermittent maintenance for most patients is emphasized.

Adolescent↗
PubMed2001

Psychometric properties of the Portuguese version of the State-Trait Anxiety Inventory applied to college students: factor analysis and relation to the Beck Depression Inventory.

The psychometric properties of the Portuguese version of the trait form of the State-Trait Anxiety Inventory (STAI-T) and its relation to the Beck Depression Inventory (BDI) were evaluated in a large Brazilian college student sample containing 845 women and 235 men. STAI-T scores tended to be higher for women, singles, those who work, and subjects under 30 years. Factor analysis of the STAI-T for total sample and by gender yielded two factors: the first representing a mood dimension and the second being related to worrying or cognitive aspects of anxiety. In order to study the relation between anxiety and depression measures, factor analysis of the combination of the 21 BDI items and the 20 STAI-T items was also carried out. The analysis resulted in two factors that were analyzed according to the tripartite model of anxiety and depression. Most of the BDI items (measuring positive affectivity and nonspecific symptoms of depression) were loaded on the first factor and four STAI-T items that measure positive affectivity. The remaining STAI-T items, all of them measuring negative affect, remained in the second factor. Thus, factor 1 represents a depression dimension and factor 2 measures a mood-worrying dimension. The findings of this study suggest that, although widely used as an anxiety scale, the STAI-T in fact measures mainly a general negative affect.

Adult↗
PubMed1999

Psychometric properties of the Portuguese version of the Beck Depression Inventory on Brazilian college students.

The psychometric properties of the Portuguese version of the Beck Depression Inventory were studied on a large Brazilian college student sample (N= 1,080; 845 women, 235 men). The BDI scores according to sociodemographic characteristics and mean individual item scores for total sample and by gender were compared. BDI scores tend to be higher for women, for those who work, and for the younger participants. The reliability of the inventory estimated by alpha coefficient was high for the total sample (.86) and subgroups. Factor analysis showed three factors for the total sample (low self-esteem, cognitive-affective, and somatic) and two for each gender. Women combined affective and low self-esteem whereas men combined somatic and low self-esteem in the same dimension. Discriminant analysis showed that BDI highly discriminates depressive symptomatology in college students and measures specific aspects of depression.

Adult↗
PubMed1999

Serum levels of clomipramine and desmethylclomipramine and clinical improvement in panic disorder.

Several placebo-controlled trials have shown the efficacy of clomipramine (CMI) in panic disorder. However, none has investigated the relationship between CMI, and desmethylclomipramine (DCMI) plasma levels, and outcome. In this trial, 41 patients meeting the DSM-III-R criteria for panic disorder with/without agoraphobia received 50-200 mg of CMI daily in a single-blind, flexible dose regimen for 14 weeks. At the end of treatment, 97% of the patients were free of panic attacks. Patients were classified into two groups of improvement according to the panic symptom items of the 'Patient-Rated Anxiety Scale'. A repeated-measures analysis of variance suggested a significant association between outcome and serum DCMI level/daily dose ratio as well as total serum level/daily dose. Patients with intense improvement showed DCMI and total serum levels lower than those with moderate improvement. The results indicate the importance of monitoring clomipramine and desmethylclomipramine serum levels in this disorder.

Adult↗
PubMed1998

Stressful reactions and panic attacks induced by flumazenil in chronic benzodiazepine users.

The acute effects of flumazenil, a benzodiazepine (BZD) receptor antagonist in long-term BZD users were used as a possible test to detect physiological dependence. Thirty-four subjects (20 females, 14 males) aged 26-48 years (mean + SD, 42.4+/-8.5 years), all chronic users of low doses of diazepam (5-20 mg/day, 14.2+/-4.8 mg/day) for 5 to 28 years (10.5+/-6 years), received a single 1-mg i.v. flumazenil dose or saline, infused slowly under double-blind conditions. Physiological dependence was suggested as all patients receiving flumazenil developed an anxiety reaction while the placebo group did not. Flumazenil triggered a qualitatively different reaction amounting to a panic attack during infusion in nine out of 15 patients. These patients had a diagnosis of panic disorder or a history of panic attacks. Caution should be exercised when giving flumazenil to panic patients who are taking BZDs as maintenance treatment.

Adult↗
PubMed1998

Mood improvement in 'normal' volunteers.

To test the hypothesis that clomipramine is effective in improving subthreshold non-specific symptoms in subjects without any established psychopathology, we conducted a double-blind, cross-over controlled trial of clomipramine (oral doses of 10-40 mg/day) and propanteline (active placebo) for 5 weeks in nine normal volunteers. Four other subjects completed the first part of the trial. These subjects were selected from 275 respondents to newspaper and radio requests for subjects who considered themselves as normal but were unhappy about their usual moods. They did not reach cut-off scores in the Self-Report Questionnaire and did not meet diagnostic criteria for any lifetime or current ICD-10 or DSM-III-R condition, as assessed by an open psychiatric interview and the Schedules for Clinical Assessment in Neuropsychiatry. Despite the small sample and the low level of initial symptomatology, both subjects and observers consistently detected significant improvements with clomipramine in a number of assessments of mood, notably decreased irritability and anxiety. This controlled trial suggests that it is possible to improve subclinical complaints through psychopharmacological agents, raises questions about the mechanisms of their action and discusses their implications.

