bluuebunny/crossref_metadata_2025 huggingface dataset:
Tumor Necrosis Factor in the Pathogenesis of Human Diseases
Authors: Ghezzi P.
Published: January 2017

This paper will deal with the role of tumor necrosis factor (TNF) in the pathogenesis of various diseases. However, it will be important to remember that originally TNF was characterized as an antitumor factor. In fact, it was known that endotoxin was able to induce hemorrhagic necrosis of some tumors in mice. In 1975 Carswell et al. demonstrated the presence of a tumor necrotizing activity (termed “tumor necrosis serum”) in the sera of mice primed with C. parvum or BCG, and subsequently injected with endotoxin (1). Later it was found that this factor was a macrophage product and was termed TNF. In vivo TNF induced hemorrhagic necrosis of Meth A sarcoma and in vitro demonstrated cytotoxic activity against various tumor cell lines (2). In 1984, TNF was purified and its cDNA was cloned, and the production of substantial amounts of recombinant TNF allowed the characterization of its various biological activities (3).

In parallel to these studies on tumor necrosis, the group of Cerami, at the Rockefeller University in New York was studying the mechanisms of cachexia and wasting associated with infection. They found that infection or injection of endotoxin in laboratory animals resulted in a marked hypertrygliceridemia, which was associated with an inhibition of lipoprotein lipase. They hypothesized that a host-derived mediator was responsible for this and other metabolic derangements observed in infection. This factor, which was termed “cachectin”, was later found to be produced by macrophages, and once it was purified and sequenced it became clear that TNF and cachectin were identical (4).
Cytokines Involved in the Pathophysiology of IgE Response
Authors: Del Prete G.F. , Ricci M.
Published: January 2017

Recent data in both mouse and human systems have clearly indicated that IL-4 plays an essential role in the induction of IgE response, whereas IFN-γ exerts an opposite effect on this phenomenon. However, IL-4 alone is unable to induce IgE synthesis. A prior membrane contact signal delivered by activated T cells is required by B cells to synthesize IgE in response to IL-4. A cognate interaction between B and T cells producing IL-4 (but not IFN-γ) is optimal for induction of IgE synthesis. However, when such IL-4 producing T cells are activated, they may provide B cells with a membrane signal, through a non-cognate interaction, which also results in induction of IgE synthesis. Other cytokines, such as IL-2 and IL-6, play an auxiliary role in IL-4 dependent IgE production.

Analyses at the clonal level of the profile of cytokine production by helper T cells have shown that imbalances between IL-4 and IFN-γ producing T cells can be detected in patients with hyperproduction of IgE. In children with hyper-IgE syndrome a strong reduction of circulating T cells able to produce IFN-γ (and TNF-α) was found, whereas both, reduction of IFN-γ-producing and increase of IL-4 producing T cells were found in patients with parasitic infestation. In allergic inflammatory infiltrates, such as those found in vernal conjuctivitis, helper T cells able to produce IL-4 and to induce IgE synthesis accounted for the large majority of infiltrating T cells. It is reasonable to suggest that systemic or microenvironmental alterations of the balance between IL-4- and IFN-γ-producing T cells may be involved, at least in part, in the pathophysiology of the increased igE response occurring in a number of human diseases.
The Effect of Transforming Growth Factor β1, and Tumor Necrosis Factor α on the Cytotoxic-Cytostatic Action of Interleukin-1 (α and β Isoforms) on the Pancreatic B Cell Line Rin-5ah
Authors: Mitlianga P. , Germanidis G. , Moutsopoulos H. M. , Papadopoulos G. K.
Published: January 2017

The rat pancreatic β cell line RIN-5AH was treated with the cytokines IL-1 (α and β), TNFα and TGF-β1, in order to examine at the clonal level the reported mostly cytotoxic effects of IL-1, on isolated islets of Langerhans and islet cell preparations. In contrast to what has been previously reported for whole islets and islet cell preparations we find that IL-1 (α or β) is not cytotoxic to the RIN-5AH cells in logarithmic growth phase to any extent, even at very high cytokine concentrations (125 nM). Furthermore, TNFα does not in any way potentiate IL-1 cytotoxicity. Transforming growth factor-β1 (TGF-β1) at concentrations of 80 pM to 2 nM, has a potentiating effect on IL-1 cytotoxicity (conc. 5 nM) for this clonal cell line. The effect is proportional to the level of TGF-β1 present and is exerted regardless of the IL-1 isoform used. The effects of the various cytokines, alone or in combination, were only observed at high (25 mM) glucose concentrations, and no such effects were observed at the physiological (5 mM) glucose concentration. Furthermore the combination of TGF-β1 and IL-1 inhibits the release of insulin by these cells, whereas either cytokine alone has no effect.

We conclude that the RIN-5AH cells in showing little cytotoxic/cytostatic response to IL-1 are responding more as isolated β cells than as cells within islets. The potentiation of the action of IL-1 by TGF-β1 on these cells is a matter of further investigation.
The Effect of Nickel Compounds on Mitogen Dependent Human Lymphocyte Stimulation
Authors: Sikora J. , Zeromski J.
Published: January 2017

The effect of metal salts, three nickel and one non-nickel (manganese chloride), was examined on the ability to influence mitogen stimulated normal human blood lymphocytes by means of short term in vitro culture and a tritiated thymidine incorporation test. Purified lymphocytes were incubated for one hour with tissue culture medium containing either one of the nickel salts tested (nickel subsulfide, nickel sulfate or nickel acetate) or manganese chloride. Separate portions of cells were incubated in the metal salt mixtures containing both, nickel and manganese salts. All metal salts were used in predetermined subtoxic concentrations. Two mitogens, phytohemagglutinin (PHA) and concanavalin A (Con A), were used as lymphocyte stimulatory agents. Cells were cultured for 72 hrs.

