Robert Cooke - Academia.edu (original) (raw)

Papers by Robert Cooke

Journal of Psychiatry Neuroscience Jpn, Mar 1, 2010

The information in this column is not intended as a definitive treatment strategy but as a sugges... more The information in this column is not intended as a definitive treatment strategy but as a suggested approach for clinicians treating patients with similar histories. Individual cases may vary and should be evaluated carefully before treatment is provided.

Background: Vagus nerve stimulation (VNS) alters both concentrations of neurotransmitters or thei... more Background: Vagus nerve stimulation (VNS) alters both concentrations of neurotransmitters or their metabolites and functional activity of central nervous system regions dysregulated in mood disorders. An open trial has suggested efficacy. Methods: This 10-week, acute, randomized, controlled, masked trial compared adjunctive VNS with sham treatment in 235 outpatients with nonpsychotic major depressive disorder (n ϭ 210) or nonpsychotic, depressed phase, bipolar disorder (n ϭ 25). In the current episode, participants had not responded adequately to between two and six research-qualified medication trials. A two-week, single-blind recovery period (no stimulation) and then 10 weeks of masked active or sham VNS followed implantation. Medications were kept stable. Primary efficacy outcome among 222 evaluable participants was based on response rates (Ն50% reduction from baseline on the 24-item Hamilton Rating Scale for Depression [HRSD 24 ]). Results: At 10-weeks, HRSD 24 response rates were 15.2% for the active (n ϭ 112) and 10.0% for the sham (n ϭ 110) groups (p ϭ .251, last observation carried forward [LOCF]). Response rates with a secondary outcome, the Inventory of Depressive Symptomatology -Self-Report (IDS-SR 30 ), were 17.0% (active) and 7.3% (sham) (p ϭ .032, LOCF). VNS was well tolerated; 1% (3/235) left the study because of adverse events. Conclusions: This study did not yield definitive evidence of short-term efficacy for adjunctive VNS in treatment-resistant depression.

Archives of General Psychiatry, Dec 1, 2010

Context: Mindfulness-based cognitive therapy (MBCT) is a group-based psychosocial intervention de... more Context: Mindfulness-based cognitive therapy (MBCT) is a group-based psychosocial intervention designed to enhance self-management of prodromal symptoms associated with depressive relapse.

Journal of Psychiatric Research, Sep 1, 1997

The objective was to assess the extent and pattern of illness intrusiveness, one measure of quali... more The objective was to assess the extent and pattern of illness intrusiveness, one measure of quality of life, in subjects with bipolar disorder (BD) and to determine whether specific illness variables had influenced the degree of intrusiveness experienced. To compare findings from BD subjects relative to published findings for subjects with chronic medical conditions. The study involved the administration of a self-report assessment tool to euthymic outpatients with BD attending a university based hospital clinic. Of the 155 eligible participants, 112 completed a standardized psychiatric interview (SADS-L) and 87 of these met study criteria for euthymia and were approached to participate in the study. Sixty-eight completed self-report measures were returned. The main outcome measure was the Illness Intrusiveness Rating Scale (IIRS) which was analysed along with a composite measure of life events. It resulted that individuals' with BD experience significant illness intrusiveness into a number of life domains even after controlling for negative life events. Factors such as type of BD, the presence of a depressive episode in the preceding year and current Hamilton depression rating scale score contributed to the total illness intrusiveness. The degree of total illness intrusiveness experienced by individuals with BD was similar to that of subjects with multiple sclerosis and greater than subjects with end stage renal disease and rheumatoid arthritis. It seems apparent that quality of life, as determined by illness intrusiveness, is compromised in subjects with BD even during periods of euthymia. BD is at least as intrusive as several chronic medical conditions. Those with a type 11 BD report greater impairment in all domains compared with type I. Future research should determine specific psychosocial interventions aimed at reducing the impact of BD. C 1997 Elsevier Science Ltd. A rating scale for mania: reliability, validity and sensitivity.

