bluuebunny/crossref_metadata_2025_split huggingface dataset:
Lamotrigine treatment of bipolar disorder: data from the first 500 patients in STEP‐BD
Authors: Marangell Lauren B , Martinez James M , Ketter Terence A , Bowden Charles L , Goldberg Joseph F , Calabrese Joseph R , Miyahara Sachiko , Miklowitz David J , Sachs Gary S , Thase Michael E ,   STEP‐BD investigators
Published: December 2004

Objective:  To describe the frequency and correlates of lamotrigine therapy among the first 500 patients enrolled into the Systematic Treatment Enhancement Program for Bipolar Disorder (STEP‐BD) study.Method:  Systematic recording of psychiatric history and medication data at intake into the STEP‐BD project.Results:  Of the participants with bipolar disorder type I or II (n = 483), 77 (15.4%) were currently taking lamotrigine (mean dose: 258.12 mg/day) and 52 (10.4%) reported prior lamotrigine use. The groups were comparable with regard to duration of illness and mood state at study entry. Compared with participants who had never taken lamotrigine, those currently treated with lamotrigine were significantly more likely to have a prior history of rapid cycling (62.5% vs. 43.1%; p < 0.01) and an antidepressant‐induced switch to (hypo)mania (49.3% vs. 33.3%; p < 0.01). In contrast, only 16.9% of lamotrigine‐treated participants were taking an antidepressant at study intake, as compared with 29.1% of participants with no history of lamotrigine therapy (p < 0.03).Conclusions:  While noting the limitations of a cross‐sectional assessment, these data suggest that lamotrigine therapy was commonly used in these academic centers for patients with bipolar disorder several years before it was recommended in the American Psychiatric Association practice guidelines, particularly in patients with a history of rapid cycling or antidepressant‐induced mania.
Folie a deux in bipolar affective disorder: a case report
Authors: Patel Anish S , Arnone Danilo , Ryan William 
Published: December 2004

Background:  The syndrome of folie a deux is uncommon and often described in the context of schizophrenia. We report a case of induced delusional disorder associated with bipolar affective disorder (BAD).Case report:  We present a case of monozygotic twins in their late 60s with an unusually close relation with one another and relative isolation from other people. Both twins have been diagnosed as suffering from BAD and relapsed into mania with psychotic symptoms. During their hospital stay they exhibited features consistent with folie a deux. Separation caused disappearance of the phenomenon whilst the affective disorder persisted.Conclusion:  This case highlights the unusual and rare phenomenon of folie a deux occurring in the context of BAD. It also suggests current difficulty in defining folie a deux as an entity according to current diagnostic criteria.
Two peptidase activities decrease in treated bipolar disorder not schizophrenic patients
Authors: Breen Gerome , Harwood Adrian J , Gregory Kathryn , Sinclair Maggie , Collier David , Clair David St , Williams Robin SB 
Published: December 2004

Background:  Inhibition of prolyl oligopeptidase (PO) in primary neuronal cultures has been shown to reverse the effect of the common mood‐stabilizers lithium, valproic acid and carbamazepine. In clinical studies, abnormal plasma PO activity has been associated with bipolar disorder (BD) and schizophrenia. However, this association is complicated by the discovery in bovine plasma of a Z‐Pro‐prolinal‐insensitive peptidase (ZIP), a novel enzyme that cleaves the same substrate as PO.Methods:  We developed an assay to distinguish between ZIP and PO and measured both activities in plasma from 48 BD and 50 schizophrenic patients undergoing treatment and compared them with 50 control subjects.Results:  ZIP activity is restricted to blood plasma, whereas PO activity is present in the cytosol of lymphocytes, but can also be detected in blood plasma. Significant decreases in their plasma activities were found between treated BD (p = 0.007 and 0.03 respectively) but not schizophrenic (p > 0.05) patients and controls.Conclusions:  We have found that the enzyme activity previously reported as plasma PO actually comprises two enzymes, PO and ZIP. This study shows a statistically significant decrease of both enzymes in BD patients undergoing lithium treatment. No statistically significant change in PO or ZIP activity is observed in schizophrenic patients.
Bipolar disorder. III: Harm avoidance a risk factor for suicide attempts
Authors: Engström Christer , Brändström Sven , Sigvardsson Sören , Cloninger C Robert , Nylander Per‐Olof 
Published: December 2004

