bluuebunny/crossref_metadata_2025 huggingface dataset:
New antidepressants and 5‐HT uptake inhibitors
Authors: Montgomery S.A.
Published: August 2007

The efficacy of 5‐HT uptake inhibitors, including paroxetine, as antidepressants is compared with that of the reference tricyclic antidepressants. It is suggested that some of the older tricyclicantidepressants might not have been released for general clinical use if tested by today's rigorous standards. Placebo‐ controlled, multicentre studies indicate that 5‐HT uptake inhibitors are both effective as antidepressants and well tolerated by depressed patients. They also appear to have a role in the treatment of depression when associated with personality disorders, in the treatment of obsessive‐compulsive disorder and bulimia, and in resistant depression. Moreover, the evidence for efficacy in the prophylaxis of depression is better established for 5‐HT uptake inhibitors than for reference antidepressants.
Acute changes in cerebral blood flow associated with marijuana smoking
Authors: Mathew R.J. , Wilson W.H. , Tant S.R.
Published: August 2007

ABSTRACTCerebral blood flow (CBF) was measured in experienced (ES) and inexperienced (IS) marijuana smokers with the133xenon inhalation technique before and after smoking both a high‐potency marijuana cigarette and a placebo marijuana cigarette. CBF was measured twice under resting conditions in a control group. Mood states before and after marijuana smoking were quantified with the Profile of Mood States (POMS). Analyses of POMS factors after smoking marijuana revealed IS had an increase in anxiety while ES had a decrease. IS also had a significant increase in depression and decrease in vigor, but neither variable changed in the ES. After marijuana, CBF decreased in IS, but in ES, it increased in comparison with the 2 control runs. In both IS and ES, CBF changes following placebo administration were similar to those associated with marijuana smoking. However, in IS, the marijuana‐induced CBF decrease was significantly higher than that associated with placebo. There were no statistically significant differences between the CBF increase seen after placebo and marijuana in ES. Anxiety, anger, fatigue, confusion and depression had significant negative correlations with CBF while vigor correlated positively, but the anxiety factor was the only one to account for a significant percentage of the change (partial correlation) in hemispheric CBF.
The prevalence of dementia as measured by the Cambridge Mental Disorders of the Elderly Examination
Authors: O'Connor D. W. , Pollitt P. A. , Hyde J. B. , Fellows J. L. , Miller N. D. , Brook C. P. B. , Reiss B. B. , Roth M.
Published: August 2007

ABSTRACT General practice patients aged 75 years and over were screened for cognitive impairment using the Mini‐Mental State Examination. Those scoring 23 or below and a sample of those scoring 24 or 25 were asessed using the Cambridge Mental Disorders of the Elderly Examination (CAMDEX), a structured interview schedule specifically designed to detect mild dementia. The CAMDEX includes a mental state examination, a psychiatric history, detailed cognitive testing and an informant interview. The prevalence of dementia in 2311 patients was found to be 10.5%, about half that found in most earlier studies. Possible reasons for this low rate are discussed.
Elevated CSF somatostatin concentrations in demented patients parallel improved psychomotor functions induced by integrity‐promoting care
Authors: WiderlöV E. , Bråne G. , Ekman R. , Kihigren M. , Norberg A. , Karlsson I.
Published: August 2007

ABSTRACT Elderly demented patients from 2 nursing homes participated in this study. An experimental group (n=17) was subjected to a 3‐month program with integrity‐promoting care resulting in emotional, intellectual and physical activation, whereas a control group (n=18) had no change from the regular ward care. Dementia rating scales and psychological tests were administered before the start of the study and at the end of the 3‐month study period. Lumbar punctures were performed at the same time for assessment of neuropeptide concentrations (somatostatin (SRIF), arginine vasopressin (AVP) and corticotropin‐releasing factor) in the cerebrospinal fluid (CSF). In the control group no significant changes were found in the ratings before and after the study. In contrast, improvements in intellectual and motor functioning were observed in the experimental group. Concomitantly, the SRIF concentrations in CSF were significantly elevated in the experimental group and not affected in the control group. The CSF AVP concentrations were reduced in both groups at the end of the study, but considerably more in the control group. It is concluded that environmental factors can improve intellectual and motor functioning in demented patients and also alter CSF biochemical measures of dementia.
Decreased plasma benzylamine oxidase in a subgroup of schizophrenia
Authors: Vieira R. , Azevedo M. , Polónio P. , Manso C.
Published: August 2007

ABSTRACT Plasma benzylamine oxidase (BzAO) activity was analysed in a group of 40 schizophrenic patients and compared with that of healthy controls. Although plasma BzAO was significantly decreased in schizophrenics as a whole, when patients were divided into type I (favourable course) and type II (poor course) it was found that the reduced BzAO activity was only observed in type I. Several clinical features were associated with a low BzAO level. The clinical and biological significance of the identification of a biochemical alteration in a subgroup of schizophrenic patients is discussed, and we suggest that the possibility of BzAO being a marker for prognosis in schizophrenia should be further investigated.
The GBS scale in multi‐infarct dementia and senile dementia of Alzheimer type
Authors: Olafsson K. , Kørner A. , Bille A. , Jensen H.V. , Thiesen S. , Andersen J.
Published: August 2007

