摘要:

In the area of clinical inquiry, knowledge takes its character from its specific sources. This sobering truism is perhaps never more obvious than when investigators attempt to identify those individual differences which precede and, hopefully, might be used to anticipate individual differences in therapeutic response. At the Annual Meeting of the American College of Neuropsychopharmacology, the predictive use of pretreatment considerations served as an integrating theme for several reports of ongoing clinical investigation. Because of their common focus, these papers are presented in two consecutive issues of theJournal.

ISSN:0022-3018    

出版商:OVID    

年代:1973

数据来源: OVID

摘要:

The present report begins with a review of the literature and proceeds through a discussion which develops models for three major classes of. affective disturbance: normal grief, primary depression, and mania. Primary depressions are seen to comprise two major subclasses: the bipolar manic depressive disorders and the unipolar depression. The manifestations of manic depressive disorder are examined from a genetic standpoint which involves epidemiological considerations. The depressive disorders are further considered from the standpoint of a distinction between pure depression and a depressive spectrum. These concepts are examined in terms of such considerations as age and sex, and a distinction between females with an early onset and males with a late onset is emphasized. The proposed classification of depression relies on familial constellations of affective illness.

ISSN:0022-3018    

出版商:OVID    

年代:1973

数据来源: OVID

摘要:

The present report, based upon a partial analysis of data gathered during a study of response to antidepressant medication, is distinctive in the particular sense that it attempts to anticipate individual differences which could have emerged during the course of treatment. The present analysis is not concerned with the post-treatment individual differences. Studies limited to post-treatment individual differences may lose or obscure some important differences in response which characterize fast and effective therapy.Since the predictive emphasis is on individual differences that occur in the course of treatment, predictor-criteria relationships that existed before treatment began or that occurred in the first week of treatment only were disregarded. Specifically, in the present analyses, the predictive emphasis is on those relationships which appeared to have been strengthened after the first week and were discernible in both the second and third weeks of treatment.The analyses were based on 157 depressed female patients newly admitted to the New Jersey State Hospital at Marlboro, and assigned on a random basis to amitriptyline, imipramine, or thioridazine. The present report examines weekly assessments of WPRS-S symptoms, the Depression and Psychasthenia scores of the MMPI, and a somatic distress inventory.The three medications were quite similar in their average effect, and the set of 24 criteria applied at the successive weekly assessment periods revealed very few significant contrasts. There was some tendency for the thioridazine patients to experience greater fatigue and nasal stuffiness than the other patients. Although average treatment effects could not be offered as a guide to the selective assignment of these three medications, there were numerous indications of interaction within each treatment group, and these interactions suggest ways in which pretreatment characteristics of the patient may be used to guide the selective assignment of the available medications.

ISSN:0022-3018    

出版商:OVID    

年代:1973

数据来源: OVID

摘要:

The present report examines the predictors and modifiers of response to amitriptyline in an effort to: identify variables whose effects on drug response are general enough to apply to a range of patient types and treatment settings, isolate predictors, and evaluate the extent to which contrasting conditions across treatment settings may lead to contrasting predictors of treatment effects. The sample comprised moderately depressed neurotic outpatients from three treatment settings: 84 clinic patients from an outpatient clinic in a city hospital, 95 patients from the private practice of general practitioners, and 78 patients from the private practice of a group of psychiatrists.Potential predictors from which regressors in a step search multiple regression procedure could be selected were: patient demographic and attitudinal characteristics, assessments of presenting illness and its history, and evaluations of aspects of the patient-therapist interaction.

ISSN:0022-3018    

出版商:OVID    

年代:1973

数据来源: OVID

摘要:

A model for drug use with depressed patients was proposed to distinguish among active drug responders, placebo responders, and pill responders. A brief literature review was undertaken to provide a rationale for the choice of variables included in the model.Data from two multi-hospital collaborative studies were used to test the model's efficiency in predicting outcome to four classes of active drugs and a placebo: a major tranquilizer (chlorpromazine), a tricyclic antidepressant (imipramine), a minor tranquilizer (diazepam) and a hydrazine MAO inhibitor (phenelzine). The predictor variables included in the multiple regression analyses were sex, marital status, age, education, social desirability, number of prior psychiatric episodes, amount and type of prehospitalization medication and the psychiatrists' pretreatment ratings of severity of illness. The outcome measure in this study was the 3-week severity of illness rating by study psychiatrists.The results tended to support the proposed additive model of drug use. This model assumes that: a) there is a series of variables that predict response to either pill taking or hospitalization; b) there is an additional set of variables that predict response to an effective drug; and c) there is a third set of variables that predict response to a particular effective drug,i.e., are idiosyncratic predictors for that drug. To predict response to an ineffective drug or placebo, one would use the equations derived for pill response or hospital response. To predict response to an effective, active drug, however, this equation would have to be expanded to include all three sets of predictor variables.

ISSN:0022-3018    

出版商:OVID    

年代:1973

数据来源: OVID

ISSN:0022-3018    

出版商:OVID    

年代:1973

数据来源: OVID

ISSN:0022-3018    

出版商:OVID    

年代:1973

数据来源: OVID

ISSN:0022-3018    

出版商:OVID    

年代:1973

数据来源: OVID

ISSN:0022-3018    

出版商:OVID    

年代:1973

数据来源: OVID