Objectives: The aim of the study was to examine whether personality, i.e. temperament and character influence suicide attempts in bipolar patients.Methods: Bipolar patients were recruited from lithium dispensaries. Temperament and character inventory (TCI) was administered to 100 euthymic bipolar patients and 100 controls.Results: Age of onset was significantly lower in patients with suicide attempts in the total bipolar group (I and II) and bipolar I patients compared with patients without suicide attempts. Bipolar (I and II) and bipolar I patients with suicide attempts were significantly higher in harm avoidance (HA) and reward dependence compared with patients without suicide attempts. Patients (I and II) with suicide attempts had significantly more anticipatory worry, fatigability and asthenia than patients without suicide attempts. Bipolar I patients with suicide attempts had significantly more fatigability and asthenia and were more dependent than patients without suicide attempts. HA was lowest in patients with no suicide attempts and no family history of suicide, higher in patients with family history of suicide or patients with suicide attempts, and significantly highest in patients with suicide attempts and family history of suicide. Patients with suicide attempts and family history of suicide had more anticipatory worry, fatigability and asthenia. Bipolar disorder was significantly correlated to HA and suicide attempts to HA and PS. Family history of suicide and gender were significantly correlated to suicide attempts.Conclusions: Age of onset, HA, PS, gender and family history of suicide had a moderate to very strong effect on suicide attempts in bipolar patients.
Major stressful life events and other risk factors for first admission with mania
Authors: Kessing Lars Vedel , Agerbo Esben , Mortensen Preben Bo 
Published: December 2004

Objectives:  To investigate whether first admission with mania is associated with the occurrence of death in the family or with major stressful life events and to explore whether the associations change with age.Methods:  Case register study with linkage of the Danish Psychiatric Central Research Register, including data on all admissions at psychiatric wards in Denmark from 1981 to 1998, and the Civil Registration System, including data on death and on socio‐demographic variables. All patients who got a diagnosis of mania/mixed episode at the first ever admission at a psychiatric ward and a random gender‐ and age‐matched control group of subjects who had never been admitted to psychiatric ward were identified.Results:  A total of 1565 patients and 31 300 control subjects were identified. Suicide of a mother or of a sibling was associated with a highly increased risk of being admitted for the first time ever at a psychiatric ward with a diagnosis of mania/mixed episode. Death of a relative by other causes than suicide was not associated with increased risk of getting hospitalized with mania. Recent unemployment, recent divorce, but also a recent marriage showed moderate effects. No interaction was found on the association between life events and the first admission with mania, totally, or for men or women, separately regarding ageing.Conclusions:  The occurrence of death in the family and the experience of major life events are associated with increased risk of first admission with bipolar disorder. The susceptibility to major life stressors of inducing mania does not seem to change throughout life.
A survival analysis for recurrent events in psychiatric research
Authors: Baethge Christopher , Schlattmann Peter 
Published: December 2004

Objectives: Time to first recurrence, as analyzed by the Kaplan–Meier (KM) survival analysis, is a commonly applied statistical method in psychiatric research. However, many psychiatric disorders are characterized not by a single event, but rather by recurrent events, such as multiple affective episodes. This study aims to demonstrate a method of survival analysis that takes multiple recurrences into account.Methods: We examined data on sex differences in a sample of 181 patients undergoing prophylactic treatment with lithium or carbamazepine (serum level assayed) for bipolar disorder (ICD‐10). The classical KM method was compared with an approach developed by Peña, Strawderman and Hollander (PSH) that uses recurrent event data to estimate survival function.Results: The results obtained with the multiple events method differed considerably from those acquired using the standard KM analysis. When taking recurrent event data into account, the probability of remaining well was lower and survival times were longer. In addition, whereas the standard KM analysis indicated that male patients had a higher likelihood of remaining well, the alternative method revealed that both sexes were similarly likely to remain well.Conclusions: Survival analysis techniques that take recurrent events into account are potentially important instruments for the study of psychiatric conditions characterized by multiple recurrences. In many cases, the standard KM analysis appears to provide only a rough approximation of the course of illness.
Psychosocial variables in children and teens of extended families identified through bipolar affective disorder probands
Authors: Petti Theodore , Reich Wendy , Todd Richard D , Joshi Paramjit , Galvin Matthew , Reich Theodore , Raymond DePaulo J , Nurnberger John 
Published: December 2004

