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Biomedical subjects

J Fawcett

Publications and source records attributed to J Fawcett.

At least 163 records · Page 9Linked to original sources
PubMed1992

Efficacy and side effects of methylphenidate for poststroke depression.

BACKGROUND: Depression after stroke impedes the rehabilitation process and causes additional suffering to patient and family. Few studies have systematically examined pharmacologic treatments of poststroke depression. In the present paper, the use of the stimulant methylphenidate is studied in a depressed, elderly stroke population. METHOD: Ten subjects (mean age = 73.2 years) meeting DSM-III-R criteria for major depression were followed-up during a 3-week efficacy and side effect trial involving methylphenidate. Subjects were selected from rehabilitation patients referred for psychiatric consultation. RESULTS: A total of 80% (8 of 10) of the subjects showed either a full or partial response as measured by Hamilton Rating Scale for Depression scores. The incidence of problematic side effects was low, and no subjects had to be discontinued from the study. CONCLUSION: Results of this methylphenidate trial for poststroke depression in elderly patients suggest that it is a safe and effective treatment for poststroke depression. Future studies are called for in which methylphenidate is compared with placebo controls and antidepressant medication.

Age Factors↗
PubMed1992

Images of nephrology nursing practice: report of a survey.

The results of a survey designed to identify existing images of nephrology nursing practice are reported. The sample included 374 attendees at meetings sponsored by the American Nephrology Nurses' Association (ANNA). Content analysis revealed that the typical nephrology patient is elderly, has a chronic illness and negative affect, is not compliant, and is dependent on others. The typical nephrology nurse-patient interaction emphasizes teaching and support. The most common nursing activities are assessment, teaching, dialysis treatment, and psychological support.

Attitude of Health Personnel↗
PubMed1992

Suicide risk factors in depressive disorders and in panic disorder.

Suicide has been associated traditionally with major depression, alcoholism, and schizophrenia and in the past several years with alcoholism and comorbid depression. More recently, however, panic disorder has been linked with suicide attempts, and the importance of severe anxiety symptoms (panic attacks, psychic anxiety, and agitation) as possible predictors of suicide risk in patients with major affective disorder has been studied. The author discusses data sets from three such studies: (1) the Clinical Studies of the National Institute of Mental Health Collaborative Program on the Psychobiology of Depression, (2) a study on 17-hydroxycorticosteroid concentrations in inpatients with major affective disorder, and (3) a study on inpatient suicides. The author concludes by suggesting that anxiety, which is readily treatable, may in fact be one of the most clinically important symptoms in depressive disorders.

17-Hydroxycorticosteroids↗
PubMed1992

Enhancing adaptation to breast cancer: the addition of coaching to support groups.

This article describes a framework for research involving a modification of traditional cancer support groups (CSGs) that includes the presence of a caring partner who acts as a coach to facilitate the woman's adaptation to the diagnosis and treatment of breast cancer. The modified CSG and relevant response variables were derived from the Roy Adaptation Model of Nursing. Using the successful models of childbirth and diabetes education, the concept of coaching was introduced to breast CSGs. A review of the literature provides support for reduced symptom distress, reduced emotional distress, greater functional status, and higher quality of interpersonal relations as appropriate outcomes of participation in CSGs with coaching. The results of a pilot study of support groups with coaching are reported, and the goals of a currently ongoing experimental study testing the intervention have been identified.

Adaptation, Psychological↗
PubMed1991

Isolation and properties in culture of human adrenal capillary endothelial cells.

The isolation of human adrenal capillary endothelial (HACE) cells without resort to fluorescence activated cell sorting is described, together with their properties in culture. HACE cells were isolated by plating collagenase digests at high dilution in the presence of endothelial cell growth supplement, followed by clonal selection of endothelial colonies. HACE cells exhibit a typical endothelial 'cobblestone' morphology at confluence and formed 'tubes' when seeded onto 'Matrigel'. They are positive for human MHC1, and the endothelial markers ENDOCAM (CD31) and weakly CD34, they also take up dil-acetyl low density lipoprotein but are negative for Factor VIII. Their growth is strongly stimulated by FGF and inhibited by TGF-beta I. Like their much studied bovine counterparts they are robust in culture, retaining the properties described up to senescence. HACE cells provide a readily available alternative to human umbilical vein endothelial cells in that they are easily isolated pure and in quantity. They should be particularly useful in studies where human capillary, as opposed to large vessel endothelium, is required.

Adrenal Glands↗
PubMed1991

Follow-up and family study of anxious depression.

