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Biomedical subjects

D E Giles

Publications and source records attributed to D E Giles.

At least 55 records · Page 3Linked to original sources
PubMed1989

Polysomnographic parameters in first-degree relatives of unipolar probands.

We present polysomnographic data for psychiatrically asymptomatic first-degree relatives of unipolar depressed probands. Relatives were classified by proband rapid eye movement (REM) latency (reduced/nonreduced) and by personal REM latency (reduced/nonreduced). Reduced REM latency relatives, whether defined by the proband or by their own REM latency, had polysomnographic alterations consistent with those found in depressed patients, although none of these relatives was depressed at assessment. Reduced REM latency relatives with a history of unipolar depression were compared to reduced REM latency relatives with no history of depression. Virtually no polysomnographic differences were found. Polysomnographic alterations may be stable antecedents of the onset of depression.

Adult↗
PubMed1989

Clinical predictors of recurrence in depression.

In a longitudinal study of 30 successfully treated unipolar depressed patients, the authors evaluated number of depressive episodes, early onset of depression, and lifetime prevalence of affective disorders other than major depression as risk factors for recurrence. Early onset of depression (before age 20) and a history of affective disorders other than major depression were each significantly associated with recurrence. Number of episodes was not as powerful in predicting recurrence as either early onset or lifetime prevalence of other affective disorders.

Actuarial Analysis↗
PubMed1987

Polysomnographic findings and dexamethasone nonsuppression in unipolar depression: a replication and extension.

To evaluate the replicability of our previous findings of increased incidence of biological dysregulation in endogenous depression, we have studied a new series of patients with major depressive disorder, unipolar type (n = 103). The subtypes compared were defined by Research Diagnostic Criteria and were endogenous/nonendogenous, primary/secondary, and Winokur's family history classification. As an extension of the research, we evaluated the endogenous subtype more precisely by distinguishing those patients who met criteria for probable endogenous, comparing them to both endogenous and nonendogenous depressed patients. The findings of the replication study were consistent with our earlier report; the incidence of both dexamethasone nonsuppression and reduced rapid eye movement (REM) latency was higher in those with endogenous depression. Findings for each of the other subtypes revealed no differences. The probable endogenous depressed patients were comparable to the nonendogenous depressed patients in all variables measured.

Adult↗
PubMed1987

Reduced rapid eye movement latency. A predictor of recurrence in depression.

In this longitudinal study of 25 successfully treated depressed patients, rapid eye movement (REM) latency during an episode of depression was evaluated as a predictor of recurrence. Patients with reduced REM latency prior to treatment were more likely to develop another episode of depression during the follow-up period.

Adult↗
PubMed1987

A comparison of self-reported versus clinician-related symptoms in depression.

Self-reported and clinician-rated symptom-severity measures were administered to 19 patients with unipolar endogenous major depression, 24 patients with unipolar nonendogenous major depression, and 14 patients with dysthymic disorder. Both the dysthymic and the nonendogenous major depressive groups self-reported significantly (p less than .05) more symptoms than were recorded by clinicians, and the endogenously depressed group evidenced no significant (p = .83) discrepancy between self-rated and clinician-rated measures. The data are consistent with the idea that a negative thinking bias may in here particularly in the dysthymic and the nonendogenous depressed groups.

Adult↗
PubMed1986

Polysomnographic findings in recently drug-free and clinically remitted depressed patients.

Thirteen patients were examined by sleep polysomnograph (PSG) and the dexamethasone suppression test when clinically depressed and later when clinically remitted for six months and no longer receiving antidepressant medication for two to five weeks. None of the PSG variables (rapid eye movement [REM] latency, total sleep time, stage 1 through 4 times, REM time, and REM densities in periods 1 through 3) was significantly changed between symptomatic depression and symptom remission. While symptomatic, 11 of 13 patients exhibited a reduced REM latency (65 minutes or less). After clinical remission, eight of the 11 continued to exhibit reduced REM latencies, whereas the dexamethasone suppression test tended to show nonsuppression only during clinical depression. These data represent either longer-term (ie, slow to normalize) biologic consequences of a depressive episode or biologic antecedents of clinical depression that may herald a return of the depression in individuals vulnerable to recurrence. Whether PSG abnormalities identify clinically remitted patients who are prone to develop another depressive episode requires longitudinal follow-up studies.

Adult↗
PubMed1986

Which endogenous depressive symptoms relate to REM latency reduction?