Journal of Affective Disorders, May 31, 2003

Bipolar Disorders, Mar 1, 2000

Journal of psychiatry & neuroscience: JPN

Source: PubMed CITATIONS 99 READS 95 3 authors, including: The user has requested enhancement of ... more Source: PubMed CITATIONS 99 READS 95 3 authors, including: The user has requested enhancement of the downloaded file. All in-text references underlined in blue are added to the original document and are linked to publications on ResearchGate, letting you access and read them immediately. J Psychiatry Neurosci 2005;30(3)

Canada diseases weekly report = Rapport hebdomadaire des maladies au Canada

American Journal of Psychiatry

The Journal of Clinical Psychiatry

Clinicians may not consider using the thyroid hormone liothyronine sodium (levorotary isomer of t... more Clinicians may not consider using the thyroid hormone liothyronine sodium (levorotary isomer of triiodothyronine [T3]) for augmentation of antidepressant drugs in depressed patients who are also receiving the precursor hormone levothyroxine (levorotary isomer of thyroxine [T4]) for thyroid disease. We now report on the successful use of T3 augmentation therapy in seven of nine depressed patients who were also receiving T4 for thyroid disease. Following an earlier single case report, we prescribed T3 augmentation therapy for eight depressed patients who had not responded to an adequate antidepressant drug trial and who were receiving T4 therapy for thyroid disease. T3 was prescribed in open-label fashion, and response was judged by the clinician, whose assessment was supplemented by the use of standardized rating scales. Seven of the nine patients were judged to respond to T3 augmentation. These results are consistent with a report of differential effects for T3 versus T4 augmentation in depressed patients free of thyroid disease. The results have implications for the treatment of depression in the presence of thyroid disease and for the mechanism of thyroid hormone potentiation of antidepressants.

The Journal of Clinical Psychiatry

APA PsycNET Our Apologies! - The following features are not available with your current Browser c... more APA PsycNET Our Apologies! - The following features are not available with your current Browser configuration. - display, print, save, export, and email selected records - get My List count - save record to My List - get references ...

Journal of psychiatry & neuroscience: JPN

International Journal of Neuropsychopharmacology, 2015

Monoamine oxidase inhibitors (MAOIs) are being developed for major depressive disorder, Alzheimer... more Monoamine oxidase inhibitors (MAOIs) are being developed for major depressive disorder, Alzheimer's, and Parkinson's Disease. Newer MAOIs have minimal sensitivity to tyramine, but a key limitation for optimizing their development is that standards for in vivo monoamine oxidase-A (MAO-A) occupancy in humans are not well established. The objectives were to determine the dose-occupancy relationship of moclobemide and the occupancy of phenelzine at typical clinical dosing. Major depressive episode (MDE) subjects underwent [(11)C]harmine positron emission tomography scanning prior to and following 6 weeks of treatment with moclobemide or phenelzine. Mean brain MAO-A occupancies were 74.23±8.32% for moclobemide at 300-600mg daily (n = 11), 83.75±5.52% for moclobemide at 900-1200mg daily (n = 9), and 86.82±6.89% for phenelzine at 45-60mg daily (n = 4). The regional dose-occupancy relationship of moclobemide fit a hyperbolic function [F(x) = a(x/[b + x]); F(1,18) = 5.57 to 13.32, p = 0.002 to 0.03, mean 'a': 88.62±2.38%, mean 'b': 69.88±4.36 mg]. Multivariate analyses of variance showed significantly greater occupancy of phenelzine (45-60mg) and higher-dose moclobemide (900-1200mg) compared to lower-dose moclobemide [300-600mg; F(7,16) = 3.94, p = 0.01]. These findings suggest that for first-line MDE treatment, daily moclobemide doses of 300-600mg correspond to a MAO-A occupancy of 74%, whereas for treatment-resistant MDE, either phenelzine or higher doses of moclobemide correspond to a MAO-A occupancy of at least 84%. Therefore, novel MAO inhibitor development should aim for similar thresholds. The findings provide a rationale in treatment algorithm design to raise moclobemide doses to inhibit more MAO-A sites, but suggest switching from high-dose moclobemide to phenelzine is best justified by binding to additional targets.

