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Biomedical subjects

J Biederman

Publications and source records attributed to J Biederman.

At least 271 records · Page 15Linked to original sources
PubMed1990

Retrospective assessment of DSM-III attention deficit disorder in nonreferred individuals.

Using criterion-based structured interview techniques and blind assessment, the authors reported high rates of DSM-III childhood attention deficit disorder (ADD) in nonpatient first-degree relatives (parents and siblings) of 6- to 17-year-old clinically referred probands with ADD compared with rates found in relatives of normal comparison children of the same age. To further examine the validity of the ADD diagnosis in these nonreferred relatives, the authors examined whether the diagnosis was associated with antisocial disorders known to co-occur with ADD. As predicted, they found that relatives with childhood ADD (32% of relatives) were at a significantly higher risk for antisocial disorders (61% vs. 19%, p less than .01) compared with relatives without childhood ADD. In addition, the retrospective diagnosis of ADD among these nonreferred relatives resulted in a pattern of observations that is consistent with the literature on ADD in clinically referred children and adolescents: (1) ADD was more common among males than females; (2) the rate of ADD in a control group was consistent with the known risk of ADD in the general population (5.7%); and (3) 71% of ADD relatives reported levels of symptomatology within the range found in clinically referred children. These findings in a group of unselected and blindly evaluated relatives of ADD children provide indirect support for the validity of the diagnosis of ADD using standardized instruments and operational criteria.

Adolescent↗
PubMed1989

A double-blind placebo controlled study of desipramine in the treatment of ADD: I. Efficacy.

The tricyclic antidepressant drug desipramine (DMI) was evaluated in the treatment of young patients with attention deficit disorder with hyperactivity (ADDH) in an unselected sample of 62 clinically referred patients, 43 (69%) of whom previously responded poorly to psychostimulant treatment. The 42 children and 20 adolescents were assigned randomly to receive DMI (N = 31) or placebo (N = 31) for up to 6 weeks in a parallel groups, double-blind study. Clinically and statistically significant differences in behavioral improvement were found for DMI over placebo, at an average (+/- SEM) maximal daily dose of 4.6 +/- 0.2 mg/kg; 68% of DMI-treated patients were considered very much or much improved, compared with only 10% of placebo patients (p less than 0.001). DMI was well tolerated, even at the relatively high doses used. These findings suggest that DMI can be an effective treatment in the management of pediatric patients with ADDH, including patients who failed to respond to stimulants.

Adolescent↗
PubMed1989

A double-blind placebo controlled study of desipramine in the treatment ADD: II. Serum drug levels and cardiovascular findings.

In a 6-week study of children and adolescents with attention deficit disorder with hyperactivity (ADDH) in which desipramine (DMI) was highly effective and well tolerated, the mean maximal daily oral dose in the DMI-treated patients (N = 31) was 4.6 +/- 0.2 mg/kg. Additional data were obtained for 27 placebo nonresponders given DMI openly for 6 additional weeks following a nearly identical protocol and mean daily doses (total N = 58). Individual serum drug concentration varied widely at a given dose. The overall median serum DMI level was 152 ng/ml and in 6 of 56 cases with assayed serum (DMI), the level exceeded 500 ng/ml. Serum tended to be higher with older age and greater clinical improvement. Only small, clinically unimportant but statistically significant increases in diastolic blood pressure, heart rate, and electrocardiographic conduction parameters occurred. DMI-treated patients showed higher incidence during DMI treatment of sinus tachycardia and ECG evidence of intraventricular conduction defect (IVCD) of the right bundle branch block type, with two of these patients developing complete IVCD. Increases in ventricular rate and in ECG conduction parameters, as well as the incidence of IVCD, were higher in patients attaining serum levels of DMI above the median. These findings suggest that, although treatment with DMI at daily doses above 3.5 mg/kg may be needed in some cases of childhood ADDH, such doses require caution and monitoring of serum drug levels and ECG when they are used in the pediatric population.

Adolescent↗
PubMed1989

Fluoxetine added to non-MAOI antidepressants converts nonresponders to responders: a preliminary report.

Thirty depressed outpatients poorly responsive to various non-MAOI antidepressants had fluoxetine added to their regimens. Retrospective analysis revealed that 26 (86.7%) of the patients improved. Non-MAOI antidepressant treatment was withdrawn for 12 of the 26 responders; of these, 8 relapsed on fluoxetine treatment alone but recovered when treatment with the discontinued non-MAOI agent was restarted.

Adult↗
PubMed1988

Behavioral inhibition in children of parents with panic disorder and agoraphobia. A controlled study.

