bluuebunny/crossref_metadata_2025 huggingface dataset:
Barbital and diazepam plasma levels during treatment of delirium tremens
Authors: Kramp P. , Rønsted P. , Hansen T.
Published: August 2007

Plasma concentrations of barbital and diazepam were measured daily during a double‐blind study of the efficacy of the two drugs in the treatment of delirium tremens and less severe clinical states. Treatment was estimated as satisfactory in the majority of cases; the present study deals with the satisfactory groups only.

Both in the barbital group and in the diazepam group the same plasma level was seen in different clinical states. This result is discussed in relation to the theories about the aetiology of delirium tremens, and it is concluded that the data fits best with the assumption that delirium tremens is released from a withdrawal state, but once established, the delirious state is not interrupted by the drugs.

The barbital concentrations were rather high, many at a level where non‐alcoholics would show pronounced intoxication symptoms not seen in the present material. The diazepam concentrations on the other hand were low, often below a level where a cerebral effect is measurable in normal subjects. On this basis it is concluded, that the two drugs have different modes of action. Barbital may act by its cross‐dependence properties with alcohol and thus diminish the withdrawal reaction, whereas diazepam may act by its anti‐anxiety effect, but not in the doses here applied, by cross‐dependence properties with alcohol. Finally, this hypothesis is discussed in relation to clinical experience in the treatment of delirium tremens.
Discriminators between neurotics who die and neurotics who live
Authors: Sims A. C. P. , Rudge B. J.
Published: August 2007

An increased death rate has been found in patients treated in hospital for neurosis but the reasons for this are not known. A case note study is described in which 37 patients who were treated in hospital for neurosis and subsequently died are compared with a cross‐matched sample of treated neurotics who were alive at follow‐up. Measures believed to indicate greater severity of neurosis were found to be significantly higher in the experimental (dead) group than in the control (living) group.
Coping styles and factors in male/female social intergration
Authors: Segal S. P. , Everett‐Dille L.
Published: August 2007

As part of a larger research undertaking which explores the over all life‐experience of former mental hospital patients living in community‐based sheltered‐care facilities in California, predictors of resident social involvement – both within the facility and outside in the community at large – were delineated. In our sample of 499 residents, we found that the types of variables indicating higher levels of social integration differed between male and female residents. The predictors that were most significant for men tended to indicate a coping style based upon access to community resources and feasibility of becoming socially involved. Thus, the opportunities made available to men in sheltered‐care facilities tended to be taken advantage of provided the residents’psychological handicap was not too debilitating. Predictors of higher levels of social involvement for women residents on the other hand, involved the acceptaility of such behavior as appropriate by the community and the facilty operator. Women residents thus appeared to be more sensitive to social, rather than environmental contingencies.
Reactive psychosis – A PROSPECTIVE STUDY
Authors: Pandurangi A. K. , Kapur R. L.
Published: August 2007

A prospective study was carried out on 30 patients suffering from a psychotic episode following a stressful life event. They were found to have an Emotional, Timid, Sensitive, Tense and Insecure personality. Sleep disturbance, Affective symptoms, Histrionic behaviour and Excitement were the common clinical features. Sixty‐six per cent were found to be clinically and socially remitted during a 6 months’follow‐up. For 20% the diagnosis was revised to Affective Psychosis and for 10% to Schizophrenia.
Evaluation of drug taking behaviour – SOME THEORETICAL AND METHODOLOGICAL CONSIDERATIONS
Authors: Waal H. , Holsten F.
Published: August 2007

Evaluation of treatment modalities of drug dependence has specific theoretical and methodological difficulties. Ideological and invested interests also complicate the literature. This paper analyses the situation on different levels, concentrating on controversies about theoretical concepts, and problems connected to the variability of drug taking populations. Some suggestions are given.
The course of narcomania in adolescence – A COMPARISON OF YOUNG PSYCHIATRIC IN‐PATIENTS WITH AND WITHOUT DRUG ABUSE
Authors: Bratfos O.
Published: August 2007

Eighty‐four young drug abusers and 84 non‐abusers admitted to a psychiatric ward were followed over a period averaging 3 years after discharge. According to information from the patients and their families, about one third of the abusers had stopped taking drugs and appeared to be well adjusted socially. The remainder had continued their abuse, periodically or continuously. Many of them had a large alcohol consumption. The incidence of delinquency was high, also for those who claimed to have ceased their abuse. Therefore, it seems doubtful that the course is as favourable as stated in the literature.

The non‐abusers had fared much better, two thirds of them showing satisfactory adjustment.

