Premenstrual exacerbation and suicidal behavior in patients with panic disorder.

This study examined the relationship between premenstrual exacerbation and suicidal behavior in patients with panic disorder. Twenty-eight patients who reported a premenstrual exacerbation of panic disorder and 42 patients who reported never having an exacerbation were included in the study. The subjects completed a self-rating instrument assessing the 13 DSM-III-R panic symptoms on a 5-point scale (0 = absent, 1 = mild, 2 = moderate, 3 = severe, and 4 = very intense). They also completed the severity scale of the Clinical Global Impression. The Schedule for Affective Disorders and Schizophrenia (SADS) suicide subscale was used to rate the severity of active suicidality. We found that patients with premenstrual exacerbation of panic disorder had higher SADS suicidality scores than patients with panic disorder without premenstrual exacerbation. They were also more likely to be classified as suicidal than the others. It may be that premenstrual exacerbation is a risk factor for suicidal behavior independent of major depression in patients with panic disorder.

Sleep quality and pain threshold in patients with fibromyalgia.

The purpose of the study was to examine the association between the subjective sleep quality and pain threshold in fibromyalgia. Sixteen patients with fibromyalgia were included in the study. The pain threshold was determined using a manual algometer. The Pittsburgh Sleep Quality Index (PSQI) was used to assess sleep quality. The pain threshold was negatively correlated with the scores for subjective sleep quality, habitual sleep efficiency, and sleep disturbance and the PSQI global score. We conclude that there is a negative correlation between pain and sleep disturbance: increased pain sensitivity is associated with greater sleep disturbance.

Low cholesterol level in patients with panic disorder: the association with major depression.

BACKGROUND: The purpose of this study was to examine whether an association exists between low cholesterol level and major depression in patients with panic disorder. METHODS: The subjects of the study were 16 patients panic disorder only, 16 panic disorder patients had also current major depressive episode, and 16 normal control subjects. An automated enzymatic colorimetric method was used for cholesterol determination. RESULTS: Panic disorder patients had higher serum cholesterol than panic disorder patients with major depression and normal controls. CONCLUSION: There is an association between low cholesterol level and the presence of major depression in patients with panic disorder. LIMITATION: Future studies with large sample are needed to confirm this finding. CLINICAL RELEVANCE: A low serum cholesterol level might serve as biological marker of major depression in patients panic disorder.

Hypnotizability, pain threshold, and dissociative experiences.

BACKGROUND: There may be an association between pain threshold, hypnotizability, and dissociative experiences. The purpose of the present study was to examine this association. METHODS: Forty-one healthy subjects were included in the study. Pain thresholds were determined using a manual algometer. The Dissociative Experiences Scale was administered to all subjects. Hypnotizability of the subjects was assessed by the eye roll sign of the Hypnotic Induction Profile. There were 14, 15, and 12 subjects in the Grade 1, 2, and 3 groups, respectively. RESULTS: Highly hypnotizable subjects had lower pain thresholds and were more likely to report dissociative experiences than the less hypnotizable subjects. CONCLUSIONS: There is an association between pain threshold, hypnotizability, and dissociative experiences. It may be suggested that dissociative and somatic symptoms may be integrally linked and related to hypnotic suggestibility.

Repetitive and frightening dreams and suicidal behavior in patients with major depression.

The purpose of the present study was to examine the association between repetitive and frightening dreams and suicidal tendency in patients with major depression. Depressed patients who reported frequent nightmare (N = 29) and depressed patients who reported dreaming but never nightmares (N = 34) were evaluated using the Schedule for Affective Disorders and Schizophrenia (SADS) suicide subscale to rate the severity of active suicidality. The patients with frequent nightmares, particularly women, had higher mean SADS suicide subscale scores and were more likely to be classified as suicidal than the others. The findings demonstrate that frequent nightmares are associated with suicidal tendency in patients with major depression. Theoretical and clinical implications for the function of dreaming are discussed.

Recurrent sleep panic, insomnia, and suicidal behavior in patients with panic disorder.

The purpose of this study was to examine the association between recurrent sleep, panic, and suicidal behavior in panic disorder. We compared the recurrent sleep panickers (N = 33) with other panickers (N = 34). The Schedule for Affective Disorders and Schizophrenia (SADS) suicide subscale was used to rate the severity of active suicidality. We found that recurrent sleep panickers also had a higher percentage of insomnia and comorbid major depression than the others. A multivariate analysis demonstrated an association between recurrent sleep panic and suicidal tendencies in patients with panic disorder. Although recurrent sleep panic alone is not an independent risk factor for suicidal behavior, it may modify the severity of illness in patients with panic disorder.

Sleep disturbances and suicidal behavior in patients with major depression.

