Biomedical subjects

S Kutcher

Publications and source records attributed to S Kutcher.

At least 37 records · Page 2Linked to original sources

PubMed1995

The effect of adjunctive light therapy on ameliorating breakthrough depressive symptoms in adolescent-onset bipolar disorder.

Seven adolescents or young adults (aged 16 to 22 years) who met DSM-III-R criteria for bipolar disorder were treated for persistent depressive symptoms (greater than three weeks) with adjunctive light therapy (10,000 lux given twice per day). Patients were evaluated using the Beck Depression Inventory (BDI) and Symptoms Check List (SCL-58). Three patients showed a marked response of greater than 70% decrease of their baseline score. Two patients had a moderate decrease (40% to 74%) and two patients obtained mild to no response. There were no reported side-effects. Paired t-tests done on pre- and post-BDI scores (pre mean = 21.2 sd +/- 10.0; post mean = 11.1, sd +/- 8.8; paired t = 4.31; p > 0.0051) and pre- and post-SCL-58 scores above baseline of 58 (pre mean = 57.4, sd +/- 24.4; post mean = 28.7, sd +/- 18.6; paired t = 5.50; p > 0.0015) showed significant improvement. These preliminary results indicate that some bipolar adolescents with breakthrough depressive symptoms could benefit from light therapy as an adjunct to their continued thymoleptic treatment.

Adolescent↗

PubMed1995

The prevalence of cognitive distortion in depressed adolescents.

This study examined the prevalence of cognitive distortion in depressed adolescents. Ninety-four consecutive depressed adolescent psychiatric outpatients were administered the Beck Depression Inventory, the Dysfunctional Attitude Scale, the Interpersonal Dependency Inventory and the Maudsley Personality Inventory. Depressed patients who scored above a threshold for cognitive distortion were compared to those who fell below the threshold. Of the depressed patients, 47.4% were found to meet the severity criteria for cognitive distortion, while the remaining 52.6% were found to be below the severity threshold. Cognitive distortion was associated with more severe symptoms of depression, lack of social self confidence and greater introversion. These results do not support the hypothesis that cognitive distortion is universal in clinical depression. However, they do suggest that cognitive distortion is associated with more severe depression.

Adolescent↗

PubMed1994

Response to desipramine treatment in adolescent depression: a fixed-dose, placebo-controlled trial.

OBJECTIVE: To determine the efficacy and tolerability of the tricyclic antidepressant desipramine (DMI) in the treatment of DSM-III-R-diagnosed major depressive disorder in adolescents. METHOD: Sixty adolescents (42 female, 18 male; aged 15 to 19 years) diagnosed with major depressive disorder using clinical interview and Schedule for Affective Disorders and Schizophrenia for School-Age Children were randomized to receive either DMI (200 mg daily in divided doses) or placebo for six consecutive weeks following a 1-week placebo period. Treatment outcome was determined using the Hamilton Depression Rating Scale and the Beck Depression Inventory. Tolerability was determined using a symptom side effects scale. In addition, a variety of laboratory and cardiovascular monitoring was performed. RESULTS: No significant differences in treatment outcome between DMI- and placebo-treated groups were determined. Neither DMI, nor its metabolite 2-hydroxy-DMI, nor their ratio, was positively correlated to treatment outcome. The DMI group endorsed more side effects but there were no significant between-group differences in any laboratory, electrocardiographic, or other cardiovascular parameters apart from heart rate, which was increased in the DMI-treated group (p = .03). CONCLUSIONS: Given the findings of this study and our review of previously published reports of tricyclic antidepressant treatment in this population, the routine use of short-term (6 weeks) DMI in the treatment of adolescent depression is not supported by the data on hand. Further investigations into what constitutes optimal psychopharmacological treatment of adolescent depression are warranted.

Adolescent↗

PubMed1993

Cognitive social skills and social self-appraisal in depressed adolescents.

OBJECTIVE: This study was undertaken to determine whether the social cognitive skills and social self-appraisal of depressed adolescents differed from those of other adolescents with nonaffective psychiatric disorders or of adolescents free from disorder. METHOD: Within the age range of 15 to 19, 38 depressed adolescent outpatients (14 boys, 24 girls); 31 nondepressed adolescent outpatients (17 boys, 14 girls); and 34 normal high-school students (18 boys, 16 girls) were assessed using the following dependent measures: Interpersonal Negotiation Interview, Adolescent Social Problem Solving Measure, Adolescent Self Perception Profile, and Interpersonal Dependency Inventory. RESULTS: Depressed adolescents were found to have significantly more negative self-concepts and significantly less social self-confidence than either comparison group. They did not differ from the other adolescents in either social problem-solving ability or interpersonal understanding. CONCLUSIONS: These results indicate that depressed adolescents have unique deficits in social self-evaluation which contribute to ineffective social behavior and the maintenance of dysphoric affect. Treatment of social skill deficits should be based on a careful assessment of the patient's functioning in this area.

