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Biomedical subjects

J Endicott

Publications and source records attributed to J Endicott.

At least 145 records · Page 8Linked to original sources
PubMed1990

Outcome of patients with chronic affective disorder: a five-year follow-up.

Patients with major depression, mania, or schizo-affective disorder that had been present without remission for 2 years or more at intake (N = 129) were followed prospectively for 5 years, as were 580 patients who had been ill for shorter periods at intake. Despite very substantial durations of episode, three-quarters of the chronic patients recovered, although recovery occurred much later in the follow-up period than it did among the nonchronic patients. Factors associated with recovery were less severe illness at intake, lack of psychotic features, good friendship patterns in adolescence, and, most important, a relatively high maximum level of functioning in the 5 years preceding intake.

Adolescent↗
PubMed1990

Genetic linkage in mental illness. Limitations and prospects.

Advances in genetic linkage strategies, including techniques of molecular genetics, augur well for the discovery of disease-related genes in mental disorders. Recent studies showing linkage of chromosomal loci to bipolar affective illness and schizophrenia attest to the potential in the 'new genetics'. However, the failure to replicate some of the early findings has led to calls for re-evaluation of the methodology in psychiatric research. Problems in studying complex (psychiatric) disorders include diagnostic uncertainties, unclear mode of transmission, aetiological heterogeneity, cohort effects, and assortative mating. Knowing the potential pitfalls in linkage analysis of mental illness should avert spurious findings and will increase the prospects of success.

Genetic Linkage↗
PubMed1990

Multiple alcohol-related problems in the United States: on the rise?

Are drinking problems on the rise in the U.S. general population? Surveys of drinking practices and problems conducted in the United States in 1967, 1969, 1979 and 1984 included numerous questions on alcohol-related problems that were identical or nearly identical in wording. Using data from these surveys, we tested for ordered increases over time in the prevalence of an indicator of multiple problems, considered on both a current (1-year) and lifetime basis. We studied prevalence in men and women between the ages of 22 and 59 in all four surveys. Prevalence of the multiple problem indicator was rare, especially when considered on a current basis. However, relative increases in prevalence ranging from 53% to over 200% were found from 1967 to 1984 in the multiple problem indicator for men and women, for lifetime as well as current problems. With the exception of current problems in women (a very rare condition even in the 1984 survey), these changes were all statistically significant or showed a trend toward significance. When respondents were subgrouped by age, all subgroups still showed increases since 1967, although sample sizes decreased and significance tests of ordered increases over time were not so consistent.

Adult↗
PubMed1990

Alcohol problems increase while physician attention declines. 1967 to 1984.

Physician intervention holds the potential to arrest excess drinking in medical patients, but little information has been available on trends over time in medical attention to this problem. Three epidemiologic studies in which nationally representative samples of US adults were interviewed about their drinking practices and problems provide some data on this issue. Analyses of data from these three studies (conducted in 1967, 1979, and 1984) indicate that multiple alcohol problems and at least one occasion of recent heavy alcohol consumption have increased over time in the general population. At the same time, the probability of a physician recommending reduction in drinking declined for both males and females. When only male subjects with multiple alcohol problems were considered, physician recommendations to reduce drinking did not decline significantly between 1967 and 1984. However, the sharp decline over time in physician's medical advice to female subjects with multiple alcohol problems was statistically significant. Similar results were found for physician attention to drinking among the more inclusive group of subjects with at least one recent occasion of heavy drinking. Implications of these findings are discussed.

Adult↗
PubMed1989

Reliability of anxiety assessment. I. Diagnostic agreement.

Test-retest reliability of lifetime anxiety disorder diagnoses was determined using the Schedule for Affective Disorders and Schizophrenia-Lifetime Anxiety version. The subjects were 104 patients at an anxiety research clinic. Reliability ranged from good to excellent (kappa = +.60 to +.90) for generalized anxiety, social phobic, panic, agoraphobic, and obsessive-compulsive disorders. Simple phobia showed poor agreement. Current episodes showed better agreement than past episodes, particularly for social phobia and obsessive-compulsive disorder. Major sources of disagreement (variance in subject report, rate error, criterion ambiguity) were reviewed for each diagnosis and implications for DSM-IV are proposed.

Adult↗
PubMed1989

Reliability of anxiety assessment. II. Symptom agreement.