It was found that following incubation with nickel salts, mitogen dependent lymphocyte stimulation was inhibited proportionally to the metal salt concentration. This blocking effect on tritiated thymidine incorporation was stronger for readily soluble nickel salts i.e. sulfate and acetate than for almost insoluble nickel subsulfide with either mitogen used. Manganese chloride used as a single salt resulted in a dose-dependent increase of lymphocyte stimulation as compared to the mitogen stimulated cells without preincubation with either metal (control samples). Cells preincubated with nickel salt-manganese chloride mixtures exhibited an increase of thymidine incorporation but below values for control cells.
The Use of Immunoperoxidase in the Detection of the Erysipelothrix Insidiosa Antigen in Experimentally Infected Turkeys
Authors: Vlemmas I. , Papaioannou N. , Frydas S. , Tsangaris Th.
Published: January 2017

A simple method using direct and indirect polyclonal antibody-based immunoperoxidase techniques were used to detect E. insidiosa antigen in various organ specimens (kidney, heart, skin, joint of knee and bursa of Fabricius) in experimentally infected turkeys. The specimens were fixed in formalin and ethanol and then embedded in paraffin. By using the above methods E. insidiosa bacilli were detected intracellularly in macrophages and endothelial cells of the vessels. They were also found extracellularly in the lumen of the vessels, either free or in aggregations of bacteria trapped in fibrin thrombi. It is interesting to note the presence of the E. insidiosa bacillus antigen in the cytoplasm of the endothelial cells of the vessels, which indicates intense phagocytic activity.
Modulation of Hemopoiesis in Normal and Tumor-Bearing Mice on in Vivo Administration of FK565
Authors: Parajuli P. , Singh S. M.
Published: January 2017

The present investigations were undertaken to study the effect of in vivo administration of FK565 on the process of hemopoiesis in normal and tumor-bearing mice. FK565 administration (10 mg/kg body weight) of normal mice resulted in an enhancement of the bone marrow cell (BMC) colony foming activity (CFA) and proliferation in vitro. The counts of granulocyte- and granulocyte macrophage-colony forming units (CFU-G and CFU-GM) were significantly enhanced in the BMC of FK565-treated group. The total leukocyte count (TLC) was also augmented after FK565 administration. The differential leukocyte count (DLC) revealed an enhancement of the neutrophil count in the FK565-treated mice. A similar pattern of BMC proliferation, CFA, TLC and DLC was observed in P815 tumor-bearing mice. FK565 administration of the tumor-bearing mice, however, did not significantly alter the CFA, TLC and DLC.
Absence of Oligoclonal IgG Bands and Anti-Achr Antibodies in the Cerebrospinal Fluid of Patients with Myasthenia Gravis
Authors: Kapinas K. , Tzartos S. , Kokkas B. , Divanoglou D. , Tsolaki M. , Anogiannakis G. , Kazis A.
Published: January 2017

Myasthenia gravis (MG) is a neuromuscular disorder in which antibodies are directed against the nicotinic acetylcholine receptor (AChR) at the neuromuscular junction. Some investigators describe the existence of oligoclonal IgG bands and anti-AChR antibodies in the cerebrospinal fluid (CSF) of MG patients while other refuse it. This study was performed in 15 patients with clinical and electrophysiological diagnosis of MG. Oligoclonal IgG bands (OCB) and antibodies to the AChR from human skeletal muscle were determined in the serum and the CSF of the above MG patients. The last one was done in order to investigate any possible central nervous system (CNS) involvement.

It was found that all the MG patients who had a high titre of anti- AChR antibodies in the serum (mean titre 29.2±24.3 nM, range 1.8 to 62 nM) did not present OCB and anti-AChR antibodies in their CSF. On the same time, in a group of 10 patients with a definite multiple sclerosis it was found that eight of them presented OCB in their CSF while the results were negative in another group of 10 patients without evidence of CNS disease. The last two groups served as control groups.

Our findings are in accordance with the concept that MG is a pure neuromuscular disorder.
The Influence of Some Immunosuppressive Drugs on the Metabolic Activity of Human Phagocytes and Lymphocytes in vitro
Authors: Dušková M. , Dušek L. , Čìž M. , Lojek A. , Slavíková H.
Published: January 2017

