Biomedical subjects

T P Detre

Publications and source records attributed to T P Detre.

At least 19 recordsLinked to original sources

PubMed1977

Thiazide-lithium synergy in refractory mood swings.

The unfortunate experience with lithium chloride as a salt substitute in the 1940s still directs the clinical usuage of lithium carbonate to a certain extent. We are still warned that lithium salts should never be used in low-sodium situations (e.g., with thiazide diuretics or salt-restricted diets); however, it has recently been shown that thiazide diuretics may be safely used in the treatment of lithium-induced nephrogenic diabetes insipidus (NDI). The authors recapitulate the dangers inherent in the use of this drug combination and present detailed clinical-pharmacologic data on 13 patients which suggest that thiazides are useful in the treatment of lithium-induced NDI and may actually synergize with lithium to produce improved mood control in some lithium-refractory manic-depressive patients.

Ambulatory Care↗

PubMed1976

Incidence and signficiance of mixed affective states in a bipolar population.

The simultaneous existence of manic and depressive symptoms in a manic-depressive patient was first described by Kraepelin. This so-called mixed state has come to have much theoretical significance in recent hypotheses about the nature of bipolar affective disorders. In this investigation a mixed state is shown to be the initial episode in 31% of 84 manic-depressive outpatients. Moreover, the presence of "mixed" features does not correlate with severity of illness or mood circularity, but does correlate with sedative abuse and poor response to psychopharmacologic treatment. These results suggest that the "continuum hypothesis" and its satellite theories represent viable conceptualizations of the nature of manic-depressive illness.

Adult↗

PubMed1975

Are there two types of unipolar depression?

Personality traits and clinical characteristics in psychiatric outpatients with affective disorder were examined. Two groups of unipolar patients, divided on the basis of treatment response to tricyclic antidepressants, were compared to a bipolar group. While the unipolar-T (tricyclic responder) group showed premorbid personality traits of chronic anxiety and obsessiveness, neither the bipolar nor unipolar-L (tricyclic nonresponder, lithium carbonate responder) groups showed such findings. In fact, the unipolar-L and bipolar groups were similar not only with regard to personality variables, but also in terms of both drug response and certain family history features. These findings cast doubt on the homogeneity of unipolar depression and suggest the possibility of a subtype of unipolar depression with psychobiologic and personality features resembling bipolar disorder.

Adult↗

PubMed1975

Sleep EEG and motor activity as indicators in affective states.

This report reviews a number of studies which support our current classification schema for affective disorders. This classification differentiates between an anxious-hyperactive type and an anergic-hypoactive type which are then further subdivided into primary and secondary affective disorders. While the motor and activity measurements are for the most part limited to patients suffering from primary affective disease, current studies under way indicate that secondary affective disorders may also have characteristic biologic changes. EEG sleep and motor activity parameters provide useful pointers for differential diagnosis and treatment while having the added advantage of diminishing the clinician's almost exclusive dependency on amnestic data and the psychological observations made on the patient's behavior.

Adjustment Disorders↗

PubMed1975

Psychopharmacologic management of patients: a method for recording treatment decisions.

The authors describe a drug treatment form they designed, the KDS-8, that is suitable for use in all types of treatment settings. An important feature is a checklist of treatable target symptoms, with categories of improvement, no change, or worsening. Changes in drug regimen and the clinician's reasons for them are noted. Among the advantages the authors cite are easy retrievability of drug treatment data and the forms suitability for use in audit procedures and research.

Decision Making↗

PubMed1974