As to prognostic factors, intravenous administration proved to represent a particularly bad sign among the drug abusers, whilst a high alcohol intake was of special significance among the non‐abusers.
Resistance to inhibiting effect of dexamethasone in patients with endogenous depression
Authors: Nuller J. L. , Ostroumova M. N.
Published: August 2007

Suppression of 11‐hydroxycorticosteroids (11‐OHCS) release with dexamethasone (0.5 mg) has been investigated in 52 patients with endogenous depression and also in normals and in patients with other mental diseases. The suppression was considerably less in depressives (‐19 ± 5 %) than in control groups (approx. ‐60 %). The dexamethasone test indices were normalized during remission. To elucidate mechanisms of the dexamethasone inhibiting effect, the influence of tryptophan, DOPA and benzodiazepines on the 11‐OHCS level and the degree of its suppression with dexamethasone have been studied. The data indicate a dual effect of serotonin on the regulation of the adrenal function: it stimulates CRF secretion and increases the inhibiting effect of corticosteroids on CRF release. It is suggested that during depression the negative feedback is disturbed in the system – brain monoamines‐glucocorticoids. The possible role of this impairment in depression pathogenesis is considered.
The DTES – Drug Taking Evaluation Scale: A SIMPLE SCALE FOR THE EVALUATION OF DRUG TAKING BEHAVIOUR
Authors: Holsten F. , Waal H.
Published: August 2007

This paper describes a clinically based scale elaborated for the evaluation of drug taking behaviour. The scale is a composite scale that includes subscales for drug taking behaviour, social functioning, social identity and belonging and mental health. The scale is used in different evaluation projects from surveys to treatment research, and the experiences as well as reliability testing are described. Finally, the paper contains a manual for the use of the scale.
Lymphocyte subpopulations in peripheral blood from schizophrenic patients
Authors: Yyland H. , Néss A. , Lunde H.
Published: August 2007

Patients with acute and chronic schizophreniz were examined for T andFc receptor‐bearing lymphocytes in blood by means of rosette techniques. The patients had normal numbres of peripheral blood lumphocyte. The percentage iof T lymphocytes in patients with acute schizophrenia was reduced (60 ± 2%) comlpared with controls (66 ± 1 %) and patients with chronic schizophrenia (67 ± 3 %). The total number of T lymphocytes was significantly decreased in patients with acute schizophrenia (1, 238 ± 89 cells/mm3, p<0.02) compared with controls (1, 538 ± 157 cells/mm3), while patients with chronic schizophrenia had slightly elevated numbers (1, 778 ± 200 cells/mm3). the percentage and total numbers of Fc receptor‐bearing lumphocutes were normal in both patients groups. Both immune mechanisms and the neuroplepic drug treatment may be of importance of the observed decrease in T lymphocyte numbers in blood from patients with acute schizophrenia.
A collaborative study of genetic linkage of bipolar manic‐depressive illness and red/green colorblindness : A PROJECT OF THE BIOLOGICAL PSYCHIATRY COLLABORATIVE PROGRAM OF THE WORLD HEALTH ORGANIZATION
Authors: Gershon E. S. , Mendlewicz J. , Gastpar M. , Bech P. , Goldin L. R. , Kielholz P. , Rafaelsen O. J. , Vartanian F. , Bunney W. E.
Published: August 2007

A study of linkage of bipolar manic‐depressive illness to the protan/deutan colorblindness region of the X‐chromosome was performed on 16 informative families, in a WHO collaborative study (eight families from Brussels, six from Bethesda, one each from Basel and Copenhagen). Overall, the series did not support close linkage, but is possibly suggestive of loose linkage. but is possibly suggestive of loose linkage. The possibility of genetic heterogeneity of bipolar manic‐depressive illness, with one form linked to colorblindness, is considered.
Blood‐brain barrier selectivity and synaptic turnover during delirium tremens and related clinical states : A STUDY OF BRAIN AND BLOOD PROTEINS IN THE CEREBROSPINAL FLUID
Authors: Jørgensen O. S. , Hemmingsen R. , Kramp P. , Rafaelsen O. J.
Published: August 2007

The synaptic membrane protein D2 was measured in the cerebrospinal fluid (CSF) from patients with delirium tremens and related clinical states immediately after admission to the hospital before treatment was initiated and again after recovery. During this period of on average 5 days duration the concentration of D2 increased to double normal value possibly indicating increased breakdown of old synapses during the process of readaptation to the alcohol free state. IgG, albumin and α2‐macroglobulin were measured in plasma and in CSF and the results indicated a decreased selectivity of blood‐CSF and the results indicated a decreased selectivity of bloo‐CSF‐barrier permeability to proteins in the clinically revovered patients; this was probably due to increased micropinocytotic activity also occurring during readaptation to the alcohol free state.
An attempt at an empirical delimitation of neurasthenic neurosis and its relation with some character traits
Authors: Verhaest S. , Pierloot R.
Published: August 2007

This research examines empirically: 1) The existence and delimitation of a clinical neurasthenic neurotic syndrome as defined by van Dantzig & Waage (1962), consisting of feelings of impotence, fatigue, exhaustion and accompanying functional complaints, by means of a hierarchical cluster analysis of the rating answers to a questionnaire. 2) The relation between neurasthenic neurosis and character traits relating to different neurotic personality types and a psychopathic personality type.

The results do not confirm the existence of this theoretically defined neurasthenic neurosis, but we find a cluster of somatic complaints which can easily be identified with what most authors consider as a neurasthenic syndrome.

This empirically found neurasthenic syndrome has a significant positive relation with an anal‐obsessive character trait “over‐tidiness and over‐cleanliness” and not with a neurotic‐inhibited obsessoid character in general, other specific neurotic character traits, or a psychopathic character.

