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Biomedical subjects

J Endicott

Publications and source records attributed to J Endicott.

At least 73 records · Page 4Linked to original sources
PubMed1998

Psychiatric research interview for substance and mental disorders: phenomenologically based diagnosis in patients who abuse alcohol or drugs.

The Psychiatric Research Interview for Substance and Mental Disorders (PRISM) is a psychiatric diagnostic interview designed to diagnose DSM-IV substance and mental disorders in patients who abuse alcohol or drugs. Primary disorders tested in the DSM-III-R version of the interview showed improved reliability over existing instruments, and substantially improved reliability for major depressive disorder (MDD). Developments for DSM-IV include a systematic set of procedures for differentiating primary disorders, substance-induced disorders, and the expected effects of intoxication and withdrawal based on the phenomenology of symptoms in conjunction with alcohol and drug use. A longitudinal version of the PRISM provides data on remission and relapse that can be analyzed with survival methods. Pilot and preliminary testing of the DSM-IV and longitudinal versions of the instruments is presented. By making use of psychometric principles, particularly the need to reduce criterion variance, these instruments can clarify some of the longstanding issues in the diagnosis of patients who abuse alcohol and drugs.

Alcoholism↗
PubMed1998

Comprehensive evaluation of current and past mental health in women.

Ideally, studies of women's mental health would include a core data set that would be comparable across studies. There is general agreement that this data set should include a characterization of the clinical features of all current conditions and of past mental disorders and syndromes. The family history of mental disorders is also needed. Unfortunately, none of the currently available procedures covers all of the agreed on areas of interest, but with some supplementation, many are available to help approximate such a core data set. Greater content specificity is needed before efforts to develop new or modified procedures can be focused on such an effort.

Female↗
PubMed1997

Symptomatic improvement of premenstrual dysphoric disorder with sertraline treatment. A randomized controlled trial. Sertraline Premenstrual Dysphoric Collaborative Study Group.

CONTEXT: Premenstrual dysphoric disorder is an important cause of symptoms and functional impairment in menstruating women. OBJECTIVE: To evaluate the efficacy of sertraline hydrochloride for treatment of premenstrual dysphoria by measuring changes in symptom expression and functional impairment. DESIGN: Two screening cycles followed by 1 single-blind placebo cycle and 3 cycles of randomized, double-blind, placebo treatment. SETTING: Twelve university-affiliated outpatient psychiatry and gynecology clinics. PATIENTS: Of the 447 women who requested participation, 243 met criteria for premenstrual dysphoric disorder and were randomized; 200 women completed the study. INTERVENTION: A flexible (50-150 mg) daily dose of sertraline hydrochloride. MAIN OUTCOME MEASURES: The Daily Record of Severity of Problems, Hamilton Rating Scale for Depression, Clinical Global Impression Scale, and Social Adjustment Scale. RESULTS: Mean (+/-SD) total daily symptom scores decreased significantly (P<.001) in the sertraline-treated (64+/-22 to 44+/-19) compared with the placebo-treated (62+/-22 to 54+/-24) groups. Significant improvement (P<.05) was found for all clinically derived symptom clusters (depressive, physical, and anger/irritability symptoms). Hamilton Rating Scale for Depression scores decreased by 44% and 29% in the sertraline and placebo groups, respectively (P<.002). End-point global ratings showed much or very much improvement in 62% of the active treatment group and 34% of the placebo treatment group (P<.001). Reported functional impairment was substantial at baseline. Improvement in psychosocial functioning with treatment was similar to what is found in studies of major depression. CONCLUSIONS: Sertraline was significantly better than placebo for treatment of premenstrual dysphoria as reflected by symptomatic improvement and change in reported functional impairment. Serotonin reuptake inhibitors such as sertraline are useful therapeutic options for women with premenstrual dysphoria.

1-Naphthylamine↗
PubMed1997

First-episode major depression. Few sex differences in course.