Adult↗
PubMed1996

Benzodiazepine effects on memory tests: dependence on retrieval cues?

Acute effects of oral flunitrazepam (0.5 and 1 mg), nitrazepam (5 and 10 mg) and placebo were assessed on direct (free recall of words and prose, stem-cued recall) and indirect (stem and fragment completion) memory tasks. Fifty health volunteers took part in this double-blind, independent group study. The relative effects of the two benzodiazepines (BZs) on memory revealed a different pattern from their effects on alertness, indicating that their amnesic effects are not totally secondary to their sedative effects. The higher dose of flunitrazepam impaired free recall of words and prose but not cued recall, while neither drug affected the two indirect tasks. Differences in drug effects on the direct and indirect memory tasks were discussed in terms of resource demands of the various tests. We conclude that whether BZs impair performance on memory tasks depends more on the cues given at retrieval than the retrieval instructions (direct/indirect). The implications for this in terms of BZ amnestic effects are drawn out for contextual encoding deficits induced by BZs.

Administration, Oral↗
PubMed1996

Validation of a Portuguese version of the Beck Depression Inventory and the State-Trait Anxiety Inventory in Brazilian subjects.

We have validated a Portuguese version of the Beck Depression Inventory (BDI) and State-Trait Anxiety Inventory (STAI) tests by obtaining profiles for three Brazilian samples: 270 university students, 117 panic patients and 30 depressed patients. The mean BDI scores were higher for depressed patients (25.2 +/- 12.6), intermediate for anxious patients (15.8 +/- 10.3) and lower for students (8.5 +/- 7.0). Mean STAI scores for anxious (52.8 +/- 11.4) and depressed patients (56.4 +/- 10.5) were higher than for the student sample (40.7 +/- 8.6). BDI and STAI scores were correlated significantly in all samples. The internal consistency of the Portuguese version of BDI is in agreement with the literature (0.81 for students and 0.88 for depressed patients). The present data demonstrate that the psychometric properties of the Portuguese versions of the BDI and STAI are comparable to the original English language versions of these questionnaires, thereby indicating their use in clinical situations.

Adolescent↗
PubMed1995

Fate of lysosomes transported to the dendrites by a colchicine-induced mechanism.

Lysosomes in hypoglossal motoneurons were retrogradely labeled with fluorescent latex microspheres and their distribution as well as that of acid phosphatase was examined after a single 50 microgram intracerebroventricular (i.c.v.) injection of colchicine. In saline injected controls the fluorescent label was distributed mainly in cell bodies. Twenty-four hours after the colchicine injection we observed a re-distribution of fluorescent label from the cell body of neurons to the dendrites. Seventy-two hours after the colchicine injection the fluorescent label had returned from the dendrites to the cell body. A similar pattern was obtained by following the effect of colchicine on the distribution of acid phosphatase reaction product. We conclude that the reappearance of fluorescent label in cell bodies following colchicine treatment is the result of the retrograde transport of dendritic lysosomes.

Animals↗
PubMed1995

Scores of Brazilian University students on the Beck Depression and the State Trait Anxiety Inventories.

The profiles of the Beck Depression Inventory and State-Trait Anxiety Inventory scores were obtained for a sample of Brazilian university students and compared with those of other studies. Subjects were 270 students from various universities in São Paulo, age 23.8 yr. (SD=6.7 yr.). The mean Beck score for the total sample was 8.5 (SD=7.0); according to the cut-off score of 16, 86.9% were considered normal, 7.5% had scores compatible with dysphoria, and 5.6% had scores indicative of depression. The mean State-Trait Anxiety score for the total sample was 40.7 (SD=8.6). Considering one standard deviation as the threshold point, 17.8% published data indicated that the Portugese versions of the questionnaires are equivalent to original versions.

Adult↗
PubMed1995

Minnesota Multiphasic Personality Inventory correlates of panic disorder with agoraphobia: changes with treatment.