CITATIONS 2 READS 17 8 authors, including: Some of the authors of this publication are also worki... more CITATIONS 2 READS 17 8 authors, including: Some of the authors of this publication are also working on these related projects: Evaluation of community paramedicine programs in in northern ontario View project Interpersonal Psychotherapy -international conference

Psychiatry research, Jan 29, 1995

The harm avoidance (HA) personality dimension has been hypothesized to be a vulnerability factor ... more The harm avoidance (HA) personality dimension has been hypothesized to be a vulnerability factor for unipolar depression (UD) but not for bipolar disorder (BD). The reported difference on HA scores between these diagnostic groups may have been compromised by the assessment of BD patients who had not fully recovered. To test the diagnostic specificity of elevated HA scores and to elucidate whether assumptions about differences between patients with UD or BD might be attributed to the lingering effects of mood state, the Tridimensional Personality Questionnaire (TPQ) was administered to recovered patients with either BD or UD and a nonpatient comparison group. Both patient groups scored higher on the HA dimension than the nonpatient comparison group, but the patient groups did not differ from one another on this dimension. Moreover, novelty seeking (NS) scores were elevated in subjects with BD compared with both UD patients and nonpatient subjects. These results suggest that high HA s...

Canadian journal of psychiatry. Revue canadienne de psychiatrie, 1993

This study examined the panic symptom profiles of three diagnostic groups: those with panic disor... more This study examined the panic symptom profiles of three diagnostic groups: those with panic disorder and no history of major depression; those with panic disorder with a history of major depressive episode but no current depression; and those current major depression with panic disorder. Patients were compared on the frequency of specific panic attack symptoms based on structured interview responses. The symptom profiles of all three groups were significantly correlated. The patients with past and current depressive episodes had the most similar symptom structure.

Depression, 1994

1995 WiIey-Liss, Inc. ~~-~~ ~ ~ ~ ~

Canadian journal of psychiatry. Revue canadienne de psychiatrie, 1990

A retrospective evaluation of the clinical records of 138 depressed patients, who received the de... more A retrospective evaluation of the clinical records of 138 depressed patients, who received the dexamethasone suppression test (DST) as part of a standardized physical and psychiatric assessment protocol, revealed that 60 had acute, chronic (mild or severe), stable or remitted medical conditions. The proportion of DST nonsuppressors did not differ between depressed subjects with medical conditions (45% nonsuppressors) and those without (34.6% nonsuppressors; p greater than 0.2). However, all of the six subjects with acute or chronic-severe medical conditions were found to be nonsuppressors (p = 0.003). These results may help clarify the medical exclusion criteria for the clinical application of the DST.

Journal of psychiatry & neuroscience : JPN, 2003

Background: Studies suggest that the dorsolateral prefrontal cortex (DLPFC) participates in neura... more Background: Studies suggest that the dorsolateral prefrontal cortex (DLPFC) participates in neural circuitry that is dysregulated in Panic Disorder (PD) and Major Depressive Disorder (MDD). We tested whether low-frequency repetitive Transcranial Magnetic Stimulation (rTMS) could normalize the overactivity of right frontal regions and thereby improve symptoms. Methods: Six patients with PD and comorbid MDD were treated with daily active 1-Hz rTMS to the right DLPFC for 2 weeks in this open-label trial. Results: Clinical improvements were apparent as early as the first week of treatment. After the second week, 5/6 of patients showed improvements in panic and anxiety, and 4/6 showed a decrease in depression, with sustained improvement at 6 months of followup. Right hemisphere resting motor threshold increased significantly after rTMS. Limitations: Limitations of this study are the open design and the small sample size. Conclusions: Slow rTMS to the right DLPFC resulted in significant clinical improvement and reduction of ipsilateral motor cortex excitability. Replications in larger sample will help to clarify the relevance of this preliminary data and to define the potential role of right DLPFC rTMS in panic with major depression.