BACKGROUND: There is a sex difference in the prevalence of unipolar major depression. This study sought to determine whether there is a sex difference in its course. METHODS: The National Institute of Mental Health Collaborative Program on the Psychobiology of Depression-Clinical Studies provided data on 96 male and 101 female subjects who were diagnosed as having a first episode of unipolar major depressive disorder at intake and on whom prospective data were available. We looked for differences at intake in factors other than sex that might affect the course of illness: demographic factors, characteristic features of the first depressive episode, psychiatric history, and family history of depression. We then examined the course of depression of these subjects during the following 15 years. RESULTS: The subjects were similar at intake, enabling us to focus on sex when we looked for differences in the course. Most subjects recovered from their first episode of major depression, but the majority had at least 1 recurrence in the following 5 years. During the following 15 years, male and female subjects did not differ significantly in the time to recovery, the overall time to first recurrence, of the number or severity of recurrences of major depressive episodes. There was no evidence for a more chronic course of depression in women. CONCLUSION: There were few significant sex differences in the course of major depressive disorder in this study population.

Adult↗
PubMed1997

Recovery from major depression. A 10-year prospective follow-up across multiple episodes.

BACKGROUND: Major depressive disorder is often marked by repeated episodes of depression. We describe recovery from major depression across multiple mood episodes in patients with unipolar major depression at intake and examine the association of sociodemographic and clinical variables with duration of illness. METHODS: A cohort of 258 subjects treated for unipolar major depressive disorder was followed up prospectively for 10 years as part of the Collaborative Depression Study, a multicenter naturalistic study of the mood disorders. Diagnoses were made according to the Research Diagnostic Criteria, and the course of illness was assessed with the Longitudinal Interval Follow-up Evaluation. Survival analyses were used to calculate the duration of illness for the first 5 recurrent mood episodes after recovery from the index episode. RESULTS: Diagnosis remained unipolar major depressive disorder for 235 subjects (91%). The median duration of illness was 22 weeks for the first recurrent mood episode, 20 weeks for the second, 21 weeks for the third, and 19 weeks for the fourth and fifth recurrent mood episodes; the 95% confidence intervals were highly consistent. From one episode to the next, the proportion of subjects who recovered by any one time point was similar. For subjects with 2 or more recoveries, the consistency of duration of illness from one recovery to the next was low to moderate. None of the sociodemographic or clinical variables consistently predicted duration of illness. CONCLUSION: In this sample of patients treated at tertiary care centers for major depressive disorder, the duration of recurrent mood episodes was relatively uniform and averaged approximately 20 weeks.

Adult↗
PubMed1997

The New York High-Risk Project. Prevalence and comorbidity of axis I disorders in offspring of schizophrenic parents at 25-year follow-up.

BACKGROUND: The New York High-Risk Project is a study of offspring of patients with schizophrenia (HRSz group) or affective illness (HRAff group) and psychiatrically normal parents (NC group) observed prospectively from childhood to adulthood. We herein present lifetime prevalence and comorbidity rates of Axis I disorders in subjects and their siblings from sample A of the project. METHODS: Schedule for Affective Disorders and Schizophrenia-Lifetime Version interviews conducted with the offspring in adulthood were used to obtain diagnoses of Axis I disorders. RESULTS: Schizophrenia and unspecified psychoses occurred only in the HRSz group. However, schizoaffective and psychotic affective disorders occurred equally in the HRSz and HRAff groups. Total rates of psychosis in these groups were significantly higher than in the NC group. All groups had similar rates of nonpsychotic affective and substance abuse disorders. The HRAff group, however, had significantly more total affective illness than the NC group and tended to have more anxiety disorders than the other groups. Comorbidity rates in the HRSz and HRAff groups were nearly twice those of the NC group. CONCLUSIONS: The familial liabilities to schizophrenia and affective disorders show specificities and commonalities, differing markedly from each other in their expression of some disorders and sharing others. Patterns of comorbidity are generally, although not entirely, similar to these liabilities.

Adolescent↗
PubMed1997

Differentiating DSM-IV alcohol dependence and abuse by course: community heavy drinkers.

The purpose of this study was to investigate the differences in short-term course between DSM-IV alcohol abuse and alcohol dependence in a community sample of men and women. Eight hundred seventy-six individuals were given a baseline interview that included DSM-IV criteria for alcohol use disorders, and were followed up with a similar interview approximately one year later. Group differences were compared with chi-square tests. Multinomial logistic regression analyses were used to test group differences controlling for potential confounders. The course of alcohol abuse and dependence differed significantly from each other, and from individuals with no alcohol diagnosis at baseline. Chronicity was the most common outcome for dependence but not for abuse. Most subjects with baseline diagnoses of abuse received the diagnosis with only one symptom, repeated drunk driving. While the validity of the alcohol dependence diagnosis was supported in this community sample, the results concerning alcohol abuse remain equivocal.

