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Biomedical subjects

S Zisook

Publications and source records attributed to S Zisook.

At least 19 recordsLinked to original sources
PubMed1992

Negative symptomatology in schizophrenic outpatients.

This study examines the prevalence of negative symptoms, and assesses the convergence of negative and depressive symptoms in 60 chronically ill schizophrenic outpatients. Negative symptoms were assessed with the Scale for the Assessment of Negative Symptoms and the negative symptom cluster of the Brief Psychiatric Rating Scale (BPRS). Depressive symptoms were assessed with the depression subscale of the Brief Symptom Inventory and the depressive symptom cluster of the BPRS. A majority of patients in this group of relatively stable, schizophrenic outpatients demonstrated mild to moderate degrees of both negative and depressive symptoms. Correlations were not significant between negative symptom and depressive symptom measures, which suggests that the symptom constructs are relatively independent. Comparisons between a subgroup with prominent negative symptoms (N = 18) and a subgroup with minimal negative symptoms (N = 32) also revealed no significant group differences in variables that characterize clinical course (i.e., age of onset and frequency and duration of hospitalization) or in the severity of depressive symptoms. This lack of any significant differences on the clinical course variables may be partially explained by the heterogeneity of negative symptoms. The constellation of negative symptoms may differ not only in etiology but also in their temporal relationships to other aspects of the patient's clinical course. Longitudinal studies will be needed to track the long-term outcome of negative and depressive symptoms.

Adolescent↗
PubMed1992

Past substance abuse and clinical course of schizophrenia.

To evaluate the effects of previous alcohol and drug use on the course and symptoms of schizophrenia, the authors compared 34 patients with schizophrenia who had histories of substance abuse with 17 patients with schizophrenia who were lifelong abstainers. Surprisingly, they did not find that individuals with past histories of abuse were more impaired or had more symptoms.

Adult↗
PubMed1991

Magnetic resonance imaging abnormalities in lenticular nuclei and cerebral cortex in schizophrenia.

Neuropathologic and brain imaging studies have produced evidence of brain abnormalities in schizophrenic patients, often within the cerebrum's limbic lobe, and, less frequently, within basal ganglia. In the present study we used magnetic resonance imaging morphometric techniques to estimate volumes of specific cerebral structures in schizophrenic patients and age- and sex-matched normal controls. Estimates of the volume of mesial temporal lobe structures were reduced and estimates of the volume of the lenticular nucleus were increased in the schizophrenic patients. There was also evidence of reduced cranial volume in some schizophrenics. The magnitude of the lenticular abnormality, but not the temporal lobe abnormality, was associated with age at first psychiatric contact; earlier onset was associated with larger lenticular nuclei. The possible relevance of these results to neurodevelopmental hypotheses about the pathogenesis of schizophrenia is discussed.

Adolescent↗
PubMed1991

The generalized pattern of neuropsychological deficits in outpatients with chronic schizophrenia with heterogeneous Wisconsin Card Sorting Test results.

Forty schizophrenic outpatients and 40 normal subjects were assessed using extensive clinical (eg, Brief Psychiatric Rating Scale, Scale for the Assessment of Negative Symptoms and Scale for the Assessment of Positive Symptoms) and neuropsychological (extended Halstead-Reitan Battery) measures. The schizophrenic patients had multiple neuropsychological deficits on tests of complex conceptual reasoning, psychomotor speed, new learning and incidental memory, and both motor and sensory-perceptual abilities. Neuropsychological impairment correlated more strongly with negative than positive symptoms. Overall, the schizophrenic outpatients showed relatively modest increases in the number of perseverative responses on the Wisconsin Card Sorting Test of abstraction flexibility. A subgroup of these schizophrenic patients seemed to be particularly impaired on the Wisconsin Card Sorting Test. This pattern of results, in conjunction with previous studies, supports the idea that, while some schizophrenic patients may have fixed, frontally based dysfunctions, these dysfunctions may be most prominent, and even fixed, in deteriorated, kraepelinian patients. These data provide evidence for diffuse and far-reaching deficits in a majority of outpatients with chronic schizophrenia.

Adult↗
PubMed1991

Predictors of response to monoamine oxidase inhibitors: do they exist?

Multiple regression analysis was conducted on potential response predictors in a double-blind study of monoamine oxidase inhibitors (MAOI) and placebo treatment in 130 depressed outpatients. Positive main effects were found for sex (female), lack of prior hospitalization, presence of precipitating events. A negative main effect was found for concurrent physical illness. Treatment x predictor effects were found for distinct quality and non-reactivity. Non-reactivity was associated with positive outcome in the active drug group, but with negative outcome in the placebo group [corrected]. Distinct quality demonstrated a more complex effect, its presence being associated with decreased improvement in the treatment group and greater improvement in the control group. No atypical depressive symptoms predicted MAOI response, and we were unable to characterize a specifically responsive MAOI syndrome.

Adult↗
PubMed1991

Early psychological reaction to the stress of widowhood.

As part of an ongoing panel study, we evaluated 350 widows and widowers at 2 and 7 months following the loss of their spouses. In general, no consistent progression of grief resolution was noted. At 7 months, grief-specific feeling states remain remarkably similar to what they were at 2 months. Anxiety levels remain high and change little from 2 to 7 months. When changes do occur, they are not unidirectional. For example, subjects are about as likely to increase as to decrease their drinking or smoking. Furthermore, depression scores at month 2 correlate well with depression and anxiety scores at month 7. Over 50% of the subjects were depressed at some time during the study period, but the depression could initially manifest itself at any time during this period. Despite the presence of psychological distress in a significant minority, most bereaved individuals report good health, satisfactory work performance and good adjustment to widowhood.

