Advances in neuroscience as well as the appreciation of the often unrecognized role of behavior and disturbances of behavior in many medical disorders has led to the creation of a behavioral medicine research program based in the Consultation-Liaison Service of the Intramural Program. Ten protocols are currently active or planned investigating the mood, cognitive and behavioral concomitants of cancer of the pancreas, acquired immune deficiency syndrome, chest pain with normal coronary arteries, interferon therapy, metoclopramide administration, steroid therapy and thyroid hormone replacement and withdrawal. These protocols will address such areas as: a) the effects of previous psychiatric history on the psychiatric morbidity associated with certain diseases and their treatment; b) the psychiatric phenomenology of certain diseases and their treatment; c) the treatment response characteristics of psychiatric disorders associated with diseases or their treatment; d) biochemical factors that may serve as predictive diagnostic markers for illness or for treatment-associated mood/behavioral or cognitive syndromes. The goals of this project will be to address these areas of investigation in selected patient populations at the NIH Clinical Center. Significant findings to date include demonstration of cognitive deficits in patients with acquired immune deficiency syndrome who have no other evidence of neurologic involvement, establishment of endogenous depression as a frequent presenting symptom in cancer of the pancreas as opposed to gastric cancer, observation of significant fluctuations in mood attendant to administration of alternate day steroids in patients with lupus and identification of significant reductions of depression and anxiety following successful treatment of cystic acne.
