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Biomedical subjects

G Winokur

Publications and source records attributed to G Winokur.

At least 145 records · Page 8Linked to original sources
PubMed1979

Newer experimental methods for classifying depression. A report from the NIMH collaborative pilot study.

A total of 83 patients receiving diagnoses of major depressive disorder in the pilot phase of the National Institute of Mental Health Collaborative Study of the Psychobiology of Depression were used to evaluate two newer methods of classifying depressive disorders on the basis of family history or course. A third subtype based on family history, nonfamilial depression, was compared with the two subtypes originally proposed by Winokur and colleagues, pure depression and depression spectrum diseases. The system for classifying depressions on the basis of course and antecedent disorder, primary vs secondary depression, was also compared. These data from the pilot study indicate that two newer systems for classification have some predictive, construct, and content validity, but both are in need of further investigation before they become accepted methods for the classification of depressive disorders.

Depression↗
PubMed1979

Genetic markers in depressive disorders.

1. Association or linkage between a known genetic marker and an illness with a presumed genetic etiology supports two conclusions: a) The genetic etiology would be considered definite, and b) the illness should be considered a homogeneous disease. 2. After separating depressions on the basis of gross familial differences, a finding of linkage or association in any subgroup would indicate that the particular illness is autonomous. Data on association between bipolar and unipolar depression and subtypes of the ABO system are given. 3. Methodological problems in association studies are discussed. 4. Preliminary data suggest the possibility of linkage between the alpha-haptoglobin locus and third component of complement locus and depression spectrum disease, a depression which is familially defined by the presence of alcoholism in the first-degree family member.

Depressive Disorder↗
PubMed1979

Possible linkage between alpha-haptoglobin (Hp) and depression spectrum disease.

Depression spectrum disease is an unipolar depressive illness in which at least one member of the family has unipolar depression and at least one other first degree relative has alcoholism and/or antisocial personality; using this definition, 14 depression spectrum disease families are studied. Assuming, among other things, that variability in age of onset is environmentally caused and lognormally distributed, segregation analysis shows that the data are compatible with the dichotomy of 'affected' versus 'not affected' being due to an autosomal dominant gene. A simple environmental hypothesis in which the transmission of the illness does not depend upon the parents' type could be rejected (p less than 0.001). Linkage analysis is performed by the method of maximum likelihood, taking the best fitting Mendelian model found in the segregation analysis. The results show virtually no evidence of linkage between depression spectrum disease and C3, but suggestive evidence (lod score = 1.03) of linkage between depression spectrum disease and alpha-haptoglobin (both these linkages were previously suggested by significant results in sib-pair analyses).

Adolescent↗
PubMed1979

Secondary depression: familial, clinical, and research perspectives.

The authors evaluate the clinical and research significance of the diagnosis of secondary depression by comparing 48 cases of primary and 26 cases of secondary depression. The patients with secondary depression have a higher familial prevalence of alcoholism, affective disorder, and drug abuse. The groups differ somewhat on a few sociodemographic, behavioral, and attitudinal variables but are similar in symptomatology, sex ratio, onset and duration of symptoms, treatment received, and response to treatment. These results suggest that the distinction between primary and secondary depression should be retained in research that examines neurochemistry or genetics. Primary and secondary depression appear to be identical from the persepctive of clinical care. Management of these patients should emphasize the diagnosis of depression rather than antecedent diagnoses.

Adjustment Disorders↗
PubMed1979

Familial (genetic) subtypes of pure depressive disease.

The author reviewed data from five studies and found that depressed patients with a history of depression in a parent or child have more sibships containing depression than depressed patients without this family history. Thus, there is a clustering of depressions in certain families. Sporadic pure depressive disease (PDD), where no depressive illness exists in a first-degree family member of a depressed proband, is associated with a later age of onset than familial PDD, where depressive illness does exist in a first-degree relationship. The possibility exists that familial PDD and sporadic PDD are autonomous illnesses. The presence of a family history of depression may be predictive to some extent of a good response to adequate tricyclic medication or ECT.

Adult↗
PubMed1979

Postpartum mania.

