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Biomedical subjects

J R Davidson

Publications and source records attributed to J R Davidson.

193 records · Page 11Linked to original sources
PubMedDate not supplied

Symptom and comorbidity patterns in World War II and Vietnam veterans with posttraumatic stress disorder.

Forty-four veterans with posttraumatic stress disorder (PTSD) from World War II and Vietnam were compared. The groups were comparable on many socioeconomic and combat measures and age at onset of PTSD. Vietnam veterans exhibited more severe PTSD symptoms, higher Hamilton depression scores, and higher scores on the hostility, psychoticism, and "additional symptom" Symptom Checklist-90 (SCL-90) scales. They also had more survivor guilt, impairment of work and interests, avoidance of reminders of trauma, detachment/estrangement from others, startle response, derealization, and suicidal tendencies. Differences were noted between the groups as to the nature of upsetting experiences. Vietnam veterans had a greater lifetime frequency of panic disorder and an earlier age of onset for alcoholism. In other respects, the two groups were diagnostically similar, with PTSD being related to the sequential emergence of psychiatric diagnoses in similar manner for World War II and Vietnam patients.

Adult↗
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Psychiatric disorders in primary care patients receiving complementary medical treatments.

This study investigated lifetime and current rates of axis I diagnoses and the personality traits of neuroticism and extraversion in patients receiving complementary medical care in the United Kingdom and United States. Eighty-three patients were interviewed by means of the Structured Clinical Interview for DSM-III-R, and 78 completed the Eysenck Personality Inventory (EPI). Subjects were drawn from the Royal London Homoeopathic Hospital (n = 50) and a holistic family practice in North Carolina (n = 33). High rates of lifetime (68.7%) and current (39.8%) axis I disorders were found, with no substantial differences between the groups, apart from lifetime posttraumatic stress disorder and current social phobia, which were higher in the US sample. The subjects were more introverted but not more neurotic as compared against normative population data with the EPI. The subjects were predominantly older women. We conclude that psychiatrists may need to be aware that patients with depressive or anxiety disorders are likely to seek out complementary treatments for a wide range of medical problems, and should inquire as to use of these in their patients. They may also need to cultivate greater awareness of the health beliefs of such patients.

Adult↗
PubMedDate not supplied

A family study of chronic post-traumatic stress disorder following rape trauma.

There is evidence that familial factors serve as determinants of risk for post-traumatic stress disorder (PTSD), especially familial anxiety. This study investigates the relationship between chronic PTSD and family psychiatric morbidity. The sample was drawn from 81 female rape survivors with or without lifetime PTSD, 31 major depressive disorder controls, 20 anxiety disorder controls and 39 healthy controls. First-degree family members were directly interviewed (n = 285) and diagnoses assigned of major depressive, anxiety and alcohol or substance use disorder. Information was also available by family history for 639 relatives. In the directly interviewed sample, no consistently increased morbidity risk was observed for anxiety, PTSD, or alcohol/substance abuse in the rape survivor groups, but there was an increase in depression relative to the anxiety in healthy control groups. When comorbid depression in rape survivor probands was taken into account post hoc, an increased risk for depression was noted in family members of PTSD probands with depression, but not in relatives of PTSD probands without lifetime depression. Among rape survivor probands with non-comorbid PTSD, rates by history of familial anxiety and depression were negligible. In a logistic regression analysis, individual vulnerability to depression served as an independent predictor of chronic PTSD, along with specific trauma-related variables. In the family history group, results were consistent with those obtained from the directly interviewed group. Our findings clearly support the view that PTSD following rape is associated with familial vulnerability to major depression, which may thus serve as a risk factor for developing PTSD. The exact nature of this predisposition calls for further inquiry and there is a need to expand this study to include other PTSD populations. PTSD may on occasion represent a form of depression which is induced and/or modified neurobiologically and phenomenologically by extreme stress. Our findings may be a reflection of the sample composition, the current conceptualization of PTSD, or be related to study limitations.

Adolescent↗
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Prevalence and correlates of heavy smoking in Vietnam veterans with chronic posttraumatic stress disorder.

A study was conducted to investigate smoking patterns in 445 Vietnam veterans with and without posttraumatic stress disorder (PTSD). Combat veterans with PTSD reported similar occurrence of smoking (53%) compared to combat veterans without PTSD (45%). For those who smoked, combat veterans with PTSD reported a significantly higher rate of heavy smoking (> or = 25 cigarettes daily): 28% of combat veterans without PTSD were heavy smokers and 48% of combat veterans with PTSD were heavy smokers. PTSD diagnosis and heavy smoking status were independently and differentially related to motives for smoking. In combat veterans with PTSD, heavy smoking status was positively related to total health complaints, lifetime health complaints, health complaints in the past year, negative health behaviors, total PTSD symptoms, DSM-IV C cluster (avoidance and numbing) and D cluster (hyperarousal) PTSD symptoms. Heavy smoking status was also associated with fewer positive health behaviors.

Age Factors↗
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Demographics, treatment seeking, and diagnoses of anxiety support group participants.