ABSTRACT ABSTRACT—The GBS profile was assessed for 39 patients with multi‐infarct dementia (MID) and 34 patients with senile dementia of Alzheimer type (SDAT). The MID patients fulfilled the DSM‐III criteria for multi‐infarct dementia and had a score of 7 points or more on the Hachinski Ischemic Scale (HIS) and a score of 4 points or less on the Gustafson/Nilsson Alzheimer Scale (GNAS). The SDAT patients fulfilled DSM‐III criteria for primary degenerative dementia and had a score of 5 points or more on the GNAS and a score of 6 points or less on the HIS. The total GBS score, the GBS subscale and relative subscale scores for intellectual functioning were significantly higher in patients with SDAT as compared with patients with MID. However, these subscale scores were considerably dispersed and nearly totally overlapping between patients with MID and SDAT, which implicates that the discriminative value is minimal. The validity between the GBS versus HIS and between the GBS versus GNAS was divergent, suggesting that the GBS scale has its own unique validity. In conclusion, the study does not support the hypothesis that the GBS profile may be of diagnostic value in clinical differentiation between multi‐infarct dementia (MID) and senile dementia of Alzheimer type (SDAT).
Early separation and suicidal behaviour in the parental homes of 40 consecutive suicide attempters
Authors: Wasserman D. , Cullberg J.
Published: August 2007

ABSTRACT– Forty suicide‐attempt patients who were consecutively admitted to an intensive‐care unit, their significant others and treatment personnel were investigated by semistructured interviews. The patients were divided into neurosis (n= 14), abuse (n= 19) and psychosis (n= 7) groups. Twenty‐one of the patients (52%) had lost contact with one or both parents before the age of 18, in 25% of cases owing to death and in 27% because of the parents' divorce or separation. Parents and/or siblings of 19 patients (47%) had shown suicidal behaviour in the form of attempted suicide and/or suicide. Differences between the groups were not significant. Alcohol abuse in the parental home was overrepresented in the abuse group compared with the other groups. The role of identification with the dead and suicidal parent in prompting suicidal actions in adulthood is discussed, as well as that of the impeded evolution of stable external object relations owing to parental losses.
Evaluation of the Brief Psychopathological Rating Scale in relation to aggressive behavior by acute involuntarily admitted patients
Authors: Palmstierna T. , Lassenius R. , Wistedt B.
Published: August 2007

ABSTRACT– Aggressive behavior during acute involuntary admission was related to ratings on the Brief Psychopathological Rating Scale, age, sex and global assessment in 38 patients. The best prediction model of aggressive behavior was achieved when predicting more serious incidents occurring during the first 8 days of admission. In this prediction model, high scores of hostility and anxiety, together with low scores of grandiosity significantly and accurately predicted more serious violent behavior.
Psychiatric disorders of old age in Enugu, Nigeria
Authors: Ihezue U.H. , Okpara E.
Published: August 2007

ABSTRACT– A retrospective study of the demographic and clinical characteristics of 73 consecutive patients aged 60 years and over admitted for the first time into a psychiatric hospital in Nigeria shows that they constituted about 5% of all admissions over a 2‐year period. While the majority (58%) were aged below 70 years, 8% were aged over 80 years, with more females than males living to the older age groups. Single status, separation and divorce were more common among males; widowhood was more common among the females. A high illiteracy rate of 86% was recorded, with more males than females being literate. More than 84% belonged to the 2 lowest socioeconomic classes. There was a significant difference in the distribution of diagnostic categories, with senile dementia, affective psychosis, neurotic disorders and paranoid states more common among the females, while arteriosclerotic dementia and schizophrenia were diagnosed more often among the males. Functional psychosis (49%) was the largest diagnostic category, followed by organic psychosis (30%), while neurotic disorders (10%) ranked third. Within the functional psychoses, paranoid states (30%) predominated, followed by affective disorders (14%) consisting mainly of depressive symptoms; 6% presented with schizophrenic illness; and 11% presented with physical illness with associated psychiatric manifestations. There was a long delay before referral to hospital, associated with use of alternative medical facilities (traditional and spiritual healers). The probable sociocultural antecedents and medical and social implications of these findings are discussed.
Patterns of drug use and sensation‐seeking among adolescents in Norway
Authors: Pedersen W. , Clausen S.‐E. , Lavik N. J.
Published: August 2007

ABSTRACT– The relationship between personality and drug use was investigated by studying patterns of sensation‐seeking behaviour and drug use among adolescents. A questionnaire was distributed to a sample of 1027 Norwegian senior high school students aged 16 to 19 in the greater Oslo area. The response rate was 97%. The sensation‐seeking subscores showed moderate to strong association with the use of the different drugs. A canonical correlation analysis yielded 3 significant variates: in the drug use domain the first dimension correlated with the use of legal drugs and inhalants, the second with cannabis and tranquillizers and the third with tobacco. In the sensation‐seeking domain the first dimension was almost synonymous with the disinhibition scale, the second with experience‐seeking, and the third correlated highly negatively with thrill‐, adventure‐ and experience‐seeking. The results support the assumption that a strong link exists between sensation seeking and drug use. They further show the importance of taking different subdimensions of the sensation‐seeking trait into account for prevention and treatment of drug use and abuse.
Schizophrenia: a 13‐year follow‐up
Authors: Munk‐Jørgensen P. , Mortensen P. B.
Published: August 2007