On differentiating between patients presenting the syndrome for more or less than 6 months, it is seen that in the category of more than 6 months there is a tendency to an increase of a neurotic‐inhibited obsessoid character in general, an anal‐obsessive character trait “over‐tidiness and over‐cleanliness” and a so‐called psychasthenic character relating to an intense ego‐ideal and narcissistic tendencies.
Initial, clinical trial of a new, specific 5‐HT reuptake inhibitor, citalopram (Lu 10–171)
Authors: Gottlieb P. , Wandall T. , Fredricson K.
Published: August 2007

Ten endogenously depressed inpatients were treated once daily for at least 4 weeks with 40–50 mg citalopram (Lu 10–171) – a specific serotonin reuptake inhibitor.

The Hamilton rating scale for depression and global assessment indicated pronounced or moderate response in seven patients and slight or no response in three. Side effects were few, mild and transient and neither anticholinergic nor cardiotoxic effects were observed. No difference was observed between responders and non‐responders as regards psychopathology, plasma levels or uptake inhibition.

It is concluded, that citalopram seems to possess antidepressant properties and that controlled trials are wanted to evaluate its therapeutic value as well as the underlying hypothesis of serotonin – deficient depressions.
Influence of maternal distress during pregnancy on fetal malformations
Authors: Blomberg S.
Published: August 2007

The aim of the study was to investigate whether emotional stress in a pregnant woman might have an adverse effect in the form of malformations on fetal development. The children of 1,263 women whose applications for legal abortion in 1960 had been refused were compared with the next children born in the same delivery wards and paired matched controls were thereby obtained.

Results. 1) The incidence of malformations according to the criteria established by the Swedish Register of Malformations was 1.8 % in the proband series as against 1.1 % in the control series. 2) The incidence of malformation increased with higher age and lower social class in the proband series, whereas no such connection was found in the control series. 3) The incidence of malformations for children of abortion applicants 25 years of age and above from social class III was 3 % in the proband series as against 0.6 % in the control series (P= 0.017). 4) One malformation, cleft palate, occurred at a significantly (P < 0.01) higher incidence than in the country as a whole, four cases against the expected value of 0.69. 5) Etiological analysis showed that three of the cases were chromosomal aberrations, all of them Down's syndrome, in two cases there was a genetic background and two cases were thalidomide‐induced phocomelia. In three proband children there may have been a connection with the abuse of alcohol by the mother. 6) When the chromosomal, genetic and thalidomide cases are excluded, the preponderance of malformations in the proband children of mothers 25 years of age and above belonging to social class III still remains (2.2 % vs. 0.3 %, P= 0.017).

Conclusion. The results may be seen as support for the hypothesis that emotional stress in a pregnant woman, operationally defined by the factor unwanted pregnancy, may interfere with fetal development and result in a higher incidence of malformations.

The interference may occur directly via psycho‐endocrinal or autonomous mechanisms or indirectly by the way in which the woman might act in this situation of stress, e.g. attempts to provoke abortion, neglect of proper food intake, excessive smoking, or the abuse of alcohol or drugs.
Psychogenic psychoses A RETROSPECTIVE STUDY WITH SPECIAL REFERENCE TO CLINICAL COURSE AND PROGNOSIS
Authors: Andersen J. , Laerum H.
Published: August 2007

The study comprises a retrospective evaluation of case records of 220 patients admitted for the first time with psychogenic psychosis with special reference to clinical course and prognosis within a period of 13–14 years.

The reliability of the diagnosis at the time of the first admission is about 60% when the evaluation is based on positive criteria for psychosis. If the psychogenic psychoses are divided into subgroups, the reliability of the diagnosis of psychogenic affective psychoses is about 30%, whereas it is over 90% for psychogenic confusional psychoses and psychogenic paranoid psychoses. If subsequent cases of other functional psychoses (manic‐depressive psychosis and schizophrenia) are subtracted, the diagnostic reliability is 50% (111 of 220 cases), which represents the number of retrospectively verified psychogenic psychoses.

The frequency of recurrence of psychogenic psychosis was 18% (40), corresponding to 36% of psychogenic psychoses verified by retrospective evaluation (111 of 220 cases). The recurrences were mainly homologous, as heterologous recurrences developed only among the psychogenic affective psychoses (slightly less than half of the recurrences in question).

Schizophrenia developed in only 10% (23), and subsequent episodes of manic‐depressive psychosis occurred in 8% (18).

The stability of psychogenic psychosis on recurrence of functional psychosis was 49% expressed in relation to all subsequent cases of functional psychosis.

