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Ansseau M, Troisfontaines B, Papart P, von Frenckell R. Compulsive personality as predictor of response to serotoninergic antidepressants. BMJ (CLINICAL RESEARCH ED.) 1991; 303:760-1. [PMID: 1932937 PMCID: PMC1671020 DOI: 10.1136/bmj.303.6805.760] [Citation(s) in RCA: 30] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Affiliation(s)
- M Ansseau
- Psychiatric Unit, Centre Hospitalier Universitaire de Liège, Domaine Universitaire du Sart Tilman, Belgium
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52
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Davis BA, Boulton AA, Yu PH, Durden DA, Keegan DL, Bowen RC, Blackshaw S, D'Arcy C, Remillard AJ, Dayal N. Longitudinal effect of amitriptyline and fluoxetine treatment on plasma phenylacetic acid concentrations in depression. Biol Psychiatry 1991; 30:600-8. [PMID: 1932407 DOI: 10.1016/0006-3223(91)90029-l] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Abstract
Unconjugated (U-PAA), conjugated (C-PAA), and total phenylacetic acid (T-PAA) concentrations in blood plasma and monoamine oxidase (MAO) activity in platelets towards phenylethylamine (PE) were determined in 40 drug-free, depressed patients (23 melancholic, 17 nonmelancholic) from five psychiatric treatment centers, and in 34 normal healthy volunteers. No significant differences were found between controls and all depressed patients or between melancholic and nonmelancholic depressed patients. Treatment of the depressed patients with amitriptyline or fluoxetine over a 6-week period resulted in clinical improvement and in a significant increase in plasma PAA concentrations. A decline in the Beck and Hamilton rating scores during treatment correlated significantly with increases in the concentrations of unconjugated, conjugated, and total phenylacetic acid but not with MAO activity, which did not change during treatment. At each of the three assessment times, however, plasma PAA concentrations and psychiatric rating scores were not significantly correlated. Except for higher end-of-study T-PAA concentrations in the amitriptyline-treated subjects, no significant differences were found between the effects of the two drugs with regard to plasma phenylacetic acid levels, MAO activity, or rating scores.
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Affiliation(s)
- B A Davis
- Neuropsychiatric Research Unit, University of Saskatchewan, Saskatoon, Canada
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53
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Davis BA, Boulton AA, Yu PH, Durden DA, Bowen RC, Keegan DL, Blackshaw S, D'Arcy C, Remillard AJ, Dayal N. Deuterium-labelled p-tyramine challenge test and phenolsulfotransferase activity in depressed patients--failure to replicate decreased p-tyramine conjugation in depression. Prog Neuropsychopharmacol Biol Psychiatry 1991; 15:241-7. [PMID: 1871324 DOI: 10.1016/0278-5846(91)90087-h] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Abstract
1. Depressed and normal subjects were challenged with deuterium-labelled p-tyramine and urine was collected for 3 h. 2. Urinary excretion of conjugated p-tyramine was not significantly different between normal, melancholic and non-melancholic depressed subjects. 3. Platelet phenolsulfotransferase activity to p-tyramine (p less than 0.05) and to phenol (p less than 0.005) were significantly lower in the depressed patients.
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Affiliation(s)
- B A Davis
- Neuropsychiatric Research Unit, University of Saskatchewan, Saskatoon
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54
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Maes M, Maes L, Schotte C, Vandewoude M, Martin M, D'Hondt P, Blockx P, Scharpé S, Cosyns P. Clinical subtypes of unipolar depression: Part III. Quantitative differences in various biological markers between the cluster-analytically generated nonvital and vital depression classes. Psychiatry Res 1990; 34:59-75. [PMID: 2176296 DOI: 10.1016/0165-1781(90)90058-d] [Citation(s) in RCA: 33] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
The hypothalamic-pituitary-adrenal (HPA) axis, the hypothalamic-pituitary-thyroid (HPT) axis, and the availability of L-tryptophan (L-TRP) to the brain were studied in their relationships to (1) 14 depressive symptoms measured by the Structured Clinical Interview for DSM-III-R--Patient Version (SCID) and (2) the cluster-analytically generated vital/nonvital classes. The following biological parameters were measured in 100 depressed females: free thyroxine (FT4), baseline thyroid stimulating hormone (TSH), predexamethasone and postdexamethasone cortisol and adrenocorticotropic hormone (ACTH) values, the circulating levels of total L-TRP, and the L-TRP/sum of competing amino acids ratio. We found that the psychopathological correlates of disorders in the HPA/HPT axis and of a decreased availability of L-TRP were vital symptoms, i.e., distinct quality of mood, nonreactivity, early morning awakening, anorexia-weight loss, and psychomotor disorders. There was no significant relationship between those biological markers and the nonvital symptoms of the SCID inventory for depressive symptoms. However, we did not validate our SCID clustering in vital and nonvital classes by qualitative differences in the biological variables. It was concluded that our nonvital/vital clusters should be regarded as continuous categories with regard to the biological markers studied; these clusters constitute relevant stages in the continuum of progressing biological dysfunction.
