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Biomedical subjects

T W Uhde

Publications and source records attributed to T W Uhde.

At least 73 records · Page 4Linked to original sources
PubMed1989

Electroencephalographic sleep in panic disorder. A focus on sleep-related panic attacks.

Sleep electroencephalograms were studied in 13 patients with panic disorder, six of whom experienced panic from sleep, and seven controls. Sleep was disturbed in the patients, as manifested by increased sleep latency, decreased sleep time, and decreased sleep efficiency. Rapid eye movement (REM) latencies were not reduced in the patient group. All six of the panic awakenings were preceded by non-REM sleep, which could be further characterized as a transition from stage II toward delta sleep. The overall degree of sleep disturbance (ie, sleep latency, sleep efficiency) did not appear to be influenced by the occurrence of sleep panic. There was also an association of increased REM latency with nights of sleep panic.

Adult↗
PubMed1989

Dysphoric mania. Clinical and biological correlates.

Patients studied at peak severity of a manic episode showed substantial degrees of depression (dysphoria) and anxiety. Compared with nondysphoric manics (n = 26), the dysphoric manics (n = 22) had a significantly greater number of previous hospitalizations, and they displayed less rapid cycling both in the year before and during the index hospitalization admission. The severity of manic dysphoria tended to correlate with the number of previous hospitalizations, a finding that was highly significant in women (n = 27). Medication-free manic patients (n = 22) had significant elevations in cerebrospinal fluid norepinephrine concentrations compared with depressed and euthymic patients and normal volunteers, and the degree of elevation correlated significantly with the degree of manic dysphoria, anger, and anxiety rated at the time of the lumbar puncture. Patients with dysphoric mania, recognized by Kraepelin to have poor prognoses, have been reported to respond poorly to lithium carbonate but may be among those who respond to carbamazepine. Clinical, biologic, and pharmacologic response characteristics of manic subgroups, particularly those with extreme dysphoric components to their illness, appear to be clinically meaningful and deserving of further investigation.

Affect↗
PubMed1989

Panic disorder and the menstrual cycle: panic disorder patients, healthy control subjects, and patients with premenstrual syndrome.

The authors prospectively evaluated 20 normally menstruating women with panic disorder across a minimum of two drug-free menstrual cycles. There were no significant effects of menstrual cycle phase on anxiety ratings in the panic disorder patients or in 20 healthy control subjects; this contrasted with a robust increase in premenstrual anxiety in 20 subjects with premenstrual syndrome. These findings suggest that the symptoms of panic disorder are not commonly exacerbated by the premenstrual phase of the menstrual cycle and highlight the need for prospective evaluation in the attempt to document an association between psychiatric symptoms and the menstrual cycle.

Adult↗
PubMed1989

Social phobic symptoms in patients with panic disorder: practical and theoretical implications.

Of 35 patients with DSM-III-R diagnoses of panic disorder, 16 also received diagnoses of social phobia, and 15 of these 16 reported past episodes of major depression. Only nine of the 19 panic patients without social phobia had histories of depression. The panic patients with histories of depression had significantly higher self-ratings of social anxiety and avoidance, but not agoraphobic fear and avoidance, than those without histories of depression. Panic disorder and social phobia may coexist in many cases, and the presence of social phobia may be associated with a higher morbid risk for major depression in this population.

Adolescent↗
PubMed1989

Autoimmune thyroiditis and panic disorder.

Contrary to reports on depression, the prevalence of antithyroid antibodies was not significantly higher in 38 patients with panic disorder than in 38 matched control subjects. Autoimmune thyroiditis is not commonly associated with panic disorder but may play a role in some specific clinical circumstances.

Adult↗
PubMed1989

Infrequent occurrence of EEG abnormalities in panic disorder.

EEG abnormalities have been frequently reported in patients with panic disorder, although controlled studies are lacking. The authors examined the EEGs of 35 consecutively evaluated, medication-free patients with panic disorder and found that only five (14%) had nonspecific abnormal EEGs and none displayed EEG evidence supportive of an ictal process. The presence or absence of EEG abnormalities was not significantly associated with the presence or absence of psychosensory symptoms. Although it is not likely that panic disorder is an epileptiform disorder, temporal lobe and limbic structures probably play a major role in the pathophysiology of panic.

Adult↗
PubMed1989

Sleep panic attacks: new clinical findings and theoretical implications.

Forty-five panic disorder patients and 26 normal control subjects were surveyed regarding their histories of sleep panic attacks, insomnia, and vulnerability to exogenous panic stimuli. Sixty-nine percent (N = 31) of the patients reported having experienced sleep panic at some time in their lives, and 33% (N = 15) of the patients experienced recurrent sleep panic. The implications of these findings for the management of panic disorder are discussed.

Adult↗
PubMed1988

Normal urinary free cortisol and plasma MHPG in panic disorder: clinical and theoretical implications.