ABSTRACT– In Denmark about 11–12 per 100,000 population are diagnosed as schizophrenics for the first time each year. Less than half of these receive this diagnosis at first admission and therefore only 5–6 per 100,000 are included in the official schizophrenia incidence figures. In a cohort (n= 53), predictors for diagnosis of schizophrenia at the first admission were analysed (vs. first schizophrenia diagnosis only at a later admission). In accordance with the Danish concept of schizophrenia, affective flattening was found to have a significant correlation with the initial diagnosis of schizophrenia. Long duration of disease prior to the initial admission was also significantly correlated, indicating that a criterion of chronicity forms part of the Danish concept of schizophrenia. Schneider's first‐rank symptoms also were more weakly correlated with the initial schizophrenia diagnosis. The probands were followed up personally and by case records (13 years). Good outcome was found in 23% of the probands and poor outcome in 50%. Affective flattening and Schneiderian first‐rank symptoms at initial admission were correlated with poor outcome (NS). Schneiderian first‐rank symptoms and social unease at initial admission were significantly correlated with schizophrenia as follow‐up diagnosis. The initial clinical diagnosis of schizophrenia was not correlated with clinical outcome or with follow‐up diagnosis.
Passive euthanasia in response to attempted suicide: one form of aggressiveness by relatives
Authors: Wasserman D.
Published: August 2007

ABSTRACT– A total of 88 interviews were conducted with 40 people attempting suicide who were receiving care in an intensive‐care unit, and 129 interviews were carried out with their relatives and friends. The subjects were divided into 3 diagnostic groups: neurosis (n= 14), abuse (n= 19) and psychosis (n= 7). The incidence of relatives' failure to provide care after the suicide attempt ‐ turning‐away reactions as well as do not resuscitate orders, a form of passive euthanasia ‐ was investigated. In 8 cases, partners of patients in the abuse and neurosis groups showed turning‐away reactions. In 2 cases, relatives of elderly patinets in the neurosis group said to the doctor that life‐preserving measures should not be taken. Relatives explained their behaviour by saying that they had the best interests of the suicidal individual at heart. In‐depth interviews, however, revealed that these reactions were a manifestation of the relatives own psychic conflicts, brought forth by the confrontation with the depressed and suicidal patient. Turning‐away reactions and do not resuscitate orders might be interpreted as expressing the relatives' aggressiveness towards the suicidal individual and attempts to escape from a difficult situation. It is important that doctors stand up for the interests of suicidal people, which at times may conflict with relatives' interests, and help the relatives to sort out their problems and wishes with respect to the problem areas of passive euthanasia.
Work stress has negative effects on the attitudes of emergency personnel towards patients who attempt suicide
Authors: Suokas J. , Lönnqvist J.
Published: August 2007

ABSTRACT– Many previous studies indicate that the attitudes of the staff towards patients who attempt suicide are often negative. Nevertheless, the attitudes of the staff working in different areas of an emergency department have not been studied. The purpose of this study was to explain the attitudes of emergency personnel (n= 184) towards patients who attempt suicide in the different stages of treatment in a general hospital by comparing the attitudes of the staff in the emergency room (n= 64), emergency ward (n= 47) and intensive care unit (n= 73). There were clear differences in attitudes of staff in the various units. The attitudes were most negative among emergency room staff, where all attempters are first treated. The intensive care staff, who treat the most serious cases, shared the most positive attitudes. It seems that specialized treatment of suicide attempters makes it possible to treat these patients in a more professional way in a general hospital.
Ecological correlates of suicide in the United States and Hungary
Authors: Lester D. , Moksony F.
Published: August 2007

ABSTRACT– Ecological correlates of suicide were explored for the counties of Hungary and the states of the United States. Only one common correlate was identified (divorce rates). The remaining social indicators that were associated with suicide rates in the United States were not associated with suicide rates in Hungary. The importance of replicating ecological studies in several countries was noted.
Psychotherapy research between process and effect: the need of new methodological approaches
Authors: Werbart A.
Published: August 2007

ABSTRACT– The methodological problems and scanty results of psychotherapy research are noted and placed in a metascientific context. Efforts to attain ever greater specificity and standardization, guided by the idea of uniform methodology, are leading researchers steadily further away from the unique case. The underlying assumptions in current psychotherapy research are defined and the necessity of returning to case studies is indicated. Research methods need to be relevant and to make use of essential aspects of what is being researched (care of the research object). Psychotherapy research cannot avoid interpretations of meaning, and clinical methods should have a steering role. Case‐study methods lead to specific problems of control and generalization. The scientific research strategy used in case studies is described and compared with the hermeneutic circle.
An epidemiological survey of age‐related dementia in an urban area of Beijing
Authors: Li G. , Shen Y. C. , Chen C. H. , Zhao Y. W. , Li S. R. , Lu M.
Published: August 2007

