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Biomedical subjects

U Halbreich

Publications and source records attributed to U Halbreich.

At least 127 records · Page 7Linked to original sources
PubMed1982

The diversity of premenstrual changes as reflected in the Premenstrual Assessment Form.

The Premenstrual Assessment Form (PAF) is a new self report procedure designed to measure changes in mood, behavior, and physical condition during the premenstrual period. It reflects the great variability of premenstrual syndromes as opposed to the common practice of viewing these changes as a single entity. In comparison to commonly used procedures, the PAF 1) contains a broader variety and more specific descriptions of positive as well as negative changes; 2) provides Unipolar Summary Scales and Bipolar Continua which are sensitive measures for indexing levels of severity on various types of change; and 3) provides specific criteria for Typological Categories descriptive of different syndromes of change, especially those of mood and behavior. The paper describes the development of the PAF and the three scoring systems and illustrates the sensitivity of the individual items and scoring systems in reflecting the great diversity of change manifested during the premenstrual period.

Adult↗
PubMed1982

The mean 1300-1600 h plasma cortisol concentration as a diagnostic test for hypercortisolism.

The 24-h mean plasma cortisol concentration was compared with the mean plasma cortisol concentrations during short subperiods of the day in 88 normal subjects and 223 patients with a very wide range of mean 24-h cortisol levels. The correlation between the 1300-1600 h mean plasma cortisol concentration and the mean 24-h plasma cortisol concentration was extremely high in all groups. Mean cortisol concentrations during this short subperiod powerfully discriminate cortisol hypersecretors (patients with Cushing's syndrome, anorexia nervosa, or prostate cancer) from normal controls. Hence, it is suggested that the mean or integrated 1300-1600 h plasma cortisol concentration can be used as a reliable afternoon cortisol test for the presence of hypercortisolism.

Adrenocortical Hyperfunction↗
PubMed1981

Paradoxical cortisol responses to dextroamphetamine in endogenous depression.

Dextroamphetamine hydrochloride was administered intravenously (IV) in the morning and evening to 22 unmedicated patients with severe endogenous depressions and 18 normal control subjects. While the normal subjects generally had a sharp increase in plasma cortisol level by 30 minutes after drug administration, two thirds of the depressed patients showed instead a paradoxical suppression of cortisol levels by 60 minutes. Discrimination between normal subjects and depressives was greatest in the evening. These results are consistent with other reports of abnormal cortisol responses in depressed patients to smaller IV doses of dextroamphetamine and larger doses of methamphetamine hydrochloride. A defect in activation or noradrenergic alpha receptors may account, in part, for the abnormal cortisol responses. The dextroamphetamine cortisol test in other patient populations requires study before its diagnostic use in endogenous depression can be established.

Adolescent↗
PubMed1981

An inverse correlation between serum levels of desmethylimipramine and melatonin-like immunoreactivity in DMI-responsive depressives.

The relationship between plasma levels of the tricyclic antidepressant desmethylimipramine (DMI) and plasma levels of melatonin-like immunoreactivity was studied in 32 endogenously depressed patients. An inverse correlation between plasma levels of DMI and plasma levels of melatonin-like immunoreactivity was found in the group of clinical responders to the chronic administration of the drug. The nonresponders had higher levels of melatonin-like immunoreactivity at comparable levels of DMI. This finding is consistent with the hypothesis that chronic high plasma levels of DMI may down-regulate the beta-adrenergic receptors in man. However, some other homeostatic mechanisms may be involved in the clinical response.

Adolescent↗
PubMed1981

Relative insulin insensitivity and cortisol secretion in depressed patients.

