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Biomedical subjects

M M Weissman

Publications and source records attributed to M M Weissman.

At least 181 records · Page 10Linked to original sources
PubMed1986

Depressed parents and their children. General health, social, and psychiatric problems.

Two hundred twenty children (aged 6 to 23 years) from families with either depressed or normal (nonpsychiatrically ill) parents of comparable sociodemographic backgrounds were studied. The children from families in which at least one parent had experienced a major depression were reported to have had more adverse perinatal events; were later in achieving some developmental landmarks; had more convulsions, head injuries, operations, and psychiatric disorders (particularly major depression); and made more suicide attempts. Overall, there were no significant differences in IQ between children in both groups. Mothers in families with a depressed parent reported more medical problems during pregnancy and labor, and the children were reported to have experienced more distress at birth. Since major depression is a highly prevalent disorder in women of childbearing ages, these findings have direct clinical implications for pediatricians. Their specificity for major depression, as contrasted with other psychiatric disorders or chronic illnesses in the parents, requires further study.

Adolescent↗
PubMed1986

Understanding the clinical heterogeneity of major depression using family data.

For major depression, putative subgroups have been defined by age at onset, clinical severity, symptom patterns, or the presence of other disorders (comorbidity), yet the high degree of overlap in clinical presentation makes it difficult to determine which combination of criteria for defining subgroups best predicts familial aggregation. In dealing with this overlap, we found that only early age at onset, or major depression with an anxiety disorder or secondary alcoholism, were independently related to increased risk of major depression in relatives. Once the effects of these proband factors had been taken into account, endogenous, delusional, melancholic, or autonomous symptom patterns, recurrent depression, history of hospitalization, and suicidal ideation or attempts in probands were not associated with increased risk of major depression in relatives.

Adolescent↗
PubMed1986

Prognostic significance of psychopathology in treated opiate addicts. A 2.5-year follow-up study.

Two different methods for assessing psychopathology in opiate addicts were compared as predictors of long-term treatment outcome: (1) categorical psychiatric diagnosis using the Schedule for Affective Disorders and Schizophrenia--Lifetime Version and the Research Diagnostic Criteria and (2) global rating of psychiatric impairment using the Psychiatric Severity scale of the Addiction Severity Index (ASI). Follow-up interviews were completed 2.5 years after treatment seeking in 76% of a sample of 361 opiate addicts. Five dimensions of treatment outcome were assessed, including current functioning, psychosocial adjustment, substance use impairment, legal problems, and medical disability. Most lifetime psychiatric disorders with a prevalence of greater than 10% were significantly related to the outcome dimensions of current functioning and/or psychosocial adjustment and were unrelated to substance use impairment, legal problems, and medical disability. The ASI Psychiatric Severity rating more robustly predicted poorer functioning in the same two areas and less severe legal problems. While controlling for ASI Psychiatric Severity, the only Research Diagnostic Criteria diagnosis that remained significantly related to treatment outcome was major depression, suggesting that, as regards their prognostic characteristics, the other diagnoses are accounted for by a global underlying severity dimension.

Follow-Up Studies↗
PubMed1986

Family-genetic studies of psychiatric disorders. Developing technologies.

During the past decade new concepts and technologies have improved the conduct of family-genetic studies in psychiatry. We compiled and critically evaluated these advances, including study design, pedigree collection, diagnostic procedures in adults and children, and epidemiologic and genetic approaches to data analysis. These approaches have improved the collection of accurate information on the nature and patterns of psychiatric illness in families. The data generated from well-designed and well-conducted family studies are useful for the identification of homogeneous subgroups of psychiatric disorders, for understanding the spectrum of psychiatric disorders, for examining the associations between psychiatric disorders, and for studying the continuity between adult and childhood manifestations of psychiatric disorders. Findings from these studies also may enhance our capacity to identify the mode of transmission of the psychiatric disorders and to select potentially informative families for future genetic linkage studies using the new recombinant DNA techniques. The adaptation of these methods to routine clinical practice and new directions in the application of family-genetic studies employing more refined assessments and analytic methods are also discussed.

