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Biomedical subjects

W R Yates

Publications and source records attributed to W R Yates.

At least 37 records · Page 2Linked to original sources

An adoption study of DSM-IIIR alcohol and drug dependence severity.

OBJECTIVE: The objective of this study was to evaluate the role of genetic factors in alcohol and drug dependence at various levels of DSM-IIIR psychoactive substance dependence severity. METHOD: One-hundred-and-ninety-seven adoptees (95 case adoptees with biological parental alcoholism, drug dependence or antisocial personality disorder and 102 control adoptees) were interviewed for the presence of alcohol abuse or dependence and drug abuse or dependence using the Diagnostic Interview Schedule-DIS IIIR. RESULTS: Adoptees with five or more DSM-IIIR criteria for alcohol dependence demonstrated evidence of a genetic effect using this adoption paradigm (odds ratio = 2.3, 95% C.I. (1.1, 4.9)). Adoptees with one or more DSM-IIIR criteria for drug dependence demonstrated a genetic effect (odds ratio = 2.4, 95% C.I. (1.3, 4.4). CONCLUSIONS: This study suggests genetic factors influence the risk for alcohol and drug dependence at different thresholds of severity as determined by DSM-IIIR symptom severity count.

Adolescent↗

The effect of exogenous testosterone on total and free prostate specific antigen levels in healthy young men.

PURPOSE: We evaluated the effect of exogenous testosterone administration on serum total and free prostate specific antigen (PSA) in healthy young men. MATERIALS AND METHODS: Nine volunteers received either 100, 250 or 500 mg. testosterone by intramuscular injection each week for 15 weeks. Blood was drawn every other week for 28 weeks and at week 40. Serum total and free PSA, and total and free testosterone were measured and compared to baseline values. RESULTS: Significant elevations in total and free testosterone occurred but no significant change in serum total and free PSA was detected. CONCLUSIONS: Serum PSA is not responsive to elevated serum testosterone levels in healthy young men. PSA metabolism in the normal prostate is unclear but our findings may have implications for differentiation of pathological conditions of the human prostate.

Adult↗

Depression spectrum disease, I: The role of gene-environment interaction.

OBJECTIVE: This study used an adoption study design to separate genetic from environmental factors in the etiology of depression spectrum disease, a type of major depression characterized by families in which male relatives are alcoholic and females are depressed. The genetic etiology hypothesis of depression spectrum disease proposes that an alcoholic genetic diathesis predisposes to depression in females but alcoholism, not depression, in males. METHOD: The study examined 197 adult offspring (95 male and 102 female) of alcoholic biological parents and used logistic regression models to determine the contribution to major depression in male and female adoptees that could be explained by the genetic alcoholic diathesis combined with an environmental factor that was characterized by psychiatrically or behaviorally disturbed adoptive parents. RESULTS: Major depression in females was predicted by an alcoholic diathesis only when combined with the disturbed adoptive parent variable. The same regression model failed to predict depression in males. Other possible environmental confounding factors contributing to an increased chance of depression were found in females: fetal alcohol exposure, age at the time of adoption, and a family with an adopted sibling who had a psychiatric problem. These variables did not diminish the significance of the prediction of depression with the alcohol genetic diathesis and disturbed parent model. CONCLUSIONS: The results show that a genetic factor is present for which alcoholism is at least a marker, and which exerts its effect in women as a gene-environment interaction leading to major depression. This finding suggests that an important etiologic factor in depression spectrum disease is gene-environment interaction.

Adolescent↗

Steroids.

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Anabolic Agents↗

Adoption study demonstrating two genetic pathways to drug abuse.

