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Biomedical subjects

P Rohde

Publications and source records attributed to P Rohde.

At least 37 records · Page 2Linked to original sources
PubMed1999

Level of current and past adolescent cigarette smoking as predictors of future substance use disorders in young adulthood.

AIMS: This study examined the impact of adolescent cigarette smoking (life-time use, recency, frequency and age of onset) on the occurrence of substance use disorders during young adulthood. DESIGN: Participants were assessed while in high school (T1), approximately 1 year later (T2) and then after they had turned 24 years of age (T3). SETTING: Adolescents were randomly selected at T1 from nine senior high schools in western Oregon. PARTICIPANTS: A subset (n = 684) of 1709 adolescents who had been assessed regarding cigarette smoking during high school were evaluated for alcohol, cannabis and other drug abuse/dependence up to age 24. MEASUREMENTS: Semi-structured interviews provided information regarding life-time use of cigarettes and chewing tobacco, age of smoking onset, frequency and quantity of cigarette smoking and quit efforts in adolescence. Diagnoses of substance abuse and dependence in young adulthood were made as per DSM-IV. FINDINGS: Life-time smoking among older adolescents significantly increased the probability of future alcohol, cannabis, hard drug and multiple drug use disorders during young adulthood. Having been a former smoker did not reduce the risk of future substance use disorder, although having maintained smoking cessation for more than 12 months was associated with significantly lower rates of future alcohol use disorder. Daily smoking was associated with increased risk of future cannabis, hard drug and multiple drug use disorders. Among daily smokers, earlier smoking onset age predicted future substance use disorders. CONCLUSIONS: The results extend knowledge about relationships between cigarette smoking during adolescence and the development of substance use disorders during young adulthood, illustrating additional risks associated with early cigarette smoking. Future research is needed to examine potential causal associations.

Adolescent↗
PubMed1999

Natural course of adolescent major depressive disorder: I. Continuity into young adulthood.

OBJECTIVE: To examine the course of adolescent major depressive disorder (MDD) by comparing rates of mood and non-mood disorders between age 19 and 24 years in participants with a history of adolescent MDD versus participants with adolescent adjustment disorder with depressed mood, nonaffective disorder, and no disorder. METHOD: Participants from a large community sample who had been interviewed twice during adolescence completed a third interview assessing Axis I psychopathology and antisocial and borderline personality disorders after their 24th birthday: 261 participants with MDD, 73 with adjustment disorder, 133 with nonaffective disorder, and 272 with no disorder through age 18. RESULTS: MDD in young adulthood was significantly more common in the adolescent MDD group than the nonaffective and no disorder groups (average annual rate of MDD = 9.0%, 5.6%, and 3.7%, respectively). Adolescents with MDD also had a high rate of nonaffective disorders in young adulthood (annual nonaffective disorder rate = 6.6%) but did not differ from adolescents with nonaffective disorder (7.2%). Prevalence rates of dysthymia and bipolar disorder were low (< 1%). Adolescents with adjustment disorder exhibited similar rates of MDD and nonaffective disorders in young adulthood as adolescents with MDD. CONCLUSIONS: This study documents the significant continuity of MDD from adolescence to young adulthood. Public health implications of the findings are discussed.

Adolescent↗
PubMed1999

Cognitive-behavioral treatment of adolescent depression: efficacy of acute group treatment and booster sessions.

OBJECTIVE: This trial examined the effects of both acute and maintenance cognitive-behavioral therapy (CBT) for depressed adolescents. METHOD: Adolescents with major depression or dysthymia (N = 123) were randomly assigned to 1 of 3 eight-week acute conditions: adolescent group CBT (16 two-hour sessions); adolescent group CBT with a separate parent group; or waitlist control. Subsequently, participants completing the acute CBT groups were randomly reassigned to 1 of 3 conditions for the 24-month follow-up period: assessments every 4 months with booster sessions; assessments only every 4 months; or assessments only every 12 months. RESULTS: Acute CBT groups yielded higher depression recovery rates (66.7%) than the waitlist (48.1%), and greater reduction in self-reported depression. Outcomes for the adolescent-only and adolescent + parent conditions were not significantly different. Rates of recurrence during the 2-year follow-up were lower than found with treated adult depression. The booster sessions did not reduce the rate of recurrence in the follow-up period but appeared to accelerate recovery among participants who were still depressed at the end of the acute phase. CONCLUSIONS: The findings, which replicate and expand upon a previous study, support the growing evidence that CBT is an effective intervention for adolescent depression.