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Affiliation(s)
- M Maes
- Dept. of Biological Psychiatry, University Hospital of Antwerp, Edegem, Belgium
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55
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Maier W, Philipp M, Schlegel S, Heuser I, Wiedemann K, Benkert O. Diagnostic determinants of response to treatment with tricyclic antidepressants: a polydiagnostic approach. Psychiatry Res 1989; 30:83-93. [PMID: 2594875 DOI: 10.1016/0165-1781(89)90175-3] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Abstract
In an attempt to find diagnostic predictors of treatment response, 45 inpatients with major depression in a randomized trial received amitriptyline or imipramine for 23 days after a washout period of 16 days. A polydiagnostic approach was applied to the classification of endogenous depression. Only a minority of diagnostic schedules for endogenous depression proved predictive of a more favorable course during antidepressant treatment: the criteria of D. F. Klein, the Newcastle Scale II, and the Vienna Research Criteria. The symptoms of nonreactivity of mood and diurnal variation were the only endogenous symptoms with predictive ability. In addition, psychotic features and secondary depression predicted an unfavorable course, whereas characteristics of previous course (bipolarity, recurrence) were not predictive.
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Affiliation(s)
- W Maier
- Department of Psychiatry, University of Mainz, West Germany
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56
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Mooney JJ, Schatzberg AF, Cole JO, Kizuka PP, Salomon M, Lerbinger J, Pappalardo KM, Gerson B, Schildkraut JJ. Rapid antidepressant response to alprazolam in depressed patients with high catecholamine output and heterologous desensitization of platelet adenylate cyclase. Biol Psychiatry 1988; 23:543-59. [PMID: 2833319 DOI: 10.1016/0006-3223(88)90002-9] [Citation(s) in RCA: 25] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/02/2023]
Abstract
The present study examined the relationship between 24-hr urinary catecholamine (norepinephrine and epinephrine) output and measures of platelet adenylate cyclase (AC) activity in depressed patients (n = 17) and control subjects (n = 10). In both groups, significant inverse correlations were observed when 24-hr urinary catecholamine levels were examined in relation to measures of both receptor-mediated (prostaglandin D2 and alpha 2-adrenergic) and postreceptor-mediated (NaF) platelet AC enzyme activities, suggesting that circulating catecholamines may regulate platelet AC by heterologous (agonist-nonspecific) desensitization of the AC enzyme complex. Depressed patients who had favorable antidepressant responses to alprazolam had significantly higher pretreatment urinary catecholamine output and lower receptor-mediated platelet AC enzyme activities than control subjects, whereas the nonresponders did not. After 8 days of treatment with alprazolam, urinary catecholamine levels declined significantly. In responders, receptor-mediated measures of platelet AC activity increased significantly by day 8 to values comparable to those in control subjects; but similar changes were not observed in nonresponders. Prior to treatment, responders showed a strict linear relationship between receptor-mediated (prostaglandin D2) and postreceptor-mediated (NaF) stimulation of platelet AC activity through the stimulatory guanine nucleotide regulatory protein (Ns), whereas nonresponders did not. This suggests the presence of two distinct coupling interactions between platelet prostaglandin D2 receptors and the stimulatory guanine nucleotide regulatory protein in responders and nonresponders to the antidepressant effects of alprazolam prior to treatment. The authors propose that catecholamines, possibly acting through prostaglandins, may regulate platelet AC enzyme activity by heterologous desensitization occurring through postreceptor mechanisms.