In most research dealing with biological abnormalities in depression, the clinical diagnosis of depression is made and the occurrence of a biological abnormality, for example, reduced REM latency, is documented. In this study, that design was reversed; REM latency was used as a grouping variable to assess empirically the "biological" priority of Research Diagnostic Criteria endogenous symptoms. We found that terminal insomnia, pervasive anhedonia, unreactive mood, and appetite loss were most likely to discriminate among "reduced" and "nonreduced" REM latency depressions at various threshold values. Contrary to expectation, diurnal mood variation was found equivalently in all categories of REM latency studied. Implications for clinical decision making based on endogenous symptoms are discussed.

Adult↗
PubMed1986

The Inventory for Depressive Symptomatology (IDS): preliminary findings.

The Inventory for Depressive Symptomatology (IDS) is a new measure of depressive signs and symptoms. Both self-report and clinician-rated versions are under development. The IDS-SR (self-report) was completed by 289 patients, 285 of whom were outpatients. Unipolar major depression (n = 174), bipolar disorder (n = 44), euthymic (S/P unipolar or bipolar) depression (n = 33), and other psychiatric disorders (n = 38) were included. The IDS-SR had good internal reliability (coefficient alpha = 0.85), and significantly correlated with both the Hamilton Rating Scale for Depression (HRSD) (r = 0.67) and the Beck Depression Inventory (BDI) (r = 0.78). The clinician-rated IDS (IDS-C) was administered to 82 outpatients (75 with unipolar or bipolar disorder, 5 with other psychiatric disorders, and 2 euthymic (S/P unipolar) depressions). Coefficient alpha (0.88) suggested strong internal consistency. The IDS-C correlated highly with both the HRSD (r = 0.92) and the BDI (r = 0.61). Discriminant and factor analyses provided evidence for construct validity for both the IDS-C and IDS-SR. Both scales significantly differentiated endogenous from nonendogenous depression defined by Research Diagnostic Criteria (RDC). Factor structures for the IDS-SR revealed four factors: mood/cognition, anxiety, selected endogenous symptoms, and hyperphagia-hypersomnia. The IDS appears applicable to both inpatients and outpatients with endogenous, atypical, and nonendogenous major depression, and may have utility with dysthymics.

Adult↗
PubMed1986

Weight change in depression.

This report describes the weight changes of 109 outpatients during the course of a depressive illness and relates these changes to several potential predictors: age, gender, diagnosis, and scores on the Hamilton Rating Scale for Depression (HRSD), the Beck Depression Inventory, and the three factors on the Eating Questionnaire. Weight changes ranged from -33 to +50 pounds, with 40% of the patients reporting weight gain, 30% weight loss, and 30% no change in weight. Weight loss occurred more rapidly than did weight gain. The disinhibition factor of the Eating Questionnaire was significantly correlated with weight change during depression and, on a stepwise discriminant function analysis, differentiated weight-gaining from weight-losing patients at a high level of statistical significance. Severity of depression also differentiated weight-gaining from weight-losing patients in the discriminant function analysis, but only on the HRSD and at a level of more modest statistical significance.

Adult↗
PubMed1986

Which depressions respond to placebo?

This descriptive study of 55 outpatients with unipolar major depression compared placebo responders (n = 21) and placebo nonresponders (n = 34) with respect to demographic, diagnostic, history of illness and symptomatic features of the current episode of depression. Placebo responders were significantly more likely to be nonendogenous and were more likely to meet criteria for another Research Diagnostic Criteria diagnosis. Additionally, placebo responders were characterized by a shorter length of illness and reported a lower level of depressive symptomatology on the Beck Depression Inventory and the Carroll Rating Scale. Clinician-rated depressive symptom severity (e.g., Hamilton Rating Scale for Depression, Covi Global Anxiety Scale, and Raskin Depression Rating Scale) and demographic variables did not differentiate placebo responders from nonresponders. These data suggest candidates for antidepressant treatment and implications for antidepressant drug trials.

Adult↗
PubMed1985

Alprazolam vs amitriptyline in depressions with reduced REM latencies.

This study was designed to compare the antidepressant effects of alprazolam, a triazolobenzodiazepine, with amitriptyline hydrochloride in a group of patients with nonpsychotic, major depressions diagnosed by Research Diagnostic Criteria. A mean rapid eye movement latency of less than 65 minutes was required to enter this study. Dexamethasone suppression tests were conducted before treatment. By strictly applied Research Diagnostic Criteria, 83.6% of the subjects were endogenous, and 34.7% were inpatients. A significantly greater percentage of alprazolam-treated patients responded within the first seven days of treatment. By the end of this six-week trial, alprazolam was associated with significant reductions in Hamilton, Beck, Covi, Raskin, and Carroll Rating scores (pretreatment to posttreatment). However, by the end of treatment the effects of amitriptyline exceeded those of alprazolam on both the Hamilton and Beck scales. These data indicate that alprazolam is not as effective as amitriptyline in major depressions with a shortened rapid eye movement latency.