Objectives:  This multi‐site study investigated the frequency of risk‐related variables for developing an affective disorder using a within‐pedigree control group. We wished to determine the effect of life events, social relationships, self‐perceived competence, and aspects of home environment for youngsters from extended families with loading for bipolar disorder. Using a within‐family contrast group, we address the following two issues: (1) Do offspring or their parents from families who do and do not have an affected parent report differences (i) in home environment? (ii) in frequency and type of offspring life events? and (iii) in social relations and self‐perception? and (2) Do children or their parents who do or do not have an affective disorder report differently on these areas?Methods:  Juvenile offspring (n = 50) and their parents from 14 bipolar pedigrees were assessed. Structured interviews and self‐ or parent‐reported instruments were used to compare offspring with an affected first‐degree relative to those without and to compare offspring with or without an affective disorder.Results:  Only one significant psychosocial difference was found between offspring with or without a parent with an affective disorder but several were found between offspring who themselves did or did not have an affective disorder. These differences are in the areas of the need for discipline, social support, and dependent negative life events.Conclusions:  The findings identify potential early psychosocial markers for affective disorder in high risk offspring.
Efficacy of extended‐release doxazosin and doxazosin standard in patients with concomitant benign prostatic hyperplasia and sexual dysfunction
Authors: Kirby Roger S. , O'Leary Michael P. , Carson Culley 
Published: December 2004

Associate Editor  Michael G. Wyllie  Editorial Board  Ian Eardley, UK  Jean Fourcroy, USA  Sidney Glina, Brazil  Julia Heiman, USA  Chris McMahon, Australia  Bob Millar, UK  Alvaro Morales, Canada  Michael Perelman, USA  Marcel Waldinger, NetherlandsOBJECTIVETo report a comprehensive retrospective analysis of the favourable effects of doxazosin extended‐release (XL) and doxazosin standard on the sexual health of patients with comorbid benign prostatic hyperplasia (BPH) and erectile dysfunction (ED), augmenting a previous study of 680 patients with symptomatic BPH.PATIENTS AND METHODSMen with BPH and aged 50–80 years participated in a randomized, double‐ blind, double‐dummy, parallel‐group, multicentre trial, completing a 2‐week, single‐blind, placebo run‐in period before receiving doxazosin XL 4 or 8 mg once daily or doxazosin standard 1–8 mg once daily for 13 weeks. Baseline sexual function and changes from baseline after treatment with doxazosin were evaluated from responses of the International Index of Erectile Function (IIEF) questionnaire (with dysfunction defined as a score of ≤ 3 for any question) and the five domains for erectile function (intercourse satisfaction, orgasmic function, sexual desire and overall sexual satisfaction).RESULTSOf 680 patients randomized into the trial, 237 (35%) had ED at baseline; in these patients there were statistically and clinically significant improvements in each of the five IIEF domains with XL and standard doxazosin (P ≤ 0.0019), with the range of improvement being from 13% to 41%. There were no significant differences between treatment groups. Doxazosin XL consistently improved sexual function, as assessed by the individual questions of the IIEF questionnaire. There was no statistically significant difference between groups for any sexual function question analysed.CONCLUSIONDoxazosin XL and standard improved sexual function in men with concomitant BPH and ED at baseline. This may represent an action independent of relieving lower urinary tract symptoms, because the beneficial effect of doxazosin was reported in patients with no symptomatic BPH.
Acute urinary retention: what is the impact on patients’ quality of life?
Authors: Thomas Kay , Oades Grenville , Taylor‐Hay Cathy , Kirby Roger S. 
Published: December 2004

