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Biomedical subjects

J Endicott

Publications and source records attributed to J Endicott.

At least 181 records · Page 10Linked to original sources
PubMed1987

The antisocial and the nonantisocial alcoholic: clinical distinctions in men with major unipolar depression.

Depressed, alcoholic men were divided into those with and those without antisocial personality (ASP). The ASP alcoholics had a more severe, cross-sectional clinical picture; they had a higher rate of drug use disorder and more alcohol-related symptomatology. The medical complications of alcoholism were related to the duration of heavy drinking whereas the nonmedical complications (the psychosocial and pathologic-intake problems) were related to ASP, duration of heavy drinking, and their interaction.

Adult↗
PubMed1987

The importance of psychotic features to major depression: course and outcome during a 2-year follow-up.

Despite substantially greater levels of impairment during the five years preceding intake to this study, patients with nonbipolar psychotic depression (n = 55) were as likely to recover as were patients with nonpsychotic depression (n = 451) during a 2-year follow-up. Though patients with psychotic depression were more psychosocially impaired at 6 months, these differences resolved during the ensuing 18 months. In replication of an earlier study, early outcome was more predictive of later outcome in psychotic patients than it was in nonpsychotic patients.

Adolescent↗
PubMed1987

The hypothalamic-pituitary-adrenal system in panic disorder.

The authors evaluated 24 outpatients with panic disorder by means of the afternoon continuous test for cortisol and the 1-mg dexamethasone suppression test (DST) and compared the results with those of 38 outpatients with major depressive disorder and 61 healthy control subjects. The mean basal cortisol level of the patients with panic disorder was significantly higher than that of the normal control subjects but almost identical to that of the depressed patients. Only three of the patients with panic disorder had abnormal DST results. These results indicate that patients with panic disorder have an abnormality of at least one function of the hypothalamic-pituitary-adrenal system which overlaps the abnormality in major depressive disorder.

Adult↗
PubMed1987

The significance of past mania or hypomania in the course and outcome of major depression.

Patients with primary major depression (N = 372) were followed for 2 years to determine the prognostic importance of past manic or hypomanic episodes. While bipolar I and bipolar II patients were more likely to relapse and bipolar I patients were more likely to attempt suicide, these patients resembled nonbipolar depressed patients in likelihood of recovery and psychosocial impairment in various areas. Compared to nonbipolar patients, those with bipolar I depression were much more likely to develop mania, while bipolar II patients were more likely to develop hypomania. Cycling during the index episode predicted a relatively low likelihood of recovery for bipolar I patients but had no apparent prognostic significance for patients with bipolar II illness.

Adult↗
PubMed1986

13-cis-retinoic acid in the treatment of oral leukoplakia.

13-cis-Retinoic acid has been reported to be effective in treating oral leukoplakia. We randomly assigned 44 patients with this disease to receive 13-cis-retinoic acid (24 patients) or placebo (20), 1 to 2 mg per kilogram of body weight per day for three months, and followed them for six months. There were major decreases in the size of the lesions in 67 percent (16 patients) of those given the drug and in 10 percent (2 patients) of those given placebo (P = 0.0002); dysplasia was reversed in 54 percent (13 patients) of the drug group and in 10 percent (2 patients) of the placebo group (P = 0.01). The clinical response to the drug correlated with the histologic response in 56 percent (9 of 16) of the patients evaluated. Relapse occurred in 9 of 16 patients two to three months after treatment ended. The toxic effects of the drug were acceptable in all but two patients. Cheilitis, facial erythema, and dryness and peeling of the skin were common; conjunctivitis and hypertriglyceridemia also occurred. All adverse reactions could be reversed by reducing the dose or temporarily discontinuing the drug. We conclude that 13-cis-retinoic acid, even in short-term use, appears to be an effective treatment for oral leukoplakia and has an acceptable level of toxicity.

Aged↗
PubMed1986

Differential outcome of pure manic, mixed/cycling, and pure depressive episodes in patients with bipolar illness.

