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1.
Arch Gen Psychiatry ; 35(7): 898-9, 1978 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-678041

RESUMO

Computerized records of a large university hospital were searched to identify all women from 1967 to 1976 whose conditions had been diagnosed as breast cancer or primary cancer of another site. The records for those women with diagnoses of cancer were then examined to identify any prior psychiatric diagnoses. The rationale was that most patients treated in this hospital setting for psychiatric disorders received neuroleptic drugs, and patients with a diagnosis of schizophrenia are almost certain to be treated with major neuroleptic drugs over a prolonged period of time. No substantial difference in the relative frequency of prior psychiatric treatment was observed between breast cancer and other cancer groups.


Assuntos
Neoplasias da Mama/psicologia , Transtornos Mentais/tratamento farmacológico , Adulto , Neoplasias da Mama/induzido quimicamente , Feminino , Humanos , Prolactina/sangue , Esquizofrenia/tratamento farmacológico , Tranquilizantes/efeitos adversos , Tranquilizantes/uso terapêutico
2.
Arch Gen Psychiatry ; 36(11): 1198-1205, 1979 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-485777

RESUMO

Criteria for establishing a diagnosis of schizophrenia have been proposed by several different authors. This study compared six different research diagnostic criteria (RDC) in a series of 166 patients who received a clinical diagnosis of schizophrenia in a multicenter study. The alternative criteria differed in the proportion of clinical diagnoses that were confirmed, with the Washington University (Feighner) criteria accepting only 26%. The criteria also disagreed concerning which particular patients qualified for the diagnosis. The Washington University and New York RDC disagreed 50% of the time, and some other disagreement rates were even higher. More evaluative research is needed before arbitrary criteria are permitted to redefine the concept of schizophrenia.


Assuntos
Esquizofrenia/diagnóstico , Computadores , Diagnóstico Diferencial , Humanos , Projetos Piloto , Escalas de Graduação Psiquiátrica , Pesquisa , Psicologia do Esquizofrênico
3.
Arch Gen Psychiatry ; 35(12): 1410-5, 1978 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-569471

RESUMO

Exretion of 3-methoxy-4-hydroxyphenylglycol (MHPG) was measured repeatedly in 17 normal subjects. The amount of MHPG excreted over a 24-hour period was fairly stable over a period of three consecutive 24-hour samplings, but stability was rather poor over subsequent periods of several weeks, suggesting that execretory patterns are not traits. A normal range of MHPG excretion was estimated to be 900 to 3,500 micrograms/24 hr. This range covers the majority of persons with affective disorders whose excretion patterns have been measured, although comparisons of absolute values between laboratories must be made cautiously. Further, substantial changes within this range may occur in normal subjects with no accompanying change in affect. A slight but definite diurnal pattern of excretion was found, with a peak at the period of 1600 to 1800 hours. No clear relationship to MHPG excretion to state of physical activity, recent consumption of foods or beverages, or prevailing affective state was defined in those subjects living under normal conditions. While MHPG excretion may yet prove useful for categorizing depressed patients and predicting response to drugs, any inferences drawn regarding the pathogenesis of affective disorders must be guarded.


Assuntos
Sintomas Afetivos/urina , Glicóis/urina , Metoxi-Hidroxifenilglicol/urina , Adolescente , Adulto , Sintomas Afetivos/classificação , Ritmo Circadiano , Creatinina/urina , Depressão/urina , Emoções/fisiologia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Esforço Físico , Fatores Sexuais
4.
Arch Gen Psychiatry ; 45(2): 120-7, 1988 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-3276281

RESUMO

Isocarboxazid and placebo were evaluated in 130 anxious depressives. Drug was superior to placebo on depression, anxiety, interpersonal sensitivity, and global measures, and on symptoms of hostility, anxiety, obsessiveness, and psychological-cognitive components of depression. There were no significant differences between treatment effects on psychomotor and typical vegetative symptoms. Isocarboxazid was more effective than placebo in major, but not in minor, depression. It was significantly more effective in depression classified as endogenous depression or melancholia by various diagnostic criteria. Drug was more effective than placebo in atypical depression with vegetative reversal and in Brief Psychiatric Rating Scale (BPRS)-derived profiles of anxious and hostile depression; there were no drug-placebo differences in atypical depression without vegetative reversal, or in BPRS retarded and agitated/excited depression. Interpersonal sensitivity emerged as an important drug-responsive dimension.


