14 results on '"David J. Hellerstein"'
Search Results
2. Pilot study of single-dose psilocybin for serotonin reuptake inhibitor-resistant body dysmorphic disorder
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Franklin R. Schneier, Jamie Feusner, Michael G. Wheaton, Gloria J. Gomez, Giselle Cornejo, Akansha Mahesh Naraindas, and David J. Hellerstein
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Psychiatry and Mental health ,Biological Psychiatry - Published
- 2023
3. A randomized controlled trial of desvenlafaxine-induced structural brain changes in the treatment of persistent depressive disorder
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Ravi Bansal, David J. Hellerstein, Siddhant Sawardekar, Ying Chen, and Bradley S. Peterson
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Psychiatry and Mental health ,Neuroscience (miscellaneous) ,Radiology, Nuclear Medicine and imaging - Published
- 2023
4. Personalized symptom clusters that predict depression treatment outcomes: A replication of machine learning methods
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Ying Chen, Jonathan W. Stewart, Jin Ge, Bin Cheng, Adam Chekroud, and David J. Hellerstein
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Psychiatry and Mental health ,Clinical Psychology - Published
- 2023
5. Neurocognitive predictors of antidepressant clinical response
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Karen Abraham, Patrick J. McGrath, Jonathan W. Stewart, Jorge E. Alvarenga, John G. Keilp, Daniel M. Alschuler, David J. Hellerstein, and Gerard E. Bruder
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Adult ,Male ,Oncology ,medicine.medical_specialty ,Citalopram ,Placebo ,Article ,Double-Blind Method ,Internal medicine ,mental disorders ,medicine ,Humans ,Escitalopram ,Bupropion ,Psychomotor learning ,Depressive Disorder ,Middle Aged ,Psychiatry and Mental health ,Clinical Psychology ,Treatment Outcome ,Case-Control Studies ,Antidepressive Agents, Second-Generation ,Antidepressant ,Female ,Psychology ,Neurocognitive ,Selective Serotonin Reuptake Inhibitors ,medicine.drug ,Clinical psychology ,Executive dysfunction - Abstract
Background Executive dysfunction and psychomotor slowing in depressed patients have been associated with poor antidepressant clinical response, but little is known about the value of neurocognitive tests for differential prediction of response. Methods This report presents new findings for 70 depressed patients tested on neurocogntive tests before receiving treatment with a SSRI (escitalopram or citalopram), NDRI (bupropion) or dual mechanism therapy including a serotonergic agent, and for 57 healthy controls. Results As predicted from previous research, patients who did not respond to a SSRI or dual therapy showed poorer word fluency than responders, whereas this was not seen for patients treated with bupropion alone. Longer choice reaction time (RT) was also found in nonresponders to a SSRI or dual therapy, but the opposite trend was seen for bupropion. Using a combined index of word fluency and RT (with normative performance as a cutoff) yielded differential predictions of response. Equal to or above normal performance predicted good response to a SSRI or dual therapy, with high positive predictive value (90%) and specificity (78%) but lower sensitivity (53%). In contrast, less than normal performance predicted good response to bupropion alone (positive predictive value=82%; specificity=67%; sensitivity=90%). Limitations Relatively small sample size, no placebo control, and combining across SSRI alone and dual treatments. Conclusions Although findings are preliminary due to small sample size, brief tests of word fluency and psychomotor speed may help identify depressed patients who are unresponsive to a serotonergic agent, but who may respond to bupropion alone.