We found significant differences in time to recovery and rates of chronicity in 155 patients with bipolar illness when the episodes were subtyped into those with manic symptoms alone (pure manic), depressive symptoms alone (pure depressed), or symptoms of depression and mania (mixed or cycling) up to the time of entry into a clinical research study. Most of the patients in all three groups who did not recover received levels of somatotherapy that were generally consistent with current recommendations for intensity of treatment appropriate to each condition. Based on a median follow-up of 18 months, the life-table estimate of the probability of remaining ill for at least one year was 7% for the pure manic patients compared with 32% in patients who entered the study with episodes that were mixed or cycling. Purely depressed patients had a 22% probability of remaining ill, approximating rates found in patients without bipolar illness who have episodes of depression. Different clinical variables were found to predict time to recovery in each of these groups. We propose that this subtyping of episodes may be a clinically useful part of the classification of bipolar disorders.

Adult↗
PubMed1986

Diagnosis of schizophrenia. Prediction of short-term outcome.

Seven systems for the diagnosis of schizophrenia were compared in their ability to predict short-term outcome at follow-up: with each other, with selected specific symptoms, and with a simple additive composite symptom score. None of the systems nor the symptoms predicted strongly, but DSM-III and Schneiderian First Rank Symptoms and the composite score performed somewhat better than the other predictors.

Female↗
PubMed1986

The validation of the concept of endogenous depression. A family study approach.

Depressive illnesses are subdivided into endogenous and nonendogenous types in psychiatry throughout the world. We used one method of validating this nosologic subdivision: the determination of the extent to which the disorder is familial. Rates of depression were examined in 2,942 first-degree relatives of 566 individuals diagnosed as having unipolar major depressive disorder. Because no single definition of endogenous depression is universally accepted, four different methods for defining endogenous depression were compared: the Newcastle Scale, the Research Diagnostic Criteria, DSM-III, and the definition of "autonomous depression" proposed by investigators at Yale University (New Haven, Conn). In general, no matter which definition was used, the relatives of the patients with endogenous illness did not have higher rates of depressive illness than those of the nonendogenous group. The Newcastle Scale was the most sensitive in picking up familial transmission of recurrent unipolar depression. The results of this investigation suggest that longitudinal approaches should be added to cross-sectional approaches for the best definition of endogenous depression.

Adolescent↗
PubMed1986

The family history approach to diagnosis. How useful is it?

Determining the rate to which various psychiatric illnesses are familial is one widely used method for validating diagnostic categories and determining the likelihood of genetic or nongenetic patterns of transmission. Data for these studies can be collected through direct interview of all available relatives (the family study method) or by obtaining information indirectly from the patient and other family members (the family history method). Information based on direct interview is usually considered to be more accurate, although the family history method permits collection of data on a larger and more comprehensive group of relatives. We explored the extent to which data collected by these two methods were in agreement. In general, the results confirmed the usefulness of the family history method. Although it has some limitations, such as underreporting, it has respectable sensitivity for many major diagnoses when broad but well-specified criteria are used.

Data Collection↗
PubMed1986

Low levels and lack of predictors of somatotherapy and psychotherapy received by depressed patients.

We examined the treatment of 338 patients with nonbipolar major depressive disorders during the first eight weeks after entry into the National Institute of Mental Health-Clinical Research Branch Collaborative Program on the Psychobiology of Depression: Clinical Study. Of the 250 entered as inpatients, 31% received either no antidepressant somatotherapy or very low or unsustained levels, and only 49% received at least 200 mg of imipramine hydrochloride (or its equivalent) for four consecutive weeks. Of these patients, 19% received less than 30 minutes of psychotherapy per week. Among the 88 who entered as outpatients, 29% received no antidepressant somatotherapy; another 24% received very low or unsustained levels; only 19% received at least 200 mg of imipramine hydrochloride or its equivalent for four consecutive weeks. Of these patients, 52% received less than 30 minutes of psychotherapy per week. Only a few clinical factors were found to be predictive of treatment intensity. Very large differences in the amount and type of treatment across the five collaborating university centers do not appear to be related to differences in patient characteristics.

