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Biomedical subjects

G Winokur

Publications and source records attributed to G Winokur.

At least 109 records · Page 6Linked to original sources
PubMed1985

Differences in plasma ACTH and cortisol between depressed patients and normal controls.

Although studies have repeatedly demonstrated that depressed patients average higher baseline and postdexamethasone serum cortisol than normal controls, studies examining similar trends in adrenocorticotrophic hormone (ACTH) have produced conflicting results. The current study uniquely employs 48 hr of every 20-min serum sampling: the first 24 hr prior to dexamethasone administration and the second 24 hr subsequent. The depressed patients showed higher baseline cortisol levels than normal controls, with the greatest differences between 2 AM and 6 AM. After an 11 PM dose of dexamethasone, the difference was greatest between the hours of 8 AM and 4 PM. Among the depressed patients, those who reported recent weight loss had significantly higher plasma ACTH and cortisol levels than those without weight loss. Depressed patients without weight loss had higher baseline plasma ACTH than normal controls, and the differences reached significance during some time periods.

Adrenocorticotropic Hormone↗
PubMed1985

The relationships of historically defined subtypes of depression to ACTH and cortisol levels in depression: preliminary study.

A family history of depression (but no alcoholism), a history of bipolarity, and a history of nonsuppressor status on the Dexamethasone Suppression Test (DST) have all been positively associated with each other in previous studies. We divided depressives into three mutually exclusive groups, using the three historical parameters described above. Group A included those who were nonsuppressors at index. Group B included normal suppressors at index who met one of the following three criteria: (1) past history of a nonsuppressing DST, (2) past history of a mania, and (3) family history of depression (but no alcoholism). The remaining suppressors at index made up Group C. We found that Groups A and B show a phase advance (an earlier nadir) in the predexamethasone circadian curve for cortisol. Adrenocorticotrophic hormone (ACTH) varies in part (but not solely) with cortisol and may separate the groups.

Adrenocorticotropic Hormone↗
PubMed1985

A family study of familial positive vs. familial negative alcoholics.

Of 259 alcoholics studied, 173 were primary alcoholics. Familial positive primary alcoholics tended to have earlier onset of alcoholism and males seemed to have more complications from drinking. Family study data indicated that the familial positive group had family pedigrees more likely to contain relatives with antisocial personality disorder. This relationship to antisocial personality may help in explaining previous research findings in familial positive alcoholics.

Adult↗
PubMed1985

Separate heritability of alcoholism and psychotic symptoms.

The authors identified 259 alcoholic probands and 507 first-degree relatives. Alcoholic relatives of probands with psychotic symptoms were significantly more likely to have psychotic symptoms than those related to probands without psychotic symptoms. This finding suggests separate genetic transmission.

Alcoholism↗
PubMed1985

Suicide in schizophrenia: the Iowa Record Linkage Study.

Of 688 schizophrenics admitted to a psychiatric hospital over a 10-year period, 14 committed suicide. The numbers of suicides for both males and females significantly exceeded expected rates. Most of these deaths (71%) occurred within 2 years of discharge. Although more men than women committed suicide, women were found to be at relatively greater risk for suicide. Male suicides were significantly older than female suicides. Relevant literature is reviewed and implications for treatment and further research are discussed.

Adult↗
PubMed1984

Circadian analysis of plasma cortisol levels before and after dexamethasone administration in depressed patients.

Pituitary-adrenal regulation in healthy subjects and in depressed patients is very dynamic. Interpretation of results of the 1-mg dexamethasone suppression test has usually depended on the result of a single blood cortisol level measurement obtained in the morning or afternoon. We analyzed circulating cortisol concentrations by obtaining blood samples at 20-minute intervals for 24 hours before and after dexamethasone administration in depressed patients. The results illustrate the variability in patterns of escape from the effects of dexamethasone among depressed patients; they also indicate the influence of the sampling time on the test results and thus on the relationship of the test result to various clinical classifications. Finally, these results provide the basis for understanding the consequences of alternative sampling strategies.