The over‐all prognosis for the psychogenic/reactive psychosis is thus good as regards subsequent mental disease. Chronic functional psychosis (schizophrenia) developed in only 10% (and in less than 20% if the prognosis is assessed on the basis of the reliability of the diagnosis at the time of the first admission (about 60%)). However, in the group of psychogenic/reactive psychoses as a whole an overmortality of 100% was observed in the course of the 14 years, highest in the younger age groups.
Pregnancy and delivery complications in the births of an unselected series of Finnish children with schizophrenic mothers
Authors: Wrede G. , Mednick S. A. , Huttunen M. O. , Nilsson C. G.
Published: August 2007

Pregnancy, delivery and post partum conditions were coded from Helsinki Well Mother‐Baby Clinics and lying in hospitals for all deliveries to a birth cohort of Helsinki schizophrenic women. Greater difficulty was observed at all perinatal stages for the chronic and mild schizophrenic groups than for controls. These differences were heightened in the case of winter births.
Reliability of the AMDP‐System A PRELIMINARY REPORT ON A MULTICENTRE EXERCISE ON THE RELIABILITY OF PSYCHOPATHOLOGICAL ASSESSMENT
Authors: Busch H. , Cranach M. V. , Gulbinat W. , Renfordt E. , Tegeler J.
Published: August 2007

The AMDP‐System is a documentation System for psychiatric data widely in use in the German‐speaking countries. A summary of results of a multicentred study of interrater agreement of the Psychopathology Scale is presented. A new index of rater agreement was tested and the notion is discussed that the judgement of the presence and the absence of a symptom are two different processes with different reliability.
Haematological changes and state of hydration during delirium tremens and related clinical states
Authors: Hemmingsen R. , Kramp P.
Published: August 2007

In order to obtain some information about the state of hydration and possible haematological changes in patients with delirium tremens (grade 3) and related clinical states (grade 2) various clinico‐chemical variables were measured at the time of admission and repeatedly until clinical recovery from the psychotic state. In grade 3 patients plasma protein concentration, blood haemoglobin concentration, blood haematocrit and erythrocyte count decreased between admission and recovery probably reflecting a slight haemodilution. The changes were all within the normal range for the variables and there was thus no indication of hypo‐ or hypervolemia. Delirium tremens patients without concomitant somatic diseases should not be routinely treated with intravenous fluid therapy. In grade 2 patients no statistically significant changes occurred in the above mentioned variables.

In the grade 3 patients there was a dramatic (100 %) increase in plasma iron concentration between admission and the subsequent morning and this was probably related to the elimination of ethanol from the body. In grade 2 patients, where the initial blood alcohol concentration was lower than in grade 3 patients, no change in plasma iron concentration occurred.

A statistically significant increase in reticulocyte count between admission and recovery in both grade 3 and grade 2 patients probably reflected the recovery of haemopoietic tissue from the insult of the preceding ethanol intoxication. The same may be true for the prevailing anisocytosis, whereas the trend towards leucocytosis may be due to unspecific stress during the ethanol withdrawal reaction.

The rapid changes in some of the clinico‐chemical variables stress the importance of initiating investigational procedures immediately at the hour of admission.
Erythrocyte COMT‐activity in patients with affective disorders
Authors: Fauhndrich E. , Coper H. , Christ W. , Helmchen H. , Müller‐Oerlinghausen B. , Pietzcker A.
Published: August 2007

COMT enzyme characteristics (Km, V, ratio of meta/paramethylation) were determined in the red blood cells of 20 patients with endogenous depression, in 20 healthy controls matched as to age and sex, as well as in 10 patients with mania, and 10 patients with neurotic depression. Assessment was done twice, i.e. before and after remission in patients with endogenous depression and in the manic patients. If male and female patients are considered together there was no statistical difference between the COMT charateristics of these patients groups, either before or after remission. Only the bipolar patients showed a higher COMT‐activity (V) than their individually matched controls.

If, however, only the female patients are taken into consideration, COMT‐activity of the patients with endogenous depression vs. controls is significantly increased by 60%. This difference can be demonstrated also after remission (“free interval”) though statistical significance is reached only for the unipolar group. Further in vitro experiments indicate that antidepressant drugs do not possess a relevant influence on COMT‐activity. Ranking the mean COMT‐values leads to the following order: matched controls < neurotic depression < unipolar depression < biopolar depression, which would be in good agreement with theoretical expectations based on the amine hypothesis of depression.

Compared with normal male subjects COMT‐activity of female controls is significantly lower. On the other hand, the female patients with endogenous depression show a significantly higher enzyme activity than the corresponding male patients.
An integrated record system for the observation of the demand for medical and social aftercare as basis for organizing extramural services
Authors: an der Heiden W. , Klug J.
Published: August 2007

The importance of ambulatory care as well as the theoretical possibilities of measuring the continuity of care are discussed. A heterogenous pattern of different sorts of aftercare appears to be hidden behind the concept “attendance”. As a consequence, the first step in research on aftercare must consist of an exact desription of the patients’ behaviour after discharge. A record system is developed for the registration of patient contact in different facilities. Some of the applications of the system are illustrated concerning questions related to type of aftercare, continuity over time, change between services, and plurality of aftercare demand.
First evaluation of the Mannheim community mental health service
Authors: Häfner H. , Klug J.
Published: August 2007

