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Biomedical subjects

D E Giles

Publications and source records attributed to D E Giles.

69 records · Page 4Linked to original sources
PubMed1982

The effect of dosage on the dexamethasone suppression test in normal controls.

A sample of 23 drug-free, normal adult subjects, aged 23 to 50 years, received 1 mg dexamethasone p.o. at midnight. Serum cortisols were obtained at 0800h, 1600h, and 2330h pre- and postdexamethasone. Only 1 of these 23 subjects (4.3%) evidenced nonsuppression, as defined by any postdexamethasone serum cortisol value of greater than 4.0 micrograms/dl. A dose of 0.75 mg dexamethasone was administered to 23 drug-free, normal adult subjects, 20 of whom participated in the above 1 mg trial. Six of these 23 (26.1%) showed nonsuppression at a threshold of 4.0 micrograms/dl. Another 11 normal adults who were taking various prescription medications (e.g., sympathomimetics, nasal decongestants, birth control pills, thyroid hormones) or who were suffering from untreated upper respiratory infections, venereal infections, or allergies were tested with 1 mg of dexamethasone. In this sample, 7 of 13 (53.8%) showed nonsuppression. These findings suggest that: (1) 1 mg of dexamethasone is the lowest effective dose that can be used in diagnostic testing for melancholic depression; (2) a false-positive response to the dexamethasone suppression test (DST) may occur with infections, allergies, or possibly with certain prescription medications. Further studies of the effects of illness and/or medications on DST responses are needed.

Adult↗
PubMed1982

Sleep EEG and dexamethasone suppression test findings in outpatients with unipolar major depressive disorders.

The dexamethasone suppression test (DST) and sleep EEG were compared in three different descriptive diagnostic schemes in 70 adult patients with nonpsychotic, unipolar major depressive disorder according to Research Diagnostic Criteria. Endogenous (E)/nonendogenous (NE), primary/secondary, and Winokur's family history subtypes were evaluated. The E/NE subclassification was best supported by both biological measures. The DST provided a highly specific (95%), relatively accurate measure (confidence interval of 87%), although its sensitivity was rather low (41%) in this largely outpatient sample. A REM latency of 62 min or less provided a more sensitive (66%) but less specific (79%) indicator of E depression. Stage 4 time and age may add to the information provided by REM latency alone in identifying E patients.

Adult↗
PubMed1982

Relationship of dysfunctional attitudes and dexamethasone response in endogenous and nonendogenous depression.

Taken as a whole the data presented provide support for Klein's conceptualization of etiologically distinct subtypes of depression. A basic limbic system derangement in endogenous depression is suggested by the higher incidence of DST nonsuppression. Beck's theory that all depressions result from a primary cognitive dysfunction was not supported. However, the data do suggest dysfunctional attitudes, while present in both nonendogenous and endogenous depressions, may play an etiologically more relevant role in the nonendogenous group.

Adult↗
PubMedDate not supplied

Long-term effects of unipolar depression on cognitions.

As part of an ongoing study of risk factors for unipolar depression in a high-risk group, we have evaluated cognitive variables documented to be abnormal during an episode of depression in adult first-degree relatives of unipolar depressed probands. Asymptomatic relatives with a history of unipolar depression were compared with relatives who had never been depressed. Despite an extended period of recovery (approximately 8 years), relatives with a history of unipolar depression had more negative moment-to-moment thinking, more dysfunctional attitudes, and were more likely to attribute failure to themselves than relatives with no depression. These findings support the hypothesis that unipolar depression is associated with long-term changes in selected cognitive functioning.

Adult↗
PubMedDate not supplied

Familial influence in unipolar depression: effects of parental cognitions and social adjustment on adult offspring.

As part of an ongoing study of risk factors for unipolar depression in adult first-degree relatives of depressed probands, we have evaluated the relationship between cognitions and social adjustment in parents and adult offspring. Asymptomatic relatives of families with at least one parent with major depression, of families with no affected parent, and of normal control families were assessed. Maternal social adjustment was associated with both negative thinking and social adjustment in adult offspring. These effects were independent of the influence of personal history of depression in offspring, an effect that also influenced offspring thinking and social adjustment. These findings suggest that impairments in social adjustment in mothers may persist well beyond an episode and influence the adjustment and thinking of at least some of their offspring. Within the context of parent-child interaction, increased vulnerability for depression in offspring of depressed parents may be mediated in part by the enduring impact of these factors.

Adult↗
PubMedDate not supplied

Childbearing in women with and without a history of affective disorder. I. Psychiatric symptomatology.

