Chronic stress and major depression.

Six-month and lifetime rates of DSM-III major depressive disorder (MDD) and characteristics of the disorder were compared in mothers of children with disabilities (chronic stress sample, n = 310) and in a geographically based probability sample (controls, n = 357). The presence of DSM-III MDD was ascertained by the National Institute of Mental Health Diagnostic Interview Schedule. Although mothers in the chronic stress sample had significantly more depressive symptoms, rates of MDD were not significantly different in the two samples.

Very low birth weight infants: effects of brain growth during infancy on intelligence quotient at 3 years of age.

To evaluate the role of postnatal growth on IQ at 3 years of age, 139 appropriate for gestational age, very low birth weight infants (less than 1.5 kg) born in 1977 and 1978 were studied at 40 weeks (term), and at 8, 20, and 33 months (corrected) of age. Weight, height, and head circumference were measured at each age, neurologic status was measured at 20 months, and Stanford Binet IQ at 33 months.

Relationship of estrogen and pregnancy to calcium homeostasis in pseudohypoparathyroidism.

The relationship of estrogen administration and pregnancy to vitamin D metabolism and Ca homeostasis was examined in two young women with pseudohypoparathyroidism. Estrogen, which is believed to inhibit PTH-mediated bone resorption, caused a consistent dose-related reversible reduction of serum Ca in these patients. This finding supports the concept that PTH-mediated bone resorption may contribute to the maintenance of serum Ca in normocalcemic pseudohypoparathyroidism.

Human placental production of 1 alpha,25-dihydroxyvitamin D3: biochemical characterization and production in normal subjects and patients with pseudohypoparathyroidism.

Biochemical characterization of placental 25-hydroxyvitamin D3-1 alpha-hydroxylase was performed in placentas from eight normal women. Production of 1,25-dihydroxyvitamin D3 [1,25-(OH)2D3] was linear with time; the mean production rate was 282 +/- 74 (+/- SE) pg/mg protein X h. Only the fetally derived trophoblasts had significant 1 alpha-hydroxylase activity, and this was located solely in mitochondria.

Evidence for normal antidiuretic responses to endogenous and exogenous arginine vasopressin in patients with guanine nucleotide-binding stimulatory protein-deficient pseudohypoparathyroidism.

In six patients with pseudohypoparathyroidism (PHP) who were deficient in guanine nucleotide-binding stimulatory protein (Ns) activity, the response to endogenous arginine vasopressin (AVP) was tested during water deprivation. Hourly plasma osmolality (Posm), urinary osmolality (Uosm), and urinary AVP (UAVP) values were compared to those in normal subjects. The Uosm vs.

Refining DSM-III criteria in Major Depression. An assessment of the descriptive validity of criterion symptoms.

In this study we estimate the power of DSM-III Major Depression (MDD) symptoms to discriminate MDD from (1) Generalized Anxiety Disorder (GAD) and (2) no disorder. The NIMH-DIS was administered to 319 women exposed to chronic stress (all were mothers of disabled children). Two methods were used: (1) conditional probabilities, and (2) multiple regression analysis.

DSM-III generalized anxiety disorder: an empirical investigation of more stringent criteria.

The diagnoses of generalized anxiety disorder (GAD) according to DSM-III and according to revised criteria (requiring 6 months' duration and 6 symptoms) were determined by the use of the National Institute of Mental Health Diagnostic Interview Schedule in a probability sample of 357 women. The DSM-III GAD lifetime rate of 45% was reduced by a factor of five when the revised definition was applied. The reduction was due chiefly to the longer duration criterion.

Depressive symptoms, major depression, and generalized anxiety: a comparison of self-reports on CES-D and results from diagnostic interviews.

This study evaluates the validity of the Center for Epidemiologic Studies Depression Scale (CES-D) by comparing it to DSM-III diagnoses of major depression and generalized anxiety, using the National Institute of Mental Health Diagnostic Interview Schedule (DIS). Data were gathered on a sample of 310 mothers of children with chronic disabilities. The utility of the CES-D for detecting major depression was approximately equal to its utility for detecting generalized anxiety.

Psychological disturbance in children with physical disabilities: continuity and change in a 5-year follow-up.

This study measures continuity in behavioral disturbance over a 5-year period among 255 children with physical disabilities who were 6 to 18 years old at first assessment. The pattern of the results differed from that reported previously for a sample of the general population of children. Disabled children showed little stability in aggression, an area in which stability over time had been consistently reported for the general child population.

Use of health services by chronically ill and disabled children.

Hospitalization and use of outpatient health care services during a 1-year period by 369 pediatric patients with cystic fibrosis, cerebral palsy, myelodysplasia, or multiple physical handicaps and 456 randomly selected children without congenital conditions from the Cleveland area were examined. Use of hospitalization and outpatient services by the average chronically ill or disabled child was 10 times that of the average comparison child. Physician specialists, occupational and physical therapists, and school nurses were the major outpatient categories used disproportionately by children with chronic illnesses or disabilities.

