Russell T. Joffe's research while affiliated with Staten Island University Hospital and other places

Publications (268)

Article
Full-text available
There is a well-established relationship between alterations of various hormonal systems and psychiatric disorders, both in endocrine and psychiatric patients. This has led to clinical and research studies examining the efficacy of the different hormones for treatment of depression. These data will be reviewed with particular regard to the thyroid,...
Chapter
The relationship between clinical thyroid disease and psychiatric symptoms and disorders is well established. The relationship between alterations of thyroid function and primary mood disorders is more complex. While various abnormalities of the thyroid axis have been identified, none is specific for depression and there is no clear evidence that t...
Article
This is a study of the metabolic and distal cardiovascular/cerebrovascular outcomes associated with the use of second-generation antipsychotics (SGAs) compared to antidepressants (ADs) in adults aged 18-65 years, based on data from Thomson Reuters MarketScan® Research Databases 2006-2010, a commercial U.S. claims database. Interventions included cl...
Article
To discuss the approach to the isolated finding of an elevated thyrotropin (TSH) level on routine biochemical screening of a depressed patient. A focused literature review as well as discussion of published clinical guidelines and the formulation of a rational clinical approach. Screening for thyroid dysfunction is part of the routine assessment of...
Article
Objectives: To perform a critical review of the literature on the mood and cognitive changes associated with subclinical hypothyroidism (SCH), with an emphasis on older adults. To evaluate these data against the Consensus Statement on the management of SCH from the American Association of Clinical Endocrinologists, the American Thyroid Association...
Article
Full-text available
There is a well-established relationship between alterations of various hormonal systems and psychiatric disorders, both in endocrine and psychiatric patients. This has led to clinical and research studies examining the efficacy of the different hormones for treatment of depression. These data will be reviewed with particular regard to the thyroid,...
Article
Full-text available
An abstract is unavailable. This article is available as HTML full text and PDF.
Article
The relationship between the thyroid axis and psychiatric symptoms and disease is well established. In particular, clinical hypothyroidism leads to depressive symptoms which resolve with replacement therapy. The relationship between alterations of thyroid function and primary major depression is more complex. While various abnormalities of the thyr...
Article
Bilateral reductions in the volume of the anterior cingulate cortex have been reported in patients with major depressive disorder (MDD) when compared with findings in healthy controls. We compared regional brain volumes in the subgenual prefrontal cortex (SGPFC; Brodmann area (BA) 24(sg)), subcallosal gyrus (BA25) and paracingulate gyrus (BA32) in...
Article
Altered hippocampal volume, the brain-derived neurotrophic factor (BDNF) Val66Met polymorphism, and neuroticism have each been implicated in the etiology of psychiatric disorders, especially depression. However, the relationship between these variables is not well understood. Here, we determined the effects of the BDNF Val66met polymorphism on the...
Article
There is a current argument in thyroidology about whether the normal range for basal thyrotropin (TSH) is too broad. Some groups suggest that a TSH of less than 2.5 mIU/L is a better cut-off for euthyroidism. Because major depression is associated with changes in thyroid hormone status and thyroid hormones may be an effective treatment for major de...
Article
A functional polymorphism of the brain-derived neurotrophic factor, BDNF Val66Met, is associated with risk for major depression alongside impairments in memory and selective attention. This study aims to identify the mediating neural mechanisms in links between BDNF and depression using highly heritable electroencephalographic (EEG) recordings. In...
Article
Objective: The aim of this paper is to review outcome in patients with bipolar disorder as assessed by interepisode level of functioning, as until recently this dimension of outcome has been relatively under-emphasized. Method: Studies that examined psychosocial outcome in bipolar disorder were reviewed on the basis of rating measurements employed,...
Article
The hippocampus (HC) is smaller in patients with recurrent major depressive disorder (MDD), but few longitudinal studies have examined whether volume is associated with clinically meaningful outcomes such as response to treatment. We compared regional (head and body/tail) HC volumes in 46 patients with MDD, 14 of whom remitted after 8 weeks of firs...
Article
Patients with mood disorders have higher rates of obesity than the general population. With respect to this, little is known regarding how patient look like prior to treatment or the rates of change. To identify changes in the rates of obesity in never-treated patients with mood disorder over 4 years of follow-up. Sixty-six never-treated patients w...