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Affiliation(s)
- J J Mooney
- Neuropsychopharmacology Laboratory, Massachusetts Mental Health Center, Boston 02115
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57
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Zimmerman M, Coryell W, Stangl D, Pfohl B. Validity of an operational definition for neurotic unipolar major depression. J Affect Disord 1987; 12:29-40. [PMID: 2952692 DOI: 10.1016/0165-0327(87)90058-9] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
Abstract
After we reviewed the literature to identify the clinical and phenomenologic correlates of neurotic depression, we constructed a 6-item operational definition to distinguish neurotic unipolar major depressive disorder from non-neurotic major depression. The neurotic depressives were characterized by a low rate of abnormal dexamethasone suppression test (DST) results and a strong family history of alcoholism. Neurotic depressives improved less than non-neurotic depressives during the index hospitalization, and were more frequently rehospitalized during a 6-month prospective follow-up. Neurotic subtyping was significantly negatively associated with DSM-III melancholia. Neurotic classification remained significantly associated with the above validating variables after melancholic status was held constant, whereas melancholic subtyping did not predict DST results, familial alcoholism rates, or outcome when neurotic status was controlled.
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58
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Maier W, Philipp M. A polydiagnostic scale for dimensional classification of endogenous depression. Derivation and validation. Acta Psychiatr Scand 1986; 74:152-60. [PMID: 3776660 DOI: 10.1111/j.1600-0447.1986.tb10599.x] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
Abstract
Several operational diagnoses (OPD) for endogenous depression have been proposed. However--though aiming at similar clinical concepts--the amount of association and agreement between different OPD is rather low. In this study the relationship between eight OPD (Research Diagnostic Criteria, DSM-III, Michigan Discrimination Index, Newcastle Scale I, Newcastle Scale II, Taylor-Abrams Criteria, Vienna Research Criteria, Hamilton Endogenomorphy Index) was assessed by applying latent trait analyses to the classificatory data of these eight OPD which were rated simultaneously in a sample of 173 depressive inpatients. According to these analyses six OPD (RDC, DSM-III, NCS-I, NCS-II, TAC and VRC) are tapping the same phenomenon. This latent trait represents compatible concepts of endogenous depression; it is strongly associated with the independently assessed clinical ICD-9 diagnosis of endogenous depression. The six OPD can be considered as items of a scale (so-called OPD-scale). The total scores of the OPD-scale represent a dimensional assessment of the decisiveness of the diagnosis endogenous depression. Coefficients and parameters of this new scale are presented.
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59
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Zimmerman M, Coryell W, Pfohl B, Stangl D. Validity of the Hamilton Endogenous Subscale: an independent replication. Psychiatry Res 1986; 18:209-15. [PMID: 3749383 DOI: 10.1016/0165-1781(86)90108-3] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
Abstract
We calculated scores on the Hamilton Endogenous Subscale (HES) (Thase et al., 1983) for 252 depressed inpatients. The HES scores were bimodally distributed, and HES classification was significantly associated with endogenous (Research Diagnostic Criteria) and melancholic (DSM-III) subtyping. Based on a cutoff score of 8, HES classification was not associated with either family history of specific psychiatric illness or abnormal dexamethasone suppression test (DST) results. When the cutoff was raised to 10, DST nonsuppression was more frequent in HES endogenous depressives, although we again failed to find an association with a family history of psychiatric disorders.
