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Biomedical subjects

E Robins

Publications and source records attributed to E Robins.

At least 55 records · Page 3Linked to original sources
PubMed1980

Effect of tricyclic antidepressants on individual symptoms.

Improvements of individual depressive symptoms in patients with depression was compared between those treated with tricyclic antidepressants (TAD) and those treated with other psychoactive drugs or placebo. In the majority of comparisons, patients did not improve significantly more with TAD than with other drugs or placebo. These findings indicated that tricyclic antidepressants are not useful in the treatment of most patients with depression. Despite our findings, it is realized that a minority of patients with depression may benefit by treatment with tricyclic antidepressants.

Affective Disorders, Psychotic↗
PubMed1979

The natural history of acute organic mental syndrome after bilateral electroconvulsive therapy.

Thirty-one patients undergoing electroconvulsive therapy (ECT) were followed prospectively for the development of acute organic mental syndrome (AOMS); 15 patients (48.4%) developed AOMS during ECT. For these 15 patients, the average number of ECTs before development of AOMS was 5.5 with average duration of AOMS being 20.1 days. Comparison of these 15 patients to the 16 patients who did not develop AOMS for diagnoses, demographic data, pre-ECT laboratory data, and medications, differed only in exposure to psychoactive medications and prior presence of major medical illness.

Acute Disease↗
PubMed1978

Research diagnostic criteria: rationale and reliability.

A crucial problem in psychiatry, affecting clinical work as well as research, is the generally low reliability of current psychiatric diagnostic procedures. This article describes the development and initial reliability studies of a set of specific diagnostic criteria for a selected group of functional psychiatric disorders, the Research Diagnostic Criteria (RDC). The RDC are being widely used to study a variety of research issues, particularly those related to genetics, psychobiology of selected mental disorders, and treatment outcome. The data presented here indicate high reliability for diagnostic judgments made using these criteria.

Alcoholism↗
PubMed1978

Diagnosis and chronic mental illness.

This paper describes the occurrence of chronicity in varying psychiatric illnesses. There is not an unequivocal definition of chronicity, but with the exception of the illnesses that will be described below and that lead directly or indirectly to death from CNS complications of the illness, chronicity will require a duration of a minimum of five years without a significant remission. Chronicity is further differentiated into four different kinds of chronicity: chronic--death, chronic--self-limited, chronic--remission, and chronic--recurrent. The illnesses that may be considered as possibly fulfilling the criteria for chronic will be noted and a method for deciding whether an illness qualifies will be outlined.

Alcoholism↗
PubMed1978

Effects of central nervous system accumulation of tellurium on behavior in rats.

Rats were treated for 112 days with daily injections of 2 mg/kg potassium tellurite in Sorensen's phosphate buffer or with the buffer vehicle only. At sacrifice, the cerebral gray matter of the animals treated with tellurite was grossly darkened. The presence of tellurium in cerebellum was confirmed by atomic absorption spectrophotometry. Growth of the tellurite-treated animals was significantly impaired when compared with control animals. However, in a T-maze the activity level of the tellurite-treated animals was increased. On a simple delayed response task, the performance of the tellurite-treated animals was more consistent than that of the buffer-treated animals.

Animals↗
PubMed1977

A contrast of the three more common illnesses with the ten less common in a study and 18-month follow-up of 314 psychiatric emergency room patients.

The present study combines four factors: an initial research interview, a blind follow-up of the patients seen initially, the use of specified diagnostic criteria, and the application of these techniques to a psychiatric emergency room population of 314 patients. Follow-up studies were done in 299 patients (95%) a mean of 18.2 months after the initial interview. The patients were described diagnostically and demographically. There were three more common diagnoses: affective disorder, alcoholism, and antisocial personality. There were ten additional less common diagnoses, as well as an undiagnosed group and a group without diagnosis. There were single diagnoses in 190 patients and multiple diagnoses in the remaining 124 patients. Three diagnoses or less per patient were not uncommon; more than three diagnoses per patient were uncommon. Diagnoses of affective disorder, alcoholism, and antisocial personality occurred in 64% of the total number of diagnoses. The remainder of the diagnoses occurred in 36%. Prompt hospitalization occurred in 14% of the total sample.

Adult↗
PubMed1977

A contrast of the three more common illnesses with the ten less common in a study and 18-month follow-up of 314 psychiatric emergency room patients. II. Characteristics of patients with the three more common illnesses.

The three more common illnesses diagnosed in the sample of 314 emergency room patients were (in order of frequency) affective disorder (N = 135), alcoholism (N = 112), and antisocial personality (N = 57). This study describes the occurrence and frequency of affective disorders and evaluates the relative usefulness of three separate sets of diagnostic criteria for the depressive phase of the illness, which are considered in three self-evident, mutually exclusive groups, the definition of which depends on chronology of onset in relation to other diagnoses. Findings show a 3:2 ratio of primary affective disorder to secondary affective disorder. The 112 diagnoses of alcoholism were based on defined criteria that separated "definite" (N = 102) from probable (N = 10) alcoholism. A high incidence of secondary affective disorder (38%) in patients with a first diagnosis of alcoholism is noted. The third most common diagnosis, antisocial personality, was based on defined criteria requiring a specified number of manifestations both before and after age 15 years. Only 11% of the antisocial personality patients received a single diagnosis of antisocial personality. An additional diagnosis of alcoholism occurred in 61%. Besides antisocial symptoms, the 57 patients reported 74 different nonantisocial symptoms, supporting the conclusion that antisocial personality patients may be as susceptible to neurotic and psychotic symptoms as other patients.