Circadian Rhythm↗
PubMed1984

Leukocyte regulation in depression and schizophrenia.

The distribution of leukocytes in the blood stream is affected by levels of circulatory glucocorticoids. Elevated concentrations of cortisol are usually associated with an increase in the number of neutrophils and a decrease in the number of lymphocytes. Since primary depressive illness is often associated with hypercortisolemia, we hypothesized that similar changes in the blood stream of depressive patients may occur. To test this hypothesis, we retrospectively compared leukocyte counts in 177 untreated depressive patients and 178 untreated schizophrenic controls. We found a significant increase in the absolute and relative numbers of neutrophils and a significant decrease in the absolute and relative numbers of lymphocytes in the depressive group. Furthermore, when compared to normative values from the general population, depressed patients showed higher frequencies of both neutrophilia and lymphopenia than the schizophrenic group. These results indicate differences in the regulation of leukocytes in depression and schizophrenia consistent with the effects of higher levels of plasma cortisol in the depressive group.

Adult↗
PubMed1984

Provocative endocrine testing in recovered depressives.

Twenty-eight patients underwent a series of provocative endocrine tests an average of one year after their last admission for depression. Hypersecretion of cortisol, early escape of cortisol from dexamethasone suppression, diminished growth hormone response to insulin-induced hypoglycemia and altered thyrotropin response to thyrotropin-releasing hormone reported in acute primary depression were not observed after recovery. There were no differences in these measures after recovery between previous suppressors and nonsuppressors to dexamethasone. The cortisol response to insulin-induced hypoglycemia was less than expected in 6 of 16 recovered patients tested. There were significant differences in post-dexamethasone urinary free cortisol and in basal and early post-insulin serum cortisol levels between patients who had been suppressors and those who had been nonsuppressors to dexamethasone during acute depression. Further studies need to be done to substantiate these findings. These data indicate that hormone responses in recovered depressives are largely normal, suggesting that abnormalities during depression are "state" related phenomena.

Adolescent↗
PubMed1984

Hypertension and paranoia.

No differences in blood pressure on admission were found between samples of paranoid, paranoid schizophrenic, and nonparanoid psychiatric inpatients. The findings provide evidence against the catecholamine hypotheses of these disorders.

Adult↗
PubMed1984

Depression in the abstinent alcoholic.

Of 72 alcoholics who had abstained for a mean of 64 months, 15% had serious, debilitating depressive symptoms, which had begun after a mean of 35 months of sobriety.

Adult↗
PubMed1984

Psychosis in bipolar and unipolar affective illness with special reference to schizo-affective disorder.

Bipolar and unipolar patients respectively were separated into psychotic and non-psychotic sub-types. The bipolar psychotic patients were more likely to have certain severe symptoms, such as hallucinations and motor abnormalities, than were the unipolar patients, but the family histories of the four sub-groups were identical. The psychotic sub-groups had a different course of illness, in that they were less likely to have had a history of multiple episodes on admission and were more likely to show chronicity for a period of time on discharge. The data are interpreted as being opposed to the concept of a continuum of vulnerability in the affective disorders, and as not favouring either psychotic unipolar or psychotic bipolar illnesses or schizo-affective disorder being considered autonomous. One possible interpretation of the findings is that a trait or propensity to psychosis is transmitted totally independently of the major affective illness, and that this propensity is silent or not observed when the patient is in remission.

Adult↗
PubMed1984

Depressed women with panic attacks.

