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Biomedical subjects

E Hollander

Publications and source records attributed to E Hollander.

At least 163 records · Page 9Linked to original sources
PubMed1989

Do panic disorder patients indiscriminately endorse somatic complaints?

Ehlers et al. (1986b) and Margraf et al. (1986) suggested that panic disorder patients indiscriminately endorse somatic complaints and that their responses to lactate infusion are nonspecific. Their Symptom Questionnaire was composed of anxiety/panic/lactate infusion relevant symptoms, while the Somatic Control Scale was composed of "irrelevant" symptoms. In an attempt to address and in part replicate the above findings among panic disorder patients, we adopted the SCS of Margraf et al. (1986) for use with our Acute Panic Inventory, an instrument similar to their Symptom Questionnaire. Contrary to their reports, we did not find a tendency for panic patients to indiscriminately endorse somatic complaints. Only Acute Panic Inventory scores differed significantly across assessment points.

Adult↗
PubMed1989

Arterial blood gas changes in panic disorder and lactate-induced panic.

Lactate infusions were conducted in 12 male panic patients and 8 male normal controls with arterial catheters in place to reassess previously reported acid-base changes based on venous blood samples. The analysis of arterial pH, carbon dioxide pressure, and bicarbonate concentration confirmed most venous findings. At baseline, before the infusion, venous blood shows evidence of mixed chronic and acute respiratory alkalosis in patients while arterial blood gasses are most consistent with developing acute respiratory alkalosis. During the infusion both bloods are consistent with mixed metabolic and respiratory alkalosis with the patients hyperventilating more than normal controls and panicking patients hyperventilating more than nonpanicking patients. Arterial blood seems more sensitive than venous blood in detecting baseline differences between panicking and nonpanicking patients. A baseline arterial carbon dioxide pressure of 40 mmHg or higher and an arterial pH below 7.40 may predict no subsequent panic to lactate infusion.

Acid-Base Equilibrium↗
PubMed1989

Prolactin and sodium lactate-induced panic.

Sodium lactate infusions reliably induce panic attacks in panic disorder patients but not in normal controls, but the mechanism underlying this response is unknown. We studied the plasma prolactin response to infusion of 0.5 molar sodium lactate in 38 patients with panic disorder or agoraphobia with panic attacks, and 16 normal controls. As expected, baseline plasma prolactin was significantly higher in female subjects than in male subjects. However, the males who experienced lactate-induced panic had significantly elevated baseline prolactin levels compared to male nonpanickers and controls. Prolactin levels increased in all groups during lactate infusion, which may reflect osmotic effects, but were blunted in the late panickers compared to nonpanickers and controls. The elevated baseline prolactin for male panickers supports a relationship between prolactin and anticipatory anxiety. The blunted prolactin response for late panickers suggests a net diminution, rather than a sensitization, of prolactin response in panic anxiety.

Adult↗
PubMed1989

Characteristics of males at a public health department contraceptive service.

To effectively confront teenage pregnancy, the characteristics, attitudes, and behaviors of males, along with females, need to be better understood. This pilot study examined young males who visited the family planning clinic of a public health department to obtain free condoms. Questionnaires were distributed over a 4-week period. Nearly 30% of males reported having sex 11+ times a month. However, an equal proportion reported having sex three or fewer times in the same interval. Most males reported using condoms during sex, although one quarter reported use as "seldom." The health department was a major source of condoms and was positively evaluated because condoms were free and there were "no questions asked." Only one third of the males reported using another method of contraception. Results suggest a major role of the health department in condom availability and the potential need for contraceptive services for males.

Contraceptive Devices, Male↗
PubMed1989

Treatment of body-dysmorphic disorder with serotonin reuptake blockers.

The authors describe five patients with body-dysmorphic disorder who responded preferentially to serotonin reuptake blockers. They review the literature, describe how patients with excessive concern about body abnormalities lie along a spectrum of doubt and certainty, and discuss similarities and differences between this disorder and obsessive-compulsive disorder.

Adult↗
PubMed1989

Hypersensitivity to carbon dioxide in panic disorder.

Seven male panic patients did not panic but were significantly more sensitive to steady-state carbon dioxide inhalation than five male normal control subjects. The male patients' hypersensitivity to carbon dioxide was unrelated to current state of anxiety or acute panic.

Anxiety↗
PubMed1989

Conceptual and methodological issues in studies of obsessive-compulsive and Tourette's disorders.