OBJECTIVETo evaluate the impact of admission for acute urinary retention (AUR) on patients’ health‐related quality of life (HRQoL) compared with that on admission for elective surgery for benign prostatic hyperplasia (BPH) and emergency admission for renal colic (RC).PATIENTS AND METHODSOver a 2‐year period, three groups of men were recruited from one institution: group 1, men aged >50 years presenting to the accident and emergency (A&E) department with AUR; group 2, for comparison, men aged >50 years admitted for elective surgery for BPH; and group 3, men aged >40 years presenting to A&E with RC. A self‐completed HRQoL questionnaire was administered at five visits (72 h from admission, and 1, 2, 3 and 6 months afterward) over a 6‐month follow‐up.RESULTSGroup 1 reported mean pain scores on admission of 7.7, compared with 5.6 for group 2 and 8.3 for group 3. Patients in group 1 had the most investigations and recurrent attendance to A&E throughout the study, compared with almost none for the other two groups. There was a substantial economic burden for group 1; 15% had extra help at home at a mean cost of £403 for the duration of the study. For the other domains assessed (e.g. emotions, mental state, general health) groups 1 and 2 were similar.CONCLUSIONSAn episode of AUR has a measurable impact on patients’ HRQoL, which often occurs in the community and therefore may not be appreciated by the urology team providing their care. Further work is therefore required to improve the ‘patient journey’ for those with AUR, and to prevent patients developing AUR in the future.
Improved quality of life in patients with overactive bladder symptoms treated with solifenacin
Authors: Kelleher Con J. , Cardozo Linda , Chapple Christopher R. , Haab Francois , Ridder Arwin M. 
Published: December 2004

OBJECTIVETo assess the effect of solifenacin succinate treatment on quality of life (QoL) measured in clinical trials in patients with overactive bladder (OAB).PATIENTS AND METHODSQoL data using the King's Health Questionnaire (KHQ) were analysed from two phase‐3, 12‐week studies (1984 patients) and a long‐term extension of these studies (1637 patients) where patients received solifenacin for up to an additional 40 weeks (i.e. a 52‐week exposure to solifenacin). The 12‐week studies were multinational, multicentre, randomized, double‐blind, and placebo‐controlled. The 10 domains from the KHQ evaluated were general health perception, incontinence impact, role limitations, physical limitations, social limitations, personal relationships, emotions, sleep/energy, severity measures, and symptom severity. Changes from baseline to endpoint in QoL variables were assessed by analysis of variance, and from pooled outcomes of the 12‐week studies by analysis of covariance. Descriptive statistics were used to evaluate data in the extension study.RESULTSIn the two 12‐week studies (1033 and 857 patients), those receiving once‐daily solifenacin had statistically significantly better QoL than those on placebo. Changes in the KHQ were statistically significantly (P < 0.05) different from placebo for both solifenacin 5 and 10 mg once daily on five of the 10 KHQ domains in each of the studies. Pooled data from the two 12‐week studies showed statistically significant (P < 0.05) differences from placebo for both solifenacin doses in nine of the 10 domains. Improvements in QoL scores for solifenacin were 35–48% in nine of the 10 domains for the 1347 patients providing QoL data in the extension study. About two‐thirds of this overall improvement occurred during the original 12‐week study, with an additional third reported during the extension, with an improvement in QoL over time in patients treated with solifenacin.CONCLUSIONSResults from the KHQ in study participants in the two double‐blind studies showed that solifenacin significantly improved the QoL in patients with OAB symptoms after 12 weeks of treatment, with further improvements during long‐term administration up to 1 year. Clinical trial outcomes show a favourable balance of efficacy and tolerability with solifenacin; the present report further supports this efficacy and tolerability by providing evidence for both short‐ and long‐term improvements in QoL.
A prospective, double‐blind, randomized cross‐over study evaluating changes in urinary pH for relieving the symptoms of interstitial cystitis
Authors: Nguan Christopher , Franciosi Luigi G. , Butterfield Noam N. , Macleod Bernard A. , Jens Martha , Fenster Howard N. 
Published: December 2004