The development of a comprehensive community mental health service in Mannheim, a West‐German industrial city, is evaluated on an epidemiological basis with the data recorded by the case register of the Central Institute for Mental Health. The initial bed rate of 1.5 beds per 1,000 population was comparably low. In spite of an increase in hospital admissions by 40 per cent within four years, the number of occupied beds remained stable, although the rate rose slightly to 1.7/1,000 due to a population decrease in younger and medium age groups. The increase in treated prevalence by over 100 per cent was partly due to an increase in morbidity: Alcohol‐ and drug‐related diseases and attempted suicides increased, partly because unmet needs were covered, mainly by facilities for psychiatric crisis intervention and emergency care in co‐operation with general hospitals and practising physicians. An increase in treated episodes was primarily to be found in out‐patient services, followed by a distinctly lower rise of the number of short‐and medium‐term in‐patient treatments. The rates for short‐ and medium‐term bed occupancy were very similar to the rates reported for Denmark, Camberwell, and Salford. In the sector of long‐term hospital stays (over 1 year), an analogous development took place as in Salford or Camberwell, although the initial bed rates were lower. The rate for long‐term bed occupancy fell by 5–6/100,000 per year from 118/100,000 to 104/100,000. Old long‐stay patients diminished by approximately 8/100,000. The distribution of diagnostic categories and of age groups failed to differ distinctly from those recorded for old long‐stay patients.
The feasibility of price control in reducing alcoholism
Authors: Walsh B. , Walsh D.
Published: August 2007

Alcohol consumption is increasing in most western European countries and leading to higher levels of several alcohol‐related problems. It is therefore a legitimate public health endeavour of the preventive type to try to halt this growth and if possible bring about a reduction in drinking. Prominent among the measures currently being promoted in social medicine circles to achieve this goal is raising the price of alcoholic beverages through tax increase of sufficient magnitude to ensure that drinking becomes more expensive in real terms. This paper explores some of the factors that should be taken into account in assessing the potential contribution that could be made by taxation to the control of alcohol consumption, using the Irish experience as an example. It is concluded that even fairly substantial price increases would not have a major impact on alcohol consumption, which has tended to grow rapidly as real incomes have grown and does not seem to be very sensitive to price. Moreover, the price of drink is reflected immediately in the cost of living, and significant increases in the real tax on alcohol are therefore not an attractive option politically. The reasons why Irish consumers should be so insensitive to the price of drinking, and so willing to devote additional real purchasing power to buying alcoholic beverages, is at the root of the problem posed by alcohol in our society. The paper also reviews the trends in prices between beer and spirits and the scope for price manipulation between beverage types in the interest of public health.
REGISTER STUDY: A small cohort of multiple‐service‐users from a geographically circumscribed area
Authors: Horn G.H.M.M. ten
Published: August 2007

Since 1974 a psychiatric case register, covering an urban population of approximately 43,000 in one of the northern provinces, has been operated by the Department of Social Psychiatry of the State University of Groningen, along the lines of the Camberwell Case Register. The complexity of the Dutch network of mental health services and the problem of continuity of care is studied from the delivery of care to a small cohort of 31 people, who contacted at least 4 different services during 1977 and 1978. A case register which collects unduplicated and cumulative data lends itself particularly well for such a study. Of the total intake of 1,594 patients from the register area from December 31, 1973 to January 1, 1976, 28% had contact with two or more services, 9.3% with three or more, and 2.4% with four or more. The 31 patients who used four or more services during 1977 and 1978 were analysed in more detail. This group did not differ much from other patients with regard to their social and medical characteristics. They tend to use intensively many services during brief periods of time, and spend most of their time in the community without any care. Their pattern of using the services shows how disconnected the network of mental health services really is.
A 5‐year retrospective investigation of all first admitted schizophrenics to Danish psychiatric institutions in the fiscal year from April 1st, 1970, to April 1st, 1971
Authors: Gam J.
Published: August 2007

A 5‐year retrospective study of 492 patients with a diagnosis of schizophrenia is reported. 81 % of the patients were discharged less than 6 months after their first admission, mostly to their homes. About 80% of the patients were admitted more than 1 time. After the first year, the readmission rate was about 15 % of all admissions. Thirty‐five per cent of the patients were committed one or more times to a mental hospital. The patient spent an average of 418 days in hospital. 9–60 % of the patients can be considered to be chronically ill, depending on the definition of chronicity. After 2 years in hospital, the chance of discharge was 15%. Suicide rate was 9 times higher in the patients than in the normal population. Sixty‐eight per cent of patients got a disability pension during the period of the study. The incidence rate of schizophrenia differed by a factor of 14 between capital‐city area and rural districts. The expectancy of schizophrenia was estimated to be between 0.34 % ‐ 0.67 %, depending on sex.
Perinatal complications in adopted and non‐adopted schizophrenics and their controls: Preliminary results
Authors: Jacobsen B. , Kinney D. K.
Published: August 2007

Pregnancy and birth complications (PBCs) noted in midwife reports recorded at the time of birth were compared in 34 adopted schizophrenics and their matched controls, and in 29 matched pairs of nonadopted schizophrenics and controls. Subjects were matched for sex, age, and social class of the rearing parents. Overall PBC scores were higher for schizophrenics than controls in both adopted and nonadopted subsamples, and the difference between schizophrenics and controls was statistically highly significant when pooled samples of schizophrenics and controls were compared. Long labor was the particular complication that most clearly distinguished schizophrenics and controls, being much more frequent for schizophrenics.
DL‐propranolol and chlorpromazine following admission for schizophrenia
Authors: Yorkston N. J. , Zaki S. A. , Weller M. P. , Gruzelier J. H. , Hirsch S. R.
Published: August 2007