BACKGROUND: The purpose of this study was to examine the association between sleep disturbances and suicidal behavior in patients with major depression (N = 113). METHOD: The sleep symptomatology of each patient was ascertained from the Schedule for Affective Disorders and Schizophrenia (SADS) questions concerning sleep in the section on major depression. The patients were retrospectively classified as having hypersomnia (N = 20), insomnia (N = 69), and no sleep disturbance (N = 24). The SADS suicide subscale was used to rate the severity of active suicidality. RESULTS: The patients with hypersomnia and insomnia had significantly (p < .05) higher scores on the SADS suicide subscale than those without sleep disturbance. We also found that the patients with insomnia and hypersomnia were significantly (p < .001) more likely to become suicidal than the others. CONCLUSION: These data demonstrate that both insomnia and hypersomnia are associated with suicidal behavior in patients with major depression.

Acupuncture and hypnotic suggestions in the treatment of non-organic male sexual dysfunction.

We have examined the effects of acupuncture and hypnotic suggestions, and compared them with placebo in the treatment of male sexual dysfunction with no detectable organic cause. The study comprised 15 men (mean age 36.7 +/- 10.43 years) who received acupuncture treatment, 16 men (mean age 38.4 +/- 10.75 years) who underwent hypnosis (mean age 35.3 +/- 11.52 years) and 29 men (mean age 36.2 +/- 11.38 years) who served as controls. They were interviewed periodically; the patients' reports were verified by interviewing their partners. Men who received placebo had a 43-47% improvement in sexual function, while the rates of improvement in the treated groups were higher, but not significantly so. The success rates of acupuncture and hypnotic suggestions were 60% and 75% respectively. Although the improvement was not statistically significant, treatment with acupuncture could be used as an adjuvant therapy in non-organic male sexual dysfunction. The only treatment superior to placebo seemed to be hypnosis. A more effective treatment may be obtained by combining these therapeutic modalities, but this needs further study.

Subjective sleep quality and suicidality in patients with major depression.

The purpose of this study was to examine the association between sleep quality and suicidality in major depressive disorder. We evaluated 41 patients with major depression by using the Pittsburgh Sleep Quality Index (PSQI) and the Schedule for Affective Disorders and Schizophrenia (SADS) suicide subscale. We found that suicidal depressive patients had significantly higher scores of subjective sleep quality, sleep latency, sleep duration, habitual sleep efficiency and PSQI global scores than nonsuicidal patients. We also found significant correlations between the SADS suicide subscale scores and most measures of the PSQI. These data suggest that there is an association between poor subjective sleep quality and suicidal behavior in patients with major depressive disorder.

The efficacy of fluoxetine in the treatment of premature ejaculation: a double-blind placebo controlled study.

PURPOSE: The efficacy of the selective serotonin re-uptake inhibitor fluoxetine in the treatment of premature ejaculation was examined. MATERIALS AND METHODS: The study comprised 17 patients with premature ejaculation who presented to the urology clinic of our medical school. In this double-blind study the patients were randomized into treatment groups receiving 20 mg. fluoxetine daily for 1 week and 40 mg. daily afterward (group 1) or 1 capsule placebo daily for 1 week and 2 capsules daily afterward (group 2). The groups were evaluated according to the latent period of intravaginal ejaculation. RESULTS: The latent period of intravaginal ejaculation in group 1 was significantly longer than that in group 2. Nausea, headache and insomnia were reported side effects. CONCLUSIONS: Fluoxetine may be regarded as a safe and effective alternative in the treatment of premature ejaculation.

Efficacy of testosterone, trazodone and hypnotic suggestion in the treatment of non-organic male sexual dysfunction.

OBJECTIVE: To examine the effects of hypnotic suggestions or the administration of testosterone or trazodone to impotent men with no detectable organic cause for the impotence. PATIENTS AND METHODS: The study comprised 79 men in whom clinical and laboratory examinations revealed no organic cause for their impotence: 20 men (mean age 38.7 +/- 11.47 years) received testosterone, 21 men (mean age 39.5 +/- 10.73 years) received trazodone, 20 men (mean age 34.2 +/- 11.69 years) underwent hypnosis and 18 men (mean age 39.1 +/- 11.46 years) served as controls. They were assessed by interview 4, 6 and 8 weeks after starting treatment: the patient's reports were verified by interviewing their partners. RESULTS: Men who received a placebo had a 39% improvement in sexual function, while the rates of improvement in the treated groups were higher, but not significantly so. The success rates of testosterone and trazodone treatment and hypnotic suggestions were 60%, 67% and 80%, respectively. CONCLUSION: Although the improvement was not statistically significant, treatment with testosterone and trazodone could be used as an adjuvant therapy in nonorganic male sexual dysfunction. The only treatment superior to placebo seemed to be hypnosis. A more effective treatment may be obtained by combining these therapeutic modalities, but this needs further study.