Journal of Psychiatry Neuroscience Jpn, Mar 1, 2010

The information in this column is not intended as a definitive treatment strategy but as a sugges... more The information in this column is not intended as a definitive treatment strategy but as a suggested approach for clinicians treating patients with similar histories. Individual cases may vary and should be evaluated carefully before treatment is provided.

Background: Vagus nerve stimulation (VNS) alters both concentrations of neurotransmitters or thei... more Background: Vagus nerve stimulation (VNS) alters both concentrations of neurotransmitters or their metabolites and functional activity of central nervous system regions dysregulated in mood disorders. An open trial has suggested efficacy. Methods: This 10-week, acute, randomized, controlled, masked trial compared adjunctive VNS with sham treatment in 235 outpatients with nonpsychotic major depressive disorder (n ϭ 210) or nonpsychotic, depressed phase, bipolar disorder (n ϭ 25). In the current episode, participants had not responded adequately to between two and six research-qualified medication trials. A two-week, single-blind recovery period (no stimulation) and then 10 weeks of masked active or sham VNS followed implantation. Medications were kept stable. Primary efficacy outcome among 222 evaluable participants was based on response rates (Ն50% reduction from baseline on the 24-item Hamilton Rating Scale for Depression [HRSD 24 ]). Results: At 10-weeks, HRSD 24 response rates were 15.2% for the active (n ϭ 112) and 10.0% for the sham (n ϭ 110) groups (p ϭ .251, last observation carried forward [LOCF]). Response rates with a secondary outcome, the Inventory of Depressive Symptomatology -Self-Report (IDS-SR 30 ), were 17.0% (active) and 7.3% (sham) (p ϭ .032, LOCF). VNS was well tolerated; 1% (3/235) left the study because of adverse events. Conclusions: This study did not yield definitive evidence of short-term efficacy for adjunctive VNS in treatment-resistant depression.

Archives of General Psychiatry, Dec 1, 2010

Context: Mindfulness-based cognitive therapy (MBCT) is a group-based psychosocial intervention de... more Context: Mindfulness-based cognitive therapy (MBCT) is a group-based psychosocial intervention designed to enhance self-management of prodromal symptoms associated with depressive relapse.

Journal of Psychiatric Research, Sep 1, 1997

The objective was to assess the extent and pattern of illness intrusiveness, one measure of quali... more The objective was to assess the extent and pattern of illness intrusiveness, one measure of quality of life, in subjects with bipolar disorder (BD) and to determine whether specific illness variables had influenced the degree of intrusiveness experienced. To compare findings from BD subjects relative to published findings for subjects with chronic medical conditions. The study involved the administration of a self-report assessment tool to euthymic outpatients with BD attending a university based hospital clinic. Of the 155 eligible participants, 112 completed a standardized psychiatric interview (SADS-L) and 87 of these met study criteria for euthymia and were approached to participate in the study. Sixty-eight completed self-report measures were returned. The main outcome measure was the Illness Intrusiveness Rating Scale (IIRS) which was analysed along with a composite measure of life events. It resulted that individuals' with BD experience significant illness intrusiveness into a number of life domains even after controlling for negative life events. Factors such as type of BD, the presence of a depressive episode in the preceding year and current Hamilton depression rating scale score contributed to the total illness intrusiveness. The degree of total illness intrusiveness experienced by individuals with BD was similar to that of subjects with multiple sclerosis and greater than subjects with end stage renal disease and rheumatoid arthritis. It seems apparent that quality of life, as determined by illness intrusiveness, is compromised in subjects with BD even during periods of euthymia. BD is at least as intrusive as several chronic medical conditions. Those with a type 11 BD report greater impairment in all domains compared with type I. Future research should determine specific psychosocial interventions aimed at reducing the impact of BD. C 1997 Elsevier Science Ltd. A rating scale for mania: reliability, validity and sensitivity.

