Richard Rabkin - Academia.edu (original) (raw)

Papers by Richard Rabkin

American Journal of Psychiatry, 1963

American Journal of Psychiatry, 1968

The author discusses the similarities between the concepts of the "imponderables"—a gro... more The author discusses the similarities between the concepts of the "imponderables"—a group of weightless substances including heat, electricity, and love—of the 19th century—and the psychodynamic factors of the 20th century. He espouses a new concept of affect in which it is viewed not as a substance or as inner states of one person but as part of a process in which the tensions and emotions of the family and other natural groups are determined by the configuration and motion of their systems.

The American journal of psychiatry, 1968

The author relates Freud's theory of the unconscious to that of Descartes and compares both t... more The author relates Freud's theory of the unconscious to that of Descartes and compares both to C. S. Peirce's doctrine of "contrite fallibilism," which held that no knowledge is direct and intuitive—that all knowledge is subject to error. The author believes that anyone confined to insisting on the doctrine of the unconscious is limited in his ability to inquire and thus is impaired in his responsibility for learning and teaching. The consequences for therapy are also pointed out.

American Journal of Psychiatry, 1964

American Journal of Psychiatry, 1979

The choices of answers were those used for the Neurotic Distress Scale. 3. General Well-Being Sch... more The choices of answers were those used for the Neurotic Distress Scale. 3. General Well-Being Schedule.

American Journal of Psychiatry, 1966

Journal of Acquired Immune Deficiency Syndromes & Human Retrovirology, 1995

Our objective was to assess whether illness stage, markers of illness progression, and use of med... more Our objective was to assess whether illness stage, markers of illness progression, and use of medications believed to lower testosterone are associated with low serum testosterone in HIV+ men. Data were available for 234 HIV+ men screened for eligibility for a study of testosterone replacement therapy and/or an antidepressant trial. A screening interview was used to elicit demographic and medical information. Blood was drawn to measure markers of immunodeficiency and serum testosterone. Thirty-eight percent of the sample had testosterone levels below the normal range. Low testosterone was associated with lower CD4 cell count, later stage of illness, use of megestrol, and older age. Regression analysis showed that only age and use of such medications as megestrol were significant predictors of low testosterone. Given the prevalence of low testosterone in HIV+ men and its link to sexual dysfunction, more research is needed on treatments aimed at correcting or compensating for this hormonal deficiency as well as the study of the impact of such medications as megestrol on testosterone levels in older men.

Journal of Family Counseling, 1975

Psychiatric Services, 1983

Caring : National Association for Home Care magazine, 1995

AIDS is no longer an obscure, mystifying disease. However, it still carries with it many of the s... more AIDS is no longer an obscure, mystifying disease. However, it still carries with it many of the social stigmas that it did when the world was just learning about it. And along with those stigmas providers naturally see signs of depression. Depression in persons with AIDS can be treated either with psychotherapy or with medication. First, however, providers must recognize the signs of depression and focus on improving the quality of the patient's life.

The Journal of clinical psychiatry, 1994

To date, the efficacy of sertraline in treating depression in the context of human immunodeficien... more To date, the efficacy of sertraline in treating depression in the context of human immunodeficiency virus (HIV) has not been investigated, despite the agent's advantageous side effect profile, low toxicity with overdose, and lack of adverse effect on the cardiovascular system. This 8-week open trial addresses the efficacy of sertraline in the treatment of depressed HIV-infected persons, as well as its toleration and effects on immune status (T cells and natural killer cells). Eligibility criteria included a DSM-III-R diagnosis of major depression; among the exclusion criteria were substance abuse, dementia, and severe gastrointestinal complaints. Major outcome variables included the Hamilton Rating Scale for Depression, the Clinical Global Impressions scale, and laboratory tests measuring T cell subsets and natural killer cells. Twenty-seven gay men and 1 woman entered treatment; 20 completed 8 weeks. Fourteen (70%) of the completers were rated responders. Five of the 8 dropouts...

The Journal of clinical psychiatry, 1993

With no cure or vaccine for AIDS expected in the near future, researchers have tried to locate pr... more With no cure or vaccine for AIDS expected in the near future, researchers have tried to locate predictors of high-risk sexual activity and develop interventions that emphasize primary prevention and encouragement of safe sex. This study examines the roles of depression, feelings of hopelessness, relationship status, and illness stage in mediating sexual activity among 85 HIV-seropositive (HIV+) gay men seeking psychiatric treatment for clinical depression. Subjects were participants in a randomized, double-blind, placebo trial of imipramine. A self-report was used to assess sexual activity during the month prior to each assessment. Before and after initiation of treatment, a substantial proportion of these men were sexually abstinent and the vast majority of those who were sexually active denied practicing unprotected anal intercourse. Sexual abstinence was found to be associated with feelings of hopelessness (t = 2.8, p < .01), diagnosis of AIDS (chi 2 = 11.3, p < .01), and l...