BACKGROUND: Studies of adoptees have demonstrated that there are two genetic factors leading to alcohol abuse and/or dependence (abuse/dependence). In addition, environmental factors found in the adoptive family also predict alcohol abuse/dependency independently. One study has found evidence that a similar model of two genetic factors and independent adoptive family factors were involved in drug abuse. Our study was designed to test the hypothesis that genetic factors defined by alcohol abuse/dependency and anti-social personality disorder in biologic parents were etiologic in drug abuse/dependency and that psychiatric problems in adoptive parents were an additional factor associated with drug abuse/dependence. METHODS: A sample of 95 male adoptees, separated at birth from their biologic parents, were followed up as adults to determine their psychiatric diagnosis and their substance use/abuse in a structured interview administered blind to biologic parent diagnoses. A high-risk, case-control design was used wherein half of the adoptees came from biologic parents known to be alcohol abuser/dependent and/or have antisocial personalities (diagnoses from hospital or prison records). These adoptees were matched for age, sex, and adoption agency to a control group of adoptees whose biologic parents were not found in the hospital and prison record search. Adoptive home environment was assessed by structured interviews, including psychiatric assessment of both adoptive parents. RESULTS: Data were analyzed by log-linear modeling, which showed evidence of two genetic pathways to drug abuse/dependency. One pathway went directly from a biologic parent's alcoholism to drug abuse/dependency. The second pathway was more circuitous, and started with anti-social personality disorder in the biologic parent and proceeded through intervening variables of adoptee aggressivity, conduct disorder, antisocial personality disorder, and, eventually, ended in drug abuse/dependency. Environmental factors defined by psychiatric conditions in adoptive families independently predicted increased antisocial personality disorder in the adoptee. Adoptees born of alcohol-abusing mothers showed evidence of fetal alcohol syndrome, but controlling for this did not diminish the evidence for the direct genetic effect between an alcohol-abusing biologic parent and drug abuse/dependency in offspring. CONCLUSIONS: This study confirms the model of two independent genetic factors involved in drug abuse/dependence and previous findings that disturbed adoptive parents are associated with adoptee drug abuse/dependency.

Adolescent↗

Genetic-environmental interaction in the genesis of aggressivity and conduct disorders.

BACKGROUND: The purpose of this study was to determine the effect of an adverse adoptive home environment on adoptee conduct disorder, adult antisocial behavior, and two measures of aggressivity, all of which are behaviors that contribute to adult antisocial personality disorder and that also are associated with increased vulnerability to drug abuse and/or dependence. METHODS: The study used an adoption paradigm in which adopted offspring who were separated at birth from biologic parents with documented (by prison and hospital records) antisocial personality disorder and/or alcohol abuse or dependence were followed up as adults. They and their adoptive parents were interviewed in person. These adoptees were compared with controls whose biologic background was negative for documented psychopathologic behavior. Subjects were 95 male and 102 female adoptees and their adoptive parents. RESULTS: Multiple regression analysis was used to measure separately genetic and environmental effects. It showed that (1) a biologic background of antisocial personality disorder predicted increased adolescent aggressivity, conduct disorder, and adult antisocial behaviors, and (2) adverse adoptive home environment (defined as adoptive parents who had marital problems, were divorced, were separated, or had anxiety conditions, depression, substance abuse and/or dependence, or legal problems) independently predicted increased adult antisocial behaviors. Adverse adoptive home environment interacted with biologic background of antisocial personality disorder to result in significantly increased aggressivity and conduct disorder in adoptees in the presence of but not in the absence of a biologic background of antisocial personality disorder. CONCLUSIONS: Environmental effects and genetic-environmental interaction account for significant variability in adoptee aggressivity, conduct disorder, and adult antisocial behavior and have important implications for the prevention and intervention of conduct disorder and associated conditions such as substance abuse and aggressivity.

Adoption↗

Postmastectomy reconstruction: comparative analysis of the psychosocial, functional, and cosmetic effects of transverse rectus abdominis musculocutaneous flap versus breast implant reconstruction.