To investigate the role of "behavioral inhibition to the unfamiliar" as an early temperamental characteristic of children at risk for adult panic disorder and agoraphobia (PDAG), we compared children of parents with PDAG with those from psychiatric comparison groups. Fifty-six children aged 2 to 7 years, matched for age, socioeconomic status, ethnic background, and ordinal position, were blindly evaluated at the Harvard Infant Study laboratory, Cambridge, Mass. The rates of behavioral inhibition in children of probands with PDAG, with or without comorbid major depressive disorder (MDD), were significantly higher than for our comparison group without PDAG. Further, the data suggest a progression of increasing rates of inhibition from the comparison group without MDD (15.4%), to MDD (50.0%), and to comorbid PDAG and MDD (70%) and PDAG (84.6%). In contrast, the rate of behavioral inhibition in children of probands with MDD did not meaningfully differ from the comparison group without MDD. Behavioral inhibition to the unfamiliar, as defined and measured in the previous work of the Harvard Infant Study program, is highly prevalent in the offspring of adults in treatment for PDAG. These children appear to be at risk for distress and disability in childhood and also perhaps for development of psychiatric disorder in later childhood and aulthood.

Adolescent↗
PubMed1988

Desipramine and cutaneous reactions in pediatric outpatients.

The association of adverse cutaneous effects with administration of the tricyclic antidepressant drug desipramine was systematically reviewed in a clinic population of 205 child psychiatry outpatients over a 3-year period. Transient maculopapular rashes developed in 12 children and adolescents treated with desipramine. The rashes had a benign course, disappearing completely in 2 to 7 days, and were not associated with clinical or chemical hepatitis or any other physical symptoms.

Adolescent↗
PubMed1988

Further evidence for an association between affective disorders and anxiety disorders: review and case reports.

The relationship between anxiety and affective disorders continues to be debated in the literature. The authors report a case of identical twins concordant for attention deficit disorder and somnambulism but discordant for major depression and agoraphobia with panic attacks. The authors discuss the implications of this "finding in nature." Results from neuroendocrinological, family, and twin studies are also reviewed that either lend support or question the existence of a relationship between anxiety disorders and affective disorders.

Adult↗
PubMed1988

Adjunct low dose lithium carbonate in treatment-resistant depression: a placebo-controlled study.

Resistance to antidepressant therapy is a common clinical problem in the treatment of affective disorders. Adjunctive low dose lithium is a promising strategy based on biochemical models and encouraging clinical trials. After a mean duration of 9.2 months of conventional therapy, 16 healthy patients with treatment-resistant depression were treated for a minimum of 2 weeks with either adjunctive lithium or placebo using a double-blind design. We found no difference between the two groups in rate or degree of response. The two most dramatic responses occurred in patients treated with placebo, although 50% of patients treated with lithium had at least a partial response. The number of patients studied was clearly inadequate to avoid a type 2 error. The cumulative response rate reported in the literature of greater than 60%, however, suggests that lithium is indeed an effective adjunct in some patients with treatment-resistant depression. Our patients differed from those in other studies in that they were treated with a lower dose of lithium, the duration of conventional antidepressant therapy was longer, and, finally, they were less depressed and possibly depressed for a longer period. These differences may explain the comparable lithium and placebo responses in this study.

Adult↗
PubMed1987

High rate of affective disorders in probands with attention deficit disorder and in their relatives: a controlled family study.

In a controlled family study of attention deficit disorder, data were collected on first-degree relatives of 22 children with attention deficit disorder and 20 normal children. The rate of major affective disorder was significantly higher in the attention deficit disorder probands (32%) and their relatives (27%) than in the normal control subjects (0%) and their relatives (6%). The findings indicate that attention deficit disorder is associated with higher risk for affective disorder and suggest that probands who have both disorders may represent a distinct subgroup.

Adolescent↗
PubMed1987

Clonazepam in the treatment of prepubertal children with panic-like symptoms.

Three prepubertal children who suffered severe, incapacitating anxiety disorders with panic-like symptoms were treated successfully with clonazepam. The daily doses ranged from 0.5 to 3 mg. Symptoms were rapidly controlled after a therapeutic dose was attained, and no adverse effects were reported. The children were symptom-free at follow-up, which ranged from 5 months to 3 years. These three cases illustrate the diagnostic and therapeutic overlap between childhood and adult anxiety disorders and indicate the need for empirical studies aimed at evaluating diagnostic and treatment issues in childhood anxiety disorders.

Adolescent↗