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Biomedical subjects

R Noyes

Publications and source records attributed to R Noyes.

At least 127 records · Page 7Linked to original sources
PubMed1982

Excess mortality in panic disorder. A comparison with primary unipolar depression.

We located 113 former inpatients with panic disorder 35 years after index admission. According to age- and sex-specific Iowa population figures, patients with panic disorder had significant excess mortality due to death by unnatural causes. Other studies suggest that secondary depression and alcoholism may have had a role in these deaths. Men with panic disorder also exhibited excess mortality due to circulatory system disease. In an age- and sex-matched patient group with primary unipolar depression, both men and women showed excess mortality. Suicide accounted for 20.0% and 16.2% of deaths in the panic disorder and primary depression groups, respectively. We conclude that panic disorder accounted for much of the excess mortality formerly noted in the "neuroses."

Agoraphobia↗
PubMed1981

Treatment of cancer pain.

Undertreatment of cancer pain results not only from the limited expectations of patients but also from the inadequate knowledge of many physicians. Successful management of this pain requires awareness of the importance of emotional factors and detailed knowledge of various treatment options. When indicated, analgesic drugs should be administered according to a regular schedule and in sufficient dose to prevent the emergence of pain. Psychological techniques including supportive psychotherapy, relaxation training, hypnosis, and the hospice milieu may contribute to a comprehensive approach to pain. Likewise, psychotropic drugs including phenothiazines and tricyclic antidepressants may be useful adjuncts when administered along with appropriate analgesic medication. Although most pain associated with advanced cancer may be relieved by currently available methods, research in this area is urgently needed.

Analgesics, Opioid↗
PubMed1981

Depression secondary to cancer.

Depression is the most frequent psychiatric complication experienced by cancer patients. Recent surveys indicate that 17--25% of patients hospitalized with neoplastic disease suffer from depression severe enough to warrant psychiatric intervention. The disorder tends to be reactive in nature and occurs mot frequently among the severely ill. Despite an increased risk of suicide, self-destruction remains a rare occurrence in cancer victims. The most important etiologic factors are associated with the disease itself but additional factors have to do with its treatment. Those related to the illness include the psychological reaction to cancer, reaction to physical distress, central nervous system metastases, paraneoplastic syndromes, and metabolic disturbances. Factors related to the treatment include reaction to surgical procedures, radiation therapy, chemotherapy, and hormone therapy. Treatment for depression secondary to cancer should begin with careful assessment leading to identification of specific mechanisms and may include antidepressant drugs, psychotherapy, and a variety of adjunctive techniques. Little research has been done in this area, and most of it suffers from the use of inadequate diagnostic criteria. Controlled trials of available pharmacologic and nonpharmacologic treatments are urgently needed.

Adaptation, Psychological↗
PubMed1980

The prognosis of anxiety neurosis.

One hundred twelve anxiety neurotics originally seen in the medical clinics of a university hospital were interviewed after six years, and their outcome was compared with that of 110 surgical control subjects. Although socially impaired to a greater extent than control subjects, the majority of patients with anxiety neurosis, despite persisting symptoms, were shown to have a favorable outcome. Sixty-eight percent were either recovered or mildly impaired at follow-up examination. Of the prognostic variables examined, duration of illness and social class proved predictive of outcome. Secondary depression, which was reported by 44% of the neurotic subjects, represented the most frequent and potentially serious complication.

Adult↗
PubMed1980

Propranolol in chronic anxiety disorders. A controlled study.

In a double-blind crossover study the beta-adrenergic blocking drug propranolol hydrochloride reduced symptoms in 17 of 26 patients with chronic anxiety disorders. Both somatic and psychic symptoms improved as judged by patient and observer ratings. The most frequent side effects (dizziness, fatigue, and insomnia) were difficult to distinguish from anxiety symptoms and were, for the most part, mild. The therapeutic and side effects observed suggested CNS activity of the drug. Although propranolol is of benefit to patients with anxiety, its efficacy, compared with that of other antianxiety drugs, has not been established.

Adolescent↗
PubMed1980

Mitral valve prolapse in anxiety neurosis (panic disorder).

Our purpose was to determine the incidence of mitral valve prolapse in patients with anxiety neurosis or panic disorder, with symptoms including recurrent anxiety attacks, dyspnea, palpitations, chest pain, dizziness, and paresthesias. Twenty-one patients and 20 age- and sex-matched normal controls were studied. Objective cardiac abnormalities were significantly (p < 0.05) more frequent in the patient group as compared to the control group; these comprised echocardiographic prolapse, ST-T abnormalities on resting ECG, premature ventricular contractions on exercise ECG, and the combination of echo prolapse with clicks/murmurs of exercise-induced PVC. We conclude that patients with anxiety neurosis or panic disorder may also have evidence of an organic abnormality--the mitral prolapse syndrome.

