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Biomedical subjects

J Endicott

Publications and source records attributed to J Endicott.

At least 199 records · Page 11Linked to original sources
PubMed1985

Birth-cohort trends in rates of major depressive disorder among relatives of patients with affective disorder.

As part of the National Institute of Mental Health-Clinical Research Branch Collaborative Program on the Psychobiology of Depression Clinical Study, 2,289 relatives of 523 probands with affective disorder were interviewed with the Schedule for Affective Disorders and Schizophrenia and diagnosed for major depressive disorder by the Research Diagnostic Criteria. Data were analyzed using life-table and survival methods. The findings suggest a progressive increase in rates of depression in successive birth cohorts through the 20th century and an earlier age at onset of depression in each birth cohort. A predominance of female depressives was found in all birth cohorts but the magnitude of female-male differences fluctuated over the decades. The existence of these trends is reported to stimulate further research. These findings are discussed in terms of possible gene-environment interactions. However, no conclusive causal inferences can be drawn pending further investigation.

Actuarial Analysis↗
PubMed1985

Treatment of premenstrual symptoms.

The etiology of premenstrual syndrome is unknown. A wide variety of etiological explanations has been suggested, but controlled studies based on these theories have generally failed to provide confirmation. This article reviews the literature on treatment of premenstrual symptoms and provides some practical suggestions for clinical management.

Bromocriptine↗
PubMed1985

Phenomenology and family history in DSM-III psychotic depression.

Depressed inpatients with psychotic features were compared to those without them in terms of demographic features, depressive symptoms at intake and family history. These variables were then used to compare patients with mood-congruent psychotic features to those with mood-incongruent psychotic features. Patterns of familial psychopathology were similar for psychotic and non-psychotic patients. In accord with other studies, the families of mood-incongruent patients had slightly more schizophrenia and significantly less depression than did the families of mood-congruent patients. Depressive symptoms, particularly those used to define major depression and melancholia, were more severe in psychotic patients. Moreover, these particular depressive symptoms were more likely to distinguish mood-congruent from mood-incongruent patients than were other depressive symptoms. Thus mood-congruent psychotic features accompanied a more typical depressive syndrome than did mood-incongruent psychotic features.

Adult↗
PubMed1985

Alcoholism in antisocial and nonantisocial men with unipolar major depression.

Men with primary and secondary unipolar major depression were divided into those with and without antisocial personality (ASP). The ASP depressives had a higher rate of alcoholism than the nonASP depressives, and among the nonASP depressives, those with drug abuse had a higher rate of alcoholism than those without drug abuse. The course of depression appeared to be related to the presence of nonaffective psychopathology. Depressed men with additional nonaffective disorders had fewer, but larger episodes than depressed men without, and depressed men with alcoholism had a higher risk of suicide. Our results confirm the close association of alcoholism and ASP and highlight the importance of recognizing nonaffective syndromes in the depressed patient.

Adult↗
PubMed1985

Methodological issues in studies of premenstrual changes.

The main methodological issues that should be considered in studies of premenstrual changes are discussed. They include: the selection of well-defined groups of subjects who reflect the diversity of subtypes of premenstrual changes (PMC); the confirmation of retrospective reports through daily monitoring of changes by ratings, or by objective procedures when possible; the need to consider the diversity of premenstrual biological changes instead of comparing average levels, since there is a likelihood that different pathophysiological changes are connected with diverse behavioral and mood changes; application of a multivariate, time-related approach to explore the pathophysiology of PMC; the need to exclude placebo responders prior to the active drug phase in treatment trials and the need for such trials to be double-blind, placebo-controlled and, if possible, of a cross-over design. Attention to such issues should lead to increased consistency of findings across studies and eventually to a better understanding of the pathophysiology of PMC and to a rational, effective treatment.

20-alpha-Dihydroprogesterone↗
PubMed1985

Relationship of dysphoric premenstrual changes to depressive disorders.

An association between premenstrual dysphoric changes and depressive disorders is demonstrated in 170 women. Each woman underwent an evaluation for current and life-time diagnosis using the Research Diagnostic Criteria (RDC). Premenstrual dysphoric changes were evaluated with the Premenstrual Assessment Form (PAF). Criteria for PAF Full Depressive Syndrome were met by 57% of women with a life-time diagnosis of Major Depressive Disorder. Only 14% of the Never Mentally Ill women met these PAF criteria. Eighty-four percent of those who had PAF Full Depressive Syndrome also had RDC Major Depressive Disorder while only 9% were Never Mentally Ill.

Depression↗
PubMed1985

Bipolar I, bipolar II, and nonbipolar major depression among the relatives of affectively ill probands.

An earlier report described symptoms and background features in depressed probands grouped by polarity: bipolar I, bipolar II, and nonbipolar. The present study made similar comparisons among relatives with a lifetime history of major depression. The 73 relatives with bipolar II disorder had the highest rates of marital disruption, psychopathology in the previous month, nonserious suicide attempts, and nonaffective syndromes and were the youngest when first treated.

Adult↗
PubMed1985

The clinical diagnosis and classification of premenstrual changes.

Recent interest in premenstrual changes and increasing referrals for treatment when such is warranted, bring to focus the need for accurate definition of the problem and a reliable procedure for clinical and research assessments of premenstrual phenomena. A definition is suggested and the steps taken to establish the diagnosis of the various premenstrual subtypes are described. The suggested classification may contribute to differential treatment modalities for each subtype.

Depression↗
PubMed1984

Long-term outcome of episodes of major depression. Clinical and public health significance.

