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Biomedical subjects

F G Zitman

Publications and source records attributed to F G Zitman.

At least 73 records · Page 4Linked to original sources
PubMed1990

Low dose amitriptyline in chronic pain: the gain is modest.

In the double-blind placebo-controlled study presented here, the effects were investigated of a low dose of amitriptyline (75 mg) in patients with chronic pain of various origins. The active drug was superior to placebo in reducing pain intensity. The reduction was small. In the second treatment week, the amitriptyline treated patients slept longer. No differences between active drug and placebo were found with respect to daily activities or use of analgesics. Based on our data and those of other studies, it is concluded that amitriptyline (and other antidepressants) in low doses does have a positive effect on the intensity and some other aspects of chronic pain, but that the effect is modest. It must be kept in mind that chronic pain is a very treatment-resistant condition. Therefore, even modest positive effects may be worthwhile.

Adult↗
PubMed1987

Therapeutic drug monitoring of amitriptyline: impact of age, smoking and contraceptives on drug and metabolite levels in bulimic women.

Concentrations of amitriptyline (AT), nortriptyline (NT) and E-10-hydroxynortriptyline (E-10-OH-NT) were measured in 18 women with bulimia receiving 100 mg AT/day for at least 6 wk. After onset of treatment between days 36 and 57 there is a decrease in AT and an increase in E-10-OH-NT concentrations, probably due to an autoinductive effect on hydroxylation. The estimated mean (+/- SD; range; n) elimination half-life time of AT was 14.0 (+/- 7.8 h; 7.5-38.5 h; 14). On day 36, AT concentrations in females using oral contraceptives (OC) were higher than in non-users of OC, which indicates inhibition of AT metabolism by OC. In all smokers the E-10-OH-NT concentrations on day 36 were lower than in non-smokers. Our findings suggest induction of N-demethylation and glucuronidation by smoke components.

Adolescent↗
PubMed1986

Analgesic and antidepressive effects of low-dose amitriptyline in relation to its metabolism in patients with chronic pain.

The analgesic and antidepressive effects of amitriptyline (AT) in relation to its kinetics and metabolism were studied in 19 outpatients with chronic pain who received a daily dose of 75 mg AT for at least 6 weeks. Riboflavin was added to the medication to check compliance. On days 0, 4, and 8 and weeks 3, 6, 9, and 12 after the start of dosing, blood samples were drawn from the patients 10 +/- 1 hours after the first morning dose and a sample of the first morning urine was taken to check riboflavin. Serum levels of AT and its metabolites, especially nortriptyline (NT) and E-10-hydroxy-nortriptyline (E-10-OH-NT), were measured by HPLC. On day 0 and at 3, 6, and 12 weeks the severity of depression was scored by means of a self-rating depression scale and pain intensity scores were measured. In addition, after 6 weeks of dosing patients estimated their percentage of pain in comparison with baseline. Mean (+/- SD) steady-state concentrations of AT, NT, and E-10-OH-NT were 36 +/- 23.5, 28 +/- 14.9, and 52 +/- 23.7 micrograms/L, respectively, in male patients (n = 8; age 45 +/- 7.4 years) and 34 +/- 14.6, 45 +/- 25.1, and 40 +/- 15.6 micrograms/L, respectively, in female patients (n = 11; age 46 +/- 6.8 years). There was a significant sex-related difference in the NT/AT ratio, which was higher in women.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1984

Patient evaluation of a cognitive behavioral group program for patients with chronic low back pain.

Traditional approaches to curing patients with chronic benign pain have had only limited success. Rehabilitation becomes therefore more important and in recent years management programs have been developed to achieve this goal. This study was based on the hypothesis that a program can be more effective with its structure according to the comments of patients with respect to the various components of the program. After testing this hypothesis we conclude that such subjective evaluation of treatment is an important factor which merits receiving more attention than previous work has suggested.

Analgesics↗
PubMed1984

Amitriptyline metabolism in relation to antidepressive effect.

The relationship between amitriptyline (AT) metabolism and clinical response was studied in 14 outpatients treated with a daily dose of 150 mg AT. Riboflavin was added to the medication to check compliance. On days 0, 2, and 7 and at 3, 6, 9, and 13 wk after onset of therapy, blood samples were drawn from the patients 3 (+/- 0.5) hr after the first morning dose and a sample of the first morning urine was taken to check riboflavin. Serum levels of AT and its metabolites, nortriptyline (NT), E- and Z-10-hydroxynortriptyline (E- and Z-10-OH-NT), total (E + Z) 10-hydroxyamitriptyline (tot-10-OH-AT), and desmethylnortriptyline (DNT), were measured by means of HPLC while minimizing adsorption onto glass. On day 0 and after 6 and 13 wk the severity of the depressive disorder was scored by means of the self-rating depression scale of Zung.28 Mean steady-state concentrations of AT, NT, and E-10-OH-NT were in the order of 100 micrograms/l and tot-10-OH-AT and Z-10-OH-NT approximated 20 micrograms/l. DNT concentrations were under 15 micrograms/l. There was great variation in metabolic pattern between patients. After 6 wk concentrations of all compounds were approximately 15% lower than at 3 wk, indicating a weak autoinducible effect of AT or its metabolites. Steady-state concentrations of AT correlated well with that of NT (r = 0.64; P less than 0.05) but not with that of E-10-OH-NT.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1980

[Biofeedback].

