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Biomedical subjects

R Kellner

Publications and source records attributed to R Kellner.

At least 145 records · Page 8Linked to original sources

Prolactin, aggression and hostility: a discussion of recent studies.

Several studies are summarized in which the relationship of high prolactin levels and self-rated anger-hostility was examined. The Symptom Questionnaire, a state measure which contains an anger-hostility scale, was included in all studies. Women with hyperprolactinemic amenorrhea were found to have higher hostility scores than amenorrheic women with normal prolactin levels. In another study, hyperprolactinemic women were found to have higher hostility scores than female family practice patients, random employees and there was a nonsignificant trend for higher hostility scores than in female nonpsychotic psychiatric outpatients. In both studies, depression and anxiety were also significantly higher. When bromocriptine, a prolactin lowering drug, was administered to hyperprolactinemic women in a double blind crossover study, there was a significant and progressive decrease of hostility, depression and anxiety while on bromocriptine, parallel with the decrease in prolactin and no change on placebo. Post-partum women who had high prolactin levels were significantly more hostile than a control group of employees and as hostile as hyperprolactinemic women. Hyperprolactinemic males were no more hostile than controls. The relationship of prolactin to post-partum aggression in mammals is briefly reviewed. The findings are inconclusive; in the three species studied, postpartum aggression is perhaps enhanced, but does not depend on high prolactin levels. There are no studies on the relationship of prolactin levels and violence in women. Hostility associated with high prolactin levels in postpartum women is perhaps a phylogenetic remnant which may have had the evolutionary advantage of protecting the young.

Aggression↗

Prognosis of treated hypochondriasis. A clinical study.

Thirty-six patients who had hypochondriacal neurosis for 6 months or longer were treated with individual psychotherapy which focused predominantly on presenting complaints, fears and beliefs. Antianxiety drugs were used at times of anxiety. Sixty-four percent either recovered or improved to the extent that they no longer believed that they had a disease. The improvement was largely maintained on a 2-year follow-up. Good outcome was associated with illnesses of less than 3 years duration, the absence of an additional diagnosis of a personality disorder and there was a nonsignificant trend to belong to a higher social class. Outcome was not associated with age, sex, or severity of initial ratings of anxiety, depression or somatic symptoms. It appears that the prognosis of treated hypochondriacal neurosis is good in a substantial proportion of patients.

Adolescent↗

Psychosomatic aspects of hyperprolactinemia.

A review of some recent studies on the psychosomatic aspects of hyperprolactinemia is presented. Women seem to be more prone to suffer from the behavioral effects of prolactin than males. Women with hyperprolactinemic amenorrhea rated themselves significantly more hostile, more depressed and more anxious than women with amenorrhea only and other control groups. Hyperprolactinemic males did not rate themselves more hostile and depressed than matched controls. Psychological distress and hostility appear to remit upon treatment with bromocriptine. Postpartum patients matched for prolactin levels with hyperprolactinemic women showed significantly less depression and anxiety but about the same levels of hostility. Hostility, depression and loss of libido may coexist in the same hyperprolactinemic patient but they may be also present independently.

Adaptation, Psychological↗

Italian validation of the Symptom Rating Test (SRT) and Symptom Questionnaire (SQ).

Two self-rating scales of psychological distress, the Symptom Rating Test (SRT) and the Symptom Questionnaire (SQ), have been validated in translations in Italy. They were administered in several studies to psychiatric patients (neurotics and depressives), matched controls, and patients suffering from various organic illnesses (dermatologic disorders, hypertension, secondary amenorrhea and patients undergoing amniocentesis). The SRT and the SQ sensitively discriminated between psychiatric patients and normals, between different levels of psychological distress in several of the somatic illnesses, and detected significant changes in the psychological status of patients participating in medical procedures such as amniocentesis. The scales were found to be useful in research in psychiatry and psychosomatic medicine. The findings suggest that the Italian translations are valid and sensitive scales of distress and can apparently be used as effectively in research as the original. They are likely to be of value in cross-cultural research in Canada. Both scales may be helpful in the psychological assessment of Italian immigrants in North America and Australia, especially in those whose English is poor.

