Background Very-low-birth-weight infants (those weighing less than 1500 g) born during the initial years of neonatal intensive care have now reached young adulthood. Methods We compared a cohort of 242 survivors among very-low-birth-weight infants born between 1977 and 1979 (mean birth weight, 1179 g; mean gestational age at birth, 29.7 weeks) with 233 controls from the same population in Cleveland who had normal birth weights. We assessed the level of education, cognitive and academic achievement, and rates of chronic illness and risk-taking behavior at 20 years of age. Outcomes were adjusted for sex and sociodemographic status. Results Fewer very-low-birth-weight young adults than normal-birth-weight young adults had graduated from high school (74 percent vs. 83 percent, P=0.04). Very-low-birth-weight men, but not women, were significantly less likely than normal-birth-weight controls to be enrolled in postsecondary study (30 percent vs. 53 percent, P=0.002). Very-low-birth-weight participants had a low...

Outcomes in Young Adulthood for Very-Low-Birth-Weight Infants

OBJECTIVE: The authors sought to observe the long-term clinical course of anxiety disorders over 12 years and to examine the influence of comorbid psychiatric disorders on recovery from or recurrence of panic disorder, generalized anxiety disorder, and social phobia. METHOD: Data were drawn from the Harvard/Brown Anxiety Disorders Research Program, a prospective, naturalistic, longitudinal, multicenter study of adults with a current or past history of anxiety disorders. Probabilities of recovery and recurrence were calculated by using standard survival analysis methods. Proportional hazards regression analyses with time-varying covariates were conducted to determine risk ratios for possible comorbid psychiatric predictors of recovery and recurrence. RESULTS: Survival analyses revealed an overall chronic course for the majority of the anxiety disorders. Social phobia had the smallest probability of recovery after 12 years of follow-up. Moreover, patients who had prospectively observed recovery from their i...

/pdf/influence-of-psychiatric-comorbidity-on-recovery-and-zplqu1fo40.pdf

Influence of Psychiatric Comorbidity on Recovery and Recurrence in Generalized Anxiety Disorder, Social Phobia, and Panic Disorder: A 12-Year Prospective Study

Neurobehavioral Effects of Interferon-α in Cancer Patients: Phenomenology and Paroxetine Responsiveness of Symptom Dimensions

For the past 40 years, various forms of interferon (IFN) have been evaluated as therapy in a number of malignant and non-malignant diseases. With the advent of gene cloning, large quantities of pure IFN became available for clinical study. This paper reviews the biology, pharmacology, and clinical applications of IFN formulations most commonly used in oncology. It then reviews the most common side effects seen in patients treated with IFN, and makes recommendations for the management of IFN-induced toxicity. The major oncological indications for IFN include melanoma, renal cell carcinoma, AIDS-related Kaposi’s sarcoma, follicular lymphoma, hairy cell leukemia, and chronic myelogenous leukemia. Unfortunately, IFN therapy is associated with significant toxicity, which can be divided into constitutional, neuropsychiatric, hematologic, and hepatic effects. These toxicities have a major impact on the patient’s quality of life, and on the physician’s ability to optimally treat the patient. Careful attention to all aspects of patient care can result in improved tolerability of this difficult but promising therapy. Conclusion: a better understanding of IFN biology, indications, side effect profiles, and toxicity management will aid in optimizing its use in the treatment of patients with cancer. The Oncologist 2001;6:34-55

Interferon in Oncological Practice: Review of Interferon Biology, Clinical Applications, and Toxicities

Multi-target strategies for the improved treatment of depressive states: Conceptual foundations and neuronal substrates, drug discovery and therapeutic application.

https://www.thelancet.com/pdfs/journals/lancet/PIIS0140-6736(98)04793-X.pdf

Treatment with interferon-α in patients with chronic hepatitis and mood or anxiety disorders

Mania induced by withdrawal of treatment with interferon alfa.

Aims — Patients with chronic viral hepatitis suffer from a high prevalence of psychiatric problems. Furthermore, the treatment for chronic viral hepatitis, with interferon (IFN) alpha, induces the occurrence of further psychopathological symptoms. The autors examined whether patients with a pre-existing psychiatric diagnosis had more severe IFN alpha-induced psychiatric adverse effects, and whether they were more likely to interrupt the IFN alpha therapy, compared with control patients with no pre-existing psychiatric diagnosis. They also examined the psychopharmacological management of the interferon-alpha-induced psychiatric side effects. Methods — The authors studied prospectively 60 patients with chronic hepatitis B or C in Cagliari, Italy. Patients underwent psychiatric assessment before starting interferon alpha and monthly throughout the therapy. Results — After adjusting for the baseline psychopathology, there was no statistically significant difference in interferon-alpha-induced psychiatric adverse effects between patients with a pre-existing psychiatric diagnosis and controls. There was also no evidence that psychiatric cases were more likely than controls to interrupt the IFN alpha therapy because of psychiatric side effects. Moreover, there was no difference in the psychiatric adverse effects severe enough to require psychopharmacological treatment. Finally, psychopharmaco-logical management successfully treated psychiatric symptoms induced by the IFN alpha. Conclusions — Patients with a pre-existing psychiatric diagnosis do not have a specific vulnerability to interferon-alpha-induced psychiatric adverse effects.Declaration of Interest: none of the authors have conflict of interests in writing this paper; CM. Pariante is funded by the UK Medical Research Council and by the NARSAD and the Guy's and St Thomas Charity

[Interferon-alpha-induced psychiatric side effects in patients with chronic viral hepatitis: a prospective, observational, controlled study].

OBJECTIVE The "Questionario sull'Impatto della Malattia Cronica sulla Famiglia" (IMPAT) ("Impact-on-Family Scale", by Stein & Reissman) in its Italian version (by Casari & Fantino, modified) has been used to evaluate family burden in relatives of chronic patients with cancer, chronic patients with other internistic pathology and acute patients. The aims of the study were to evaluate validity and reliability of the Impat and to compare family burden and anxoius/depressive symptoms in the three groups of relatives. METHOD 35 relatives of cancer patients, 20 relatives of patients with chronic, non neoplastic illness and 20 relatives of acute patients were studied. 85% of relatives of cancer patients was assisted continuously by volunteers and psychiatrists with regard to their psychological problems. Impat questionnaire, Beck Depression Inventory and State-Trait Anxiety Inventory were used for psychological evaluation. RESULTS Validity of the Impat was confirmed. Mean scores from relatives of chronic patients were higher than scores from relatives of acute patients (ANOVA, f = 38.0; df = 2,72; p < 0.0001). Test-retest analysis was satisfactory (Person's test, N = 20 r = 0.77, p < 0.0001). Both groups of relatives of chronic patients showed higher level of anxious-depressive symptoms compared to relatives of acute subjects. No differences were found between relatives of neoplastic and non neoplastic chronic patients. CONCLUSIONS The italian version of Impat has been confirmed as a useful and simple means of evaluation of family burden in this context. Psychosocial support seems to reduce distress in relatives of cancer patients.

The family burden in chronic diseases. The study of validity and reproducibility of the questionnaire on the impact of the chronic disease on the family (IMPAT)

Evolución clínica y psicosocial de los pacientes afectados por trastorno de angustia con o sin agorafobia: resultados de un estudio de seguimiento naturalista

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