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Biomedical subjects

R M Hirschfeld

Publications and source records attributed to R M Hirschfeld.

At least 91 records · Page 5Linked to original sources
PubMed1986

Psycho-social predictors of chronicity in depressed patients.

Nineteen patients with an episode of major depressive disorder who did not recover within two years of prospective follow-up were compared with an equal number who recovered within a year of the initial evaluation and remained well through the two-year follow-up date. The groups were individually matched for age, sex, primary/secondary status, and prior duration of episode. The only psycho-social variable that predicted chronicity was increased neuroticism on self-report personality inventories administered during the index evaluation. Early loss, recent life events, and recent social supports were not predictive of outcome.

Adult↗
PubMed1985

Situational major depressive disorder.

Fifty-seven patients with situational major depression diagnosed by the Research Diagnostic Criteria were compared with 72 subjects with nonsituational major depression on demographic, clinical, and psychosocial variables. The situational patients tended to be younger and had fewer prior episodes of depression and fewer hospitalizations. No differences were found in categories of life events, in overall clinical picture, in social supports, or in family history.

Adjustment Disorders↗
PubMed1984

Sex-related differences in depression. Familial evidence.

After a description of threshold models of familial transmission based on an underlying continuous liability distribution, family data from the NIMH-CRB Collaborative Psychobiology of Depression Program-Clinical are described. No sex differences are found for bipolar illness, whereas female relatives have an increased rate of primary unipolar illness when compared to male relatives. This effect persists when relatives are classified according to recurrence, current illness, onset within the last 10 years, and treatment. Moreover, a cohort effect is present in the data and indicates a sex ratio close to one in the young cohort (less than or equal to 25). We considered the transmission of illness from parent to offspring by using survival analysis to examine the proportion of ill brothers and sisters of probands according to the affection status of parents. A maternal effect is found, with the mother having a greater influence on the liability of offspring of either sex. This is at odds with the notion that males and females have identical liabilities, but females have a lower threshold reflecting acknowledgement of more symptoms, etc. However, the mean difference in liability between the sexes may be due to systematic biological/cultural differences, with parental transmission contributing to variation about their means.

Bipolar Disorder↗
PubMed1984

Personality and gender-related differences in depression.

Seventy recovered female nonbipolar depressed patients and 32 recovered males were individually matched for age, sex and marital status with never mentally ill control subjects. Difference scores on personality scales indicative of interpersonal dependency, learned helplessness, and other features were compared for female patients and their matched controls, vs male patients and their controls. The difference between patients and controls was not less for females than for males. Thus the hypothesis that the higher prevalence of depression in women is due to the fact that their general personality features resemble those associated with a predisposition to depression was not supported.

Adult↗
PubMed1983

The clinical utility of the dexamethasone suppression test in psychiatry. Summary of a National Institute of Mental Health workshop.

The dexamethasone suppression test (DST) is being increasingly used in psychiatry, especially in the differential diagnosis of affective disorders. In light of this, the National Institute of Mental Health convened a workshop of clinical scientists drawn from neuroendocrinology, psychopathology, and general clinical psychiatry to review the evidence for the efficacy of the use of the DST in psychiatry. Specifically considered were DST's relevance to differential diagnosis, its use as a predictor of response to treatment, its relationship with other biologic variables, and technical issues. The panelists concluded that at this time there are no clear indications for routine use of the DST in diagnosis or clinical management of depression, although it is a useful research tool. Areas of potential utility include prediction of suicidal activity, prediction of relapse, and differential diagnosis.

Depressive Disorder↗
PubMed1983

The relationship of personality to affective disorders.

Although characterologic constellations such as obsessionalism, dependency, introversion, restricted social skills, and maladaptive self-attributions are popularly linked to the pathogenesis of depressive disorders, the evidence in support of this relationship remains modest. Indeed, many of these attributes may reflect state characteristics woven into the postdepressive personality. Current evidence is strongest for introversion as a possible premorbid trait in primary nonbipolar depressions. By contrast, driven, work-oriented obsessoid, extroverted, cyclothymic, and related dysthymic temperaments appear to be the precursors of bipolar disorders. Other personalities, while not necessarily pathogenic in affective disorders, nevertheless may modify the clinical expression of affective disorders and their prognosis.