Similar improvement followed when propranolol and ‐ chlorpromazine were randomly used as the first drug after admission. Forty‐six patients with florid symptoms of schizophrenia were assigned at random to have either racemic propranolol (24) or chlorpromazine (22). Each individual's drug was adjusted to an optimal dose, and the progress of the groups was followed for 12 weeks. Thirty‐five patients remained in the study for 6 weeks, and 27 for 12 weeks. By weeks 6 and 12 the total schizophrenia scores on a modified Brief Psychiatric Rating Scale had improved significantly when the results from both groups were combined. The numbers leaving the study, and the amount and rate of improvement, were similar for both groups, but with a possible advantage to chlorpromazine. Side‐effects, which usually were mild, were commoner in the chlorpromazine group.
The classification of psychiatric disorder
Authors: Giel R. , Busnello E. d';Arrigo , Climent C. E. , Elhakim A. S. E. D. , Ibrahim H. H. A. , Ladrido‐Ignacio L. , Wig N. N.
Published: August 2007

Altogether 26 psychiatrists and other mental health workers, from Colombia, Brazil, Sudan, Egypt, India and the Philippines tried to reach agreement on the classification of 10 case histories, using the International Classification of Diseases (8th revision). The exercise was part of the WHO Collaborative Study on Strategies for Extending Mental Health Care. Conventions, mistakes, differences of opinion and a lack of rules are discussed as causes for disagreement.
Effects of parental absence and institutionalization on the development of clinical symptoms in high‐risk children
Authors: Walker E. F. , Cudeck R. , Mednick S. A. , Schulsinger F.
Published: August 2007

Longitudinal data on 207 Danish subjects at high‐risk for schizophrenia (they have schizophrenic mothers) were examined to assess the direct and indirect effects of parental absence and institutionalization on the development of schizophrenic symptomatology. Information on the amount of parental absence and institutional child care during the first through 10th year was collected in 1962. A psychiatric evaluation, consisting of a standardized interview and two questionnaires (PSE and CAPPS), was administered to the subjects in 1972. Factors were constructed relating to eight clinical symptoms from the interview and questionnaires. Path analyses were performed separately for males and females with maternal absence, paternal absence and institutionalization as the predictors and the clinical syndromes as the dependent variables. The analyses showed both direct effects of parental absence and indirect effects mediated by institutionalization. For males, the absence of a schizophrenic mother was related to decreased symptomatology, but only when it did not result in institutionalization. Institutionalization was related to increased symptoms in males but not females. These results are discussed in light of previous research, and explanations are offered for the differential effects by sex.
The temporo‐spatial context
Authors: León C. A.
Published: August 2007

This study deals with the role of time or space factors in bringing about depressive disorders. Anniversaries, dates or sensory perceptions associated with a depressive experience are seen to act as cues which can automatically unchain a depressive response at a later occasion. In a series of 53 patients suffering with different types of depressive disorders, a group of 18 (one third) were identified as presenting this kind of response.

Clinical illustrations and descriptive characteristics are presented, together with an attempt at explanation of some of the mechanisms involved.
Some behavioural and psychosocial aspects of alcohol and drag dependence in Kuwait Psychiatric Hospital
Authors: Demerdash A. M. , Mizaal H. , Farouki S. El , Mossalem H. El
Published: August 2007

Seventy Kuwaiti alcohol and drug‐dependent inpatients at Kuwait Psychiatric Hospital were compared with a matched group of 40 abstinent inpatients on a surgical ward in a general hospital in order to find out the drugs abused, pattern of consumption, the effects of prohibition and sanctions, motives, personality type, social complications, religious attitudes and family history. The majority abused alcohol (62%) followed by hypnotics. The reason most frequently stated for starting consumption was to relieve boredom (39%). Gamma type drinking was prominent at an early stage. The addicts showed a greater proportion of abnormal personalities. Prohibition and sanction had little effect but led to a shift to more toxic substances. The commonest legal involvement was driving offences. Compared with the control group there was higher marital instability and a higher incidence of alcohol and/or drug addicts in the families of the experimental group, and they were also less religious. The role of cultural and religious factors is discussed in detail.
Prevalence of dementia disorders in institutionalized Swedish old people THE WORK LOAD IMPOSED BY CARING FOR THESE PATIENTS
Authors: Adolfsson R. , Gottfries C.‐G. , Nyström L. , Winblad B.
Published: August 2007

The prevalence of dementia disorders was determined among 3,523 institutionalized patients aged 65 years or more in the county of Vasterbotten. Approximately one‐third of the clientele were considered demented. The prevalence was calculated to be 3.7 % of the population in the county. The frequency of dementia disorders among the patients in the somatic long‐stay wards, the nursing homes, and the mental hospital was rather similar (55–65 %). A surprisingly high percentage of demented (17.1 %) was found in the homes for the aged. The work load was nighest in the somatic long‐stay wards and in the nursing homes. Patients in the mental hospital, however, differed markedly from those in other institutions with higher scores for aggressive and disturbing behaviour, which accounted for the large number of patients in the mental hospital with maximal work load. The findings are discussed with regard to future institutional care of demented patients and point out the need for better education in psychiatric care for the staff.
Manic‐depressive states and daily temperature
Authors: Pflug B. , Johnsson A. , Ekse A. Tveito
Published: August 2007

