bluuebunny/crossref_metadata_2025 huggingface dataset:
Dehospitalization of psychiatric care in The Netherlands
Authors: Haveman M. J.
Published: August 2007

ABSTRACT What are the major changes in the Dutch mental health system? In this article some main lines of the de jure mental health policy are compared with de facto developments in the period 1970–1982, utilizing data from a national inpatient case register.
Characterizing paranoia in the DSM‐III borderline personality disorder
Authors: Snyder S. , Pitts W. M.
Published: August 2007

ABSTRACT— The relationship between paranoia and the borderline personality disorder continues to be the subject of debate. This study compares the extent and intensity of paranoia in 29 subjects fulfilling DSM‐III criteria for borderline personality disorder. The control group consists of 22 subjects with dysthymic disorder. Paranoia was both more prevalent and severe in borderline patients. Results are discussed in light of previous descriptive and research literature.
The dexamethasone suppression test in depressed and non‐depressed geriatric medical inpatients
Authors: Magni G. , Schifano F. , Leo D. De , Dominicis M. G. De , Garbin A , Zangaglia O.
Published: August 2007

ABSTRACT— The frequency of an abnormal response to the dexamethasone suppression test (DST) was examined in 38 geriatric patients hospitalized for medical illnesses and affected by depressive disorders diagnosed according to the DSM III, and in 18 medical patients (used as controls) hospitalized in the same ward. Only 11% of the controls and 11% of those affected by dysthymic disorder had an abnormal DST vs 73% of the patients with major depressive disorder (MDD). The sensitivity of the DST for MDD, in this particular setting, was found to be about 73% and the specificity 89%. The importance of this clinical adjunct in diagnosing the severe depressive disorders is discussed.
Computed tomography and pattern reversal visual evoked potentials in chronic schizophrenic patients
Authors: Romani A. , Zerbi F. , Mariotti G. , Callieco R. , Cosi V.
Published: August 2007

ABSTRACT— Eighteen chronic schizophrenic subjects treated with a uniform dosage (4–6 mg/day p. o.) of haloperidol were submitted to computed tomography (CT) and to pattern reversal visual evoked potentials (VEPs). Compared to age‐matched controls, schizophrenic patients showed lateral and third ventricular enlargement, greatly delayed VEP latencies and reduced amplitudes. These abnormalities were not related to diagnostic subgroups. Schizophrenic patients with a positive family history for major psychiatric disorders showed normal CT scan measures and greatly abnormal VEP measures, whereas patients with a negative family history showed CT scan signs of atrophy and less pronounced VEP abnormalities.
Pathoplastic influences on symptoms of schizophrenia
Authors: Maslowski J.
Published: August 2007

ABSTRACT: Libya and Malta are Mediterranean neighbours, but have very different cultures and histories. Compared with 97 Libyan schizophrenics who exhibited poor symptomatology, 100 Maltese cases were similar to those of other European countries.
Depressive disorders in Ethiopia
Authors: Keegstra H. J.
Published: August 2007

ABSTRACT: Fifty‐two depressed patients were selected from out‐patients at the psychiatric department of St. Paul's Hospital in Addis Ababa. A clinical assessment on each patient was carried out using a slightly revised SADD schedule. The findings were very similar to those from previous SADD studies in different cultures. The same “core” of depressive symptomatology could be detected in Ethiopian depressed patients. Most patients presented with somatic complaints. An interesting finding was that more women than men admitted aggressive feelings or acts. Remarkably few “culture‐specific” data were found, which probably is not surprising when using a diagnostic tool with a cultural bias. Suggestions are put forward to explain the difference in frequency of some symptoms in Ethiopian patients compared with patients from other countries.
Mentally ill mothers and their children
Authors: Bågedahl‐Strindlund M.
Published: August 2007

ABSTRACT Antenatal care consumption, obstetric conditions, and neonatal health, were studied retrospectively in all women in the county of Stockholm who had a baby during 1976–77 and also had been admitted to a psychiatric department after the 20th week of pregnancy or within the first postpartum year, and the findings were compared in matched obstetric controls. Fewer index women had had uncomplicated pregnancies than the controls. A positive relationship was found between acute mental illness and pregnancy complications. Delivery complications tended to to be more common in the index group than in controls, but, only in patients with prepartum onset of mental illness. More index women had a history of several previous abortions than the controls. The index women, and especially the addicts, attended the antenatal care clinics significantly less frequently than the controls. The neonatal health of the index children seemed to be more closely correlated with alcohol or drug dependency per se in the mothers than with mental illness.
Suicide and violent death among patients with schizophrenia
Authors: Allebeck P. , Varla A. , Wistedt B.
Published: August 2007

