6 results on '"David J. Hellerstein"'
Search Results
2. Double-blind comparison of sertraline, imipramine, and placebo in the treatment of dysthymia: effects on personality
- Author
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Wilma Harrison, David J. Hellerstein, Douglass Chapman, James H. Kocsis, and Jonathan W. Stewart
- Subjects
Adult ,Male ,medicine.medical_specialty ,Imipramine ,Personality Inventory ,Antidepressive Agents, Tricyclic ,Placebo ,Tridimensional Personality Questionnaire ,Placebos ,Double-Blind Method ,Sertraline ,medicine ,Humans ,Age of Onset ,Psychiatry ,Temperament ,Dysthymic Disorder ,Novelty seeking ,medicine.disease ,Psychiatry and Mental health ,Treatment Outcome ,Reward dependence ,Harm avoidance ,Female ,Personality Assessment Inventory ,Psychology ,Factor Analysis, Statistical ,Social Adjustment ,Selective Serotonin Reuptake Inhibitors ,medicine.drug ,Clinical psychology ,Personality - Abstract
Although previous studies have shown that dysthymia, or chronic depression, commonly responds to antidepressant medications (with improvements in depressive symptoms and psychosocial functioning), there have been no systematic studies of the impact of antidepressant treatment on personality variables in patients with this disorder.In a multicenter study, 410 patients with early-onset primary dysthymia were treated in a randomized prospective fashion with sertraline, imipramine, or placebo. The data were analyzed in terms of the subjects' scores on the Tridimensional Personality Questionnaire, a 100-item self-report instrument that measures four temperamental dimensions: harm avoidance, reward dependence, novelty seeking, and persistence.At baseline, the harm avoidance scores of the dysthymic subjects were approximately 1.5 standard deviations higher than those of a previously reported community sample. After treatment, there was a significant decrease in harm avoidance scores, with no significant between-group differences. Remission of dysthymia was associated with significantly greater improvement in harm avoidance, with the greatest numerical change found in the patients treated with sertraline. Subjects' Tridimensional Personality Questionnaire scores were correlated at a 0.50 level with the Social Adjustment Scale both pre- and posttreatment, suggesting that a high degree of harm avoidance may be associated with poor social functioning.Before treatment, chronically depressed patients demonstrate an abnormality in temperament, as measured by elevated degrees of harm avoidance. Remission of dysthymia is associated with improvement in this aspect of temperament.
- Published
- 2000
3. Double-blind comparison of sertraline, imipramine, and placebo in the treatment of dysthymia: psychosocial outcomes
- Author
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Kimberly A. Yonkers, Sidney Zisook, Uriel Halbreich, David J. Hellerstein, Richard C. Shelton, James H. Kocsis, Jonathan R. T. Davidson, and Jerrold F. Rosenbaum
- Subjects
Adult ,Male ,medicine.medical_specialty ,Imipramine ,Global Assessment of Functioning ,Placebo ,Placebos ,Pharmacotherapy ,Double-Blind Method ,Sertraline ,medicine ,Humans ,Age of Onset ,Psychiatry ,Adverse effect ,Aged ,Psychiatric Status Rating Scales ,Middle Aged ,Antidepressive Agents ,Psychiatry and Mental health ,Mood ,1-Naphthylamine ,Treatment Outcome ,Physical therapy ,Quality of Life ,Patient Compliance ,Female ,Dysthymic Disorder ,Psychology ,Psychosocial ,Social Adjustment ,medicine.drug ,Follow-Up Studies - Abstract
Objective: The purpose of this study was to determine the effects of antidepressant pharmacotherapy on mood symptoms and psychosocial outcomes in dysthymia. Method: In a multicenter, double-blind, parallel-group trial, 416 patients with a diagnosis of early-onset primary dysthymia (DSM-III-R) of at least 5 years’ duration without concurrent major depression were randomly assigned to 12 weeks of acute-phase therapy with sertraline, imipramine, or placebo. The psychosocial outcome measures used in the study were the Global Assessment of Functioning Scale, the Social Adjustment Scale, the Longitudinal Interval Follow-up Evaluation psychosocial ratings, and the Quality of Life Enjoyment and Satisfaction Questionnaire. Results: Sertraline and imipramine were significantly better than placebo in improving psychosocial outcomes as measured by the first three instruments. The Quality of Life Enjoyment and Satisfaction Questionnaire scores demonstrated significant improvements from baseline, and both active treatments produced significantly greater improvements than placebo. Significantly fewer patients discontinued sertraline (6.0%) than discontinued imipramine (18.4%) because of adverse events. Conclusions: Pharmacotherapy is an effective treatment for dysthymia in terms of psychosocial functioning as well as depressive symptoms, even when the dysthymia is long-standing. (Am J Psychiatry 1997; 154:390‐395)