Adolescent↗

PubMed1993

Dimenhydrinate abuse among adolescents.

Dimenhydrinate may be a relatively common yet unrecognized substance of abuse among adolescents. Abuse of this drug may present as a psychiatric syndrome, particularly depression. Three cases are presented which illustrate this relationship. A review of the literature is presented and suggestions are made for identifying adolescents who abuse dimenhydrinate.

Adolescent↗

PubMed1993

Cognitive distortion in depressed adolescents.

Cognitive theories of the etiology of depression in adulthood have received widespread acceptance. To date there is little evidence of the role of cognitive distortion in the etiology of depression among adolescents. This study was conducted to determine whether or not cognitive distortion differentiates depressed adolescents from non-depressed adolescents. The Dysfunctional Attitude Scale, a measure of cognitive distortion, was administered to three groups of adolescents: clinically depressed; non-depressed with non-psychotic psychiatric disorders; and a non-clinical group of adolescents without psychiatric disorders. A subset of the depressed patients was re-administered the scale after they had clinically recovered from the depressive episode. The depressed adolescents had significantly greater cognitive distortion than the non-depressed adolescents. Remission of the depressive disorder was associated with a significant reduction in cognitive distortion, although the level of cognitive distortion was still significantly higher than normal.

Adolescent↗

PubMed1992

Specificity of psychoanalytic hypotheses regarding the onset of adolescent psychoses: an empirical test of a psychodynamic model.

The specificity of psychodynamic hypotheses regarding the onset of adolescent psychosis was assessed in a group of rigorously diagnosed psychotic (N = 75) and depressed (N = 53) adolescents. None of the four operationally defined psychodynamic hypotheses purported to be etiologically specific in the onset of adolescent psychotic illness: success and its opportunities; intimacy and its attempts; intent to act autonomously; or involved in insight-oriented psychotherapy was more commonly observed in the psychotic than the depressed group, thereby not supporting the hypotheses. The consequences of this finding are discussed.

Adolescent↗

PubMed1992

Substance abuse among adolescents with chronic mental illnesses: a pilot study of descriptive and differentiating features.

Twenty-six adolescents with a chronic mental illness (schizophrenia or schizoaffective disorder of at least 1.5 years' duration) were assessed for the presence or absence of comorbid substance abuse. The two groups were compared on a number of variables believed to identify or predict substance abuse. The substance abusing subgroup were significantly different in levels of social functioning, school achievement, premorbid substance abuse, having parents or siblings who abused substances, dysfunctional families, cigarette smoking, number of hospital admissions, and emergency room visits. These findings are discussed in the context of clinical issues regarding the management of adolescents with chronic mental illnesses.

Adolescent↗

PubMed1992

Anxiety disorders in children and adolescents: clinical and related issues in pharmacological treatment.

Anxiety disorders in children and adolescents are receiving more attention from clinicians and researchers. Psychopharmacological approaches to controlling symptoms of anxiety are possible as part of a multi-model treatment approach. This paper provides an overview of some recent findings in child and adolescent anxiety disorders that may influence treatment decisions. It also reviews studies of the use of benzodiazepines and tricyclic antidepressants in treating children and adolescents who suffer from anxiety disorders, and suggests methods of integrating pharmacological treatment with other modalities in these disorders.

Adolescent↗

PubMed1992

REM latency in endogenously depressed adolescents.

Twenty-three adolescents with DSM-III major depressive disorder (endogenous subtype) and 23 normal controls were studied polysomnographically (PSG). The depressed group showed significantly shortened REM latencies (P = 0.005) and longer sleep latencies (P = 0.04). No other PSG measures differentiated the two groups. The implications of these findings for adolescent depression are discussed.

Adolescent↗

PubMed1991

Affective disorders in first-degree relatives of adolescent onset bipolars, unipolars, and normal controls.

Two hundred and fifty-nine first-degree relatives of 23 adolescent bipolars (81 relatives); 26 unipolars (95 relatives); and 24 normal controls (83 relatives) were assessed for the presence of affective disorders, using the family history method. First-degree relatives of bipolar probands were significantly more likely to have a bipolar illness than those of unipolar probands (p = 0.03) and normal controls (p = 0.001). Rates of unipolar depression in first-degree relatives of bipolars and unipolars were not significantly different but differed significantly between bipolars and normals (p = 0.002) and unipolars and normals (p = 0.006). The implications of these findings for clinical work, diagnosis, and research in adolescents with affective disorders are discussed.

Adolescent↗

PubMed1991

Nocturnal cortisol, thyroid stimulating hormone, and growth hormone secretory profiles in depressed adolescents.