Adaptation, Psychological↗
PubMed1991

Depression through the first year after the death of a spouse.

OBJECTIVE: This study assesses the frequency of depressive syndromes during the first 13 months after the death of a spouse. METHOD: Men and women whose spouses had recently died were identified through death certificate records. These subjects completed a multidimensional questionnaire and were interviewed 7-8 weeks (2 months) after the death. Follow-up questionnaires were completed 7 and 13 months after the death. The questionnaires contained specific items corresponding to DSM-III-R criteria for depressive episodes as well as other widely used measures of depressive symptoms such as the Zung Depression Scale and the Hopkins Symptom Checklist. RESULTS: Eighty-four (24%) of 350 widows and widowers met criteria for depressive episodes at 2 months, 72 (23%) of 308 did so at 7 months, and 46 (16%) of 286 did so at 13 months. At each time period, the prevalence was substantially higher than the 4% rate of depressive episodes observed in a comparison group of 126 subjects whose spouses were still living. Widows and widowers most likely to meet criteria for depressive episodes 13 months after the bereavement were younger, had past histories of major depression, were still grieving 2 months after the loss, and met DSM-III-R criteria for depressive episodes 2 and/or 7 months after the death. CONCLUSIONS: Depressive episodes are common after the death of a spouse. Clinicians should maintain a high index of suspicion for the possibility of depression, particularly in young widows and widowers who have a past history of depression or who experience a full depressive syndrome soon after the loss.

Depressive Disorder↗
PubMed1990

Anxiety and bereavement.

The results reported here support the observations that anxiety symptoms are prevalent, often severe, and may last through at least the first seven months of bereavement. In addition, many widows and widowers are prescribed, or take on their own, medications geared to attenuate the discomfort of these symptoms. A preliminary profile of persons most likely to suffer substantial and relatively prolonged anxiety after the stress of widowhood includes: someone who is young, female and experiences a loss of income related to the death; someone who lacks social support; and someone who experiences acute grief, a depressive syndrome and anxiety symptoms at the end of two months. We hope to build on this profile over time, so that vulnerable individuals might be identified and offered early intervention.

Adaptation, Psychological↗
PubMed1990

Depression in the context of human immunodeficiency virus infection: implications for treatment.

A chart review of 90 male outpatients was conducted to document the type of depressive symptomatology associated with HIV infection and to review the nature of antidepressant treatment provided in two university-affiliated outpatient settings. Forty-five individuals who tested positive for HIV infection and who were treated with antidepressant medications were compared with a like number of individuals who had no known risk factors as determined by chart review for HIV infection. Although depressive symptoms were generally similar among the two groups, HIV-positive individuals reported greater decreases in sleep and appetite than the HIV-negative comparison group. Overall, imipramine and fluoxetine earned the most favorable efficacy ratings while producing minimal side effect ratings in both HIV-positive and HIV-negative patients. Among the HIV-positive patients, the asymptomatic group had a better response to treatment with antidepressant medications than either the ARC or AIDS patient groups.

AIDS-Related Complex↗
PubMed1978

The hysterical personality--I. The healthy hysteric.

This paper examines the meaning and validity of 'hysterical personality disorders'. Theories and descriptions of hysterical personalities have been conflicting and often mutually incompatible, leading to a vague and imprecise nosology. No generally accepted specific inclusion criteria or follow-up studies are available; consequently, the diagnosis of 'hysterical personality disorder' has reflected adaptive as well as maladaptive traits. This paper critically examines the healthy dimension of Lazare's continuum of personality pathologies exhibiting hysterical traits. The continuum, in an attempt to reconcile the inconsistencies of this diagnosis, ranges from the relatively healthy (good, genital, true) hysteric, to the sick (bad, oral, 'so-called good') hysteric. But this paper concludes that here, too, evidence for diagnostic legitimacy is lacking. Women at the healthy end of the hysterical personality spectrum are best regarded as healthy and do not meet criteria for the diagnosis of a personality disorder.

Female↗
PubMed1978

Absence of hostility in outpatients after administration of halazepam--a new benzodiazepine.

A number of benzodiazepine have been shown to increase hostility and aggression. This study examines whether halazepam, a new benzodiazepine structurally very similar to diazepam, is associated with increases in hostility. Fifty-one adult outpatients in a double blind, 6 week study were randomly assigned either halazepam or placebo. Hostility was measured by changes in response on four different scales, the anger-hostility factor of the Patient Symptom Checklist and three MMPI hostility scales. The results of our study indicated that halazepam does not induce significant changes in hositility.

Adult↗
PubMed1977

Emotional factors in inflammatory bowel disease.

Inflammatory bowel diseases are not caused by emotional conflicts, but emotional factors influence both the pathogenesis and the course of the illness. Establishing a trusting physician-patient relationship is important in helping the patient to (1) avoid denial of illness or chronic illness behavior, (2) understand symptoms and diagnostic and treatment procedures, and (3) cope with loss of a key person or the threat of lessened self-control.

Adolescent↗