Journal of Affective Disorders, May 31, 2003

Bipolar Disorders, Mar 1, 2000

Journal of psychiatry & neuroscience: JPN

Source: PubMed CITATIONS 99 READS 95 3 authors, including: The user has requested enhancement of ... more Source: PubMed CITATIONS 99 READS 95 3 authors, including: The user has requested enhancement of the downloaded file. All in-text references underlined in blue are added to the original document and are linked to publications on ResearchGate, letting you access and read them immediately. J Psychiatry Neurosci 2005;30(3)

Canada diseases weekly report = Rapport hebdomadaire des maladies au Canada

American Journal of Psychiatry

The Journal of Clinical Psychiatry

Clinicians may not consider using the thyroid hormone liothyronine sodium (levorotary isomer of t... more Clinicians may not consider using the thyroid hormone liothyronine sodium (levorotary isomer of triiodothyronine [T3]) for augmentation of antidepressant drugs in depressed patients who are also receiving the precursor hormone levothyroxine (levorotary isomer of thyroxine [T4]) for thyroid disease. We now report on the successful use of T3 augmentation therapy in seven of nine depressed patients who were also receiving T4 for thyroid disease. Following an earlier single case report, we prescribed T3 augmentation therapy for eight depressed patients who had not responded to an adequate antidepressant drug trial and who were receiving T4 therapy for thyroid disease. T3 was prescribed in open-label fashion, and response was judged by the clinician, whose assessment was supplemented by the use of standardized rating scales. Seven of the nine patients were judged to respond to T3 augmentation. These results are consistent with a report of differential effects for T3 versus T4 augmentation in depressed patients free of thyroid disease. The results have implications for the treatment of depression in the presence of thyroid disease and for the mechanism of thyroid hormone potentiation of antidepressants.

The Journal of Clinical Psychiatry

APA PsycNET Our Apologies! - The following features are not available with your current Browser c... more APA PsycNET Our Apologies! - The following features are not available with your current Browser configuration. - display, print, save, export, and email selected records - get My List count - save record to My List - get references ...

Journal of psychiatry & neuroscience: JPN

International Journal of Neuropsychopharmacology, 2015

Monoamine oxidase inhibitors (MAOIs) are being developed for major depressive disorder, Alzheimer... more Monoamine oxidase inhibitors (MAOIs) are being developed for major depressive disorder, Alzheimer's, and Parkinson's Disease. Newer MAOIs have minimal sensitivity to tyramine, but a key limitation for optimizing their development is that standards for in vivo monoamine oxidase-A (MAO-A) occupancy in humans are not well established. The objectives were to determine the dose-occupancy relationship of moclobemide and the occupancy of phenelzine at typical clinical dosing. Major depressive episode (MDE) subjects underwent [(11)C]harmine positron emission tomography scanning prior to and following 6 weeks of treatment with moclobemide or phenelzine. Mean brain MAO-A occupancies were 74.23±8.32% for moclobemide at 300-600mg daily (n = 11), 83.75±5.52% for moclobemide at 900-1200mg daily (n = 9), and 86.82±6.89% for phenelzine at 45-60mg daily (n = 4). The regional dose-occupancy relationship of moclobemide fit a hyperbolic function [F(x) = a(x/[b + x]); F(1,18) = 5.57 to 13.32, p = 0.002 to 0.03, mean 'a': 88.62±2.38%, mean 'b': 69.88±4.36 mg]. Multivariate analyses of variance showed significantly greater occupancy of phenelzine (45-60mg) and higher-dose moclobemide (900-1200mg) compared to lower-dose moclobemide [300-600mg; F(7,16) = 3.94, p = 0.01]. These findings suggest that for first-line MDE treatment, daily moclobemide doses of 300-600mg correspond to a MAO-A occupancy of 74%, whereas for treatment-resistant MDE, either phenelzine or higher doses of moclobemide correspond to a MAO-A occupancy of at least 84%. Therefore, novel MAO inhibitor development should aim for similar thresholds. The findings provide a rationale in treatment algorithm design to raise moclobemide doses to inhibit more MAO-A sites, but suggest switching from high-dose moclobemide to phenelzine is best justified by binding to additional targets.

