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Biomedical subjects

D W Black

Publications and source records attributed to D W Black.

At least 19 recordsLinked to original sources
PubMed1995

Psychiatric disorders in relatives of probands with obsessive-compulsive disorder and co-morbid major depression or generalized anxiety.

The authors report findings from a blind, controlled study of obsessive-compulsive disorder (OCD). Prevalence rates of generalized anxiety disorder (GAD) and major depressive disorder (MDD) were compared among first-degree relatives of probands with OCD and co-morbid GAD or MDD, respectively. Rates of MDD were not increased in relatives of probands with OCD and MDD; neither were rates of GAD increased in relatives of probands with OCD and GAD, although rates of GAD were increased among relatives of probands with OCD compared to relatives of healthy controls. The authors explore the implications of the findings.

Adolescent↗
PubMed1995

The long-term outcome of antisocial personality disorder compared with depression, schizophrenia, and surgical conditions.

The objective of this study was to assess the long-term outcome of antisocial personality disorder (APD) compared with depression, schizophrenia, and surgical conditions. Seventy-one men meeting DSM-III criteria for APD and hospitalized at the University of Iowa Department of Psychiatry between 1945 and 1970 were followed up between 1986 and 1990, an average of 29 years after discharge. Comparison groups, collected during the Iowa 500 study, included depressed subjects (n = 225), schizophrenic subjects (n = 200), and surgical control subjects (n = 160). Patients were rated as having good, fair, or poor adjustment for marital, residential, occupational, and psychiatric status. The Global Assessment Scale was also used to rate subjects. At follow-up, antisocial subjects were doing significantly better than schizophrenic subjects for marital and residential, but not occupational or psychiatric, adjustment. Both depressed subjects and surgical controls had significantly better adjustment than antisocial subjects in all areas except residential status. Although these data apply to antisocial men who had been psychiatrically hospitalized, we conclude that APD causes significant long-term impairment in important domains of life.

Adolescent↗
PubMed1994

Risperidone: review of its pharmacology and therapeutic use in schizophrenia.

The discovery of antipsychotic medications has revolutionized the treatment of schizophrenia and other psychotic disorders. However, side effects such as extrapyramidal symptoms (EPS) and tardive dyskinesia have been limiting factors in treatment. The introduction of atypical drugs such as clozapine and risperidone has ushered in a new era. This article provides an overview of the pharmacology, efficacy, and techniques for the clinical use of risperidone, which has recently become available.

Antipsychotic Agents↗
PubMed1992

A family study of obsessive-compulsive disorder.

First-degree relatives of probands with obsessive-compulsive disorder (OCD) (n = 32) and psychiatrically normal controls (n = 33) were blindly interviewed with the use of the Diagnostic Interview Schedule. The morbidity risk for anxiety disorders was increased among the relatives of obsessional subjects compared with that for the relatives of controls, but the risk for OCD was not. Risk for a more broadly defined OCD (including relatives with obsessions and compulsions not meeting criteria for OCD) was increased among the parents of obsessional subjects but not among the parents of controls (16% vs 3%). The findings suggest that an anxiety disorder diathesis is transmitted in families with OCD, but that its expression within these families is variable. The findings also support the current practice of classifying OCD as an anxiety disorder.

Adolescent↗
PubMed1992

Effect of axis II diagnoses on treatment outcome with clomipramine in 55 patients with obsessive-compulsive disorder.

We used the Structured Interview for DSM-III Personality Disorders to diagnose DSM-III personality disorders systematically in 55 patients with obsessive-compulsive disorder in the active-treatment cell of a controlled trial of clomipramine hydrochloride. Patients with a cluster A personality disorder had significantly higher obsessive-compulsive disorder severity scores at baseline, and the number of personality disorders was strongly related to baseline severity of obsessive-compulsive disorder symptoms. At the conclusion of the 12-week study, we found no significant difference in treatment outcome with clomipramine between those patients with at least one personality disorder and those with no personality disorders. However, the presence of schizotypal, borderline, and avoidant personality disorders, along with total number of personality disorders, did predict poorer treatment outcome. These variables were strongly related to having at least one cluster A personality disorder diagnosis, which was also a strong predictor of poorer outcome. Implications of these findings are discussed.

Adult↗
PubMed1992

Depression and other mental disorders in the relatives of morbidly obese patients.

The authors systematically interviewed 88 bariatric clinic patients presenting for vertical banded gastroplasty. The typical subject was middle-aged, female and of low socioeconomic status as indicated by his or her method of payment. Morbidly obese subjects were more likely than a comparison group to have first-degree relatives with a history of depression, bipolar disorder, antisocial personality, and other psychiatric disorders. These data indicate that relatives of morbidly obese subjects are frequently emotionally disturbed. Reasons for the findings are discussed.

Adult↗
PubMed1992

Mortality in DSM-IIIR schizophrenia.

Mortality was investigated in 356 DSM-IIIR schizophrenics admitted to a university psychiatric hospital over a 12-year period. Determination of death was made through a record-linkage process and observed death was compared with the mortality experience of the general population of the State of Iowa. Schizophrenics had nearly a three-fold increase in overall mortality. Mortality was primarily attributable to unnatural causes of death, particularly suicide, which was more than twenty-three times greater than expected. Mortality was greater in schizophrenic patients younger than 40 years and during the early portion of follow-up. Studies of mortality in psychiatric patients continue to be important, particularly as diagnostic criteria become better refined.