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60
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Philipp M, Maier W, Holsboer F. Psychopathological correlates of plasma cortisol after dexamethasone suppression: a polydiagnostic approach. Psychoneuroendocrinology 1986; 11:499-507. [PMID: 3562743 DOI: 10.1016/0306-4530(86)90010-7] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
Abstract
Seventy-seven consecutively admitted inpatients with depressive syndromes were examined with the Present State Examination and classified according to eight different operational diagnoses of endogenous depression. All patients received a 1.5 mg dexamethasone suppression test (DST). Sensitivity, specificity and the corrected predictive values of DST nonsuppression (50 or more ng/ml at 0800 hr, 1600 hr, or 2300 hr), adjusted to a 50% prevalence of endogenous and nonendogenous depression, varied considerably depending on the diagnostic definition used. The highest predictive value (89.9%) was found with the Taylor-Abrams criteria (sensitivity = 43.9%, specificity = 95.0%), and the lowest predictive value (53.3%) with DSM-III (sensitivity = 37.7%, specificity = 68.1%). Eliminating the patients with dexamethasone levels of less than 2000 pg/ml improved the diagnostic specificity of the DST for most of the eight definitions of endogenous depression. This further indicates that plasma dexamethasone levels should be analyzed in studies designed to explore the diagnostic utility of the DST. A significant, chance-corrected association between DST nonsuppression and the diagnosis of endogenous depression was found with clinical diagnosis (according to the International Classification of Diseases), and for four out of eight operational diagnoses (Newcastle Scale I, Newcastle Scale II, Taylor-Abrams Criteria, and Vienna Research Criteria). For the other diagnoses (Research Diagnostic Criteria, DSM-III, Michigan Discriminant Index, and Hamilton Endogenomorphy Index), no significant association was found. The RDC criterion "early or intermittent awakening" was the only one out of 28 diagnostic criteria tested which was significantly associated with DST nonsuppression.
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Abstract
We examined the risk of psychiatric illness in the first-degree relatives of the 257 depressed inpatients upon whom we constructed the Iowa Discriminant Index (IDI) for endogenous depression. Nonendogenous depressives had a higher rate of alcoholism and antisocial personality in their families. IDI endogenous subtyping was not associated with a family history of depression. These results provide additional support for the validity of the empirically derived IDI.
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62
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Monroe SM, Thase ME, Hersen M, Himmelhoch JM, Bellack AS. Life events and the endogenous-nonendogenous distinction in the treatment and posttreatment course of depression. Compr Psychiatry 1985; 26:175-86. [PMID: 3987246 DOI: 10.1016/0010-440x(85)90038-0] [Citation(s) in RCA: 26] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/08/2023] Open
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63
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Mooney JJ, Schatzberg AF, Cole JO, Kizuka PP, Schildkraut JJ. Enhanced signal transduction by adenylate cyclase in platelet membranes of patients showing antidepressant responses to alprazolam: preliminary data. J Psychiatr Res 1985; 19:65-75. [PMID: 2985777 DOI: 10.1016/0022-3956(85)90069-x] [Citation(s) in RCA: 20] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
Abstract
The triazolobenzodiazepine, alprazolam, was administered to 11 depressed patients over a period of six weeks, and six patients showed a favorable antidepressant response. There were no significant differences between responders and nonresponders in age, pretreatment Hamilton Depression Rating Scores, 4 p.m. postdexamethasone plasma cortisol levels, or platelet monoamine oxidase activities. Blood levels of alprazolam were not meaningfully different in responders and nonresponders when measured on treatment day 8. However, on treatment day 8, significantly enhanced prostaglandin D2-stimulated platelet adenylate cyclase activity, greater suppression of prostaglandin D2-stimulated platelet adenylate cyclase activity by epinephrine, and enhanced sodium fluoride-stimulated platelet adenylate cyclase activity were seen in the six patients who went on to respond to alprazolam, but not in the five nonresponders. In contrast, there were no significant changes in prostaglandin D2, (-)-isoproterenol, or fluoride ion-stimulated leukocyte adenylate cyclase activity in responders or nonresponders. No meaningful changes were observed in the mean densities of either the high-affinity platelet alpha 2-adrenergic receptor (for 3H-p-aminoclonidine) or the leukocyte beta-adrenergic receptor (for 3H-dihydroalprenolol) in responders or nonresponders. The present findings, taken in conjunction with findings from other recent studies, suggest that enhanced coupling between certain neurotransmitter or hormone receptors and adenylate cyclase through the guanine nucleotide regulatory proteins may help explain the antidepressant effects of alprazolam and possibly other forms of antidepressant treatment.
