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D L Dunner

Publications and source records attributed to D L Dunner.

186 records · Page 11Linked to original sources
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Onset of response in relation to outcome in depressed outpatients with placebo and imipramine.

We have retrospectively analyzed the results of the pooled data from three 6-week placebo controlled double blind phase III clinical trials, initially designed to assess the efficacy of newer antidepressants, in order to study the relationship of early onset improvement with later outcome in 145 depressed outpatients receiving placebo (n = 98) or imipramine (n = 47). The early onset response was seen in a subgroup of subjects receiving either imipramine or placebo and appeared to be independent of treatment assignment. Furthermore, the early onset response predicted outcome for the duration of the trial and was not selective as defined by specific changes in subscales measuring insomnia, anxiety or endogenous features. Exclusion of early onset responders resulted in the augmentation of the difference in outcome with drug and placebo. We recommend that future placebo controlled trials assessing therapeutic efficacy of active treatments in depressed outpatients take into account the early onset response in the analysis of results.

Adult↗
PubMedDate not supplied

Descriptive validity and stability of diagnostic criteria for dysthymic disorder.

The goal of this study is to examine different criteria for the diagnosis of dysthymic disorder (DD). Using a two-stage design, records of 37 subjects diagnosed with DSM-III-R DD were systematically reviewed. Seven of these patients met criteria except for having depression less than 50% of the time. The initial evaluation involved a comparison of the diagnostic assessments using symptom criteria of DSM-III-R and ICD-10, proposed DSM-IV criteria for DD, DSM-III-R major depressive disorder (MD) criteria, and the Columbia criteria for atypical depression (AD). A subsample of 16 subjects who were assessed at least twice several months apart was then extracted. Agreement between the assessments with the proposed DSM-IV symptom list was determined. In the initial assessment, all 37 subjects (100%) met DSM-III-R and ICD-10 criteria, proposed DSM-IV criteria for DD, and DSM-III-R MD criteria, with percentages of mean positive items on the four criteria being 77%, 84%, 89%, and 77%, respectively. In addition, nine subjects (24.3%) also met diagnostic criteria for AD. All 16 subjects (100%) of the subsample again met proposed DSM-IV criteria for DD when assessed 75 to 145 days after their initial assessment. Items with the highest agreement between each two assessments were pessimism and low self-esteem, whereas social withdrawal and decreased activity had lower agreement. The proposed DSM-IV criteria for DD had good sensitivity and reliability in assessing core symptoms of DD. The use of different criteria for DD is discussed.

Adult↗