Janelle Gabel

Reliability and validity of a scale to measure change in persons with compulsive buying

A new scale to measure severity and change in persons with compulsive buying is described. Data were gathered during an open-label study in which compulsive buyers were treated with fluvoxamine, a serotonin reuptake inhibitor. The instrument showed good-to-excellent interrater reliability and high internal consistency. Its 10 separate items showed at least moderate correlations with the total score. The instrument was also sensitive to clinical change and correlated highly with other measures of illness severity. We conclude that this new instrument is both reliable and valid in measuring severity and change in persons with compulsive buying.

Predictors of short-term treatment response in 66 patients with panic disorder

Short-term treatment response in panic disorder was studies in 66 subjects who had completed 3 weeks of treatment with fluvoxamine (n = 23), cognitive therapy (n = 20), or placebo (n = 23). Clinical and self-rated assessments were gathered at baseline, during, and after treatment. Using multiple logistic regression, treatment with fluvoxamine, a low panic attack severity score, and absence of a comorbid personality disorder were identified as significant predictors of recovery. Personality disorder was an important negative predictor to outcome with cognitive therapy. The results support the efficacy of fluvoxamine, and show that patients with low symptom severity and a normal personality respond well to treatment.

Serotonin transporter gene (5‐HTT) polymorphisms and compulsive buying

We examined a panel of 21 patients diagnosed with compulsive buying for two DNA sequence polymorphisms found in the gene that encodes the serotonin transport (5-HTT). One polymorphism, found in the promoter region of the 5-HTT gene, involves a 44-base pair (bp) deletion, and the other, found in the second intron, is due to variable numbers of a repeat sequence. We also typed a panel of 38 psychiatrically normal controls for both 5-HH markers. When compared to this control panel, no significant differences were seen for either 5-HTT marker among the compulsive buyers.

Psychiatric illness in the first-degree relatives of persons reporting multiple chemical sensitivities:

The multiple chemical sensitivities (MCS) syndrome is characterized by unexplained physical and psychiatric complaints attributed by patients and some of their physicians to low-level chemical exposures. In this study, we interviewed 15 subjects with MCS and 21 controls about their first-degree relatives using the Family History-Research Diagnostic Criteria (FH-RDC). Subjects with MCS were more likely than controls to report their relatives to have major depression, alcoholism, panic disorder, obsessive-compulsive disorder, and antisocial personality disorder. They were also likely to have past suicide attempts, and to have received some form of psychiatric treatment (hospitalization, medication or electroconvulsive therapy, or counseling). Nearly 30% of the relatives of subjects with MCS were reported to have MCS themselves. Possible reasons for the findings are discussed.

Acute Treatment Response in Outpatients with Panic Disorder: High Versus Low Depressive Symptoms

The authors studied 75 outpatients with DSM-III-R panic disorder who had participated in a clinical trial and had been randomly assigned to receive fluvoxamine, cognitive therapy, or placebo for an 8-week period. They compared a group with high levels of depressive symptoms and a group with low levels of depressive symptoms. At baseline, patients with high levels of depressive symptoms were more likely to have severe phobic avoidance and to have higher scores on measures of anxiety, hyochondriasis, and disability. An important finding was that depressive symptoms improved at a rate which paralleled improvement in panic and anxiety. Likewise, the presence of depressive symptoms did not interfere with treatment response in panic disorder. Clinical implications of the findings are discussed.