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Biomedical subjects

M Strober

Publications and source records attributed to M Strober.

At least 55 records · Page 3Linked to original sources
PubMed1992

The pharmacotherapy of depressive illness in adolescence: II. Effects of lithium augmentation in nonresponders to imipramine.

The antidepressant value of lithium augmentation was assessed in a 3-week open trial involving 24 adolescents who remained highly depressed after 6 weeks of treatment with imipramine hydrochloride. Two patients responded dramatically during the first week, with an additional eight patients showing partial improvement during the 3-week trial. The overall magnitude of improvement in depression ratings was significantly greater than in an historical control group of nonresponders who continued to receive imipramine monotherapy during their hospital treatment. Results suggest the potential use of this adjunctive strategy in some tricyclic resistant adolescent depressives, although it appears less efficacious overall in this age group than in adults.

Adolescent↗
PubMed1992

Relevance of early age-of-onset in genetic studies of bipolar affective disorder.

Early age-of-onset appears to predict higher familial loading in bipolar affective disorder. This finding, coupled with ongoing attention to the importance of genomic heterogeneity for segregation and linkage analyses, underscores the value of research on juvenile samples. This research is reviewed, and implications for future research on genetic classification of bipolar illness are noted.

Bipolar Disorder↗
PubMed1991

Pituitary-adrenal-immune system in normal subjects and in patients with anorexia nervosa: the number of circulating helper T lymphocytes (CD4) expressing the homing receptor Leu8 is regulated in part by pituitary-adrenal products.

The association between plasma pituitary-adrenal (PA) hormones and the number of certain populations of peripheral blood lymphocytes (PBL) was examined in subjects with normal PA function and in patients with anorexia nervosa (AN). AN patients display several neuroendocrine dysfunctions, including hypercortisolemia. In the normal subjects there were positive correlations between adrenocorticotropic hormone (ACTH) and the number of PBL and helper T lymphocytes expressing the homing receptor Leu8 (CD4+Leu8+); there was a negative relationship between cortisol and these lymphocyte populations. These latter, inverse correlations did not occur in the AN patients, either while underweight or after weight recovery, with some persistence of hypercortisolemia. Administration of dexamethasone (DEX) suppressed cortisol levels and reduced, perhaps via a receptor-mediated mechanism, the number of circulating PBL and CD4+Leu8+ in the normal subjects but not in the AN patients. These results support the physiological relevance of PA-CMI interaction in subjects with normal PA function and indicate that the PA-CMI interrelationship is disrupted in AN patients with hypercortisolemia.

Adrenocorticotropic Hormone↗
PubMed1991

Family-genetic studies of eating disorders.

The possible contribution of genetic factors to the etiology of anorexia nervosa and bulimia nervosa is a question of mounting interest. Empirical studies are few in number, yet there is suggestive evidence of familial aggregation. The existing literature is reviewed and methodological problems are highlighted. It is suggested that predisposing elements are best accounted for by genetically transmitted dispositional traits, especially as are observed in the background of individuals with anorexia nervosa.

Anorexia Nervosa↗
PubMed1990

Relapse following discontinuation of lithium maintenance therapy in adolescents with bipolar I illness: a naturalistic study.

The authors conducted an 18-month naturalistic prospective follow-up study of 37 adolescents whose bipolar I illness had been stabilized with lithium carbonate during inpatient hospitalization. Thirteen of the patients discontinued prophylactic lithium therapy shortly after discharge. The relapse rate of bipolar illness in these 13 patients was nearly three times higher than the rate in patients who continued lithium prophylaxis without interruption. Early relapse among lithium-treated patients was associated with a greater risk of relapsing again. The authors discuss the theoretical and clinical implications of these findings.

Adolescent↗
PubMed1990

The pharmacotherapy of depressive illness in adolescence: I. An open label trial of imipramine.

The efficacy of imipramine hydrochloride (IMI) for adolescents with major depressive illness meeting Research Diagnostic Criteria (RDC) and DSM-III criteria was assessed in an open-label trial of 35 inpatients. Patients were treated for 6 weeks up to a target dosage of 5 mg/kg/day and assessed weekly by the Hamilton Rating Scale for Depression (HAM-D) and Clinical Global Impressions Improvement scale (CGI). A total of 34 patients in the sample completed the trial, 28 achieving the full target dosage (mean = 222 mg; mean IMI plus desmethylimipramine (DMI) plasma level = 237 ng/ml). Among 24 nondelusional patients, only one third were considered responders based on pattern analysis of the time of onset and persistence of symptom reduction. Among 10 delusional patients, the response rate was 10 percent. Although total IMI plus DMI plasma level did not differ between responders and nonresponders, no responder had a level below 180 ng/ml. In univariate linear regression analysis, no single variable was predictive of response status at 6 weeks. These findings underscore the importance of a comprehensive study of the potency of antidepressant compounds in adolescents and the need for further investigation of psychobiological process mediating drug effects.

Adolescent↗
PubMed1988

Correlates of psychopathology in adolescents.

The authors examined the relationship among measures of self-perception and the family environment for both general psychopathology and diagnostic clusters. The subject pool was a community sample of adolescents. The findings emphasize the relationship of the home environment to the presence of general psychopathology and specific diagnoses.

Adolescent↗
PubMed1988

Coronary dissection following chest trauma with systemic emboli.

Coronary artery dissection is a rare entity which occurs following blunt chest trauma, during coronary angiography and coronary bypass surgery, and spontaneously in the peripartum period. We report a young man who presented with recurrent systemic emboli following an asymptomatic anterior wall myocardial infarction associated with dissection of the LAD and mural thrombus three years earlier after sustaining blunt chest trauma.

