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PubMed1998

Determinants of spontaneous extrapyramidal symptoms in elderly psychiatric inpatients diagnosed with Alzheimer's disease, major depressive disorder, or psychotic disorders.

Extrapyramidal symptoms (EPS) occur more frequently in dementia of the Alzheimer's type (DAT) than in normal aging. Other late-life mental disorders, however, have also been associated with EPS. To examine whether EPS are increased in DAT patients relative to neuropsychiatric control subjects, the authors compared EPS in 127 neuroleptic-free elderly patients diagnosed with either DAT, major depressive disorder (MDD), or a psychotic disorder (SCHIZ/DELUS). They also examined whether depressive or psychotic symptoms were associated with EPS independently of diagnosis. Severity of parkinsonian rigidity was found to be independently associated with DAT. Rank order of rigidity was DAT > MDD > SCHIZ/DELUS. Bradykinesia, although not associated with diagnostic group, was positively correlated with withdrawn depression. These findings suggest that rigidity is associated with DAT independently of any concurrent psychotic or depressive process, whereas bradykinesia does not appear to be specific to DAT among late-life neuropsychiatric illnesses.

Age Factors↗
PubMed1994

Neuropsychiatric and neuropsychological findings in conduct disorder and attention-deficit hyperactivity disorder.

Neuropsychiatric and neuropsychological evaluations were performed in a pilot study of adolescents with DSM-III-R disruptive behavior disorders, including conduct disorder (CD) and attention-deficit hyperactivity disorder (ADHD). The following comparisons were made: 1) CD comorbid with ADHD vs. CD only; 2) all subjects with ADHD vs. all non-ADHD; and 3) all subjects with CD vs. all non-CD. The CD + ADHD group had increased left-sided soft signs compared with the CD group. CD + ADHD subjects significantly underperformed CD subjects on several executive functioning measures, with no differences on Verbal IQ subtests. Results are discrepant with previous findings of deficient verbal functioning in delinquent populations. However, findings may not be generalizable because of sampling limitations.

Adolescent↗
PubMedDate not supplied

Differentiating attention-deficit/hyperactivity disorder from pervasive developmental disorder not otherwise specified.

This study investigated early clinical differences between children with a diagnosis of pervasive developmental disorder not otherwise specified (PDD-NOS) and children with attention-deficit/hyperactivity disorder (ADHD). Differential diagnoses between the two disorders is often difficult in infancy or early childhood. Twenty-seven children with PDD-NOS were matched with 27 children with ADHD as to IQ and chronological age. Their parents were retrospectively questioned on pre-, peri-, and postnatal complications and on atypical or delayed development of the children between 0 and 4 years of age. This exploratory study revealed almost no differences between both groups with respect to pregnancy or birth complications. The results suggest that differences between the two groups become more pronounced and specific with growing age. Consequently, this investigation offers sufficient guidelines for more specific research with larger samples.

Age Factors↗
PubMed2001

Serum lipid concentrations in patients with comorbid generalized anxiety disorder and major depressive disorder.

OBJECTIVE: To examine the lipid levels in a sample of patients with comorbid generalized anxiety disorder (GAD) and major depressive disorder (MDD). METHODS: Serum lipid concentrations were examined in 40 patients with both GAD and MDD, in 27 patients with MDD only, in 26 patients with GAD only, and in 24 healthy control subjects. RESULTS: All mean serum cholesterol concentrations are presented in Table 1. The mean serum total cholesterol concentration in patients with both GAD and MDD was significantly higher than in MDD-only patients, GAD-only patients, and control subjects. The triglyceride concentration was also significantly higher in patients with both GAD and MDD than in MDD-only patients, GAD-only patients, and control subjects. Patients with both GAD and MDD had a lower mean high-density lipoprotein cholesterol (HDL-C) concentration than did patients with GAD only and control subjects. The serum concentration of low-density lipoprotein cholesterol (LDL-C) was higher in patients with both GAD and MDD than in patients with MDD only and GAD only and healthy control subjects. CONCLUSIONS: Our findings indicate that the patients with both GAD and MDD have increased serum cholesterol, triglyceride, and LDL-C and reduced HDL-C levels. These patients may have a greater risk of mortality from coronary artery disease (CAD) than do patients with either depression or anxiety disorder.

Adult↗
PubMed1995

Interpersonal disorder in schizoid and avoidant personality disorders: an attachment perspective.