Adolescent↗
PubMed1977

A contrast of the three more common illnesses with the ten less common in a study and 18-month follow-up of 314 psychiatric emergency room patients.

An 18-month follow-up of 314 randomly selected psychiatric emergency room patients showed that, although there were 15 possible diagnostic groups the diagnoses made at initial interviews proved to be largely accurate. Follow-up results showed the prediction based on those initial diagnoses was 84% correct in the 299 patients (95%) that could be followed up. Follow-up results also showed that 88% of the individual diagnoses (as opposed to diagnosed patients) were correct. The kappa coefficients were high, all of them being above 0.60, some between 0.80 and 0.90. In addition to the relatively high diagnostic validity, the results also demonstrated a high item reliability for the more than 400 separate items for which kappa coefficients were calculated. Less than 15% of these items had a kappa coefficient of less than 0.60. This study thus demonstrated a high diagnostic reliability and a high diagnostic validity The basis of these diagnoses in a heterogeneous psychiatric population was the application of precisely defined and applied diagnostic criteria. The diagnostic process was blind in that the follow-up diagnosis was made in the absence of knowledge of the initial diagnosis. The use of precisely defined and systematically applied criteria may prove to be superior to multivariate analysis, cluster analysis, or other statistical techniques.

Adult↗
PubMed1977

New concepts in the diagnosis of psychiatric disorders.

The salient points in this paper include the following: (a) a description of categorical (typological) diagnosis, applicable to psychiatric as well as to medical illness; (b) description and discussion of the five steps necessary to validate clinically a categorical (typological) diagnosis; (c) a description of the currently primitive state of laboratory studies of functional disorders (e.g. schizophrenia, affective disorders, and other functional disorders); (d) a definition of various psychiatric illnesses and a description of the criteria necessary to qualify a symptom for describing them; and (e) the means and purposes of assessing diagnostic homogeneity or heterogeneity in psychiatric illnesses.

Clinical Laboratory Techniques↗
PubMed1976

Regional serotonin levels in brain: a comparison of depressive suicides and alcoholic suicides with controls.

The levels of 5-hydroxytryptamine have been measured in 33 areas of the human brain and these levels compared in depressed suicides, in alcoholic suicides, and in controls. The values obtained for control brains ranged from 5.3 mumole 5-HT/kg wet weight in substantia nigra to 0.4 mumole 5-HT/kg wet weight in frontal gray. No significant differences were found among diagnostic groups in any of the areas studied.

Adult↗
PubMed1975

Function of the male sex organs in heroin and methadone users.

The function of the secondary sex organs was found to be markedly impaired in 29 participants in a methadone maintenance program. The ejaculate volume and seminal vesicular and prostatic secretions were reduced by over 50 per cent in methadone clients, as compared to 16 heroin addicts and 43 narcotic-free controls. Serum testosterone levels were also approximately 43 per cent lower in methadone clients than in controls or heroin users. Although the sperm count of methadone clients was more than twice the control levels, reflecting a lack of sperm dilution by secondary-sex-organ secretions, the sperm motility of these subjects was markedly lower than normal. On all measures of secondary-sex-organ and testicular function, heroin addicts appeared to fall between the methadone and control subjects, but, with the exception of sperm motility, the deviation from control values did not reach statisitcal significance.

Adult↗
PubMed1975

Clinical criteria for psychiatric diagnosis and DSM-III.

The authors identify the differences in formal inclusion and exclusion criteria used to classify patient data into diagnoses as the largest source of diagnostic unreliability in psychiatry. They describe the efforts that have been made to reduce these differences, particularly the specified criteria approach to defining diagnostic categories, which was developed for research purposes. On the basis of studies showing that the use of specified criteria increases the reliability of diagnostic judgments, they suggest that including such criteria in the next edition of APA's Diagnostic and Statistical Manual of Mental Disorders (DSM-III) would improve the reliability and validity of routine psychiatric diagnosis.

Humans↗
PubMed1975

Regional distribution of norepinephrine and dopamine in brains of depressive suicides and alcoholic suicides.

Norepinephrine (NE) and Dopamine (DA) were measured in 30 brain areas of depressive suicides and alcoholic suicides and in controls who had died of natural causes, in an effort to test directly the "catecholamine hypothesis" of depressive illness. Levels of NE were highest in the hypothalamus, tegmentum of pons, red nucleus and mesencephalic tegmentum; lowest in centrum semi-ovale, hippocampus and cingulate gyrus. Highest values for DA were found in the putamen, head of caudate, substantia nigra, globus pallidus, red nucleus and a few areas of the hypothalamus; lowest in cerebral cortex, ventral pons and thalamus. Our data showing a slight increase in NE levels in four areas of the suicide brains is probably of little clinical importance. In no case were the NE or DA levels in the suicide brains significantly less than in the controls. Alteration of monoamine metabolism as an etiologic factor in depressive illness remains a possibility if the mechanism involves blocking of the uptake of amines into neurons or changes in membrane permeability. It is unlikely that an alteration of amine metabolism per se is involved, since four selected metabolizing enzymes previously studied showed no difference in activity and the present study shows no depletion of amines.

Alcoholism↗