An association between recurrent motor and phonic tics and obsessive-compulsive behaviors has been noted since Tourette's Syndrome (TS) was first described. Obsessive-compulsive disorder (OCD) until recently was considered a rare disorder with poor prognosis. Currently, OCD is considered among the most common psychiatric diagnoses, and new treatments have spurred the development of considerable clinical, epidemiological, genetic, and biological research. Recent studies suggest a high rate of obsessive-compulsive symptoms in Tourette's Syndrome patients. A high rate of OCD among relatives of TS probands, both with and without OCD symptoms, suggest that some forms of OCD may represent an alternative expression of factors responsible for TS and/or chronic motor tics. Areas of conceptual controversy in the differentiation of tics, impulsions, and compulsions are discussed, confusing aspects of differential diagnosis are explored, and the relationship of diagnostic issues to clinical and familial studies are highlighted. There is considerable evidence for neuropsychiatric abnormalities in both OCD and TS; however, no studies have directly compared both disorders with similar methodological design. While studies of neurotransmitter function have primarily implicated dopaminergic dysfunction in TS and serotonergic function in OCD, other systems may be involved in each disorder, and neurotransmitter systems may be tightly linked, such that alterations of one system will affect other systems. This article reviews and discusses some of the conceptual and methodological issues associated with clinical, familial, neuropsychiatric and biological studies attempting to elucidate the association among tics, obsessive-compulsive disorder, and Tourette's Syndrome.

Brain Damage, Chronic↗
PubMed1989

Fluoxetine treatment of obsessive-compulsive disorder: an open clinical trial.

The selective serotonin reuptake blocker fluoxetine was administered to 49 patients with obsessive-compulsive disorder in a 12-week open clinical trial. A minimum adequate trial of at least 8 weeks of treatment was completed by 39 patients. Response rates were 62% (24/39) of adequately treated patients and 49% (24/49) of the whole sample. These uncontrolled findings suggest that fluoxetine is of significant benefit for a substantial proportion of obsessive-compulsive disorder patients. However, controlled trials comparing fluoxetine with placebo and other active agents are needed to confirm this, as are studies aimed to delineate fluoxetine's full dose range, optimal length of treatment and relapse rate following discontinuation.

Adult↗
PubMed1988

Tricyclic therapy of the DSM-III anxiety disorders: a review with implications for further research.

Existing data suggests dramatic efficacy for all tested tricyclics in disorders involving spontaneous panic attacks; moderate efficacy for clomipramine but not other tricyclics in obsessive-compulsive patients; possible, but as yet not well established, tricyclic efficacy in generalized anxiety; and lack of efficacy in simple phobias. Further studies in all DSM-III Anxiety Disorders are both warranted and required to answer the nosological, pathophysiological and treatment questions raised by these findings.

Adolescent↗
PubMed1988

Effects of clonidine on alprazolam discontinuation in panic patients: a pilot study.

Effects of adjunctive clonidine (0.15 to 0.7 mg/day) on symptoms experienced during and for 4 weeks after gradual alprazolam discontinuation were observed in panic disorder patients after 6 weeks of successful treatment. Twelve of 14 entered patients were considered to have had a sufficient period of discontinuation (2 weeks) and clonidine administration (1 week) for effects to be assessed adequately. Nine of these 12 patients reached zero dose of alprazolam in 3 to 4 weeks. However, 10 of 12 patients experienced new withdrawal symptoms and 11 of 12 experienced recurrent panic attacks during tapering. Although a greater proportion of patients were successfully discontinued in a shorter time than in a previous nonclonidine trial, clonidine did not appear to have a specific effect on relapse or withdrawal. A placebo-controlled trial is needed to discriminate between possible contributions of clonidine and other factors (e.g., physician attitude, placebo effect of pill taking) to this improved outcome.

Adult↗
PubMed1988

Pharmacotherapy of social phobia: an interim report of a placebo-controlled comparison of phenelzine and atenolol.

Forty-one patients meeting DSM-III criteria for social phobia completed a randomized comparative trial of the monoamine oxidase inhibitor phenelzine, the cardioselective beta-adrenergic blocker atenolol, and placebo. No significant differences were seen after 4 weeks of treatment in this preliminary trial. At the end of 8 weeks, however, phenelzine demonstrated greater efficacy than atenolol or placebo on dimensional ratings of overall severity of social phobia. No atenolol-placebo differences were observed. The authors shall present maintenance and discontinuation findings in a final report. Phenelzine may act in patients with social phobia by directly reducing interpersonal hypersensitivity.

Adult↗
PubMed1987

RS 86 in the treatment of Alzheimer's disease: cognitive and biological effects.

Twelve patients who met Research Diagnostic Criteria for Alzheimer's disease (AD) completed a double-blind crossover study comparing oral RS 86, a long-acting and specific muscarinic agonist, with placebo. Cognitive and noncognitive effects were assessed with the Alzheimer's Disease Assessment Scale (ADAS). RS 86 was found to improve ADAS test scores consistently (both cognitive and noncognitive subscales) in seven patients, with a clinically obvious improvement in only two patients. RS 86 produced a significant increase in peak nocturnal cortisol levels, and this increase correlated with improvement on ADAS testing. Similarly, there was a 38% increase in amplitude of the P300 evoked potential with RS 86. The biological findings suggest that RS 86 was effective only to the extent that it enhanced central cholinergic activity.

Aged↗