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Biomedical subjects

G Winokur

Publications and source records attributed to G Winokur.

At least 253 records · Page 14Linked to original sources
PubMedDate not supplied

A polyepisodic course in bipolar illness: possible clinical relationships.

Using archival data, we conducted a systematic study of consecutive admissions of bipolar patients and found that an early age of onset, a subacute onset, a family history of bipolarity, and the administration of electroconvulsive therapy (ECT) during an index episode were individually associated with a polyepisodic course of illness (three to nine or more episodes) during a period of observation which included onset of illness, index admission, and a period of follow-up. The family history of biopolarity which seems to predispose to multiple episodes suggests that what may be transmitted may not necessarily be a bipolar illness but possibly an illness with many episodes, thus increasing the likelihood of occurrence of a manic episode.

Age Factors↗
PubMedDate not supplied

Classification of alcoholism with reference to comorbidity.

Classification of individuals with alcoholism is currently limited. The purpose of this analysis was to determine whether antisocial personality disorder and other primary psychiatric syndromes identified subgroups of alcoholics with differing characteristics. Alcoholic probands (n = 224) with alcoholism were divided into those with primary alcoholism (n = 128), antisocial alcoholism (n = 50), and secondary alcoholism (n = 46). These groups were evaluated with regard to alcohol-related symptoms and upon a variety of psychiatric signs and symptoms. The secondary alcoholism. The antisocial alcoholic and primary alcoholic groups demonstrated many similarities, but overall, the antisocial alcoholic group appeared most severe. The antisocial alcoholic group additionally exhibited a dissociation between the subjectively reported and the observed behavior. These findings support the concept of heterogeneity within the alcoholism spectrum. Longitudinal data are needed to determine whether the observed cross-sectional differences predict outcome differences.

Adult↗
PubMedDate not supplied

Primary and secondary affective disorders: baseline characteristics of unipolar patients.

We studied 569 patients with RDC non-bipolar major depressive disorder from the clinical portion of the NIMH Program on the Psychobiology of Depression. Primary (n = 327; never had a non-affective disorder), secondary (n = 191; had a non-affective disorder before ever having a major depressive episode), and "complicated' (n = 51; had at least one depressive episode before and another since developing a non-affective condition) patients were compared on demographic variables, past episodes of depression, past treatments received, and symptoms seen in the index episode. For most characteristics, the groups fell in the order primary, secondary, complicated, such that complicated cases had the earliest onset, the longest duration and the greatest severity in the index episode. These data do not discriminate between two hypotheses: that secondary and complicated depressions are basically depressions which happen to occur in a non-affectively ill person, or that they are different disorders which are distinguished clinically by characteristics related to severity.

Adult↗
PubMedDate not supplied

Age, mortality and chronic schizophrenia.

Mortality data are presented from a 0 to 10 year follow-up of 636 chronic schizophrenic patients. Death ascertainment was made through a record-linkage process and comparisons made with the general population of the State of Iowa using sex and age standardized mortality ratios (SMRs). Risk for mortality was most pronounced among men younger than 40 and women younger than 70. No suicides occurred in chronic schizophrenic patients over age 40 years. The data demonstrate that patients at greatest risk for premature death are those younger than 40 years. Reasons for these findings are discussed.

Adult↗
PubMedDate not supplied

Schizophrenia and affective disorder--distinct entities or continuum?: an analysis based on a prospective 6-year follow-up.

The purpose of this study was to determine whether the preponderance of data support a continuum hypothesis of the psychoses or a concept of separate, autonomous illnesses. Patients (N = 70) were hospitalized for nonmanic psychoses, given structured interviews and a dexamethasone suppression test (DST), and diagnosed according to the Research Diagnostic Criteria (RDC). Patients were then evaluated at 1 year and 6 years with a structured interview. Diagnoses were made at three points of time: intake, 1 year, and 6 years. The patients were divided into groups that had a consistent (over the three points) set of affective disorder diagnoses (affective disorder or schizoaffective disorder, mainly affective [AD group]) and those that had a consistent set of schizophrenic diagnoses (schizophrenic or schizoaffective disorder, mainly schizophrenic [S group]). A third group (inconsistently diagnosed) consisted of subjects who at one point were diagnosed in the AD group and at another in the S group. A series of discriminant function analyses suggested that the AD group differs widely from the S group; and the inconsistently diagnosed group most closely resembled the AD group. The family background of the inconsistent group was similar to that of the AD group. The DST and outcome showed that the inconsistent group was more like the AD group than the S group. Using the characteristics of the medical model-clinical picture, outcome, laboratory tests, and family history-the group that was inconsistent with regard to diagnosis over time appeared similar to the AD group. Taking the follow-up evaluation into account, the data favor the possibility that patients who have a variable clinical diagnosis over time do not suffer from schizophrenia.

Adult↗