Over 40,000 postmastectomy breast reconstructions are performed annually. In this study, we investigated the psychosocial, functional, and cosmetic effects of transverse rectus abdominis musculocutaneous (TRAM) flap versus breast implant reconstruction. Thirty-three women who had undergone postmastectomy breast reconstruction were contacted by telephone and agreed to participate in the study. Twenty-two women completed the self-assessment questionnaires regarding their quality of life, psychological symptoms, functional status, body image, and global satisfaction. The TRAM and implant groups contained 8 and 14 patients, respectively. The groups were well matched for age, employment status, marital status, race, religion, and severity of medical and surgical illnesses. The average follow-up was 36 months. Statistical analysis of the responses revealed that women who had undergone TRAM flap reconstruction were more satisfied with how their reconstructed breast felt to the touch (p = .01), and there was a trend toward greater satisfaction with the appearance of their reconstructed breast (p = .08). However, these same patients identified more difficulties as far as functioning at work or school, performing vigorous physical activities, participating in community or religious activities, visiting with relatives, and interacting with male friends (p < .04). There were no statistically significant differences in body image or overall satisfaction. In this small cohort study, both the TRAM flap group and the implant group were satisfied with the results of their breast reconstruction, but the TRAM flap group was more satisfied with how their breast felt and tended to be more satisfied with the cosmetic result. The TRAM flap group reported greater psychological, social, and physical impairments as a result of their reconstruction.

Adult↗

Prognostic validity of short-term abstinence in alcoholism.

A demonstrated period of abstinence is often viewed as a good prognostic sign in alcoholism. For example, short-term abstinence is one factor often considered important as a selection criteria for alcoholics who are being evaluated as liver transplant candidates. However, the prognostic validity of short-term abstinence is unclear. We evaluated the effects of 3 and 6 months of abstinence on readmission rates in a series of 299 alcoholics following discharge from inpatient treatment. Readmission rates were stratified using a 3-factor model of alcoholism severity. This 3-factor model defined groups with 1-year readmission rates, ranging from 15.8% to 62.7%. Short-term abstinence did not have strong effects on readmission rates for the most severe alcoholics, nor did short-term abstinence produce clinically significant reduction for readmission rates for the least severe alcoholics. We conclude that short-term abstinence has minimal effect on prognosis for alcoholics with various levels of baseline severity.

Adult↗

Descriptive and predictive validity of a high-risk alcoholism relapse model.

A major problem with alcoholism treatment is the high rate of early recidivism to drinking and re-admission for alcoholism treatment. The objective of this study was to retest a model or predict early (within 6 months) re-admission to alcoholism treatment using a second independent sample. Additionally, we compared a high-risk alcoholism relapse (HAR) model (defined by chronicity of heavy drinking, daily alcohol consumption and previous treatment history) with three previously defined alcoholism typologies for descriptive and predictive validity. Male alcoholics (N = 299) admitted for treatment at a Veterans Affairs inpatient treatment program were interviewed and then followed for 6 months after discharge. The HAR model identified 107 (35.8%) alcoholics at high-risk for relapse prior to discharge. Of the HAR group 61% were re-admitted within 6 months compared to 28% of the low-risk alcoholism relapse (LAR) group (OR = 4.0, 95% CI = 2.4-6.8). The HAR group was older with a lower socioeconomic status, fewer legal problems, more physical and mental health problems and decreased evidence of social support. The HAR model was more successful than were the typologies for predicting early relapse. The HAR model demonstrates descriptive and predictive validity and compares favorably to existing typology models.

Adult↗

Social support and depression in men during alcoholism treatment.

Psychiatric comorbidities have been shown to be important predictors of the outcome of alcoholism treatment. This study examines whether perceived lack of social support can be identified as an independent predictor of symptoms of depression experienced during alcoholism treatment over and above the effects of personality characteristics and the severity of alcohol and psychiatric history. We studied 189 alcoholic men in treatment at a rural midwestern Department of Veterans Affairs medical center. Multiple regression analyses found that reduced social support significantly predicted depression (measured by the Beck Depression Inventory) during treatment while controlling for personality characteristics and the alcoholism and psychiatric subscales of the Addiction Severity Index. Although self-esteem, neuroticism, and psychiatric severity also were significantly associated with depression in the hierarchical regression model, social support demonstrated the strongest unique contribution to depression of any of the predictors. These results suggest that social support has an independent association with depression and perhaps may play an important role in improving treatment compliance and the outcome of alcoholism treatment.

Adult↗

Anabolic steroid use among substance abusers in treatment.