Hypercalcemia associated with increased serum calcitriol levels in three patients with lymphoma.

A radioreceptor assay for serum 1,25-dihydroxyvitamin D (calcitriol) was used to screen patients with hypercalcemia of malignancy. Three patients with non-Hodgkin's lymphoma and hypercalcemia (serum Ca, 12.0, 13.

Evidence for bone remodeling but lack of calcium mobilization response to parathyroid hormone in pseudohypoparathyroidism.

Twenty-eight patients with hypoparathyroidism were classified into PTH-deficient (HP; n = 14) or PTH-resistant [pseudohypoparathyroid (PHP); n = 14] groups on the basis of serum PTH level and urinary cAMP response to PTH infusion. Bone density (BD; bone mineral content/bone width) was determined by 125I photon absorptiometry in the distal third of the radius of each patient. After 3 days of equilibration on a constant diet, fasting serum Ca, 1,25-dihydroxyvitamin D [1,25-(OH)2D] and 24-h urinary hydroxyproline (OHP) were measured during 4 control days and 4 treatment days [Lilly Parathyroid Extract (PTE); 100 U, im, every 6 h].

The psychological study of chronically ill and disabled children: are healthy siblings appropriate controls?

This study examined the appropriateness of siblings as controls in the psychological assessment of children with chronic illness or disability. Findings from 304 cases and 360 randomly selected controls were compared to findings from a subset of 206 case-sibling pairs. Cases were children 6 to 18 years of age with cystic fibrosis, cerebral palsy, myelodysplasia, and multiple handicaps, selected from specialty clinics in two teaching hospitals in the Cleveland area.

Distance and contacts: interactions of black urban elderly adults with family and friends.

Distance is the major factor determining the frequency of social interaction with family and friends for elderly whites. Age, sex, marital status, length of residence, and income also affect the number of social contacts. These relationships have not been studied for elderly blacks.

Care of disabled children and women's time use.

Previous research has estimated the effect of children's health care needs on women's market and nonmarket roles. This article reports the results of a study on the impact of health care for disabled children on women's nonmarket work. (Effects on women's market work are reported elsewhere.

Lack of effect of salt intake on urinary uric acid excretion.

Although it has been established that acute expansion of the extracellular fluid volume results in enhanced uric acid clearance, the effect of chronic volume expansion by a high salt diet on urinary uric acid excretion has not been examined. Eleven normal subjects were placed on a constant diet containing 10 mEq. sodium per day for 10 days, followed by 240 mEq.

Access of the black urban elderly to medical care.

Access to medical care of 492 black urban respondents 60 years of age and older was measured in a house-to-house survey in a large midwestern city. Of those in this study, 93 percent indicated that they had a regular source of medical care, and 88 percent reported a visit to a physician or clinic within the past year. These percentages are higher than those reported for the general population of elderly people in the United States.

The role of dietary sodium on renal excretion and intestinal absorption of calcium and on vitamin D metabolism.

Earlier studies have shown that an oral sodium (Na) load may induce hypercalciuria in previously normocalciuric subjects and may also increase intestinal calcium (Ca) absorption. To probe the cause of the increased intestinal Ca absorption, we simultaneously measured parathyroid function, serum 1,25-dihydroxyvitamin D [1,25-(OH)2D], and fractional intestinal 47Ca absorption before and after a salt load. Eleven normal subjects and two patients with postsurgical hypoparathyroidism were placed on a 10 meq Na, 400 mg Ca per day diet for 10 days, followed by another 10-day period in which the same diet was supplemented by 240 meq Na daily.

Psychological distress in mothers of disabled children.

We examined the impact of child disability on psychological distress in mothers, by comparing scores on two indexes of psychological distress of 369 mothers of children with cystic fibrosis, cerebral palsy, myelodysplasia, or multiple physical handicaps, with those of 456 mothers from a randomly selected sample of families ("control" subjects). Mothers of disabled children scored significantly higher than control subjects on both indexes of psychological distress. This finding persisted when the mothers' education, family income, and racial composition were controlled for.

Deficiency of hormone receptor-adenylate cyclase coupling protein: basis for hormone resistance in pseudohypoparathyroidism.

Pseudohypoparathyroidism is an inherited disorder associated with resistance to the action of several hormones, including parathyroid hormone, thyroid-stimulating hormone, follicle-stimulating hormone, and luteinizing hormone. The disorders described under this designation are heterogeneous in regard to the underlying genetic defects, the phenotypic manifestation, and the severity of the defects in hormone action. The majority of affected individuals who also have the characteristic skeletal changes (heredity osteodystrophy) have a defect in the guanine nucleotide regulatory protein (G protein) that is essential for coupling certain cell-surface hormone receptors to the adenylate cyclase system.