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T Reich

Publications and source records attributed to T Reich.

At least 127 records · Page 7Linked to original sources
PubMed1987

The familial transmission of primary major depressive disorder.

This is a study of the familial transmission of Primary Major Depressive Disorder in the families of 235 probands with this disorder ascertained as part of the NIMH-CRB Collaborative Depression Program. Eight hundred and twenty-six interviewed first degree relatives and 109 spouses are included. Research Diagnostic Criteria have been used and interviews were done using the SADS-L schedule. Prior analyses of these data have established the presence of strong secular trends in the age-of-onset and prevalence of Major Depressive Disorder in these families. Accordingly, new methods for the analysis of family data which incorporate secular variation were developed. Non-parametric Survival Analysis, using the Cox Proportional Hazards Model, guided the formulation of a quantitative family transmission model. Then a family analysis was conducted with the Multifactorial Model of Disease Transmission and the Tau Path Analytic Model. Using the non-parametric approach, only the sibs birth cohort, sex and affectational status of the mother were significantly related to the time of onset of illness in siblings. Proband sex, age-of-onset, and the presence of illness in the father were not significant. The quantitative analysis confirmed that more recently born cohorts of individuals had an increased expected lifetime prevalence and a decreased age-of-onset of Primary Major Depressive Disorder. Assortative mating was present and environmental factors common to siblings did not make a significant contribution to the phenotypic variance. Sex specific transmissibilities were found and the transmissibility in females (t2 = 0.62) was significantly greater than that of males (t2 = 0.28). There was a trend for the transmissibility of Primary Major Disorder to be greater in more recently born cohorts.

Adult↗
PubMed1987

Isolation and characterization of a nuclear depressive syndrome.

We investigated the nosology of endogenous depression by numerical taxonomy. Five hundred and sixty-nine patients diagnosed as having unipolar major depressive disorder in the NIMH Clinical Research Branch Program on the Psychobiology of Depression-Clinical were studied. Thirty-six symptoms which might distinguish endogenous from non-endogenous depressions were chosen from the literature. Patients' symptom profiles assessed by structured interview were grouped by two methods: a K-means improvement of Ward's method of cluster analysis, and a latent class algorithm. The methods produced very similar groups and several internal validity criteria suggested that the groups were not spurious. Cluster 1, 'nuclear depression,' included a nucleus of patients common to multiple definitions of endogenous depression. The non-nuclear group scored as less neurotic than the nuclear group on personality tests administered during the index episode. The groups do not differ in frequency, number or severity of reported life events prior to onset of the index episode. The nuclear group shows a poor prognosis on two-year prospective follow-up, greater disturbance on personality inventories, and increased heritability of depression in siblings.

Adult↗
PubMed1987

Effects of pentoxifylline on severe intermittent claudication.

Pentoxifylline has been shown to improve treadmill walking distances under blinded, controlled conditions in patients with intermittent claudication. From the pooled data of a blinded, controlled, randomized, multicenter trial, the data from all enrolled patients with severe claudication (less than 70 m on treadmill at baseline) were evaluated. The treadmill data from these more severely ill patients were analyzed separately as a "severe subset" (placebo n = 17; pentoxifylline n = 21). No differences between the two treatment groups were observed in demography, history, or baseline treadmill walking distances. The initial claudication distance (ICD) improved 68% over baseline with pentoxifylline and 12% with placebo (p = .012) after twenty-four weeks of treatment. A new, derived efficacy variable was developed, "minimum distance walked," which tended to minimize psychological effects on treadmill performance. Over sixteen to twenty-four weeks of treatment, the pentoxifylline group improved 49% over baseline and the placebo group 3% (p = .019), when the "minimum distance walked" measurement was used. In this controlled trial the subset of patients with severe intermittent claudication benefited from pentoxifylline therapy.

Aged↗
PubMed1987

The changing relationship between age and suicide rates: cohort effect, period effect or both?

Massive changes in suicide rates over time have been recognized in the United States. An attempt has been made to describe these changes with age-period-cohort analyses. A variety of approaches has led us to conclude that suicide rates of non-white males, white and non-white females can be described adequately without a cohort effect. Recent suicide trends lead to the conclusion that a model based on a rising rate in more recently born white male cohorts coupled with an independent age effect could be rejected. If a cohort effect is postulated for more recent birth cohorts, it would require that the cohort suicide rate is decreasing with each successive birth cohort. Models based on high suicide rates in recent cohorts and additive age effects are probably misleading for future predictions. An association was noted between recent changes in the teenage and young adult suicide rates and rates of depression. Both may be the product of similar social influences.

Adolescent↗
PubMed1986

[Cancer mortality in the Thurgau canton 1970 and 1980 with a comparison between urban and rural areas].