OBJECTIVE: To investigate the characteristics related to avoidant attachment of 13 schizoid/avoidant psychiatric outpatients and 20 nonschizoid/avoidant psychiatric outpatients. METHOD: Three scales ("maintains distance in relationships", "high priority on self-sufficiency" and "attachment relationship is a threat to security") differentiated schizoid and avoidant personality disordered patients from other personality disordered patients. RESULTS: The results are discussed in terms of the attachment and DSM diagnostic models of avoidant styles in relationships. CONCLUSION: The 2 groups of schizoid and avoidant personality disordered patients were not significantly different on the desire for close affectional bonds scale.

Adult↗
PubMed2004

Major depression, adjustment disorders, and post-traumatic stress disorder in terminally ill cancer patients: associated and predictive factors.

PURPOSE: Few studies have been conducted to elucidate the psychological distress of terminally ill cancer patients. This study attempted to determine the prevalence of adjustment disorders (AD), major depression (MD), and post-traumatic stress disorder (PTSD) among terminally ill cancer patients, to identify factors that contribute to them, and to determine how they change longitudinally. PATIENTS AND METHODS: Consecutive terminally ill cancer patients were recruited. Patients were assessed for psychiatric disorders by structured clinical interview twice: once at the time of their registration with a palliative care unit (baseline), and again at the time of their palliative care unit admission (follow-up). Possible contributed biomedical and psychosocial factors were evaluated. RESULTS: The proportions of patients diagnosed with AD, MD, and PTSD at baseline (n = 209) were 16.3%, 6.7%, and 0% respectively, whereas at follow-up (n = 85), 10.6% were diagnosed with AD and 11.8% with MD. Lower performance status, concern about being a burden to others, and lower satisfaction with social support were significantly associated with AD/MD at baseline. There were changes in the diagnosis of AD and MD in 30.6% of the patients. Only the Hospital Anxiety and Depression Scale at the baseline was significantly predictive of AD/MD at follow-up. CONCLUSION: The factors underlying psychological distress are multifactorial. Early intervention to treat subclinical anxiety and depression may prevent subsequent psychological distress.

Adult↗
PubMed2003

Personality disorders, coping strategies, and posttraumatic stress disorder in women with histories of childhood sexual abuse.

Using a treatment-seeking sample of adult female survivors of childhood sexual abuse, the relationships between coping strategies, personality disorders (PD) and Posttraumatic Stress Disorder (PTSD) were explored. A variety of PDs were found to exist in this population, with avoidant, antisocial, dependent PDs having higher frequencies than borderline PD. Avoidant coping and PTSD severity significantly correlated with many of these PDs. PTSD severity and avoidant coping were also significantly correlated. Additionally, women with PTSD displayed higher rates of avoidant and dependent PDs, as well as more avoidant coping, than did women without PTSD. Results support a more complex conceptualization of the trauma-related symptoms that occur in adult survivors of childhood sexual abuse that incorporate the relationships between avoidant coping, personality disorders, and PTSD.

Adaptation, Psychological↗
PubMed2006

Dissociative symptomatology in posttraumatic stress disorder and disorders of extreme stress.

The present study was designed to assess differences in dissociative symptoms in adults with Posttraumatic Stress Disorder (PTSD) vs. PTSD plus Disorders of Extreme Stress Not Otherwise Specified (DESNOS). This study was done for two reasons: (1) to better understand the clinical profile of DESNOS clients in order to inform more effective treatment, and (2) to further empirical research on the validity of the DESNOS construct. To assess severity of dissociative symptoms, the authors administered the Dissociative Experiences Scale (DES) to 155 participants with PTSD. Using the Structured Interview for Disorders of Extreme Stress (SIDES), participants were divided into two groups: those who also met criteria for DESNOS and those who did not. DES means are provided for the two groups. Participants with PTSD plus DESNOS scored higher than participants with only PTSD on the measure of dissociative symptomatology, particularly on the DES scales that tap absorption/fantasy and depersonalization/derealization. The two groups did not differ on the amnesia subscale of the DES. Findings support the construct validity of the DESNOS concept and further delineate the clinical profiles of community-based PTSD with and without DESNOS, thus contributing to the knowledge base on the assessment of complex adaptations to trauma.

Adolescent↗
PubMed2004

Possible reduction in posttraumatic stress disorder symptoms with oxcarbazepine in a patient with bipolar disorder.