Adult↗
PubMed1986

Methylphenidate-induced mania in a prepubertal child.

A case of methylphenidate-induced mania is described in a 10-year-old boy with severe hyperactivity and a positive family history for bipolar illness. Similarities between symptoms manifested in this patient and developmental disturbances observed in young offspring of affectively ill parents are discussed. Although the predictive relationship between early childhood psychopathology and later emergence of manic-depressive illness remains unknown, caution is suggested when using psychostimulant medications in children with familial affective disorders.

Attention Deficit Disorder with Hyperactivity↗
PubMed1985

A controlled family study of anorexia nervosa.

A family study of eating disorders in first and second-degree relatives of anorexia nervosa and nonanorexic psychiatrically ill control probands found increased rates of anorexia-nervosa, bulimia nervosa, and subclinical anorexia nervosa in relatives of anorexic probands. The pattern of familial clustering suggests that these disorders may represent variable expressions of a common underlying psychopathology, although restricter and bulimic subforms of eating disorder may segregate within families. Implications of these findings for understanding factors important to the pathogenesis and subclassification of eating disorders are discussed.

Adolescent↗
PubMed1982

Bipolar illness in adolescents with major depression: clinical, genetic, and psychopharmacologic predictors in a three- to four-year prospective follow-up investigation.

Sixty adolescents, aged 13 to 16 years, hospitalized for major depression were studied prospectively, for three to four years to determine the utility of clinical, genetic, and pharmacologic response variables in predicting a bipolar course of illness. Bipolar outcome was observed in 20% of the cohort. Statistical analyses showed that bipolarity was predicted by (1) a depressive symptom cluster comprising rapid symptom onset, psychomotor retardation, and mood-congruent psychotic features; (2) a "loading" of affective disorder in the family pedigree, a family history of bipolar illness, and the presence of illness in three successive generations of the pedigree; and (3) pharmacologically induced hypomania. All predictors were shown to have high specificity for bipolar outcome, whereas pharmacologic hypomania and symptom cluster permitted the highest confidence of prediction, 100% and 80%, respectively. Even in juvenile depression, careful attention to clinical and biologic variables may aid in the predictive differentiation of meaningful diagnostic subtypes.

Adolescent↗
PubMed1982

Locus of control, psychopathology, and weight gain in juvenile anorexia nervosa.

Based on a hypothesized disturbance in personal control and efficacy in anorexia nervosa, locus of control score in female adolescents with anorexia nervosa was compared to scores obtained from depressed and conduct disorder controls, and to adolescent female standardization norms. Results indicated that (a) as a group, anorectics were significantly more internal than each of the controls; (b) anorectics scoring in a more external direction showed greater denial of illness, fear of weight change, impulse dyscontrol, rigidity of self-imposed controls, use of purgatives and diuretics, and body-image distortion; and (c) more internal anorectics evidenced more rapid weight gain during treatment. Findings were discussed in terms of the psychopathology of anorexia nervosa and the empirical literature relating locus of control to personality functioning and symptom alleviation.

Adolescent↗
PubMed1982

Anxiety and depressive disorders in psychiatrically disturbed children.

Of 102 systematically interviewed children, age 7 to 17 years, 28 met DSM-III criteria for depressive disorders and 14 for anxiety disorders. Because the adult psychiatric literature suggests overlapping symptomatology between these disorders, depressive and anxiety symptoms were compared in these groups of children. Depressed children, like depressed adults, reported many anxiety symptoms. However, anxious children, unlike their adult counterparts, never reported panic attacks and complained much less often of depressive symptoms. In contrast to adults with anxiety disorders, no child met criteria for a secondary depression. Longitudinal studies and validation measures for diagnoses of anxiety and depressive disorders are necessary for more definitive conclusions. This study suggests that there are more similarities between childhood and adult depressive disorders than anxiety disorders.

Adolescent↗
PubMed1981

Reliability of psychiatric diagnosis in hospitalized adolescents. Interrater agreement using DSM-III.

To determine the reliability of psychiatric diagnosis in hospitalized adolescents, 95 consecutively admitted patients were diagnosed independently by two experienced clinicians using DSM-III criteria. Diagnostic judgments were based on joint interview of the patient via a structured mental-status examination, nursing observations, and referral materials. Concordance was analyzed by the kappa coefficient. A total of 13 DSM-III categories were used to classify this cohort, with the majority of categories representing traditional syndromes of functional psychopathology. There was complete agreement between the raters for more than three fourths of the patients. Levels of agreement for the categories of schizophrenia and major affective disorder were similar to values obtained in recent studies of adult patients. The results are discussed in relation to historical conceptions of adolescent psychopathology.

Adolescent↗
PubMed1981

Ego boundary disturbance in juvenile anorexia nervosa.

Tested the hypothesis that ego boundary disturbance is present in adolescent females with anorexia nervosa. Twenty anorexics were compared to 20 female depressed controls on Rorschach scales designed to measure theoretically relevant aspects of boundary impairment. Results showed that anorexics scored higher on scales that measure inner-outer and conceptual boundary disturbance and produced significantly more responses that emphasized the solidity of object boundaries. Boundary scores were unrelated to degree of weight loss and global symptom severity, and follow-up testing after normal weight was restored revealed little change from initial levels. These findings are discussed in relation to current theory on the role of developmental ego pathology in the origins and phenomenology of anorexia nervosa.

Adolescent↗