Data Collection↗
PubMed1986

The use of survival time models with nonproportional hazard functions to investigate age of onset in family studies.

The use of survival time models with non-proportional hazard functions is introduced as a method of studying age of onset effects in family studies. Statistical methods for investigating non-proportionality of the hazard function are described, and the application of these methods is illustrated using data from a family study of depression to investigate transmission of age of onset between probands and their first degree relatives. The method is broadly applicable and useful for many chronic diseases where transmission of a disorder in families varies by age of onset of the disorder. It may also be used to investigate the effect of other proband factors such as sex on the age of onset of disease in relatives.

Adolescent↗
PubMed1986

The epidemiology of anxiety and panic disorders: an update.

Epidemiologic data on the prevalence rates for various DSM-III categories of anxiety disorders, including panic disorder, agoraphobia, and generalized anxiety disorder, are now available from several community studies of adults. High degrees of co-morbidity have been found, especially among the anxiety disorders and between anxiety and affective disorders. Risk factors for anxiety disorders include young age, female gender, and familial history. The results of twin studies suggest that genetic factors are involved in the etiology of the anxiety disorders, particularly for panic disorder and agoraphobia. Implications for case finding and family psychiatry are discussed.

Adolescent↗
PubMed1985

Familial transmission of depression and alcoholism.

The familial transmission of major depression and alcoholism among probands who had depression and alcoholism was examined. Our findings indicated that depressives without alcoholism did not transmit alcoholism, and probands with depression and alcoholism tended to transmit both depression and alcoholism. This confirms the observation that depression and alcoholism are not manifestations of the same underlying disorder. An increased risk of anxiety disorders in the relatives of probands with alcoholism, which could specifically be attributed to the presence of alcoholism in addition to an anxiety disorder in the proband, was also observed. This suggested that the alcoholism in these probands may result from self-medication of anxiety symptoms. The results of this study underscore the importance of examining combinations of diagnoses in patients in decreasing the heterogeneity of diagnostic categories.

Adult↗
PubMed1985

Multiple threshold models for the affective disorders: the Yale-NIMH collaborative family study.

From the Yale-NIMH collaborative family study, the 1482 first degree relatives of 90 bipolar 1, and 163 major depression probands were examined to test the hypothesis that bipolar 1 and major depression are due to a single underlying genetic liability. We attempted to fit multifactorial-polygenic and single-major-locus multiple threshold models for sex and severity to the relatives in the major depression and bipolar 1 families. With relatives classified as affected only if they met criteria for major depression or bipolar 1, there was at best only marginal support for these models. Differences between these and previously reported results were examined in relation to differences in underlying assumptions. Additional analyses of these and other data from families of NIMH bipolar 2 and schizoaffective probands suggest that different methods of age adjustment, the relative placement of bipolar 2 and schizoaffective disorders in a hypothesized liability continuum and the inclusion or exclusion of sex thresholds were not primarily responsible for differences in the fit of genetic threshold models. Factors which do appear to be important are variability in rates between samples, the possibility of genetic heterogeneity, and the presence of a large secular increase in affective illness over the past three generations; the secular trend cannot be accommodated in the models of genetic transmission examined.

Adult↗
PubMed1985

Genetic factors in the sex ratio of major depression.

A twofold increase in the prevalence of depression among women has been consistently observed. Several possible explanations, including methodological, endocrine, psychosocial, and genetic factors, have been proposed for the increased rates of depression among women. This paper describes the analysis of data from a family-genetic study of depressed probands to examine whether genetic factors can explain the preponderance of depressed females. Our data indicate that the excess of females with major depression cannot be attributed to increased genetic loading for depression in women. Other factors which may explain increased rates of major depression in women are discussed.

Alcoholism↗
PubMed1985

Contact with health professionals for the treatment of psychiatric and emotional problems.