As an addition to the recently published data by the Swiss Statistics Office in cooperation with the Swiss Cancer Registry, this report presents a microanalysis of trends in Canton Thurgau (185 000 inhabitants) based on the corresponding data. In the course of only 10 years the number of deaths due to cancer in rural areas has come to equal to that in city areas. This trend is particularly obvious for bronchial carcinoma in men. The decrease in mortality due to carcinoma of the stomach is more obvious in the urban population than in rural areas, a trend in which it can be assumed that environmental factors play a role. Further developments must be observed carefully, and corresponding analyses should also be performed in other cantons.

Cross-Sectional Studies↗
PubMed1986

The validation of the concept of endogenous depression. A family study approach.

Depressive illnesses are subdivided into endogenous and nonendogenous types in psychiatry throughout the world. We used one method of validating this nosologic subdivision: the determination of the extent to which the disorder is familial. Rates of depression were examined in 2,942 first-degree relatives of 566 individuals diagnosed as having unipolar major depressive disorder. Because no single definition of endogenous depression is universally accepted, four different methods for defining endogenous depression were compared: the Newcastle Scale, the Research Diagnostic Criteria, DSM-III, and the definition of "autonomous depression" proposed by investigators at Yale University (New Haven, Conn). In general, no matter which definition was used, the relatives of the patients with endogenous illness did not have higher rates of depressive illness than those of the nonendogenous group. The Newcastle Scale was the most sensitive in picking up familial transmission of recurrent unipolar depression. The results of this investigation suggest that longitudinal approaches should be added to cross-sectional approaches for the best definition of endogenous depression.

Adolescent↗
PubMed1986

The family history approach to diagnosis. How useful is it?

Determining the rate to which various psychiatric illnesses are familial is one widely used method for validating diagnostic categories and determining the likelihood of genetic or nongenetic patterns of transmission. Data for these studies can be collected through direct interview of all available relatives (the family study method) or by obtaining information indirectly from the patient and other family members (the family history method). Information based on direct interview is usually considered to be more accurate, although the family history method permits collection of data on a larger and more comprehensive group of relatives. We explored the extent to which data collected by these two methods were in agreement. In general, the results confirmed the usefulness of the family history method. Although it has some limitations, such as underreporting, it has respectable sensitivity for many major diagnoses when broad but well-specified criteria are used.

Data Collection↗
PubMed1986

ECT in primary and secondary depression.

The response of depressive symptoms to ECT was studied in 58 subjects who met DSM-III criteria for major depression. For data analysis, the sample was divided by diagnosis into categories of primary unipolar depression, bipolar depression, and secondary depression. Only 56% of the secondary depression group had a partial or complete remission of depressive symptoms, but 91% of the primary unipolar group and 100% of the primary bipolar group improved. Subdividing the secondary depression group by primary diagnosis revealed a differential response, with alcoholism and schizophrenia having the most favorable outcomes.

Adolescent↗
PubMed1985

Birth-cohort trends in rates of major depressive disorder among relatives of patients with affective disorder.

As part of the National Institute of Mental Health-Clinical Research Branch Collaborative Program on the Psychobiology of Depression Clinical Study, 2,289 relatives of 523 probands with affective disorder were interviewed with the Schedule for Affective Disorders and Schizophrenia and diagnosed for major depressive disorder by the Research Diagnostic Criteria. Data were analyzed using life-table and survival methods. The findings suggest a progressive increase in rates of depression in successive birth cohorts through the 20th century and an earlier age at onset of depression in each birth cohort. A predominance of female depressives was found in all birth cohorts but the magnitude of female-male differences fluctuated over the decades. The existence of these trends is reported to stimulate further research. These findings are discussed in terms of possible gene-environment interactions. However, no conclusive causal inferences can be drawn pending further investigation.

Actuarial Analysis↗
PubMed1985

Familial analysis of qualitative traits under multifactorial inheritance.

The analysis of family data is described for qualitative multifactorial traits. For such a trait, affectational status is determined by an underlying liability distribution with one or more thresholds. The distribution of families (either selected at random or through probands) is used to estimate sex-specific parent-offspring and sibling correlations in liability and the prevalence in each sex. In contrast to using pairs of relatives, this approach permits estimation of age-specific population prevalences without a control sample. Moreover, by allowing for sex-specific correlations and a correlation between mates, path analysis can be used to model and test various cultural transmission models in addition to polygenic inheritance. Parameter estimation, hypothesis testing, and a goodness-of-fit test for path analytic models are described, and a computer program implementing these procedures is outlined.

Age Factors↗
PubMed1984

HLA and major affective disorder.

Fifteen unrelated multiplex families, each containing two or more offspring with a diagnosis of major affective disorder, were HLA typed to provide additional data bearing on the proposed linkage of affective disorder susceptibility genes with the major histocompatibility complex on chromosome 6. Altogether 19 parents, 38 affected children, and 13 unaffected children were typed. The distribution of shared HLA haplotypes among pairs of affected siblings, pairs of affected-unaffected siblings, and various diagnostic subsets of these families fails to lend any support for the HLA linkage hypothesis.

Adult↗
PubMed1984

Sex-related differences in depression. Familial evidence.