ABSTRACT From the Stockholm County in‐patient register we selected all patients with schizophrenia, discharged from all hospitals in the county during 1971, in voluntary and compulsory care. The cohort of 1190 patients was followed for 10 years in the national cause‐of‐death register. 231 deaths were identified and 68 came under the ICD chapter XVII, “Injuries…”. These 68 deaths were analysed through medical records and death certificates in order to find out detailed causes of death, evidence of misclassification, and information on suicides during psychiatric care. Of the 68 deaths 33 were classified as suicides, 14 undetermined, 20 accidents and one homicide. Suicides predominated among the younger patients and accidents among the elderly. By scrutinizing medical records we identified seven deaths we judged to be suicides but which had been classified as accidents or undetermined. 36% of all deaths and 44% of those classified as suicides occurred during psychiatric care. The record‐linkage method proved valuable for identifying deaths among psychiatric patients and for obtaining data on hospital care, thus giving access to medical records, and should be useful in further research.
Covariation of depressive symptoms, parkinsonism, and post‐dexamethasone plasma cortisol levels in a bipolar patient: simultaneous response to ECT and lithium carbonate
Authors: Jaeckle R. S. , Dilsaver S. C.
Published: August 2007

ABSTRACT A patient presented with concurrent mood congruent delusions, parkinsonism, and elevated post‐dexamethasone plasma cortisol levels. This triad could result from simultaneous development of cholinergic‐monoaminergic dysfunction within critical limbic and extrapyramidal loci. The magnitude of each abnormality decreased in concert during a course of electroconvulsive therapy (ECT). Remaining abnormalities disappeared during treatment with lithium. Actions of ECT and lithium on muscarinic systems are reviewed, and a strategy for testing the hypothesis that dysfunction of cholinergic‐monoaminergic mechanisms develops in parallel in different neural networks is considered.
Working conditions of male and female psychiatrists
Authors: Kastrup M. , Petersson B.
Published: August 2007

ABSTRACT The percentage of females among Danish medical graduates has increased from 1% in 1900–10 to 33% in 1980–84. In 1980 women doctors comprised 21% of all Danish medical doctors; the percentage among psychiatrists was 29. The purpose of the study has been to analyse the job‐profiles of male and female psychiatrists, and their activities in research, teaching, committees, etc. The job‐profiles of males and females differ, females more likely being in less influential positions. Based on an investigation among members of the Danish Psychiatric Association, the working conditions and professional activity of 307 male and female psychiatrists were analysed. Male psychiatrists were found to complete their training at a younger age than females. Among those aged 25–44, 29% of males and 6% of females had reached a position as chief consultant. Males report greater activity in all areas of research, and 35% of females and 17% of males do no research at all. In all age groups and all fields investigated more males take part in organisational activities, while 48% of females and 25% of males report no such activtity. No difference was found regarding teaching experience, but men were relatively more often involved in teaching professional groups and women, nursing staff. A significant preponderance of males had their main interest in biological psychiatry, females in psychotherapy.
Female alcoholics
Authors: Haver B.
Published: August 2007

ABSTRACT In a long‐term follow‐up study of 44 young female alcoholics, 57% were abstainers, light, or moderate drinkers with good social functioning. The women's vocational functioning had improved compared with the situation at intake. Nevertheless, many needed public financial support, and 62% reported mental disturbances relevant to their present functioning. Anxiety disorders with phobias, depression and psycho‐somatic complaints were most frequently reported. A few women suffered from a post‐traumatic stress syndrome following a relationship with a violent partner. The symptom picture of the abstainers and heavy drinkers was much the same whan measured by the SCL‐90, whereas the light and moderate drinkers had fewer symptoms and lower symptom intensity. The article discusses the complicated relationship between life situation, mental disorders, and personality disorders, in women alcoholics. All these aspects must be dealt with to allow a more effective treatment of female alcoholics.
Neuropsychological test performance, brain morphological measures and CSF monoamine metabolites in schizophrenic patients
Authors: Nyman H. , Nybäck H. , Wiesel F. ‐A. , Oxenstierna G. , Schalling D.
Published: August 2007

ABSTRACT Twenty‐three drug‐free patients with an acute schizophrenic psychosis were studied by clinical rating scales, neuropsychological tests, computed tomography (CT) of the brain and analysis of monoamine metabolites in the cerebrospinal fluid (CSF). The psychological tests used were the Swedish version of the Wechsler‐Bellevue Intelligence scale (WBI) and the Block Design test. The patients’ performance in the Block Design test was negatively correlated to the width of the third and lateral ventricles. Test profiles indicative of schizophrenic cognitive impairment and left hemisphere dysfunction correlated significantly with a wide third ventricle, but not with the size of the lateral ventricles. Patients with a test profile indicative of left hemisphere dysfunction also had wider Sylvian fissures than the remaining patients. Neuropsychological test scores did not correlate with the CSF levels of the monoamine metabolites HVA, MHPG and 5‐HIAA. Positive psychotic and autistic symptoms did not correlate with psychological test results, monoamine metabolites or with CT measures. The association between neuropsychological impairment and enlargement of the brain ventricles is in line with previous findings indicating that a subgroup of schizophrenic patients may be identified by neuropsychological and morphological methods.
Clinical methods in psychiatric genetics III. Environmental stratification may simulate a genetic effect in adoption studies
Authors: Clerget‐Darpoux F. , Goldin L. R. , Gershon E. S.
Published: August 2007