This study focuses on predisposing, enabling, and need factors affecting contact with health professionals for the treatment of psychiatric and emotional problems during a 6-month period. Data are from the first wave of the Yale Epidemiologic Catchment Area (ECA) Project. The study confirms the important relationship of psychopathology to both the likelihood of using mental health related services and the quantity of service contacts. Sex, age, race, education, marital status, usual source of medical care, and attitudes toward mental health services were found to exert independent effects on the likelihood of contact with a health professional after controlling for clinical status. Factors affecting the quality of service contacts among utilizers were psychiatric status, usual source of care, and attitudes.

Adult↗
PubMed1985

Psychiatric disorders (DSM-III) and cognitive impairment among the elderly in a U.S. urban community.

Results are presented on the current prevalence rates of psychiatric disorder in 2,588 non-institutionalized persons aged 65 and older who were drawn from a probability sample of New Haven, Connecticut, and 12 surrounding towns in South Central Connecticut. Based on the Diagnostic Interview Schedule (DIS), 6.7% of the respondents had a psychiatric diagnosis (DSM-III), and based on the Mini-Mental Status Exam (MMS), 3.4% had severe cognitive impairments during the past 6-month period. Therefore, more than 10% currently had either a psychiatric or a severe cognitive problem. Overall, these rates of psychiatric disorders are lower than those found in adult populations under age 65. As with younger samples, anxiety and affective disorders were among the most common psychiatric problems. The majority of elderly reported themselves in good emotional and physical health and felt they had sufficient finances to meet their needs. The rate of severe cognitive impairment did not increase until after age 79. Among those 80 years and older, cognitive impairments were more common in women than men, probably due to differential survival rates. Since less than 6% of the elderly sample are living in institutions these results among non-institutionalized elderly point to the relative psychiatric well-being of the majority of the elderly. However, in view of the longer life expectancy, the next decade will see an increase in the absolute number of persons with cognitive impairments.

Age Factors↗
PubMed1985

Depressives with secondary alcoholism: psychiatric disorders in offspring.

The risk of psychiatric illness among the offspring of probands with major depression and secondary alcoholism was examined. The offspring aged 6-17 (N = 107) and 18 + (N = 171) of probands with major depression (114 with depression only and 19 with secondary alcoholism) were compared with the offspring aged 6-17 (N = 87) and 18 + (N = 103) of controls (N = 82). Offspring of probands with secondary alcoholism had a threefold greater risk of alcoholism and a fivefold greater risk of antisocial personality-conduct disorder compared with offspring of probands with depression only, and a threefold greater risk of alcoholism and a 20-fold greater risk of antisocial personality-conduct disorder compared with offspring of controls. Familial aggregation of alcoholism was observed only among probands with secondary alcoholism. The presence of secondary alcoholism in depressed probands did not convey additional increase in risk of either major depression or anxiety disorders to offspring beyond that observed among offspring of probands with depression only. This suggests that depression and alcoholism are not alternate forms of expression of the same underlying illness. Assortative mating for alcoholism among parents was related to increased risk of both alcoholism and antisocial personality-conduct disorder but not of major depression among offspring. A linear effect on rates of these disorders according to the number of parents with alcoholism was observed.

Adolescent↗
PubMed1984

Psychiatric disorders in the relatives of probands with affective disorders. The Yale University--National Institute of Mental Health Collaborative Study.

A family study of psychiatric disorders in 2,003 first-degree relatives of 335 probands found increased rates of bipolar I disorder and major depression (MD) in the relatives of probands with bipolar disorder and increased rates of MD in the relatives of probands with MD. There was a similarity in rates of affective disorders in the relatives of ambulatory and of hospitalized depressed probands (suggesting that ambulatory depressed patients may be as suitable as hospitalized ones for biological studies) and a comparability of rates of illness in relatives between centers for most disorders when comparable diagnostic criteria and procedures were used.

Adult↗