After a description of threshold models of familial transmission based on an underlying continuous liability distribution, family data from the NIMH-CRB Collaborative Psychobiology of Depression Program-Clinical are described. No sex differences are found for bipolar illness, whereas female relatives have an increased rate of primary unipolar illness when compared to male relatives. This effect persists when relatives are classified according to recurrence, current illness, onset within the last 10 years, and treatment. Moreover, a cohort effect is present in the data and indicates a sex ratio close to one in the young cohort (less than or equal to 25). We considered the transmission of illness from parent to offspring by using survival analysis to examine the proportion of ill brothers and sisters of probands according to the affection status of parents. A maternal effect is found, with the mother having a greater influence on the liability of offspring of either sex. This is at odds with the notion that males and females have identical liabilities, but females have a lower threshold reflecting acknowledgement of more symptoms, etc. However, the mean difference in liability between the sexes may be due to systematic biological/cultural differences, with parental transmission contributing to variation about their means.

Bipolar Disorder↗
PubMed1984

Pentoxifylline in the treatment of intermittent claudication of the lower limbs.

Pentoxifylline, a methyl xanthine analogue was evaluated for treatment of intermittent claudication in a double-blind placebo controlled parallel group study in seven centers in the United States. Tests were performed on 128 cases, including 42 who took pentoxifylline (600 mg by mouth daily, increased stepwise to 1200 mg daily at the end of one month) and 40 who took placebo for 24 weeks. Twenty-five patients on pentoxifylline and 21 on placebo were dropped from the study for reasons unrelated to the drug. Walking ability on a treadmill was increased significantly after 2 weeks and remained so throughout the study in the pentoxifylline vs. the placebo group. Ability to walk until first experiencing intermittent claudication was a more sensitive index than the maximum ability to walk. The drug did not cause changes in blood pressure or in heart rate. Other than mild nausea, there were no significant side effects.

Clinical Trials as Topic↗
PubMed1984

A family study of bipolar II disorder.

Professional raters who were blind to proband diagnosis used the schedule for affective disorders and schizophrenia (SADS-L) and the Research Diagnostic Criteria (RDC) to evaluate 1,210 first-degree relatives of 327 probands with primary major depression, participating in the family sub-study of the NIMH Collaborative Study of the Affective Disorders--Clinical Branch. Bipolar II probands were significantly more likely to have bipolar II relatives than were non-bipolar or bipolar I probands. Bipolar II probands were slightly more likely than non-bipolar probands and slightly less likely than bipolar I probands to have relatives with bipolar I illness. Similar patterns have emerged in two other recently reported family studies of bipolar II illness. Taken together, these data suggest heterogeneity among patients with bipolar II depression. Some appear to be genotypes for bipolar I illness, while a small proportion may be genotypes for non-bipolar illness. A third group, of undetermined size, may breed true.

Adult↗
PubMed1984

Primary and secondary affective disorder: Part III. Longitudinal differences in depression symptoms.

Depressed inpatients (29 primary and 31 secondary) were blindly rated at several time points on 137 depressive symptoms. Of the 7 high-frequency symptoms or symptom clusters analyzed, significantly greater symptom persistence was seen for secondary depressives on low mood, pessimism, change in usual interests, and suicidal ideation. Day-to-day variability in symptoms did not differ between groups. Scalability of symptoms (Guttman scales) was acceptable for primary but not secondary depressives. Suicidal ideation tended to be the first symptom to remit in primary depression but persisted in the secondary group, even after remission of the most severe symptom. Implications for treatment are discussed.

Depressive Disorder↗
PubMed1983

Hyperbaric-oxygen treatment of multiple sclerosis. A randomized, placebo-controlled, double-blind study.

Several uncontrolled studies have suggested a beneficial effect of hyperbaric oxygen on multiple sclerosis. We studied 40 patients with advanced chronic multiple sclerosis who were randomly divided into two matching groups. The experimental group received pure oxygen, and the placebo group received a mixture of 10 per cent oxygen and 90 per cent nitrogen; both groups were treated at a pressure of 2 atmospheres absolute for 90 minutes once daily, for a total of 20 exposures. Objective improvement occurred in 12 of 17 patients treated with hyperbaric oxygen and in 1 of 20 patients treated with placebo (P less than 0.0001). Improvement was transient in seven of the patients treated with oxygen and long-lasting in five. Those with less severe forms of the disease had a more favorable and lasting response. At one year of follow-up, deterioration was noticed in 2 patients (12 per cent) in the oxygen group, neither of whom had had an initial response, and in 11 patients (55 per cent) in the placebo group, one of whom had had a positive initial response (P less than 0.0008). Minor ear problems and reversible myopia were the only side effects observed. These preliminary results suggest a positive, though transient, effect of hyperbaric oxygen on advanced multiple sclerosis, warranting further study. This therapy cannot be generally recommended without longer follow-up periods and additional confirmatory experience.

Adult↗