American Journal of Psychiatry, 1999

The goals of this study were to determine whether fluoxetine is superior to placebo in treating H... more The goals of this study were to determine whether fluoxetine is superior to placebo in treating HIV-seropositive patients with major depression or dysthymia or both, whether severity of immunosuppression is associated with treatment response, and whether fluoxetine treatment is associated with change in immune status as measured by CD4 cell count. A double-blind, randomized, placebo-controlled 8-week trial of fluoxetine was conducted in a university-affiliated research outpatient clinic. The fluoxetine-placebo randomization was 2:1. All patients were offered 4 months of additional open treatment. Main outcome measures included the Clinical Global Impression, Hamilton Depression Rating Scale, and CD4 cell count. Of 120 patients randomly assigned to fluoxetine or placebo, 87 completed 8 weeks of treatment. In the total group, 51% had AIDS. All but three were men, 35% were nonwhite, and 6% had intravenous drug use as a risk factor. In an intention-to-treat analysis, 57% of fluoxetine patients and 41% of placebo patients were responders. Among patients who completed the study, 74% responded to fluoxetine and 47% to placebo; this difference was statistically significant. Severity of immunosuppression was not related to antidepressant response, attrition, or side effects, and fluoxetine treatment was not associated with change in CD4 cell count. Fluoxetine is an effective antidepressant in the context of HIV illness. However, both placebo response and attrition were substantial, suggesting both that nonspecific factors may be more salient and that yet another medication (i.e., an antidepressant) may be less acceptable among patients with serious medical illness already requiring multiple concomitant medications.

Journal of Acquired Immune Deficiency Syndromes and Human Retrovirology, 1996

American Journal of Psychiatry, 1983

Psychosomatics, 2011

Objective-To evaluate the efficacy and safety of armodafinil in the treatment of fatigue in HIV +... more Objective-To evaluate the efficacy and safety of armodafinil in the treatment of fatigue in HIV + patients, and to assess effect on depressive symptoms and behavior once fatigue remitted. Method-HIV+ patients with clinically significant fatigue were treated in a placebo controlled randomized double-blind trial for 4 weeks. Armodafinil responders and placebo non-responders or relapsers were treated openly for a total of 16 weeks of armodafinil. The primary outcome measure for fatigue and depression was the Clinical Global Impressions-Improvement Scale, supplemented by the Fatigue Severity Scale, Hamilton Depression Rating Scale and Beck Depression Inventory. Safety was assessed with assays of CD4 cell count and HIV RNA viral load and the SAFTEE side effects rating scale. Maximum trial dose of armodafinil was 250 mg/day. Results-70 patients were enrolled. Attrition was 9%. In Intention-to-treat analyses, fatigue response rate to armodafinil was 75% and to placebo, 26%. Armodafinil did not reduce depressive symptoms in the absence of improved energy, but of those patients with an Axis I depressive disorder at study entry whose energy improved, 82% experienced improved mood as well. Markers of immunologic suppression did not change during treatment. At 6 months, those still taking armodafinil had more energy and fewer depressive symptoms than those who were no longer taking it. Conclusions-As we found in our RCT of modafinil, armodafinil appears effective and well tolerated in treating fatigue in HIV+ patients. Side effects were minimal and most patients reported substantially improved energy and mood.

