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Biomedical subjects

M M Weissman

Publications and source records attributed to M M Weissman.

At least 271 records · Page 15Linked to original sources
PubMed1978

Rates and risks of depressive symptoms in a United States urban community.

The results of a U.S. urban community survey, conducted in 1967 and in 1969, show that 16--18% of the population have depressive symptoms at any one time. Similar rates are reported in five other studies where self-report depression symptom scales have been used. The relationship between depressive symptoms and the diagnosis of major depressive disorders still requires investigation since the presence of depressive symptoms does not necessarily indicate the diagnosis of a major or minor depressive disorder.

Adolescent↗
PubMed1978

Psychiatric disorders in a U.S. urban community: 1975-1976.

The authors point out that new findings in psychiatric genetics and psychopharmacology support the heterogeneity of psychiatric disorders. They present data on the current rates of specific psychiatric disorders, using a recently developed diagnostic technique in a survey conducted in New Haven, Conn., during 1975-1976. The survey showed that depressive disorders are the most common diagnoses.

Adolescent↗
PubMed1978

Personality and the prediction of long-term outcome of depression.

In a follow-up study of 150 women who had undergone treatment on an outpatient basis for acute depression, it was found that the most important predictor of their long-term clinical outcome (8, 20, and 48 months after the acute episode) was personality as measured by the Neuroticism Scale of the Maudsley Personality Inventory (MPI-N). Age, race, social class, marital status, religion, number of previous depressions or suicide attempts, diagnosis, history of early deaths of or separations from significant others, history of neurotic traits as a child, amount and type of stress in the 6 months before onset, and severity and pattern of pretreatment symptoms were not predictive of outcome.

Acute Disease↗
PubMed1978

Suicide attempts 1970--75: updating a United States study and comparisons with international trends.

This paper brings up to date a 1970 study of suicide attempters coming to a major emergency room in an United States urban community and reviews international trends in suicide attempts. Results of the study and the review of the international literature indicate that the high rates of suicide attempts that were observed in 1970 are continuing into 1975. The incidence of suicide attempts continues to be a public health problem primarily amoung young women. Pill ingestion, usually barbiturates and psychotropic drugs, continues to be the most common method used.

Adolescent↗
PubMed1977

Sex differences and the epidemiology of depression.

This article reviews the evidence for differing rates of depression between the sexes in the United States and elsewhere during the last 40 years, and then critically analyzes the various explanations offered. These explanations include the possibility that the trends are spurious because of artifacts produced by methods of reporting symptoms, or that they are real because of biological susceptibility (possibly genetic or female endocrine), psychosocial factors such as social discrimination, or female-learned helplessness.

Alcohol Drinking↗
PubMed1977

Symptom patterns in primary and secondary depression. A comparison of primary depressives with depressed opiate addicts, alcoholics, and schizophrenics.

The primary-secondary distinction in affective disorders has been proposed to reduce the heterogeneity of depression. An investigation of the frequency of secondary depression and its nature in depressed opiate addicts, alcoholics, and schizophrenics was undertaken. Findings show that secondary depression in ambulatory patients with other psychiatric disorders is relatively common. The sociodemographic characteristics of the secondary depressive are consistent with the population from which they derive but differ from primary depressives. The symptom patterns of secondary depressives are similar to primary depressives but are overall less severe. These findings give further support to the value of separating out secondary from primary depression in future research studies.

Adult↗
PubMed1977

Assessing depressive symptoms in five psychiatric populations: a validation study.

Data from five psychiatric populations and a community sample are presented on the CES-D, 20-item self-report depression symptom scale developed by the Center for Epidemiologic Studies. Results show that the scale is a sensitive tool for detecting depressive symptoms and change in symptoms over time in psychiatric populations, and that it agrees quite well with more lengthy self-report scales used in clinical studies and with clinician interview ratings. Although a symptom scale cannot differentiate between diagnositc groups, the CES-D has demonstrated its validity as a screening tool for detecting depressive symptoms in psychiatric populations.

Adolescent↗
PubMed1976

Assessment of social adjustment by patient self-report.

Current emphasis on early case finding, outpatient care, and on longitudinal studies of asymptomatic patients has focused attention on the community adjustment of psychiatric patients. Thus, simple and inexpensive methods such as self-report scales, which allow the routine assessment of patient adjustment, are potentially useful. The derivation and testing of such a method, the Social Adjustment Scale Self-Report, is described. This scale covers the patient's role performance, interpersonal relationships, friction, feelings and satisfaction in work, and social and leisure activities with the extended family, as a spouse, parent, and member of a family unit. Self-report results based on 76 depressed outpatients were comparable to those obtained from relatives as well as by a rater who interviewed the patient directly.

Depression↗
PubMed1976

Maintenance therapy of depression.

This paper summarises findings from a study of maintenance treatment in predominantly neurotic depressive responding to initial treatment with amitriptyline. Patients were continued on amitriptyline for eight months, withdrawn double-blind to placebo after two months, or withdrawn overtly to no medication, with and without individual psychotherapy from social workers in the factorial design. Continuation significantly reduced early relapse and symptom return, compared with either condition of early withdrawal. Psychotherapy improved social adjustment after eight months in patients who did not relapse, without any significant interactions. Side effects were minimal, except for carbohydrate craving. These findings suggest that tricyclic antidepressants should be routinely continued for several months after drug-induced remission.