Assuntos
Transtorno Depressivo/tratamento farmacológico , Isocarboxazida/uso terapêutico , Adulto , Ansiedade/efeitos dos fármacos , Ensaios Clínicos como Assunto , Transtorno Depressivo/classificação , Transtorno Depressivo/psicologia , Método Duplo-Cego , Feminino , Hostilidade/efeitos dos fármacos , Humanos , Relações Interpessoais , Isocarboxazida/farmacologia , Masculino , Avaliação de Processos e Resultados em Cuidados de Saúde , Placebos , Escalas de Graduação Psiquiátrica
5.
Arch Gen Psychiatry ; 34(7): 839-45, 1977 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-406875

RESUMO

Evaluation of treatment modalities, including pharmacotherapy, for organic brain syndrome (OBS) has been difficult because of sampling and methodological problems, and comparisons of research studies are all but impossible. In this study, an ergot derivative, a combination of dihydroergocornine mesylate, dihydroergocristine mesylate, and dihydroergokryptine mesylate (Hydergine) was compared with placebo, using a double-blind technique in a sample of nursing home residents with evidence of OBS. An 18-category symptom rating scale was used for periodic assessment over a six-month interval. Comparisons of the two groups of subjects disclosed that the Hydergine-treated group showed statistically significantly more improvement in most of the variables measured, especially during the last three months of treatment. Furthermore, sophisticated analysis revealed that positive changes in cognitive function cannot be accounted for as a mere reflection, or "halo" effect, associated with improved mood and general sense of well-being.


Assuntos
Di-Hidroergotoxina/uso terapêutico , Transtornos Neurocognitivos/tratamento farmacológico , Administração Oral , Idoso , Cognição/efeitos dos fármacos , Di-Hidroergotoxina/administração & dosagem , Combinação de Medicamentos , Avaliação de Medicamentos , Feminino , Seguimentos , Humanos , Masculino , Pessoa de Meia-Idade , Placebos , Escalas de Graduação Psiquiátrica , Fatores de Tempo
6.
Arch Gen Psychiatry ; 32(6): 798-801, 1975 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-1093507

RESUMO

Marihuana or placebo cigarettes were smoked by 12 subjects in two environments, one "favorable" and one "neutral". The object was to determine the contribution of setting to the effects reported from the drug. Two quantifiable self-report measurements, the linear euphoriant scale and the card-sort version of the Addiction Research Center Inventory (marihuana and hallucinogen scales), were the major reporting criteria. Analyses of variance consistently demonstrated strong effects for subjects and drug but not for the environmental conditions. Reports of marihuana effects may be assumed to be highly colored by psychological differences in the mental set of subjects, or biological variations in their responses to the drug. The actual environment in which the drug is taken seems to play little, if any, role.


Assuntos
Cannabis/farmacologia , Meio Ambiente , Pressão Sanguínea/efeitos dos fármacos , Ensaios Clínicos como Assunto , Dronabinol/farmacologia , Euforia/efeitos dos fármacos , Alucinações/induzido quimicamente , Humanos , Masculino , Placebos , Pulso Arterial/efeitos dos fármacos , Autoavaliação (Psicologia) , Fatores de Tempo
7.
Arch Gen Psychiatry ; 45(7): 655-9, 1988 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-3289523

RESUMO

Fifty-five schizophrenic outpatients with negative symptoms were treated for up to six weeks by the addition of alprazolam (mean dose, 4.2 mg/d), diazepam (mean dose, 40.4 mg/d), or placebo to their ongoing neuroleptic treatment. A repeated-measures analysis of variance with baseline measurements entered as covariates indicated the presence of a significant time X drug interaction effect for the weekly Brief Psychiatric Rating Scale (BPRS) withdrawal/retardation subfactor scores. During the initial weeks of the study, the alprazolam-treated group had lower scores, while the diazepam-treated group had higher scores than the placebo-treated group. However, an end point analysis performed on the final BPRS withdrawal/retardation subfactor scores showed no significant differences among the three groups, nor were beneficial effects observed on any of the BPRS subfactor scores that assess positive symptoms. Plasma alprazolam levels were maintained throughout the study and ranged from 20 to 100 ng/mL. These results suggest that alprazolam had no sustained significant effect on negative schizophrenic symptoms.