Psychoneuroendocrinology, 2000

Dr hab. n. med. Maria Kalina (1975-2019) 19 marca br. odeszła od nas nasza Koleżanka Maja Kalina.... more Dr hab. n. med. Maria Kalina (1975-2019) 19 marca br. odeszła od nas nasza Koleżanka Maja Kalina. Przez wiele miesięcy zmagała się heroicznie z ciężką chorobą, prawie do ostatnich dni współpracując z nami w diagnozowaniu i leczeniu "swoich" pacjentów z rzadkimi i skomplikowanymi zaburzeniami genetycznymi. Pracowała w Klinice Pediatrii i Endokrynologii Dziecięcej Śląskiego Uniwersytetu Medycznego od 2001 r., przechodząc kolejne etapy awansu naukowego i zdobywając specjalizacje z pediatrii, endokrynologii i diabetologii dziecięcej oraz z genetyki klinicznej. Wszystkie Jej dokonania były zawsze na najwyższym poziomie, poczynając od międzynarodowej matury w United World College of the Atlantic w Wielkiej Brytanii, dyplomu ukończenia studiów lekarskich z najwyższą lokatą na roku, uzyskania stypendium ESPE na staż kliniczny w Edynburgu oraz wykładów na wielu międzynarodowych kursach i szkoleniach. Miała ogromną wiedzę i doświadczenie kliniczne. Wykorzystywała je w pracy z pacjentami oraz na zajęciach ze studentami Wydziału Lekarskiego, których potrafiła zarażać swoją pasją. Swoją imponującą wiedzą dzieliła się z całym zespołem Kliniki, otaczając opieką rezydentów i pomagając młodszym koleżankom w pracy naukowej. Opublikowała szereg prac naukowych, uzyskując w 2016 r. stopień doktora habilitowanego. Maja kochała swoją pracę i kochała życie. Miała przyjaciół na całym świecie i utrzymywała z nimi regularne kontakty, często dzieląc się z nami opowieściami ze swoich podróży i spotkań. Miała też wiele planów na przyszłość. Rok wcześniej podjęła decyzję o objęciu funkcji kierownika Zakładu Genetyki Klinicznej Katedry Biologii Molekularnej i Genetyki. We wszystkich swoich działaniach mogła zawsze liczyć na starszą siostrę Basię, która była dla Niej po śmieci rodziców najbliższą osobą. Pracując w tej samej dziedzinie, stworzyły obie niezwykle zgrany zespół wspólnie podejmujący trudne decyzje kliniczne. Basia była obecna w życiu Mai "w zdrowiu i w chorobie", czuwając przy niej każdego dnia, do ostatniej chwili nie tracąc nadziei, że będzie lepiej. Kochana Maju, bardzo nam Ciebie brakuje i nie możemy pogodzić się z Twoim odejściem. Będziesz zawsze obecna w naszych wspomnieniach i w naszych sercach. Śpij spokojnie. Ewa Małecka-Tendera wraz z zespołem pracowników

Nutrition Research, 1999

This report presents findings on the anabolic effects of testosterone therapy in HIV+ men with lo... more This report presents findings on the anabolic effects of testosterone therapy in HIV+ men with low testosterone levels, CD4 cell counts under 400 cells/cu.mm, and clinical symptoms of hypogonadism, including significant loss of body weight or muscle mass (5 90% of normative body cell mass). Fifty-two men enrolled in the trial, of whom 44 completed 12 weeks of treatment. Treatment consisted of biweekly 400 mg intramuscular injections of testosterone cypionate. Body weight, as well as body cell mass as measured by bioelectric impendance analysis, increased significantly after 12 weeks, with average increases of 2.4 kgs and 1.7 kgs, respectively (p < ,000). Although body fat increased as well, 83% of weight gained was fat free mass. In the absence of a randomized. doubleblind controlled trial, definitive conclusions cannot be made; however, the data suggest that testosterone is well tolerated and effective in treating HIV-related loss of weight and body cell mass.

Nutrition Research, 2001

This report presents findings from a randomized trial that compared the efficacy of 1) 400 mg biw... more This report presents findings from a randomized trial that compared the efficacy of 1) 400 mg biweekly IM injections of testosterone plus daily "placebo" standard nutritional supplements (containing 8 g of protein per serving), 2) high protein (37 g per serving) supplements and placebo IM injections, and 3) both testosterone and high protein supplements, in the treatment of HIV-related weight loss. Sixty-five HIVϩ men with Յ90% of normative body weight or body cell mass entered the study, of whom 54 (83%) completed the 12-week trial. In an intention to treat analysis, the response rates (defined as an increase of at least 5% in the ratio of body cell mass to height) for testosterone (55%), high protein supplements (62%), and both testosterone and protein supplements (73%) were statistically similar (p ϭ NS). Amount of change in body weight, body cell mass, fat free mass and body fat from baseline to Week 12 (as measured by bioelectric impedance analysis), all of which were statistically significant within each group, did not differ across the three groups. Among all completers, the average gain in body weight and body cell mass after 12 weeks was 3.5 kgs and 2.0 kgs, respectively; 77% of the increase in body weight was fat free body mass, compared to 23% fat. These data support the efficacy of both testosterone and high protein supplements as independent treatments for HIV-related weight loss, but do not demonstrate a further advantage of combining the treatments.