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Biomedical subjects

E K Silberman

Publications and source records attributed to E K Silberman.

30 records · Page 2Linked to original sources
PubMed1983

Thinking disorder in depression.

This experiment demonstrated abstract reasoning deficits in depressed patients and detailed some of the components of cognition that may determine such deficits. Subjects were given a discrimination learning problem in which possible solutions had to be formulated and tested against new information. Depressed subjects performed more poorly on the task than controls. Two types of errors--inability to narrow down the set of possible solutions (poor "focusing") and perseveration on disconfirmed hypotheses--hampered the performance of depressed but not control subjects. While logic, memory, and attention were intact at an elementary level, the inability to coordinate these functions in a complex task appeared to be an important feature of the depressive impairment.

Adult↗
PubMed1983

Processing of emotional properties of stimuli by depressed and normal subjects.

This study investigated whether depressed subjects differ from controls in their ability to appreciate emotional aspects of verbal material, or in their use of emotional qualities of stimuli in learning and remembering. When asked to rate the degree of emotionality of words, depressed subjects did so essentially identically with controls. However, despite apparently similar evaluatory processing, the depressed failed to remember as well as controls. Depressed subjects were more dependent than controls on both high emotionality and high stimulus concreteness for recognition memory, but were less benefited by these properties in free recall. While providing no evidence for deficits specific to emotionality, our results suggest that relatively shallow processing of semantic aspects of stimuli may be an important factor in the memory impairment of depression.

Adult↗
PubMed1983

Altered lateralization of cognitive processes in depressed women.

Eighteen normal men and women had a left hemisphere advantage for processing a verbal task, but depressed women showed a trend toward right hemisphere superiority. In depression the right hemisphere may share functions performed exclusively by the left hemisphere in normal subjects. Altered laterality may be a trait of depression-prone people or a change related to depressive episodes themselves. In the latter case, the right hemisphere may be compensating for relative deactivation of the dominant left hemisphere.

Adult↗
PubMed1982

Growth hormone response to clonidine as a probe of noradrenergic receptor responsiveness in affective disorder patients and controls.

The growth hormone (GH) response to the alpha-adrenergic agonist clinidine was blunted in 19 depressed patients compared to 20 controls. The difference remained significant when age- and sex-matches pairs of patients and controls were compared from this sample, either including or excluding subjects with elevated GH baseline levels. Plasma levels of free 3-methoxy-4-hydroxyphenyl-glycol (MHPG) were assayed in blood samples drawn just before the clonidine infusion. A modest negative correlation was found between the plasma MHPG values and the magnitude of the GH responses to clonidine, although baseline plasma MHPG levels were not significantly different between patients and controls. The diminished GH response to clonidine observed suggests that many depressed patients may have decreased alpha-adrenoreceptor responsiveness. Decreased responsiveness may in some cases be associated with relatively increased indices of presynaptic noradrenergic availability. Such a model might have implications for understanding the functional status of the noradrenergic neurotransmitter system in depressed patients and the possible subtyping of affective disorder patients.

Clonidine↗
PubMed1982

Atypicality in primary depressive illness: a preliminary survey.

Primary depressive illness comprises a wide variety of clinical presentations which may represent disorders with different underlying biology, life course, and treatment response. In order to explore possible correlates of such clinical heterogeneity, we have constructed a rating scale for atypical depressive illness. Forty-four patients, all meeting Research Diagnostic Criteria for primary major depressive disorder were evaluated for atypicality using the scale. Within this group, atypicality was found to be characterized by lack of clearly encapsulated episodes of depression, a high degree of character pathology, prominent anxiety, somatization, and neurotic symptoms, and a past history of diagnostic confusion. Atypical patients were younger than typicals, more likely to be unipolar or bipolar II, and more often hospitalized, despite lower frequency of depressive episodes. While both typical and atypical groups showed decreased REM latency and increased urinary-free cortisol, they differed in measures related to noradrenergic metabolism, monoamine oxidase activity, and slow wave sleep. Preliminary results also raised the question of possible differences in treatment response between typical and atypical patients.

Age Factors↗
PubMed1981

Heterogeneity of amphetamine response in depressed patients.

There is considerable diversity of opinion as to the nature of the response of depressed patients to amphetamine infusion. The authors report on the clinical response of 18 endogenously depressed patients to double-blind, intravenous administration of amphetamine or saline. Although the drug produced activation, mood elevation, and recall of emotionally charged material in the group as a whole, there was considerable heterogeneity of response as well as a tendency for response dimensions to vary independently of one another. The heterogeneity of clinical response may be associated with differences in underlying clinical, biological, and genetic variables in affectively ill patients.

Adult↗
PubMed1980

Carbachol triggering of desynchronized sleep phenomena: enhancement via small volume infusions.

Two physical factors affecting the behavioral effects of drugs microinjected into the pontine tegmentum have been studied. Reducing the volume of vehicle produced a dramatic enhancement of the capacity of the long-acting cholinergic agent carbachol to induce desynchronized (D) sleep-like behavior (Dcarb). Enhancement of Dcarb was also achieved by substitute passive diffusion for active pumping of a given volume of carbachol solution. Controlling these two physical factors makes Dcarb a compelling experimental model for the study of D sleep mechanisms. The results also give support to the concept of a localized population of cholinoceptive neurons in the pontine reticular formation whose activation is a key step in the generation of physiological D.

Animals↗
PubMed1980

The march of symptoms in a psychotic decompensation. Case report and theoretical implications.

The onset and evolution of symptoms were studied in a female patient with a history of recurrent depressive psychoses. In each episode, her psychotic decompensations were characterized by an orderly and progressive sequence including similar psychological or somatic precipitants, mounting anxiety, nystagmoid eye movements associated with panic, unfolding delusions, and olfactory hallucinations, culminating in a complete psychotic regression. The evolving sequence repeated during each episode in the present case is compared with that of a similarly stereotyped progression of symptoms in temporal lobe and Jacksonian seizures. Kindling is suggested as a model relevant to the understanding of both epilepsy and the functional psychoses. Detailed observation of the evolution of symptoms during psychotic episodes may provide important clues to the underlying pathological anatomy and physiology of psychotic illness.

Adolescent↗
PubMedDate not supplied

Should we train psychiatrists as primary care providers?

The author discusses the proposition that psychiatrists would be appropriate primary physicians for specific types of patients. The author reviews the arguments for and against psychiatrists as primary care providers, proposes questions that must be addressed in training for such a role, and describes current models of primary care education and practice for psychiatrists. The author believes that primary care may be an appropriate career track within psychiatry and suggests that the development of family medicine may provide useful guidance in incorporating primary care functions into psychiatry.

Family Practice↗
PubMedDate not supplied

Aura phenomena and psychopathology: a pilot investigation.

We investigated a possible relation between aura phenomena and psychopathology in patients with seizure disorders. Twenty-one patients with a variety of seizure types (90% with generalized seizures, 72% with complex partial seizures, CPS) were studied. Aura phenomena were evaluated with the Silberman-Post Psychosensory Phenomena Scale; psychopathology was assessed with the Schedule for Affective Disorders and Schizophrenia-Lifetime Version (SADS-L), the Minnesota Multiple Personality Inventory (MMPI), and the Washington Psychosocial Seizure Inventory (WPSI). Psychosensory symptoms occurring in the absence of frank seizures, but not those occurring with seizures, were related to increased psychopathology (primarily mood and anxiety related) and greater time in psychiatric treatment. Psychosensory symptoms may reflect ongoing neurophysiologic dysfunction related to epilepsy and may therefore be a useful subject for further study.

Adaptation, Psychological↗