Article
Increasing financial pressures, along with a desire to realign resources with institutional priorities, has resulted in the adoption of mission-based funding (MBF) at many medical schools. The lack of inclusion of quality and the time and expense in developing and implementing mission based funding are major deficiencies in the models reported to d...
Article
Full-text available
The anterior cingulate cortex (ACC) is implicated in the cognitive and affective abnormalities observed in mood disorders. Bilateral ACC volume reductions have been reported in patients with major depressive disorder (MDD) when compared to healthy controls. We compared regional brain volumes in the subgenual prefrontal cortex (SGPFC; Brodmann area...
Article
Full-text available
The aim was to evaluate whether adjunctive T3 can help accelerate the antidepressant response and improve overall outcomes when used under naturalistic conditions. Fifty consecutive psychiatric outpatients diagnosed with major depressive disorder who were initiated on antidepressant therapy were randomized to receive adjunctive T3 or placebo in a d...
Article
Despite increasing awareness of the extent and severity of cognitive deficits in major depressive disorder (MDD), trials of cognitive remediation have not been conducted. We conducted a 10-week course of cognitive remediation in patients with long-term MDD to probe whether deficits in four targeted cognitive domains, (i) memory, (ii) attention, (ii...
Article
Major depression is a chronic disorder with a high morbidity and mortality. Approved treatment for major depression at present includes monotherapy with antidepressants of different pharmacologic classes. There is increasingly widespread use of two other options: augmentation, the addition to an antidepressant of a second compound that is not an an...
Article
Full-text available
Thyroxine is the standard replacement therapy for patients with clinical hypothyroidism. However, there has been recent interest in examining the potential advantages of combined thyroxine and triiodothyronine treatment for the treatment of hypothyroidism. The authors review the nine studies to-date and conclude that the variability and limitations...
Article
This link between the thyroid and depres- sion 1,2 provided optimism that study of the thyroid axis in unipolar depression would unravel the mystery of the etiol- ogy of the disorder. An enormous research effort over the last 50 years 3 failed to achieve this goal but, nonetheless, produced some important findings. First, the vast majority of patie...
Article
To evaluate the relative benefits of the combination of lithium and triiodothyronine (T3) in augmentation of antidepressants, compared with either lithium or T3 alone. We performed a 2-week, randomized, double-blind, placebo-controlled pilot study of the addition of lithium compared with T3 compared with the combination of both in subjects with maj...
Article
To examine the risk of relapse into mania or depression with varying duration of antidepressant treatment in a cohort of 59 patients with bipolar disorder. An open naturalistic evaluation using life charting methods of patients with 1 year follow-up, who responded to antidepressant treatment and who then less or more than 6 months of antidepressant...
Article
Substitution of T4 with T3 for T4 replacement in patients with hypothyroidism was undertaken using a randomized placebo controlled study design. Forty individuals were included who had depressive symptoms on stable doses of levothyroxine. Combined T4 plus T3 did not have a significantly different effect on mood and well-being scores than did T4 alo...
Article
Full-text available
There are few data addressing the effect of alcohol consumption on response to antidepressants among nonalcoholics with depression. Similarly, the effect of antidepressant treatment on alcohol consumption in this group is not yet understood. This study focuses on changes in depressive symptoms and alcohol consumption in response to treatment with d...
Article
There is a recent appreciation that patients with bipolar disorder spend a substantial period of time with minor or subsyndromal mood symptoms both manic and depressive. This study examined time spent in minor and subsyndromal mood states as well as with mania and depression in a cohort of well characterized bipolar I and II patients who were follo...
Article
Many patients with bipolar disorder (BD) do not regain full function following an acute illness episode, but the extent to which this impairment is the result of persistent symptoms has not been well established. This study examined factors associated with persistent subsyndromal symptoms in a well characterized group of BD patients who were prospe...
Article
Endocrine disorders are associated with significant psychiatric morbidity. Psychiatric symptoms may manifest as discreet psychiatric syndromes or, more commonly, with a heterogenous group of nonspecific symptoms. Research is needed to understand the relations between hormone excess or deficiency and alterations of mood, cognition, and perception. I...
