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Biomedical subjects

P H Soloff

Publications and source records attributed to P H Soloff.

At least 37 records · Page 2Linked to original sources
PubMed1988

The amphetamine challenge test in patients with borderline disorder.

The authors used amphetamine as a psychopharmacological probe to investigate the hypothesis that patients with borderline personality disorder are prone to psychosis following ingestion of a dopamine agonist. Sixteen patients with borderline personality disorder participated in the study. Significant increases in the mean total Brief Psychiatric Rating Scale scores and in activation and thought disturbance factors after amphetamine administration were noted in the sample. Patients with diagnoses of both schizotypal and borderline personality disorders worsened transiently with amphetamine administration, but patients with only the borderline diagnosis improved. These results indicate the usefulness of pharmacological probes to further understand DSM-III axis II disorders.

Acute Disease↗
PubMed1987

Sexual practices among patients with borderline personality disorder.

The authors found that 12 (57%) of 21 consecutive male patients with borderline personality disorder who presented for psychiatric treatment at two distant geographic sites were homosexual. They then obtained the sexual histories of 80 patients who met standardized criteria for borderline disorder and found that 17 (21%) of these patients were homosexual, four (5%) were bisexual, and nine (11%) had diagnoses of paraphilias. Ten (53%) of the 19 men with borderline disorder were homosexual, compared with seven (11%) of the 61 women. Homosexuality was 10 times more common among the men and six times more common among the women with borderline personality disorder than in the general population or in a depressed control group.

Adult↗
PubMed1987

Neuroleptic treatment in the borderline patient: advantages and techniques.

A low-dose neuroleptic strategy is indicated in borderline personality disorder as an acute treatment for symptoms of anger, hostility and suspiciousness, referential thinking and paranoid ideation, anxiety and dissociation, depressed mood, and related behavioral dyscontrol. Medication effects are clinically significant although modest in magnitude. Recommended duration of treatment is generally brief (3-12 weeks), although continued pharmacotherapy may be warranted in selected cases. The risks of treatment include the well-recognized side effects of neuroleptics (minimized by low doses) and the possibility of abuse, overdose, or interaction with alcohol or street drugs. Pharmacotherapy is seen as an adjunct to supportive psychosocial intervention.

Antipsychotic Agents↗
PubMed1987

Characterizing depression in borderline patients.

The comorbidity of depression and borderline disorder was studied in 39 symptomatic borderline inpatients defined by the Diagnostic Interview for Borderlines using three independent methods for assessing depression and three definitions of depression. Evaluations were conducted by the Schedule for Affective Disorders and Schizophrenia interviews for Research Diagnostic Criteria (RDC) depressive disorders, by clinical ratings for atypical depressive disorder, and by self-rated questionnaires for hysteroid dysphoria. Diagnoses of an RDC depression were made in 25 (64.1%), atypical depressive disorder in 16 (41%), and hysteroid dysphoria in 25 (64.1%) of the borderline patients. Two depressive diagnoses were present in 64.1% of patients, while 17.9% of patients met criteria for all three depressive disorders. No one method accurately characterized depression in borderline patients.

Adult↗
PubMed1986

Progress in pharmacotherapy of borderline disorders. A double-blind study of amitriptyline, haloperidol, and placebo.

In symptomatic patients with borderline disorder, we conducted a double-blind, placebo-controlled trial of haloperidol and amitriptyline hydrochloride to test the differential efficacy of medication against the affective and schizotypal symptoms that characterize the disorder. Sixty-one patients, diagnosed by the Diagnostic Interview for Borderline of Gunderson et al, completed randomized trials of haloperidol (n = 21), amitriptyline (n = 20), and placebo (n = 20). Medications were given in dose ranges of 4 to 16 mg for haloperidol (mean, 7.24 mg) and 100 to 175 mg for amitriptyline hydrochloride (mean, 147.62 mg) for five-week periods, with weekly self-rated and observer-rated measures of mood, schizotypal symptoms, and global functioning. Haloperidol was superior to both amitriptyline and placebo on a composite measure of overall symptom severity, with no difference between amitriptyline and placebo. Haloperidol produced significant improvement on a broad spectrum of symptom patterns, including depression, anxiety, hostility, paranoid ideation, and psychoticism. In contrast, amitriptyline was minimally effective, with small gains limited to some areas of depressive content. The magnitude of change tended to be modest and was more apparent in self-rated than observer-rated measures.

Adolescent↗
PubMed1986

Paradoxical effects of amitriptyline on borderline patients.