Twenty-one percent (20/97) of patients with an episode of major depressive disorder and no history of chronic minor depression who sought treatment at five university medical centers had not recovered after two years of prospective follow-up. The rate of recovery was highest in the three months after entry into the study, with a notable decrease in rate after one year. Most patients who did not recover had severe depressive symptoms throughout the two years of follow-up. Long duration of episode before entry into the study, inpatient hospitalization status at entry, intact marriage, low family income, admitting research center, and a history of nonaffective psychiatric disorders (including alcoholism) predicted a chronic course. The implications of these findings for clinicians, researchers, and public health planners are discussed.

Adult↗
PubMed1984

Measurement of depression in patients with cancer.

The recognition or detection of depressive symptoms and syndromes in patients with cancer is of value to the patient because his mental distress may respond to treatment, and to the clinician because some of the clinical complications or difficulties in diagnosis and treatment of the patient may be reduced. Many factors militate against the diagnosis of depressive syndromes in patients with cancer. These include problems with the application of standard sets of criteria for depression, the assumption on the part of medical staff, family, and patients that depression is a "natural" response and therefore not treatable, and the pressure on all involved to "think positive." Some ways of modifying the usual screening and diagnostic procedures for depressive disorders are suggested.

Depression↗
PubMed1984

Outcome in schizoaffective, psychotic, and nonpsychotic depression. Course during a six- to 24-month follow-up.

In the National Institute of Mental Health Collaborative Study of the Psychobiology of Depression, six-month follow-up evaluations are available for 24 patients with schizoaffective disorder (depressed type), 56 with psychotic depression, and 274 with nonpsychotic major depression. Outcome for patients with schizoaffective depression was significantly worse than for patients with nonpsychotic depression. The psychotic depression group held an intermediate position on most outcome measures and on psychosocial measures had outcomes significantly worse than those of the nonpsychotic group. Recovery rates assumed a very similar pattern in another cohort admitted more than 40 years ago and followed up without somatic treatment. Follow-ups of 12, 18, and 24 months are available for proportions of each diagnostic group. Survival curves suggest similar outcomes in psychotic depression and nonpsychotic depression, whereas outcomes in schizoaffective depression remain disparate. These trends together with family history studies suggest that a small proportion of patients with schizoaffective disorder, depressed type, will have a long-term course consistent with schizophrenia. Moreover, these data show that outcome studies of schizoaffective disorder must control for follow-up length and the effects of psychosis per se.

Adult↗
PubMed1984

Sex-related differences in depression. Familial evidence.

After a description of threshold models of familial transmission based on an underlying continuous liability distribution, family data from the NIMH-CRB Collaborative Psychobiology of Depression Program-Clinical are described. No sex differences are found for bipolar illness, whereas female relatives have an increased rate of primary unipolar illness when compared to male relatives. This effect persists when relatives are classified according to recurrence, current illness, onset within the last 10 years, and treatment. Moreover, a cohort effect is present in the data and indicates a sex ratio close to one in the young cohort (less than or equal to 25). We considered the transmission of illness from parent to offspring by using survival analysis to examine the proportion of ill brothers and sisters of probands according to the affection status of parents. A maternal effect is found, with the mother having a greater influence on the liability of offspring of either sex. This is at odds with the notion that males and females have identical liabilities, but females have a lower threshold reflecting acknowledgement of more symptoms, etc. However, the mean difference in liability between the sexes may be due to systematic biological/cultural differences, with parental transmission contributing to variation about their means.

Bipolar Disorder↗
PubMed1984

Informed versus blind: the reliability of cross-sectional ratings of psychopathology.

Fifty subjects at the New York facility of the National Institute of Mental Health Clinical Research Branch Collaborative Program on the Psychobiology of Depression were evaluated for cross-sectional psychopathology and functional impairment at the 2-year followup by two professional raters, one blind and one with extensive knowledge of the subject's psychiatric history and course of illness and treatment (the cohort rater). Ratings were made on the change version of the Schedule for Affective Disorders and Schizophrenia. Interrater reliability, as tested using the intraclass correlation coefficient, was quite good for most of the symptom ratings and fair on measures of functional impairment and social functioning. However, there was a consistent tendency for the blind rater to score higher levels on symptoms of depression and anxiety than the informed cohort rater. Reasons for disagreement in different symptom areas are discussed. Using only the informed rater provides a very adequate picture of severity and patterns of psychopathology on a cross-sectional basis.

Adult↗
PubMed1984

Course-related depressive syndromes in schizophrenia.

The authors evaluated 20 patients, diagnosed by Research Diagnostic Criteria after 1 week of hospitalization as having schizophrenia, weekly throughout their hospitalization. Four patients developed syndromes of depression after resolution of their psychoses: three manifesting a "minor" and one a "major" postpsychotic depressive syndrome. Four other patients went on to develop syndromes equivalent to major depression at a time when they were still actively psychotic, and their cross-sectional diagnoses were therefore changed to schizoaffective disorder, depressed type. The authors discuss the implications of these findings for diagnosis.

Adult↗
PubMed1984

A family study of bipolar II disorder.

Professional raters who were blind to proband diagnosis used the schedule for affective disorders and schizophrenia (SADS-L) and the Research Diagnostic Criteria (RDC) to evaluate 1,210 first-degree relatives of 327 probands with primary major depression, participating in the family sub-study of the NIMH Collaborative Study of the Affective Disorders--Clinical Branch. Bipolar II probands were significantly more likely to have bipolar II relatives than were non-bipolar or bipolar I probands. Bipolar II probands were slightly more likely than non-bipolar probands and slightly less likely than bipolar I probands to have relatives with bipolar I illness. Similar patterns have emerged in two other recently reported family studies of bipolar II illness. Taken together, these data suggest heterogeneity among patients with bipolar II depression. Some appear to be genotypes for bipolar I illness, while a small proportion may be genotypes for non-bipolar illness. A third group, of undetermined size, may breed true.

Adult↗