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- 2014
6. T102. White Matter Integrity in Bipolar Disorder: Relationship to Cardiovascular Function and Comparison to Major Depressive Disorder
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Martin J. Lan, David J. Hellerstein, Maria A. Oquendo, Jonathan W. Stewart, Harry Rubin-Falcone, J. John Mann, Patrick J. McGrath, Francesca Zanderigo, and M. Elizabeth Sublette
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White matter ,medicine.medical_specialty ,medicine.anatomical_structure ,business.industry ,medicine ,Major depressive disorder ,Bipolar disorder ,medicine.disease ,Psychiatry ,business ,Biological Psychiatry - Published
- 2019
7. Abnormal functional brain asymmetry in depression: Evidence of biologic commonality between major depression and dysthymia
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Jorge E. Alvarenga, Gerard E. Bruder, David J. Hellerstein, Daniel M. Alschuler, Patrick J. McGrath, and Jonathan W. Stewart
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Adult ,Male ,medicine.medical_specialty ,Adolescent ,Statistics as Topic ,Neuropsychological Tests ,Audiology ,Functional Laterality ,Article ,Lateralization of brain function ,Young Adult ,Sex Factors ,medicine ,Humans ,Young adult ,Psychiatry ,Biological Psychiatry ,Depression (differential diagnoses) ,Aged ,Psychiatric Status Rating Scales ,Analysis of Variance ,Depressive Disorder, Major ,Dysthymic Disorder ,Dichotic listening ,Brain ,Middle Aged ,medicine.disease ,Psychiatry and Mental health ,Acoustic Stimulation ,Auditory Perception ,Major depressive disorder ,Female ,Analysis of variance ,Abnormality ,Psychology - Abstract
Prior studies have found abnormalities of functional brain asymmetry in patients having a major depressive disorder (MDD). This study aimed to replicate findings of reduced right hemisphere advantage for perceiving dichotic complex tones in depressed patients, and to determine whether patients having “pure” dysthymia show the same abnormality of perceptual asymmetry as MDD. It also examined gender differences in lateralization, and the extent to which abnormalities of perceptual asymmetry in depressed patients are dependent on gender. Unmedicated patients having either a MDD (n=96) or “pure” dysthymic disorder (n=42) and healthy controls (n=114) were tested on dichotic fused-words and complex-tone tests. Patient and control groups differed in right hemisphere advantage for complex tones, but not left hemisphere advantage for words. Reduced right hemisphere advantage for tones was equally present in MDD and dysthymia, but was more evident among depressed men than depressed women. Also, healthy men had greater hemispheric asymmetry than healthy women for both words and tones, whereas this gender difference was not seen for depressed patients. Dysthymia and MDD share a common abnormality of hemispheric asymmetry for dichotic listening.
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- 2012
8. Impairment in psychosocial functioning associated with dysthymic disorder in the NESARC study
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David J. Hellerstein, Vito Agosti, M. Bosi, and Sarah R. Black
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Adult ,Male ,medicine.medical_specialty ,Adolescent ,Population ,Comorbidity ,Alcohol use disorder ,Social Security ,Disability Evaluation ,Young Adult ,Activities of Daily Living ,medicine ,Humans ,Psychiatry ,education ,Depression (differential diagnoses) ,Aged ,Depressive Disorder, Major ,education.field_of_study ,Dysthymic Disorder ,Medicaid ,Mental Disorders ,Rehabilitation, Vocational ,Odds ratio ,Middle Aged ,medicine.disease ,Health Surveys ,Mental health ,United States ,Psychiatry and Mental health ,Clinical Psychology ,Socioeconomic Factors ,Chronic Disease ,Utilization Review ,Female ,Psychology ,Social Adjustment ,Psychosocial ,Clinical psychology - Abstract
Background Chronic depression is associated with impaired functioning. The National Epidemiologic Survey of Alcoholism and Related Conditions (NESARC) is a representative sample ( N = 43,093) of the United States non-institutionalized population aged 18 years and older. We hypothesized that individuals with chronic low-grade depression, dysthymic disorder, would have more impaired functioning than individuals with acute major depression or the general population. Method Diagnoses were generated by the NIAAA Alcohol Use Disorder and Associated Disabilities Interview Schedule-DSM-IV Version (AUDADIS-IV). The dysthymic disorder (DD) sample ( N = 328) consisted of DD diagnosis without current MDD. The dysthymic group was not chosen on the basis of alcohol use or abuse. Individuals with MDD with duration ≦24 months, without lifetime DD constituted the acute depression (AD) sample ( N = 712). All other respondents were classified as general population (GP) ( N = 42,052). Past year functioning was assessed by Supplemental Social Security Income (SSI), employment, and Medicaid statuses. Past month functioning was assessed by Short-form 12-Item Health Survey (SF-12), with scores for social functioning, role emotional functioning, and mental health, using odds ratios. Results Over the past year, compared to AD, persons with DD were less likely to work full-time (36.2% vs. 44%; OR = 0.70, CI = .54,.92) and more often received SSI (13.9% vs. 4.5%; OR = 3.4, CI = 2.0,5.9) and Medicaid (20.2% vs. 13%; OR = 1.7 , CI = 1.1,2.6). Dysthymics reported accomplishing less over the past month due to emotional problems, and that emotional or physical problems interfered with social activities. Relative to GP, respondents with DD were more likely to receive SSI (13.9% vs. 2.9%; OR = 4.6, CI 3.4,6.2) and Medicaid (20.2% vs. 5.9%; OR = 2.9, CI 2.0,4.1). Compared to GP, dysthymics reported accomplishing less due to emotional problems, and that emotional or physical problems interfered with social activities and work functioning. Conclusions DD-associated psychosocial impairment in the community setting comprises a significant public health burden.