OBJECTIVE: To report the effect of oxcarbazepine in a patient with bipolar illness and posttraumatic stress disorder (PTSD). CASE SUMMARY: A 38-year-old white woman with PTSD and bipolar disorder who had partially responded to carbamazepine was treated with oxcarbazepine. Within a month of initiation of treatment with oxcarbazepine, she reported progressive improvement in her PTSD symptoms. As oxcarbazepine monotherapy with 750 mg twice daily continued, she reported significant reduction of her PTSD symptoms and stabilization of her mood. She tolerated oxcarbazepine without adverse effects. DISCUSSION: PTSD symptoms tend to wax and wane. Spontaneous remission also occurs in some patients with PTSD. There are a few reports indicating that carbamazepine alleviates PTSD symptoms. Since oxcarbazepine is an analog of carbamazepine, it is theorized that oxcarbazepine also has efficacy in significantly reducing PTSD symptoms. CONCLUSIONS: There are case reports and uncontrolled studies suggesting that antiepileptic drugs (AEDs) alleviate PTSD symptoms. Oxcarbazepine may also benefit patients with PTSD. However, controlled studies are needed to investigate the use of AEDs in patients with PTSD and bipolar disorder.

Adult↗
PubMed2001

The impact of borderline personality disorder on process group outcome among women with posttraumatic stress disorder related to childhood abuse.

The outcome of a 12-week interpersonal process group therapy for women with postraumatic Stress Disorder (PTSD) related to childhood sexual abuse with and without borderline personality disorder (BPD) was assessed by comparing three naturally occurring treatment conditions: groups that did not have any members with borderline personality disorder (BPD-) (n = 18), groups in which at least one member carried the diagnosis (BPD+)(n = 16), and a 12-week waitlist (WL) (n = 15). PTSD, anger, depression, and other symptoms were significantly reduced in the BPD- groups. However, the BPD+ and WL conditions did not show any pre- to posttreatment improvements. Furthermore, the BPD+ condition showed a significant worsening on measures of anger. Analyses within the BPD+ condition indicated that women with and without the diagnosis experienced equal posttreatment increases in anger problems. These latter results suggest the presence of an anger "contagion" effect. That is, women without BPD did well in the BPD- groups but showed increased anger similar to the BPD+ women when treated in groups with them. Implications for client-treatment matching considerations in PTSD group therapy are discussed.

Adult↗
PubMed2006

Therapeutic challenges of attention-deficit hyperactivity disorder with substance use disorders.

Attention-deficit hyperactivity disorder (ADHD), a common neuropsychiatric disorder of childhood, adolescence and adulthood, is frequently comorbid with substance use disorders (SUDs) in both adolescents and adults. This paper will provide an overview of the relationship between ADHD and SUDs and discuss the primary areas of therapeutic challenge in the treatment of individuals with comorbid ADHD and SUDs, including the diagnosis of ADHD in populations with SUDs, selecting appropriate agents for use and prevention of abuse and/or diversion of the therapeutic pharmacological agents used in ADHD treatment. The authors will also provide a discussion on the future of research and treatment in this area and key issues for clinicians.

Attention Deficit Disorder with Hyperactivity↗
PubMed1983

Schizophrenia, conduct disorder and depressive disorder: neuropsychological, speech sample and EEG results.

The relationship between degree of schizophrenia and neuropsychological impairment was investigated in 24 adolescent and adult hospitalized and non-hospitalized psychiatric patients with diagnoses of depressive disorder, conduct disorder, and schizophrenia. Schizophrenic adults and conduct disordered adolescents showed greater cognitive impairment than depressed patients on a neuropsychological test of rhythm perception and attention and showed greater frequency of EEG abnormality. Schizophrenics were differentiated from other groups by their impaired abstraction ability on the Halstead-Reitan Category Test. Use of these tests for prediction of adolescents at high risk for schizophrenia was discussed.

Adolescent↗
PubMed1991

Symptom correlates among adolescents showing Posttraumatic Stress Disorder versus Conduct Disorder.

21 adolescents with a primary diagnosis of Posttraumatic Stress Disorder, 24 Conduct Disordered, and 23 control adolescents were compared on measures of depression, anxiety, behavior problems, and fears. Analyses showed that posttraumatic adolescents showed associated symptoms of depression and state-anxiety, Conduct Disordered adolescents showed depressive trends, and both groups were evaluated by their teachers as showing significant behavior problems.

Adolescent↗
PubMed1995

Prevalence of victimization and posttraumatic stress disorder among women with substance use disorders: comparison of telephone and in-person assessment samples.

A structured interview with behaviorally specific probes was used to assess victimization and posttraumatic stress disorder (PTSD) in a clinical and a national, epidemiologic sample of women who had received treatment for a substance use disorder. Separate clinical and epidemiologic approaches to evaluating substance use disorders were compared. More than 80% of women in both samples had a history of sexual and/or physical assault and approximately one-quarter had current PTSD. The similarity in patterns of victimization, PTSD, and substance use across two samples suggests that telephone structured interviews are a valid method of collecting data/information about these important phenomena.