Assuntos
Alprazolam/uso terapêutico , Diazepam/uso terapêutico , Esquizofrenia/tratamento farmacológico , Psicologia do Esquizofrênico , Adulto , Alprazolam/sangue , Assistência Ambulatorial , Ensaios Clínicos como Assunto , Diazepam/sangue , Método Duplo-Cego , Humanos , Placebos , Escalas de Graduação Psiquiátrica
8.
Am J Psychiatry ; 149(1): 121-2, 1992 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-1728160

RESUMO

Twenty acutely manic patients were studied in a double-blind randomized trial comparing verapamil with lithium. The Petterson Mania Scale, the Brief Psychiatric Rating Scale (BPRS), and the Clinical Global Impression (CGI) were administered before treatment and weekly during 4 weeks of treatment to evaluate response to verapamil and lithium. Both treatment groups improved significantly, and there were no significant overall differences between treatments.


Assuntos
Transtorno Bipolar/tratamento farmacológico , Carbonato de Lítio/uso terapêutico , Verapamil/uso terapêutico , Doença Aguda , Adulto , Transtorno Bipolar/psicologia , Método Duplo-Cego , Feminino , Humanos , Masculino , Escalas de Graduação Psiquiátrica
9.
Am J Psychiatry ; 146(12): 1598-601, 1989 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-2686478

RESUMO

The combination of haloperidol, 5 mg, and lorazepam, 4 mg, was both effective and safe for managing agitated behavior in an open trial with acutely psychotic patients. The combination also appeared to be superior to its individual components when studied in a randomized, nonblind trial. The principle of the combined use of antipsychotics and sedative-hypnotics was further tested by comparing two new combinations: thiothixene, 5 mg, and lorazepam, 4 mg, versus haloperidol, 5 mg, and phenobarbital sodium, 130 mg. These combinations had comparable efficacy and safety, and the level of transquilization approached that produced by the haloperidol-lorazepam combination in the preceding studies.


Assuntos
Haloperidol/administração & dosagem , Lorazepam/administração & dosagem , Agitação Psicomotora/tratamento farmacológico , Transtornos Psicóticos/tratamento farmacológico , Adolescente , Adulto , Combinação de Medicamentos , Quimioterapia Combinada , Feminino , Humanos , Injeções Intramusculares , Masculino , Pessoa de Meia-Idade , Fenobarbital/administração & dosagem , Projetos Piloto , Agitação Psicomotora/psicologia , Transtornos Psicóticos/psicologia , Ensaios Clínicos Controlados Aleatórios como Assunto , Tiotixeno/administração & dosagem
10.
Am J Psychiatry ; 144(2): 151-8, 1987 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-3492931

RESUMO

Using [11C]-deoxy-D-glucose and positron emission tomography (PET), the authors measured brain metabolism in 18 patients with chronic schizophrenia to assess which of the metabolic measures from two test conditions was more closely related to the patients' differing clinical characteristics. The two conditions were resting and activation, and an eye tracking task was used. Patients with more negative symptoms showed lower global metabolic rates and more severe hypofrontality than did the patients with fewer negative symptoms. Differences among the patients were distinguished by the task: sicker patients failed to show a metabolic activation response. These findings suggest that cerebral metabolic patterns reflect clinical characteristics of schizophrenic patients.


Assuntos
Encéfalo/metabolismo , Glucose/metabolismo , Esquizofrenia/metabolismo , Psicologia do Esquizofrênico , Adulto , Fatores Etários , Encéfalo/diagnóstico por imagem , Radioisótopos de Carbono , Doença Crônica , Desoxiglucose , Lobo Frontal/diagnóstico por imagem , Lobo Frontal/metabolismo , Humanos , Masculino , Escalas de Graduação Psiquiátrica , Desempenho Psicomotor , Esquizofrenia/diagnóstico , Tomografia Computadorizada de Emissão
11.
Am J Psychiatry ; 151(2): 178-83, 1994 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-8296885