Two peer-led anxiety disorder support groups were surveyed to ascertain characteristics of individuals seeking the services of these groups. Both groups had received information and consultation from the Anxiety Disorders Association of America. One hundred and eighty-four individuals were interviewed for diagnosis by structured clinical interview; demographics and treatment-seeking behaviors were ascertained by self-report questionnaires. Both groups surveyed were composed of more females than males and were predominantly Caucasian. Treatment was most frequently sought from psychiatrists, psychologists, and family doctors. One fourth of the sample had sought help for anxiety in a hospital emergency room. Eighty-eight subjects (94%) at the Dallas site and 57 subjects (61%) at the Durham site met criteria for at least one current anxiety or affective disorder. More than half of those who met criteria for current panic disorder with agoraphobia also met criteria for at least one other anxiety disorder, or for major depression. Approximately one third of each support group met criteria for current social phobia. Severity of social phobia symptoms was assessed by four scales. An increased risk of substance abuse was noted for individuals with a diagnosis of social phobia, as compared with diagnoses of other anxiety disorders.

Adult↗
PubMedDate not supplied

Effects of flunixin meglumine on dogs with experimental gastric dilatation-volvulus.

Gastric dilatation-volvulus (GDV) was created experimentally and maintained for 90 minutes in 16 anesthetized, mixed-breed dogs. After the GDV was corrected, normal saline solution (0.044 mL/kg intravenously [IV]) was administered to eight dogs (controls), and flunixin meglumine (2.2 mg/kg IV) was administered to eight dogs. Microspheres labeled with radioactive cobalt, scandium, tin, or niobium were injected intravenously at baseline (before GDV) and minutes 90, 100, and 270, respectively, to determine tissue blood flows. Plasma endotoxin and prostacyclin were measured at the same intervals. Electrocardiogram, mean arterial pressure, portal pressure, and cardiac output were recorded continuously. Dogs were euthanatized at minute 270 and necropsied. There was no significant difference between treatment groups for any measured variable at any time. Endotoxin levels increased significantly during GDV. Prostacyclin levels were lower in dogs treated with flunixin meglumine than in controls at minutes 210 and 270. Histopathologic findings were similar for all dogs and consistent with those associated with endotoxemia. Flunixin meglumine treatment did not alter cardiac indices or tissue blood flows significantly. However, elevation of prostacyclin was inhibited by flunixin meglumine, which suggested that continued effects of endotoxic damage might be attenuated or inhibited.

Animals↗
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Using a treatment-tradeoff method to elicit preferences for the treatment of locally advanced non-small-cell lung cancer.

The study was designed to evaluate a treatment-tradeoff method for its potential in helping lung cancer patients make treatment decisions. A treatment-tradeoff interview was conducted to determine how patients weighed potential survival benefits against the potential toxicities of different treatment options: 1) low-dose versus high-dose radiotherapy, and 2) high-dose radiotherapy versus combination chemo-radiotherapy. Fifty-six patients who had experienced cancer and 20 clinic staff participated; twenty of these participants repeated the interview in an assessment of response consistency. The treatment-tradeoff method proved feasible: all staff and 53 of the 56 patients were able to complete the process. A wide range of threshold scores across participants was observed for both tradeoffs. Sixty percent of the patients would accept the more toxic combination therapy over high-dose radiotherapy if the former offered a 10% absolute improvement in three-year survival. The method also proved reliable: test-retest correlations were high (tau ranged from 0.7 to 0.87 and r from 0.82 to 0.94) and test-retest mean score differences were low (1.3-4.2). The most clinically useful measure of consistency was a "preference consistency" index, which revealed that most patients declared the same treatment preference at test and retest. The authors conclude that, while there is great interindividual variability in willingness to accept aggressive treatments for lung cancer, patients' values can be consistently elicited with the tradeoff method. The method has potential for clinical application in decision making and for health-care policy development.

Aged↗
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Immunology of a serum sickness/vasculitis reaction secondary to streptokinase used for acute myocardial infarction.

We have studied six patients who received streptokinase for acute myocardial infarction (MI). One of these patients experienced a serum sickness/vasculitis reaction nine days after receiving the drug. Immunologic investigation of serum obtained from these individuals demonstrated that IgE and IgG anti-streptokinase antibody concentrations (measured by radioimmunoassay) were significantly elevated, both pre and post (IgE antibody, 36-fold increase) drug exposure, in the individual having the serum sickness/vasculitis reaction. Two of five of the remaining MI patients receiving the drug had post-exposure elevation of IgE anti-streptokinase antibody, but no patient had the immunologic profile seen in the individual with vasculitis. One should be aware that the serum sickness/vasculitis reaction can occur late after administration of streptokinase when the acute MI patient is recuperating.

Adult↗
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Suicides on Ontario farms.

PURPOSE: To describe the epidemiology of suicides on Ontario farms from 1980-1989, and the ecological relationship between economic strain and farm suicide risk. METHOD: Farm suicides were identified using a computer-assisted search of vital records. Distributions of farm suicides were examined by several demographic variables. Linear and Poisson regression were used to describe potential associations between ten economic indicators and the incidence of farm suicide. RESULTS: 126 farm suicides were identified. After adjustment for age and under-reporting, the farm suicide rate was estimated at 7.2 per 100,000 per year. The highest suicide rate was observed among elderly farm owner-operators. Regression analyses failed to find any associations between the economic indicators and farm suicide rates. CONCLUSION: The results do not support the notion that farmers in Ontario generally have a high rate of suicide, the ecological analysis provided no evidence for increased farm suicide risk with increasing economic strain.

Adolescent↗