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Biomedical subjects

S Zisook

Publications and source records attributed to S Zisook.

At least 73 records · Page 4Linked to original sources
PubMed1988

Effects of transdermal clonidine treatment on withdrawal symptoms associated with smoking cessation. A randomized, controlled trial.

In a double-blind, randomized, placebo-controlled trial, we studied 40 cigarette smokers to determine the effects of one week of transdermal clonidine hydrochloride (Catapres-TTS No. 2) treatment on the withdrawal symptoms associated with smoking cessation. Subjects were instructed to maintain their usual cigarette intake during days 1 through 3 and cease smoking for days 4 through 6. All of the withdrawal symptoms measured (craving, irritability, anxiety, restlessness, difficulty concentrating, and hunger) significantly increased during the three days of smoking cessation in the placebo group. There was a 4.3-fold increase in craving, a 3.8-fold increase in irritability, a 3.7-fold increase in anxiety, and a 3.3-fold increase in restlessness in the placebo group compared with the transdermal clonidine group during the three days of smoking cessation. Impairment of concentration and hunger were not significantly diminished by transdermal clonidine treatment during smoking cessation. In addition, a trend was present in the transdermal clonidine group to spontaneously decrease the number of cigarettes smoked per day during the smoking period. Side effects were generally mild. We conclude that transdermal clonidine treatment ameliorates some of the short-term withdrawal symptoms, especially craving, associated with smoking cessation.

Acute Disease↗
PubMed1988

Cyclic 48-hour unipolar depression.

This single case study reports on a 74-year-old woman with 48-hour cycles of mood disturbance for 2 years. Every other day she awakened feeling sad with low energy, decreased appetite, fatigue, diminished enjoyment of normal activities, increased irritability, occasional self-deprecatory thoughts, and difficulty concentrating. On alternative days she was active, outgoing, energetic, and cheerful. Her past history was marked by mild postpartum depressions, not requiring treatment, with each of her six pregnancies, and a more severe depression at age 57, which seemed to respond to Premarin. During the recent 2-year period of mood swings, the patient was given trials of several heterocyclic antidepressant medications, but side effects precluded the use of therapeutic doses or durations of treatment. Reluctantly, the patient agreed to a trial of lithium carbonate. After the second week of lithium treatment, at a level of 0.4 mEq/ml, she reported marked improvement, feeling fine every day without mood fluctuations. After almost 1 year at this blood level, she remains asymptomatic. Thus, the patient's cyclic 48-hour unipolar depression responded dramatically and completely to low doses of lithium carbonate.

Aged↗
PubMed1988

Delirium.

Explore the source record for details and available documents.

Aged↗
PubMed1988

Depression in the aged. An overview.

Depression in the aged is common and associated with substantial medical and social morbidity and mortality. It is often missed or misdiagnosed because of masked or somatic symptoms, delusions, and pseudodementia. At any given time, about 2 per cent of the elderly have major depression and a third to a half of older psychiatric inpatients and outpatients have mood disorders. Aged depressives have more somatization, hypochondriasis, anxiety, retardation, and delusionality but less guilt, loss of libido, and family history of depression than young ones. Both the illnesses common in the elderly and the medicines used to treat them may be etiologically connected with depression. After precipitating causes are remedied, remaining symptoms respond to antidepressant treatment. Medication doses are much lower and side effects more troublesome. ECT or concomitant antipsychotic medication are more likely to be indicated.

Aged↗
PubMed1987

Efficacy and safety of fezolamine in depressed patients.

Forty-two outpatients with major depressive disorder were treated with oral fezolamine in a 6-week, three-center open-label study. Therapy was initiated at 100 mg/day; thereafter dosage was increased based on the response of the patient. Maintenance dosage usually ranged between 100 and 450 mg/day. Clinically significant improvement relative to the patient's prestudy state was observed after 2 weeks in both patient and physician-rating scales. Fifty-five percent of patients improved their Hamilton Psychiatric Rating Scale for Depression (HAM-D) scores by more than 50%. The median dose associated with a clinically significant response was 245 mg/day. Five of the 6 patients who dropped out did so because of gastrointestinal adverse effects. The most common adverse effects were nausea (36%), headache (29%), constipation (26%), and dry mouth (24%).

Adult↗
PubMed1987

Male primary alcoholics with and without family histories of affective disorder.

The relationship between the clinical course and a family history of affective disorder among 377 carefully diagnosed male primary alcoholics admitted to the Alcohol Treatment Program (ATP) at the San Diego Veterans Administration Medical Center is evaluated. Data were gathered from interviews with patients and two resource persons at intake and from patients and one resource person interview obtained on 361 (95%) of the men 12 months after discharge. The 37 primary alcoholic men (10%) who had a first-degree family member with affective disorder were themselves more likely to have had secondary depressions and to have experienced more alcohol-related problems at 1-year follow-up than the 90% of primary alcoholic men without such family histories. However, many clinical characteristics associated with a family history of affective disorder were similar to those observed in men with family histories of alcoholism. This indicates the possibility that the presence of a family history of illness in general may be as important as the specific diagnoses of affective disorder or alcoholism in the close family member.