Article
Some hypothyroid patients receiving levothyroxine replacement therapy complain of depressive symptoms despite normal TSH measurements. It is not known whether adding T(3) can reverse such symptoms. We randomized 40 individuals with depressive symptoms who were taking a stable dose of levothyroxine for treatment of hypothyroidism (excluding those wh...
Article
Few studies have examined the question of how personality features impact outcome in bipolar disorder (BD), though results from extant work and studies in major depressive disorder suggest that personality features are important in predicting outcome. The primary purpose of this paper was to examine the impact of DSM-IV personality disorder symptom...
Article
Full-text available
Studies have examined hippocampal function and volume in depressed subjects, but none have systematically compared never-treated first-episode patients with those who have had multiple episodes. We sought to compare hippocampal function, as assessed by performance on hippocampal-dependent recollection memory tests, and hippocampal volumes, as measu...
Article
There are limited systematic data on psychotherapeutic approaches to the treatment of bipolar depression. These will be reviewed according to types of therapy applied. These include individual psychotherapy, psychoeducation, cognitive behavior therapy, marital and family therapy, interpersonal and social rhythm therapy, and group psychotherapy. Alt...
Article
The authors review studies examining relationships among depression, sex, and thyroid function, and the possible association of thyroid dysfunction and depression related to women's reproductive phases.
Article
The treatment of bipolar depression is a significant clinical problem that remains understudied. The role for antidepressant (AD) agents vs. mood stabilizers has been particularly problematic to ascertain. Detailed life charting data from 42 patients with 67 depressive episodes were reviewed. Response rates and rates of switch into mania were compa...
Article
To assess the effect of different antidepressants on induction of mania and cycle acceleration, commonly accepted unwanted effects of antidepressant treatment for acute bipolar depression. There is, however, the suggestion that certain classes of antidepressants may be less likely than others to cause these unwanted effects. We conducted a prospect...
Article
Fifty-eight outpatients with major depression completed the NEO Personality Inventory at intake (time 1) and after up to three months of anti-depressant treatment (time 2). Within this group, 26 patients met additional Research Diagnostic Criteria for chronic minor depression. Repeated-measures analyses revealed significant decreases in Neuroticism...
Article
Neuropsychological studies have suggested that memory systems reliant on medial temporal lobe structures are impaired in patients with depression. There is less data regarding whether this impairment is specific to recollection memory systems, and whether clinical features predict impairment. This study sought to address these issues. A computerize...
Article
Objective: To examine the relationship between number of episodes and inter-episode functioning in bipolar disorder.Method: Sixty-four euthymic subjects with bipolar affective disorder completed the Medical Outcomes Questionnaire Short Form and the Global Assessment of Functioning Scale. Goodness-of-fit models were used to define the relation betwe...
Article
Full-text available
A. T. Beck (1983) has proposed the existence of two personality dimensions, sociotropy and autonomy, as specific and influential factors in the onset, course, and treatment of major depression. In this study, the stability and discriminant validity of the Revised Personal Style Inventory (PSI-II), a measure designed to assess the sociotropy and aut...
Article
Several studies have suggested that visual backward masking (VBM) impairment is present in patients with bipolar disorder, but the clinical features, such as current symptoms, treatment status and past burden of illness that may contribute to the impairment have not been well described. This study examined well-characterized euthymic patients on tw...
Article
Bipolar disorder (BD) is a common disorder that results in significant psychosocial impairment, including diminished quality of life and functioning, despite aggressive pharmacotherapy. Psychosocial interventions that target functional factors could be beneficial for this population, and we hypothesized that the addition of group cognitive behavior...
Article
The aim of this paper is to review outcome in patients with bipolar disorder as assessed by interepisode level of functioning, as until recently this dimension of outcome has been relatively under-emphasized. Studies that examined psychosocial outcome in bipolar disorder were reviewed on the basis of rating measurements employed, length of follow-u...
Article
To examine the use of fluoxetine in an adult population in Saskatchewan. All adults in the Saskatchewan health care databases who had begun fluoxetine therapy between January 1992 and June 1996 and had not received an antidepressant in the six months before the index fluoxetine prescription were identified. Fluoxetine use for the subsequent six-mon...