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- 2010
9. Does personality disorder decrease the likelihood of remission in early-onset chronic depression?
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Jonathan W. Stewart, David J. Hellerstein, and Vito Agosti
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Adult ,Male ,medicine.medical_specialty ,Adolescent ,lcsh:RC435-571 ,media_common.quotation_subject ,Remission, Spontaneous ,Personality Disorders ,Young Adult ,Narcissistic personality disorder ,lcsh:Psychiatry ,medicine ,Humans ,Personality ,Age of Onset ,Psychiatry ,Borderline personality disorder ,Depression (differential diagnoses) ,Aged ,media_common ,Depressive Disorder ,Marital Status ,Middle Aged ,medicine.disease ,Health Surveys ,Schizotypal personality disorder ,Personality disorders ,United States ,Psychiatry and Mental health ,Clinical Psychology ,Logistic Models ,Paranoid personality disorder ,Educational Status ,Female ,Age of onset ,Psychology - Abstract
Background The impact of personality disorders (PD) on the course of depression has been gaining interest among clinical researchers over the past decade. Recent observational studies have found that PD was associated with impaired social functioning and reduced likelihood of depression recovery. Elevated rates of PD have been noted in early-onset and chronic forms subtypes of depression. However, scant data exist regarding the link between PD and outcome for this depression subtype. Methods The National Epidemiological Survey on Alcohol and Related Conditions database was analyzed. This survey included 43 093 respondents, 18 years and older, conducted in 2001 through 2002. Logistic regression was used to identify demographic and clinical predictors of remission in early-onset chronic depression. Results The absence of PD, having more years of education, and being married considerably improved the likelihood of remission. Paranoid personality disorder and obsessive-compulsive disorder were the only specific PD found to be associated with a reduced probability of remission. Limitations Depression remission status may have biased the recollection of PD symptoms. Borderline personality disorder, narcissistic personality disorder, and schizotypal personality disorder were not assessed. Conclusions This study suggests that PD are significant predictors of remission in early-onset chronic depression.
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- 2009
10. Aripiprazole as an adjunctive treatment for refractory unipolar depression
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David J. Hellerstein, Sarai Batchelder, Steven Hyler, Bachaar Arnaout, Virginia Corpuz, Lisa Coram, and Gony Weiss
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Adult ,Male ,Pharmacology ,Depressive Disorder ,Time Factors ,Adolescent ,Aripiprazole ,Middle Aged ,Quinolones ,Drug Administration Schedule ,Piperazines ,Diagnostic and Statistical Manual of Mental Disorders ,Treatment Outcome ,Brief Psychiatric Rating Scale ,Drug Evaluation ,Humans ,Female ,Prospective Studies ,Social Behavior ,Biological Psychiatry ,Aged ,Antipsychotic Agents - Abstract
Aripiprazole may be an effective adjunctive treatment in outpatients with unipolar depression that has been refractory to treatment with SSRI or SNRI medication.Fifteen subjects with a current DSM-IV diagnosis of MDD which had not responded to SSRI or SNRI treatment were enrolled in a 12 week open-label study of aripiprazole with a maximum dose of 30 mg/day. Patients' current episode averaged 10.4+/-16.6 years, with a range of 3 months to 54 years. Baseline severity averaged 30.1+/-7.1 on HDRS-24, and 19.7+/-8.4 on BDI. Patients had been treated with a mean dose of 79.2+/-28.2 mg/day of fluoxetine equivalents for an average of 1 year prior to starting the study. Five subjects were on SNRI medications and 10 on SSRIs.Seven of 14 (50.0%) subjects were classified as treatment responders, as defined by at least 50% reduction in the HDRS-24 at week 12. Four subjects (28.6%) achieved remission, based on STAR D criteria (HDRS-17 scoreor=7). 26.7% (4/15) of subjects discontinued participation due to side effects. Two (40%) of 5 SNRI-treated subjects responded to aripiprazole augmentation.These findings support previous studies for the effectiveness of aripiprazole in augmenting SSRIs or SNRIs in treatment-resistant major depression.