The effect of azathioprine, cyclosporine A and FK 506 on the production of reactive oxygen species by polymorphonuclear leukocytes (Iuminol-dependent chemiluminescence) and on the blast transformation of lymphocytes ([3H]thymidine incorporation) was studied in dose-response experiments under in vitro conditions. Although there were no significant effects of immunosuppressives on non-stimulated blast transformation, FK 506 and cyclosporine A significantly inhibited the blast transformation stimulated by concanavaline A and protein A and the effects made it possible to build 2nd-order polynomial dose-response models. Azathioprine was found to be a relatively weak inhibitor of [3H]thymidine incorporation in lymphocytes (76% of control value). Spontaneous production of reactive oxygen species by polymorphonuclear leukocytes was significantly inhibited, particularly by FK 506 (1–100 ng.ml−1) in comparison to the control value, while there was no effect of the immunosuppressives on this system activated either by starch grains or zymosan. Only the highest applied concentrations of azathioprine (100 ng.ml−1) and cyclosporine A (1000 ng.ml−1) led to a significant decline in spontaneous phagocytosis. The direct effect of immunosuppressives on activated production of reactive oxygen species by neutrophiles was not proved.
Protein M and Fibronectin-Binding Proteins are Not Sufficient to Promote Internalization of Group a Streptococci into Hela Cells
Authors: Greco R. , von Hunolstein C. , Orefici G. , Donnarumma G. , Polidoro M. , Modica F. , Nicoletti M. , Valenti P.
Published: January 2017

Infection by group A streptococci is often associated with highly invasive diseases resulting in sepsis and shock. Recently, this species has renewed interest in the mechanism by which some strains are better able to invade mucosal epithelia and to penetrate into the bloodstream than are others. In this work we have evaluated the invasive ability of eight group A Streptococcus pyogenes strains isolated either from patients with severe invasive diseases, or with pharyngitis, or from healthy carrier. Five out of the eight strains studied were efficiently internalized within HeLa cells and, of these, four produced the M6 protein. A recombinant S.gordonii strain constitutively expressing the M6 protein failed to invade HeLa cell monolayers, suggesting that the expression of the M6 protein is not sufficient to allow the non-invasive S.gordonii to be internalized within Hela cells. As fibronectin-binding proteins have been implicated as primary adhesins in host-parasite interactions, we assayed the adhesiveness and the invasiveness of five invasive GAS strains in competition experiments where HeLa cells were infected with bacteria in the presence of purified fibronectin. The results obtained indicated that fibronectin moderately inhibits bacterial adhesion, while it does not affect internalization. These results indicate that other factors, together with fibronectin-binding proteins, participate in the adhesion of streptococci, and that fibronectin-mediated adhesion does not seem to be important in the internalization process of streptococci within HeLa cells.
Functional Characterictics of Bone Marrow Immune Suppressive Cells in Patients with Gastric Cancer
Authors: Kusmartsev S. A. , Kusmartseva I. N. , Tcherdyntseva N.V. , Afanasyev S.G. , Vasilyev N.V.
Published: January 2017

The progressive growth of cancer is accompanied by alteration in the regulation of both hematopoiesis and immunity. In this study we assessed the immunoregulatory features of bone marrow (BM) plastic non-adherent cells in patients with primary gastric cancer. Suppressive activity of BM cells or its culture supernatants was determined by inhibition of normal peripheral blood mononuclear cells (PBMC) response to phytohemagglutinin (PHA) or NK cell cytotoxicity. It was shown that fresh isolated BM cells from gastric cancer patients are capable markedly inhibit the mitogen-induced proliferative response of PBMC as well as NK cell cytotoxic activity. The immune suppressive cell activity was revealed among the non-adherent cell fraction only. The addition of indomethacin, inhibitor of prostaglandin synthesis, or NG-monomethyl-L-arginine (L-NMA), a competitive inhibitor of nitric oxide (NO) synthase, to the cultures did not diminish the suppressive effect of non-adherent BM cells in cancer patients. This BM cell mediated suppression of mitogen-induced proliferation of PBMC could be reduced, at least in part, by addition of neutralizing monoclonal antibodies to TGF-β. When normal PBMC were cultured with supernatant of BM cells derived from cancer patients, their natural killer cell activity was strongly down-regulated. It was shown also that NK cell capacity to bind tumor target cells was reduced in the presence of BM cell supernatant. Taken together our data demonstrate that BM non-adherent cell of patients with gastric cancer exhibit the immune suppressive activity which should be supposed to contribute to impairment of tumor immunity as malignant growth progresses.
Diabetic Polyneuropathy and the Genetics of Signal Transduction. Evidence of Association with Cytosolic Low Molecular Weight Phosphotyrosine-Phosphatase
Authors: Antonacci E. , Bottini N. , Gloria-Bottini F. , Amante A. , Lucarini N.
Published: January 2017

We have studied 263 subjects with non-insulin-dependent diabetes mellitus (NIDDM) and have found a highly significant interaction between cytosolic low molecular weight phosphotyrosine phosphatase (cLMWPTP) and RhE genotypes concerning their effects on polyneuropathy.

A discriminant analysis has revealed two distinct clusters of subjects with neuropathy differing for both cLMWPTP and RhE genotypes. A high glycemic level is present in one cluster only, suggesting that genetic variability of signal transduction may have an important role especially in patients developing neuropathy in spite of a satisfactory metabolic control of diabetes.
Staff Feelings and Patient Diagnosis
Authors: Holmqvist Rolf
Published: January 2017

Objective:

To assess the associations between staff feelings toward patients and the patients' diagnoses, in view of the fact that clinical reports of such associations have not been corroborated by systematic research.

Method:

At 24 psychiatric units, 143 patients were assessed according to their personality organization, and staff feelings toward these patients were followed for 5 years. The feelings were reported on a feeling checklist twice yearly, and outcome was assessed as the effect size at year 5, using ratings on Kernberg's structural model complemented with ratings on Strauss-Carpenter's function scale.