CITATIONS 2 READS 17 8 authors, including: Some of the authors of this publication are also worki... more CITATIONS 2 READS 17 8 authors, including: Some of the authors of this publication are also working on these related projects: Evaluation of community paramedicine programs in in northern ontario View project Interpersonal Psychotherapy -international conference

Psychiatry research, Jan 29, 1995

The harm avoidance (HA) personality dimension has been hypothesized to be a vulnerability factor ... more The harm avoidance (HA) personality dimension has been hypothesized to be a vulnerability factor for unipolar depression (UD) but not for bipolar disorder (BD). The reported difference on HA scores between these diagnostic groups may have been compromised by the assessment of BD patients who had not fully recovered. To test the diagnostic specificity of elevated HA scores and to elucidate whether assumptions about differences between patients with UD or BD might be attributed to the lingering effects of mood state, the Tridimensional Personality Questionnaire (TPQ) was administered to recovered patients with either BD or UD and a nonpatient comparison group. Both patient groups scored higher on the HA dimension than the nonpatient comparison group, but the patient groups did not differ from one another on this dimension. Moreover, novelty seeking (NS) scores were elevated in subjects with BD compared with both UD patients and nonpatient subjects. These results suggest that high HA s...

Canadian journal of psychiatry. Revue canadienne de psychiatrie, 1993

This study examined the panic symptom profiles of three diagnostic groups: those with panic disor... more This study examined the panic symptom profiles of three diagnostic groups: those with panic disorder and no history of major depression; those with panic disorder with a history of major depressive episode but no current depression; and those current major depression with panic disorder. Patients were compared on the frequency of specific panic attack symptoms based on structured interview responses. The symptom profiles of all three groups were significantly correlated. The patients with past and current depressive episodes had the most similar symptom structure.

Depression, 1994

1995 WiIey-Liss, Inc. ~~-~~ ~ ~ ~ ~

Canadian journal of psychiatry. Revue canadienne de psychiatrie, 1990

A retrospective evaluation of the clinical records of 138 depressed patients, who received the de... more A retrospective evaluation of the clinical records of 138 depressed patients, who received the dexamethasone suppression test (DST) as part of a standardized physical and psychiatric assessment protocol, revealed that 60 had acute, chronic (mild or severe), stable or remitted medical conditions. The proportion of DST nonsuppressors did not differ between depressed subjects with medical conditions (45% nonsuppressors) and those without (34.6% nonsuppressors; p greater than 0.2). However, all of the six subjects with acute or chronic-severe medical conditions were found to be nonsuppressors (p = 0.003). These results may help clarify the medical exclusion criteria for the clinical application of the DST.

Journal of psychiatry & neuroscience : JPN, 2003

Background: Studies suggest that the dorsolateral prefrontal cortex (DLPFC) participates in neura... more Background: Studies suggest that the dorsolateral prefrontal cortex (DLPFC) participates in neural circuitry that is dysregulated in Panic Disorder (PD) and Major Depressive Disorder (MDD). We tested whether low-frequency repetitive Transcranial Magnetic Stimulation (rTMS) could normalize the overactivity of right frontal regions and thereby improve symptoms. Methods: Six patients with PD and comorbid MDD were treated with daily active 1-Hz rTMS to the right DLPFC for 2 weeks in this open-label trial. Results: Clinical improvements were apparent as early as the first week of treatment. After the second week, 5/6 of patients showed improvements in panic and anxiety, and 4/6 showed a decrease in depression, with sustained improvement at 6 months of followup. Right hemisphere resting motor threshold increased significantly after rTMS. Limitations: Limitations of this study are the open design and the small sample size. Conclusions: Slow rTMS to the right DLPFC resulted in significant clinical improvement and reduction of ipsilateral motor cortex excitability. Replications in larger sample will help to clarify the relevance of this preliminary data and to define the potential role of right DLPFC rTMS in panic with major depression.