David C. Garron

Psychological depression and 17-year risk of death from cancer.

&NA; Psychological depression, measured in 1957‐1958 by the Minnesota Multiphasic Personality Inventory at the baseline examination of 2,020 middle‐aged employed men, was associated (p less than 0.001) with a twofold increase in odds of death from cancer during 17 years of follow‐up. The association did not vary appreciably in magnitude among the early (1958‐1962), middle (1963‐1968), and later (1969‐1974) years of follow‐up, persisted after adjustment for age, cigarette smoking, use of alcohol, family history of cancer, and occupational status, and was apparently not specific to any particular site or type of cancer. This result, predicted in advance on the basis of findings by other investigators, is consistent with the hypothesis that psychological depression is related to impairment of mechanisms for preventing the establishment and spread of malignant cells.

Mood disturbance versus other symptoms of depression in multiple sclerosis.

We administered the Multiscale Depression Inventory (MDI) and the Beck Depression Inventory (BDI) to 84 multiple sclerosis (MS) patients, 101 patients diagnosed with major depression and 87 nonmedical, nonpsychiatric controls. The MDI consists of three separate depression scales measuring mood, vegetative, and evaluative symptoms. We found that: (a) MS patients did not significantly differ from the controls in mood symptoms, (b) the depression prevalence rate in MS patients was significantly lower when measured by the mood scale (17.7%) than by the BDI (30.5%) or MDI total score (26.6%), and (c) MS patients showed significantly less mood disturbance than a non-MS comparison group matched on BDI measured depression severity. We suggest that the inclusion of nonmood symptoms in self-report depression scales may artificially raise both prevalence rates and severity ratings of MS related depression and that the most valid measure of depression in MS is mood disturbance.

High speed memory scanning in parkinsonism.

This study tested the hypothesis that the slowing seen in parkinsonism includes cognitive as well as motoric components. The sample consisted of 20 nondemented parkinsonian patients, group matched to 16 normals by age, education, and verbal IQ. Each group was divided into young (64 and under) and old (65 and over) subsets. The Sternberg character classification paradigm was used to measure the speed and accuracy of one cognitive function, short term memory scanning. Following a logarithmic transformation of the reaction time data, scanning speed was found to be increased, but only for the elderly patients (p = .01). Scanning accuracy was normal for both patient groups. These findings suggest that at least one cognitive function, the scanning of elements held in short term memory, is slowed in parkinsonism. This mnemonic slowing, like bradykinesia, is seen primarily in elderly parkinsonian patients. It is not readily explained as a motor phenomenon, as part of a generalized mnemonic or intellectual deficit, or as an artifact secondary to periodic extreme reaction times. The term bradyphrenia, used in early descriptions of parkinsonism, may be an apt descriptor of this deficit.

Affective and sensory dimensions of back pain.

&NA; Pain words used to communicate suffering were analyzed to identify specific dimensions of back pain. The words were obtained from a group of 131 patients suffering from back pain who described their discomfort on a standardized 87‐item pain questionnaire. The results indicate that words descriptive of back pain are not associated in completely random ways. When patients complain of back pain, their report falls into 7 distinguishable patterns. The major pattern accounts for 38% of the variance and refers almost entirely to emotional discomfort. The second pattern accounts for 9% of the variance and is a mixed emotional and sensory factor. The remaining 5 patterns account for 29% of the variance and constitute an entirely sensory class of factors.

Intelligence among persons with Turner's syndrome

Wechsler intelligence scale IQ distributions from a representative sample of 67 persons with Turners syndrome are compared with distributions from a control sample of subjects individually matched for age, race, education, and other social characteristics. Among the probands, there is no increased incidence of either severe or moderate retardation, intelligence is similar regardless of karyotype or somatic stigmata, and the characteristic cognitive deficit is similar among both children and young adults.

Autoimmune thyroiditis and a rapidly progressive dementia: Global hypoperfusion on SPECT scanning suggests a possible mechanism

We report the clinical, laboratory, EEG, and SPECT findings in a 59-year-old euthyroid woman with previously undiagnosed autoimmune thyroiditis, subclinical hypothyroidism, and rapidly progressive dementia. We made a diagnosis of Hashimotos encephalopathy based on elevated thyrotropin, abnormal EEG, and clinical improvement after thyroid hormone replacement. SPECT demonstrated global hypoperfusion with normalization on clinical recovery, suggesting a possible mechanism for the pathogenesis of Hashimotos encephalopathy.

Cerebral atrophy, EEG slowing, age, education, and cognitive functioning in suspected dementia

Seventy-eight hospital patients, 50 years of age or older, were selected for suspected changes in mentation and for the absence of focal or other organic brain disease. They were studied in relation to education, age, cerebral atrophy (by computerized tomography), electroencephalographic (EEG) slowing, and performance in several neuropsychologic tests. Adequate test-retest reliability of the cognitive measures and interjudge reliability of the cerebral atrophy and EEG measures were demonstrated. Stepwise multiple regression analyses suggested the following: (1) EEG slowing is the strongest and most general pathologic influence on cognition in elderly persons without overt brain disease. (2) Cerebral atrophy independently affects primarily the verbal recall of recent and remote information. (3) Age independently affects primarily recent memory for both verbal and nonverbal material. (4) Formal education is a powerful influence that must be accounted for in all studies of the effects of age on cognition.

Performance of Compensation Seeking and Non-Compensation Seeking Samples on the Victoria Symptom Validity Test: Cross-validation and Extension of a Standardization Study

Previous research suggests that the Victoria Symptom Validity Test (VSVT) is effective in confirming or disconfirming the validity of a patients reported cognitive impairments. We sought to cross-validate the findings of the VSVT standardization study, and to determine cut-off scores that are most efficient in discriminating our samples of compensation-seeking patients, primarily with mild traumatic brain injury (CS; n = 53), and non-compensation seeking patients with intractable seizures (NCS; n = 30). All patients in the NCS sample scored in the “valid” range on the VSVT difficult memory items, compared to only 58.5% of the CS sample. We also identified VSVT measures and cut-off scores maximally efficient in discriminating these samples. This study confirms previous research that non-compensation seeking patients do well on the VSVT, but that many compensation seeking patients perform poorly on this measure.

The detection of psychological disturbance in patients with low back pain.

Abstract The feasibility of developing a pain scale for detecting psychological disturbance in patients with low back pain was investigated in two studies. In the first study, stepwise discriminant analysis was used to identify the best combination of pain terms that would discriminate the functional group from the organic group. Thirteen pain variables were identified which correctly identified 93.6% of the cases of low back pain. These pain terms were used to categorize 159 new cases in the second. Cross-validation shrinkage was only 10.6%. One hundred and thirty-two out of 159 cases in the new sample were correctly classified. The advantages of this pain scale over existing methods are discussed, along with implications for clinical orthopedic practice.

Self-Reported Sleep Disorder Symptoms in Epilepsy

Summary: Three groups of adult epileptic subjects with simple partial, complex partial, and generalized seizures and normal control subjects completed a brief self‐report sleep questionnaire. The simple partial and complex partial groups indicated significantly more sleep disorder symptoms, especially frequent night awakenings. The generalized group was most similar to the controls. Irrespective of seizure type, the epileptic patients with the most frequent seizures also had the most sleep disturbances. Sleep disorder symptoms did not increase with age in the seizure groups. It would thus seem that epileptic patients with partial seizures and those with more frequent seizures are at risk for developing sleep disorders.