Relative insulin insensitivity occurs in a substantial portion of patients with major endogenous depressions, and about half such cases also hypersecrete cortisol in the afternoon and evening. This study assessed the relation between these two abnormalities in 16 patients with major endogenous depression. Over several days, insulin tolerance tests (ITTs) were performed in the morning and evening, and measures of cortisol secretion taken: plasma cortisol at 0800, 1600, and 2300 hours, both before and after dexamethasone; baseline cortisol before ITTs; and mean 24-hour plasma cortisol concentrations (in 10 cases). After clinical recovery, some of these patients had repeat ITTs (n = 10) and repeat predexamethasone and postdexamethasone cortisol assessments (n = 9). Additionally two control groups of 15 normal subjects and of 12 schizophrenic patients received morning ITTs. None of the control subjects manifested insulin insensitivity. However, during illness, 8 of the 16 depressed patients manifested relative insulin insensitivity (glucose drop less than 50%, glucose nadir greater than 50 mg/dl); compared to the insulin responsive depressed group, the insensitive group had insignificantly greater afternoon and evening cortisol secretion by nearly all indices. After clinical recovery, hypoglycemic response for the entire group was significantly greater than during illness; this improvement was accounted for by the increased insulin responsivity of the previously insulin resistant subgroup. There was also substantial plasma cortisol reduction in the previously insulin resistant group after clinical recovery, but not in the insulin sensitive group.

Adult↗
PubMed1981

Endocrine responses to thyrotropin-releasing hormone in major depressive disorders.

The endocrine response to thyrotropin-releasing hormone (TRH) was studied in severely endogenously depressed patients during illness (n = 21) and after recovery (n = 18). The thyroid-stimulating hormone (TSH) response to TRH was blunted (deltaTSH less than 5 microIU/ml) in over one third of depressives during illness and remained blunted in most even after recovery. There was no correlation between multiple measures of cortisol secretion (the mean 24-hour plasma cortisol, dexamethasone suppression test, and plasma cortisol during the TRH procedure) and the TSH response during illness and after recovery. The TSH and prolactin (PRL) responses to TRH, as well as the baseline PRL, were significantly lower during illness. The role of possible abnormalities in dopamine and/or serotonin in depression contributing to these endocrine disturbances is discussed.

Adult↗
PubMed1981

The prolactin-stimulating potency of reserpine in man.

The prolactin (PRL) response to 0.5 mg i.m. of reserpine was compared to 0.5 mg i.m. of haloperidol in eight young men. The fact that reserpine was found to be a potent releaser of PRL--significantly greater than haloperidol--suggests a major role of storage pool dopamine in regulating PRL Secretion. Since the PRL response to neuroleptics is highly correlated with clinical potency, reserpine could be a potent antipsychotic, and further clinical trials are indicated.

Adult↗
PubMed1981

Possible involvement of endorphin withdrawal or imbalance in specific premenstrual syndromes and postpartum depression.

Premenstrual and postpartum dysphoric changes are very prevalent. However, their etiology is still obscure. The authors hypothesize that changes in levels of endorphins may be involved in the pathophysiology of these changes. Studies of various endorphins indicate a possible relationship between levels of endorphins and depressive symptoms. In addition, some studies of naloxone and naltrexone suggest a relationship between a blockage in the action of endorphins and the development of a syndrome of dysphoric symptoms similar to the depressive features manifested premenstrually and postpartum by many women and frequently seen in some depressed outpatients. There is also some evidence that there may be a relationship between elevated levels of endorphins and other subtypes of depressive syndromes. Endorphins and estrogen levels have been shown to covary. During the postpartum and the premenstrual period, levels of both change rapidly and substantially. Therefore the link between changes in levels of endorphins and the dysphoric changes during the periods in focus is supported from three complementary directions: (1) the characteristic psychiatric symptomatology, (2) the reported hormonal changes, and (3) the possible involvement of endorphins in neuroendocrine regulation.

Animals↗
PubMed1981

Cortisol secretion in relation to age in major depression.