Adult↗

Life events and hypochondriacal concerns.

In a study of 165 employees of a retail firm, life events were associated with several hypochondriacal concerns and with most of the self-rating distress scales. Life events related to illness and death were associated with fear of disease and showed weak associations with somatic symptoms and anxiety. Life events unrelated to illness and death were associated with hypochondriacal beliefs, bodily preoccupations, fear of death, and most of the distress scales. Illness and death do not appear to be common recent precipitants of hypochondriacal concerns in a normal population. One of the reasons for the observed associations appears to be that preoccupation with illness and death can occur at times of distress, regardless of the nature of the recent stressful life events.

Adolescent↗

Psychological reactions to amniocentesis: a controlled study.

Fifty women who underwent amniocentesis and a matched control group of pregnant women were administered the Symptom Questionnaire to evaluate changes in distress. Anxiety, depression, and somatic symptoms had significantly decreased after the results of amniocentesis were communicated to the patient, but the decrease was similar in the normal control women. Hostility was higher in the amniocentesis group and decreased to normal levels after amniocentesis was performed, even before the results were communicated to the patient.

Amniocentesis↗

Depression and hostility in hyperprolactinemia.

1. Patients with hyperprolactinemia offer a unique opportunity to investigate the effects of prolactin on psychological states. Women with hyperprolactinemic amenorrhea rated themselves significantly more hostile, more depressed and more anxious than women with amenorrhea only and normal women. 2. The hyperprolactinemic patients were compared with a group of post-partum (7th day) women, matched for sociodemographic variables and prolactin levels. The post-partum women showed significantly less depression and anxiety than those with hyperprolactinemic amenorrhea but about the same levels of hostility. 3. Hyperprolactinemic males did not rate themselves more hostile and depressed than matched controls.

Amenorrhea↗

Losses, Hostility, and depression.

Forty outpatients with a primary unipolar major depression of recent onset and a matched control group of employees were administered the hostility scale of the Kellner Symptom Questionnaire, depression was rated with the Hamilton Rating Scale for Depression, and life events were recorded in a structured interview. In a subgroup of depressives who had not reported losses, there was an association of hostility and depression, whereas no such association was found in depressives who had reported losses. The findings are consistent with those of previous studies showing that hostility is largely limited to a subgroup of depressives. In a substantial proportion of the depressives, depression and hostility are independent affects.

Depressive Disorder↗

The Hamilton Depression Rating Scale in normals and depressives.

The Hamilton Rating Scale for depression (HDRS) has become the standard observer rating scale for depression, yet there are no adequate data from normal samples. The present study was carried out in northern Italy. The purposes were 1) to examine the ratings in normals and 2) to examine the scale's validity in the different language and culture. The scale was used in 40 normals and 40 depressives who were matched. Two self-rating scales of depression were administered: the Symptom Rating Test and the Symptom Questionnaire. The results show that the HDRS is a valid measure in that it sensitively discriminates between depressed patients and normals. The findings support Hamilton's view that only the first 17 items of the scale are appropriate for computing the score. The use of self-rating scales yielded additional information. The misclassification rate of the Symptom Rating Test was similar to that of the HDRS. The combined use of Research Diagnostic Criteria (RDC) and HDRS appears to be more reliable for the selection of depressed patients for research than the RDC only.

Ambulatory Care↗

Psychological correlates of hyperprolactinemia in males.

In a previous study with hyperprolactinemic female patients, self-rated hostility, depression and anxiety were significantly higher than in other female patients. The study was repeated in hyperprolactinemic males, using the same psychological assessments. Hyperprolactinemic males were significantly more anxious but did not differ significantly in hostility and depression from other male patients. The findings support the view that the psychological effects of high serum prolactin levels depend in part on interactions with gonadal hormones.

Adenoma↗

Psychotherapeutic strategies in hypochondriasis: a clinical study.