ABSTRACT– An epidemiological survey of age‐related dementia among community residents of an urban of Beijing was conducted in 1986. Initial screening of 1331 subjects aged 60 and above was made using the Mini‐Mental State Examination (MMSE) with a cutoff point of 17. All suspected cases of dementia and 5.5% of all others were then given a full clinical examination, with subjects being diagnosed and classified according to DSM‐III criteria. The MMSE was found to have satisfactory sensitivity, although scores were significantly correlated with education. Prevalence rates of moderate and severe dementia were 1.28% for those aged 60 and above and 1.82% for those aged 65 and above. Rates for multi‐infarct dementia were higher than those for primary degenerative dementia; females had higher rates than males and rates increased sharply with age. All the dementia cases were cared for in their own homes, by relatives. There is a need for increased knowledge and services for elderly people in the community.
Clinical characteristics, health beliefs and compliance with maintenance treatment: a comparison between regular and irregular attenders at a depot clinic
Authors: Pan P.‐C. , Tantam D.
Published: August 2007

ABSTRACT– This study investigated the relationship between clinical characteristics, health beliefs and compliance with depot neuroleptic maintenance treatment in schizophrenic patients by comparing a group of 40 irregular clinic attenders with another group of regular attenders matched by age and sex. While the 2 groups showed no difference in drug‐induced extrapyramidal effects, the former were significantly more often depressed than the latter. Test‐retest reliability coefficients of a 4‐section health belief questionnaire showed marked variation in individual items. The 2 groups showed no difference in their perception of past effect of illness, likelihood of a relapse if maintenance treatment was stopped and effects of maintenance treatment.
Obsessive‐compulsive disorder in people that abuse codeine
Authors: Senjo M.
Published: August 2007

ABSTRACT– The author describes patients with severe obsessive‐compulsive disorder observed only when they abused codeine.
A cerebrospinal fluid study of the pathophysiology of panic disorder associated with alcoholism
Authors: George D. T. , Adinoff B. , Ravitz B. , Nutt D. J. , Jong J. De , Berrettini W. , Mefford I. N. , Costa E. , Linnoila M.
Published: August 2007

In order to investigate the neurochemistry of panic disorder in alcoholics, we measured various cerebrospinal fluid (CSF) parameters in subjects with both conditions and compared them with an age‐ and sex‐matched population of alcoholics and normal controls. When height, age and weight were covaried, subjects with panic disorder had higher levels of B‐endorphin in CSF. There were no differences in other CSF measures between the groups. Alcoholics with panic disorder had higher plasma MHPG concentrations compared with alcoholics without panic disorder but these were not statistically different from controls.
The influence of gender on the classification of psychotic disorders — a multidiagnostic approach
Authors: Copolov D. L. , McGorry P. D. , Singh B. S. , Proeve M. , Riel R. Van
Published: August 2007

A multidiagnostic approach was used prospectively to classify a sample of 176 psychotic patients. An excess of males was found with only one out of 11 systems of schizophrenia, the World Health Organization “flexible” system of schizophrenia, with an excess of females noted in 2 of 5 systems of schizoaffective disorder, the Kasanin schizoaffective system and the Feighner schizoaffective depressed category. Correlation matrices of the diagnostic categories were generated for men and women and multidimensional scaling was used to plot the distribution of diagnostic categories. In the male sample, patients appeared to cluster according to affective symptoms and the mood‐congruence of psychotic symptoms. Four clusters were apparent, but were less evident in the female sample. This gender difference was given partial support by quantitative measures of concordance. It is suggested that women manifested a greater admixture of symptoms, especially mixed affective and psychotic symptoms, than men.
Hallucinations in schizophrenia
Authors: Mueser K. T. , Bellack A. S. , Brady E. U.
Published: August 2007

The prevalence of different types of hallucinations and their clinical correlates were examined in 117 DSM‐III‐R schizophrenic or schizoaffective disorder patients. Auditory hallucinations were by far the most common, followed by visual hallucinations, and then by tactile and olfactory or gustatory hallucinations. Auditory hallucinations were associated with an earlier age of first hospitalization among the schizophrenics. Global severity of the illness for schizophrenics was related to the presence of visual hallucinations, but not other types of hallucinations. Tactile and olfactory or gustatory hallucinations were strongly correlated with each other and with the severity of delusions for both schizophrenic and schizoaffective patients. The results suggest that important clinical differences exist between patients with different types of hallucinations, and that these clinical variables need to be controlled for in cross‐cultural studies of hallucinations.
The new revolving‐door patients: results from a national cohort of first admissions
Authors: Lewis T. , Joyce P. R.
Published: August 2007

A cohort of all first admissions to New Zealand psychiatric hospitals and psychiatric wards of general hospitals in 1980 and 1981 was followed up for 5 years. The cohort consisted of 3875 males and 3965 females aged from 15 to 64 years. Of these subjects, 59.4% had only one admission; 14.6% met our criteria for a revolving‐door patient, as they had 4 or more admissions within the 5‐year follow‐up period. Based on first‐admission information, patients who were younger and had a psychotic diagnosis had an increased likelihood of becoming a revolving‐door patient. Stepwise logistic regression showed that younger age and psychotic diagnosis inde pendently and in interaction were associated with a high probability of becoming a revolving‐door patient. Although patients with a first‐admission diagnosis of schizophrenia constitute a large group of the new revolving‐door patients for both males and females, for women those with affective disorders and for men those with substance abuse comprise the largest proportion of the new revolving‐door patients. This is because affective disorders in women and substance abuse in men are the most common diagnoses on first admission, rather than because the disorders themselves are associated with a high probability of the patients having multiple ad missions.
From community mental health services to specialized psychiatry: the effects of a change in policy on patient accessibility and care utilization
Authors: Stefansson C.‐G. , Cullberg J. , Ekecrantz L. Steinholtz
Published: August 2007

