Thyroid function in psychotic depression.
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Adult↗
Biomedical subjects
R T Joffe
Publications and source records attributed to R T Joffe.
The effect of tricyclic antidepressants on basal thyroid hormone levels in depressed patients.
The effect of tricyclic antidepressant treatment on basal thyroid hormone levels was evaluated in 28 subjects with primary major depression. In the total group, tricyclic antidepressant treatment was associated with significant reductions in measures of thyroxine. Furthermore, responders to antidepressant treatment had significantly greater decrements in thyroxine and the free thyroxine index as compared with nonresponders. This finding appears consistent with the effects of a wide range of antidepressant treatments on thyroid function tests.
Adult↗
Models for research in consultation psychiatry.
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Adrenal Cortex Hormones↗
Neuropsychiatric manifestations of altered thyroid state.
The authors assessed the mood and cognitive effects of sequential T4, T3, and withdrawal of thyroid hormone replacement on 25 patients who had had thyroidectomies for thyroid cancer. The patients experienced increased sadness and anxiety when they were without medication, but not significant difference in mood was noted between T4 and T3. The patients who experienced increased affective symptoms when not taking medication were more likely to have histories of affective illness or mood lability.
Adult↗
A perspective on the thyroid and depression.
There is extensive literature documenting an association between abnormalities of the hypothalamic-pituitary-thyroid axis and disorders of mood. However, the specific abnormality in thyroid functioning associated with primary affective disorder remains poorly understood. Various aspects of the relationship between thyroid functioning and affective illness are reviewed. Particular attention is paid to psychiatric symptoms and clinical thyroid disorders as well as abnormalities of basal thyroid hormone levels in depression and the use of thyroid hormones in the treatment of depressive illness. Current hypotheses regarding the association between altered thyroid functioning and depressive illness are critically reviewed.
Antidepressive Agents↗
Afternoon fatigue and somnolence associated with tranylcypromine treatment.
The author examined a series of 23 depressed and 15 obsessive compulsive disorder outpatients who were treated with 40-80 mg/day of tranylcypromine to determine the frequency and clinical features of fatigue and somnolence. Four (all depressed) of the 38 patients experienced hypersomnolence and fatigue in the late afternoon. The somnolence was severe enough to impair their ability to work and drive. Afternoon fatigue and somnolence appear to be important and not uncommon side effects of tranylcypromine treatment.
Adult↗
The prevalence of cyclothymia in borderline personality disorder.
Sixty patients with personality disorders were evaluated by several different diagnostic instruments to determine the prevalence of cyclothymia in borderline personality disorder (BPD) and in other personality disorders (OPD). Cyclothymia occurred more frequently in BPD than in OPD, regardless of which diagnostic system was used. In contrast, the prevalence of major, minor, and intermittent depression, hypomania, and bipolar disorder was not significantly different in BPD as compared with OPD. Cyclothymic borderlines and noncyclothymic borderlines could not be distinguished on behavioral or functional measures. These results have implications for the diagnostic validity of both BPD and cyclothymia.
Adult↗
Folate, B12, and life course of depressive illness.
Forty-four consecutive, unmedicated outpatients with a major depressive disorder were evaluated to determine the relationships in life course, severity of depressive illness, and serum folate and B12 levels. Duration of current episode was significantly inversely correlated with folate levels. Age at onset of illness was significantly correlated with B12. In a subgroup of recurrent depressives, current age and age at onset of depressive illness were positively correlated with folate. The findings are discussed in light of the current hypotheses regarding the association of folate and mood.
Adult↗
Personality and depression: a further evaluation.
This brief report provides additional data indicating that the depressed state may lead to a significant increase in the frequency of diagnosis of personality disorder, and that the assessment of personality disorder should be delayed until successful treatment of an acute depression.
Adult↗
Life events and mania: a case-controlled study.
Life events were evaluated in 14 patients with bipolar affective disorder in the year preceding a mania as well as in 14 patients with bipolar affective disorder without a mania matched for age, sex, and time of recall. There were a significantly greater number of uncontrolled and unanticipated life events in the patients with as compared to those without a mania. However, neither the total number of life events nor measures of distress and stress distinguished bipolar patients with as compared to those without mania.
Adaptation, Psychological↗
Personality and response to tricyclic antidepressants in depressed patients.