Adult↗
PubMed1997

Blunted serotonin response to fenfluramine challenge in premenstrual dysphoric disorder.

OBJECTIVE: Indirect evidence suggests that abnormalities in serotonergic function may be involved in the pathogenesis of premenstrual dysphoric disorder. The goal of this study was to test the hypothesis of serotonergic deficiency in premenstrual dysphoric disorder by measuring the prolactin response to fenfluramine. METHOD: The authors administered the serotonin-releasing drug dl-fenfluramine in a placebo-controlled protocol to nine women with premenstrual dysphoric disorder and 11 healthy female volunteers in the luteal phase of the menstrual cycle. RESULTS: Compared to the normal subjects, the women with premenstrual dysphoric disorder had a significantly blunted prolactin response to fenfluramine. CONCLUSIONS: Premenstrual dysphoric disorder appears to be associated with serotonergic deficiency.

Adult↗
PubMed1997

The Overt Agitation Severity Scale for the objective rating of agitation.

Two studies tested the reliability and validity of the Overt Agitation Severity Scale (OASS), a new instrument developed to define and objectively rate the severity of agitated behavior. The authors postulate that agitation should be conceptualized as vocal and motor behaviors on a continuum of expressions that extends from anxiety to aggression. Content validity through expert agreement was achieved in the development of test construction over a 2-year period. Results of two pilot studies (n = 25 and n = 14 subjects) established the reliability and validity of the OASS to measure agitation severity. The OASS differs from other agitation scales in that it confines its rating exclusively to observable behavioral manifestations of agitation.

Aged↗
PubMed1997

Alcohol dependence and abuse diagnoses: validity in community sample heavy drinkers.

Despite the widespread influence of the alcohol dependence syndrome concept on the major nosological classification systems, little work has been done to test the validity of the alcohol dependence syndrome in community samples. In addition, numerous questions have been asked about the validity of current definitions of alcohol abuse. We examined the cross-sectional validity of DSM-IV alcohol dependence and abuse in 936 household residents randomly selected and screened for elevated drinking. We investigated validity by testing the association of a set of seven "criterion" variables, external to the alcohol diagnostic criteria, with dependence and abuse diagnoses. Results indicated that dependence diagnoses were significantly associated with all criterion variables when compared to those with no diagnosis, even though all subjects had elevated drinking and the cases of alcohol dependence were mild. In contrast, abuse diagnoses did not show a pattern of association with the criterion variables when compared to no diagnosis. When associations were tested comparing dependence cases to those with abuse only, results were mixed. This study is one in a series of investigations in this sample of household residents screened for elevated drinking levels.

Adult↗
PubMed1997

Endicott Work Productivity Scale (EWPS): a new measure to assess treatment effects.

The Endicott Work Productivity Scale (EWPS) is a brief self-report questionnaire designed to enable investigators to obtain a sensitive measure of work productivity. The total score is based on the degree to which behaviors and subjective feelings or attitudes that are likely to reduce productivity and efficiency in work activities characterize the subject during the week before evaluation. The total score was found to be reliable and valid within a group of depressed outpatients and a group of nonpatients in the community. The EWPS score is related to, but not redundant with, measures of overall severity of illness and severity of depression in these samples. The EWPS shows considerable promise as an easily used, brief, and sensitive measure for assessing the effects on work performance of various disorders and the efficacy of different therapeutic interventions.

Dysthymic Disorder↗
PubMed1996

Parent-of-origin effect in transmission of bipolar disorder.

Recently, possible involvement of a parent-of-origin effect in the transmission of bipolar disorder has been suggested. We examined the possible contribution of parent-of-origin effect by using data from a large family and family history study of bipolar patients in the Collaborative Depression Study. In 276 probands with bipolar I disorder, family histories were examined using three diagnostic criteria: 1) bipolar I disorder, 2) bipolar I or bipolar II disorder, and 3) bipolar disorders or recurrent unipolar depression for parents and siblings. An excess of affected mothers was not observed when unipolar depression was excluded. Age-at-onset was significantly lower in probands having a father with bipolar disorders or recurrent unipolar depression than in probands with an affected mother. This difference was not observed when unipolar depression was excluded. There was no significant difference of prevalence rate in children of affected mothers and those with affected fathers. These data do not support the contribution of parent-of-origin effect in the transmission of bipolar disorder.

