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A prospective study of male in-patients over 55 years old who met Feighner criteria for non-bipolar depression was performed to determine if a previous history of alcoholism significantly influenced treatment or response to treatment. Among 58 subjects with complete follow-up information, the 16 who had a history of alcoholism had a presentation at index which differed from that of the non-alcoholics, and on follow-up they clearly had more chronic illness. This elderly sample with alcoholism resembles 'neurotic-reactive' depressives described in younger samples, and supports a past history of alcoholism as being a risk factor for chronicity of depression on follow-up in the elderly population. [ABSTRACT FROM AUTHOR]

Bipolar and unipolar patients respectively were separated into psychotic and non-psychotic sub-types. The bipolar psychotic patients were more likely to have certain severe symptoms, such as hallucinations and motor abnormalities, than were the unipolar patients, but the family histories of the four sub-groups were identical. The psychotic sub-groups had a different course of illness, in that they were less likely to have had a history of multiple episodes on admission and were more likely to show chronicity for a period of time on discharge. The data are interpreted as being opposed to the concept of a continuum of vulnerability in the affective disorders, and as not favouring either psychotic unipolar or psychotic bipolar illnesses or schizo-affective disorder being considered autonomous. One possible interpretation of the findings is that a trait or propensity to psychosis is transmitted totally independently of the major affective illness, and that this propensity is silent or not observed when the patient is in remission. [ABSTRACT FROM AUTHOR]

The charts of 52 hebephrenic/catatonic schizophrenics requiring long-term institutionalization were selected from the Iowa 500 study and reviewed. The presence or absence of 28 different symptoms was noted on a year by year basis over a span of 35 years. Symptoms usually classified as positive symptoms of schizophrenia, such as hallucinations and delusions, were found to have earlier onset and greater tendency to resolve over time than symptoms usually classified as negative such as flat affect, decreased social interaction and sensorium defects. [ABSTRACT FROM AUTHOR]

One thousand five hundred and seventy eight first degree relatives of schizophrenics, manics, depressives and controls were personally interviewed using the Iowa Structured Psychiatric Interview Form without knowledge of the probands' diagnoses. Our data, based on blind diagnostic assessment of the relatives, support the distinction between schizophrenia and affective disorders, although the distinction between schizophrenia and mania was not clear-cut. Our data could not support familial subtyping of paranoid and non-paranoid schizophrenia, and unipolar and bipolar affective disorders. Future studies attempting to develop research criteria for subtyping schizophrenia and effective disorders should utilize not only clinical and familial data but also biological markers and other non-familial variables. [ABSTRACT FROM AUTHOR]

Twenty-one patients with bipolar affective disorder (20 manic episodes, one depressive episode) during the postpartum period were evaluated. They were compared to an unselected group of womicantly more Schneiderian symptoms and fewer recurrences of illness within the three-year periofectively ill relatives than the controls. The practical significance of these findings with rey of the bipolar syndrome. [ABSTRACT FROM AUTHOR]

In this archival study, 58 patients with unipolar depression who were 55 years of age or older were compared to 155 depressed control patients age 54 years or less. The older patients with unipolar depression had a significantly worse outcome, with only 51.7% experiencing a period of full remission during follow-up. Medical disorders were common, and older depressed patients showed a clear excess of cardiovascular disorders. Clinical symptoms did not separate the two groups, with the exception of psychomotor retardation and agitation. Electroconvulsive therapy was associated with less continuous hospitalization and an overall superior outcome. (J Geriatr Psychiatry Neurol 1988;1:220-225). [ABSTRACT FROM PUBLISHER]

Objective: This 5-year follow-up study was designed to explore the factors that might lead to alcoholism in patients with bipolar disorder.Method: The authors studied patients with bipolar illness (70 with alcoholism and 161 without), their relatives, and a comparison group composed of relatives' acquaintances. All were evaluated with versions of the Schedule for Affective Disorders and Schizophrenia, and diagnoses were made according to the Research Diagnostic Criteria. Thirty of the bipolar alcoholic patients whose affective disorder was primary were also compared with 34 whose alcoholism was primary.Results: Alcoholism was more frequent in the bipolar patients than in the comparison subjects. There no significant differences between the alcoholic and nonalcoholic bipolar patients in family history of alcoholism or affective disorders, suggesting that bipolar illness with alcoholism is not explicable by a family history of alcoholism and that the alcoholism seen in bipolar illness is dissimilar to alcoholism as a primary disorder. Alcoholism associated with bipolar illness was more likely to remit than primary alcoholism. There was no significant difference in family history between the patients with primary alcoholism and those with primary bipolar disorder. The patients with primary alcoholism had significantly fewer episodes of affective disorder during followup, suggesting that their type of bipolar illness was less severe and may have needed the added insult of alcoholism to make it manifest.Conclusions: The study supports the idea that not all alcoholism is primary with a corresponding familial diathesis. Rather, alcoholism associated with bipolar disorder is often a secondary complication. [ABSTRACT FROM AUTHOR]

Ninety-one patients with panic attacks limited historically to depressive episodes had more severe depressive symptoms and were less likely to recover during a 2-year follow-up than 417 depressed patients who did not have panic attacks. Family study data clearly distinguished another 15 patients with panic disorder and secondary depression; interviewed relatives of panic disorder patients were significantly less likely to have primary depression and significantly more likely to have various anxiety disorders. These data support the hierarchical system by which many of the contemporary diagnostic systems separate panic disorder and major depression. [ABSTRACT FROM AUTHOR]

The article investigates the incidence of depressive illness in Iowa and its relevant associations of follow-up data, age at index admission, and sex of probands. The study was participated by 225 depressives, 100 manics, and 200 schizophrenics who were admitted at the Iowa Psychopathic Hospital between 1934 and 1944. The subjects were selected based on a strict criteria for depression diagnosis including a dysphoric mood, poor appetite, weight loss, and decrease in sexual drive. The study found that less than 5% of the patients showed manic signs in the follow-up period. It also showed that depressive male patients are the ones most likely to have subsequent episodes and early-onset females have prototype of depression because of their association with familial alcoholism and sociopathy.