OBJECTIVE: The failure of the concept of anxious depression to find its way into DSM-III-R led the authors to conclude that a further report on the occurrence of anxiety symptoms in depressed subjects is indicated. METHOD: The subjects were 327 consecutively evaluated inpatients and outpatients with primary unipolar depressive disorder at five university medical centers participating in the National Institute of Mental Health Collaborative Program on the Psychobiology of Depression--Clinical Studies. The authors restricted their sample selection to patients with primary depressive disorder so that patients with other preexisting psychiatric disorders, especially anxiety disorders, would not contaminate the symptom picture, family studies, or follow-up. The examined six anxiety symptoms and derived a new anxiety summary score to show the effect of anxiety in depression on family data and 5-year outcome. RESULTS: Depressed subjects with higher ratings for anxiety took longer to recover. There was also a significant relationship between anxiety in depressed probands and the risk for primary unipolar depressive disorder, but not anxiety disorders or alcoholism, among 832 blindly interviewed first-degree relatives. CONCLUSIONS: These data confirm the usefulness of subdividing depressed patients according to anxiety symptoms: psychic and somatic symptoms of anxiety, taken together, significantly predict family illness and course. The data also emphasize the wisdom of requiring that generalized anxiety disorder not be diagnosed in the presence of a mood disorder. Clearly, symptoms of anxiety coexist with depression and need to be recognized for the effective treatment of the underlying depressive disorder.

Ambulatory Care↗
PubMed1991

The assessment and management of the suicidal patient.

This chapter will be oriented toward the problem faced by the clinician in attempting to prevent suicide in patients under treatment. It will focus on the clinician's difficult task of assessing suicide potential and initiating interventions to prevent suicide in patients at high risk. Specifically, the state of the art in identifying the suicidal patient will be reviewed, and various interventions available to the clinician will be discussed.

Anxiety Disorders↗
PubMed1991

Development of the inventory of functional status-cancer.

The purpose of this article is to report the development and psychometric testing of the Inventory of Functional Status-Cancer (IFS-CA). The IFS-CA was developed to measure functional status in women with cancer. The questionnaire includes four subscales measuring the extent to which the woman continues her usual household and family, social and community, personal care, and occupational activities. Content validity was established at 98.5%. Internal consistency reliability testing used a sample of 100 women receiving treatment for cancer. Internal consistency reliability using average correlations for the subscale item to subscale total scores ranged from 0.56 to 0.82. Subscale to total IFS-CA score correlations ranged from 0.73 to 0.92. Test-retest reliability used a sample of 17 women who had completed treatment for cancer. The coefficients ranged from 0.43 to 0.96 for the four subscales. Initial construct validity testing was accomplished by examination of subscale correlations and by comparing the functional status of women in active treatment for cancer with those who had completed treatment. The study's findings reveal content validity, internal consistency, test-retest reliability, and beginning construct validity; thus, they demonstrate strong evidence for further development and testing of the IFS-CA's construct validity.

Activities of Daily Living↗
PubMed1991

The role of serotonin in sexual dysfunction: fluoxetine-associated orgasm dysfunction.

Iatrogenic sexual dysfunction has been associated with many pharmacologic agents. The authors report 6 cases of orgasm dysfunction associated with the use of fluorxetine in 77 depressed outpatients. Fluoxetine is a novel antidepressant known to block the reuptake of serotonin with little effect on other neurotransmitter systems. Because fluoxetine has a specific mechanism of action, it serves as a useful model to hypothesize about potential mechanisms of drug-induced sexual dysfunction. The possible effects of serotonin on central, spinal, and peripheral anatomical areas are discussed in relation to drug-induced sexual dysfunction.

Adult↗
PubMed1991

Antidepressant combination and potentiation.

This chapter will describe the clinical indications and safety/efficacy factors of antidepressant potentiation. Examples include TCA/MAOI combinations, MAOI/stimulant combination, antidepressant potentiation with thyroid, lithium or l-tryptophan.

Antidepressive Agents↗
PubMed1991

Innovative somatic treatments for depression.

This chapter will briefly review the current theories on the biochemical etiology of depression that are contributing toward the development of innovative somatic treatments. A description of clinically approved pharmacological treatments will be described in detail. Investigational pharmacological treatments that have demonstrated a high probability for general clinical use will also be discussed. Finally, a description of sleep deprivation will be included.

Antidepressive Agents↗
PubMed1991

CNS stimulant potentiation of monoamine oxidase inhibitors in treatment-refractory depression.