Of a group of 288 depressed female inpatients, 43 (15%) had secondary panic attacks. Compared to other depressives, the subgroup with panic attacks had significantly higher frequencies of anorexia, weight loss, gastrointestinal disturbances, hypochondriasis, and psychomotor agitation, and significantly lower frequencies of melancholic symptoms, including loss of interest in usual activities, guilt feelings, delusional thinking, psychomotor retardation, and orientation or memory impairment. Patients with panic attacks were less likely to have a depressed parent and were more likely to be described as having been nervous, worrisome, sensitive, and sexually dysfunctional before the onset of depression. Phenomenologically, they resembled "anxious depressives" as described by other authors.

Adult↗
PubMed1984

Psychiatric disorders among relatives of surgical controls.

The risks of various psychiatric illnesses among the first-degree relatives of 160 surgical control patients were estimated. Morbidity risks were calculated separately for males and females because of previous findings showing significant sex differences for certain diagnoses. The findings, based on ICD-9 criteria, demonstrate a significantly higher risk of depression, neurosis, and organic brain syndrome in females than in males. The risk of alcoholism was significantly higher in males.

Adult↗
PubMed1983

Bipolar illness. The sex-polarity effect in affectively ill family members.

We examined the sex ratios of unipolar and bipolar affective disorder in 14 studies of bipolar illness. The data are highly consistent in demonstrating that (1) females are more frequently affected than males; (2) among affected females, the ratio of unipolar depression to bipolar illness is about 2:1; whereas (3) among affected males, the ratio of bipolar to unipolar illness is approximately 1:1. This curious discrepancy between the sexes may hold a clue to understanding familial transmission as well as heterogenicity in bipolar illness.

Bipolar Disorder↗
PubMed1983

Differentiation of depressive subtypes by insulin insensitivity in the recovered phase.

The glucose response to a standard insulin tolerance test (ITT) has been reported to be blunted in the acute phase of heterogeneous depressive disorders and to be normal in the recovered phase. We studied the glucose response to ITT in the recovered phase depression in patients who had previously been subclassified according to familial and clinical characteristics. All patients with depressive spectrum disease had an adequate glucose response to the ITT, whereas only 40% of patients with familial pure depressive disease and 56% of patients with bipolar illness had an adequate hypoglycemic response. There was also a trend toward a decrease in insulin sensitivity in patients who had been nonsuppressors to dexamethasone when depressed. These findings suggest that the glucose response to ITT may be a useful tool in differentiating among the heterogeneous depressive disorders.

Adult↗
PubMed1983

Dexamethasone suppression, protirelin stimulation, and insulin infusion in subtypes of recovered depressive patients.

Twenty-eight patients (10 bipolar, 13 depressive spectrum disease, and 5 familial pure depressive), recovered from depression for an average of 1 year, underwent a series of basal and provocative endocrine tests. No significant differences were found among depressive subtypes in thyrotropin, cortisol, or growth hormone measurements either before or after provocative testing with the exception of growth hormone response to insulin-induced hypoglycemia. Patients with depressive spectrum disease showed a significantly different growth hormone response to insulin-induced hypoglycemia than patients with bipolar disorder, a finding which suggests differences in alpha-adrenergic receptor sensitivity between these groups.

Adult↗
PubMed1983

The micropsychopathology of hebephrenic/catatonic schizophrenia.

All hospital records, interviews, and notes are reviewed on a group of 52 chronic hebephrenic/catatonic schizophrenics who were institutionalized before the era of antipsychotic medications. The authors catalog the presence or absence of individual symptoms of schizophrenia on a year by year basis over a span of 25 years and present this data in a series of bar graphs. Symptoms such as avolition, impaired social interaction, and flat affect become more frequent over the 25 years of follow-up. Hallucinations and delusions become less frequent. Eighteen of the patients are noted to have had a DSM-III personality disorder premorbidly and eight of these are characterized as schizoid personality disorder. Level of insight is found to be poor at the onset of schizophrenia and deteriorates further over the next 5 years. Although the study design contains a sampling bias in favor of chronically institutionalized cases, several lines of evidence suggest that the trends reported here are not artifacts of institutionalization but are due to schizophrenia.

Adult↗