Accurate assessment of "subdisorder" anxiety symptoms, ie, anxiety symptoms central to DSM-III-R-diagnosed anxiety disorders but not meeting disorder criteria because of insufficient frequency, duration, or accompanying subjective distress or impairment, may be critical to case identification in genetic, epidemiologic, and high-risk studies. However, concerns that the mild and often transient nature of these phenomena will foster unreliability have discouraged their use. We assessed the test-retest reliability of "subdisorder" anxiety symptoms in 104 outpatients with anxiety. Good to excellent agreement was found for lifetime occurrence of any panic attack, the spontaneous and situationally predisposed subtypes of panic, and five nonsocial irrational fears (public transportation, driving oneself, crowds, situations associated with death [eg, dead bodies and funerals], and cats and dogs). Four social and three additional nonsocial fears were considered to have adequate reliability. However, agreement on stimulus-bound panic, "near" panic attacks, persistent generalized anxiety, and the remaining nine nonsocial and six social irrational fears was only fair to poor. The major source of unreliability was variation in information reported by the subject to the rater.

Ambulatory Care↗
PubMed1989

NIMH Collaborative Program on the Psychobiology of Depression: clinical.

As part of the National Institute of Mental Health Collaborative Program of Depression study, data were collected on 2,225 first-degree relatives of 612 probands. A subset consisting of 187 families of bipolar patients was made available to participants of Genetic Analysis Workshop 5 (GAW5). A description of these data, including sample sizes, diagnoses, and a summary of published analyses, is given.

Adult↗
PubMed1989

Screening and selection process for studies of menstrually-related changes.

The screening process of women who volunteered to participate in "studies of the menstrual cycle" is described. It is demonstrated that in order to arrive at a desired number of subjects who meet criteria for premenstrual changes and are in a good physical and mental status, one should recruit an extremely large number of candidates to start with. The yield of each screening procedure is presented. It is clear that fulfillment of inclusion and exclusion criteria can be obtained by a phone interview while important criteria can be clarified only by prospective monitoring of symptoms and personal structured interviews. Methods and procedures that can improve yield and decrease effort in recruitment are suggested.

Advertising↗
PubMed1989

Provocation of panic with carbon dioxide inhalation in patients with premenstrual dysphoria.

The effects of double breath inhalation of a 35% CO2 mixture in oxygen and placebo air inhalation were compared in 14 women seeking treatment for marked premenstrual dysphoric changes who did not have panic disorder and 12 control women. The first exposure to CO2 inhalation induced a panic attack reaction (severe subjective anxiety with autonomic symptoms) in 9 of 14 women with premenstrual dysphoria but none of the controls. Neither patients nor controls panicked in response to the air inhalation. Control subjects experienced mild anxiety and/or somatic symptoms after CO2 inhalation, but these did not resemble panic attacks and were clearly different from the response of the patient group.

Adult↗
PubMed1989

Characteristics of women seeking treatment for premenstrual syndrome.

Controversy has developed about the existence of a relatively discrete condition of severe premenstrual dysphoric changes in the absence of underlying mental disorder (late luteal phase dysphoric disorder). With careful screening and evaluation, women with this disorder can be identified. In this study, women who sought treatment for premenstrual syndrome were divided into two groups: individuals who experienced mood and behavior changes and impaired social functioning that were limited to the premenstrual period (n = 86), and women with persistent mental disorders who experienced exacerbation or complication of symptoms during the premenstrual period (n = 54). These groups were compared with a control group of women who had no significant premenstrual changes and no current mental disorder (n = 61). Most of the differences between subjects seeking treatment and controls that were not attributable to premenstrual changes were accounted for by the women with persistent mental disorders.

Adolescent↗
PubMed1989

Bipolar II illness: course and outcome over a five-year period.

A five year semi-annual follow-up of patients with non-bipolar (N = 442), bipolar II (N = 64) and bipolar I (N = 53) major depression tracked the courses of prospectively observed major depressive, hypomanic and manic syndromes. In all three groups, depression was much more likely in any given week than was hypomania or mania. However, during the majority of weeks, no full syndrome was present and none of the groups exhibited evidence of continuing psychosocial deterioration. Though all three groups exhibited similar times to recovery from index and subsequent major depressive episodes, both bipolar groups had substantially higher relapse rates and developed more episodes of major depression, hypomania and mania. The two bipolar groups, in turn, differed by the severity of manic-like syndromes and thus remained diagnostically stable; the bipolar II patients were much less likely to develop full manic syndromes or to be hospitalized during follow-up. In conjunction with family study data showing that bipolar II disorder breeds true, these data support the separation of bipolar I and bipolar II affective disorder.