Results:

The study showed that it was possible, using discriminant analyses, to separate diagnostic groups by the different feelings that they evoked in the staff. Patients with borderline personality organization (BPO) evoked fewer relaxed and more aggressive feelings, in contrast to patients with psychotic personality organization (PPO). In contrast to patients with neurotic personality organization (NPO), who evoked feelings of sympathy and helpfulness, PPO patients evoked more feelings of insufficiency and disappointment. A stepwise discriminant analysis of reactions to patients with positive treatment outcome separated the 3 personality organizations with 2 functions using only 2 feelings, “relaxed” and “objective.” The feeling relaxed separated the NPO patients from the BPO patients, and the feeling objective separated the PPO patients from the other groups. The patients' diagnoses accounted for larger proportions of variance in feelings for the patients with positive outcome.

Conclusion:

The results implied that the patients' different personality organizations evoked different staff feelings in this treatment context and that positive treatment outcome was associated with more pronounced and clear-cut staff reactions.
Déficit en théorie de l'esprit dans la schizophrénie: Relecture clinique et revue des arguments expérimentaux
Authors: Sarfati Yves
Published: January 2017

Objectifs:

Cet exposé de synthèse se propose de réunir, de confronter et de commenter les arguments cliniques et expérimentaux plaidant en faveur de l'hypothèse d'un déficit en théorie de l'esprit dans la schizophrénie.

Méthode:

Après la définition du terme « théorie de l'esprit », suit une revue qui se veut exhaustive de la documentation concernant l'hypothèse d'un déficit en théorie de l'esprit dans la schizophrénie. Les différents arguments cliniques ou expérimentaux sont présentés en huit chapitres, et suivis d'une synthèse de la question.

Résultats:

L'hypothèse d'un déficit en théorie de l'esprit dans la schizophrénie est convaincante, surtout au vu des expériences les plus récentes. Ce déficit cognitif permettrait d'expliquer la présence de certains signes schizophréniques comme le délire d'influence ou de référence, les troubles de l'adaptation sociale ou les signes de désorganisation dans le champ de la communication. Le rôle de l'ambiguïté des situations, du niveau intellectuel et du traitement est discuté.

Conclusions:

Le déficit en théorie de l'esprit est une voie de recherche récente dans le domaine de la schizophrénie, susceptible de répercussions cliniques. Les modèles explicatifs et les paradigmes expérimentaux doivent être perfectionnés pour pouvoir déterminer plus précisément le rôle d'un tel déficit dans la survenue des symptômes.
Inpatient Treatment of Severe Disruptive Behaviour Disorders with Risperidone and Milieu Therapy
Authors: Ad-Dab'bagh Yasser , Greenfield Brian , Milne-Smith Jennifer , Freedman Hyman
Published: January 2017

Objectives:

To evaluate the therapeutic impact of adding risperidone to milieu therapy of latency-aged inpatients with severe disruptive disorders.

Methods:

The charts of 90 latency-aged patients consecutively admitted to a psychiatry ward were reviewed retrospectively. Fifteen of these patients received 0 risperidone treatment, were nonpsychotic, and did not suffer from pervasive developmental disorder (12 male, 3 female; mean age 9.99 years, SD 1.76). Their scores on the Children's Global Assessment Scale (CGAS) were compared at admission, before risperidone treatment, and at discharge.

Results:

All subjects were diagnosed with a disruptive behavioural disorder. Ten (66.67%) had additional learning difficulties, and 13 (86.7%) had pathological personality traits. The characteristics of the sample suggested borderline pathology or multiple complex developmental disorder. Following a mean of 38 days after admission (SD 22.3), the patients received risperidone for a mean of 46 days (SD 28.2) before being discharged. The mean maintenance dose of risperidone was 1.27 mg daily (SD 0.36). Mean CGAS scores increased from admission (21.9, SD 7.0) to before risperidone treatment (26.8, SD 7.6, P < 0.0001) and to discharge (50.3, SD 5.3, P < 0.0001). Only 2 patients had documented side effects.

Conclusions:

Low-dose risperidone used adjunctively to milieu therapy led to statistically and clinically significant additional improvement in the functioning of hospitalized latency-aged children with severe behavioural disorders. Low-dose risperidone is a safe and effective adjunct to milieu therapy for treating this population in inpatient settings. Prospective randomized controlled trials are needed to confirm these findings.
Natural Disasters and Service Delivery to Individuals with Severe Mental Illness—Ice Storm 1998
Authors: McMurray Lisa , Steiner Warren
Published: January 2017

Objective:

To review the literature on the responses of individuals with severe mental illness (SMI) to natural disasters, to describe the impact of the 1998 Ice Storm on a group of SMI patients, and to describe the steps taken at a Canadian university teaching hospital to ensure the ongoing provision of mental health services throughout the crisis.

Method:

Published articles describing the impact of natural disasters on SMI populations, as well as service provision to these patients, are reviewed. Service use at the Montreal General Hospital (MGH) Department of Psychiatry is described. A questionnaire about the impact of the ice storm was administered to a group of patients in an assertive community treatment program.

Results:

Service use during this natural disaster was consistent with that described in the literature, in that these patients were no more likely to be admitted or to visit the emergency room during the crisis. Continuous mental health service delivery may have contributed to this positive outcome. This service delivery was provided by ensuring staff access to information, by securing the physical safety of both staff and patients, and by taking a flexible, outreach-oriented approach to service delivery.