Abnormalities of the hypothalamic-pituitary-adrenal (HPA) axis and noradrenergic function have been reported in patients with panic disorder. Mean urinary free cortisol and plasma MHPG were measured in 12 medication-free panic disorder patients and 12 normal controls. No significant difference in urinary free cortisol and plasma MHPG was observed between the patients and controls. There was no relationship between plasma MHPG and urinary free cortisol in the panic patients or normal controls. These findings are described within the context of current concepts of stress and noradrenergic dysfunction in panic disorder.

Adult↗
PubMed1988

Cortisol response to clonidine in panic disorder: comparison with depressed patients and normal controls.

Abnormalities in regulation of noradrenergic function have been proposed as part of the pathology of depressive and panic anxiety disorders. However, abnormalities in hypothalamic-pituitary-adrenal (HPA) axis function have largely been limited to patients with depressive disorders. Using the cortisol response to clonidine, an alpha 2-adrenergic receptor agonist, this study examined the relationship between the noradrenergic system and the HPA axis in 10 patients with major depression (4 unipolar, 6 bipolar), 10 patients with panic disorder, and 10 normal controls. Baseline cortisol was significantly elevated in depressed as compared with panic patients, but not with controls. Depressed patients also tended to exhibit a greater absolute fall in plasma cortisol (5.2 +/- 4.0 micrograms/dl) compared with panic patients (1.7 +/- 2.4 micrograms/dl) (p less than 0.06, t-test). When expressed as a percentage of baseline, however, the cortisol response to clonidine did not differ significantly between diagnostic groups (p greater than 0.10). Basal levels of cortisol were highly correlated with the degree of decrease in cortisol induced by clonidine in the group of 30 subjects (r = -0.81, p less than 0.0001). These findings are discussed in the context of the utility of clonidine as a probe of the functional relatedness of the noradrenergic system and the HPA axis in these disorders.

Adult↗
PubMed1988

Alpha-2 adrenergic receptor binding in platelets and brains of nervous and normal pointer dogs.

Nervous pointer dogs have been suggested as an animal model for certain human pathological anxiety states. Work done in humans and in animals suggests a role for noradrenergic overactivity in the manifestations of anxiety. We studied alpha 2 adrenergic receptor binding as determined by [3H]-yohimbine in platelets and brains of the nervous and normal dogs in our colony. Our findings indicate that alpha 2 adrenergic receptor density and affinity are similar in platelets and frontal cortex, but we did not observe significant differences in binding between the two groups of dogs.

Animals↗
PubMed1988

The relationship between genetic deafness and fear-related behaviors in nervous pointer dogs.

Nervous pointer dogs have been extensively characterized as an animal model for some human pathological anxiety states. During our work with these animals suspicion developed that some of these dogs had a hearing deficit. We decided to systematically evaluate this observation and to study the relation between hearing status and fear-related behaviors in the nervous pointer dogs. Our results revealed that a majority of the nervous dogs in our colony (75%) suffer from bilateral deafness as demonstrated by complete absence of brain stem auditory evoked response. Furthermore, behavioral ratings revealed that hearing and deaf dogs do not differ in their pathological response to the characteristic fear-provoking stimuli (e.g., human interaction) and that both hearing and deaf nervous dogs markedly differ from normal dogs in that respect. The relation between these abnormalities and their implications for research involving breeding of animals for selected traits are further discussed in this report.

Animals↗
PubMed1988

Ventricular-brain ratio and life course of illness in patients with affective disorder.

The relationship between ventricular-brain ratio (VBR) on computed tomography of the brain and life course of illness was assessed in 59 hospitalized patients with recurrent affective disorder. In contrast to the implications of some, but not all, prior studies. VBR was not positively related to episode frequency, severity, pattern, or chronicity. In fact, when analyzed by sex, in both males and females, VBR was inversely related to several measures of illness chronicity.

Adult↗
PubMed1988

Controlled study of verapamil for treatment of panic disorder.

The authors conducted a 16-week double-blind, crossover study in 11 patients with panic disorder to study the effects of verapamil, a calcium channel blocker commonly used in the treatment of cardiovascular disorders, on the treatment of panic disorder. Their findings suggest that verapamil has modest antianxiety and antipanic properties.

Adult↗
PubMed1988

Thyroid indices in panic disorder.

The authors compared indices of thyroid function in 26 patients with panic disorder and 26 closely matched control subjects. No significant differences in T3, T4, free T4, thyrotropin, or thyroxine-binding globulin were found between the two groups. Clinical and theoretical implications are discussed.

Adult↗
PubMed1988

Graphic representation of the life course of illness in patients with affective disorder.

The authors illustrate methods for the graphic depiction of the course of unipolar and bipolar affective illness. The utility and advantages of such an approach include 1) accurate assessment of episode patterns, 2) elucidation of relationships to environmental events, endocrine and seasonal factors, and psychosocial stressors, 3) better delineation of treatment response, 4) a greater understanding of the longitudinal and characteristic patterns of illness, and 5) the associated better patient management with psychotherapeutic and pharmacological interventions.

Bipolar Disorder↗