RESUMO

OBJECTIVE: To differentiate withdrawal-related abnormalities in brain glucose metabolism among alcoholics from abnormalities that may be irreversible or antedate alcohol use, the authors evaluated metabolic recovery during alcohol detoxification. METHOD: Regional brain glucose metabolism was measured with positron emission tomography and 2-deoxy-2-[18F]fluoro-D-glucose in 10 male alcoholics at 8-15 days, 16-30 days, and 31-60 days after last use of alcohol. The alcoholics' metabolic values were compared with those of 10 age-matched male healthy volunteers. RESULTS: Brain metabolism increased significantly during detoxification. There were significant differences in global and regional measures between the first and last time points but not between the second and third points, suggesting that recovery occurred predominantly within 16-30 days. Regional increases in metabolism were greater in the frontal regions. Whereas during the first evaluation the alcoholics showed significantly lower metabolism in various brain regions than the comparison group, at the end of detoxification the alcoholics showed significantly lower absolute and relative metabolic values in the basal ganglia and lower relative metabolic values in the parietal cortex. Among the alcoholics, but not the comparison group, metabolism in the frontal, parietal, and left temporal cortexes was negatively correlated with years of alcohol use and with age. CONCLUSIONS: This study shows significant increases in brain metabolism during alcohol withdrawal and documents persistent low metabolic levels in the basal ganglia of detoxified alcoholics.


Assuntos
Alcoolismo/reabilitação , Encéfalo/metabolismo , Glucose/metabolismo , Síndrome de Abstinência a Substâncias/metabolismo , Adulto , Consumo de Bebidas Alcoólicas , Alcoolismo/diagnóstico por imagem , Alcoolismo/metabolismo , Gânglios da Base/metabolismo , Encéfalo/diagnóstico por imagem , Humanos , Masculino , Lobo Parietal/metabolismo , Síndrome de Abstinência a Substâncias/diagnóstico por imagem , Tomografia Computadorizada de Emissão
12.
Neuropsychopharmacology ; 3(4): 233-5, 1990 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-2400542

RESUMO

The p value associated with a test of significance is supposed to represent the probability of observed results given that the null hypothesis is actually true. In evaluating the efficacy of a new drug against placebo, regulatory considerations focus on superiority of the new drug over placebo. The disapproval consequence of placebo superiority is no different from the disapproval consequence of equivalence between drug and placebo. It is furthermore inconceivable that a drug company will submit a New Drug Application claiming superior efficacy for placebo. Thus, the only probability of concern is the probability that apparent superiority of drug over placebo is a chance finding, and that is the probability associated with a one-tailed test. Where multiple studies must be evaluated with regard to the regulatory decision, meta-analytic considerations further support the relevance of one-sided p values.


Assuntos
Ensaios Clínicos como Assunto , Placebos , Análise de Variância , Humanos , Probabilidade , Projetos de Pesquisa
13.
Neuropsychopharmacology ; 4(4): 273-81, 1991 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-1867736

RESUMO

Three methods of correcting for baseline differences are evaluated for use with randomized experimental designs and nonrandomized quasi-experimental designs. Cases where baseline means differ significantly in spite of random assignment and cases where observed baseline means do not differ significantly in quasi-experimental designs are given special attention. For comparison of treatment-induced change in randomly constituted treatment groups, analysis of covariance (ANCOVA) provides appropriate type I error protection and superior power regardless of the apparent significance of chance baseline differences. Correcting for baseline differences by expressing outcome scores as percentage of the baseline value for each individual produces results that closely approximate ANCOVA under specified conditions. Tests on simple pre-post difference scores are nonconservative when baseline means differ significantly in spite of randomization. In quasi-experimental research where treatment groups represent samples from different predefined populations, ANCOVA and percentage change provide inadequate baseline corrections even when the observed baseline means do not differ significantly. Although no method of baseline correction is entirely satisfactory in the absence of random assignment, tests on simple pre-post difference scores are generally superior for quasi-experimental designs in which treatment groups represent samples from different populations.


Assuntos
Ensaios Clínicos como Assunto/métodos , Psicotrópicos/uso terapêutico , Ensaios Clínicos Controlados Aleatórios como Assunto/métodos , Software , Análise de Variância , Humanos , Projetos de Pesquisa
14.
Pediatrics ; 63(6): 847-50, 1979 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-450520

RESUMO

This article reviews the literature on possible growth-suppressing effects of stimulant medications in the long-term treatment of children with the hyperkinetic behavior syndrome. The evidence clearly indicates a temporary retardation in the rate of growth in weight and suggests a temporary slowing of growth in stature, but no effect on adult stature or weight. This temporary effect on growth is present during the first few years of treatment and seems related to drug dosage and to the presence or absence of drug holidays. These conclusions related specifically to treatment during the prepubertal period; little is known of the growth-related effects of treatment extending through pubescence.