Conclusions:

SMI patients who have ongoing access to psychiatric services in disaster situations tend to cope well. A flexible, proactive, assertive approach to service delivery during the crisis situation will help to ensure that needs for care will be met.
Who Develops Severe or Fatal Adverse Drug Reactions to Selective Serotonin Reuptake Inhibitors?
Authors: Dalfen Ariel K , Stewart Donna E
Published: January 2017

Objective:

To ascertain the risk factors associated with the development of severe and fatal adverse drug reactions (ADRs) or intentional overdoses by patients on selective serotonin reuptake inhibitors (SSRIs).

Methods:

We undertook a data analysis of Health Canada's database of Adverse Drug Reactions to SSRIs from 1986 to 1996, as well as a literature review.

Results:

Among the complete ADR reports in the SSRI database, there were no sex differences in occurrences of all ADRs (n = 1011), severe ADRs (n = 295), drug–drug interactions (n = 312), deaths (n = 87), or intentional overdoses (n = 79), when sex differences in prescription practices were considered. There were no differences in ADR rates among different SSRIs. The most common cause of death among patients taking SSRIs was intentional overdose (n = 65, 74.7%). This was reported in 47 (72.3%) women and 18 (27.7%) men. The most common drugs taken with SSRIs in patients who died of intentional overdoses were benzodiazepines, tricyclic antidepressants (TCAs), narcotics, alcohol, and diphenhydramine. Patients who had severe or fatal ADRs were more likely to be taking an SSRI with 2 or more other drugs, including alcohol. Drug combinations that included another CYP-450 drug were especially problematic. A total of 129 cardiovascular ADRs were reported, most of which were severe. These included rhythm disturbances, blood pressure perturbations, and chest pain or angina. Cardiovascular ADRs most often occurred with concomitant drug use of benzodiazepines, TCAs, histamine H2 antagonists, lithium, and calcium channel blockers. There were 3 deaths from malignant neuroleptic syndrome unassociated with intentional overdose.

Conclusions:

SSRIs are relatively safe when their widespread use is compared with the prevalence of ADRs. SSRIs may, however, be associated with ADRs, and even death, following intentional overdose or when taken with 2 or more other drugs or alcohol (particularly another drug metabolized by CYP-450). Physicians prescribing SSRIs need to consider drug-drug interactions and carefully monitor patients with severe affective disorders, comorbid medical conditions (especially cardiovascular disease), alcohol abuse, or a history of overdosing.
Attention-Deficit Hyperactivity Disorder in Manitoba Children: Medical Diagnosis and Psychostimulant Treatment Rates
Authors: Brownell Marni D , Yogendran Marina S
Published: January 2017

Objective:

To describe physicians' diagnosis rates for attention-deficit hyperactivity disorder (ADHD) for children in the province of Manitoba and to describe the rate of psychostimulant medication use by these children.

Methods:

This descriptive study reviewed the computerized administrative records of physician visits and prescriptions dispensed to examine a population-based, cross-sectional cohort of children diagnosed with ADHD or prescribed stimulant medication, or both. We found 4787 children with a diagnosis of ADHD over a 24-month period or a prescription for stimulant medication over a 12-month period, or both. Rates were calculated by age, sex, region of residence, neighbourhood income level, and physician specialty.

Results:

Among Manitoba children, 1.52% received a medical diagnosis of ADHD and 0.89% received stimulant medication. Regionally, diagnosis rates for ADHD varied almost 4-fold, and over 8-fold for medications prescribed. Urban areas had higher rates than did rural areas, regardless of physician specialty. Diagnosis and prescription rates varied according to physician specialty, with the highest rates found among pediatricians. An income gradient was evident in rural areas, with rates of ADHD diagnosis and medication prescribed increasing with increased neighbourhood income level.

Conclusions:

The pattern of regional variation found in this study suggests that the diagnosis and treatment of ADHD in Manitoba are influenced strongly by the practice styles of local physicians.
Lamotrigine: A Review of Clinical Studies in Bipolar Disorders
Authors: Zerjav-Lacombe S , Tabarsi E
Published: January 2017

Objective:

This article reviews published studies on the use of lamotrigine in the treatment of bipolar disorder (BD).

Method:

We performed a Medline search to identify the literature data base available on double-blind, open-label studies and case series on the use of lamotrigine to treat BD.

Results:

Three double-blind studies, 3 open-label studies, and 2 case series have been conducted to date (n = 401 patients). Most patients were either nonresponders or partial responders to other mood stabilizers. Overall, 50% to 83% of the patients responded to lamotrigine; doses in the studies ranged from 50 to 400 mg daily. Switching to mania while on 200 mg of lamotrigine or more was extremely rare, and there were no reports of serious adverse effects during the study periods.

Conclusion:

Lamotrigine is proving to be an effective agent in the treatment of BD and may be useful for patients who have not responded to other mood stabilizers.
A Family Study of Juvenile Obsessive—Compulsive Disorder
Authors: Reddy P Srinivas , Reddy YC Janardhan , Srinath S , Khanna S , Sheshadri SP , Girimaji SR
Published: January 2017

Objectives:

To determine whether juvenile obsessive–compulsive disorder (OCD) is familial and whether the rate of Tourette syndrome (TS) and tic disorders is higher among relatives of patients with OCD than among relatives of controls subjects.