Explore the source record for details and available documents.

Biofeedback, Psychology↗
PubMedDate not supplied

Clinical evaluation of 14 patients with the Charles Bonnet syndrome (isolated visual hallucinations).

A group of 14 patients with isolated visual hallucinations who met the criteria proposed by Gold and Rabins for Charles Bonnet syndrome (with the exception of the criterion "hallucinations are stereotyped") underwent psychiatric, neurologic, and ophthalmologic tests. Additional common characteristics of the hallucinations included the absence of personal meaning of the content of the hallucinations and the disappearance of the hallucinations when the patients closed their eyes. There was no evidence for a relationship of the syndrome to psychiatric disorders. In the majority of cases, ocular pathology and neurologic disturbances were diagnosed. There was also evidence that most patients were suffering from social isolation. From these data it is concluded that a combination of factors is probably responsible for the Charles Bonnet syndrome.

Aged↗
PubMedDate not supplied

The Hamilton Depression Rating Scale (HDRS); changes in scores as a function of training and version used.

The co-existence of different versions of the Hamilton Depression Rating Scale (HDRS) may introduce a source of error in depression research. In a training procedure, based on 16 videotapes, over 900 scores were used to investigate differences between two prominent versions. The HDRS published by Bech et al. in 1986 produced significantly lower total scores than the original HDRS presented by Hamilton in 1960. Previous experience of the raters, both in psychiatry and in the use of the scale, increased the scores in a nonsignificant way. During the training raters' scores increased significantly. These effects were small, one point each in the total scores, but they were consistent throughout our material. In depression research, training procedures and the exact version of the scales used should be specified.

Adult↗
PubMedDate not supplied

Scalability, reliability, and validity of the benzodiazepine dependence self-report questionnaire in outpatient benzodiazepine users.

As there is no multidimensional instrument available that reflects the severity of benzodiazepine (BZD) dependence comprehensively, the Benzodiazepine Dependence Self-Report Questionnaire (Bendep-SRQ) was developed and investigated. The Bendep-SRQ, Symptom Checklist-90 (SCL-90), Schedules for Clinical Assessments in Neuropsychiatry (SCAN), and Addiction Severity Index-Revised (ASI-R) were administered to 115 general practice (GP) patients, 124 psychiatric outpatients, and 33 self-help patients who were using BZDs. Factor and Rasch analyses were applied to construct scales. Reliability assessments were made in terms of subject discriminability, item discriminability, and test-retest stability. To support the construct validity of the scales, theoretical rationales were required to explain the specific item order provided by the Rasch scale values. To assess the concurrent and discriminant validity, a matrix consisting of the above-mentioned measures was factor-analyzed. Four Rasch-homogeneous scales were delineated: problematic use, preoccupation, lack of compliance, and withdrawal. Nearly all subject discriminability, item discriminability, and test-retest results indicated good reliability. A BZD dependence factor was extracted with high loadings for the Bendep-SRQ scales and the concurrent measures. The discriminant measures had high loadings on other factors. The scalability, reliability, and validity of the Bendep-SRQ scales appeared to be good. The Bendep-SRQ shows great promise as a useful and easily manageable instrument for assessment of the severity of BZD dependence in clinical practice and scientific research.

Adolescent↗
PubMedDate not supplied

Social and psychological characteristics of elderly visually handicapped patients with the Charles Bonnet Syndrome.

The Charles Bonnet syndrome (CBS) is characterized by the presence of complex visual hallucinations in psychologically normal people. The syndrome occurs predominantly in the visually handicapped elderly. Little is known about its etiology and pathogenesis. The aim of this study was to examine the associations of CBS with psychological and social determinants. All subjects were patients older than 64 years from a low-vision unit. Using a case-control approach, 50 patients with CBS and 80 patients without visual hallucinations were interviewed about their educational level, social circumstances, number of social contacts, and ability to cope with visual handicap. Loneliness was measured with the De Jong-Gierveld-Kamphuis loneliness scale, and personality traits were examined with the Dutch-language short version of the Minnesota Multiphasic Personality Inventory ([MMPI] Nederlandse Verkorte MMPI [NVM]). Compared with the control group, significantly more CBS patients were lonely. Mean scores on the NVM shyness scale and extraversion scale were significantly higher and lower, respectively, in CBS patients. In multiple logistic regression analysis for the three determinants simultaneously, loneliness and low extraversion were significant predictors for CBS, but shyness was not. It is concluded that loneliness, low extraversion, and shyness are risk indicators for CBS in elderly visually handicapped people. The findings suggest that CBS is associated with a low quality of social contacts.