Adult↗
PubMed1992

Psychotic symptoms and age of onset in affective disorders.

Prevalence of hallucinations and delusions was studied in 1,763 patients with unipolar major depression, bipolar affective disorder, and schizoaffective disorder. The authors found that the presence of psychotic features was negatively associated with age of onset for the group as a whole, and bipolar affective disorder (manic or mixed type) specifically. The clinical implications of the findings are discussed.

Adult↗
PubMed1992

Prevalence of mental disorder in 88 morbidly obese bariatric clinic patients.

OBJECTIVE: The authors sought to determine the association between mental disorder and morbid obesity, defined as weight at least 100% or 100 lb over ideal body weight. METHOD: Eighty-eight morbidly obese subjects who had come to a tertiary care center surgery clinic requesting vertical banded gastroplasty were systematically interviewed with the National Institute of Mental Health Diagnostic Interview Schedule (DIS) and the Structured Interview for DSM-III Personality Disorders. A comparison group of 76 psychiatrically normal subjects who were matched in age (within 5 years) and gender to the morbidly obese subjects were also interviewed. RESULTS: Most of the morbidly obese subjects were women, were of low socioeconomic status as indicated by method of payment for medical care, weighed more than 300 lb, and had been obese for more than 14 years. The morbidly obese subjects were more likely than the comparison group to have a lifetime history of mood disorders, anxiety disorders, bulimia, and tobacco dependence. The morbidly obese subjects were also more likely to meet diagnostic criteria for one or more personality disorders. CONCLUSIONS: Substantial psychopathology exists in morbidly obese individuals requesting gastroplasty, a finding that has important clinical implications.

Comorbidity↗
PubMed1991

Lack of linkage to chromosome 5q11-q13 markers in six schizophrenia pedigrees.

We examined linkage between schizophrenia and five genetic markers on chromosome 5 in six pedigrees. Analyses were run considering the affected phenotype to be schizophrenia, schizophrenia plus a spectrum of related disorders, and these disorders plus any axis I diagnosis. None of the analyses were suggestive of linkage at any of the markers, either considering the pedigrees individually or in the aggregate. In our pedigrees, multipoint linkage analyses excluded much of the region that had supported linkage in an earlier study. These findings are consistent with other attempts to replicate the chromosome 5 linkage finding.

Chromosome Mapping↗
PubMed1991

The prediction of suicide. Sensitivity, specificity, and predictive value of a multivariate model applied to suicide among 1906 patients with affective disorders.

Stepwise multiple logistic regression was utilized in an attempt to develop a statistical model that would predict suicide in a group of 1906 Iowans with affective disorders admitted to a tertiary care hospital. The risk factors identified by this approach included the number of prior suicide attempts, suicidal ideation on admission, bipolar affective disorder (manic or mixed type), gender, outcome at discharge, and unipolar depressive disorder in individuals with a family history of mania. However, the model failed to identify any of the patients who committed suicide. The results appear to support the contention that, based on present knowledge, it is not possible to predict suicide, even among a high-risk group of inpatients.

Adult↗
PubMed1991

The prediction of recovery using a multivariate model in 1471 depressed inpatients.

Stepwise multiple logistic regression was used in an attempt to develop a statistical model which would predict "recovery" in a group of 1471 depressives admitted to a tertiary care hospital. Six variables identified by this approach included: Electroconvulsive therapy, personality disorder, chronicity, anxiety disorder, organic mental disorder, and dysthymia. The meaning and significance of the findings are discussed.

Adult↗
PubMed1990

Environmental illness. A controlled study of 26 subjects with '20th century disease'.

Environmental illness is a polysymptomatic disorder believed by "clinical ecologists" to result from immune dysregulation brought on by common foods and chemicals. We systematically evaluated 26 subjects who had been assigned a diagnosis of environmental illness. The subjects indicated a strong interest in their diagnosis, were generally satisfied with their clinical ecologist, and were dissatisfied with traditional medical approaches. Subjects reported varying treatments, including dietary restrictions, avoidance of offending agents, and physical treatments. Using the Diagnostic Interview Schedule, we found that 15 (65%) of 23 subjects met criteria for a current or past mood, anxiety, or somatoform disorder compared with 13 (28%) of 46 age- and sex-matched community controls. We conclude that patients receiving this diagnosis may have one or more commonly recognized psychiatric disorders that could explain some or all of their symptoms.

Adult↗
PubMed1990

Tritiated imipramine binding in obsessive-compulsive volunteers and psychiatrically normal controls.

The authors evaluated platelet tritiated imipramine binding in 22 outpatients with obsessive-compulsive disorder (OCD) and 22 psychiatrically normal controls matched for age and gender. Mean maximal binding site density (Bmax) and equilibrium dissociation affinity (Kd) values were not significantly different. In OCD patients, Bmax was positively associated with age but was not associated with age of onset, gender, personality disorder, or five measures of illness severity. Eight patients with OCD were subsequently treated with clomipramine up to 300 mg/day for 10 weeks. Among these 8 patients, Bmax values had a 65% mean decrease from baseline, but Bmax values did not change among 7 OCD patients receiving placebo. The results suggest that a reduced density of tritiated imipramine binding sites may not be associated with OCD.

Adult↗