Character↗
PubMed1983

Personality and depression. Empirical findings.

The Clinical Studies of the National Institute of Mental Health--Clinical Research Branch Collaborative Program on the Psychobiology of Depression offer an opportunity to clarify the relationship between personality and depression. Thirty-one female patients with primary nonbipolar major depressive disorder were assessed diagnostically using the Schedule for Affective Disorders and Schizophrenia and completed a battery of standard self-report personality inventories when they were completely symptom free. Their personality scale scores were compared with those of female relatives who had recovered from the same type of disorder, those of female relatives with no history of psychiatric illness, and published scale norms. Compared with the normal population, both groups of recovered depressives were introverted, submissive, and passive, with increased interpersonal dependency but normal emotional strength. Comparison to never-ill relatives yielded similar results except that the never-ill relatives had scores reflecting extraordinary emotional strength.

Adult↗
PubMed1983

Assessing personality: effects of the depressive state on trait measurement.

The influence of the clinically depressed state on personality assessment was evaluated by comparing self-report personality inventories of patients while clinically depressed and at follow-up 1 year later. The authors examined two groups from the National Institute of Mental Health (NIMH)-Clinical Research Branch Collaborative Program on the Psychobiology of Depression: Clinical Studies--patients whose symptoms had completely remitted and those who had not recovered. The clinically depressed state strongly influenced assessment of emotional strength, interpersonal dependency, and extraversion. Assessment of rigidity, level of activity, and dominance did not change after symptomatic recovery.

Adult↗
PubMed1982

Epidemiology of affective disorders.

Data from recent epidemiological studies involving psychosocial risk factors for affective disorders are reviewed. The results of these studies are divided into the categories of depressive symptoms, bipolar depressive disorder, and nonbipolar depressive disorder. When the data are examined using these categories, remarkable consistency in psychosocial risk factors for depressive symptoms and nonbipolar depressive disorder is observed, suggesting possible continuity between these conditions. Psychosocial risk factors for bipolar disorder differ substantially from those identified for depressive symptoms and nonbipolar depressive disorder and, therefore, provide further support for the bipolar-nonbipolar distinction.

Adolescent↗
PubMed1982

Assessment of reliability in multicenter collaborative research with a videotape approach.

The authors, as part of the ongoing NIMH Collaborative Study on the Psychobiology of Depression, used an analysis of variance design and videotaped interviews to explore the effects of sources of variance on the reliability of the measures being used by the NIMH study. In spite of substantial differences among interviewers in background or orientation, the authors found that diagnoses and symptom ratings were made with a high level of reliability. These results suggest that the use of structured interviews and diagnostic criteria, when combined with a careful and systematic training program, can lead to good levels of diagnostic reliability.

Bipolar Disorder↗
PubMed1981

Reliability of lifetime diagnosis. A multicenter collaborative perspective.

It is important to determine the reliability of lifetime diagnosis in a nonpatient population, for this type of diagnostic data and this type of sample are used in many genetic, epidemiological, and nosological studies. We examined the reliability of lifetime diagnosis when the Schedule for Affective Disorders and Schizophrenia-Lifetime Version and Research Diagnostic Criteria were used to interview ill and well relatives of probands in the National Institute of Mental Health Collaborative Study of the Psychobiology of Depression. Subjects were interviewed three times, so data are available concerning both short- and long-interval test-retest reliability. Short-interval test-retest reliability was excellent for both diagnoses and symptoms. Reliability was also quite high in the long-interval test-retest study. We conclude that it is possible to make lifetime diagnoses reliably in a nonpatient population.

Anxiety Disorders↗
PubMed1981

Situational depression: validity of the concept.