Adolescent↗
PubMed1984

TRH-induced prolactin release is blunted in females with endogenous unipolar major depression.

Twenty-five women with unipolar primary major depressive disorder (20 endogenous, 5 nonendogenous) and 20 female control subjects were studied with the thyrotropin-releasing hormone stimulation test (TRH-ST). Prolactin (PRL) levels were measured before and after TRH administration for patients and control subjects. For patients, thyrotropin (thyroid-stimulating hormone; TSH) levels were measured from the same serum specimens as PRL levels, and the 1 mg dexamethasone suppression test (DST) was performed. Patients with endogenous depression (ED) had significantly lower maximal serum PRL levels (max PRL) following TRH, and a significantly reduced increase over basal serum PRL (delta max PRL) compared to normal controls (NC). Nonendogenous depressed (NED) patients did not differ significantly from the ED or NC groups on either of these measures. For the ED group, delta max PRL was inversely correlated with severity of depressive symptomatology. Basal PRL levels did not differentiate the depressed subgroups (ED, NED) from each other or from the NC group. Depressed patients with blunted delta max PRL values tended to have blunted delta max TSH values and vice versa. Almost all patients with blunting of either delta max PRL or delta max TSH were also DST nonsuppressors; conversely, only about half (7 of 12) of patients who were DST nonsuppressors had either blunted delta max PRL or delta max TSH. Patients with clinical diagnoses of melancholia or psychotic features were significantly more likely to have blunted delta max PRL values than patients without these diagnoses. A disturbance of central noradrenergic function could explain these findings.

Adult↗
PubMed1983

Neuropsychological dysfunctions in unipolar nonpsychotic major depressions.

Twenty-two patients with unipolar, non-psychotic major depression were evaluated with a neuropsychological test battery. The endogenous patients performed more poorly than the non-endogenous on the test battery as a whole. When compared to performance norms obtained from non-depressed controls, both E and NE groups showed performance impairments on the majority of subtests in the battery. The test battery employed in the present study may be clinically useful in assessing neuropsychological alterations in patients with mild to moderately-severe depression.

Adult↗
PubMed1983

Psychobiological predictors of antidepressant drug response.

Forty-nine patients with major depression and a reduced (less than 65.0 minute) REM latency were treated in a randomized, double-blind study with either amitriptyline or alprazolam. Predictors of response were sought for the whole group and for each drug cell individually. A longer current episode and a higher Beck Depression Inventory to Hamilton Rating Scale ratio were predictive of a poorer response for the whole group and for the alprazolam group. A longer current episode was also predictive of a poor response to amitriptyline. These data suggest that (1) a longer current episode and (2) a greater level of self-reported compared to clinician-observed symptoms correlate with a poorer response to antidepressant medications.

Alprazolam↗
PubMed1983

Relationships among the TRH, REM latency, and dexamethasone suppression tests: preliminary findings.

The DST and TRH stimulation test (TRHST) were administered to 68 depressed in- and outpatients; 28 subjects also received 2 nights of sleep EEG. Results indicated that (1) the TRHST differentiated RDC endogenous from nonendogenous unipolar subtypes at the 5 but not the 7 IuU/ml threshold, (2) neither order nor timing of DST and TRHST testing affected TRHST response, (3) the TRHST detected subjects not identified by the DST, and (4) REM latency detected some patients (23%) not identified by either the TRHST or DST.

Ambulatory Care↗
PubMed1982

Natural networks: help-giving and help-seeking in two rural communities.

A group of 213 respondents in rural communities were interviewed about their help-giving and help-seeking behaviors related to 11 problems of living. Respondents were asked whom they had talked to within their natural community networks, who was most helpful, and how effective they rated the helping. The results indicate that over 80% of the respondents saw themselves as active help-givers and receivers in exchanges with spouses, friends, relatives, and others. A wide range of helping activities were reported, led by attempts to understand another person's situation and feelings and just listening. Differences in help-giving and help-seeking were noted. Respondents indicated a general willingness to tackle problems, a preference for help from people within their networks, and that this type of help is effective.

Adaptation, Psychological↗