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Biomedical subjects

M A Jenike

Publications and source records attributed to M A Jenike.

At least 91 records · Page 5Linked to original sources
PubMed1992

Neurosurgical treatment of malignant obsessive compulsive disorder.

Although the majority of patients with obsessive compulsive disorder (OCD) respond well to behavioral techniques, pharmacotherapy, or combinations of these two approaches, a small percentage of patients remain refractory and are severely disabled by their symptoms. Such patients may well be helped by neurosurgical interventions. This article reviews the selection guidelines, indications and contraindications, available procedures, probable outcome, hazards involved, preoperative work-up, and the rationale behind neurosurgery in OCD.

Brain Mapping↗
PubMed1991

Cingulotomy for refractory obsessive-compulsive disorder. A long-term follow-up of 33 patients.

To evaluate the feasibility of cingulotomy as a treatment for patients with intractable obsessive-compulsive disorder, we evaluated the records of all 35 patients with this diagnosis who had undergone one or more such procedures at Massachusetts General Hospital, Boston, during the last 25 years. Retrospectively, all but two of these patients met DSM-III-R criteria for obsessive-compulsive disorder. Six patients were deceased; four by suicide. Questionnaires were sent to the remaining 27 patients with obsessive-compulsive disorder; 17 patients returned the questionnaire and another agreed to an interview without completing the forms. Sixteen of these 18 patients participated in a telephone interview, and patient reports were corroborated by an informant in 10 cases. Despite the presence of some side effects, such as easily controlled seizures (9%) and transient mania (6%), the results of this investigation support the use of cingulotomy as a potentially effective treatment for patients with severe and disabling obsessive-compulsive disorder. With the use of very conservative criteria, we estimated that at least 25% to 30% of the patients benefited substantially from this procedure. Similar results were found in a preliminary prospective study of four patients who recently underwent cingulotomy after state-of-the-art preoperative treatments had failed.

Adult↗
PubMed1990

Standardized assessment of personality disorders in obsessive-compulsive disorder.

We assessed 96 patients with obsessive-compulsive disorder for DSM-III personality disorder diagnoses with a standardized interview instrument (Structured Interview for the DSM-III Personality Disorders). Fifty patients (52%) met criteria for at least one personality disorder, with mixed, dependent, and histrionic personality disorders most frequently diagnosed. Compulsive personality disorder was diagnosed in only 6 patients (6%), 5 of whom had had onset of obsessive-compulsive symptoms before the age of 10 years, indicating that DSM-III compulsive personality disorder is not invariably a premorbid condition for the development of obsessive-compulsive disorder. Schizotypal personality disorder, at 5%, was found to be less common than in past samples, reflecting differences in either assessment methods or sampling.

Adolescent↗
PubMed1990

Oral physostigmine as treatment for dementia of the Alzheimer type: a long-term outpatient trial.

Six patients with dementia of the Alzheimer type (DAT), treated with oral physostigmine and followed from 9 to 27 months (mean +/- SD, 17.8 +/- 7.3 months), were matched for sex, age, initial degree of dementia, and length of follow-up with six control patients who did not receive oral physostigmine. The small sample size precluded drawing definite conclusions about overall efficacy; however, three in the physostigmine group did not deteriorate during the course of follow-up while all of the controls deteriorated although the difference was nonsignificant. The data generated in these patients provides evidence of the safety of long-term trials of oral physostigmine. The possible role of cholinesterase inhibition in retarding the progression of DAT is discussed.

Administration, Oral↗
PubMed1990

Clomipramine versus fluoxetine in obsessive-compulsive disorder: a retrospective comparison of side effects and efficacy.

Since it will be some time until data will be available comparing clomipramine and fluoxetine for the treatment of patients with obsessive-compulsive disorder (OCD), a meta-analysis of previous studies was performed in an attempt to gain some information about comparable efficacy and side effects of these two commonly used agents. In 31 OCD patients receiving clomipramine in a controlled trial and 72 OCD patients receiving fluoxetine openly, both drugs appeared effective, with clomipramine having a somewhat larger effect than fluoxetine. Different side effect profiles may have a bearing on patient selection.

Clomipramine↗
PubMed1990

Sertraline in obsessive-compulsive disorder: a double-blind comparison with placebo.

Many agents that affect the brain's serotonergic system appear to be at least partially effective in the treatment of patients with obsessive-compulsive disorder. However, in this 10-week double-blind trial in which 10 patients received sertraline and nine received placebo, sertraline was ineffective according to four measures of obsessive-compulsive symptoms. The authors discuss the implications of these preliminary findings for the serotonergic theory of obsessive-compulsive disorder and the need to explore the role of other neurochemical systems in this disorder.

1-Naphthylamine↗
PubMed1990

A controlled trial of fluvoxamine in obsessive-compulsive disorder: implications for a serotonergic theory.

Thirty-eight patients with primary obsessive-compulsive disorder participated in a 10-week, double-blind, placebo-controlled trial of the potent, selective serotonin reuptake inhibitor fluvoxamine. Fluvoxamine was significantly better than placebo on two of three measures of improvement in obsessive-compulsive symptoms. The authors also compared studies of the serotonergic agents fluvoxamine, sertraline, fluoxetine, and clomipramine and found that a greater effect size was associated with less serotonergic specificity and that some ability to affect other neurotransmitter systems may be a necessary but not sufficient requirement for antiobsessional activity. These data lend only partial support to a serotonin hypothesis of obsessive-compulsive disorder.

1-Naphthylamine↗
PubMed1990

Unusual lymphocyte subset distribution in some depressed patients.

Depression has been previously associated with immunologic dysfunction. The lymphocyte subsets of 10 patients with major depression were found to show a mean T4-T8 (helper-suppressor) ratio lower than that of controls, a difference attributable to increased numbers of suppressor cells in the depressed group. One possible cause of increased suppressor cells is prior or current viral infection.

Adult↗
PubMed1990

Oral physostigmine treatment for patients with presenile and senile dementia of the Alzheimer's type: a double-blind placebo-controlled trial.

Twelve patients aged 53 to 89 years with presenile or senile dementia of the Alzheimer's type participated in a treatment trial of oral physostigmine. Patients first received the drug during an open dose-finding phase. In a double-blind crossover design phase, the patients' memory performance during treatment with an optimal memory-enhancing dose was compared with memory performance during placebo treatment. Response to medication was assessed by the Delayed Recognition Span Test, the Selective Reminding Test, and the Alzheimer's Disease Assessment Scale. Intergroup differences in response to physostigmine were nonsignificant. Age at onset of the disease did not differentiate partial responders from nonresponders.

Administration, Oral↗
PubMed1990

Approaches to the patient with treatment-refractory obsessive compulsive disorder.

Modern therapies have dramatically improved the treatment outcome for patients with obsessive compulsive disorder (OCD), but many clinicians are not aware of what is presently available in terms of effective treatments. Clinicians now know that if patients receive appropriate treatment, usually consisting of behavior therapy and/or psychotropic medication, the majority will improve substantially, and occasionally completely, within a few months. This article reviews some of the treatment options for managing refractory patients with OCD.

Behavior Therapy↗
PubMed1989

Open trial of fluoxetine in obsessive-compulsive disorder.

A 12-week open trial of fluoxetine in 61 obsessive-compulsive disorder patients significantly improved depressive and obsessive-compulsive symptoms. Baseline depression scores were not related to improvement on two obsessive-compulsive scales. The results reinforce the hypothesis of serotonergic abnormalities in obsessive-compulsive disorder.

Adult↗