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Biomedical subjects

M J Gitlin

Publications and source records attributed to M J Gitlin.

At least 37 records · Page 2Linked to original sources
PubMed1991

Communication deviance in families of schizophrenic and manic patients.

Levels of communication deviance (CD) distinguish parents of schizophrenic patients from parents of nonpsychotic patients, but the prevalence of intrafamilial CD in other psychotic disorders has not been examined. Levels of CD were compared across biological parents of schizophrenic (n = 39) and bipolar manic (n = 16) patients and across patients themselves. CD ratings were based on Thematic Apperception Test protocols (parents only) and family interactions (parents and patients). Total levels of CD did not distinguish between groups of parents or patients. However, instances of odd word usage were more frequent among parents of manic patients than among parents of schizophrenic patients on both CD measures. Also, during the interaction task, odd word usage was more frequent among manic patients, whereas schizophrenic patients made more ambiguous references. Results suggest that high levels of intrafamilial CD are not unique to schizophrenia.

Adolescent↗
PubMed1991

Clinical aspects of depression in chronic pain patients.

It has been widely recognized that an appreciable proportion of chronic pain patients have depressive disorders. Although numerous studies and several literature reviews have examined the relationship between chronic pain and depression, disorders of mood come in many forms, and little attention has been paid to the different types of depressive disorders found among patients with chronic pain. In this article, the different ways in which a chronic pain patient may manifest depression are discussed. Diagnostic criteria for major depression, dysthymia, and atypical depression are described, and the relevance of these disorders and of masked depression to chronic pain is discussed. The medical illnesses and medications that can cause symptoms of depressive disorders are also briefly described. Depressive disorders and their concomitants are an integral part of the experience of chronic pain and are important in developing an optimal treatment plan. For these reasons, they should be carefully evaluated in all patients with chronic pain.

Chronic Disease↗
PubMed1989

Psychiatric syndromes linked to reproductive function in women: a review of current knowledge.

Four psychiatric syndromes related to reproductive function in women have been identified: postpartum depression, premenstrual syndrome (PMS), post-hysterectomy depression, and involutional melancholia. The authors review what is known about these syndromes and conclude, first, that postpartum depression comprises three separate syndromes, the most severe of which is most likely a variant of primary affective disorder. Second, research into the syndromal nature, biology, and treatment of PMS is still in its infancy due to a variety of methodological difficulties. Third, the rate of depression among women during the involutional period or following hysterectomy for benign pathology is not higher than it is at other times.

Depressive Disorder↗
PubMed1989

Maintenance lithium treatment: side effects and compliance.

Fifty-one bipolar patients receiving maintenance lithium treatment were evaluated for the presence of side effects, their degree of distress, and the association of these side effects with compliance. Cognitive side effects and weight gain were the most disturbing to patients, whereas thirst and polyuria were the most common. Self-reported noncompliance correlated most highly with coordination (r = .38, p less than .01) and cognition (r = .30, p less than .05) side effects. Current depressed mood also showed a strong correlation with side effect scores, especially those for cognitive disturbances. However, the correlations between noncompliance and coordination and cognitive side effects were just as strong when the effects of depressed mood were partialled out. These findings indicate the link between noncompliance and lithium-induced central nervous side effects and suggest that related treatment issues must be addressed to ensure maximum clinical response.

Adult↗
PubMed1988

Attitudinal correlates of lithium compliance in bipolar affective disorders.

Lithium noncompliance is a significant barrier to effective treatment of manic-depressive disorders, yet the reasons for it are not well established. This questionnaire study of 48 lithium outpatients evaluated the utility of Ajzen and Fishbein's Theory of Reasoned Action in explicating the relationships among lithium-related beliefs and attitudes, normative beliefs, behavioral intentions, and self-reported compliance with the treatment regimen. Results support the usefulness of this model, with some modification, in conceptualizing patients' compliance behaviors. Findings underscore the importance of the patient-physician relationship in lithium compliance.

Adult↗
PubMed1988

Persistence of fluphenazine in plasma after decanoate withdrawal.

We discontinued fluphenazine decanoate using a double-blind, crossover random order design, in 12 recent onset clinically stable schizophrenics who had been given fluphenazine decanoate 12.5 mg intramuscularly every 2 weeks for at least 1 year prior to drug withdrawal. Each condition (drug or placebo) lasted 12 weeks. Using a radioimmunoassay verified by comparison to a gas chromatographic-mass spectrometric method, plasma fluphenazine levels were measured every 2 weeks during drug continuation and drug withdrawal conditions. No patient relapsed over the 24-week period of the study. Mean fluphenazine levels between drug continuation and withdrawal conditions showed a progressively larger difference over time, although significant differences were not seen until week 8. By week 12 after drug withdrawal, 33% of subjects still showed notable plasma fluphenazine levels. On the basis of our preliminary findings, we suggest that 2-week intervals between injections may be too short and that wider intervals may achieve similar clinical results.