Forty-seven patients meeting DSM-III-R criteria for panic disorder with agoraphobia (PAG) were assessed by the Minnesota Multiphasic Personality Inventory (MMPI) at baseline and after 8 weeks of treatment with imipramine, clomipramine and placebo. At pre-treatment patients had higher MMPI scores than the local normative data, the highest scores being for depression, hypochondria and hysteria. At week 8 the scores of most MMPI scales were significantly reduced. In addition, patients who showed clinical improvement had pre- and post-treatment scores lower than the unimproved patients. The results suggest that the abnormal MMPI profile found in PAG patients reflects the clinical state and that personality pathology relates to treatment outcome. The reduction in MMPI scores was associated with response to active treatment. We conclude that therapeutic interventions that successfully reduce PAG symptoms also modify personality scores.

Adolescent↗
PubMed1994

Differential response of neutral endopeptidase 24.11 ("enkephalinase"), and cholinergic and opioidergic markers to hypoglossal axotomy.

Neutral endopeptidase 24.11 (NEP; "enkephalinase") may inactivate a number of centrally active neuropeptides including the enkephalins and substance P. In most areas of the central nervous system, the cell types which express NEP activity are not known. The hypoglossal nucleus (N.XII) was selected as a model system to characterize the cytochemical localization of NEP. The effect of hypoglossal nerve axotomy upon the distribution of NEP activity in the hypoglossal nucleus was compared to the effect upon cholinergic markers, the mu opiate receptor, and the enkephalins. By use of a fluorescence histochemical method, NEP was localized at all levels of N.XII to the soma and proximal processes of the majority of the apparent motor neurons in the nucleus. Fluorescent double-labeling studies revealed the presence of numerous enkephalinergic varicosities which localized to the neuropil surrounding NEP-stained motor neurons. To determine whether NEP was synthesized by these motor neurons, 18 rats received a unilateral transection of the hypoglossal nerve. A pronounced decrease in NEP staining in N.XII was observed on the operated side as early as 3 days following axotomy. This decrease persisted at all levels of the nucleus for about 5 weeks. By 7 weeks, the staining between the control and operated sides was indistinguishable. By contrast, there was no apparent change in the density or distribution of enkephalin-immunoreactive varicosities in five animals examined 6 to 32 days following axotomy. Radioligand binding of [3H]DAMGO to the mu-opiate receptor in N.XII was studied in 20 animals by quantitative autoradiography at 2, 6, and 11 days after axotomy. No significant changes in the level of radioligand binding to the mu-receptor were detected in response to axotomy. In contrast to the opiate system, the cholinergic enzymes choline acetyltransferase, acetylcholinesterase, and pseudocholinesterase showed a coordinate decrease in motor neuron-associated staining on the operated side of N.XII at 3, 6, and 11 days following axotomy which paralleled the decrease in NEP staining. By contrast, the lysosomal enzyme marker, acid phosphatase, showed a pronounced increase in staining on the operated side. The results of this study are consistent with the synthesis of NEP by cholinergic N.XII motor neurons and indicates that the enkephalins and NEP in N.XII are closely associated, but derive from separate neuronal populations. The widespread overlap in the distribution of NEP-stained motor neurons and enkephalinergic varicosities in N.XII provides additional anatomical support for a potential role for NEP in the inactivation of centrally active enkephalins.(ABSTRACT TRUNCATED AT 400 WORDS)

Acetylcholine↗
PubMed1994

Differential acute psychomotor and cognitive effects of diazepam on long-term benzodiazepine users.

The aim of this study is to determine whether long-term use (5-20 years) of therapeutic doses of diazepam (5-20 mg/day) in anxious patients (n = 28) is associated with tolerance to its psychomotor and cognitive effects. Patients were tested at baseline, before and after a 10 mg oral dose of diazepam during chronic use, and at 3 weeks and 10 months after benzodiazepine (BZ) discontinuation. The effects of a single i.v. dose of flumazenil (1 mg administered 5 days before baseline) on reversing tolerance were also assessed. No acute effect of diazepam was observed on the psychomotor performance of patients both under BZ treatment and after short- and long-term discontinuation, suggesting persistence of tolerance. In contrast, acute effects of diazepam were observed in memory measures at all times. Given subjects' very prolonged BZ use, it is possible to predict that tolerance to the memory effects never fully develops. Flumazenil administration did not reverse tolerance. This suggests that neuroadaptative mechanisms, other than benzodiazepine receptor set-point shift, occur after long-term use.

Adult↗
PubMed1993

Differential effects of lorazepam and oxazepam on priming.

The effects of lorazepam (2 mg), oxazepam (30 mg) and placebo on performance in implicit and explicit memory tasks were compared in a double-blind, independent group study with 36 healthy volunteers. Both benzodiazepines (BZs) impaired performance on the explicit task (free recall). However, only lorazepam impaired performance of the implicit task (word-stem completion). A similar pattern of drug effects was observed on a secondary task which used different instructions at stimulus presentation. BZ effects on the explicit task were more associated with levels of sedation (indexed by finger tapping speed) than their effects on the implicit task. It is concluded that both BZs impair episodic memory but only lorazepam impairs priming.

Adolescent↗