Twelve depressed adolescents and 12 controls matched for age, sex, Tanner stage, time of menstrual cycle (females), weight, and time of year assessed were studied over 3 nights. Measurements for cortisol, thyroid stimulating hormone, and growth hormone were made on serum collected at 10 P.M., 12 midnight, 1 A.M., 2 A.M., 3 A.M., 4 A.M., and 6 A.M. in eight pairs and every 20 minutes from 8 P.M. to 7 A.M. in four pairs. Cortisol secretion did not significantly differentiate the groups. Thyroid stimulating hormone secretion was significantly elevated in the depressed group at one time point. Growth hormone secretion significantly differentiated the two groups at most time points, and the depressed adolescents significantly hypersecreted growth hormone (area under the curve). Implications for the diagnosis, etiology, and treatment of adolescent depression are discussed.

Adolescent↗

PubMed1991

Diagnostic utility of the Beck Depression Inventory with adolescent psychiatric outpatients and inpatients.

The utility of the Beck Depression Inventory (BDI) for differentiating adolescents with depressive disorders from adolescents with non affective psychiatric disorders was examined using a sample of 93 psychiatric outpatients and 26 inpatients. The Diagnostic Interview for Children and Adolescents (DICA) was administered to establish the patients' diagnosis. Psychiatric diagnoses were made by experienced clinicians who used all available information on the patient. The BDI scores discriminated between patients with depressive disorders and patients with non affective psychiatric disorders. This differentiation was true for boys and girls, outpatients and inpatients. The classification accuracy of the instrument was 75% at thresholds of 11 and 16 on the scale. The results indicate that the BDI is a useful instrument for screening for depression in adolescents, and can also be used in conjunction with other tests. However, the BDI by itself is inadequate to establish a diagnosis of depression.

Adolescent↗

PubMed1991

Response to desipramine treatment in adolescent major depression.

Thirty adolescents (ages 15-20) who met DSM-III-R criteria for major depressive disorder completed a double-blind, placebo-controlled, 6-week, fixed-dose (200 mg daily) study of desipramine (DMI). Thirty-three percent of the placebo group and 50 percent of the DMI group improved (greater than or equal to 50% change on the Hamilton Rating Scale for Depression). Subjective reports of adverse effects did not significantly differentiate the two groups. Major adverse effects, necessitating study discontinuation, occurred solely in the DMI group.

Adolescent↗

PubMed1990

Feeling states during adolescence.

Adolescence is characterized by a wide variety of feeling states with certain stages in adolescence being associated with particularly strong affects, a result of the normative developmental process. Affective psychopathology during the adolescent years, particularly in the disorders of depression and mania/hypomania, is characterized by abnormalities in the quality and quantity of affective patterns and additionally by the appearance of feeling states, which may be historically uncharacteristic for the teen (i.e., out of keeping with his previous longitudinal pattern of personality development). Clinicians faced with assessing disturbances in feeling states during the adolescent years must carefully distinguish fluctuating developmental problems from clinical syndromes. A longitudinal assessment period is usually necessary before this distinction can be made with some certainty. The prescription of treatment, be it psychologic, biologic, or systems based, should await the completion of a careful clinical assessment prior to its institution.

Adolescent↗

PubMed1989

Personality dysfunction in depressed adolescents.

The personality characteristics of 35 consecutively assessed adolescents who met the DSM-III criteria for a current depressive disorder were assessed using independent structured interviews and paper and pencil measures. Sixty-five percent of the sample met the criteria for an Axis II personality disorder. The single most common diagnosis was borderline personality disorder (30%). Depressed adolescents with a concurrent personality disorder were less self-confident, displayed more neuroticism, and were emotionally reliant on others. They also demonstrated greater cognitive distortion. Teenagers who present with a depressive disorder warrant a comprehensive personality assessment. The combination of affective and personality disorder in such patients is associated with attitudes and interpersonal problems which should be therapeutically addressed in addition to symptomatic treatment of the depressed mood. Clinicians should be aware that depressed adolescents with personality disorder may be more likely to make a suicide attempt.

Adolescent↗

PubMed1989

Successful clonazepam treatment of neuroleptic-induced akathisia in older adolescents and young adults: a double-blind, placebo-controlled study.

In a double-blind, placebo-controlled trial of clonazepam in the treatment of neuroleptic-induced akathisia in older adolescents, clonazepam was significantly more effective at reducing akathisia scores at the end of the first treatment week than placebo (p less than 0.0001). Clonazepam may be a safe and effective treatment for neuroleptic-induced akathisia in this age group.

Adolescent↗

PubMed1988

Thyroid function and bipolar affective disorder.

Thyroid function tests and life course of illness were evaluated in 42 patients with bipolar affective disorder who had received at least 3 months of lithium carbonate treatment. Eight of 42 patients (19%) required thyroid replacement or had evidence of subclinical hypothyroidism associated with lithium treatment. Abnormalities of thyroid function were related to female sex and duration of lithium treatment but not to a rapid-cycling course of illness.

Adolescent↗