Adolescent↗
PubMed1999

Molecular detection of prostate cells in ejaculate and urethral washings in men with suspected prostate cancer.

PURPOSE: To determine whether prostatic cells were normally present in ejaculate and if the sensitivity and specificity of the detection of malignant prostate cells in ejaculate and urethral washings from men with suspected prostate cancer could be improved using the more sensitive molecular technique of reverse transcriptase-polymerase chain reaction (RT-PCR). MATERIALS AND METHODS: RT-PCR for prostate-specific antigen (PSA), prostate-specific membrane antigen (PSM) and Apoliprotein D (3 putative prostate-specific and/or cancer-specific markers) was performed on RNA extracts of ejaculate (80) and urethral washings (52) from 77 men with suspected prostate cancer and 12 young controls (<30 years of age) and urines from 5 men who had radical prostatectomies and 10 women. RESULTS: PSA, PSM and Apolipoprotein D expression was detected in ejaculates and urethral washings from both patient and control groups. No differences were observed in the results obtained for 58 men with suspected or 19 men with confirmed prostate cancer or the 18 vasectomized men within the patient group. Urines from the 5 men who had radical prostatectomies and 10 women were all negative for PSA, but PSM was detected in 2 female urines and in 3 radical prostatectomy samples. As few as 10 LNCaP prostate tumor cells could be detected by PSA RT-PCR when added to female urine. CONCLUSION: We have established a sensitive method of detecting prostatic cells in ejaculate and urethral washings and shown that PSA RT-PCR is a reliable indicator of prostate cells in these samples. However, RT-PCR for PSA, PSM and Apoliprotein D were not useful for discriminating malignant from non-malignant prostate cells.

Adult↗
PubMed1998

Treatment of adolescent depression: frequency of services and impact on functioning in young adulthood.

In this report, we (a) present descriptive information about the extent and the kinds of treatments being provided to depressed adolescents; (b) identify the factors that are related to treatment utilization; and (c) examine whether the provision of treatment during adolescence reduced the risk for the occurrence of depression during young adulthood (19-24 years). The sample consisted of 1,507 randomly selected high school students who were diagnostically assessed on two occasions with an interval of approximately one year; 627 were assessed a third time when they reached the age of 24. The findings may be summarized as follows: 60.7% of those with major depressive disorder were provided with treatment. The modal treatment was outpatient, individual psychotherapy administered by a mental health provider. Inpatient treatment and medications were rare. Factors found to be related to treatment utilization were the severity of the depression, the existence of a comorbid nonaffective disorder, the number of previous episodes of depression, history of suicide attempt, academic problems, lack of intact family, and female gender. Unexpectedly, those who had received treatment were not less likely to relapse into another episode of depression during young adulthood.

Adolescent↗
PubMed1998

Major depressive disorder in older adolescents: prevalence, risk factors, and clinical implications.

In this article we summarize our current understanding of depression in older (14-18 years old) adolescents based on our program of research (the Oregon Adolescent Depression Project). Specifically, we address the following factors regarding adolescent depression: (a) phenomenology (e.g., occurrence of specific symptoms, gender and age effects, community versus clinic samples); (b) epidemiology (e.g., prevalence, incidence, duration, onset age); (c) comorbidity with other mental and physical disorders; (d) psychosocial characteristics associated with being, becoming, and having been depressed; (e) recommended methods of assessment and screening; and (f) the efficacy of a treatment intervention developed for adolescent depression, the Adolescent Coping With Depression course. We conclude by providing a set of summary statements and recommendations for clinicians.