In 1975, a community mental health (CMH) centre with most of its resources channelled to outpatient services was set up in a defined catchment area of 75,000 inhabitants near Stockholm. In 1981, the CMH centre was allocated 3 inpatient wards of its own. An outpatient unit to treat long‐term psychotic patients was also built up from existing resources. Emergency cases were directed to the primary health care services or to the emergency department of a hospital. During the same period, the number of doctors in the area's primary health care services increased fourfold. The social, demographic and diagnostic composition of the patient population and its utilization of in‐ and outpatient care in connection with these organizational changes are described. The population of the cathment area increased by 12.5% and the patient population decreased by 40%. The decrease was particularly great among first‐time visitors (– 54%), patients from lower social groups (– 53%) and those with crisis diagnosis (– 71%). The number of patients with psychoses increased (+ 26%). Outpatient visits and hospital utilization increased by one third. The number of compulsory admissions increased by 20% (still being far below the mean number in Stockholm). The decrease in the patient population is attributed to the reduction in accessibility to the CMH centre at a time when primary care services in the area were undergoing a sizeable expansion. The increased care utilization is the result of an internal redistribution of resources in favour of resource‐demanding, long‐term psychotic patients.
Relationship of psychotic symptoms to haloperidol‐stimulated prolactin release
Authors: Kulkarni J. , Keks N. A. , Stuart G. , Mackie B. , Minas I. H. , Singh B. S. , Copolov D. L.
Published: August 2007

Prolactin (PRL) response to a single dose of intravenous haloperidol (0.5 mg) was measured as a marker of tuberoinfundibular dopamine (TIDA) activity in 24 neuroleptic‐free, male, psychotic patients. The PRL responses were then correlated with psychotic symptoms measured with Andreasen's Scales for the Assessment of Positive and Negative Symptoms (SAPS, SANS). Correlation analyses revealed a significant inverse relationship between PRL response and the severity of delusional symptoms. There was no significant correlation between the symptoms of hallucinations, formal thought disorder, or global negative symptoms and PRL response to haloperidol, nor were there any significant correlations between basal PRL and symptom severity. These results suggest that among the positive and negative symptoms associated with psychoses, only delusions may be associated with TIDA overactivity.
P300 and smooth eye pursuit: concordance of abnormalities and relation to clinical features in DSM‐III schizophrenia
Authors: Ebmeier K. P. , Potter D. D. , Cochrane R. H. B. , Mackenzie A. R. , MacAllister H. , Besson J. A. O. , Salzen E. A.
Published: August 2007

Twenty‐five DSM‐III‐diagnosed schizophrenics and 37 normal and age‐matched controls were examined using an oddball paradigm for the generation of P300 and smooth eye‐pursuit tasks. Results were compared between groups and related to clinical characteristics, including a family history of psychiatric illness. Group differences were found for P300 amplitudes, latencies and eye‐tracking. A family history of psychiatric illness was associated with normal eye‐tracking in patients. Small P300 amplitudes alone and in combination with long P300 latencies were associated with a family history in controls.
Risk factors of alcoholism in Taiwan Chinese: an epidemiological approach
Authors: Hwu H.‐G. , Yeh E.‐K. , Yeh Y.‐L.
Published: August 2007

This study investigated the risk factors of alcohol abuse and alcohol dependence, as defined by DSM‐III criteria, in 11,004 Chinese subjects in the Taiwan community. Risk factors were analyzed using chi‐square and multivariate logistic regression statistics. The logistic regression shows that the risk factors of alcohol dependence include male, having had childhood or adulthood behavior problems; of alcohol abuse include male, having had childhood or adulthood behavior problems, non‐metropolitan community, age cohort, job‐holder. The etiological models proposed are biological for Chinese alcohol dependence and interactional for Chinese alcohol abuse.
A longitudinal study of cerebrospinal fluid beta‐endorphin‐like immunoreactivity in delirium: changes at the acute stage and at one‐year follow‐up
Authors: Koponen H. , Riekkinen J.
Published: August 2007

Cerebrospinal fluid beta‐endorphin‐like immunoreactivity (CSF BLI) was determined on 3 occasions for elderly delirious patients and the BLI levels were compared with age‐equivalent controls. Delirious patients showed a significant reduction in the BLI values in the first sample and a declining trend was seen in the follow‐up. The results suggest a role for beta‐endorphinergic dysfunction in the genesis of some symptoms of delirium, and this dysfunction may be a common phenomenon in various forms of delirium and dementia.
Bright light treatment of winter depression: morning versus evening light
Authors: Avery D. H. , Khan A. , Dager S. R. , Cox G. B. , Dunner D. L.
Published: August 2007

