Search PubMed⌕ Search

Biomedical subjects

W Coryell

Publications and source records attributed to W Coryell.

At least 199 records · Page 11Linked to original sources
PubMed1980

Diagnostic instability and depression.

Blind raters applied research criteria to the charts of patients whose discharge diagnosis changed through several hospital admissions from depression to schizophrenia and to the charts of matched control patients. Fewer diagnostically unstable patients than control patients satisfied research criteria for depression despite matching discharge diagnoses. The use of operational criteria, then, can be expected to reduce diagnostic instability in depression and thus improve prognostic accuracy. Some patients satisfied the research criteria for depression when they were initially admitted and for schizophrenia at their final admission. This suggests that diagnostic error may not account for all cases of major diagnostic instability.

Adult↗
PubMed1980

Mania during adolescence. The pathoplastic significance of age.

A search of all multiple admissions to the University of Iowa Psychiatric Hospital yielded 20 bipolar patients first admitted during adolescence and 21 bipolar patients first admitted between the ages of 30 and 40 years. Inclusion required the patient to meet criteria for mania on some admission other than the first. Adolescents were as likely as adults to meet criteria for mania and/or depression during their first admission. There were no group differences in distribution of criteria symptoms or in rates of associated symptoms. Likewise, the groups had similar rates of recovery at discharge and subsequent time spent in hospital. The authors conclude that differences between adolescents and adults need not obscure an appropriate diagnosis of mania.

Adolescent↗
PubMed1979

Should 'non-Feighner schizophrenia' be classified with affective disorder?

Narrow definitions of schizophrenia increase homogeneity at the expense of leaving unclassified many patients with shizophrenic symptoms. Family history and follow-up studies indicate that many such patients ought to be classified with those having affective disorders. This study determines morbid risks for affective disorder and schizophrenia in first degree relatives of patients with chart but not research diagnoses of schizophrenia. Comparisons with morbid risk figures for relatives of individuals satisfying research criteria for depression, mania or schizophrenia indicate that the 'non-Feighner schizophrenia' group is probably too heterogenous to be classified entirely as affective disorder or as schizophrenia.

Adolescent↗
PubMed1978

Attitudes toward issues in psychiatry among third-year residents: a brief survey.

The authors surveyed 378 third-year psychiatric residents on their attitudes toward psychiatric training, forms of psychotherapy, and the medical model; their treatment preferences for 4 given psychiatric disorders; and their career plans. Correlation coefficients and analysis of variance indicated clustering of attitudes along a dynamic-biological continuum, with medical education and experience with drug therapy rated highest of the training aspects and personal analysis or psychotherapy, training in psychoanalysis, and research rated lowest.

Alcoholism↗
PubMedDate not supplied

Bipolar II. Combine or keep separate?

Data on prior course, characteristics of index episode, and familial aggregation of patients with bipolar II disorder is discussed. The data supports the separation of this condition from both bipolar I and recurrent unipolar disorder.

Adult↗
PubMedDate not supplied

Four definitions of endogenous depression and the dexamethasone suppression test.

We examined the relationship between the DST and 4 definitions of endogenous depression: DSM-III, Feinberg and Carroll, Newcastle and RDC. Endogenous patients had a significantly higher rate of nonsuppression than nonendogenous patients according to the DSM-III and Newcastle definitions but not according to the RDC and Feinberg and Carroll criteria. Moreover, the relationship between the DST and the DSM-III and Newcastle definitions was significant even after individually controlling for age, psychosis and weight loss. We review the literature on the relationship between the DST and the RDC definition of endogenous depression and suggest that interstudy differences in criteria application may be partially responsible for the inconsistent results across studies.

Adult↗
PubMedDate not supplied

Are serial dexamethasone suppression tests useful in electroconvulsive therapy?

In addition to its diagnostic utility, the dexamethasone suppression test (DST) may also have value as a predictor of recovery or relapse. Evidence for this has derived mainly from patients receiving antidepressants while some paradoxical findings have emerged for patients undergoing electroconvulsive therapy (ECT). To explore this we charted Hamilton rating scale scores and DST results during ECT for 30 patients who were nonsuppressors before ECT. While week-to-week severity measure corresponded roughly to DST changes in the expected fashion, shifts in test results had no apparent predictive value. In fact, changes to nonsuppressor status were more often followed by improvement than were changes to suppressor status. These findings suggest that ECT may have a number of opposing, direct and indirect effects on the hypothalamic-pituitary-adrenal axis.

Depressive Disorder↗
PubMedDate not supplied

The relationship between age and post-dexamethasone cortisol: a test of three hypotheses.

Previous studies report that DST nonsuppressors are older than normal suppressors. Data are presented on 188 primary unipolar major depressive inpatients and 35 healthy controls. In males, age appeared to correlate positively with post-dexamethasone cortisols in depressed patients and normal controls, although mean levels were higher in depressives. Female controls showed no consistent relationship between age and post-dexamethasone cortisol. A positive relationship did exist for depressed women. However, the association disappeared when age-of-onset was entered into the model, suggesting that in females early onset may identify a subtype of depression with normal DST suppression.

Adult↗
PubMedDate not supplied

Schizo-affective disorders: bipolar-unipolar subtyping. Natural history variables: a discriminant analysis approach.

In view of tackling the problem of heterogeneity among the schizo-affectives, methods of univariate and multivariate statistical analysis (canonical discriminant analysis) were applied to the sociodemographic and natural history variables of four groups of affective disorder patients from the NIMH Collaborative Study on the Psychobiology of Depression Clinical section: the schizo-bipolar (SBP, n = 45), the schizo-unipolar (SUP, n = 30), the bipolar I (BP, n = 159) and the primary unipolar depressed (UP, n = 387) defined by Research Diagnostic Criteria. Two dimensions were identified among the four groups of 'affective' patients: the 'bipolar' and the 'schizophrenic' dimensions. They provided highly significant discrimination among the means of the four groups but were not very accurate in predicting group membership. The 'bipolar' dimension separates the UP from the BP and SBP, the SUP taking some intermediate value. The 'schizophrenic' dimension separates the BP and UP from the SUP, the SBP being intermediate. The two groups with the most similarities were the SBP and BP. The group with the most heterogeneity was the SUP, sharing similarities with the UP and SBP mostly. These conclusions are supported by results of familial aggregation on the same group of patients.

Bipolar Disorder↗