Adaptation, Psychological↗
PubMed1997

Regression of gastric MALT lymphoma after eradication of Helicobacter pylori is predicted by endosonographic staging. MALT Lymphoma Study Group.

BACKGROUND & AIMS: Recent studies suggest that eradication of Helicobacter pylori may result in complete regression of low-grade lymphoma of the gastric mucosa-associated lymphoid tissue (MALT). Which patients benefit from this treatment is unknown. The aim of this study was to prospectively study whether staging by echoendoscopy predicts the outcome of treatment of MALT lymphoma by eradication of H. pylori. METHODS: Twenty-two patients positive for H. pylori with low-grade gastric B-cell MALT lymphoma were examined by echoendoscopy at the time of diagnosis. Treatment for H. pylori consisted of a 2-week course of oral omeprazole and amoxicillin. Patients were followed up by endoscopy and biopsy. RESULTS: H. pylori was eradicated in all patients. Complete regression of MALT lymphoma was observed in 12 patients (54%), partial regression in 5 patients (23%), and no response in 5 patients (23%) during follow-up. Twelve of 14 patients with lymphoma restricted to the mucosa or submucosa (stage E-I1) at echoendoscopy, but none of the 10 patients with higher stage (P < 0.01), showed complete regression of MALT lymphoma. In stage E-I1 patients, the probability of complete regression of lymphoma was 60% at 6, 79% at 12, and reached 100% at 14 months, respectively. CONCLUSIONS: Staging of gastric low-grade MALT lymphomas by endoscopic ultrasonography allows prediction of the response to therapy by eradication of H. pylori.

Adult↗
PubMed1997

Correspondence between adolescent report and parent report of psychiatric diagnostic data.

OBJECTIVE: To examine the degree of agreement between parent and adolescent report of major psychiatric disorders in the adolescent (14 to 18 years of age). METHOD: A total of 281 parent-adolescent pairs were interviewed separately regarding psychopathology in the adolescent. RESULTS: The kappa values for parent-adolescent agreement on the disorders ranged from .19 for alcohol abuse/dependence to .79 for conduct disorder, with an average kappa of .42. Excellent agreement was found for conduct disorder and the core symptom of anorexia; good agreement was found for separation anxiety disorders, attention-deficit/hyperactivity disorder, oppositional defiant disorder, substance abuse/dependence, and the core symptom for bulimia; poor agreement was found for major depression, dysthymia, anxiety disorders other than separation anxiety, alcohol abuse/dependence, and the infrequent core symptoms of bipolar and obsessive-compulsive disorders. Parent-adolescent agreement was not influenced by gender, current adolescent age, parental education level, disorder onset age, or severity of disorder. CONCLUSIONS: For detecting cases of adolescent psychopathology, there are clear advantages to the current consensus position that combines adolescent and parent report, especially for externalizing disorders. However, if forced to choose one informant, assessing the adolescent will result in the detection of more diagnosed cases.

Adolescent↗
PubMed1997

Axis II psychopathology as a function of Axis I disorders in childhood and adolescence.

OBJECTIVE: To examine the occurrence of elevated personality disorder (PD) dimensional scores in a community sample of young adults as a function of the occurrence of Axis I disorders through age 18 years. METHOD: 299 individuals who had been interviewed regarding Axis I disorders twice while in adolescence (first when 14 through 18 years of age) were carefully assessed regarding Axis I and II psychopathology at age 24. RESULTS: The prevalence of PD diagnoses was relatively low (3.8% in participants with a history of Axis I versus 1.7% in participants with no Axis I history). The occurrence of all four Axis I diagnostic categories (major depression, anxiety disorders, disruptive behavior disorders, substance use disorders) in childhood and adolescence was associated with elevated PD dimensional scores. The likelihood of elevated PD dimensional scores increased as a function of the number of Axis I disorders. Elevated PD scores were significantly associated with a negative course of major depression. CONCLUSIONS: Although the rates of PDs were low, the findings suggest a substantial degree of association between early-onset Axis I disorders and Axis II psychopathology in young adulthood. More research is needed to develop assessment and treatment recommendations addressing the early manifestations of PDs.

