摘要:

Eighty-five female depressed patients were treated for 4 weeks with amitriptyline in a flexible dose (median, 150 mg daily). Predictive analyses of outcome were carried out, using both typological and regressional models based on the same 29 predictor variables.The typological prediction utilized a previously described four-group typology derived by multivariate cluster analysis and comprising psychotic depressives, anxious depressives, hostile depressives, and young depressives with personality disorder. Patients were assigned to groups by discriminant functions on the basis of scores on the predictor variables. The four groups were found to predict outcome significantly. Psychotic depressives, initially the most severely depressed, improved the most; anxious depressives, a little less severely ill initially, showed the least improvement and the most residual illness at 4 weeks; hostile depressives and young depressives with personality disorders, initially the least severely ill, showed intermediate improvement and were least ill, by a small margin, at 4 weeks.The 29 predictor variables also predicted outcome significantly in linear multiple regression analyses. Five variables showed regression weights significantly different from zero: high initial severity predicted high improvement but more residual illness; initial insomnia, more previous depressions, longer illness, and hypochondriasis all predicted low improvement and more residual illness.Predictions by using typological and regression models were compared, and their interrelationships were examined. The regression prediction accounted for more variance in outcome measures than did the typology, but the statistical significances of the regression and typological predictions were of the same order. Two variables appeared particularly important—high initial severity of illness which characterized the psychotic depresives and increased number of previous depressions which characterized the anxious depressives. Typological prediction was not solely due to these two variables in linear regression model sicne it remained significant when the outcome measure was adjusted for both by analysis of covariance.Both typological and regressional models provide useful approaches to prediction, with only limited overlap. The typological approach, which has been relatively neglected in recent years, warents more frequent application as an alternative to multiple regression.

ISSN:0022-3018    

出版商:OVID    

年代:1973

数据来源: OVID

摘要:

Assessments of depression based on patients' self-reports and clinical interview ratings were compared for two different samples. Relationships between these two sources of information were examined. Concordances were only moderate and there were some systematic discrepancies suggesting the existence of self-report response sets and psychiatric rater biases. The findings are interpreted to support the value of the use of multiple assessments.

ISSN:0022-3018    

出版商:OVID    

年代:1973

数据来源: OVID

摘要:

Our work in the drug treatment of personality disorders has led to several conclusions. Drug therapy has a definite, but limited place in the treatment of these conditions, and drug-diagnosis interactions are now clearly established for both global clinical outcome and discrete qualitative outcome categories. The consistently beneficial effects of chlorpromazine in emotionally unstable personalities and imipramine in “pseudoneurotic” patients are contrasted with the lack of drug responsivity in hysterical and passive-aggressive patients. Although the present investigation supports the predictive utility of diagnosis, the problem of inter-judge unreliability is serious and requires the development of new, objective diagnostic methods.An empirical, decision tree method of generating psychiatric diagnoses by computer is described. The method makes no assumptions about univariate or bivariate distribution characteristics and is consequently free of some of the criticisms levelled at multiple-discriminant function analyses of psychiatric rating scale data. The present data support the validity of these “machine diagnoses” and show drug-diagnosis interactions of a similar magnitude to our criterion, clinical diagnoses.

ISSN:0022-3018    

出版商:OVID    

年代:1973

数据来源: OVID

摘要:

The results of a double blind, placebo-controlled study of the effects of imipramine among 35 school phobic children between the ages of 6 to 14 are reported. The children and families were given a multidiscipline treatment program concurrently with imipramine or placebo treatment. Imipramine, over a 6-week period, was found to be significantly superior to placebo in inducing school return and in global therapeutic efficacy. Doses of medication ranged from 100 to 200 mg/day after 6 weeks of treatment.It was found that imipramine effects could not be detected after 3 weeks of therapy but were clearly present after 6 weeks. Of 10 items rated by the psychiatrists at baseline and after 6 weeks of treatment, 4 items which reflect the severity of the child's phobic behavior, the child's venturesomeness from the mother, physical symptoms while going to school, and fear of going to school were significantly improved by imipramine treatment.Among 10 items rated by mothers, only 1 item reflecting depressive mood showed a significant drug effect. On the whole, side effects were not significant, and only one child required dosage alteration due to orthostatic hypotension.The diagnostic characteristics of this population are discussed. Further, the relevance of the findings to theories of school phobia is examined.

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