Psychiatric symptoms and morbidity were examined prospectively in 34 obstetrically healthy volunteers recruited early in pregnancy. All women were free of current psychiatric disorder. Fourteen women had a history of affective disorder, and 20 had no lifetime history of any psychiatric disorder. Symptoms were assessed using both clinician- and self-administered ratings at specified points from 12 weeks of gestation through 8 months' postpartum. All women reported mild symptom elevation during pregnancy and the early puerperium, regardless of psychiatric history. The most frequently endorsed symptoms in both groups were somatic. However, women with a history of affective disorder reported more psychic and somatic distress than women with no psychiatric history. Onset of a psychiatric disorder did not occur during pregnancy in this sample, and only one woman, with both a personal and family history of affective disorder, met criteria for a new episode postpartum. Brief periods of symptom elevation occurred postpartum for 14.7% of the sample (five women, two with and three without a personal history of affective disorder) in the context of additional life stressors combining with the stress of new motherhood. These findings suggest that the impact of childbearing alone on psychiatric symptoms and morbidity is modest among women who are psychiatrically healthy at pregnancy onset and have sound social support networks.

Adult↗
PubMedDate not supplied

Childbearing in women with and without a history of affective disorder. II. Electroencephalographic sleep.

Electroencephalographic (EEG) sleep was examined longitudinally in 34 obstetrically healthy volunteers recruited early in pregnancy. All women were free of current psychiatric disorder. Fourteen women had a personal history of affective disorder, and 20 had no history of any psychiatric disorder. EEG sleep was recorded in subjects' homes at specified points from 12 weeks' gestation through 8 months' postpartum to examine the impact of childbearing on sleep and psychiatric symptoms in women with a history of affective disorder. EEG sleep measurements, as well as clinical ratings of sleep, indicated that sleep disturbances were most pronounced over the first 2 to 3 months' postpartum and were characterized primarily by interrupted sleep. The obstetrical course of these women was uneventful, and the outcome with respect to affective disturbances was highly favorable. Nevertheless, childbearing was associated with greater changes in total sleep time and with rapid eye movement (REM) latency reduction in women with a history of affective disorder, even in the absence of clinically significant mood changes. Findings suggest that the sleep system of women with a history of affective disorder may be more sensitive to the psychobiological changes associated with childbearing, as evidenced by earlier onset of sleep disruption over the childbearing course and a reduction in REM latency in the final trimester that persisted throughout the eighth postpartum month.

Adult↗
PubMedDate not supplied

Secondary depression: a comparison among subtypes.

Forty-five patients who met Research Diagnostic Criteria (RDC) for secondary depression were assessed by St. Louis criteria, and by demographic, illness history, REM latency and dexamethasone suppression test measures. Fully one-third of the RDC secondary sample met St. Louis criteria for primary depression; only age at onset and length of illness discriminated St. Louis primary from secondary depression. RDC depressed patients secondary to alcoholism were compared to those secondary to nonsubstance abuse disorders (excluding schizophrenia). The subgroup with a history of alcoholism reported less severe depression and were preponderantly male. Neither dexamethasone response nor REM latency differentiated the RDC secondary subtypes. Little support was found to validate separation of the RDC secondary subtypes studied.

Adult↗
PubMedDate not supplied

Risk factors in families of unipolar depression. I. Psychiatric illness and reduced REM latency.

In this report, we present data documenting the incidence of reduced REM latency and the lifetime prevalence of psychiatric illness in the parents and siblings of early onset unipolar depressed probands. The prevalence of psychiatric illness (49.3%), especially affective disorders (34.3%), was very high among these relatives. Reduced REM latency in the family members of reduced REM latency probands showed a concordance rate of 70.6% regardless of psychiatric history. The relative risk for unipolar depression among relatives with reduced REM latency was almost three times greater than for relatives with nonreduced REM latency.

Adult↗
PubMedDate not supplied

Secular trend in unipolar depression: a hypothesis.

To address the observation of a secular trend in the incidence of major depression, we have evaluated prevalence of unipolar depression in first-degree relatives of unipolar depressed probands, all of whom were studied in the sleep laboratory. A threshold value of reduced (less than or equal to 65.0 min) or non-reduced (greater than 65.0 min) REM latency was used to define groups for both parents and siblings. Unipolar depression occurred at the same rate in both reduced REM latency siblings (57.1%) and parents (66.7%). Siblings with non-reduced REM latency had a higher rate of depression (36.8%) than non-reduced REM latency parents (0.0%). Implications for biological and environmental factors associated with liability for unipolar depression are discussed.