Article
Full-text available
Being female and having comorbid anxiety are both thought to increase suicidality in patients with major depression. Whether these effects are independent or related to severity of depression is not known. We conducted a retrospective review of 533 patients (190 men, 343 women) with major depression at the time of assessment. Suicidal ideation was...
Article
The relationship between basal thyroid hormone levels and acute antidepressant response has been studied, but any relationship between basal thyroid hormone levels and long-term course of depressive illness has not been evaluated. The authors used a Cox regression survival analysis to evaluate the relationship between life course of depressive illn...
Article
To examine estimates of lifetime prevalence of seasonal affective disorder (SAD) in Toronto, Ontario. Random telephone numbers were generated for the city of Toronto, and 781 respondents completed a telephone interview. Trained nonphysician interviewers conducted all interviews, which involved structured questions for diagnosing major depression. P...
Article
Full-text available
The current study aimed to assess the role of self-criticism and dependency in response to cognitive therapy (CT) or pharmacotherapy (PT). It was hypothesized that (a) self-criticism would moderate treatment outcome to CT and PT, and (b) the degree of change in self-criticism and the relationship of this change to treatment response would be greate...
Article
A substantial number of depressed patients will fail to respond to standard antidepressant therapy. Thyroid hormones, particularly T3, may be particularly useful in enhancing response to antidepressants. This review focuses on the use of T3 augmentation in unipolar major depression. The study clearly suggests that approximately half of patients wil...
Article
To examine the relationship between number of episodes and inter-episode functioning in bipolar disorder. Sixty-four euthymic subjects with bipolar affective disorder completed the Medical Outcomes Questionnaire Short Form and the Global Assessment of Functioning Scale. Goodness-of-fit models were used to define the relation between episode number...
Article
Impaired distractor inhibition may contribute to the selective attention deficits observed in depressed patients, but studies to date have not tested the distractor inhibition theory against the possibility that processes such as transient memory review processes may account for the observed deficits. A negative priming paradigm can dissociate inhi...
Article
The purpose of this study was to evaluate the efficacy and safety of mexiletine, a medication with antiarrhythmic, anticonvulsant and analgesic properties, in treatment-resistant bipolar disorder patients. Twenty subjects with rapid-cycling bipolar disorder who had failed to respond or were intolerant to lithium, valproic acid and carbamazepine wer...
Article
This study further examined the diagnostic specificity of the self-critical personality dimension, as measured by the Depressive Experiences Questionnaire (DEQ; Blatt et al., 1976. The Depressive Experiences Questionnaire. Yale University Press, New Haven). Patients with major depression (n=26) were compared to social phobia patients (n=32). Depres...
Article
Full-text available
This study's purpose was to clarify the appropriate treatment of bipolar depression by comparing the addition of an antidepressant versus a second mood stabilizer for inpatients being treated with lithium carbonate or divalproex sodium. Twenty-seven patients were randomly assigned to groups that received double-blind treatment with paroxetine or a...
Article
Full-text available
In this study we examined whether the factor structure and traits of the five-factor model of personality (FFM), derived from non-clinical samples, could be replicated in a sample of psychiatric patients. The revised NEO Personality Inventory (NEO PI-R) was administered to a study group of psychiatric patients ( n = 176). The test scores from these...
Article
Response style theory of depression (RST) predicts that individuals who ruminate in response to their depressed mood will suffer an amplification and prolongation of that mood, whereas individuals who engage in distraction responses will alleviate and attenuate their depressed mood. RST has been shown to predict prolonged depression in samples of n...
Article
Recent evidence suggests that the combination of fluoxetine and desipramine may provide a rapid and effective treatment for depression. The current study evaluated 13 subjects with DSM-III-R nonpsychotic major depression who had previously failed either desipramine or imipramine and who were currently unsuccessfully treated with fluoxetine. Desipra...
Article
To evaluate the efficacy of gabapentin as an adjunctive treatment for bipolar disorder in both depressed and manic phases. Thirty seven patients with bipolar type I or II with or without a rapid cycling course were openly treated with gabapentin added to current treatment for up to six months. Mood symptoms were rated weekly for 12 weeks then month...