In a randomized crossover design, 7 patients with winter depression were treated with 7 d of bright morning light (0600 to 0800) and 7 d of evening light (2000 to 2200). Bright lights in the morning significantly reduced the Hamilton Rating Scale for Depression (HRSD) score (18.4 to 5.0); the bright light in the evening moderately decreased the HRSD score (19.4 to 15.1). The improvement in the HRSD score was significantly greater with morning light than with evening light.
Psychopathological and social status of patients with affective, schizophrenic and schizoaffective disorders after long‐term course
Authors: Marneros A. , Deister A. , Rohde A.
Published: August 2007

A total of 106 affective, 101 schizoaffective and 148 schizophrenic disorders were investigated after a long‐term course of illness (mean follow‐up period 25.1 years), employing narrow definitions and using reliable international instruments of evaluation. In addition, the social consequences of the illness were evaluated (upward and downward social and occupational drift, premature retirement and achievement of the expected social development). Considering all aspects of outcome, schizophrenic patients (narrow defined, slightly modified DSM‐III criteria) had persistent alterations in several aspects of social life, communication and cognitive functions, in some cases to a very high degree. Although the outcome of affective disorders is not always favourable, it is significantly more favourable than that of schizophrenia. Schizoaffective disorders occupy a position between affective and schizophrenic disorders regarding outcome, but with more similarities to that of affective than to that of schizophrenic disorders.
Personality, parental rearing behaviour and parental loss in attempted suicide: a comparative study
Authors: Benjaminsen S. , Krarup G. , Lauritsen R.
Published: August 2007

Thirty psychiatric patients (aged 18‐29) who had attempted suicide were compared with 2 matched control groups, one consisting of nonsuicidal psychiatric patients and the other of normal subjects, for personality patterns, parental rearing practices and personal loss before the age of 15. The instruments used were the Eysenck Personality Questionnaire (EPQ), the Lazare‐Klerman‐Armor Trait Scale (LKAS), the Narcissistic Personality Inventory (NPI) and the Own Memories of Child‐Rearing Experiences (EMBU). Patients admitted for suicide attempts differed significantly from normals on several personality dimensions, whereas suicide attempters did not have personality characteristics that made them substantially different from nonsuicidal psychiatric controls. The suicide attempters had experienced significantly more negative and less positive parental rearing factors than normals, but no difference was found between suicidal and nonsuicidal patients for own memories of parental rearing patterns. Parental loss due to divorce had occurred significantly more often among suicide attempters than among both nonsuicidal psychiatric patients and normals.
The impact of phenotypic variation on genetic analysis: application to X‐linkage in manic‐depressive illness
Authors: Baron M. , Hamburger R. , Sandkuyl L. A. , Risch N. , Mandel B. , Endicott J. , Belmaker R. H. , Ott J.
Published: August 2007

Genetic linkage studies have opened new vistas for behavioral and psychiatric genetics. However, phenotypic diversity and diagnostic uncertainties can lead to spurious linkage findings. A method of analysis is proposed that takes these factors into account. When applied to manic‐depressive disease, the results indicate that previous evidence for a major gene localized on the distal long arm of the X‐chromosome cannot be ascribed to phenotypic uncertainties and misclassifications, i.e., a type I error. Although the lod score (the logarithm of odds) favoring linkage is reduced with the more restrictive clinical definitions of the phenotype, it remains significant nonetheless. Thus, the linkage finding is robust over a range of phenotypic patterns and presumed phenocopy frequencies. The results also suggest that the X‐linked phenotype is a particularly severe form of manic depression characterized by early onset, high familial prevalence of the bipolar form, and high recurrence rate of major depression. These findings may have important implications for the design and interpretation of genetic linkage studies and for refining diagnostic techniques in mental disorders.
Lithium discontinues. I. Clinical characteristics and outcome
Authors: Nilsson A. , Axelsson R.
Published: August 2007

Eleven patients with major affective disorder (DSM‐III) were investigated after a mean of 6.7 years on lithium prophylaxis and reinvestigated 7 years later, at which time they had discontinued lithium for a mean 2.3 years. Outcome was assessed by the Comprehensive Psychopathological Rating Scale, by relapse frequencies, by need for psychotropic medication and for inpatient treatment. The study period was associated with an increase in the rated score for depression, as previously observed also in lithium continuers. Although the relapse frequencies remained largely unchanged, a significantly increased number of inpatient treatment days indicated considerably more severe episodes after the discontinuation of lithium. Long periods without lithium were associated with higher doses of neuroleptic drugs.
Zinc in depressive disorder
Authors: McLoughlin I. J. , Hodge J. S.
Published: August 2007

Plasma zinc levels were measured in 14 patients with primary affective disorder on admission to hospital; they were compared with plasma zinc levels in group of 14 age‐ and sex‐matched controls. A significant difference in zinc levels was found between the 2 groups. Plasma zinc levels of 9 of the depressed patients on admission to hospital and at the point of discharge were compared; a significant increase in zinc levels was detected.
Clinical characteristics of the Pisa syndrome
Authors: Suzuki T. , Koizumi J. , Moroji T. , Sakuma K. , Hori M. , Hori T.
Published: August 2007