Several studies have shown that disturbances of personality are poor predictors of response to antidepressants. None of these studies, however, has used personality measures similar to the DSM-III. We evaluated the relationship between antidepressant response and personality scores obtained on the Millon Clinical Multiaxial Inventory, which provides personality measures congruent with DSM-III. Personality features such as assertiveness, independence, and competitiveness distinguished responders from nonresponders. However, the frequency of personality disorder diagnoses did not differ between responders and nonresponders.
Adult↗
Lithium and carbamazepine-induced agranulocytosis.
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Agranulocytosis↗
Pharmacological management of refractory depression.
Managing patients with "treatment resistant depression" offers a major challenge to clinical psychiatrists, psychopharmacologists, and others. Firstly, patient heterogeneity must be recognized in terms of symptom presentation, biological variables, co-morbidity with other psychiatric and medical disorders and associated personality disorder. Secondly, a rigorous approach to the treatment resistant patient must allow for adequate individual and combination therapies including heterocyclic agents, monoamine oxidase inhibitors, electroconvulsive therapy, and augmentation with lithium carbonate or thyroid hormone. The novel antidepressant therapies have not so far altered the relapsing course of depressive illness for many patients.
Antidepressive Agents↗
Normal urinary free cortisol and plasma MHPG in panic disorder: clinical and theoretical implications.
Abnormalities of the hypothalamic-pituitary-adrenal (HPA) axis and noradrenergic function have been reported in patients with panic disorder. Mean urinary free cortisol and plasma MHPG were measured in 12 medication-free panic disorder patients and 12 normal controls. No significant difference in urinary free cortisol and plasma MHPG was observed between the patients and controls. There was no relationship between plasma MHPG and urinary free cortisol in the panic patients or normal controls. These findings are described within the context of current concepts of stress and noradrenergic dysfunction in panic disorder.
Adult↗
Personality and depression.
Several studies suggest that measures of personality traits and disorders are affected by depressed state. However, none of the studies to date have evaluated the effect of depressed mood on personality using current diagnostic criteria. The effect of depressed mood on personality scale scores and personality disorder diagnoses using the Millon Clinical Multiaxial Inventory was assessed in 42 depressed patients. There was a significant alteration in mean personality trait scores and reduction in personality disorder diagnosis between the depressed and remitted states. The clinical and theoretical implications of these findings are discussed.
Adult↗
Effects of thyroid alterations and carbamazepine on cortical beta-adrenergic receptors in the rat.
The effect of alteration in thyroid status on beta adrenergic receptors in the cortex of the rat was assessed. Normal animals were treated with large doses of thyroxine (T4) and triiodothyronine (T3) and thyroidectomized animals were treated with physiological replacement doses of T4 and T3 in order to assess the possible differential effects of these hormones. In addition, a group of rats was treated with a diet of carbamazepine (an anticonvulsant also used in the treatment of manic-depressive illness), which has been shown to reduce peripheral levels of thyroid hormone in humans. The intended manipulations of the thyroid were achieved by the various treatments with thyroid hormone, and carbamazepine-diet-treated animals had significantly lower plasma T4 levels as compared with controls. No significant alteration in the density or affinity of beta-adrenergic receptors in the cortex was noted with major, short-term alterations in thyroid status or with treatment with carbamazepine. It is concluded that even marked, but relatively short-term, changes in thyroid status do not necessarily affect beta-receptors in the cerebral cortex and that carbamazepine may represent an exception to the general proposition that antidepressant agents decrease the number of beta-receptors.
Animals↗
Mood effects of alternate-day corticosteroid therapy in patients with systemic lupus erythematosus.
Mood and cognition were assessed on consecutive days in 18 female patients with systemic lupus erythematosus on alternate-day corticosteroid therapy. No overall differences in mood and cognition were observed between the on- and off-medication days. However, 10 patients showed marked worsening or improvement of either depression or anxiety on their off-medication day. Two weeks of prospective behavioral ratings confirmed the observed mood changes in several patients. The clinical and theoretical implications of these findings are discussed.
Adult↗
Ventricular-brain ratio and life course of illness in patients with affective disorder.
The relationship between ventricular-brain ratio (VBR) on computed tomography of the brain and life course of illness was assessed in 59 hospitalized patients with recurrent affective disorder. In contrast to the implications of some, but not all, prior studies. VBR was not positively related to episode frequency, severity, pattern, or chronicity. In fact, when analyzed by sex, in both males and females, VBR was inversely related to several measures of illness chronicity.
Adult↗