OBJECTIVETo provide evidence for the clinical efficacy of changes in urinary pH on the pain associated with interstitial cystitis (IC).PATIENTS AND METHODSA prospective, randomized, double‐blind cross‐over study was conducted with 26 women with IC between 2000 and 2002, consisting of cross‐over instillations of urine at physiological pH (5.0), and neutral buffered pH (NaH2PO4 buffered to pH 7.5). The outcome measured was the subjective symptom of pain assessed using a visual analogue scale at baseline, after the initial instillation of solution, at washout, and after the crossover instillation. Data were analysed using repeated‐measures analysis of variance.RESULTSThere was no statistically significant difference between the mean (sd) change from baseline pain scores after instilling neutral buffered solution, at 0.50 (2.78), and acidic solution, at 0.33 (3.43) (P = 0.85). Secondary outcomes were analysed, including baseline variability and treatment‐order effects; neither were significantly different between the groups.CONCLUSIONSThere was no statistically significant difference in subjective pain scores on instilling urine at physiological pH or sodium‐phosphate buffered saline in these patients with IC. Further work is required to define the role, if any, of urinary pH in the pathophysiology and treatment of IC.
Managing patients with an overactive bladder and glaucoma: a questionnaire survey of Japanese urologists on the use of anticholinergics
Authors: Kato Kumiko , Yoshida Kazuhiko , Suzuki Koichi , Murase Tatsuro , Gotoh Momokazu 
Published: December 2004

OBJECTIVESTo establish the views of urologists on the use of anticholinergic drugs for treating the overactive bladder (OAB) in patients with glaucoma.SUBJECTS AND METHODSIn February 2004 a self‐description questionnaire was mailed to all 417 urologists who were members of the Tokai Society of Voiding Dysfunction, to determine current practice in Japan for patients with an OAB and glaucoma. Subgroups were analysed between the types of practice and the duration since the urologists had graduated from medical school.RESULTSOf the 155 respondents, 76 (49%) routinely enquired about a history of glaucoma before prescribing anticholinergics, and 45 (29%) routinely referred patients with such a history to ophthalmologists. To treat patients with OAB and glaucoma, 102 (66%) would prescribe anticholinergics if permission were available from the ophthalmologist, 33 (21%) chose other treatments and 17 (11%) abandoned treatment. Forty‐nine urologists (32%) were currently prescribing anticholinergics to patients with glaucoma. As to knowledge about glaucoma, 132 (85%) urologists knew that there were two types of glaucoma and 98 (63%) knew about laser iridotomy. The proportion of urologists who knew of the two types of glaucoma and asked patients for this information was significantly higher in university than in general hospitals (P < 0.05).CONCLUSIONSAlthough anticholinergic drugs can precipitate angle‐closure glaucoma by pupillary block, they are not contraindicated in open‐angle glaucoma or in angle‐closure glaucoma that has already been treated by laser iridotomy. Not all urologists are aware of this difference, at least in Japan. Some urologists avoid anticholinergics in all patients with glaucoma, while others pay little attention to glaucoma. Routine history taking and referral to ophthalmologists allows many patients with OAB and glaucoma to benefit safely from anticholinergics. Moreover, clinicians should be aware of patients with OAB who have not been evaluated by ophthalmologists but who are at risk of angle‐closure glaucoma.
Transurethral resection of the ejaculatory ducts for treating ejaculatory symptoms
Authors: Johnson Christopher W. , Bingham Jonathan B. , Goluboff Erik T. , Fisch Harry 
Published: December 2004

OBJECTIVESTo report our experience with transurethral resection of the ejaculatory ducts (TURED) in infertile men with symptomatic ejaculatory duct obstruction (EDO).PATIENTS AND METHODSWe retrospectively reviewed the operative cases of one urologist from 1995 to 2001, identifying 15 patients with symptomatic EDO who underwent TURED. These men had normal hormone levels and no other known genitourinary dysfunction. Investigations included a history, physical examination, semen analysis, semen culture, and high‐resolution transrectal ultrasonography. Responses to focused questions and semen analysis were evaluated after surgery.RESULTSBefore surgery, all patients complained of a decrease in the volume of their ejaculate, 14 of 15 had a non‐projectile ejaculation, nine had a genitourinary infection necessitating antibiotic treatment, and five had pain with orgasm. The mean ejaculate volume and total motile sperm count was 1.1 mL and 8.1 million sperm per ejaculate. After surgery, at a mean follow‐up of 2 months, 10 men reported having projectile ejaculation, and eight reported a marked improvement in their sensation of orgasm. Overall, 14 men reported a subjective improvement in their ejaculation. The average postoperative ejaculate volume was 2.3 mL and the total motile sperm count was 38.1 million per ejaculate.CONCLUSIONSMen with symptomatic EDO who underwent TURED showed improvements in their ejaculation, sensation of orgasm, semen analysis values and fertility.