The Pisa syndrome is not yet well characterized, although there have been increasing reports on its prevalence and the clinical features of drug‐induced dystonia. In this report, we present 20 cases of the Pisa syndrome and discuss the clinical symptoms compared with those of classical types of drug‐induced dystonia. The Pisa syndrome may occur not only as a subtype of acute dystonia but also as a subtype of tardive dystonia. Abnormal findings on brain CT were noted in both acute and tardive types of the Pisa syndrome, indicating that, like tardive dystonia, the Pisa syndrome may be associated with cerebral lesions. Young female patients were susceptible to both acute and tardive types of the Pisa syndrome, but the prevalence of both types of dystonia was inconsistent in these patients. Thus, it seems likely that very complicated pathophysiological changes in the brain are involved in the development of the Pisa syndrome.
Mental illness and admission to general hospitals: a register investigation
Authors: Fink P.
Published: August 2007

Admissions to psychiatric departments and general hospitals in an 8‐year period were studied for the 17‐ to 49‐year‐old population in 2 Danish municipalities. Information was extracted from the National Patient Register and the Danish Psychiatric Register, registers containing information on all admissions to nonpsychiatric and psychiatric departments, respectively, in Denmark. Fourteen percent of the patients who had been admitted at least once to a general hospital (or 7.5% of the background population) had an indication of a mental disorder. They comprised one fourth of all general admissions of the population during the 8‐year period. Patients who had been admitted to a general hospital had a 4 times greater risk of having been admitted to a psychiatric department than the rest of the population and the risk increased markedly with number of general admissions. A pronounced association was found between the number of admissions to general hospitals and psychiatric departments; i.e., both types of admissions clustered in some individuals. The excessive general admissions of psychiatric patients were found to be correlated to all types of psychiatric diagnoses, but was less prominent in nonorganic psychoses. The implication is that there is a very close association between somatic and psychiatric morbidity and that the mentally disturbed use a great part of the nonpsychiatric health services.
Monoamines and schizophrenia
Authors: Sedvall Göran
Published: August 2007

Abstract The hypothesis that central biogenic amines may play a role in the pathophysiology of schizophrenia was originally based upon the fact that hallucinogenic and antipsychotic drugs have profound effects on central transmitter pathways where dopamine, noradrenaline and serotonin are involved. The structural similarities between hallucinogenic drugs such as amphetamine and mescaline, and catecholamines on the one hand and lysergic acid diethylamide (LSD) and indolamines such as serotonin on the other hand have by direct experimentation been shown to explain their important effects on the transmitter systems. The marked effect of several classes of chemically different antipsychotic drugs on central dopamine receptor function formed the basis for the dopamine hypothesis regarding the mechanisms of action of these drugs and also for the hypothesis that dopamine D2 receptor function played a significant role in the pathophysiology of schizophrenia. Direct experimental analysis of aminergic functions in the brain of schizophrenic patients, both during life and post mortem, has been and will for die foreseeable future continue to be a rational approach to the further elucidation of the validity of these hypotheses. Analysis of metabolite levels in the cerebrospinal fluid and plasma of schizophrenic patients has shown great variation in the results with reports of both elevated and reduced release of amines in the brains of schizophrenic patients. Analysis of the aminergic receptor structures in the postmortem human brain has relatively consistently revealed an increased density of D2 receptors in the major basal ganglia of schizophrenic patients. Whether these alterations represent a primary feature of brain structure in schizophrenia or a drug‐induced effect still remains to be shown. Positron emission tomographic (PET) scan studies of D2 receptors in schizophrenia have demonstrated both increased densities and absence of change in the characteristics of D2 receptors in the patients as compared to matched controls. This review gives a critical account of the biochemical studies that examine the possible role of biogenic amine abnormalities in the brains of schizophrenic patients.
Atypical neuroleptics: role of multiple receptors, endogenous dopamine, and receptor linkage
Authors: Seeman Philip
Published: August 2007

Abstract A variety of biological factors may account for the atypical lack of parkinsonism that is a characteristic of the administration of the many ‘atypical’ neuroleptics. Although dopamine D2 receptor blockade continues to be a dominant feature of successful neuroleptics, the concomitant blockade of muscarinic or serotonergic S2 receptors helps to prevent neuroleptic‐induced parkinsonism for some atypical neuroleptics (clozapine, thioridazine, risperidone). The D2‐selective benzamides, however, do not block other known receptors (with the possible exception of sigma sites). Therefore, the atypical nature of the benzamides may be based on their sensitivity to the level of endogenous dopamine released in the different regions of the brain. Finally, atypical neuroleptic action may possibly stem from direct linkage between different receptors coupled through components of the G protein system.
Neuropharmacological and behavioural properties of remoxipride in the rat
Authors: Ögren S‐O , FIoryall L. , Hall H. , Magnusson O. , Ängeby‐Möller K.
Published: August 2007