BACKGROUND: Increasing illicit use of anabolic steroids in adolescent and young adult populations has been reported. To determine the scope of this problem and its relationship to psychoactive substance abuse, we evaluated the prevalence of anabolic steroid use among individuals seeking inpatient treatment for substance abuse. METHOD: A randomized mail survey of 175 inpatient substance abuse treatment directors elicited information regarding the prevalence of anabolic steroid use for inpatients treated in 1989 and the first half of 1990. Additionally, directors were surveyed for experience with DSM-III-R psychoactive substance dependence criteria for anabolic steroid use. RESULTS: Only 19% of centers responding had treated at least one individual using anabolic steroids. Facilities encountering anabolic steroid users reported a prevalence of less than 1% among all admissions. Anabolic steroid users were seen more commonly in privately funded facilities. Directors reported a majority of anabolic steroid users had at least three DSM-III-R psychoactive substance dependence criteria for anabolic steroid use. Treatment directors rarely found anabolic steroid use acknowledged as a problem by users and rarely found anabolic steroid use a primary reason for treatment. CONCLUSION: Users of illicit anabolic steroids may have significant clinical differences compared with users of other psychoactive substances of abuse and dependence.

Adolescent↗

Patient factors predicting early alcohol-related readmissions for alcoholics: role of alcoholism severity and psychiatric co-morbidity.

The current study was undertaken primarily to identify whether psychiatric co-morbidity was associated with the rate and time of alcohol-related inpatient readmissions for a group of 255 patients discharged from alcoholism treatment at a midwestern rural medical center. A structured interview obtained information regarding psychiatric disorders, including depression, antisocial personality disorders and polysubstance abuse, as well as alcohol history and sociodemographics. Ninety-eight subjects (38.4% of sample) were readmitted for alcoholism-related diagnoses within 15 months of discharge. Patients with a long history of heavy drinking, high daily alcohol consumption and history of previous alcoholism treatment were most likely to be readmitted with an alcoholism-related primary diagnosis. Once these variables were controlled for, other major psychiatric disorders, polysubstances abuse and sociodemographic variables did not appear to predict time to readmission. However, other potentially more sensitive outcome measures such as return to drinking were not evaluated in the present study.

Alcohol Drinking↗

Ventricular enlargement in schizophrenia evaluated with computed tomographic scanning. Effects of gender, age, and stage of illness.

We evaluated ventricular-brain ratio with computed tomographic scanning in a sample of 108 DSM-III-diagnosed schizophrenic patients and 75 healthy normal volunteers. Significant differences were noted between the patients and controls, but our large sample size also permitted us to determine that the statistically significant difference was contributed primarily through the male patients. Ventricular enlargement occurs only in some schizophrenic patients. In this particular sample, only 6% of schizophrenics had ventricular-brain ratios greater than 2 SDs from the control mean, and 28% were 1 SD greater than the control mean. However, the corresponding figures for male schizophrenics were 19% and 43%, indicating that there is much less overlap between normal individuals and ill subjects in the male population. First-admission schizophrenic patients also had significantly greater ventricular enlargement than did their age-equivalent normal controls, suggesting that ventricular enlargement in schizophrenia may antedate the onset of symptoms. Examination of ventricular size in schizophrenics and normal subjects from a broad age range suggests that ventricular enlargement does not progress over time at a greater rate in schizophrenic patients than in normal subjects.

Adult↗

Illicit anabolic steroid use: a controlled personality study.

The illicit use of anabolic steroids for strength and cosmetic reasons appears to be an increasing problem. Although alcohol and drug abuse have been associated with increased risk for personality psychopathology, the personality correlates of illicit anabolic steroid abuse are unknown. To determine whether personality psychopathology is common among anabolic steroid users, we evaluated a series of illicit anabolic steroid users and compared them with a group of age-matched alcoholics and 2 control groups. Anabolic steroid users were found to have increased risk for personality psychopathology compared with community controls. The risk appeared to be partially explained by a group membership effect. Additionally, similar to the alcoholic group, illicit anabolic steroid users also demonstrated significant antisocial traits.

Adolescent↗