Russell Gardner

Mononuclear leukocyte glucocorticoid receptor binding characteristics and down-regulation in major depression

Some patients with major depressive disorder (MDD) have elevated plasma cortisol concentrations and show failure to suppress cortisol secretion upon administration of dexamethasone (DEX), yet they do not have Cushingoid features. To study whether this represents glucocorticoid (GC) resistance, [3H]-DEX-binding assays were used to measure, in vitro, the GC receptor affinity (1/Kd) and number (Bmax) in mononuclear leukocytes of 11 MDD patients and 15 control subjects. No receptor abnormalities were detected in the MDD group; thus any cellular defect leading to a lack of responsiveness to GC in the MDD patients, if present, probably lies beyond the initial receptor binding. DEX (1.0 mg orally) was administered to study in vivo GC receptor down-regulation. Compared to the control group, fewer depressed subjects down-regulated Bmax after DEX. By paired t-test, Bmax decreased significantly in the control group but not in the depressed group. Receptor number on the control day did not correlate significantly with the degree of receptor down-regulation, severity of depression or cortisol concentrations across all the subjects. These results do not lend support to previous reports suggesting that GC resistance in MDD results from a GC receptor-binding abnormality, and they emphasize the importance of considering receptor studies in the context of GC-mediated cell processes in order to identify the exact cellular defect(s) leading to GC resistance.

Glucocorticoid receptor binding in three different cell types in major depressive disorder: Lack of evidence op receptor binding defect

1. In order to further understand the apparent glucocorticoid resistance in major depressive disorder, circadian variation in cortisol concentration, dexamethasone suppression and glucocorticoid receptor binding in mononuclear leukocytes, polymorphonuclear leukocytes and cultured skin fibroblasts were measured in rigidly defined major depressive disorder patients and non-depressed psychiatric controls. 2. Mononuclear leukocytes binding to glucocorticoid correlated significantly with polymorphonuclear leukocytes binding to glucocorticoid, but both determinations failed to differentiate major depressive disorder and control subjects. 3. Initial and post-dexamethasone in vitro fibroblast binding to glucocorticoid was not different between major depressive disorder and non-depressed control subjects. 4. The phenomenon of glucocorticoid resistance in major depressive disorder remains unexplained.

Conceptual basis of animal models in psychiatry: A conference summary

Abstract Future progress in selected areas of psychiatric research will depend upon use of animal models. The incorporation of such models into clinical psychiatry needs to be done carefully and in a way not only consonant with descriptive psychiatry and cellular-molecular biology, but also with evolutionary biology and related fields. This report summarizes critical concepts of evolutionary biology that provide a framework for relating animal modeling research to clinical issues.

Long-term Evaluation of a Psychiatry Clerkship.

For over 14 years, students completing a psychiatry clerkship were asked to rate their educational experience. Comparisons were made across clinical assignment, length of rotation (6 vs. 8 weeks), and teaching modes. Consultation and acute services were rated higher than open adult or child/adolescent services. General units were rated higher than specialty units. Ratings were higher for 8-week rotations, and case conferences were preferred to lecture formats. Ratings were not significantly correlated with National Board of Medical Examiners examination scores, which were higher during years with 8-week rotations and case conferences. There was a tendency for students on the consultation and acute services to enter psychiatry residencies at a higher rate.

Gifted Students Meet the Institutionalized Elderly: Learning about Aging and the Aged in a Rural Nursing Home

Gifted eighth grade students in a rural Minnesota school district participated in a volunteer-run educational program simultaneously addressing their needs for an enhanced, stimulating educational experience and the needs of institutionalized elderly people for psychosocial stimulation. This article reports the successful impacts of the program on the students; students showed cognitive growth, and enjoyed interpersonal development through interactions with persons whom they would otherwise not encounter. The projects successes and problems encountered in its implementation are described within the framework of the developmental stages of groups.

Arjuna and Job: depression relieved by submission to gods - psychiatry and sacred texts

In the Bhagavad Gita, the hero Arjuna is in a bad situation in that he is required to fight an army composed partly of his mentors, relatives and friends. He has a panic attack and becomes depressed. Krishna advises him to fight, but he will not take Krishna’s advice. After 16 chapters of dialogue