ISSN:0022-3018    

出版商:OVID    

年代:2000

数据来源: OVID

摘要:

The objectives of the present report were: a) to determine the spontaneous remission rate in depressed outpatients who do not receive antidepressant medication; b) to develop a novel method for obtaining a control group that can be used to gauge the effectiveness of antidepressant medication in clinical practice; and c) to compare response rates from the present sample with outcomes of depressed patients in our practice who were treated with antidepressant medications. By using a naturalistic design, prospective assessments were made on all depressed outpatients. Twenty-five patients who met full criteria for a major depressive episode ended up not taking antidepressant medication for a variety of reasons. "Response" rates to a no-treatment trial were determined with standard outcome criteria using the Clinical Global Impression-Improvement scale. Eight patients (32.0%) had a positive response, 5 patients (20.0%) had a partial response, and 12 patients (48.0%) were nonresponders to a no-treatment trial. These response rates were higher than expected, but significantly lower than what we had found in a cohort of depressed patients who underwent an antidepressant trial (p= .02). Likewise, treatment-resistant patients fared better on pharmacotherapy, though this difference was not statistically significant. These results suggest that the occurrence of spontaneous remissions may be common in clinical practice, and therefore the specific short-term benefits of antidepressant medication in clinical practice may frequently be overestimated. Despite the high rate of spontaneous remission in our sample, the present study allowed us to confirm the effectiveness of antidepressant medication in clinical practice using a novel method for obtaining a control comparison group.

ISSN:0022-3018    

出版商:OVID    

年代:2000

数据来源: OVID

摘要:

Those afflicted with bipolar disorder often suffer from substantial functional impairment both when in episode and when in remission. This study examined the psychometric properties of a brief assessment of psychosocial functioning, the Range of Impaired Functioning Tool (LIFE-RIFT), among subjects with bipolar I disorder. The study sample consisted of 163 subjects who presented with bipolar I disorder at intake into the NIMH Collaborative Depression Study (CDS). All LIFE-RIFT items come from the Longitudinal Interval Follow-up Evaluation (LIFE). Follow-up data that were used to examine the reliability and validity of the scale come from assessments of psychosocial functioning that were conducted 6, 12, 18, and 24 months after intake into the CDS. The results of factor analyses indicate that the scale items are measures of one construct,psychosocial functioning.The interrater agreement on the scale score was very good with an intraclass correlation coefficient was 0.94. The internal consistency reliability among the scale items was uniformly satisfactory over the four assessment periods, with coefficient alpha ranging from 0.78 to 0.84. Mixed-effect regression analyses showed that during mood episodes subjects were significantly more impaired than those in recovery. In conclusion, the psychometric properties of the LIFE-RIFT were examined in subjects with bipolar I disorder. The analyses from this longitudinal, observational study provide empirical support for the reliability and validity of the scale. The LIFE-RIFT provides a brief, inexpensive alternative to scales currently used to assess psychosocial functioning and can be easily added to semistructured assessments that are used in clinical and treatment outcome studies.

ISSN:0022-3018    

出版商:OVID    

年代:2000

数据来源: OVID

摘要:

We describe the design and development of the Cognitive Evaluation Protocol® (CEP), a computer software program for evaluating cognitive and functional capacities and mood. The program is self-administered by subjects using touchscreen monitors for input. Stimuli in CEP subtests are randomized to reduce the effects of learning on repeated assessments. Findings demonstrate that a) minimum instruction is required for touchscreen use, even for computer-naïve subjects; c) both normative subjects and psychiatric patients respond positively to self-administered evaluations; and c) CEP can be used for within-subject repeated evaluations with minimal distortion of results due to practice effects. The CEP Report Generator® provides immediate printed performance results and creates a database for long-term digital storage and information use.

ISSN:0022-3018    

出版商:OVID    

年代:2000

数据来源: OVID

摘要:

We report a study of memory, attention, function, and mood among 36 male Vietnam War Veterans suffering from chronic posttraumatic stress disorder (PTSD). PTSD subjects (N= 36) were in good physical health, suffering from moderate depression, and not knowingly suffering from other mental disorders. Control subjects (N= 18) were in good physical health, not knowingly suffering from a mental disorder, and matched with PTSD subject for age, sex, and level of education. Assessment instruments for PTSD subjects included the PostTraumatic Stress Diagnostic Scale™ (clinician administered), the Hamilton Depression Rating Scale (clinician administered), and the Cognitive Evaluation Protocol® (CEP), a touchscreen computer assessment instrument that is self-administered by subjects. CEP was administered twice to PTSD subjects 1 month apart; other instruments were administered at the beginning of the study. Control subjects took CEP once and were administered the Hamilton Depression Rating Scale and the PostTraumatic Stress Diagnostic Scale once. Compared with control subjects, PTSD subjects performed significantly less well on CEP for the three cognitive domains of attention, memory, and function and had highly elevated depression scores. An interaction between depression and memory was found but not with depression and attention. There was no evidence of reduced information processing speed among PTSD subjects. Comparisons between the three assessment instruments showed a high degree of cross-assessment agreement. The findings are consistent with reports that chronic PTSD is associated with compromised memory, attention, and function. The study documents the feasibility of using self-administrated touchscreen computer programs to evaluate and track features of mental disorders.

ISSN:0022-3018    

出版商:OVID    

年代:2000

数据来源: OVID

摘要:

This work attempts to explore the association between depression and prosody impairment through acoustic techniques of voice analysis. For this purpose, we selected 10 quantitative vocal parameters, obtained instrumentally, and related to the variability and psychomotor control of phonation, which we have considered as prosody indicators. The sample consisted of 23 patients with diagnosis DSM-III-R of major depression and a control group of 20 healthy volunteers. We obtained results in 7 of the 10 acoustic parameters that suggest reduced prosody in depressed subjects. In a second voice test, carried out 2 months after baseline situation, and while patients were under antidepressant treatment, it was not possible to demonstrate that all these prosody indicators change to normality in those 13 subjects who clinically improved.

ISSN:0022-3018    

出版商:OVID    

年代:2000

数据来源: OVID

摘要:

College students screened for hallucination-proneness using the Launay-Slade Hallucination Scale (LSHS) were compared on measures of self-report vividness of imagery and on behavioral measures of imagery and perception (visual and auditory). Specifically, we tested the hypothesis whether hallucination-prone individuals would show smaller differences between imagery and perception performance, which may be indicative of increased sensory characteristics of mental images. We replicated earlier findings of higher self-report imagery ratings in the high hallucination-prone group. However, the two groups did not differ on five of six behavioral imagery-perception comparisons. On one visual task, hallucination-proneness was associated with larger imagery-perception differences. Our results reveal a dissociation between the level of subjective experience and the information processing level. Although vividness of mental images may be subjectively associated with mild hallucinatory experiences, we suggest that cognitive processes associated with reality discrimination rather than increased perceptual characteristics of mental images may play a role at the information processing level.

ISSN:0022-3018    

出版商:OVID    

年代:2000

数据来源: OVID

ISSN:0022-3018    

出版商:OVID    

年代:2000

数据来源: OVID

ISSN:0022-3018    

出版商:OVID    

年代:2000

数据来源: OVID

ISSN:0022-3018    

出版商:OVID    

年代:2000

数据来源: OVID