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- 2008
11. A preliminary study of serotonergic antidepressants in treatment of dysthymia
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Arnold Winston, Camille Hemlock, Phillip Yanowitch, Lisa Wallner Samstag, Jesse Rosenthal, Karen Kasch, Cynthia Schupak, and David J. Hellerstein
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Adult ,Male ,Serotonin ,medicine.medical_specialty ,Serotonergic ,Fluoxetine ,Internal medicine ,medicine ,Humans ,Psychiatry ,Biological Psychiatry ,Depression (differential diagnoses) ,Psychiatric Status Rating Scales ,Pharmacology ,Depressive Disorder ,business.industry ,Trazodone ,Middle Aged ,Antidepressive Agents ,Clinical trial ,Antidepressant ,Female ,Open label ,business ,medicine.drug - Abstract
Rosenthal, Jesse et al. A Preliminary Study of Serotonergic Antidepressants in the Treatment of Dysthymia. Prog. Neuro-Psychopharmacol. & Biol. Psychiat. 1992, 16(6): 933–941. 1. 1. There is increasing evidence that antidepressants may alleviate symptoms of dysthymia, but few prior studies on selective serotonergic agents. 2. 2. Twenty patients meeting criteria for dysthymia, but not meeting criteria for major depression, received open label trials of a serotonergic antidepressant, either fluoxetine or trazodone. 3. 3. Seventeen (85%) completed three-month medication trials, and of these, twelve (70.6% of completers) responded to treatment. Seven (41.2% of completers) were still in remission on followup at five months. 4. 4. Both fluoxetine and trazodone were well tolerated in dysthymics, and showed similar short-term effectiveness in treating dysthymic symptoms.
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- 1992
12. Assessing HIV risk in the general hospital psychiatric clinic
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David J. Hellerstein and Mindy E. Prager
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Adult ,Counseling ,Male ,medicine.medical_specialty ,Outpatient Clinics, Hospital ,Human immunodeficiency virus (HIV) ,HIV Infections ,Psychiatric Department, Hospital ,Hospitals, General ,medicine.disease_cause ,Hiv risk ,Hospitals, Urban ,Patient Admission ,Acquired immunodeficiency syndrome (AIDS) ,Risk Factors ,Interview, Psychological ,medicine ,Health Status Indicators ,Humans ,Psychiatric hospital ,Risk factor ,Psychiatry ,Health Services Needs and Demand ,business.industry ,Mental Disorders ,medicine.disease ,Mental health ,Psychiatry and Mental health ,Ambulatory ,HIV-1 ,Female ,Viral disease ,business - Abstract
Of 101 new admissions to an urban outpatient psychiatric clinic, 17 (16.8%) were known to be at high risk and 11 (10.9%) at suspected high risk for developing or transmitting HIV infection, but apparently few were appropriately counseled. This suggests a need for implementing specific policies and procedures for HIV assessment and counseling.
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- 1992
13. Psychosocial impairment in dysthymic disorder in the NESARC Study
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M. Bosi, Vito Agosti, David J. Hellerstein, and Sarah R. Black
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Psychiatry and Mental health ,Clinical Psychology ,medicine.medical_specialty ,Dysthymic Disorder ,business.industry ,medicine ,Psychiatry ,business ,Psychosocial - Published
- 2010
14. Aripiprazole as an adjunctive treatment for refractory major depression
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David J. Hellerstein
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Pharmacology ,Fluoxetine ,medicine.medical_specialty ,medicine.drug_class ,Atypical antipsychotic ,Venlafaxine ,behavioral disciplines and activities ,Partial agonist ,Refractory ,Internal medicine ,mental disorders ,Adjunctive treatment ,medicine ,Aripiprazole ,Psychology ,Biological Psychiatry ,Depression (differential diagnoses) ,medicine.drug - Abstract
Introduction Aripiprazole may be an effective adjunctive treatment in outpatients with unipolar depression that has been refractory to treatment with SSRI or SNRI medication. Methods Fifteen subjects with a current DSM-IV diagnosis of MDD which had not responded to SSRI or SNRI treatment were enrolled in a 12 week open-label study of aripiprazole with a maximum dose of 30 mg/day. Patients' current episode averaged 10.4 ± 16.6 years, with a range of 3 months to 54 years. Baseline severity averaged 30.1 ± 7.1 on HDRS-24, and 19.7 ± 8.4 on BDI. Patients had been treated with a mean dose of 79.2 ± 28.2 mg/day of fluoxetine equivalents for an average of 1 year prior to starting the study. Five subjects were on SNRI medications and 10 on SSRIs. Results Seven of 14 (50.0%) subjects were classified as treatment responders, as defined by at least 50% reduction in the HDRS-24 at week 12. Four subjects (28.6%) achieved remission, based on STAR ⁎ D criteria (HDRS-17 score ≤ 7). 26.7% (4/15) of subjects discontinued participation due to side effects. Two (40%) of 5 SNRI-treated subjects responded to aripiprazole augmentation. Conclusions These findings support previous studies for the effectiveness of aripiprazole in augmenting SSRIs or SNRIs in treatment-resistant major depression.
- Published
- 2004
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