A paradoxical increase in suicide threats, paranoid ideation, and demanding and assaultive behavior occurred among 15 borderline inpatients receiving amitriptyline in a double-blind study. This pattern differed significantly from that of 14 nonresponding patients receiving placebo.

Aggression↗
PubMed1986

Schizotypal symptoms in patients with borderline personality disorders.

The authors assessed the frequency of schizotypal symptoms in 48 criteria-defined borderline patients. In the total sample schizotypal symptoms were surprisingly common; the average patient had more than seven symptoms and every patient at least one. Even in the "pure" DSM-III borderline subgroup, 67% of the patients had perceptual symptoms, 92% had cognitive symptoms, and 87% reported other "affective" symptoms. Visual phenomena were more prevalent than auditory ones, suggesting a possible contributing role for organic factors in borderline disorders. The results also indicate a close link between borderline and schizotypal personality disorders.

Adult↗
PubMed1986

The pharmacological treatment of delusional depression: Part II.

This study investigated the pharmacological treatment of delusional depressives by assigning patients on a random double-blind basis to amitriptyline (AT) alone, perphenazine (PER) alone, or AT + PER. As reported in an earlier paper, the combination of AT + PER was the superior treatment with a response rate of 78% compared with 41% for AT alone and 19% for PER alone. This difference is both clinically and statistically significant (p less than 0.01). In this second article, the authors report that the patients on AT + PER had higher plasma levels of AT and its pharmacologically active metabolite nortriptyline (NT) than the patients on AT alone. Although the response rate had a direct relationship to AT + NT plasma levels, an analysis of variance showed that the group of patients treated with AT + PER still had a significantly higher response rate, even after controlling for the plasma levels of AT + NT (p less than 0.05). There was also a correlation between PER plasma levels and clinical response.

Amitriptyline↗
PubMed1985

Depression in borderline patients: a prospective EEG sleep study.

The relationship between borderline personality disorder and primary major depression was studied prospectively using Schedule for Affective Disorders and Schizophrenia-Lifetime Version (SADS-L) interviews and electroencephalographic (EEG) sleep studies. Ten consecutively admitted borderline patients (a prospective sample), defined by Gunderson's Diagnostic Interview for Borderlines (DIB), underwent EEG sleep studies on two consecutive nights and were compared to previously reported samples of nonborderline depressed patients (defined by Research Diagnostic Criteria; RDC), normal controls, and DIB-defined borderline patients who had been referred "to rule out major depression" (a retrospective sample). EEG sleep data were analyzed visually and by automated techniques. Rapid eye movement (REM) latency values were similar in depressed and both borderline groups but significantly different from controls. Eighty-five percent of REM latency values in RDC major depressives were less than or equal to 65 minutes, compared to similar rates of 75% in the prospective sample of borderline patients and 65% in the retrospective sample, versus 35% for controls (chi 2 = 10.7, p less than 0.005). The REM latency in borderline patients did not vary with the severity of depression as measured by the Hamilton Rating Scale for Depression. In the prospective borderline sample, the major SADS-L diagnoses were chronic intermittent depression (five), current major depression (four) (two unipolar, two bipolar II), and labile personality (one). A convergence of nosologic and EEG sleep data is suggested, and supports the concept of a close relationship between criteria-defined borderline personality disorder and affective illness.

Adolescent↗
PubMed1985

The pharmacological treatment of delusional depression.

The authors investigated the pharmacological treatment of delusional depression by assigning patients on a random double-blind basis to amitriptyline alone, perphenazine alone, or a combination of the two. Fourteen (78%) of the 18 patients assigned to amitriptyline plus perphenazine were responders, compared with seven (41%) of 17 patients treated with amitriptyline alone and three (19%) of the 16 patients treated with perphenazine alone. The combination of amitriptyline and perphenazine was clearly superior (p less than .01).

Adolescent↗
PubMed1985

Seclusion and restraint in 1985: a review and update.

The 1982 Supreme Court decision in Youngberg v. Romeo gave mental health professionals flexibility to exercise professional judgment in using seclusion to control violent patients, and also suggested that seclusion and restraint might be used when patients exhibit disruptive behavior that may lead to violence. The authors reviewed 13 studies of seclusion and restraint in adult inpatient psychiatric settings to define indications for use. They found that seclusion and restraint practices varied widely depending on the population served and the philosophical orientation of the hospital staff, and were more often used to contain behavior that might lead to violence rather than to control violent behavior itself. They conclude that there is overwhelming empirical support for using seclusion and restraint to limit the progression of disruptive behavior to actual violence, but that the decision to do so should be based on sound clinical judgment.

Dangerous Behavior↗