We report on our clinical experience with a combination of a CNS stimulant (either pemoline or dextroamphetamine) and a monoamine oxidase inhibitor (MAOI) for treating 32 depressed patients (mainly outpatients) refractory to standard antidepressant pharmacotherapy. This combination, though not approved by the FDA, appears to be safe and effective. Twenty-five (78%) of these patients experienced at least 6 months of symptom remission with a stimulant + MAOI combination. Many patients required adjunctive antidepressant treatment, including tricyclics and lithium. Side effects were not excessive, though 6 patients (3 unipolar and 3 bipolar) cycled to mania (N = 1) or hypomania (N = 5). None developed hypertensive crises. With properly motivated and complaint patients and careful clinical monitoring by the prescribing psychiatrist, stimulant potentiation of MAOIs may be a viable option for treatment-resistant depressed patients.

Bipolar Disorder↗
PubMed1990

Maternal employment following childbirth.

This longitudinal study was an investigation of differences in demographic, health, psychosocial, and family variables, and in functional status for nonoccupational activities, between employed and nonemployed mothers for 6 months following childbirth. Variables associated with employed mothers' functional status in occupational activities also were examined. Fifty-three (58%) of the 92 women in the sample were employed by 6 months postpartum. Although employed mothers performed more roles than nonemployed mothers, the two groups appeared more similar than different on the variables studied. In addition, functional status for occupational activities was positively related to parity and level of physical energy.

Adaptation, Psychological↗
PubMed1990

Challenging the amphetamine challenge test: report of an antidepressant treatment study.

The primary goal of this study was to determine whether the amphetamine challenge test (ACT) response, as measured by a subjective rating scale, the How I Feel Scale (HIF), could predict antidepressant treatment outcome. Following a 1-day non-blind ACT with dextroamphetamine (d-AMPH), patients were treated double-blind for 6 weeks with either desipramine, alprazolam, or a desipramine-alprazolam combination. Regression (true score) analyses were carried out on pre- and post-ACT HIF scores and on baseline and end of study Hamilton Depression Rating Scale (HDRS) scores to determine the magnitudes of improvement measured in response to the ACT and antidepressant treatment, respectively. Regression analyses were performed on the residuals (true scores of improvement) to determine the best fitting (linear) prediction equation. Improvement in the HIF total score predicted HDRS improvement for the whole sample. Possible sources of error contributing to the outcome are identified and the results are discussed in relation to previous clinical investigations of the potential usefulness of the ACT as a predictor of antidepressant response.

Adult↗
PubMed1990

Antidepressant or antianxiety? A study of the efficacy of antidepressant medication.

The authors analyzed the relative contributions of improvement in depressive and anxiety symptoms, as measured by the Hamilton Rating Scale for Depression (HRSD) and the Hamilton Rating Scale for Anxiety (HRSA), respectively, after 1 week of treatment to the prediction of improvement in HRSD score after 6 weeks of antidepressant pharmacotherapy. Fifty-six subjects completed 6 weeks of treatment with either desipramine (n = 20), alprazolam (n = 18), or a desipramine-alprazolam combination (n = 18). The results showed that early improvement in the HRSD was a moderately strong predictor of the total 6-week improvement in HRSD score, and a better predictor than early improvement in the HRSA. Partial correlations showed that early HRSD improvement was significantly related to total HRSD improvement within the alprazolam group. This pattern of response differed from those observed for the other treatment groups. Desipramine-treated subjects showed gradual improvement over the course of the study, and the improvement in week 1 was not so strongly predictive of overall improvement. The relationship between early and total HRSD improvement for the combination treatment group was intermediate to the other two groups. These findings are discussed in the context of the relationship between depression and anxiety, and potential implications for the treatment of these overlapping and often mixed syndromes.

Adult↗
PubMed1990

A statistical method for evaluating suicide clusters and implementing cluster surveillance.

The absence of any standard definition of suicide cluster events hinders understanding of the prevalence of the problem, hinders the development of appropriate public health responses to observed clusters, and ultimately hinders investigation of the mechanisms underlying contagious communication of suicidal behavior. The authors introduce a Poisson mixture model for assessing potential clusters of adolescent suicide, apply that model to the monthly incidence rates of adolescent suicide for one populous US county over the last 11 years, and generate 99% tolerance limits with 95% confidence for the number of suicides which may occur by chance within specific intervals of time in that county. The suicide incidence data showed a remarkable fit to a single Poisson distribution, suggesting it is not unreasonable to consider the cases as randomly-distributed and independent events. The authors conclude that there is no evidence that adolescent suicides occurred in clusters in the place and in the time frame under study, and recommend the Poisson mixture model for ascertaining clusters as well as implementing cluster surveillance.

Adolescent↗