Adult↗
PubMed1980

A genetic study of panic disorder pedigrees.

Pedigree analysis is done on 19 kindreds of panic disorder, and the results suggest that this disorder is transmitted as an autosomal dominant trait. Seven of these 19 kindreds were ascertained through a panic disorder proband with mitral valve prolapse. When the analysis is done omitting these seven kindreds, the results also suggest that panic disorder without prolapse is transmitted as an autosomal dominant trait.

Anxiety Disorders↗
PubMed1979

Exercise and anxiety neurosis: comparison of patients with and without mitral valve prolapse.

It has been hypothesized that mitral valve prolapse may account for a substantial number of patients who have symptoms of chronic anxiety neurosis. In a previous investigation, this hypothesis was confirmed in eight of 21 patients who had anxiety neurosis. In the present investigation, we reevaluated the hypothesis that persons with anxiety neurosis have impaired exercise ability by exercising 20 of the anxiety neurotics according to a standard treadmill exercise protocol. Compared with the control group, the anxiety neurotics required less exercise to achieve an equivalent heart rate and therefore their estimated maximum oxygen consumption was less, thus confirming the hypothesis. However, this difference was due entirely to the anxiety neurotics with mitral valve prolapse, and those without prolapse did not differ significantly from the controls. This suggests that impaired exercise tolerance in anxiety neurotics may be attributable to a subgroup of these patients with mitral valve prolapse.

Adult↗
PubMed1979

The familial prevalence in second-degree relatives of patients with anxiety neurosis (panic disorder).

A family history study of second-degree relatives of 19 patients with anxiety neurosis (panic disorder) and 19 controls showed a morbidity risk of 9.5% among the former compared with 1.4% among the latter. These risks were approximately half those found among first-degree relatives. Female relatives were at higher risk for anxiety neurosis. The risk for other psychiatric illnesses did not differ between the relatives of anxiety neurosis and controls.

Alcoholism↗
PubMed1979

Stressful life events and burn injuries.

About half of the 67 adults admitted to a burn treatment unit during the course of a year were found to have pre-existing physical and/or psychiatric conditions that increased their susceptibility to injury. In addition, the majority of victims were unmarried, unemployed, and came from low social class, circumstances that tended to increase their vulnerability. A significant increase in stressful life events was reported by these patients during the year preceding burn injury. This life change was negatively correlated with age, income, and number of friends, and positively correlated with social class and psychiatric illness. Two subgroups of persons vulnerable to burns were identified, the first, older women with physical illness, and the second, persons of low social class with psychiatric disorders. The findings have implications for burn prevention and rehabilitation of burn victims.

Adult↗
PubMed1979

Distribution of ancestral secondary cases in anxiety neurosis (panic disorder).

The Slater computational model for use in distinguishing between polygenic inheritance and the effects of a single dominant gene with incomplete penetrance was applied to 15 kindreds of anxiety neurosis (panic disorder). The number of observed unilateral pairs (two ancestral cases from one side of the kindred) was significantly greater than the number expected. Therefore, these results suggest a dominant mode of transmission for anxiety neurosis.

Anxiety Disorders↗
PubMed1978

The familial prevalence of anxiety neurosis.

A family history study of 112 anxiety neurotics and 110 surgical controls showed that the morbidity risk for anxiety neurosis among first-degree relatives of neurotics was 18% compared to 3% among control relatives. Relatives of anxiety neurotics were also shown to be at higher risk for the development of alcoholism. Female relatives were found to be at greater risk than male relatives, reflecting their increased susceptibility to the illness. These data confirm previous findings of an increased familial prevalence of anxiety neurosis.

Alcoholism↗
PubMed1978

Effect of benzopyranoperidine, a delta-9-THC congener, on pain.

In a double-blind, 5-way crossover designed study, single doses of placebo, 2 doses of codeine sulfate (60 and 120 mg), and 2 doses of benzopyranoperidine (2 and 4 mg) were administered orally to 35 patients who required analgesics for chronic pain due to malignancies. Benzopyranopyridine is an analogue of delta-9-tetrahydrocannabinol and was chosen on the basis of its sedative, hypnotic, and analgesic properties in animals. Pain relief scores indicated a degree of relief of clinical significance with 120 mg of codeine but no consistent difference between placebo and any other active agent. On the basis of the data, bezopyranoperidine (2 or 4 mg) is not as effective as codeine (120 mg or 60 mg) and not more effective than placebo in relieving pain due to cancer; indeed, pain perception appeared to be augmented by both doses.

Adult↗