Article
The current approach to mood disorders is that bipolar disorder, comprising both mania and depression, is a discreet illness distinct from unipolar depression. This formulation has profoundly influenced the approach to understanding the biology and etiology of these disorders, as well as the manner in which the various phases of bipolar disorder ar...
Article
Full-text available
Current series of depression suggests that episodes of major depression sensitize a patient to further episodes so that the illness adopts a recurrent course. This suggested pathophysiological process may also lead to increased risk of treatment resistance and a chronic course of illness. This hypothesis has received little empirical support and, i...
Article
Recent investigations suggest that serotonergic mechanisms modulate dimensions of personality, in particular decreases in Anger-Hostility and increases in Affiliation. None of these studies, however, demonstrated a specific serotonergic effect on personality, as other neurotransmitter systems have not been assessed for their impact on these persona...
Article
To assess the family-of-origin characteristics of patients with bipolar disorder relative to those of control subjects. Fifty-six euthymic patients meeting research diagnostic criteria for bipolar disorder and 21 control subjects completed the Family Environment Scale (FES) for the family they grew up with. The 2 groups showed strikingly similar pr...
Article
Various abnormalities of thyroid function have been inconsistently reported in major depression. The inconsistency between studies may be due to several factors including the stage of treatment resistance. One hundred and one patients with major depressive disorder receiving their first antidepressant for their current major depressant episode had...
Article
To evaluate the relationship between the degree of antidepressant nonresponse and subsequent response to lithium and triiodothyronine (T3) augmentation. This is a retrospective analysis of data combined from two previous controlled studies of lithium and triiodothyronine augmentation of tricyclic antidepressants. There was no difference in the rate...
Article
Antidepressants are one of the most effective treatments for major depressive disorder. However, despite optimal treatment, a substantial number of patients, up to 50%, may have a partial or no response to the first antidepressant used. In such cases, several options are available. These include substitution of the first antidepressant with a secon...
Article
The purpose of this study was to investigate the relationship between cognitive disability and performance of daily living skills and stability of cognitive level after discharge in a sample of adult psychiatric inpatients (N = 40). The Allen Cognitive Level Test-90 (ACL-90) was administered at time of discharge (Time I) and at 21 days to 28 days a...
Article
In experimental animals, exposure to uncontrollable stress induces a number of behavioral and biochemical changes that resemble symptoms seen in human depression and other psychiatric conditions. The present study used a yoked design to examine the effects of uncontrollable footshock stress on brain thyroid hormones in male and female rats. Animals...
Article
To evaluate the adequacy of the reports of methodological and statistical aspects of randomized, controlled trials that evaluate antidepressant medications and the degree to which their results can be used in subsequent metaanalyses. Randomized, controlled trials published in English that compared 2 antidepressant drugs with a placebo were reviewed...
Article
Studies to date suggest that venlafaxine is effective, well tolerated, and safe in a broad spectrum of patients. We examined the clinical utility and tolerability of venlafaxine in patients treated by community-based psychiatrists and family physicians in a naturalistic clinical setting. Nineteen physicians each recruited 10 to 20 physicians to enr...
Article
Antidepressant response is associated with a rise in red cell folate (RCF) and a reduction in thyroxine (T4). Since T4 levels may directly influence folate status, it is possible that the increase in folate with recovery results from the decline in T4. To examine the possible role of thyroid hormones in the observed change in folate status during a...
Article
Background: The importance of gender on the course and outcome in bipolar disorder (BD) has been widely acknowledged. The limited data suggest that the prevalence is similar between sexes but that the course of illness may be different. This study investigated gender differences in a clinic sample of patients with BD including a measure of subject...
Article
Full-text available
There is emerging evidence of serotonergic dysfunction in patients with seasonal affective disorder (SAD). We examined central serotonergic function in female patients with SAD (fall-winter pattern) by means of neuroendocrine and subjective responses to the postsynaptic serotonin receptor agonist m-chlorophenylpiperazine. Using a double-blind, rand...
Article
Full-text available
The revised Personal Style Inventory (PSI) was developed to measure the sociotropy and autonomy personality dimensions; both of these dimensions are thought to confer specific vulnerabilities to the onset, maintenance, and reoccurrence of depression. Confirmatory factor analysis was used to test the theoretical structure that informed the construct...