Twenty-one patients with bipolar affective disorder (20 manic episodes, one depressive episode) during the postpartum period were evaluated. They were compared to an unselected group of womicantly more Schneiderian symptoms and fewer recurrences of illness within the three-year periofectively ill relatives than the controls. The practical significance of these findings with rey of the bipolar syndrome.

Adult↗
PubMed1979

Manic depressive illness and EEG abnormalities.

In evaluating 40 manic-depressive (bipolar) patients who had clinical electroencephalograms, there was a significant relationship between abnormal EEG findings and a negative family history for affective disorder when a comparison was made between patients with various classes of family history.

Bipolar Disorder↗
PubMed1978

Suicide, attempted suicide, and relapse rates in depression.

Suicide, attempted suicide, and relapse rates in 519 depressives were examined, comparing the effects of different treatments. After six months, suicide attempts were seen significantly less frequently in the ECT groups (0.8%) than in the antidepressant group (4.2%) or the "adequate" antidepressant subgroup (7.0%) Fewer suicide attempts occurred in the ECT group compared to the antidepressant group among both in those who had attempted suicide prior to admission (0% vs 10%) and in those who had not (1.1% vs 3.6%). A history of attempted suicide showed a greater risk of both suicide (2.9%) in the following year and subsequent suicide attempt (5.9%). A depressive diagnosis may be as good a predictor of suicidal behavior as a history of attempted suicide. Relapse rates did not differ between treatment groups.

Adjustment Disorders↗
PubMed1978

Is a familial definition of depression both feasible and valid?

On the basis of familial constellations it is possible to separate out most of the unipolar depressive patients that are seen in the hospital. The groups may be called depression spectrum disease, pure depressive disease, and sporadic depressive disease. The sporadic depressive disease group is older at onset and older at index of admission than the other two groups. The depression spectrum disease and pure depressive disease groups are separated by virtue of the fact that there are more episodes of illness in the latter.

Adult↗
PubMed1978

Baseline characteristics of pure depressive disease.

A chart review study of 86 females with pure depressive disorder (i.e., a diagnosis of depression plus a parental history of depression) is reported. Findings regarding family history of depressive illness are described. Clinically, the group is noted to be most homogeneous, various attempts at subdivision failing.

Age Factors↗
PubMed1977

The family history method using diagnostic criteria. Reliability and validity.

Data concerning familial history of psychiatric disorders are often used to assist in diagnosis, to examine the role of genetic or nongenetic familial factors in etiology, or to develop new methods of classification. Information concerning familial prevalence may be collected by two different methods: the family history method (obtaining information from the patinet or a relative concerning all family members), and the family study method (interviewing directly as many relatives as possible concerning their own present or past symptomatology). This study compares these two methods. In general, the family study method is preferred since information is likely to be more accurate. The family history method leads to significant underreporting, but this can be minimized through the use of diagnostic criteria. This study reports on an instrument that has been developed for collecting information concerning family history and that provides criteria for 12 diagnoses--the Family History-Research Diagnostic Criteria. Using diagnostic criteria leads to greater sensitivity, but underreporting remains a major problem of the family history method.

Diagnosis, Differential↗
PubMed1977

Depression spectrum disease versus pure depressive disease. Clinical, personality, and course differences.

In a group of 191 women admitted to the University of Iowa Psychiatric Hospital for depression over a 45-year period and selected on the basis of alcoholism or antisocial personality, vs. depression, in a parent, 105 probands fit into the depression spectrum group (parental alcoholism or antisocial personality) and 86 into the pure depression group (parental depression). Few differences were found between the presenting clinical pictures (including precipitating factors) of the two groups; but depression spectrum patients and pure depressive patients showed study differences in the areas of personal problems and personality as well as course of illness. The depression spectrum patients were significantly less likely to have loss of interest in usual activities as a symptom at index admission. They were significantly more likely to have had a history of sexual problems, to have been divorced or separated before, to have been described as irritable, and to report having previously been depressed. They are nonetheless significantly more likely to recover completely and have no relapse of depression. The pure depression group were significantly more likely to have depressed sisters, and suicide was much more frequent in their ill parents. Thus, important personality and course differences separate depressive spectrum disease from pure depressive disease;

Age Factors↗