Adult↗
PubMed1987

Sweets, chocolate, and atypical depressive traits.

An original questionnaire, the Foods and Moods Inventory (FMI) was used to investigate appetite for sweets and chocolate and its relationship to dysphoric mood. The FMI was administered to a group of subjects with an identified interest in chocolate (chocolate group, N = 73), a comparison sample (comparison group, N = 172), and a sample of former alcoholics (N = 22). Those who reported "self-medicating" with sweets or chocolate were more likely to have personality traits associated with hysteroid dysphoria, an atypical depressive syndrome. In addition, the tendency to eat compulsively, in general, and appetite for sweets and chocolate, in particular, were significantly greater among women.

Adult↗
PubMed1987

Verapamil in treatment-resistant mania: an open trial.

Fourteen patients with mania unresponsive to lithium were treated with verapamil in an open study. None of the eight patients treated for acute episodes of mania or hypomania showed improvement, although four patients experienced dysphoria, with two of the four switching into depression. Four patients were treated with verapamil prophylactically; one showed a mild improvement and one, a clear positive response. Two patients with persistent pharmacological hypomanias tolerated antidepressants and became euthymic while on verapamil. A case of pharmacological hypomania successfully treated with verapamil is presented in detail. A controlled trial using verapamil to prevent pharmacological mania/hypomania is indicated.

Adult↗
PubMed1986

The dexamethasone suppression test and response to somatic treatment: a review.

The dexamethasone suppression test (DST) has been primarily investigated as an aid in diagnosing endogenous depression; yet, its major clinical use has been as a predictor of treatment response. It is commonly held that 1) an abnormal DST predicts response to somatic (and not psychologic) therapies, 2) an abnormal DST predicts response to noradrenergic antidepressants, and 3) a normal DST predicts response to serotonergic agents. The DST predicted response to somatic therapies in only 6 of 16 published studies. No single methodologic factor, such as population variables, DST technique, or study design, can explain the marked discrepancy in study results. Only two of seven studies examining the DST and response to neurotransmitter-specific antidepressant groups found a positive relationship. The evidence that the DST predicts response to noradrenergic agents is weak. The DST does not predict acute response to somatic treatment in general or response to specific antidepressants. The selection of the appropriate treatment for depressed patients is still best made using clinical criteria.

Antidepressive Agents↗
PubMed1984

Lithium clinics: theory and practice.

The authors surveyed 19 university-affiliated lithium clinics to examine their clinical practices and standards of care. Most commonly the clinics obtained lithium levels every two months and checked serum creatinine, urinalysis values, and thyroid function yearly. Psychotherapy was used in 18 of the clinics: 45 percent of the unipolar patients and 36 percent of the bipolar patients were receiving individual or group therapy. A variety of mental health personnel staffed the clinics, but in the majority of them physicians were used as the primary staff members for medication visits. The authors compare the characteristics of present-day clinics with those of the early lithium clinics of the late 1960s and early 1970s.

Academic Medical Centers↗
PubMed1984

Dexamethasone suppression test and treatment response.

The dexamethasone suppression test (DST) is frequently used to predict response to antidepressant therapy or to noradrenergic vs. serotonergic antidepressants. In a study of 173 inpatients and outpatients, the DST was not found to be predictive of response to antidepressant treatment for all depressed patients or of treatment response in a subgroup of melancholic patients (N = 86). Response of DST suppressors and nonsuppressors to antidepressants stratified by neurotransmitter specificity was not found to differ.

Adolescent↗
PubMed1984

Verapamil as maintenance treatment in bipolar illness: a case report.

The authors report the successful maintenance treatment of a bipolar woman with verapamil. Whereas the patient had previously demonstrated multiple antidepressant-induced manias despite prophylactic lithium treatment, she was able to maintain on verapamil plus trazodone without manic or depressive episodes over a 1-year period. It is suggested that verapamil may have a place in the maintenance treatment of bipolar patients.

Adult↗
PubMed1981

Assessment of naltrexone in the treatment of schizophrenia.

Naltrexone, a long acting opiate antagonist, and placebo were administered to eight schizophrenics in doses of 200 mg per day for 1 week in a double-blind, crossover design. No improvement was noted, and no side effects resembling the opiate withdrawal syndrome with naltrexone were found. Naltrexone does not appear to alter schizophrenic symptomatology.

Adult↗