Proceeding from the hypothesis of disturbed circadian rhythms in endogenous depression, we observed the oral temperature of four patients in a long‐term study. The results showed the following: 1) Depression is linked to higher mean daily temperatures compared with normal states. In manic states, the mean daily temperature is even higher than in depressive states. Sleep deprivation as effective treatment causes a decrease in mean daily temperature. 2) The daily temperature maximum changes its position in depressive states. This is interpreted as indicating a disturbed circadian system. 3) A period shorter or longer than 24 h cannot be observed in depressive states.
A relation between seasonal temperature and the birth rate of schizophrenic patients
Authors: Hare E. , Moran P.
Published: August 2007

The relation between schizophrenia birth rates and environmental temperature was studied in patients born in England and Wales during 1921–1955 and first admitted there in 1970–1977. A methodological difficulty due to varying age‐incidence was avoided by the use of indices independent of yearly changes in rates.

Birth rates in the second quarter and in the first half of the year showed high negative correlations with mean temperatures of the first quarter and first half of the year. Comparison of years with the coldest and with the warmest seasons showed the schizophrenia birth rate to be consistently higher in the coldest years. No comparable relations between birth rates and temperature were found for patients with affective psychosis, neurosis or personality disorder.

The findings indicate an association between schizophrenia birth rates and temperature of a kind similar to that between infant death rates and temperature during the years 1921–55. Some implications are discussed.
Growth hormone response in patients with depression
Authors: Matussek N. , Laakmann G.
Published: August 2007

We interpreted our previous findings obtained with clonidine in depressive patients to indicate that in endogenous depressive patients ‐ in contrast to neurotic depressive patients and controls ‐ there is a reduced sensitivity of postsynaptic α‐adrenergic receptors or of structures related to them. In the present study, after desipramine (DMI) (75 mg i.m.), endogenous depressives show a significantly reduced growth hormone (HGH) response as compared to neurotic depressive patients and to controls. The HGH response to DMI can be blocked by pretreatment with the α‐blocker phentolamine (30 and 60 mg i.v.). Therefore we assume that in the DMI test, postsynaptic α‐receptors are involved, thus giving further evidence for the importance of postsynaptic α‐receptors in depression.
The action of antidepressant drugs on 5‐hydroxy‐tryptamine uptake by platelets ‐ relationship to therapeutic effect
Authors: Coppen A. , Swade C. , Wood K.
Published: August 2007

The uptake of 5‐hydroxytryptamine (5‐HT) by the blood platelets of depressive patients treated with amitriptyline and zimelidine has been examined. Both drugs significantly reduce the uptake of 5‐HT into the platelet and the degree of inhibition is correlated with the plasma drug level of amitriptyline. No significant correlations could be detected between the degree of inhibition of uptake and clinical change. The accepted mode of action of tricyclic antidepressant drugs, i.e. the inhibition of reuptake of released amines, is discussed.
A double blind comparison of zimelidine and amitriptyline in endogenous depression
Authors: Montgomery S. A. , McAuley R. , Rani S. J. , Roy D. , Montgomery D. B.
Published: August 2007

In a randomised double‐blind group comparison study of 40 patients with endogenous depression zimelidine appeared to be as effective an antidepressant as amitriptyline at 4 and 6 weeks using the Hamilton Rating Scale (HRS) and the Montgomery and Åsberg Depression Rating Scale (MADRS). At 2 weeks there was a significantly better response (P< 0.05) on zimelidine compared to amitriptyline on the clinician's global scale and 4 out of 10 items on the MADRS suggesting an early onset of action. A significantly better response to zimelidine was seen on the item somatic anxiety (HRS) while the effect on sleep and appetite was better in the amitriptyline group. There were significantly more side effects, raw and corrected, in the amitriptyline‐treated group.

High steady state plasma concentrations of norzimelidine (>800 nmol/l) which were significantly correlated with age (r = 0.8) were associated with a significantly poorer response suggesting that a lower dose than 200 mg in older patients may be appropriate.
Influence of depression and antidepressants on weight
Authors: Gottfries C. G.
Published: August 2007

Depression is often combined with loss of appetite and weight. Treatment with some psychotropic drugs, especially many of the tricyclic antidepressives, causes weight gain. Zimelidine, an antidepressive drug with selective inhibitory effect on the reuptake of 5‐hydroxytryptamine (5‐HT), causes no weight gain in treated patients. As even weight loss is seen it can be discussed whether the drug has an inhibitory effect on feeding behaviour. This would be of theoretical interest as animal experiments show that 5‐HT may be an anorectic transmitter. It is also of practical importance as then the embarrassing side effect of weight gain might be avoided in antidepressive treatment.
Comparison of the cardiovascular effects of amitriptyline and zimelidine using thoracic impedance cardiography
Authors: Christie J. E. , Brown D.
Published: August 2007

Twelve depressed patients were allocated to amitriptyline (7 days 75 mg nocte, increasing to 150 mg nocte) or zimelidine (100 mg nocte increasing to 200 mg nocte) in a randomised double‐blind design. Cardiovascular assessment was made at pre‐drug, 7 and 14 days using thoracic impedance cardiography, a non‐invasive technique for measurement of both cardiac output (CO) and systolic time intervals.