Adolescent↗
PubMed1997

Comparability of telephone and face-to-face interviews in assessing axis I and II disorders.

OBJECTIVE: The present study examined the comparability of data obtained by telephone and face-to-face interviews for diagnosing axis I and II disorders. METHOD: Sixty young adults from the community were interviewed face-to-face and over the telephone regarding axis I disorders; another 60 subjects were interviewed twice regarding axis II disorders. The order of interviews was counterbalanced, and subjects with a history of disorder were oversampled. Agreement between telephone and face-to-face interviews was contrasted with interrater values, which were obtained by having a second interviewer rate a recording of the original interview. RESULTS: Interrater reliability was excellent. Agreement between telephone and face-to-face assessment was excellent for anxiety disorders and very good for major depressive disorder and alcohol and substance use disorders; agreement was problematic, however, for adjustment disorder with depressed mood. Strong support was shown for the validity of the axis II telephone assessment format. Small but consistent trends were noted for lower rates of psychopathology reported in the second interview. CONCLUSIONS: This is the first study in which telephone and face-to-face assessments of axis I and II psychopathology were conducted with the same subjects assigned to conditions in a counterbalanced manner. The present findings provide qualified justification for the use of telephone interviews to collect axis I and II data. The apparent concerns do not appear sufficient to override the economic and logistic advantages of telephone interviewing.

Adolescent↗
PubMed1997

Correlates of suicidal behavior in a juvenile detention population.

The present study identifies the correlates of current suicidal ideation and past suicide attempt among 555 adolescents in a county juvenile detention center. Suicidal behavior in delinquent boys was generally associated with depression and decreased social connection, whereas suicidal behavior in delinquent girls was associated with impulsivity and instability. Current ideation was most significantly associated with current depression. In multivariate analyses, past attempts were associated with suicidal ideation and ineffective coping for males, with major life events and impulsivity for females, and with not residing with at least one biological parent prior to detention for both males and females.

Adolescent↗
PubMed1996

Relationship of physical disease and functional impairment to depression in older people.

Physical disease is commonly considered a risk factor for depression among older adults. However, this pattern is not consistently supported, and a theoretical framework for understanding such a relationship has not been articulated. P.M. Lewinsohn, H. Hoberman, L. Teri, and M. Hautzinger's (1985) integrative model of depression predicts that disease will be a risk factor for depression only when disease results in functional impairment, and that impairment in the absence of disease is also a risk factor for depression. The authors tested these predictions in a community-based sample of older adults followed longitudinally and found that functional impairment was a significant risk factor for depression, regardless of disease status. Disease was not a significant predictor of major depression, nor did it interact with impairment to predict depression.

Activities of Daily Living↗
PubMed1996

Alcohol consumption in high school adolescents: frequency of use and dimensional structure of associated problems.

The goal of this paper is to present data regarding the occurrence of alcohol consumption and the relative prevalences and the factorial structure of DSM-IV symptoms of alcohol abuse/dependence in a sample of 1507 older (14-18 years) community adolescents. Participants were diagnostically assessed at two time points, approximately 1 year apart. Three-quarters of the sample had tried alcohol. Boys in general had greater usual frequency and quantity of alcohol consumption than girls and began drinking at an earlier age; girls with a diagnosis of alcohol abuse/dependence had a significantly earlier mean age of alcohol disorder onset and were more likely to have a relapse of alcohol disorder. However, gender differences in symptom prevalence were non-significant. Seventeen per cent of the sample had at least one alcohol abuse/dependence symptom. The most frequent symptoms included reduced activities because of alcohol use, consumed more than intended, and tolerance. Eight of the 11 symptoms made a unique contribution to the prediction of diagnosis in a multiple logistic regression analysis. Components analysis supported the general division of symptoms into the categories of abuse and dependence.

Adolescent↗
PubMed1996

Psychiatric comorbidity with problematic alcohol use in high school students.