Thirty-six patients who had hypochondriacal neurosis for six months or longer were treated with individual psychotherapy. The therapy focused mainly on: accurate information about the psychophysiologic processes involved, emphasis on the innocuousness of the phenomena and the good prognosis, and making the patient aware of his selective perception. Physical examinations were repeated with reassurance when necessary and antianxiety medication was prescribed when appropriate. A substantial proportion of patients recovered or improved and the improvement was maintained on follow-up.

Adolescent↗

Life events and depression. A replication.

A study which was first carried out in the United States was repeated in Northern Italy. Life events reported to have occurred 6 months before the onset of illness were compared in 40 outpatients who had a first episode of primary depression, and a matched normal control group. Depressives reported significantly more events than the control groups, and had significantly more of the following: undesirable events, exits from the social field, events which had an 'objective negative impact' (rated as being traumatic) and 'independent events' (events which were unlikely to be a consequence of the depression); the last 2 were judged by a rater who was unaware whether the event had occurred in a depressed patient or in a control subject. There were no significant differences in desirable events, entrances into the social field and events which were within the subjects' control. These findings replicate previous results and are consistent with the view that certain recent life events play a substantial role as precipitants in some depressed patients.

Adult↗

HLA antigen frequencies in cirrhotic and noncirrhotic male alcoholics: a controlled study.

Although epidemiological data suggest that the development of cirrhosis in alcohol abusers is related to the duration and amount of ethanol intake, the fact that only a small percentage of alcohol abusers develop cirrhosis remains unexplained and suggests a possible predisposing genetic factor. Several previous studies have reported an association between various human leucocyte antigens (HLA) and alcoholic cirrhosis. In this study HLA antigen frequencies were determined in Anglo- and Spanish-American cirrhotic and noncirrhotic alcoholics and in a control group of nonalcoholic patients without liver disease. No statistically significant differences in HLA frequencies among the groups were found. Our comparisons of HLA frequencies between cirrhotic and noncirrhotic alcoholic patients do not support the hypothesis that individual susceptibility to the development of alcoholic cirrhosis is genetically determined.

Alcohol Drinking↗

Depression hostility and anxiety in hyperprolactinemic amenorrhea.

In order to evaluate the relationship of psychological distress to hyperprolactinemia, 20 patients with secondary amenorrhea were evaluated by a semi-structured research interview and administered the Kellner Symptom Questionnaire. Group A (10 patients with amenorrhea and hyperprolactinemia) reported significantly more symptoms of depression, hostility and anxiety than group B (10 patients with amenorrhea and normal basal levels of plasma prolactin). Both groups were significantly more anxious, depressed and reported more somatic symptoms than a normal control group (n = 10). 6 of the 10 patients in group A reported decrease in libido, while this was found only in 1 of the 10 patients of group B. The findings suggest that the syndrome of depression, hostility and anxiety in a woman complaining of amenorrhea, especially if associated with decreased libido and galactorrhea, can be a manifestation of hyperprolactinemia.

Adolescent↗

The effects of chlordiazepoxide on self-rated depression, anxiety, and well-being.

The main purpose of this study was to compare sensitivity of several self-rating scales to drug effects in anxious and depressed patients. Twenty-two distressed nonpsychotic outpatients completed a double-blind crossover trial of chlordiazepoxide and placebo. All self-rating scales of depression, anxiety, somatic symptoms, and feelings of inadequacy discriminated significantly between chlordiazepoxide and placebo. The decrease in self-rated depression was about equal to the decrease in self-rated anxiety. Subscales describing well-being were more sensitive to drug effects than subscales describing symptoms. A questionnaire (The Symptom Questionnaire) and one of the self-rating scales (Symptom Rating Test) were more sensitive than global self-rating scales, global observer-rating scales, and the Hamilton Anxiety Rating Scale. Some of the self-rating scales discriminated significantly between drug and placebo even when the sample size was reduced to two subsamples of eight patients each. High and significant positive correlations between two scales did not indicate equal sensitivity in discriminating between drug and placebo.

Adult↗