Adult↗
PubMed1987

Predictors of psychological reactions during the early stages of widowhood.

In conclusion, this preliminary study of 2-month outcome to spousal bereavement found (1) most widows and widowers had social supports and lack of such supports was not related to outcome; (2) a clinical depressive syndrome was common, and a history of past depressions was associated with poor outcome; (3) more subjects increased alcohol consumption and cigarette use after their loss than decreased their use, but a past history of problems with alcohol was not related to outcome; (4) female, younger, and poorer survivors had the worst outcomes; (5) more disturbed marital relationships correlated highly with poor outcomes; (6) when the deceased spouse died without warning and without a prolonged illness, the survivor was more apt to have a difficult adjustment; and (7) the continued presence of active grief was associated with increased levels of anxiety, somatization, interpersonal sensitivity, and depression. Finally, the results of the study show that self-rated overall adjustment is highly correlated with other, standardized psychometric scale scores as well as with grief-specific affects. Assessing global adjustment may, therefore, be a simple, time-efficient, yet meaningful area of inquiry in clinical situations. This is the first in a series of studies on this widowed population. Future reports will focus on other dimensions of widowhood, changes over long-term follow-up, and the validity and reliability of the Widowhood Questionnaire.

Adult↗
PubMed1987

Treating depressions of bereavement with antidepressants. A pilot study.

Seven of 10 bereaved, depressed spouses had moderate to marked improvement of depressive symptoms during a 4-week open trial of tricyclic antidepressants. Several considerations suggested that this was a response in large part to the pharmacologic intervention and not simply to a therapeutic relationship. The application of antidepressants to treatment of the persistent major depressive syndromes observed late in the course of bereavement should be studied in systematic, controlled studies with larger samples. This is an important clinical issue given the high risk of prolonged depressive syndromes in acutely bereaved spouses.

Adult↗
PubMed1986

The dexamethasone suppression test in acute grief.

Nineteen recently widowed women and men were given diagnostic interviews, psychometric evaluations, and dexamethasone suppression tests (DSTs). While 58% of the subjects (N = 11) met Research Diagnostic Criteria for depression, only 16% (N = 3) were nonsuppressors on the DST. In this population, nonsuppression was related more to levels of anxiety than to depression.

Acute Disease↗
PubMed1986

Delirium: recognition and management in the older patient.

The EEG can be an enormous aid in distinguishing between organic and "functional" problems and between acute drug intoxication and other forms of delirium. The characteristic EEG finding in delirium is bilateral diffuse slowing that parallels the severity of the syndrome. The vulnerability of the elderly cannot be overstressed. Their health and nutritional status, borderline cerebral changes, and sensory deprivation due to impaired vision or hearing are all predisposing factors for delirium.

Aged↗
PubMed1985

Unresolved grief.

This paper has reviewed the literature on bereavement and, with particular emphasis on the authors' own work, describes three syndromes which seem to be related to the nonresolution of distinct phases of the grief process. The possibility of unresolved grief should receive a high index of suspicion for the patient with otherwise unexplainable depression, chronic illness behavior, or symptoms similar to those of a deceased relative or friend. When any of these syndromes are identified, it is useful to ask the patient who he has lost, how he has lost them, how he felt about the loss, whether he felt that he grieved, whether he still cries or feels the need to cry, and whether he has adjusted. The answer to these questions--both verbal and nonverbal--will help identify unresolved grief, when present, and may be a guide to specific interventions. On the other hand, our studies have suggested that unresolved grief is a somewhat overly simplistic concept. Most, if not all, people never totally resolve their grief; significant aspects of the bereavement process go on for years after the loss, even in otherwise normal patients. For some, identification syndromes continue. Others may continue to feel the presence of the deceased or have daily visions of him or her. Still others may feel pain, anger, and guilt for years after the death. It is still unclear at what point and to what degree these behaviors and symptoms become medical or psychiatric concerns and become pathological or predispose to serious medical, psychological, or social complications. Investigations into these unreported areas have been initiated and, we trust, will lead to clinically useful answers.

Adaptation, Psychological↗
PubMed1985

Time course of spousal bereavement.

This article reports the results of a survey on 300 widows and widowers who experienced spousal bereavement weeks to years prior to the study, and discusses the symptoms, syndromes, and behaviors seen at various time intervals. Although the reactions to widowhood were highly variable and individual, it was clear that for many widows and widowers, the time course of grief was much more prolonged than generally expected. Dysphoric feelings, symptoms, and behaviors were most frequent during the first year of bereavement, but often remained present even four or more years after the death. In particular, anger, guilt, depression, and anxiety tended to diminish over time, but not to statistically significant degrees. Many widows and widowers never fully accepted the fact of their spouses' deaths and maintained a continuing relationship with their deceased spouses, in their own ways, indefinitely. The implications of these findings and directions for future research are discussed.

Adult↗