- Published
- 1997
4. A randomized double-blind study of fluoxetine versus placebo in the treatment of dysthymia
- Author
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P Yanowitch, Karen Kasch, Arnold Winston, Jesse Rosenthal, Lisa Wallner Samstag, M Poster, M Cantillon, M Maurer, L Burrows, and David J. Hellerstein
- Subjects
Adult ,Male ,Personality Inventory ,Placebo ,Serotonergic ,law.invention ,Placebos ,Randomized controlled trial ,Double-Blind Method ,law ,Fluoxetine ,medicine ,Humans ,Depression (differential diagnoses) ,Psychiatric Status Rating Scales ,Depressive Disorder ,business.industry ,Clinical trial ,Psychiatry and Mental health ,Anesthesia ,Antidepressant ,Female ,Reuptake inhibitor ,business ,medicine.drug - Abstract
The purpose of this study was to assess the efficacy of fluoxetine, a selective serotonergic antidepressant, in the treatment of dysthymia.Thirty-five patients who met criteria for dysthymia, but not major depression, began randomized, double-blind 8-week trials of fluoxetine or placebo.Of 32 patients who completed the study, 10 (62.5%) of the 16 patients given fluoxetine and three (18.8%) of the 16 given placebo responded to treatment. Response was defined as 1) 50% or greater decrease in Hamilton Rating Scale for Depression score and 2) a score of 1 or 2 on the Clinical Global Impression (CGI) improvement subscale. Fluoxetine subjects showed significantly greater improvement at week 8 than placebo subjects on the Hamilton depression and CGI scales, but not on the Hopkins Symptom Check-list (58-item) or the Cornell Dysthymia Rating Scale.When compared to placebo, fluoxetine showed short-term effectiveness in treating dysthymic symptoms.
- Published
- 1993
5. Outpatient group therapy for schizophrenic substance abusers
- Author
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Beth Meehan and David J. Hellerstein
- Subjects
Adult ,Male ,medicine.medical_specialty ,Substance-Related Disorders ,medicine.medical_treatment ,education ,Pilot Projects ,Group psychotherapy ,medicine ,Ambulatory Care ,Humans ,Psychiatry ,Psychotropic Drugs ,business.industry ,Therapy group ,medicine.disease ,Substance abuse ,Hospitalization ,Psychiatry and Mental health ,Outcome and Process Assessment, Health Care ,Schizophrenia ,Psychotherapy, Group ,Patient Compliance ,Female ,business ,Follow-Up Studies - Abstract
A once-a-week outpatient therapy group was designed for schizophrenic substance abusers. Over 1 year, the group members (including dropouts) had a marked decrease in days of hospitalization.
- Published
- 1987
6. The clinical significance of command hallucinations
- Author
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Harold W. Koenigsberg, David J. Hellerstein, and W Frosch
- Subjects
Adult ,Male ,Psychosis ,medicine.medical_specialty ,genetic structures ,Hallucinations ,Poison control ,Violence ,Suicide prevention ,Occupational safety and health ,Injury prevention ,Dangerous Behavior ,medicine ,Humans ,Risk factor ,Marriage ,Psychiatry ,Suicidal ideation ,Mental Disorders ,Age Factors ,medicine.disease ,Hospitalization ,Psychiatry and Mental health ,Social Isolation ,Auditory Perception ,Female ,Schizophrenic Psychology ,medicine.symptom ,Seclusion ,Psychology - Abstract
Patients with command hallucinations (voices ordering particular acts, often violent or destructive ones) are commonly assumed to be at high risk for dangerous behavior. The authors reviewed 789 consecutive inpatient admissions. Of 151 patients with auditory hallucinations, 58 (38.4%) heard commands. The presence of auditory hallucinations was significantly associated with diagnosis, demographic variables, and use of maximal observation and seclusion. However, patients with command hallucinations were not significantly different from patients without commands on demographic and behavioral variables, including suicidal ideation or behavior and assaultiveness. These findings suggest that command hallucinations alone may not imply greater risk for acute, life-threatening behavior.
- Published
- 1987
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