Assuntos
Transtornos do Comportamento Infantil/tratamento farmacológico , Dextroanfetamina/efeitos adversos , Transtornos do Crescimento/induzido quimicamente , Crescimento/efeitos dos fármacos , Hipercinese/tratamento farmacológico , Imipramina/efeitos adversos , Metilfenidato/efeitos adversos , Pemolina/efeitos adversos , Adolescente , Estatura , Peso Corporal , Dextroanfetamina/uso terapêutico , Humanos , Imipramina/uso terapêutico , Metilfenidato/administração & dosagem , Metilfenidato/uso terapêutico , Pemolina/uso terapêutico
15.
J Clin Psychiatry ; 45(4 Pt 2): 85-8, 1984 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-6370983

RESUMO

Results from 11 independent double-blind placebo controlled studies of nomifensine were analyzed to assess the efficacy of the active drug vs. placebo in four depressive subtypes classified by Hamilton Depression Rating Scale profiles. Substantial nomifensine-placebo differences were seen in the anxious, suicidal, and vegetative subtypes; high rates of placebo response in the somatizing subtype resulted in nonsignificant treatment effects. Differing responses to antidepressant drugs based on phenomenologic subtypes of depression appear to merit further investigation.


Assuntos
Transtorno Depressivo/tratamento farmacológico , Isoquinolinas/uso terapêutico , Nomifensina/uso terapêutico , Transtornos de Ansiedade/psicologia , Ensaios Clínicos como Assunto , Transtorno Depressivo/classificação , Transtorno Depressivo/psicologia , Método Duplo-Cego , Humanos , Transtornos Paranoides/psicologia , Placebos , Escalas de Graduação Psiquiátrica , Distribuição Aleatória , Transtornos Somatoformes/psicologia , Suicídio/psicologia
16.
J Clin Psychiatry ; 46(11): 461-5, 1985 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-4055705

RESUMO

In an attempt to validate several subtypes of affective disorders, 52 consecutive patients hospitalized at a clinical research center were comprehensively classified along several diagnostic and phenomenologic axes. Cortisol levels of each patient were evaluated at baseline and after the administration of 0.5 and 1.0 mg dexamethasone. None of the depressive subtypes responded significantly differently to the 1.0 mg dose. However, the bipolar subtype was associated with significantly different DST responses to the 0.5 mg dose. Patients with bipolar affective disorder, both manic and depressed, had higher postdexamethasone mean cortisol levels than all other groups. The results support the distinctiveness of the bipolar diagnosis.


Assuntos
Transtorno Bipolar/diagnóstico , Transtorno Depressivo/diagnóstico , Dexametasona , Adolescente , Adulto , Fatores Etários , Transtorno Bipolar/sangue , Transtorno Bipolar/classificação , Transtorno Depressivo/sangue , Transtorno Depressivo/classificação , Dexametasona/administração & dosagem , Diagnóstico Diferencial , Relação Dose-Resposta a Droga , Feminino , Hospitalização , Humanos , Hidrocortisona/sangue , Masculino , Pessoa de Meia-Idade , Escalas de Graduação Psiquiátrica
17.
J Clin Psychiatry ; 48(1): 15-9, 1987 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-3542981

RESUMO

A 6-week double-blind comparison of the therapeutic efficacy of alprazolam and imipramine in 90 depressed psychiatric outpatients revealed a significantly superior response to alprazolam in the first 2 weeks of treatment as measured by total scores on the Hamilton Rating Scale for Depression and the Brief Psychiatric Rating Scale. Further analyses revealed that all significant differences could be accounted for by the superior effect of alprazolam on sleep disturbance. By the end of Weeks 4 and 6, no significant differences in therapeutic response between the two treatment groups were noted, with patients in both groups evidencing improvement on all measures. A differentially high dropout rate among patients in the imipramine treatment group posed a problem for interpretation of results in the latter weeks of treatment.


