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Biomedical subjects

D F Klein

Publications and source records attributed to D F Klein.

At least 217 records · Page 12Linked to original sources
PubMed1986

Psychobiology and psychopharmacology: issues in clinical research training.

Although the scope of basic studies in psychopharmacology and psychobiology has been expanding steadily for about 30 years, relatively few clinical psychiatrists, psychologists, and psychopharmacologists now choose to become researchers or teachers in these disciplines. Such training is crucial to the future vitality of both academic and private-practice psychiatry, and in view of increasing constraints on training funds, student researchers may well be an endangered species. With these concerns in mind, at its 1984 meeting, the American College of Neuropsychopharmacology's Education and Training Committee organized a symposium of investigators, administrators, and former trainees to explore aspects of effective clinical research training in psychobiology and psychopharmacology. Aspects discussed included mentoring, settings and content of training, depth versus breadth of curriculum, and the effect of a critical mass of colleagues at various stages of professional development. Following a brief overview, selected panelists addressed the issues from their individual perspectives.

National Institute of Mental Health (U.S.)↗
PubMed1985

Social phobia. Review of a neglected anxiety disorder.

While other anxiety disorders have recently become the subjects of increasing investigation, social phobia remains, except among behavior therapists, relatively unstudied. As a result, major uncertainties exist concerning classification, prevalence, severity, etiology, assessment, and treatment of social phobia. Existing findings do suggest that in its own right and as a comparison for other anxiety disorders, social phobia should prove a fertile area for psychobiological and clinical investigation.

Adrenergic beta-Antagonists↗
PubMed1985

Platelet monoamine oxidase activity in patients with panic disorder.

Preliminary reports have indicated that platelet monoamine oxidase (MAO) activity is elevated in patients with anxiety disorder. We compared MAO activity in 20 drug-free patients with panic disorder with 20 age- and sex-matched normal controls. MAO activity in patients was significantly higher than in normals. MAO activity was not correlated with age or plasma catecholamine levels. The authors speculate about the possible significance of elevated MAO activity in patients with panic disorder.

Adult↗
PubMed1985

Lactate vulnerability of remitted panic patients.

Sodium lactate precipitates panic in 70-100% of clinically ill patients with panic disorders. The lactate vulnerability of remitted patients is unknown. In this study, 13 panic patients completed three sequential sodium lactate infusions: one before treatment, a second when panic free on tricyclic antidepressants (TCA), and a third when in remission and unmedicated for 1 to 6 months. Three out of 13 patients panicked at the third infusion as compared to 0/13 infused on TCA and 7/12 at pretreatment infusion. This result (1) indicates that lactate vulnerability can exist in clinically well, unmedicated patients, and (2) raises the possibility that lactate vulnerability may be a trait characteristic. Further studies are needed before definite conclusions can be drawn.

Adult↗
PubMed1985

Normalization of venous pH, pCO2, and bicarbonate levels after blockade of panic attacks.

Recent evidence suggests that hyperventilation may be associated with spontaneous panic attacks in patients with panic disorder. This is reflected in abnormal patterns of blood gas and blood pH levels in these patients. In this study, absolute levels and variances of pH, pCO2, and bicarbonate were compared between controlled patients before and after successful pharmacological treatment. The results indicate that successful treatment of panic disorder results in a normalization of pH, pCO2, and bicarbonate levels.

Adult↗
PubMed1985

Treatment of social phobia with atenolol.

Social phobia is the least well studied phobic disorder of those included in DSM-III. Reports from the British literature indicate that the condition is a distinct one that usually begins in adolescence and affects males more often than females. Patients characteristically complain of somatic symptoms and a fear of humiliation when confronted with specific social stimuli. Ten social phobic patients were openly treated with the cardioselective, peripherally active beta-adrenergic blocking drug atenolol. Five patients had complete response and four had moderate response. Side effects were minimal. Atenolol appears to work in social phobic patients by reducing autonomic nervous system response to phobic stimuli.

Adult↗
PubMed1985

Lactate infusions in obsessive-compulsive disorder.

Panic attacks followed sodium lactate infusions in one of seven patients with obsessive-compulsive disorder and 26 of 48 patients with panic disorder or agoraphobia with panic attacks. This suggests that lactate-induced panic is specific to the latter groups.

Adult↗
PubMed1985

Specificity of lactate infusions in social phobia versus panic disorders.

Lactate infusions produced panic attacks in one of 15 patients with social phobia, four of nine with agoraphobia, and 10 of 20 with panic disorder in a blind study. The proportion of patients with social phobia who panicked in response to lactate was significantly lower than that of patients with agoraphobia or panic disorder. These findings lend validity to the DSM-III classification of anxiety states. They also suggest that the pathophysiology of social phobia differs from that of disorders characterized by spontaneous panic attacks.

Adult↗
PubMed1984

Phenelzine v imipramine in atypical depression. A preliminary report.

Sixty patients meeting specific criteria for atypical depression completed six weeks of double-blind, randomly assigned treatment with phenelzine sulfate, imipramine hydrochloride, or placebo. The overall response rates were 67% with phenelzine, 43% with imipramine, and 29% with placebo. At week 6, phenelzine was superior to placebo on many measures, while the superiority of imipramine to placebo was confined to several variables. Phenelzine was superior to imipramine on the interpersonal sensitivity and paranoia factors of the 90-item Hopkins Symptom Checklist, with trends toward superiority on several other measures, while imipramine was not differentially superior on any measure. Atypical depressive patients with a history of spontaneous panic attacks and hysteroid dysphoric patients both showed extremely low rates of response to placebo and high rates of response to phenelzine. Conversely, those without panic or hysteroid dysphoric features responded equally to all three treatments. Responders to pheneizine also had greater platelet monoamine oxidase inhibition while receiving drug therapy than did nonresponders. Completion of the 120-patient sample will allow more detailed analyses.

Adolescent↗
PubMed1984

The tyramine challenge test as a marker for melancholia.

A previous study reported that unipolar depressives excrete significantly lower amounts of urinary tyramine-O-sulfate following oral administration of a tyramine hydrochloride load than do normal control subjects. This study replicates and extends those findings by showing that within the heterogeneous group of unipolar depressives, patients with melancholia and bipolar patients with a history of melancholia manifest a tyramine excretion deficit. A small subgroup of medication-free patients in remission from episodes of melancholia had abnormally low tyramine sulfate excretion levels while they were euthymic, supporting the suggestion that reduced tyramine sulfate excretion following oral tyramine loading is a trait marker for depression. Further study of the role of trace amines in affective illness is warranted. Clinical application is not warranted until further evaluation of the sensitivity, specificity, and reproducibility of this oral tyramine challenge test.

Adult↗
PubMed1984

Reading-disabled hyperactive children: a distinct subgroup of attention deficit disorder with hyperactivity?

Mixed hyperactive/reading-disabled children, selected from a large sample of hyperactive children, were compared to pure hyperactive children on demographic, behavioral, and neuropsychological measures. Children in the Mixed group were reading-disabled relative to age and IQ; those in the Pure group had achievement scores that were average relative to age and IQ. The Mixed group was significantly older than the Pure group; there were no differences in gender, race, or socioeconomic status. Behaviorally, the groups did not differ significantly on teacher ratings or on psychiatric ratings of aggression. The Mixed group had a significantly higher Performance IQ, whereas the Pure group had a significantly higher Verbal IQ and performed better on measures of cognitive impulsivity. Several other measures failed to distinguish the groups. The data give minimal support to the notion that pure hyperactive and mixed hyperactive/reading-disabled children constitute distinct subgroups of Attention Deficit Disorder with Hyperactivity.

Achievement↗