Adult↗
PubMedDate not supplied

Personality traits as predictors of good diabetic control.

To identify personality characteristics that might contribute to overall good control of type I diabetes mellitus, we used a biological correlate of control, glycosylated hemoglobin A1c values, as a means of selecting patients. Patients with evidence of good control (HbA1c less than 7.5%) were compared with patients with evidence of poor control (HbA1c greater than 10.4%). All patients were administered the Personality Research Form E. Need for achievement and a socially desirable response style were associated with good glycemic control. This finding is placed in the context of the complexity of health care behaviors required for adequate self-management.

Adult↗
PubMedDate not supplied

Personality traits of women with a history of childhood sexual abuse.

This study examined relationships between specific dimensions of childhood sexual abuse and personality traits in adulthood. Study participants were 74 hospitalized female psychiatric patients with a self-reported history of childhood sexual abuse. Characteristics of childhood sexual abuse were obtained from a structured life-events interview. Personality was measured with the NEO-Five-Factor Inventory (NEO-FFI), which yields scores on neuroticism, extraversion, openness to experience, agreeableness, and conscientiousness. We hypothesized that parental abuse, intercourse, and the combination of these two childhood sexual abuse characteristics would be associated with personality traits. Supporting this hypothesis, women who were abused by a parent had lower scores on openness to experience than women who were abused by someone else. Patients whose abuse history included both parental abuse and intercourse had very low extraversion scores. Our findings suggest that there are associations between personality traits and childhood sexual abuse characteristics in psychiatric patients. Specifically, women who experienced intercourse by a parent may be more introverted and less open to experience than women whose sexual abuse history does not include parental incest.

Adolescent↗
PubMedDate not supplied

The mesograde amnesia of sleep may be attenuated in subjects with primary insomnia.

In this study, we pilot tested one of the more controversial components of the Neurocognitive Model of Insomnia; the proposition that subjects with chronic primary insomnia are better able to recall and/or recognize information from sleep onset intervals than good sleeper controls. Nine subjects participated in this pilot study, five of whom had a complaint of insomnia. The remaining four subjects were self-reported good sleeper controls. Subjects were matched for age, sex, and body mass. All subjects spent two nights in the sleep laboratory. The first night served as an adaptation night. The second night served as the experimental night during which a forced awakening and memory task was deployed. In this procedure, subjects were played single-word stimuli across four time periods: at natural sleep onset (Trial 1) and at the sleep onset transitions following three forced awakenings (Trials 2-4 from Stage 2 sleep). All subjects were awakened after about 6 h had elapsed from lights out and were tested for free recall and recognition memory for the word stimuli. The insomnia subjects, tended to identify more of the word stimuli on the recognition task (average for the four trials) and recognized significantly more of the words that were presented at sleep onset proper (Trial 1). This finding suggests that the natural mesograde amnesia of sleep may be attenuated in subjects with insomnia.

Acoustic Stimulation↗
PubMedDate not supplied

Preparing librarians to meet the challenges of today's health care environment.

OBJECTIVE: Refine the understanding of the desirable skills for health sciences librarians as a basis for developing a training program model that reflects the fundamental changes in health care delivery and information technology. DESIGN: A four-step needs assessment process: focus groups developed lists of desirable skills; the research team organized candidate skills into a taxonomy; a survey of a random sample of librarians and library users assessed perception of importance of individual skills; and the research team framed, as a unifying hypothesis, a training model. SURVEY METHODS: The survey was distributed to random samples of 150 librarians, stratified by type of library, and 150 library users, stratified by type of use. A non-randomized sample was obtained by mounting the survey on a World Wide Web server. The survey instrument included 96 distinct skills organized into 13 categories. Respondents rated the importance of each skill on a Likert scale and provided a separate ranking by identifying the ten most important skills for the profession. RESULTS: Among the participants, 51% of librarians and 36% of library users responded to the survey. All categories of skills were rated above the midpoint of priority on the Likert scale. All groups rated personality characteristics and skills as most important, with an understanding of the health sciences, education, and research being rated comparably to technical skills. CONCLUSIONS: Health sciences librarians need a new educational model that provides them with broad-based tools to discover new roles and new resources for acquiring individual skills as the need arises. A unifying training model would involve trainees in developing their learning plan in a way that promotes proactive inquiry and self-directed learning, and it would rotate the trainees through projects to provide skills and an understanding of end-user work processes.

Curriculum↗