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Biomedical subjects

R Abrams

Publications and source records attributed to R Abrams.

At least 91 records · Page 5Linked to original sources
PubMed1980

Familial and non-familial mania.

We compared 34 manics with a positive family history of affective disorder (familial mania) and 84 manics with a negative family history of affective disorder (non-familial mania) for clinical, demographic and historical variables related to abnormal brain function and for cortical functioning measured by neuropsychological and electroencephalographic techniques. Proband and relative research diagnosis, neuropsychological and electroencephalographic interpretations were made blindly and independently of each other. Except for index admission severity of illness being greater in familial manics, we could find no significant differences for any of the variables studied. We conclude that differences in family illness patterns do not identify subgroups of manics and if it exists, heterogeneity, must be sought by studying other biologic correlates of psychopathology.

Adult↗
PubMed1980

Cognitive taska in the mental status examination.

We evaluated the reliability of 20 cognitive tasks as part of a clinical mental status examination. Twenty-five adult psychiatric inpatients were selected at random and inter viewed before three board-certified psychiatrists who, without any knowledge of each other's ratings, completed a form determining the presence or absence of abnormal responses. We found 19 of the 20 items to yield R values of greater than .50, with 14 of these having R values of .80 or better. All correlations were significant at the less than .01 level. We suggest that these cognitive tasks with demonstrated reliability be included in the standard mental status examination. As a group, the tasks are easily and rapidly administered and should provide more accurate clinical screening of patients suspected of cortical dysfunction. These tasks will enable clinicians to make more precise and cost-effective referrals for elaborate, time-consuming, and expensive neuropsychological testing.

Adult↗
PubMed1980

A comparison of unipolar and bipolar depressive illness.

In a study of 40 consecutively hospitalized patients with research diagnoses of endogenous depression, the authors found no difference between unipolar and bipolar depressive patients in the risk for affective disorder in first-degree relatives, proportion of EEG or neuropsychological abnormalities, clinical evidence of the depressive syndrome, or response to doctor's choice of treatment. Bipolar patients had an earlier age of onset and displayed more manic symptoms that did unipolar patients. The authors conclude that the two forms of depressive illness are clinically and genetically homogeneous, are without identifying EEG or cognitive differences, and have an equally good response to somatic treatments.

Adult↗
PubMed1980

Psychopathology and the electroencephalogram.

We investigated the relationship between EEG abnormalities and clinical psychopathological features in a consecutive sample of 159 patients who satisfied our research criteria for schizophrenia or affective disorder and in whom an EEG was obtained. In the 44 patients with abnormal EEGs, we found significant correlations between left-sided EEG abnormality and the clinical features of formal thought-disorder and emotional blunting, correlations which were independent of the variance associated with age, sex, past or present drug administration, or research diagnosis. The correlation for formal thought-disorder was specifically related to the left temporal lobe, a finding which we discuss in terms of the similarity between formal thought-disorder defined as a language dysfunction and fluent posterior aphasia. Because of the small sample size these results, although statistically significant, should be interpreted with caution and require confirmation by other workers.

Affective Disorders, Psychotic↗
PubMed1979

Differential EEG patterns in affective disorder and schizophrenia.

We analyzed the EEGs of 27 schizophrenic patients and 132 patients with affective disorder who received diagnoses according to rigorous research criteria. The proportion of abnormal EEGs was twice as great among schizophrenics as among affectives, and when the groups were compared for localized cortical differences, schizophrenics had more temporal abnormalities and affectives more parieto/occipital abnormalities. There was also a trend toward different hemispheric lateralization for the two groups, with a reversal of the relative proportions of left- and right-sided abnormalities. These differences were unrelated to age, sex, severity of illness, or past or present drug administration. These findings are complementary to those of other workers, lend support to the validity of our diagnostic research criteria, and provide additional evidence for neurophysiological differences between schizophrenics and patients with affective disorder.

Adult↗
PubMed1979

Unipolar mania revisited.

In a more sophisticated replication of an earlier study (Abrams and Taylor 1974), we examined 77 manic patients, of whom 29 had never suffered a depressive illness, and had two or more manic attacks. These unipolar manics were similar to the 48 bipolar manics for a wide variety of clinical, phenomenological, historical, laboratory and demographic variables, generally supporting our earlier findings. However, the present sample showed a striking excess of males among the unipolar manics, as well as an increased morbid risk for unipolar depression in first-degree relatives. Although not readily explainable, these differences suggest that it is premature to equate unipolar mania with classical bipolar illness. Further studies of unipolar mania are in progress.