Abstract Remoxipride blocks dopamine agonist‐induced effects in the rat, mediated by dopamine D2 receptors with an in‐vivo potency less than that of haloperidol but greater than that of chlorpromazine, thioridazine, and sulpiride. Unlike haloperidol and sulpiride, remoxipride has weaker antagonistic effects towards presynaptic dopamine activity compared to its effects on postsynaptically mediated activity. Remoxipride causes a preferential inhibition of dopamine agonist‐induced locomotion as compared to stereotyped behaviour, suggesting that it may exert a preferential blockade of mesolimbic dopamine neurotransmission. The low tendency of remoxipride to cause catalepsy in the rat is indicative of a weak effect on striatal dopamine neurotransmission and predicts a low liability to induce extrapyramidal side effects in man. Remoxipride causes a smaller elevation of prolactin than sulpiride at doses producing central dopamine receptor blockade. The results suggest that remoxipride, unlike haloperidol, can discriminate between different types of dopamine mediated functions probably by having a preferential action on subpopulations of functionally coupled dopamine D2 receptors.
Plasma concentration of remoxipride in relation to antipsychotic effect and adverse symptoms
Authors: Jostell K.‐G. , Lapierre Y. D. ,   the Canadian Remoxipride Study Group
Published: August 2007

Abstract The possible relationship between plasma concentration of remoxipride and antipsychotic effect/adverse symptoms has been evaluated in a 6‐week double‐blind dose‐finding study in schizophrenic patients. The study comprised 3 parallel groups with fixed daily doses of 30–90 mg, 120–240 mg or 300–600 mg, divided in order to be given three times a day. A total of 79 patients from the three groups, who were treated with the maximum dose for 4 weeks or more, were included in the analysis. All patients had reached steady‐state at week 2 and the intra‐individual trough remoxipride plasma levels remained stable over the study period. The mean steady‐state trough concentrations were found to be linearly related to the dose. Responders to remoxipride treatment were observed over the total concentration range of 0.24–13.50 μmol/l. Reductions of dose or discontinuations of treatment due to adverse symptoms were not associated with elevated remoxipride concentrations. In conclusion, no obvious relationship between plasma concentration of remoxipride and its antipsychotic effect or adverse symptoms was established.
Drug interaction studies with remoxipride
Authors: Yisak W. , von Bahr C , Farde L. , Grind M. , Mattila M. , Ogenstad S.
Published: August 2007

Abstract The interaction potential of remoxipride was investigated with biperiden, warfarin, diazepam, and ethanol. The studies were conducted in 12 healthy volunteers each of whom received single doses of remoxipride, the interacting drug, and the combination in a randomized crossover design. Remoxipride and biperidene had no influence on each other's pharmacokinetics. The pharmacokinetics of warfarin enantiomers were uninfluenced by remoxipride. Ethanol and diazepam had no effect on the pharmacokinetics of remoxipride. The effect of remoxipride on the elevation of plasma prolactin levels was not modified by biperiden and the effect of warfarin on the prolongation of prothrombin time was uninfluenced by remoxipride. Remoxipride showed no pharmacokinetic interaction with any of the drugs studied, nor was any pharmacodynamic interaction observed in the remoxipride versus biperiden and remoxipride versus warfarin studies.
Distribution of remoxipride to the human brain and central D2‐ dopamine receptor binding examined in vivo by PET
Authors: Farde L. , von Bahr C.
Published: August 2007

Abstract Remoxipride is a new antipsychotic drug that binds selectively to the D2‐dopamine receptor subtype as demonstrated in animal studies in vitro and in vivo. It is generally assumed that the antipsychotic effect of neuroleptic drugs is mediated by blockade of dopamine receptors. The aim of the present study was to use positron emission tomography (PET) and the ligand [C] raclopride to examine the central D2‐dopamine receptor occupancy in man during oral administration of remoxipride. After oral administration of remoxipride 100 mg three times daily to a healthy male subject there was a 73% central D2‐dopamine receptor occupancy. In a schizophrenic patient treated with remoxipride 200 mg twice daily there was a 71 % occupancy. These occupancy values are similar to the values of 65–85% previously found in a series of patients treated with neuroleptics representative of all currently used chemical classes. In a separate experiment, remoxipride was labelled with C and injected intravenously and the distribution of radioactivity to the brain examined. Radioactivity appeared in the brain during the first minutes after injection and 4.5 min after injection it accounted for 0.8% of the total radioactivity injected, thus indicating that [C]remoxipride had rapidly passed through the blood‐brain barrier.
Antidepressants, alcohol and psychomotor performance
Authors: Tiller J. W. G.
Published: August 2007

The acute psychomotor effects of moclobemide, a reversible inhibitor of MAO‐A antidepressant (100 and 300 mg) compared with amitriptyline (25 and 75 mg) showed that moclobemide caused no significant impairment in contrast with amitriptyline, which caused significant impairment at both doses. Two other studies are reviewed. One study reported the acute effects of moclobemide (100 and 300 mg), trazodone (100 mg), placebo, and alcohol (0.5 g/kg) or placebo in an elderly group: moclobemide caused little impairment or alcohol potentiation and may reverse some alcohol impairment, whereas trazodone caused substantial impairment and alcohol potentiation. Another study of the acute and chronic effects of moclobemide (200 mg 3 times daily) or clomipramine (25 mg twice daily) and their interactions with alcohol (blood alcohol concentration 0.6 g/1) showed that alcohol caused significant impairment, whereas clomipramine tended to enhance and moclobemide to reduce some impairment. Moclobemide appears to be an antidepressant with few psychomotor effects and minimal alcohol potentiation and may reduce some alcohol impairment.