Amitriptyline↗
PubMed1976

Utilization review, attempted suicide, and involuntary hospitalization.

A patient's refusal to participate in recommended treatment is a problem faced in all branches of medicine. However, psychiatry faces special problems because of its authority to impose hospitialization of suicide attempters, cases were identified where there was indepdent agreement between both the experts' standards and the treating resident psychiatrists that hospitalization was required. Despite this agreement, the patients were not hospitalized because the patients refused. By most criteria, these patients were a high risk group. They had made repeated suicide attempts, used lethal means which eventuated in serious medical consequences, and were still suicidal when referred for treatment. The emergency room psychiatrists reported feeling confused, anxious, and annoyed in dealing with these patients, and the patients signed out against medical advice. A review of these cases indicated that discussions of social control vs. medical responsibility and clear criteria for hospitalization should be incorporated into residency training programs since the emergency room resident faces these tension-producing issues frequently with several different types of patients. Moreover, utilization review criteria may help to set standards which will assist the psychiatrist in making these difficult decisions.

Adult↗
PubMed1976

Clinical depression among narcotic addicts maintained on methadone in the community.

In a study of 106 predominantly young, lower-social-class men participating in a methadone maintenance program, the authors found that about one-third were moderately to severely depressed as assessed on standard rating scales of depression. The depressive symptoms were associated with a decrease in social functioning, increase in stress in the past 6 months, and a history of alcohol abuse. Because the combination of depression and drug addiction creates a high risk for suicide, depressive symptoms require early detection and treatment. The authors point to the need for more research on treatment approaches, particularly the use of psychotropic drugs.

Adult↗
PubMed1976

Follow-up of depressed women after maintenance treatment.

The authors present follow-up results based on 150 women 1 year after maintenance treatment for depression. Maintenance treatment consisted of 8 months of amitriptyline, psychotherapy, or a combination of the two, administered by random assignment following recovery from an acute depressive episode. Approximately 30% of the patients remained in complete remission, 60% experienced recurrence of symptoms, and 12% remained mildly but chronically symptomatic. The implications of these findings for planning care for the ambulatory depressed patient on both an individual and a public health basis are discussed.

Amitriptyline↗
PubMed1976

Help-seeking in depressed out-patients following maintenance therapy.

This paper reports on the clinical status, help-seeking and subsequent treatment experiences of 150 women one year after they had completed out-patient maintenance treatment by amitriptyline and/or psychotherapy for a depressive episode. While the majority of patients were asymptomatic at follow-up, a substantial minority had a return of acute symptoms and 2 per cent made minor suicide attempts during the year. Admission to hospital was rare. However, only 30 per cent of the patients did not seek any treatment during the year and the majority received some psychotropic medication. The findings support the long-term need for prompt access to treatment by patients who have recovered from an acute depression.

Acute Disease↗
PubMed1975

The assessment of social adjustment. A review of techniques.

Interest in the community adjustment of psychiatric patients has led to the development of rating techniques for its evaluation. Selection of an appropriate scale for the task should include a review of its item content, anchor points, coverage, method of obtaining information, informant, psychometric properties, precision, cost, scoring, and instructional material. While no scale is without limitations, this report describes 15 currently available scales that meet many of the important criteria for assessing social adjustment and are sufficiently developed to be useful in evaluative research. This review also contains a list of pertinent references to the scales and guide to the literature on behavioral rating scales.

Adaptation, Psychological↗
PubMed1975

Wrist cutting. Relationship between clinical observations and epidemiological findings.

Reports of select samples have described suicide attempt by wrist cutting as a unique clinical syndrome occurring in young, single, attractive women, associated with specific psychological characteristics. A St. Louis study of a large unselected sample found that persons who cut their wrists were similar to other suicide attempters and were not more apt to be single females who made repeated attempts. These findings are repeated in a New Haven, Conn, study suggesting that reports of persons cutting their wrists should be reconsidered in light of these epidemiologic findings. Institutional differences in patient sampling can account for lack of agreement. While clinical observations are important, additional study through epidemiologic approaches is necessary before conclusions about new syndromes can be made. Current evidence on wrist cutting raises questions about the existence of a separate syndrome.

Adolescent↗
PubMed1975

Symptom patterns in depressed patients and depressed normals.

The availability of outpatient psychiatric treatment and community social support services has brought increasing numbers of persons with mild depressive symptoms to the attention of clinicians. However, little attention has been directed toward the study of these mild disturbances. A comparison of symptom patterns and clinical course is presented between clinically depressed psychiatric outpatients being treated with amitriptyline (depressed patients) and a group of unhappy and sad women not under psychiatric treatment but coming to a career guidance center (normal depressives). These data support the finding that normal depression is similar in degree to the mood disturbances of clinical depression but is not similar in symptom patterns. Normal depression is characterized by a relative absence of somatic complaints and somatic anxiety. The short term clinical course of drug-treated depressed patients and vocationally assisted unhappy women is quite similar in that both groups improve. This improvement is characterized by a reduction of most symptoms and of the central core of depressed mood. Further research is needed on the frequency, patterns, and course of these mild depressive states to determine their clinical importance and treatment indications.

Adolescent↗