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Biomedical subjects

E S Paykel

Publications and source records attributed to E S Paykel.

At least 19 recordsLinked to original sources
PubMed1991

Platelet alpha 2-adrenoceptors, defined with agonist and antagonist ligands, in depressed patients, prior to and following treatment.

Saturation binding of the alpha 2-adrenoceptor antagonist, 3H-yohimbine, and displacement of 3H-yohimbine with the alpha 2-adrenoceptor agonist, UK-14,304, were performed concurrently in platelet membranes obtained from drug-free depressed patients and healthy volunteers. Where possible platelet binding was repeated in depressed patients following treatment. The number and affinity of 3H-yohimbine binding sites did not differ between controls and depressed patients, or when depressed patients were divided on the basis of endogenicity (Newcastle or RDC criteria) or dexamethasone test result. The proportion of alpha 2-adrenoceptor binding sites with high affinity for UK-14,304 and KD values for the two states of the receptor did not differ in the total sample of depressed patients compared to controls. The KD for both states of the receptor and the proportion of sites with high affinity for UK-14,304 was lower in RDC non-endogenous patients than RDC endogenous patients. Treatment did not alter the total number of alpha 2-adrenoceptors or the proportion of sites with high affinity for UK-14,304, but reduced the KD for 3H-yohimbine and the KD of UK-14,304 for the low affinity state of the alpha 2-adrenoceptor.

Adrenergic alpha-Agonists↗
PubMed1979

Factor patterns in depression. A replication study.

A principal component analysis was carried out on symptom ratings and selected history items from 79 depressed patients. Three interpretable factors were obtained. The first was a general factor reflecting severity. The second a bipolar factor contrasting endogenous and neurotic depression, the third a bipolar contrasting anxiety and depressive symptoms. These replicate similar factors found previously in a different sample. The stability and predictive value are emphasized of other factors as well as the endogenous-neurotic dimension.

Adult↗
PubMed1979

Depressive classification and prediction of response to phenelzine.

A variety of depressive classifications were used to predict response to four weeks' treatment with phenelzine. Better response was found in outpatients rather than inpatients, in atypical depressives, in less severe depressives with a pattern of anxiety and other neurotic symptoms, and in groups characterized as hostile and agitated. The findings, although a little patchy, gave clear support to the concept of a specific clinical group responsive to MAO inhibitors.

Adolescent↗
PubMed1978

Contribution of life events to causation of psychiatric illness.

This paper discusses the magnitude of the effect of life events in the causation of psychiatric illness. It is argued that an established epidemiological concept, relative risk, provides a useful measure of association which can be approximately adapted for retrospective controlled studies. Examination of studies employing general population controls consistently indicates effects of some importance, with risks of illness increased by factors of between 2 and 7 in the 6 months after an event. Risks are greater for the more stressful types of events, greater for depression and neuroses than schizophrenia, and even greater for suicide attempts. However, similar events occur commonly and a large proportion of event occurrences are not followed by illness. Events must interact with a wide variety of background factors, and the appropriate model is one of multifactorial causation.

Depression↗
PubMed1978

Classification of suicide attempters by cluster analysis.

Cluster analytic procedures for classification were carried out on a sample of 236 suicide attempters. Rating variables concerned previous suicidal behaviour, details of the recent attempt and its motivation, mental state, and demographic characteristics. Results suggested the existence of three groups of attempters. The first comprised patients taking overdoses, on the whole showing less risk to life, less psychiatric disturbance, and more evidence of interpersonal rather than self-destructive motivation. The second groups, fewer in number, made severe attempts with more self-destructive motivation, by violent methods rather than overdose. The third and smallest group had a previous history of many attempts and gestures, made relatively mild attempts and were overtly hostile, engendering reciprocal hostility in the treating psychiatrist. These groups show some resemblance to those found in other studies.

Adult↗
PubMed1977

Application of cluster analysis in the classification of depression. A replication study.

This paper reports a replication study of a four-group cluster-analytic typology of depressed patients. Several hierarchial agglomerative clustering procedures were applied on the original patient sample using a slightly reduced variable pool. The best replication obtained used Ward's error sum of squares method and was stable on iterative relocation. Three groups, psychotic depressives, anxious depressives, and young depressives with personality disorders replicated well, while hostile depressives failed to separate clearly from the young depressives.