Adolescent↗
PubMed1998

Clinical features distinguishing patients with Tourette's syndrome and obsessive-compulsive disorder from patients with obsessive-compulsive disorder without tics.

OBJECTIVE: It is not clear whether obsessive-compulsive disorder (OCD) in the context of Tourette's syndrome (TS) is the same as that disorder found in patients with OCD alone. This study evaluated the severity and characteristics of the obsessive-compulsive symptoms in adult patients with OCD and TS compared to adult patients with OCD alone. METHOD: Thirteen subjects with both DSM-III-R TS and OCD and 13 subjects with OCD alone were recruited. Obsessive-compulsive severity was determined by using the Yale-Brown Obsessive Compulsive Scale. The Tourette Syndrome Association Unified Tic Rating Scale was administered to determine tic severity, and the adult version of the Attention Deficit and Hyperactivity Checklist was used to detect a history of childhood attention-deficit hyperactivity disorder (ADHD). RESULTS: Subjects with OCD alone had very few obsessions and compulsions that were not also experienced by subjects with both TS and OCD. In contrast, subjects with TS and OCD were significantly more likely to report obsessions involving nonviolent images, excessive concern with appearance, and need for symmetry. Touching, blinking or staring, and counting compulsions were also significantly more common in this group. Eight subjects with OCD and TS had a childhood history of ADHD, compared to none of the pure OCD subjects. CONCLUSION: There are subtle but definite differences in symptomatology of subjects with pure OCD compared to those with OCD and TS consistent with putative differences in pathophysiology between the 2 groups, i.e., abnormalities in the serotonergic system in OCD patients and serotonergic and dopaminergic abnormalities in those with OCD and TS. These observations may be consistent with genetic heterogeneity within both OCD and TS.

Adult↗
PubMed2006

The prevalence of temporomandibular disorders in war veterans with post-traumatic stress disorder.

The purposes of this study were to assess the prevalence of temporomandibular disorders in Croatian war veterans suffering from post-traumatic stress disorder (PTSD) and to analyze the impact of the disease on mandibular function. One hundred eighty-two male subjects participated in the study. The examined group consisted of 94 subjects who had taken part in the war in Croatia and for whom PTSD had previously been diagnosed. Patients were compared with an age- and gender-matched group of subjects who had not taken part in the war and for whom PTSD was excluded by means of a psychiatric examination. The study used a clinical examination and standard questionnaire. Statistically significant differences were found in almost all measured parameters. With regard to restricted movements, overbite, and overjet, the differences obtained did not have clinical significance. The most significant differences were found in the parameters of pain. Headache was experienced by 63.83% of the subjects with PTSD, facial pain by 12.77%, and pain in the region of the jaw by 10.64%. Headache was the most intense pain, with an average intensity of 4.92 on a scale of 0 to 10. Pain on loading, temporomandibular joint clicking, and intrameatal tenderness were more prevalent in the PTSD group than in the healthy control group. The study supports the concept that PTSD patients are at increased risk for the development of temporomandibular disorder symptoms.

Adult↗
PubMed2003

Misidentification of the self in a patient with a psychotic disorder and post-traumatic stress disorder.

The central characteristic of the delusional misidentification syndromes is a delusion of personal misidentification of the self or of others. Other symptoms of psychopathology in addition to delusional misidentification may be important contributors to the misidentification of people. In this article we report the case of a man who suffered from the syndrome of subjective doubles, reverse subjective doubles associated with a psychotic disorder and post-traumatic stress disorder. The contribution of his psychiatric disorders in the genesis of delusional misidentification is explored. Capgras Syndrome was also present.

Adult↗
PubMed1992

Psychometric differentiation of conduct disorder and attention deficit disorder with hyperactivity.

Using a retrospective chart review procedure, children diagnosed as having attention deficit disorder with hyperactivity (ADDH), conduct disorder (CD), and ADDH+CD, as defined by DSM-III, were compared on measures of cognitive and academic functioning as well as on a continuous performance test (CPT). The groups did not differ in age or IQ, but children in the ADDH and ADDH+CD groups missed significantly more target stimuli on the CPT and performed significantly poorer on measures of academic achievement than did the pure CD group. However, poor CPT performance was not accounted for by learning problems. These findings in clinically referred patient groups are consistent with dimensional and epidemiological studies that suggest that ADDH may be a cognitively based disorder, whereas CD children are characterized by behavioral symptoms with fewer cognitive and learning deficits.

Attention↗