Method:

We assessed first-degree relatives of 35 juvenile OCD probands (aged 16 years or less) and 34 matched, psychiatrically unaffected control subjects, using the Diagnostic Interview for Children and Adolescents–Revised (DICA-R) (unpublished), a Questionnaire for tic disorders, the Children's Version of Leyton's Obsessional Inventory (CV-LOI), and the Children's Version of the Yale-Brown Obsessive Compulsive Scale (CY-BOCS). Similarly, we assessed adult relatives, using the Schedule for Clinical Assessment in Neuropsychiatry (SCAN), Leyton's Obsessional Inventory (LOI), the Yale-Brown Obsessive Compulsive Scale (Y-BOCS), and a Questionnaire for tic disorders. The diagnoses were determined by consensus, using DSM-III-R criteria. We calculated age-corrected morbid risk, using Weinberg's method.

Results:

The morbid risk for OCD among the relatives of OCD probands was 4.96%, while none of the relatives of unaffected control subjects had OCD. We did not diagnose TS in any of the relatives of either OCD probands or control subjects. We diagnosed chronic motor tic disorders in only 1 of the relatives of OCD probands, while none of the relatives of control subjects had any tic disorder.

Conclusion:

Most juvenile cases of OCD are nonfamilial and unrelated to tic disorders, while only a few are familial. There is a need to re-examine the issue of familiality in cases of OCD, as well as its relation to TS, using larger community samples to better understand the hypotheses of familial transmission and comorbidity with tic disorders.
The Effect of Divalproex Sodium on Viral Load: A Retrospective Review of HIV-Positive Patients with Manic Syndromes
Authors: Maggi Julie D , Halman Mark H
Published: January 2017

Objective:

In vitro studies report that valproic acid causes an increase in HIV-1 replication. This retrospective study examines a sample of patients with HIV disease and behavioural disturbances, for which the treatment of choice is divalproex sodium (DVP), to determine whether DVP causes an increase in HIV-1 replication.

Method:

A chart and database review identified 15 patients with HIV disease presenting with either 1) mania or hypomania or 2) dementia with mania or with hypomania or behavioural disturbances. HIV-1 viral load was compared before and after mood stabilizer initiation.

Results:

Eleven patients started therapy with DVP, and 4 patients declined treatment with a mood stabilizer. Nine of the 11 patients taking DVP were also receiving antiretroviral therapy. HIV-1 viral load did not increase in 6 of the 9 patients who had measurements between 1 week and 3.5 months after DVP initiation. No follow-up was available for the other 3 patients. Of the 2 patients receiving DVP but not antiretroviral medication, 1 had an increase of 0.17 log in HIV-1 viral load at 4 months. No follow-up record was available for the second patient. The 4 patients not taking DVP were all on antiretroviral therapy; viral loads in 2 of them remained nondetectable over 3 to 4 months, and 1 had an increase of 0.32 log in HIV-1 viral load at 3 months. No follow-up record was available for the fourth patient.

Conclusions:

These preliminary data suggest that, in the presence of effective antiretroviral therapy, HIV-1 viral load appears not to be adversely affected by the administration of DVP. The results for the patients receiving DVP in the absence of antiretroviral medication remain indeterminate. Further prospective study is required.
Occupational Effects of Stalking
Authors: Abrams Karen M , Robinson Gail Erlick
Published: January 2017

Objective:

This case report and discussion describe the psychiatric and social consequences of being a stalking victim, with particular focus on its impact on the victim's occupation.

Method:

Data were gathered from the assessment and arbitration hearing of a female employee who lost her job while being stalked. Computerized literature searches were used to identify relevant papers from psychiatric and legal journals.

Results:

This case illustrates many of the common features of stalking. The female victim was harassed by a male after a failed intimate relationship. The victim suffered from depression, anxiety, guilt, shame, helplessness, humiliation, and posttraumatic stress disorder (PTSD). The stalking affected her psychological, interpersonal, and occupational functioning. Consequently, she was fired for poor work performance and poor attendance.

Conclusion:

Stalking may affect a victim's ability to work in several ways. The criminal behaviours often interfere directly with work attendance or productivity and result in the workplace becoming an unsafe location. Further, stalking may indirectly affect a person's ability to work through the many adverse emotional consequences suffered.
The Persistence of Folly: A Critical Examination of Dissociative Identity Disorder. Part I. The Excesses of an Improbable Concept
Authors: Piper August , Merskey Harold
Published: January 2017

Objective:

To examine the concept of dissociative identity disorder (DID).

Method:

We reviewed the literature.

Results:

The literature shows that 1) there is no proof for the claim that DID results from childhood trauma; 2) the condition cannot be reliably diagnosed; 3) contrary to theory, DID cases in children are almost never reported; and 4) consistent evidence of blatant iatrogenesis appears in the practices of some of the disorder's proponents.

Conclusions:

DID is best understood as a culture-bound and often iatrogenic condition.
Client and Community Services Satisfaction with an Assertive Community Treatment Subprogram for Inner-City Clients in Edmonton, Alberta
Authors: Chue Pierre , Tibbo Philip , Wright Evelyn , Van Ens Jelle
Published: January 2017

Objectives:

To evaluate client and agency satisfaction with a specific assertive community treatment subprogram, known as inner-city support, developed in Edmonton to target the inner-city population, and to determine the demographics and potential needs of this population.

Method:

Clients were administered questionnaires based on the Client Satisfaction Questionnaire and the Satisfaction With Life Scale. We also conducted a face-to-face interview. We contacted and similarly surveyed 18 community agencies.