Age Factors↗
PubMed1977

Typological prediction of response to amitriptyline: a replication study.

This paper reports a replication study of prediction of outcome by a cluster-analysis derived four-group typoloy of depression. 143 acutely depressed women were treated with amitriptyline for 4 weeks. In replication of the earlier findings, anxious depressives showed the worst response, hostile depressives and young depressive with personality disorder the best, with psychotic depressive intermediate. The findings provide further validating evidence for the typology, and for the view that nonpsychotic depressives are heterogenous.

Adult↗
PubMed1976

Life events, depressive relapse and maintenance treatment.

Occurrence of life events was recorded in 30 recovered depressed women undergoing clinical relapse in a controlled trial of maintenance treatment with amitriptyline and psychotherapy, and in 30 matched patients who did not relapse. Overall, patients who relapsed experienced significantly more life events in the three months before relapse, and especially in the month immediately preceding it. Undesirable events were particularly implicated. Event rates prior to relapse were closely comparable in treatment subgroups, giving no evidence that differential stress was required to produce relapse. The findings reinforce previous studies indicating an overall relationship between life events of certain types and depression, but do not suggest that the beneficial effects of maintenance treatment are specifically protective against life stress.

Adjustment Disorders↗
PubMed1976

Maintenance therapy of depression.

This paper summarises findings from a study of maintenance treatment in predominantly neurotic depressive responding to initial treatment with amitriptyline. Patients were continued on amitriptyline for eight months, withdrawn double-blind to placebo after two months, or withdrawn overtly to no medication, with and without individual psychotherapy from social workers in the factorial design. Continuation significantly reduced early relapse and symptom return, compared with either condition of early withdrawal. Psychotherapy improved social adjustment after eight months in patients who did not relapse, without any significant interactions. Side effects were minimal, except for carbohydrate craving. These findings suggest that tricyclic antidepressants should be routinely continued for several months after drug-induced remission.

Amitriptyline↗
PubMed1976

Life stress, depression and attempted suicide.

This paper summarizes a series of controlled studies into the relationship of life events to depression and to suicide attempts. Life events, particularly exit events and events regarded as undesirable, tend to cluster prior to onset of depression. These findings are supported by comparisons with general population controls, depressives after recovery, other patient groups, and by studies of relapse. Interactions with predisposing and biological causes are probably of great importance. Suicide attempters are a rather different patient group and they experience a particularly striking accumulation of threatening events. There is a marked peaking of events in the month before the attempt, suggesting a crisis response and the potential relevance of crisis intervention techniques.

Adaptation, Psychological↗
PubMed1976

Temporal stability of symptom patterns in depression.

Temporal stability of symptom patterns was examined in 33 depressives studied initially at the height of illness and again some months later in a relapse following earlier recovery. Relapse symptoms were significantly less severe at the time of rating, and initial and relapse severity were not significantly related. Neverthless there were significant correlations between initial and relapse scores on two factors orthogonal to severity. One of these reflected symptom patterns important to the endogenous-neurotic distinction, the other a contrast between depression and anxiety. These findings indicate some consistency in symptom patterns in successive episodes of depression, and thereby support the value of clinical classifications depending on symptom patterns.

Adjustment Disorders↗
PubMed1976

Personality and symptom pattern in depression.

This paper reports relationships between symptoms and premorbid personality in a varied sample of depressed patients. Symptoms were rated by a psychiatrist at clinical interview; personality was rated by patients on a self-report after clinical improvement, using the Maudsley Personality Inventory and an inventory of obsessive, hysterical and oral personality. Additional ratings on the latter were obtained at interview with a relative. The most prominent finding was that patients with premorbid neuroticism also showed a neurotic rather than an endogenous symptom pattern. Additional relationships were relatively weak but consistent with previous studies. Depressives with neurotic rather than endogenous symptom pattern showed more evidence of oral dependent personality and less obsessionality. Patients with hysterical personalities tended to be less severely ill and to show a pattern characterized by mixed depression and hostility with less evidence of anxiety.

Adjustment Disorders↗