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Biomedical subjects

E A Workman

Publications and source records attributed to E A Workman.

16 recordsLinked to original sources
PubMed1997

A 30-year progress report on a VA satellite psychiatric clinic program.

This paper describes a program of rural satellite psychiatric clinics that has evolved within a Veterans Affairs medical center over the past three decades. The eight clinics are staffed by a single team that includes a psychiatrist, a psychiatric nurse, and two mental health technicians. The team travels to the eight sites at least once each month. The program has achieved its goal of providing outpatient screening, diagnosis, and treatment services to veterans who would otherwise have no access to specialty psychiatric care due to distance and transportation problems.

Adult↗
PubMed1993

Atypical antidepressants versus imipramine in the treatment of major depression: a meta-analysis.

BACKGROUND: Our investigation involved a quantitative literature review technique known as meta-analysis to compare the efficacy of three newer antidepressants and imipramine. METHOD: We examined seven major journals in psychiatry from 1980 through 1990, inclusive, and selected those investigations of imipramine, trazodone, bupropion, and fluoxetine that met our minimal criteria for interpretability. These criteria included: (1) the presence of a placebo control, (2) double-blind status, (3) the use of the Hamilton Rating Scale for Depression as a dependent variable measure, (4) the use of nongeriatric adults with a diagnosis of major depression by DSM or RDC standards, and (5) the presence of reported means and standard deviations in the investigation, or sufficient data that allowed such to be computed. Each study of four antidepressants was analyzed for an effect size of the drug investigated. The effect size allows for a determination of the efficacy of a particular drug as compared with placebo, measured in standard deviation units. RESULTS: The data indicated that all four agents are effective as compared with placebo. Furthermore, there is no evidence that the newer heterocyclic agents are less effective than imipramine, as an ANOVA showed no statistically significant difference between the effect sizes of the four antidepressants. CONCLUSION: These data are discussed in terms of characteristics of the various investigations and the need for further research comparing the efficacy of psychopharmacologic agents.

Antidepressive Agents↗
PubMed1991

Psychoneuroimmunology: where are we, where are we going?

We have reviewed briefly the current status of research on central nervous system-immune system interactions, focusing attention on the neural and humoral pathways by which CNS and IS communicate and interact and on the effects of stress and psychiatric illness on immune function. It is evident that CNS-IS communication occurs by direct innervation of lymphoid organs and by means of hormones, neuropeptides and cytokines. There is also clear evidence that humoral substances each of which were thought to be the product of one specific cell type are elaborated and secreted by a variety of cell types. This observation suggests a new unified concept of CNS-IS interactions with mediators of these interactions being produced ubiquitously and acting on cells of the two systems. In examining the effects of stress on IS it has become apparent that stress of various types can have a depressive effect on immune functions, primarily at the level of T lymphocytes and NK cells. This suggests that the defense mechanisms affected by stress are those which are responsible for cytotoxic effector responses. These findings are interesting in that they support older studies implicating stress in the pathogenesis and/or the clinical course of neoplastic diseases. Further support for a role of stress-induced immunodepression in morbidity comes from a very interesting, recent prospective study showing that stress will affect susceptibility to viruses. Finally, exploration of the mechanisms of stress-induced immunodepression, suggests that a variety of mediators which regulate lymphocyte interactions and activation may be affected, perhaps at the level of gene expression.(ABSTRACT TRUNCATED AT 250 WORDS)

Adaptation, Psychological↗
PubMed1987

T-lymphocyte polyclonal proliferation: effects of stress and stress response style on medical students taking national board examinations.

This study investigated the effects of stress and stress response style on T-lymphocyte polyclonal proliferation (TLPP). The TLPP levels of 15 medical students taking NBME Part I were compared to those of a matched (on age and sex) sample of students not taking exams and hospital employees. All subjects completed the Impact of Events Scale to measure recent stress levels and style of responding to stress. TLPP data for both experimental and control groups, pre- and post-boards, were analyzed via a 2 X 2 factorial analysis of variance. Results indicated a significant main effect for the NBME stress vs control conditions and a significant interaction between stress response style (avoidance vs intrusion) and NBME stress vs control conditions. TLPP levels were significantly depressed (relative to the controls) for the NBME stress group 1 week after examinations. Furthermore, those students whose stress response style was characterized by intrusion were significantly more immunosuppressed than those characterized by an avoidance stress response style. Four- and six-week follow-up measures of TLPP were taken on 10 and 11 NBME group students, respectively. Follow-up results, analyzed via t tests, indicated that TLPP levels were significantly suppressed for 4 weeks but returned to initial normal levels at 6 weeks. Results are discussed in terms of needed research examining the mechanism of stress intruders' susceptibility to stress-induced immunosuppression and the possible clinical significance of brief periods of stress-induced decrements in TLPP levels.

Adult↗