Twenty-five unmedicated hospitalized patients, ages 26-64, with severe major depressive disorders, endogenous subtype, were evaluated both clinically and endocrinologically. Although measures reflecting cortisol secretion did not correlate with symptom dimensions and diagnostic subtypes, we did find a significant relationship between cortisol secretion and age during endogenous depressive illness; this included the mean 24 hour plasma cortisol, assessed by sampling every 30 minutes for 24 hours, as well as other single plasma cortisol assessments on other days. After clinical recovery, when plasma cortisol levels returned to normal, there was no significant relationship between cortisol secretion and age. Replication is required of this apparent interaction among age, depressive illness, and cortisol secretion. The result may relate to the proposed role of brain noradrenalin in tonically inhibiting cortisol secretion, the decline of hypothalamic noradrenalin with age, and the hypothesized deficit in depressive illness.

Adult↗
PubMed1981

Premenstrual changes and affective disorders.

The differential relationship between specific subtypes of premenstrual changes and specific subtypes of mental disorder was studied. Premenstrual changes were evaluated with the Premenstrual Assessment Form, which provides specific criteria for the classification of the various subtypes of premenstrual change. The Research Diagnostic Criteria were used to make lifetime diagnoses of mental disorder. Differential relationships were found between subtypes of premenstrual change and subtypes of mental disorder. The results suggest that premenstrual changes characterized by a depressive syndrome may represent a mild or subclinical manifestation of affective disorder.

Affective Disorders, Psychotic↗
PubMed1981

Cortisol secretion and dexamethasone response in depression.

The authors administered 2 mg of dexamethasone at 11:00 p.m. to 37 unmedicated hospitalized endogenously depressed patients and assessed their plasma cortisol response at 4:00 and 11:00 p.m. the next day. In addition, on nondexamethasone days 26 of these patients had mean 24-hour plasma cortisol concentration determinations from samples taken at 30-min intervals and 32 had plasma determinations from a single sample taken at 4:00 and 11:00 p.m. Mean 24-hour plasma cortisol concentration was elevated in 50%; only 7 of the 26 were dexamethasone resistant, and 6 of these 7 were hypersecretors. The authors suggest that dexamethasone resistance reflects the abnormality of cortisol hypersecretion in depression and that the 2-mg dexamethasone suppression test is a highly specific but not very sensitive indicator of hypersecretion.

Adult↗
PubMed1981

Amphetamine-induced dysphoria in postmenopausal women.

Dextroamphetamine (0.15 mg/kg) intravenously administered to a group of normal postmenopausal women induced a dysphoric reaction with drowsiness, annoyance, sadness and anger. Young normal men, receiving the same dosage, responded with elation of mood and alertness. It is suggested that age and hypoestrogenism may alter the behavioural response to amphetamine.

Adult↗
PubMed1981

Failure of dopaminergic blockade to affect prolactin, growth hormone, and cortisol responses to insulin-induced hypoglycemia in schizophrenics.

The PRL, GH, and cortisol responses to insulin tolerance tests (ITTs) were evaluated in 12 medically healthy schizophrenic patients during a drug-free period and after 1 and 6 weeks of treatment with penfluridol, a potent, long acting, dopamine-blocking neuroleptic. Hypoglycemic responses were the same before and during penfluridol therapy. Although resting PRL levels were evaluated during initial penfluridol therapy (week 1), hypoglycemia provoked a further substantial PRL increment, not significantly different in magnitude from that induced by hypoglycemia during the drug-free period. However, there was a 54% reduction (P less than 0.05) in the increase in the area under the PRL curve during week 6 compared to the drug-free period. Regarding GH and cortisol, resting levels, areas under the curve, and maximal increments after ITT were essentially the same during weeks 1 and 6 of penfluridol treatment as in the drug-free period. The failure of 1 week of dopaminergic blockade to significantly alter the hormonal (PRL, GH, and cortisol) responses to ITT in the group as a whole suggests that dopamine-blocking mechanisms play little role in mediating these responses, at least in schizophrenic patients.

Female↗