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Biomedical subjects

S Zisook

Publications and source records attributed to S Zisook.

At least 91 records · Page 5Linked to original sources
PubMed1985

Clinical implications of DSM-III diagnoses of alcohol abuse and alcohol dependence.

The authors explored the clinical significance of the DSM-III distinction between alcohol abuse and alcohol dependence by studying 403 male primary alcoholics consecutively admitted to an inpatient alcohol treatment program. On intake, 186 men met criteria for alcohol abuse and 217 met criteria for alcohol dependence. The two groups were virtually identical except that subjects with alcohol dependence took more drinks per drinking day and had more alcohol-related medical problems and past hospitalizations. During a 1-year follow-up, men with alcohol dependence were more likely to have visited a public detoxification facility. The results do not support prognostic implications for the differentiation between alcohol abuse and alcohol dependence in alcoholic inpatients.

Adult↗
PubMed1985

Monoamine oxidase inhibitors in the treatment of atypical depression.

In a 6-week, double-blind study outpatients diagnosed as suffering from atypical depression were treated with either isocarboxazid or placebo. Selection criteria were purposely broad so as to capture the entire range of patients so diagnosed. Patients were then subclassified along several symptomatic, syndromal, phenomenological, and diagnostic categories in order to identify clinical characteristics specifically responsive to isocarboxazid. Although isocarboxazid was clearly superior to placebo for the overall group of atypical depressives, the authors were by and large unable to identify subgroups specifically responsive to the monoamine oxidase inhibitor. A few factors correlated with better response to both isocarboxazid and placebo: no family history of alcoholism or sociopathy, lack of self-pity, and not meeting Research Diagnostic Criteria for major depressive disorder. The single item that was associated with a statistically significant advantage of isocarboxazid over placebo was loss of anticipatory pleasure. Clinical implications and suggestions for further research are discussed.

Adjustment Disorders↗
PubMed1985

The dexamethasone suppression test and unipolar/bipolar distinctions.

In an attempt to validate several subtypes of affective disorders, 52 consecutive patients hospitalized at a clinical research center were comprehensively classified along several diagnostic and phenomenologic axes. Cortisol levels of each patient were evaluated at baseline and after the administration of 0.5 and 1.0 mg dexamethasone. None of the depressive subtypes responded significantly differently to the 1.0 mg dose. However, the bipolar subtype was associated with significantly different DST responses to the 0.5 mg dose. Patients with bipolar affective disorder, both manic and depressed, had higher postdexamethasone mean cortisol levels than all other groups. The results support the distinctiveness of the bipolar diagnosis.

Adolescent↗
PubMed1984

Side effects of isocarboxazid.

Three double-blind, placebo controlled studies found isocarboxazid (40-50 mg/day) to be efficacious and safe for the treatment of atypical depression. The few instances of liver function elevations were generally borderline; one patient had a marked increase of both SGOT and SGPT (with normal bilirubin and alkaline phosphatase) at Week 6 which normalized over the next several months. Another patient had a mild, temporary hypertensive reaction after eating cheese but did not require any treatment alterations. Drops in both systolic and diastolic blood pressures, as well as orthostatic changes, were common but generally mild and well-tolerated. The most frequently noted side effects were dizziness, headache, dry mouth, insomnia, and constipation. Clinical adverse reactions tended to be mild and to respond to dosage decreases. Isocarboxazid appears to be an underutilized and potentially valuable agent for the treatment of depressed patients.

Adult↗
PubMed1983

Isocarboxazid in the treatment of depression.

Of 50 outpatients with nonpsychotic, nonmelancholic, anxious depression, the 24 patients taking isocarboxazid had better scores on all outcome measures than the 26 patients taking placebo. Differences on several variables reached statistical significance by weeks 4-6.

Adult↗
PubMed1982

Measuring symptoms of grief and bereavement.

As part of an effort to develop an instrument to measure grief, a 58-item questionnaire was completed by 211 subjects who had lost a loved one because of death. The results demonstrated wide individual variations in specific symptoms and in their intensity and duration. Long after the immediate grief period, most bereaved individuals continued to feel upset, empty, or tearful; many experienced anniversary reactions and/or physical symptoms; and some had persistent identification phenomena. Although the acute dysphoria peaked between 1 and 2 years, several grief-related feelings, symptoms, and behaviors continued indefinitely. The relevance of present work and directions for future studies are discussed.

Adult↗
PubMed1982

Amoxapine and amitriptyline: serum levels and clinical response in patients with primary unipolar depression.

Amoxapine, a new antidepressant of the dibenzoxazepine class, was compared with amitriptyline in 80 patients with primary unipolar depressive disorders. In a four-week double-blind trial, the two medications were equally effective and had similar onsets of therapeutic action. The range of side effects was similar, although there was a trend for fewer side effects in the amoxapine group. Serum levels were not related to therapeutic response for either medication.

Adolescent↗
PubMed1981

Treatment validity of different diagnostic concepts of depression.

This study evaluated the comparative treatment validity of four different but overlapping sets of criteria for the diagnosis of depression: the St. Louis, New York, Texas Actuarial, and Composite criteria. Results revealed that none of the criteria offered predictive strength or demonstrated particular advantages over the others. Patients excluded by each of the various criteria tended to do as well as those included; a small percentage of patients included by each of the criteria were nonresponders to drug therapy. Once a clinical and psychometric diagnosis was established, then no additional (short-term) prognostic information was gained by further scrutiny with the various research diagnostic criteria examined.

Adult↗
PubMed1981

Life events and response to antidepressants.

The present study examined the relationship of life events and response to tricyclic antidepressants among 80 outpatients with unipolar, primary depressions. Participants were randomly assigned to receive either amitriptyline or amoxapine. Events occurring in either the two or 12 months prior to starting treatment (antecedent events) were unrelated to antidepressant response. However, events occurring during the treatment period itself (concurrent events) were significantly related to tricyclic response. Patients evidencing the poorer response reported almost three times as many concurrent events as the more improved patients. A poorer tricyclic response was associated in particular with concurrent events which were undesirable, health related, and perceived as being outside of the patient's own control. It was suggested that the continuing occurrence of stressor events probably interferes with treatment efforts and, therefore, it may be important for the therapist to pay careful attention to the ongoing life stresses of the depressed patient.

Adolescent↗
PubMed1980

Research criteria for the diagnosis of depression.

Four sets of research criteria for depression are compared: the Feighner, Spitzer, Texas Actuarial, and Composite methods. Of 80 carefully selected depressed patients, 68% satisfied Feighner's criteria, 71% Spitzer's, 75% the Texas Actuarial, and 94% the Composite criteria. Not only did the criteria sets select different proportions of the total, but they also selected substantially different patients, suggesting that results obtained from studies using one set of criteria for diagnosis or selection might not be generalizable to other groups of "depressed" patients. The authors recommend further studies, comparing relative validity as well as reliability, of alternative research diagnostic criteria.

Adolescent↗
PubMed1980

Drug treatment of depression: a classification system for agent selection.

Depressive illness can be severe, debilitating, and life threatening, but it often responds well to medication. The appropriate agent and dosage depend not only on accurate diagnosis of the type of depression present but also on the age of the patient, previous response to various medications, concurrent medical conditions, other medications being taken, and potential side effects of the antidepressants being considered for treatment.

Adult↗