Assuntos
Alprazolam/uso terapêutico , Assistência Ambulatorial , Transtorno Depressivo/tratamento farmacológico , Imipramina/uso terapêutico , Adolescente , Adulto , Ensaios Clínicos como Assunto , Transtorno Depressivo/psicologia , Método Duplo-Cego , Humanos , Pessoa de Meia-Idade , Pacientes Desistentes do Tratamento , Inventário de Personalidade , Escalas de Graduação Psiquiátrica
18.
J Clin Psychiatry ; 48(2): 51-4, 1987 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-3542984

RESUMO

Early dropouts from a double-blind comparison of the therapeutic efficacy of alprazolam and imipramine were examined. The dropout rate across the total sample of 99 analyzable outpatients with major depression was 3 times higher in the imipramine treatment group. Although essentially all patients met DSM-III criteria for major depressive episode, only two thirds of the total sample met the restrictive Feighner criteria for primary depressive disorder. Early termination in the imipramine group was concentrated in the group of depressed outpatients who failed to satisfy the Feighner criteria. Implications of these and other recently reported results for choice of drug treatment for depressed psychiatric outpatients are discussed.


Assuntos
Alprazolam/uso terapêutico , Transtorno Depressivo/tratamento farmacológico , Imipramina/uso terapêutico , Cooperação do Paciente , Assistência Ambulatorial , Ensaios Clínicos como Assunto , Transtorno Depressivo/diagnóstico , Método Duplo-Cego , Humanos , Manuais como Assunto , Pacientes Desistentes do Tratamento , Inventário de Personalidade , Escalas de Graduação Psiquiátrica , Distribuição Aleatória
19.
J Clin Psychiatry ; 49(10): 400-4, 1988 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-3049561

RESUMO

The authors describe five patients with senile dementia of the Alzheimer type (SDAT) who were treated with oral physostigmine from 1 to 3 3/4 years. An abbreviated form of the Buschke selective reminding test was used to assess the patients' short-term verbal memory at periodic clinic visits. Although one of the patients deteriorated progressively from the start of the physostigmine therapy and was taken off the drug after 1 year, there was no evidence of deterioration in memory performance on the average in the other four patients. Equally important, this open trial provides evidence of the safety of long-term treatment with physostigmine on an outpatient basis. The authors view their results as supporting the potential value of cholinesterase inhibition as a means of forestalling memory decline in SDAT patients.


Assuntos
Doença de Alzheimer/tratamento farmacológico , Assistência Ambulatorial , Fisostigmina/uso terapêutico , Administração Oral , Idoso , Doença de Alzheimer/diagnóstico , Doença de Alzheimer/psicologia , Ensaios Clínicos como Assunto , Feminino , Humanos , Masculino , Transtornos da Memória/diagnóstico , Transtornos da Memória/tratamento farmacológico , Transtornos da Memória/psicologia , Pessoa de Meia-Idade , Fisostigmina/administração & dosagem , Testes Psicológicos , Projetos de Pesquisa/normas
20.
Psychopharmacology (Berl) ; 77(1): 24-30, 1982.
Artigo em Inglês | MEDLINE | ID: mdl-6126898

RESUMO

A large clinical psychopharmacology data bank consisting of results from several hundred clinical drug trials was used to refine phenomenological classification concepts and methodology. Brief Psychiatric Rating Scale (BPRS) profiles for 2623 psychiatric patients from that data bank were analyzed to define prototypical patterns that are maximally representative of homogeneous subgroup within the drug treatment population. Prototype profiles and classification functions that can be used to accomplish similar classifications of future research subjects are presented. Placebo response rates and active drug response rates for subjects in the large data pool are compared across the eight phenomenological types. It is suggested that anxious and hostile subtypes of depressive disorder may be poor subjects in clinical drug trials because of the excessive placebo response rate. In contrast, withdrawn-disorganized thinking disturbance types tend to be poor subjects for trials of neuroleptic drugs because they respond poorly to both active drug and placebo.


Assuntos
Transtornos Mentais/classificação , Psicofarmacologia/métodos , Antidepressivos/uso terapêutico , Antipsicóticos/uso terapêutico , Ensaios Clínicos como Assunto , Humanos , Transtornos Mentais/tratamento farmacológico , Transtornos Mentais/psicologia , Escalas de Graduação Psiquiátrica , Pesquisa
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