Article
Despite methodological flaws that limit conclusions, a considerable database documents the efficacy of triiodothyronine (T-3) as an augmentation strategy for response to various classes of antidepressants. One study suggests that T-3 and lithium are of comparable efficacy in antidepressant nonresponders. No clear biochemical or clinical predictors...
Article
To determine whether the chronological relationship between the onset of dysthymia and the onset of the first major depression influences treatment outcome in patients with double depression (DD). Clinical and outcome measures previously collected in 77 consecutive outpatients who presented with major depression and who had pre-existing dysthymia (...
Article
Full-text available
Critics have argued that personality factors believed to represent a vulnerability to depression are not stable and are therefore state dependent. However, conclusions regarding the stability of personality and the relation between personality and depression have been drawn (a) without differentiating relative stability among individual differences...

Citations

... The 550 Canadians among them include Simon Young, coeditor-in-chief of JPN. 11 But even this effort has failed, as few journals have bent to the pressure. Recently, the Public Library of Science initiative has launched an appeal for funds to start its own electronic-only journals. ...
... A large population-based study also reported that the mean serum TSH level was higher in females than males (40). A possible explanation for the lower TSH level in males is that males are more likely to have blunted response to TRH stimulation (41). In addition, the negative correlation between serum FT3 and FT4 levels and the TSH level might explain why FT3 and FT4 levels were lower among females. ...
... MetS prevalence is 2-3 times greater in people with schizophrenia or bipolar disorder compared to the general population [12]. A growing body of evidence suggests SMI and MetS share certain pathological features, including hypothalamic-pituitary adrenal and mitochondrial dysfunction, neuroinflammation, common genetic links as well as epigenetic interactions [13][14][15][16][17]. Despite this well recognised risk for cardiovascular diseases among people with SMI, there is limited access to health care with less opportunity for cardiovascular risk screening and prevention for this group of patients than would be expected in a non-psychiatric population. ...
... In addition, TSH secretions are theoretically sensitive to very small changes in serum FT4, which means that TSH changes could occur during early-stage hypothyroidism even before FT4 abnormalities are detectable (27). However, in practice, TSH concentrations are influenced by numerous factors, including age, race, sex (28), acute illness, renal insufficiency, medications (29), pregnancy (30), depression (31), and anorexia nervosa (32). Meanwhile, between-assay differences and variations in reference ranges can directly impact the diagnosis and management of subclinical hypothyroidism (33). ...
... The items had a six-point answer scale from totally disagree to totally agree. In the present study, we discarded the four items about Perfectionism/Self-Criticism (see Bagby et al., 1998;Desmet et al., 2010). Van Geel et al. (2016) examined the correlational structure of a combined set of ASQ and PSI items in two nonclinical samples (N = 661, N = 528). ...
... 1 3 fluctuate independently in an uncorrelated manner [6], there have been calls to consider whether mania and depression can be considered to be separable syndromes within bipolar disorder [7]. Taken together, it seems important to consider whether the social environment has direct contributions to the course of mania, and to examine which facets of the social environment are relevant. ...
... Both potentially reversible remodelling and irreversible cell death is likely to be caused by dysregulation of glucocorticoid secretion and elevated activity of excitatory amino-acid neurotransmitters (McEwen, 1999 ;Sapolsky, 2002). Dysregulation of the HPA axis is a common feature of depression in humans (Young et al., 1994) and the hippocampus is implicated in the pathophysiology of depression by a number of preclinical (Sapolsky, 2002), neuroimaging (Sheline, 2000) and neuropsychological studies (MacQueen et al., 2002). Thus it is plausible that the stress of early maternal separation, which leads to longstanding changes in the HPA axis, might also be associated with changes in hippocampal integrity. ...
... The S-QoL 18 was lower in female (statistical trend in our study), low education level (statistical trend in our study), single, and unemployed patients [34]. Robb et al. reported gender differences in QoL scores; women possessed numerically lower scores in different dimensions except for mental health, with significant differences in the domains of pain and physical health [47]. Educational level, social disadvantage, and unemployment were reported to be at greater risk for improvement in quality of life and functioning [34,48]. ...