The validity of the concept of situational (i.e. reactive) depression as distinct from other major depressive subtypes is examined in terms of psychosocial stressors, personality features, current symptomatology, and clinical course and follow-up. Thirty-eight patients with a recent onset of situational major depressive disorder (i.e. the disorder developed after an event or in a situation the diagnostician deemed likely to have contributed to the episode at that time) were compared with 68 non-situational major depressive patients. These patients were participants in the clinical studies of the NIMH-Clinical Research Branch Collaborative Program on the Psychobiology of Depression. No significant differences between the two groups were found in the total number, content areas, or other categorizations of life events, experienced prior to onset. Some statistically significant differences in current symptomatology and in clinical course and follow-up measures were obtained, but there were none in personality traits. Implications of these results in relation to previously published reports are discussed and caution is recommended in the use of the term situational depression until more definitive data become available.

Adjustment Disorders↗
PubMed1979

NIMH clinical research branch collaborative program on the psychobiology of depression.

This is a report on the history and implications of the collaborative effort that evolved from the 1969 National Institute of Mental Health conference on the psychobiology of depression. The major issues identified at that time were the need to (1) assess relative validities of current systems of nosology and (2) retest critical biological hypotheses concerning the etiology and nature of the depressive disorders. Research was required that would be multidisciplinary and involve clinical settings treating diverse types of depression. The objectives and the nature of the biological and clinical collaborative programs that were designed to address these problems are described. These unique programs, initiated in the early 1970s, currently span research on nosology, genetics, neurochemistry, neuroendocrinology, and psychosocial factors. Although these studies are still in the early stages, they have resulted in significant methodologic developments in diagnosis, descriptive psychopathology, and biological measurements.

Adrenocorticotropic Hormone↗
PubMed1979

Neurotic depressions: a systematic analysis of multiple criteria and meanings.

Neurotic depression, the most commonly used psychiatric diagnosis, has multiple meanings that are often used interchangeably in clinical practice. The authors identify six different meanings of neurotic depression and present data from a study of 90 depressed inpatients to determine how many patients met several different criteria; 16 patients met four sets of criteria. The overlap that exists between the different meanings is higher than chance alone but not sufficiently high to allow complete interchangeability. Until new diagnostic classes are developed, the authors recommend that the term "neurotic depression" no longer be used clinically because of its vagueness.

Adjustment Disorders↗
PubMed1979

Personality attributes and affective disorders.

To determine the personality characteristics associated with affective disorders the authors administered a battery of self-report personality inventories to a sample of hospitalized affective patients when their manifest symptoms had abated. Patients were instructed to answer according to their premorbid personalities. The personality characteristics assessed in the 73 depressive and 24 manic patients included neuroticism and extraversion from the Maudsley Personality Inventory, obsessional pattern, hysterical pattern, and oral pattern from the Lazare-Klerman-Armor Personality Inventory, obsessional state and trait from the Leyton Obsessionality Inventory, and solidity, stability, and validity from the Marke-Nyman Temperament Survey. Depressive patients demonstrated more neuroticism, introversion, and obsessionality than manic patients or normal individuals. The manic patients differed from normal persons only on obsessionality.

Adult↗
PubMed1979

Treatment of depression in the elderly.

Depression is often overlooked, misdiagnosed, or inadequately treated in older patients. Since depressions secondary to drug use or organic diseases are common in the aged, complete physical and laboratory evaluation is essential. Fortunately, depression can be alleviated if you know the therapeutic options. Selection of the best one should be made carefully in elderly patients.

Aged↗
PubMed1977

Being with madness: personality characteristics of three treatment staffs.

The personality characteristics of the nonprofessional staff of Soteria House, an innovative residential treatment program for schizophrenics, are assessed and compared with characteristics of representative staffs from two more traditional mental health programs for schizophrenics: a university psychiatric ward and a community-based program staffed by a specially trained group of state hospital aides. A battery of self-report personality questionnaires was used. Analysis of the data indicates an over-all similarity of personality profiles in the three groups. All groups demonstrated two sets of characteristics considered desirable for therapists of schizophrenics: the ego-strength qualities of self-assurance, emotional maturity, independence, and autonomy, and the affective qualities of warmth, sensitivity, and empathy. However, within a third set of characteristics, descriptive of cognitive-attitudinal qualities, the Soteria staff possessed significantly more intuition, introversion, flexibility, and tolerance of altered states of consciousness. The authors speculate that it is this last set of characteristics that allows the Soteria staff to function in the program's intensive, unstructured treatment environment.

Adolescent↗