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Biomedical subjects

D F Klein

Publications and source records attributed to D F Klein.

396 records · Page 22Linked to original sources
PubMedDate not supplied

Familial transmission of panic disorder: effect of major depression comorbidity.

This study assesses the effect of major depressive disorder (MDD) comorbidity on familial transmission of panic disorder (PD). The following questions are addressed: (1) is PD familial, i.e., do relatives of patients with PD show an increased risk for PD? (2) do PD and MDD share a common diathesis, i.e., do relatives of patients with PD without MDD show an increased risk for MDD? (3) is lifetime comorbid PD with MDD conjointly familial, i.e., do relatives of patients with PD and MDD show an increased risk for the combined syndrome? Subjects were: (1) 152 relatives of 54 anxiety clinic patients with PD and MDD; (2) 193 relatives of 72 patients with PD without MDD; (3) 231 relatives of 77 not ill controls. Relatives were interviewed by clinicians, and best estimate DSM-III-R diagnoses were formulated by senior staff. Relatives of PD with MDD (13%) and PD without MDD probands (9%) showed significantly higher rates of PD than relatives of controls (3%). Relatives of PD with MDD probands (37%) showed significantly higher rates of MDD than relatives of PD without MDD (24%) and controls (21%), with no difference between the latter two groups. Relatives of PD with MDD probands (9%) showed significantly higher rates of PD with MDD than relatives of PD without MDD (3%) and controls (1%). We conclude that: (1) PD is familial; (2) PD in the absence of MDD does not incur increased risk of MDD to relatives; and (3) PD with MDD may represent a distinct, complex syndrome.

Adolescent↗
PubMedDate not supplied

Prevalence of mitral valve prolapse in panic disorder: effect of echocardiographic criteria.

Although several investigators have found a higher incidence of mitral valve prolapse (MVP) in patients with panic disorder (PD) and agoraphobia with panic attacks (AgP), there are now several conflicting reports. Discrepancy in the rate of echocardiographic diagnosis of MVP in PD/AgP may be due to different criteria used in evaluating the echocardiogram. In this study, 15 echocardiograms performed on patients with PD/AgP were evaluated by two separate expert echocardiographers. Each used his own standard criteria for diagnosing MVP. The first reader diagnosed MVP in 9 of 15 patients with PD/AgP while the second did not diagnose MVP in any of the 15 patients. This substantiates the belief that criteria variance strongly influences estimates of the prevalence of MVP among patients with PD/AgP.

Adult↗
PubMedDate not supplied

The mitral valve prolapse--panic disorder connection.

Whether mitral valve prolapse (MVP) is more common in patients with panic disorder (PD) and agoraphobia with panic attacks (AgP) than in the normal population is controversial. A related issue is whether the presence of MVP in such patients has any clinical or biological significance. Echocardiograms were performed on 36 patients with PD/AgP and 22 normal controls. MVP was found to be more common in PD/AgP patients than in normal controls. However, MVP in the patients was mild and not associated with thickened mitral leaflets or small left ventricular size. Moderate or severe prolapse was uncommon in both groups. Patients with MVP had trends to higher heart rate and prolonged QTc interval on EKG, and reported more respiratory difficulty during panic attacks compared to patients without MVP. Lactate infusion did not affect patients with MVP differently than patients without MVP. The authors conclude that MVP is more common in patients with PD or AgP than in normal controls, but is of doubtful clinical significance.

Adult↗
PubMedDate not supplied

Pharmacotherapy of obsessive-compulsive disorder.

Due to its chronic and refractory nature, a wide variety of medications have been used in the treatment of obsessive-compulsive disorder (OCD). The most promising development has been with the tricyclic antidepressant clomipramine (Anafranil). More recently, a series of well controlled double blind studies have documented that clomipramine is more effective than placebo in reducing OCD symptoms. In a review of all 7 CMI studies with a total of 106 patients, two-thirds were found to be significantly improved on blind ratings (Insel and Zohar, 1988). Controlled studies also suggest clomipramine is more effective than other antidepressants for the treatment of OCD. Oral m-CPP (m-chlorophenyl piperazine), a selective 5HT agonist, has been found to increase obsessions in OCD patients when given acutely (Zohar, 1987; Hollander, 1988). This effect has been shown to decrease after chronic treatment with clomipramine (Zohar et al., 1988) or fluoxetine (Hollander et al., unpublished observations), suggesting that chronic treatment may correct serotonin dysregulation.

Antidepressive Agents, Tricyclic↗