Adult↗
PubMed1989

RDC alcoholism in patients with major affective syndromes: two-year course.

The authors examined the 2-year course of alcoholism as defined by Research Diagnostic Criteria (RDC) in 127 newly admitted patients with major affective syndromes and concurrent alcoholism at intake. The cumulative probability of remission (at least 6 months free of alcohol problems) in these patients was 0.67. Many of the remissions began within a few weeks of intake; the remaining were distributed over the follow-up period. Of the patients without remissions, 17% died, half by suicide. Diagnoses of schizoaffective disorder, indicators of alcohol dependence, and previous chronicity of alcohol problems predicted poor outcome of alcoholism, but none of these variables predicted subsequent relapse.

Adult↗
PubMed1989

The normalcy of self-proclaimed "normal volunteers".

Volunteers who claimed they were "healthy and normal" and did not reveal any physical or mental abnormality or medication use during brief structured interviews underwent detailed structured interviews with the Schedule for Affective Disorders and Schizophrenia. Diagnoses were based on the Research Diagnostic Criteria (RDC), and family history was determined with the Family History RDC. Of the 121 volunteers, 16.5% met criteria for diagnoses of current mental disorders. Of the 104 without current DSM-III axis I diagnoses, 35.6% had past histories and 39.4% had family histories of mental illness. These results emphasize the need for thorough assessment of "normal volunteers."

Adolescent↗
PubMed1989

Bipolar affective disorder and high achievement: a familial association.

The authors studied 442 probands with nonbipolar major depression, 64 with bipolar II disorder, and 88 with bipolar I disorder. Although the proband groups did not differ in occupational or educational achievement, the first-degree relatives of probands with bipolar disorders had significantly higher mean levels of achievement than did those of probands with nonbipolar disorder. This pattern applied whether or not the relatives themselves had bipolar illness. The authors conclude that the socioeconomic advantage previously associated with affective disorder in general may be limited to the bipolar forms.

Achievement↗
PubMed1989

Treatment of premenstrual depression with nortriptyline: a pilot study.

There are no reports on treatment of premenstrual syndrome with antidepressants, although depression is a common symptom of the syndrome. Eleven women who met DSM-III-R criteria for late luteal phase dysphoric disorder were treated with nortriptyline in an open pilot study after they failed to respond to placebo or another medication. Eight of 11 patients had a good therapeutic response. The efficacy of antidepressants in the treatment of premenstrual depression needs confirmation with double-blind studies.

Adult↗
PubMed1989

Measurement of change in personality disorders.

The nature of personality disorders introduces a number of issues that have implications for the measurement of change. This article provides an overview of issues that should be considered in the assessment of change in personality disorders, including assessment of pervasiveness and impairment, behavior sampling issues, sources of information, problems associated with comorbidity with Axis I and other disorders, and problems with subject compliance.

Humans↗
PubMed1988

Improving the validity of FH-RDC diagnosis of major affective disorder in uninterviewed relatives in family studies: a model based approach.

Analysis of family history and family study diagnoses of major affective disorder in 4806 relatives of affectively ill probands from the NIMH Collaborative Study of the Psychobiology of Depression (Clinical) suggests that rates of disorder in uninterviewed relatives are greatly underestimated by family history. The implications of these underestimates for family and genetics analyses using the family history method are discussed, and other estimates are developed that have better statistical properties. Using the Model Based Direct Adjustment method, the rate of major affective disorder in all relatives (interviewed and uninterviewed) is estimated to be 32%, compared to 25% by the consensus (standard) method, which uses the Family History-RDC interview with one or more family members to make diagnoses on all uninterviewed relatives. This difference (over ten standard errors) is due to the much higher rate of illness estimated for the uninterviewed relatives (28% compared to 14%). Analysis of the sources of insensitivity of the FH-RDC is used to explain the difference between observed and imputed diagnosis rates.

Bipolar Disorder↗