Adult↗
PubMed1979

Lateralized neuropsychological dysfunction in affective disorder and schizophrenia.

The authors compared the cognitive functioning of 22 schizophrenic patients, 105 patients with affective disorder, and 99 age-matched normal control subjects. Results of an aphasia screening test indicated that the schizophrenic patients made more total errors and more dominant temporal/temporoparietal errors than patients with affective disorders and that patients in both groups made more errors than controls. Patient sex, age, drug treatment received at test time, previous neuroleptic drug treatment, and severity of illness did not account for the differences. These findings support the validity of the authors' diagnostic research criteria and confirm prior reports of differences in dominant hemisphere dysfunction between schizophrenic patients and patients with affective disease.

Adult↗
PubMed1979

Catatonia and mania: patterns of cerebral dysfunction.

We performed a factor analysis on research data from 55 consecutive hospitalized psychiatric patients who showed one or more of eight catatonic motor features. Two factors were extracted, accounting for 32% of the variance. Factor 1 (mutism, negativism, stupor) corresponded to the clinical syndrome of negativistic stupor and was unrelated to diagnosis, sex, age at onset, family history, or treatment response. Factor 2 (mutism, stereotypy, catalepsy, automatic obedience) corresponded to the classical description of catatonia, was associated with a research diagnosis of mania, and tended (p less than 0.10) to predict a favorable treatment response. We suggest that the two factors may reflect different forms of cerebral dysfunction which, in the case of Factor 2, may provide clues as to the nature of the morbid process in mania. Republication is now in progress in a different sample.

Adult↗
PubMed1978

A rating scale for emotional blunting.

Although emotional blunting has always been considered a core symptom of schizophrenia, it has been excluded from recently developed sets of diagnostic criteria because of its alleged unreliability. The authors describe a brief rating scale for emotional blunting that is highly reliable, predicts short-term treatment response, and discriminates between patients with affective disorder and schizophrenia. They suggest that this scale will permit restoration of the important criterion of emotional blunting to modern diagnostic systems, including that proposed for DSM-III.

Affective Symptoms↗
PubMed1978

Tricyclics versus ECT.

Explore the source record for details and available documents.

Antidepressive Agents, Tricyclic↗
PubMed1978

The prevalence of schizophrenia: a reassessment using modern diagnostic criteria.

Using strict research diagnosis criteria, the authors found a hospital admission prevalence of schizophrenia of about 6%. Other recent studies yielded similar figures, with correspondingly low figures for the morbid risk of schizophrenia in the general population and in the relatives of schizophrenic probands. In view of the data supporting the validity of this "narrow" concept of schizophrenia, the authors suggest that the true prevalence of schizophrenia is much lower than generally accepted.

Epidemiologic Methods↗
PubMed1978

Response to lithium carbonate.

We examined the clinical and research records of 29 acutely ill hospitalized patients with affective disorder who received only lithium carbonate during their first week of treatment. Nineteen patients (Group I) could be continued on lithium ion alone, while 10 patients (Group 2) needed additional somatic treatment. Compared with Group 1, Group 2 patients were significantly younger at illness onset, more severely ill on admission, clinically more "colorful" in dress and behavior, stayed more than twice as long in the hospital, and (although not statistically significant) had more than twice the morbidity risk for affective disorder in first-degree relatives. At discharge, both groups were equally improved, and 70% of Group 2 patients were receiving lithium alone. We did not confirm previous reports that nonresponders to lithium alone (Group 2) were more overactive or paranoid--destructive or less euphoric--grandiose than responders to lithium alone (Group 1). Our Group 2 patients had a more severe or penetrant form of illness than our Group 1 patients, requiring neuroleptic drugs or ECT in addition to lithium therapy. Eventually, however, they had a satisfactory outcome, suggesting therapeutic optimism and tenacity even in those patients who initially fail lithium alone and require polytreatment.

Affective Symptoms↗
PubMed1978

Body fluid lithium measurements: severity of illness and prediction of outcome.

The authors measured lithium ion in saliva and serum 24 hr after a loading dose of lithium, and recorded the amount of lithium excreted in the urine during the 24-hr test period. Their results support previous work indicating a correlation between serum and mixed saliva lithium levels. On a subsample of manic patients, no correlation could be found between lithium retention and clinical outcome, age of onset, or pretreatment severity of illness. In addition, they were unable to confirm a prior report that the 24-hr postloading dose serum lithium level was a predictor of eventual therapeutic dosage.

Adult↗