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Biomedical subjects

O Lingjaerde

Publications and source records attributed to O Lingjaerde.

At least 37 records · Page 2Linked to original sources

Thyroid function in seasonal affective disorder.

Morning serum levels of triiodothyronine (T3), free thyroxine (F-T4) and thyroid-stimulating hormone (TSH) were measured in Winter-Seasonal Affective Disorder patients in nondepressed state in summer and before and after light treatment in winter. Practically all patients had hormone levels well within the reference ranges. T3 and F-T4, but not TSH, were significantly higher in winter than in summer; this is considered a normal phenomenon. There was no significant correlation between hormone levels and severity of winter depression. Light treatment did not alter serum hormone levels.

Adult↗

A double-blind comparison of moclobemide and doxepin in depressed general practice patients.

A total of 56 patients attending a general practitioner for treatment of depression, most of whom met the criteria for major depression, were included in this double-blind, parallel group, 6-week study, in which the selective MAO-A inhibitor moclobemide (MOC; maximum dose 600 mg) was compared with the tricyclic antidepressant doxepin (DOX; maximum dose 250 mg). Thirty patients on MOC and 23 on DOX were assessed after treatment for at least 1 week and are included in the response evaluation. Improvement was assessed primarily with the Montgomery-Asberg Depression Rating Scale (MADRS). There were only 4 drop-outs in the MOC group and three in the DOX group after 1 week. Overall improvement measures showed a nonsignificant difference in favor of DOX. Two factors were found to have prognostic significance: (1) previous or present panic attacks (10 patients in the MOC group and--by chance--only one in the DOX group) were associated with significantly lower improvement within the MOC group. Since we had no a priori hypothesis about this effect, it could be a chance finding. (2) Improvement was negatively correlated with age; this was statistically significant in the total group as well as in the MOC group, with a nonsignificant trend in the same direction in the DOX group. Side effects differed little between the two groups; only dryness of mouth appeared with markedly higher frequency in the DOX group.

Antidepressive Agents↗

Personality disorders in patients with winter depression.

Sixty-six patients satisfying the criteria for seasonal affective disorder (SAD) winter depression type (n = 57) or subsyndromal SAD (n = 9), were interviewed in a nondepressed state with the Structured Interview for DSM-III-R Personality Disorders (SIDP-R). Twenty-three percent of the patients in the SAD sample met DSM-III-R criteria for one or more categorical diagnosis of personality disorder (PD). Disorders in cluster C occurred in 18% of the sample, while 12% had cluster B PDs and 5% a cluster A disorder. The relative number of positive criteria, as a dimensional measure of PD, were higher for all cluster C disorders than for any PD in the other clusters. Our data indicate that the pattern of personality disorders in patients with winter SAD are similar to that previously reported for outpatients with non-SAD major depression. We explored the relationship between lifetime severity and clinical manifestation of SAD and dimensional measures of PD with multiple regression analyses. No significant association was found. This is in accordance with the hypothesis that the two disorders are distinct conditions with independent causes.

Adult↗

New perspectives on biological treatment of schizophrenia.

Recent research seems to indicate that many schizophrenics suffer from a defective brain development, which is reflected by basic disturbances in cognitive, information-processing, volitional and emotional functions. Positive symptoms like hallucinations and delusions may be secondary to the more basic disturbances. Varying degrees of defective brain development places a ceiling on the functional improvement that can be obtained in this illness. However, whereas positive symptoms usually respond best to neuroleptics, even negative symptoms can be improved, for instance by clozapine. To obtain such improvement, it seems necessary, in addition to blocking dopamine D2 receptors, to influence other receptor systems, as for instance serotonergic 5HT-2 and possibly dopaminergic D1 and/or D4 receptors. Stimulation of glutamatergic NMDA receptors also seems to be a promising possibility.

Antipsychotic Agents↗

Characteristics of winter depression in the Oslo area (60 degrees N).

This is the first comprehensive description of winter depression (WD), as part of seasonal affective disorder (SAD), from Norway, and one of the very few from so far north. A total of 128 media-recruited people had first been screened with the Seasonal Pattern Assessment Questionnaire and were thereafter personally interviewed. The criteria for DSM-III-R mood disorder, seasonal pattern, were satisfied by 85%, whereas 73% satisfied the criteria of Rosenthal et al. for SAD. Seven percent were diagnosed as subsyndromal SAD. The main characteristics of our patient group were in reasonable accordance with other clinical SAD materials: there were 81% women; the mean age was 44 years (range: 20 to 76); the mean age for SAD debut was 24 years (range: 4 to 71); and the duration of WD was most often from October to March or April. Only 12% had ever been manic or hypomanic in summer. During their WD, most patients suffered at least one of the symptoms hypersomnia, hyperphagia or carbohydrate craving; 16% also had a craving for fatty food in winter, but this may be considered "normal" at this northerly latitude.

Adult↗

Treatment of winter depression in Norway. I. Short- and long-term effects of 1500-lux white light for 6 days.

Patients with seasonal affective disorder (winter depression) from the Oslo area (at about 60 degrees N) recruited through mass media advertising were treated with 1500-lx white full-spectrum light for 2 h in the morning for 6 days. Their clinical state was assessed at baseline and 1, 3, 6, 10 and 14 weeks after commencement of treatment with an extended version of Montgomery-Asberg Depression Rating Scale (MADRS) and Clinical Global Impression. Forty patients (35 women, 5 men, age range 24 to 64 years) completed 1 week of light treatment. A subgroup of 9 patients received light in addition to ongoing drug treatment. The mean reduction in total extended MADRS score at week 1 was 48% in patients receiving only light and 56% in patients receiving light in addition to drugs. In spite of the low dose of light given, this is comparable to other reported results using light treatment for winter depression. In contrast to most other studies, however, the improvement at week 1 was maintained for the rest of the season in most patients. Only 5 patients were given another light treatment course, and another 5 were switched to drug treatment due to their unsatisfactory response to light treatment.