OBJECTIVE: To delineate the degree to which various levels of problematic alcohol use are associated with psychiatric disorders in adolescents. METHOD: The lifetime occurrence of psychiatric disorders was examined in a community sample of 1,507 older adolescents (aged 14 through 18 years) who were categorized according to their alcohol use (i.e., abstainers, experimenters, social drinkers, problem drinkers, and abuse/dependence group). RESULTS: Increased alcohol use was associated with the increased lifetime occurrence of depressive disorders, disruptive behavior disorders, drug use disorders, and daily tobacco use. There was a trend for increased alcohol use in girls to be associated with anxiety disorders. More than 80% of adolescents with alcohol abuse/dependence had some other form of psychopathology. Alcohol disorders, in general, followed rather than preceded the onset of other psychiatric disorders. Comorbidity was associated with an earlier age of alcohol disorder onset and with greater likelihood of mental health treatment utilization. CONCLUSIONS: Rates of psychiatric comorbidity with problematic alcohol use in adolescents are striking and represent an important therapeutic challenge.

Adolescent↗
PubMed1996

Cross-sectional and prospective relationships between physical morbidity and depression in older adolescents.

OBJECTIVE: To examine cross-sectional and prospective associations between major depressive disorder (MDD), physical morbidity (disease and injury), health-related reductions in activities, and functional impairment in adolescents. METHOD: Data on depression and health-related variables were available for a sample of 1,410 adolescents (aged 14 to 18 years) at point of entry into the study and approximately 1 year later. RESULTS: Girls were more likely to have been treated for a disease and to have a health-related reduction in activities, whereas boys were more likely to have been treated for an injury. The expected cross-sectional associations were found between disease, reductions in activities, functional impairment, and depression, but the association between injury and depression was not significant. Prospective analyses suggest that functional impairment and disease are risk factors for future MDD and that MDD is a risk factor for future functional impairment and disease. CONCLUSIONS: The robust prospective associations between MDD and functional impairment suggest that the impact of disease on depression is particularly strong when it disrupts important behavior patterns. Clinically, the results emphasize the importance of assessing health-related variables in depressed adolescents and of assessing depression in those with functional impairment or disease.

Adolescent↗
PubMed1996

The Life Attitudes Schedule Short Form: an abbreviated measure of life-enhancing and life-threatening behaviors in adolescents.

An abbreviated version of the Life Attitudes Schedule (LAS) was developed, consisting of 24 items, each representing one cell of the original LAS theoretical matrix (4 content categories x 2 behavior types x 2 valence). Items were retained on the basis of high correlations with LAS total score and low correlations with gender. Psychometric properties of the LAS Short Form were robust and the Short Form total score correlated .93 with the original LAS total score. As with the original LAS, boys reported more injury-related behaviors than girls. Future research and clinical directions are suggested.

Adolescent↗
PubMed1995

Adolescent psychopathology: III. The clinical consequences of comorbidity.

OBJECTIVE: To describe the clinical consequences associated with the lifetime occurrence of comorbid psychiatric disorders. METHOD: In a community sample of 1,507 older adolescents (aged 14 through 18 years), subjects with "pure" and comorbid forms of four major psychiatric disorders (depression, anxiety, substance use, and disruptive behavior) were compared on six clinical outcome measures. RESULTS: The impact of comorbidity was strongest for academic problems, mental health treatment utilization, and past suicide attempts; intermediate on measures of role functioning and conflict with parents; and nonsignificant on physical symptoms. The greatest incremental impact of comorbidity was on anxiety disorders; the least was on substance use disorders. Although some patterns of comorbidity were much more common in boys (e.g., substance use and disruptive behavior disorder) or in girls (e.g., depression and anxiety), the impact of specific comorbid disorders on the clinical measures was not different for females and males. The effect of comorbidity was not due to current psychopathology. CONCLUSIONS: The significance of comorbidity differs across specific comorbid disorders and across outcome measures, with some comorbid disorders being much more detrimental, and some outcome measures much more affected, than others.

Adolescent↗