Neither drug significantly changed systolic time intervals. Amitriptyline 75 mg significantly reduced stroke volume (SV) (sitting P <0.02, standing P <0.01) with a similar trend at 150 mg. Zimelidine tended to increase SV. Heart rate (HR) was increased by amitriptyline 75 mg (P <0.02) but zimelidine induced no consistent changes in HR. Amitriptyline 75 mg in the standing data reduced CO (P <0.005). In contrast zimelidine 100 mg increased sitting CO (P <0.05) and this trend was seen at 200 mg in both sitting and standing data. The results suggest that zimelidine has low cardiotoxicity and may have a role in the treatment of depressed patients with cardiovascular disease.
Cardiovascular, sedative and anticholinergic effects of amitriptyline and zimelidine in young and elderly volunteers
Authors: Swift C. G. , Haythorne J. M. , Clarke P. , Stevenson I. H.
Published: August 2007

Single doses of amitriptyline (50 mg) and zimelidine (100 mg) were administered orally to 4 young and 4 elderly healthy volunteers (aged 21–26 and 68–75 respectively) in a comparative study of the two drugs. Systolic time intervals, supine and standing blood pressure, salivary flow and indices of sedation were measured at regular intervals up to 6 hours post dose.

No conclusive changes in the QS2 interval, left ventricular ejection time (LVETc), LVET index, pre‐ejection period (PEPc), resting heart rate, or blood pressures were observed with either drug.

Salivary flow was reduced by about 40% at 3.5 hours and 50% at 5.5 hours after ingestion of amitriptyline. No change in salivary flow was observed after zimelidine (significant difference between treatments; P <0.01 at 3.5 and 5.5 hours).

Subjective drowsiness as measured by visual analogue ratings was significantly greater for amitriptyline at 3.5 hours (P <0.01). Postural sway was also increased by amitriptyline but not zimelidine (difference between treatments significant at 3.5 and 5.5 hours; P <0.01 and 0.05 respectively). Auditory reaction time increased with amitriptyline, the difference between treatments achieving significance at 5.5 hours.

No differences in response to either drug between young and elderly volunteers were demonstrable in these small groups, although variability was greater in the older group.

Possible implications of these findings for the treatment of depression in the elderly are discussed.
Zimelidine and amitriptyline in the treatment of depressive illness in general practice
Authors: Loudon J. B. , Tiplady B. , Ashcroft G. W. , Waddell J. L.
Published: August 2007

Depressive patients seen at hospital clinics are likely to be unrepresentative in terms of treatment response. In this study patients were always seen at their general practitioners’ surgeries for assessment by specialists after selection as being in need of antidepressant treatment. The Research Diagnostic Criteria for major or minor depressive illness and a Hamilton Depression (Ham‐D) score of at least 10 were required for inclusion, using the Present State Examination as a basis for interview. Patients were seen at weekly intervals, alternately by practitioner and assessor for further Ham‐D ratings, completion of the Kellner Sheffield Self‐Rating test (KSSRT), event record and side effect checklist.

Patients were randomly and blindly allocated to either zimelidine or amitriptyline dispensed identically at dosages of 100 mg and 75 mg at night, rising to 200 mg and 150 mg after two weeks. At four weeks there was no significant difference between the improvement found with zimelidine and amitriptyline or either the Ham‐D or the KSSRT. Amitriptyline patients tended to gain and zimelidine patients to lose weight; difference significant. Other amitriptyline side effects were not found in those taking zimelidine, the latter tending to suffer diarrhoea. Preliminary analysis shows no relationship between clinical response and plasma level of either compound.
Zimelidine: Comparison of different dosage regimes in general practice
Authors: Watson Joyce M. , Tiplady Brian
Published: August 2007

Various studies have demonstrated that depressive symptoms are a frequent and important problem in general practice. Zimelidine has been shown to have effective antidepressant activity.

A controlled double‐blind trial was set up to compare the efficacy and side effects of zimelidine when given as a single daily dose (200 mg night or morning) and when given as a divided dose (100 mg b.d.). These three dosage schedules were studied.

The trial was conducted among patients attending their general practitioners and suffering from a depressive disorder. Using one of the three dosage schedules, these patients were treated with zimelidine for a minimum period of 6 weeks. Symptom severity was measured by means of the Hamilton Rating Scale for Depression and the side effects assessed using an adverse event record and a symptom checklist.

The findings are discussed.
Genetic models of sex effect in unipolar affective illness
Authors: Baron M.
Published: August 2007

Family study data on unipolar affective illness are analyzed by multiple threshold models of inheritance that incorporate sex effect. In these models maies and females share a common geneticenvironmental liability, but the less prevalent sex, i.e., males, has a higher genetic threshold for the disorder. Neither single major locus (SML) nor multifactorial‐polygenic (MFP) transmission can account for the sex differences in the morbid risk for unipolar disorder. The implications for genetic research in affective disorders are discussed.