Adult↗
PubMed1996

Five-year course of major depression: effects of comorbid alcoholism.

Some patients enter psychiatric treatment with clear cases of both major depression and alcoholism. While assumptions are often made about the relationships of these two conditions, little empirical evidence exists on the effects of sustained remissions in alcoholism on sustained remissions in depression. 127 patients with both disorders at treatment entry were studied over a 5-year period. Survival analyses with time-dependent covariates indicating alcoholism status were used to investigate remissions and relapses in major depression. Remission in alcoholism strongly and significantly increased the chances of remission in depression and were also related to reduced chances of depression relapse, although at a weaker level.

Adult↗
PubMed1996

Personality traits in subjects with bipolar I disorder in remission.

This study compared the personality traits of subjects with bipolar I disorder in remission to the personality traits of subjects with no history of any mental illness. Subjects were assessed as part of a prospective, multicenter, naturalistic study of mood disorders. Diagnoses were rendered according to Research Diagnostic Criteria, through use of the Schedule for Affective Disorders and Schizophrenia - Lifetime Version. A total of 30 euthymic bipolar I subjects were compared to 974 never-ill subjects on 17 personality scales selected for their relevance to mood disorders. The subjects with bipolar I disorder in remission had more aberrant scores on 6 of the 17 personality measures, including Emotional Stability, Objectivity, Neuroticism, Ego Resiliency, Ego Control, and Hysterical Factor. These findings indicate that patients with bipolar I disorder in remission have personality traits that differ from those of normal controls.

Adult↗
PubMed1996

Familial alcoholism in manic-depressive (bipolar) disease.

A previous analysis found a relatively high rate of alcoholism in a cohort of bipolar I subjects, and a trend for increased rates of alcoholism in relatives of subjects with both bipolar I disorder and alcoholism, compared to relatives of subjects with bipolar I disorder and no alcoholism. The sample of subjects with bipolar I disorder has been enlarged through continued follow-up, permitting new analyses to address the association and heritability of bipolar I disorder with alcoholism. Probands with bipolar I disorder were followed for 10 years as part of the NIMH Collaborative Depression Study. The rate of alcoholism in relatives of probands with both bipolar I disorder and alcoholism was compared to the rate of alcoholism in relatives of probands with bipolar disorder and no alcoholism. The prevalence of alcoholism in relatives of subjects with bipolar I disorder was compared to the rate of alcoholism in relatives of control subjects. Relatives of probands with bipolar I disorder showed a higher rate of alcoholism than relatives of controls. Relatives of probands with bipolar I disorder and alcoholism showed a higher rate of alcoholism than relatives of probands with bipolar I disorder without alcoholism. These data suggest that familial alcoholism may contribute to a vulnerability to bipolar I disorder, and that there is a shared heritability for the two disorders.

Adult↗
PubMed1996

Recovery after 5 years of unremitting major depressive disorder.

BACKGROUND: The long-term course of depression in patients who present for treatment carries prognostic and therapeutic implications. This study presents prospective data on the time to recovery from an episode of major depressive disorder of 5 years' duration among patients followed up since 1978 in the National Institutes of Mental Health Collaborative Program on the Psychobiology of Depression. METHODS: Survival analysis was used to examine the 10-year course of the 431 probands with major depressive disorder with a specific focus on the 35 probands who were observed to be continuously ill for the first 5 years. Univariate analytic techniques were used to describe the demographic and clinical variables in the group that recovered and the group that did not. By study design, somatic treatment was assessed but not controlled by the investigators. RESULTS: By year 10, 93% (Kaplan-Meier estimate) of probands had recovered from their intake episode of major depressive disorder. In those ill for the first 5 years, 38% had recovered within the next 5 years. Shorter duration of illness prior to intake and being married were associated with the group that recovered. Pharmacological treatment dosages averaged 100 mg of imipramine hydrochloride equivalent in the chronically ill group. CONCLUSIONS: Despite lengthy periods of illness, people continued to recover from major depressive disorder for up to 10 years of prospective follow-up. Few demographic and clinical variables distinguished those who recovered from those who did not. Treatment, as observed in this naturalistic study, was at a low level despite lengthy illness.

Adult↗