Results:

The program was well received, although areas for improvements included dissemination of information and hours of operation. Clients also requested more input regarding the development of activities. Clients were predominantly male with a diagnosis of schizophrenia comorbid with substance abuse and antisocial personality disorders, a history of forensic contact, homeless, and dependent on social assistance.

Conclusion:

Among the population with serious and persistent mental illness, inner-city clients represent a particularly disadvantaged subpopulation that may benefit from specialized community programs.
Social Phobia among University Students and its Relation to Self-Esteem and Body Image
Authors: Izgiç Ferda , Akyüz Gamze , Doğan Orhan , Kuğu Nesim
Published: January 2017

Objective:

To demonstrate the prevalence of social phobia and its relation to body image and self-esteem.

Method:

Study participants were 1003 students recruited from Cumhuriyet University as a randomized sample. Subjects were administered the Diagnostic Interview Schedule-III-Revised (DIS-III-R) Social Phobia Scale, the Rosenberg Self-Esteem Scale, and the Multidimensional Body–Self Relations Questionnaire (MBSRQ). We analyzed the data, using Fisher's exact chi-square test.

Results:

Lifetime prevalence of social phobia among university students was 9.6% and past-year prevalence was 7.9%. Self-esteem was lower ( P < 0.05) among those with social phobia than among those without social phobia. Students with social phobia had lower scores on the MBSRQ than did those without social phobia ( P < 0.0001).

Conclusions:

The results show that persons with social phobia have lower self-esteem and more distorted body image than do those without social phobia.
Screening for Complicated Grief: When Less May Provide More
Authors: Piper William E , Ogrodniczuk John S , Weideman Rene
Published: January 2017

Objective:

This study aimed to discover screening questions for initial assessments of psychiatric outpatients to identify which patients are likely experiencing complicated grief (CG).

Method:

We examined the responses of 235 outpatients to questionnaire items. One set came from the Texas Revised Inventory of Grief (TRIG). This set represented events cited in clinical literature as indicators or risk factors for CG. Another set came from a factor analysis of items that define CG. We determined relations between items and CG, analyzed sensitivity and specificity, and compared the 2 sets of items.

Results:

The factor analysis items were superior. The 2 best items correctly identified nearly 90% of patients with and without CG.

Conclusion:

The items can be transformed into screening questions to be used in initial interviews.
L'insertion au travail de personnes souffrant d'une maladie mentale: Analyse des caractéristiques de la personne
Authors: Corbière Marc , Mercier Céline , Lesage Alain , Villeneuve Kathe
Published: January 2017

Une étude prospective menée auprès de personnes souffrant d'une maladie mentale vise à identifier les déterminants significatifs de leur insertion au travail. Des analyses de régression et de comparaison de moyennes ont permis d'examiner les caractéristiques les plus saillantes de la personne pour expliquer son insertion socioprofessionnelle et ce, en considérant plusieurs indicateurs d'insertion au travail. Premièrement, les résultats indiquent que ce sont les variables reliées au travail (p. ex. l'engagement vers le travail) et sociodémographiques (p. ex. l'aide financière reçue) qui permettent de prédire l'exercice d'une activité de travail et l'obtention d'un emploi compétitif. Deuxièmement, 2 variables additionnelles permettent de prédire l'autonomie en emploi, c'est-à-dire le sentiment d'efficacité en matière de recherche d'emploi et de capacité à surmonter les obstacles à l'insertion au travail. Troisièmement, les variables d'ordre cognitif et clinique sont associées au délai pour débuter un emploi. Quatrièmement, le nombre d'heures de travail effectuées par semaine est expliqué par le sentiment d'efficacité à surmonter les problèmes de santé ainsi que d'autres variables motivationnelles et psychosociales. En conclusion, il est important d'identifier clairement les indicateurs d'insertion au travail afin de déterminer quels sont les prédicteurs significatifs.
The Neuropsychological Correlates of Borderline Personality Disorder and Suicidal Behaviour
Authors: LeGris Jeannette , van Reekum Rob
Published: January 2017

Objective:

In subjects with borderline personality disorder (BPD), compared with subjects who attempted suicide, to review neuropsychological (NP) function that may predispose to suicidal behaviour along a continuum of high and low lethality.

Method:

We undertook electronic searches of MEDLINE, PsycINFO, EMBASE, Biosos Reviews, and Cinhal. The searches were restricted to English-language publications from 1985 onward. The search terms borderline personality disorder, suicide, suicide attempt, self-harm behaviour, neuropsychological, executive function (EF), neurocognitive, and neuropsychological function produced 29 neuropsychology studies involving BPD and 7 neuropsychology studies of suicide attempters, regardless of psychiatric diagnosis.

Results:

Of the BPD studies, 83% found NP impairment in one or more cognitive domains, irrespective of depression, involving specific or generalized deficits linked to the dorsolateral prefrontal and orbitofrontal regions. The functions most frequently reported (in 71% to 86% of BPD studies) are response-inhibitory processes affecting executive function performance that requires speeded attention and visuomotor skills. Decision making and visual memory impairment are also most frequently affected; 60% to 67% of BPD studies report attentional impairment, verbal memory impairment, and visuospatial organizational impairment. Least affected processes in BPD appear to involve spatial working memory, planning, and possibly, IQ. The similarities in NP deficits found in BPD and suicide-attempt studies involve decision making and Trails performances. BPD studies, however, reflect more frequent impairment on the Stroop Test and Wisconsin Card Sort Test performance than the suicide-attempt studies, whereas verbal fluency appears to be more frequently impaired in those attempting suicide.

