Kerrin White

Religion and guilt in OCD patients

Abstract The present study examined the relationships among type and severity of obsessive-compulsive symptoms, types of religious practice and upbringing, degree of religiosity, and guilt. Subjects were 33 OCDs and 24 patients with other anxiety disorders. Findings indicated that no type of religion was more prevalent among OCD patients than other groups. OCDs were not significantly more religious or more guilty than other anxious subjects. Nonetheless, severity of OCD pathology was positively correlated with both religiosity and guilt, whereas moodstate was not. Social anxiety was associated with guilt but not with religiosity. OCDs who were more religious more often reported religious obsessions, but not sexual or aggressive ones. Guilt was not related to any type of obsession. As expected, greater religious devotion was related to more guilt in OCDs, but not in other anxiety patients. The relationship between religion, guilt, and OCD symptoms is discussed and suggestions for further research are proposed.

Combined MAOI-tricyclic antidepressant treatment: a reevaluation.

Recent studies have shown that monoamine oxidase inhibitors (MAOIs), in appropriate patients and with proper precautions, are not as dangerous as once thought, especially in comparison to alternative antidepressants. We review the literature regarding the combined use of MAOIs and tricyclic antidepressants, which has been reported to be both highly toxic and highly effective. A large number of reports of adverse effects and their management, uncontrolled clinical trials, and animal studies are summarized. We also discuss the three controlled studies of combined MAOI-tricyclic therapy that have been undertaken. We conclude that the hazards of combination therapy have been exaggerated and that MAOI-tricyclic therapy is a reasonable approach in patients found resistant to standard antidepressant treatment if certain precautions are observed.

Dermatological reactions to lithium: a critical review of the literature.

This article reviews clinical reports of dermatological reactions to lithium. Such reactions include maculopapular, acneiform, and follicular eruptions, psoriasis, and other manifestations. Standard psychiatric texts offer the psychiatrist little information concerning the prevalence or seriousness of these reactions, nor do they discuss the effectiveness of various treatment alternatives. More surprisingly, most dermatology texts do not even describe skin reactions to lithium. Dermatological reactions to lithium may occur more commonly than previously documented, but with the exception of some psoriatic cases, management without the need for lithium discontinuation is usually possible.

Cognitive bias in the articulated thoughts of depressed and nondepressed psychiatric patients

Becks cognitive theory of depression postulates several types of cognitive bias among depressed patients. Empirical studies supporting this hypothesis have usually used questionnaire “endorsement” measures of cognition, which may suggest responses to subjects. We used the articulated thoughts during simulated situations (ATSS) method of cognitive assessment in comparing cognitive processes of 15 outpatients with major depression with those of 15 nondepressed psychiatric outpatients in three simulated situations. Depressed patients exceeded nondepressed patients in cognitive bias only in the negative (not the neutral or positive) simulated situation. Discussion centered on the possible utility of ATSS for research on cognition in stressful situations.

Platelet monoamine oxidase inhibition by deprenyl and tranylcypromine: Implications for clinical use

From the Medical College of Pennsylvania at Eastern Pennsylvania Psychiatric Institute (G.M.S., E.P.), Philadelphia, PA; the University of Southern California School of Medicine, Department of Psychiatry and the Behavioral Sciences (E.F., R.P., R.B.S.), Los Angeles, CA; and McLean Hospital CK.W.), Belmont, MA. Address reprint requests to Dr. George M. Simpson, Eastern Pennsylvania Psychiatric Institute, 3200 Henry Avenue, Philadelphia, PA 19129. Received April 19, 1984; revised December 20, 1984. treatment. For example, the work of Robinson et al. (1978) and Georgotas et al. (1983) with phenelzine has suggested that antidepressant effects occur with dosages of about 1 mg/kg/day, or platelet MAO inhibition of >80%, and that the time course of enzyme inhibition parallels that of clinical improvement. However, MAOIs have other effects besides enzyme inhibition, and it is far from clear that this is the mechanism of overriding therapeutic importance (Hendley and Snyder 1968; Karoum et al. 1982). Even if it were, the key variable would presumably be brain MAO activity, and the use of platelet MAO as a model would still pose problems, For example, platelet MAO is almost exclusively of the B type, which is pref-

Electrocardiographc effects of tranylcypromine vs. amitriptyline

The authors compared ECG changes during the course of treatment with a tricyclic antidepressant (amitriptyline) or a monoamine oxidase inhibitor (tranylcypromine) in 22 adult psychiatric patients. Amitriptyline-treated patients showed increased heart rate, PR, QRS, and QTc intervals. Tranylcypromine-treated patients showed no significant changes in ECG parameters. The clinical significance of the differing pattern of ECG effects for tricyclic antidepressants and monoamine oxidase inhibitors is discussed.

Platelet MAO activity in depressed patients

A number of investigators have studied platelet monoamine oxidase (MAO, E.C.1.4.3.4) activity in schizophrenia, affective disorders, alcoholism and other psychiatric illnesses. Although some of these results are still controversial, the majority of studies have shown lower MAO activity in schizophrenia (Murphy, 1972, Wyatt, 1979) and in bipolar manic-depressive illness (Landowski, 1975) when compared with normal subjects. In contrast, higher than normal MAO activity has been reported mainly in depressed patients outside the bipolar group (Klaiber, 1972, Robinson, 1975, Landowski, 1977, Edwards, 1978, and Orsulak, 1978). However, patients with unipolar depression comprise a large, heterogeneous group, and which of these patients may show elevated enzyme activity remains a major question. In an attempt to answer this question, we have previously studied platelet MAO in nonendogenous depression and found that platelet MAO increased in female nonendogenous patients (White, et al., 1980). In order to confirm this finding, we have increased the number of nonendogenous patients from 35 to 75, and the total number of patients from 96 to 180 in this study.S