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64
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Samson JA, Gudeman JE, Schatzberg AF, Kizuka PP, Orsulak PJ, Cole JO, Schildkraut JJ. Toward a biochemical classification of depressive disorders--VIII. Platelet monoamine oxidase activity in subtypes of depressions. J Psychiatr Res 1985; 19:547-55. [PMID: 4078757 DOI: 10.1016/0022-3956(85)90072-x] [Citation(s) in RCA: 17] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
Platelet monoamine oxidase (MAO) activity was examined in 77 depressed patients (40 males and 37 females) and 28 controls (14 males and 14 females). Patients were compared across increasingly specific diagnostic groupings in a four-step data analytic procedure. In step 1, MAO activity in the total sample of depressed patients was compared with that of control subjects. In step 2, Unipolar depressed patients were compared with Bipolar (Bipolar I and Bipolar II) depressed patients. In step 3, Unipolar depressed patients with and without schizotypal features were compared. In step 4, both the nonschizotypal Unipolar patients and compared. In step 4, both the nonschizotypal Unipolar patients and nonschizotypal Bipolar patients were separated into those who met RDC criteria for a definite Endogenous depression and those who did not; and platelet MAO activity was compared in the resulting four groups. Results indicated significantly higher platelet MAO activity in nonschizotypal Unipolar Endogenous depressed patients than in nonschizotypal Bipolar Endogenous depressed patients or nonschizotypal Unipolar Other patients. In addition, the presence of a definite Endogenous depressive syndrome was associated with greater overall symptom severity in both Unipolar and Bipolar depressed patients. Findings are discussed with respect to the conflicting results reported in previous studies of MAO activity in patients with depressive disorders.
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Thase ME, Hersen M, Bellack AS, Himmelhoch JM, Kornblith SJ, Greenwald DP. Social skills training and endogenous depression. J Behav Ther Exp Psychiatry 1984; 15:101-8. [PMID: 6480866 DOI: 10.1016/0005-7916(84)90003-x] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/20/2023]
Abstract
The clinical response to social skills training was studied in four women with definite endogenous depression (melancholia) to ascertain if a behavioral intervention could be effective with more severe and pervasive affective syndromes. Three of four patients responded to social skills training, although both patients available for longitudinal follow-up relapsed within 24 months post-treatment. Implications for research and practice are discussed.
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67
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Kupfer DJ, Bulik CM, Grochocinski V. Relationship between EEG sleep measures and clinical ratings of depression. A revisit. J Affect Disord 1984; 6:43-52. [PMID: 6231329 DOI: 10.1016/0165-0327(84)90007-7] [Citation(s) in RCA: 16] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/19/2023]
Abstract
The relationship between clinical and behavioral ratings and EEG sleep variables has been controversial, leading to a possible premature abandonment of the possible significance for these interrelationships. Instead, our reexamination of this issue in 62 depressed patients suggests that while the strength of these relationships do not account for the majority of variance, correlations between EEG sleep and behavioral measures should not be disregarded as trivial, for the degree of these relationships is commensurate with other behavioral-biological relationships.
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Thase ME, Last CG, Hersen M, Bellack AS, Himmelhoch JM. Symptomatic volunteers in depression research: a closer look. Psychiatry Res 1984; 11:25-33. [PMID: 6584929 DOI: 10.1016/0165-1781(84)90105-7] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/20/2023]
Abstract
Seventy-nine carefully screened volunteers were compared with 46 clinically referred outpatient primary depressives to assess the validity of use of symptomatic volunteers in research on depression. Overall, symptomatic and clinical referral samples were similar on the majority of demographic and symptomatic variables, although volunteers were less likely to be single, had slightly lower Hamilton scores, less self-reported anxiety, and a longer index episode of depression. Symptomatic volunteer and clinical referral groups had a similar prevalence of endogenous depression by either RDC or DSM-III criteria. Results in 60 patients treated with amitriptyline indicated that both groups were comparable with respect to overall dropout rate, side-effect attrition, dosage of amitriptyline received, and clinical response. Only the proportion of patients who dropped out between completion of assessment and initiation of treatment significantly differed between groups (symptomatic volunteers = 19%; clinical referrals = 0%; p less than 0.05). These findings support use of rigorously screened symptomatic volunteers in outpatient depression research.
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