Conclusions:

Impaired EF and disinhibitory processes, as indicated by verbal fluency, Trails, and Stroop performance, primarily associated with dorsolateral prefrontal cortical regions may represent a dominant executive pathway to suicide attempt. A primary motivational inhibitory pathway involving conflictual, affective, and reflexive decision-making processes associated with orbitofrontal brain regions, in combination with significant cognitive rigidity, may influence the repetitive expression of self-harm or low-lethality suicidal behaviour. The hypothesis of a specific trait-like cognitive vulnerability for suicidal behaviour involving dysregulatory, disinhibiting pathways awaits confirmation.
Suicide and its Prevention among Older Adults
Authors: Heisel Marnin J
Published: January 2017

Objective:

To review the research on the epidemiology, risk and resiliency, assessment, treatment, and prevention of late-life suicide.

Method:

I reviewed mortality statistics. I searched MEDLINE and PsycINFO databases for research on suicide risk and resiliency and for randomized controlled trials with suicidal outcomes. I also reviewed mental health outreach and suicide prevention initiatives.

Results:

Approximately 12/100 000 individuals aged 65 years or over die by suicide in Canada annually. Suicide is most prevalent among older white men; risk is associated with suicidal ideation or behaviour, mental illness, personality vulnerability, medical illness, losses and poor social supports, functional impairment, and low resiliency. Novel measures to assess late-life suicide features are under development. Few randomized treatment trials exist with at-risk older adults.

Conclusions:

Research is needed on risk and resiliency and clinical assessment and interventions for at-risk older adults. Collaborative outreach strategies might aid suicide prevention.
Profile of a Metropolitan North American Immigrant Suicidal Adolescent Population
Authors: Greenfield Brian , Rousseau Cécile , Slatkoff Joshua , Lewkowski Maxime , Davis Michael , Dube Sébastien , Lashley Myrna E , Morin Isabelle , Dray Patti , Harnden Bonnie
Published: January 2017

Objective:

Canadian immigrant adolescents have a lower suicide rate than their nonimmigrant peers. We conducted a hypothesis-generating analysis to determine whether this lower rate correlated with level of drug use and (or) with diagnostic and demographic characteristics of Canadian immigrant adolescents presenting to an emergency room for crisis assessment.

Method:

Known risk factors for suicide were compared among immigrant youth, North American youth, and a culturally mixed group of youth at baseline and at 6-month follow-up.

Results:

The immigrant group was only differentiated by a lower rate of reported drug use.

Conclusion:

The lower rate of reported drug use at the time of crisis may contribute to the lower suicide rate among immigrants.
The Epidemiology of Psychological Problems in the Elderly
Authors: Streiner David L , Cairney John , Veldhuizen Scott
Published: January 2017

Objective:

To determine the prevalence of mood, anxiety, and other disorders in the population of Canadians aged 55 years and over.

Method:

We undertook an analysis of the Canadian Community Health Survey: Mental Health and Well-Being (CCHS 1.2).

Results:

There was a linear decrease for all disorders after age 55 years. This was true for men and women; for anglophones, francophones, and allophones; and for both people born in Canada and people who immigrated to Canada after age 18 years. Consistent with previous research, the prevalences were higher for women than men. Immigrants reported fewer problems than nonimmigrants, with the differences decreasing with age. Francophones of both sexes reported more mood disorder than anglophones, but francophone men had less anxiety disorder than anglophone men.

Conclusions:

Unlike other studies that have found an upturn in the prevalence of depression and anxiety in the elderly, our results indicate a steady decrease in these disorders. Our findings are discussed in terms of explanations for age-related differences in psychiatric disorders.
The Metabolic Effects of Antipsychotic Medications
Authors: Newcomer John W , Haupt Dan W
Published: January 2017

Objectives:

To review current evidence for the hypothesis that treatment with antipsychotic medications may be associated with increased risks for weight gain, insulin resistance, hyperglycemia, dyslipidemia, and type 2 diabetes mellitus (T2DM) and to examine the relation of adiposity to medical risk.

Methods:

We identified relevant publications through a search of MEDLINE from the years 1975 to 2006, using the following primary search parameters: “diabetes or hyperglycemia or glucose or insulin or lipids” and “antipsychotic.” Meeting abstracts and earlier nonindexed articles were also reviewed. We summarized key studies in this emerging literature, including case reports, observational studies, retrospective database analyses, and controlled experimental studies.

Results:

Treatment with different antipsychotic medications is associated with variable effects on body weight, ranging from modest increases (for example, less than 2 kg) experienced with amisulpride, ziprasidone, and aripiprazole to larger increases during treatment with agents such as olanzapine and clozapine (for example, 4 to 10 kg). Substantial evidence indicates that increases in adiposity are associated with decreases in insulin sensitivity in individuals both with and without psychiatric disease. The effects of increasing adiposity, as well as other effects, may contribute to increases in plasma glucose and lipids observed during treatment with certain antipsychotics.

Conclusion:

Treatment with certain antipsychotic medications is associated with metabolic adverse events that can increase the risk for metabolic syndrome and related conditions such as prediabetes, T2DM, and cardiovascular disease.