Adaptation, Psychological↗
PubMedDate not supplied

Differentiation of cognitive and motor slowing in the Digit Symbol Test (DST): differences between depression and schizophrenia.

Schizophrenia and depression have an overlap in symptomatology, namely a slowing in both motor and mental activities, denoted in depression as 'psychomotor retardation' and in schizophrenia as 'psychomotor poverty'. By means of a new technique that allows the measurement of psychomotor speed and the computerized analysis of writing movements recorded during the performance of the Digit Symbol Test, it indeed proved to be possible to observe a slowing in both disorders. In addition, a different structure of slowing in the two patient groups could be identified.

Adult↗
PubMedDate not supplied

Who uses over-the-counter psychotropics? Characteristics, functioning, and (mental) health profile.

As part of a population study on the prevalence of psychopathology, users of "Over-The-Counter" Psychotropics (OTC-Ps) were studied. First, their mental health profile was examined by a number of subjective and objective assessments. Second, the medical consumption of the users was studied with special attention to the psychotropic drugs prescribed. The prevalence of psychological problems and symptoms of psychological distress was higher among OTC-P users than among non-users. Somatic problems and symptoms were comparable in the two groups; social support was better in the OTC-P users. Half of the users were known to have mental health problems by their Primary Care Physician (PCP). The DSM IV Axis I disorders were mostly mood and anxiety disorders. A benzodiazepine had been prescribed to one-third of the OTC-P users. No other psychotropic drugs had been prescribed, and the medical consumption was comparable in the two groups. PCPs should be aware of concomitant OTC-Ps use.

Adolescent↗
PubMedDate not supplied

The long-term perspective: a study of psychopathology and health status of patients with a history of depression more than 15 years after the first episode.

This article examines psychopathology, functioning, well-being, social support, and coping-behavior of family practice patients with a history of depressive illness, both with and without recurrences. Results of depressive patients were compared with each other and with those of "normal" controls. The patients belonged to the four practices of the Continuous Morbidity Registry of the University of Nijmegen, Netherlands. Their first episode of depression for each patient was more than 15 years ago. Data were collected with the Symptom Checklist (SCL-90) the RAND-36, the Social Support List (SSL-12), and the short Utrecht Coping List (UCL-k). Psychopathology scores of patients without recurrences were higher than "normal" controls and lower than patients with recurrences. The same pattern was found concerning health status. No significant differences were found between the groups in social support but patients with recurrences had a lower score of emotional coping than patients without recurrences or normal patients. That even a long time after an episode of depression, patients have higher levels of a variety of psychopathology than controls has implications for every-day practice as it calls for a longer and more critical follow-up of depression by clinicians.

Activities of Daily Living↗
PubMedDate not supplied

Erythrocyte aging characteristics in elderly individuals with beginning dementia.

An increase in erythrocyte-bound IgG and enhanced breakdown of the erythrocyte anion exchanger band 3, characteristics of normal erythrocyte aging are observed in old, healthy individuals when compared with young donors. These findings indicate that the rate of cellular aging increases with organismal aging. Results from previous studies on the same parameters have suggested that the erythrocyte aging process is disturbed in patients in advanced stages of Alzheimer type dementia, and in individuals with Down's syndrome who show no signs of dementia. In this study we find no changes in erythrocyte aging parameters in old individuals in beginning stages of dementia of various etiologies. We conclude that, in general, characteristics of disturbed erythrocyte aging cannot serve as presymptomatic markers of Alzheimer-type dementia.

Aged↗
PubMedDate not supplied

Cross-validation of the benzodiazepine dependence self-report questionnaire in outpatient benzodiazepine users.

The aim of this study was to cross-validate the Benzodiazepine Dependence Self-Report Questionnaire (Bendep-SRQ), which reflects the severity of benzodiazepine (BZD) dependence. The Bendep-SRQ, Symptom Checklist-90 (SCL-90) Schedules for Clinical Assessments in Neuropsychiatry (SCAN), and Addiction Severity Index-Revised (ASI-R) were administered to 102 general practice (GP) patients and 126 psychiatric outpatients who were using BZDs. The scalability and reliability of the Bendep-SRQ scales were reassessed in terms of Rasch homogeneity, subject discriminability, item discriminability, and test-retest stability. Present and original Rasch item orders were compared to evaluate construct validity. A matrix of all measures was factor-analyzed to assess concurrent and discriminant validity. The scalability of the Bendep-SRQ scales was confirmed. The reliability results were fairly good. Present and original Rasch item orders corresponded. The Bendep-SRQ scales and concurrent measures had high loadings on one factor, the discriminant measures on two other factors. In spite of some differences with respect to sociodemographic characteristics and pattern of BZD use, the cross-validation results agreed well with the results of the original study on the Bendep-SRQ. The Bendep-SRQ has presently acquired enough support of favorable and consistent results for clinical and scientific use.

Adolescent↗