Adult↗

Treatment of winter depression in Norway. II. A comparison of the selective monoamine oxidase A inhibitor moclobemide and placebo.

Thirty-four patients with seasonal affective disorder, winter depression type (WD) were randomly distributed to receive the selective monoamine oxidase-A inhibitor moclobemide (400 mg daily) or placebo in a double-blind, parallel group study lasting for up to 14 weeks. Severity measures were the Montgomery-Asberg Depression Rating Scale (MADRS) extended with characteristic symptoms of WD; summed score of the "atypical" symptoms hypersomnia, hyperphagia and carbohydrate craving; and Clinical Global Impressions (CGI). After 3 weeks, patients with unsatisfactory response were switched to open moclobemide. Three patients on placebo dropped out before 3 weeks. Extended MADRS and CGI showed no significant difference between the groups at 3 weeks, whereas the atypical score was reduced significantly more on moclobemide than on placebo already after one week. Nonresponders after 3 weeks (9 of 16 on moclobemide and 7 of 15 on placebo) improved rapidly after being given open moclobemide. Predictor analysis showed a remarkably high negative correlation between improvement at 3 weeks (extended MADRS) and age in the placebo group and a strong, nonsignificant trend in the same direction in the moclobemide group. Dichotomizing the patients according to the median age (45 years) resulted in a somewhat better effect of moclobemide than placebo in the older age group. There were no significant differences in side effects between moclobemide and placebo.

Adult↗

Risperidone versus perphenazine in the treatment of chronic schizophrenic patients with acute exacerbations.

Risperidone (RIS), a new neuroleptic with 5-HT2- and dopamine D2 receptor-blocking properties, was compared with perphenazine (PER) in a double-blind, multicentre, parallel-group study in 107 chronic schizophrenics with acute exacerbation. RIS 5-15 mg or PER 16-48 mg daily was given for 8 weeks. Psychopathology was assessed with the Positive and Negative Syndrome Scale (PANSS) and Clinical Global Impression. Seventy-eight patients completed the trial; there was an equal number of dropouts on both drugs. The mean daily dose at endpoint was 8.5 mg RIS and 28 mg PER. The reduction in total PANSS score to endpoint did not differ significantly, although there was a tendency in favour of RIS. The number of patients with predominantly negative symptoms who showed at least 20% reduction in total PANSS score was significantly larger in the RIS group. Furthermore, the number of patients showing at least 20% reduction in Brief Psychiatric Rating Scale (BPRS) score (BPRS being a subscale of PANSS) was significantly larger in the RIS group. The hostility cluster of BPRS improved more on RIS than on PER in the endpoint analysis. The overall prevalence of side effects was fairly similar in the two groups.

Acute Disease↗

[Drug therapy of depression in general practice].

The authors advocate use of the Montgomery-Asberg Depression Rating Scale in general practice as a screening instrument for depression. A score of 20 and above for more than two weeks indicates a need for treatment with antidepressant drugs. The treatment should continue with full dosage for at least two months after the patient has been cured. In order to maintain the patient's quality of life, reduce risk of drug-related toxicity and improve compliance, we recommend alfa-2-receptor blocker, a selective 5HT-re-uptake inhibitor or a selective monoamino-oxidase A inhibitor as the first drug choice for treatment of depression by general practitioners. Monitoring serum levels of the drug may be helpful, especially in persons who do not respond to treatment.

Antidepressive Agents↗

Benzodiazepines in the treatment of schizophrenia: an updated survey.

Reports on the effects of benzodiazepines in schizophrenia have appeared since the early 1960s. Conclusions drawn from these studies, most of which have been uncontrolled, have ranged from worse than placebo to better than neuroleptics. A critical appraisal of the literature seems to warrant the following main conclusions. Benzodiazepines alone, in conventional doses, have no convincing antipsychotic effect in schizophrenia, although they may reduce anxiety, tension and insomnia. However, very high doses of diazepam, and possibly other benzodiazepines, may have a symptomatic antipsychotic effect, especially in paranoid-hallucinatory schizophrenics, also when given alone. Benzodiazepines, in conventional doses, can enhance the antipsychotic effect of neuroleptics in schizophrenics who have not responded satisfactorily to neuroleptics alone. This effect may be most conspicuous against hallucinations, but improvement may also be obtained from delusions, thought disturbances, some negative symptoms, anxiety and tension. Some benzodiazepines may be more effective than others in schizophrenia, but this has been insufficiently elucidated.

Anti-Anxiety Agents↗

[Schizophrenic patients and the emotional climate in the family. Causes, consequences and treatment of intensely expressed emotions of close relatives].

In recent years it has been shown that the course of schizophrenia is influenced by the attitudes and behaviour of the close relatives with whom the schizophrenic person lives. In particular, there is greater risk of relapse if family members show a high degree of criticism, hostility, or emotional over-involvement in relation to the schizophrenic; these attitudes have been described as high expressed emotion (High EE) and are usually assessed by means of the Camberwell family interview. However, as discussed in this paper, there are still many unsettled questions regarding content, validity, causes, effects, and treatment of High EE.

Attitude to Health↗