Adult↗
PubMed1986

Schedule for Affective Disorders and Schizophrenia--Lifetime Version modified for the study of anxiety disorders (SADS-LA): rationale and conceptual development.

The SADS-LA, a modification of the Lifetime Version of the Schedule for Affective Disorders and Schizophrenia, was designed specifically for studies requiring detailed lifetime information on anxiety disorders, symptoms and traits. This article focuses on current difficulties in assessing and conceptualizing anxiety disorders, as addressed in the SADS-LA. The following topics are discussed: conceptual differentiation of certain anxiety disorders; sub-threshold symptoms and syndromes; the relationship between affective and anxiety syndromes; the residual category, Generalized Anxiety Disorder. We emphasize a lifetime sequential approach to diagnostic assessment for a comprehensive understanding of the interrelationships between mental disorders.

Agoraphobia↗
PubMed1986

The stability of diagnosis with an application to bipolar II disorder.

A temporal stability study (where independent diagnostic interviews are conducted at widely separated time points) is discussed and compared to a test/retest reliability study. We introduce a new battery of statistics, based on the sensitivity, specificity, and true base rate of a disorder, that quantifies either reliability or stability over time, and provide a table that relates these underlying parameters to the opening characteristics of the battery. We analyze data on 50 relatives who participated in the family study component of the National Institute of Mental Health's collaborative "Psychobiology Depression Program." The subjects received an interview 5 years after their initial evaluation by raters without knowledge of the initial assessment. The stability of mania, hypomania, major depression, and alcoholism is considered. Although the kappa coefficient for hypomania was small (0.09), all diagnoses of hypomania in the relatives occurred in the families of bipolar probands, suggesting that the low value of kappa is due to a low sensitivity rather than to a low specificity. This is compatible with earlier findings and demonstrates the value of multiple independent assessments when studying this disorder.

Bipolar Disorder↗
PubMed1986

Immigration and major affective disorder.

We studied bipolar (ever manic; n = 297) primary unipolar (never secondary; n = 328), and secondary unipolar (n = 241) RDC major affective disorder patients in the NIMH--CRB Collaborative Study of the Psychobiology of Depression--Clinical. We examined rates of immigration, for patients and their parents, in these three diagnostic groups. Primary patients had a twofold increase in the odds in favor of immigration, compared to secondary patients. The difference persisted when proband age was statistically controlled, and could not be accounted for by any difference in sex ratios between groups. Previous findings of an increased rate of immigration in bipolar patients could not be replicated.

Age Factors↗
PubMed1986

Premenstrual changes and changes in gonadal hormones.

Changes in plasma levels of estradiol and progesterone and their temporal relationship with changes in mood and behavior were studied along the menstrual cycle in 17 normal women with a wide range of severity and types of premenstrual changes (PMC). Emphasizing changes in hormonal levels over time as well as their rates of change, selective clinical features of premenstrual changes were found to be positively associated with peak levels of progesterone, its rate of decrease over time, and the ratio between the rates of decrease-over-time of progesterone and estradiol levels. A time-lag of 4-7 days between changes in plasma levels of progesterone and changes in clinical features was also found. Rate of change of estradiol was somewhat associated with clinical PMC. It is suggested that the association between gonadal hormones, other biological changes, and mood should be further studied as a diversified, dynamic, time-related process.

Adult↗
PubMed1986

The Overt Aggression Scale for the objective rating of verbal and physical aggression.

The authors describe the design and reliability of a rating scale that measures aggressive behaviors in adults and children. On the Overt Aggression Scale (OAS), aggression is divided into four categories: verbal aggression, physical aggression against objects, physical aggression against self, and physical aggression against others. In addition, specific interventions related to each aggressive event can be recorded on the OAS. The clinical and research applications of this scale are discussed.

Adolescent↗