ABSTRACT In adoption studies, the possibility of inadvertent matching between biological and adoptive parents for some environmental variable (known or unknown) correlated with illness must be considered. We examine such bias quantitatively and show how a genetic effect can be simulated. Existence of a genetic effect which is independent of environmental correlation can be accepted, when the frequency of a disease in adoptees who have a biological parent affected and no adoptive parents affected is significantly greater than the frequency of the disease in adoptees who have an adopted parent affected and no biological parents affected. The published data on schizophrenia, alcoholism, and criminality do not exclude the possibility of undetected environmental correlations simulating a genetic effect, according to this direct criterion.
Identifying children at high somatic risk: possible long‐term effects on the parents’ relationship to the child
Authors: McNeil T. F. , Thelin T. , Aspegren‐Jansson E. , Sveger T.
Published: August 2007

ABSTRACT The identification of α1antitrypsin deficiency (ATD) by neonatal screening was hypothesized to have had negative long‐term effects on the parents’ relationship to the child. This hypothesis was tested by comparing selected aspects of the parent‐child relationship in the families of 61 clinically healthy 5–7‐year‐old children with ATD versus the families of 61 control children without ATD. The data were collected by interviews with the parents in the home. In total, the evidence did not support the hypothesis of a negative effect on the parents’ relationship to the child.
Decreasing rates of first‐admission diagnoses of schizophrenia among females in Denmark 1970–84
Authors: Munk‐Jørgensen P. , Jørgensen P.
Published: August 2007

ABSTRACT In Denmark age‐standardized rates of first‐admission diagnoses of schizophrenia in females decreased significantly by 44% from 1970 to 1984. The slope of the regression line is ‐ 0.21 per 100,000 female inhabitants aged 15 years or more per year. All age groups, but especially the age group 45–54 years, contributed to the decrease in rates. Coinciding with the decrease in schizophrenia rates, an increase in age‐standardized rates of borderline states in the age group 15–44 years occurred. The slope of the regression line is + 0.53 per 100,000 per year. The results are compared with those in males and possible causes of the decrease are discussed. There is every probability that, as in males, part of the decrease is due to changes in diagnostic habits.
Social factors and depression in Nigerian women
Authors: Gureje O.
Published: August 2007

ABSTRACT A sample of 30 depressed patients was matched for age and social class with an equal number of non‐psychiatrically disturbed subjects. The two groups were similar with regard to the vulnerability model of Brown and his colleagues. However, more depressed patients reported job dissatisfaction than controls. Depressed patients had experienced excess of life events prior to the onset of depression. They were also distinguished from the controls by categories of events involving losses and those related to work.
Oxypertine in tardive dyskinesia: a long‐term controlled study
Authors: Soni S. D. , Freeman H. L. , Bamrah J. S. , Sampath G.
Published: August 2007

A 6‐month, double‐blind, placebo‐controlled study of oxypertine in tardive dyskinesia is described. Results suggest that any beneficial effect noticed initially is not sustained. When this effect is compared with the time course of development of supersensitivity after neuroleptics as reported in the literature, it becomes apparent that the drug, despite its different mechanism of action, behaves like any other conventional neuroleptic. On the basis of the findings, the authors feel that all proposed anti‐dyskinetic drugs should be subjected to longer, controlled trials to prove their clinical efficacy.
Bromazepam and lorazepam in generalized anxiety: a placebo‐controlled study with measurement of drug plasma concentrations
Authors: Fontaine R. , Mercier P. , Beaudry P. , Annable L. , Chouinard G.
Published: August 2007

Sixty outpatients with a diagnosis of generalized anxiety were randomly assigned to 4 weeks of treatment with bromazepam, lorazepam or placebo, following a 1‐week placebo washout period. There was no significant difference in the anxiolytic effects of bromazepam and lorazepam, both of which were superior to placebo. However, lorazepam‐treated patients tended to have a more depressed mood than those treated with bromazepam. Drug‐treated patients had consistently less cognitive impairment than those treated with placebo, the difference being statistically significant (P .05) in the case of bromazepam. The most frequent side‐effects reported with each drug were drowsiness, which tended to subside with time, and depression, which tended to emerge toward the end of the 4‐week period. There was a positive correlation (r = 0.64) between age and bromazepam plasma concentration per unit dose, adjusted for weight, and a negative correlation (r =−0.50) between weight and lorazepam plasma concentration per unit dose, adjusted for age.
Positive and negative syndromes in schizophrenia as a function of chronicity
Authors: Kay S. R. , Fiszbein A. , Lindenmayer J.‐P. , Opler L. A.
Published: August 2007

The construct validity and extended stability of positive and negative syndromes were studied via multidimensional cross‐sectional assessment of 134 schizophrenics in the acute, chronic, and long‐term chronic stages. For all groups the syndromes were internally reliable, not significantly intercorrelated, and of similar severity. The syndromal correlates with clinical, motor, historical, and genealogical dimensions, however, differed as a function of chronicity. In acute schizophrenics, a negative syndrome was associated with clinical and genealogical indicators of good prognosis, whereas the converse obtained for a positive syndrome in the acute stage and a negative syndrome in the chronic stage. The relationship of education, marital status, and attention disorder to the positive‐negative distinction also varied according to length of illness. Its meaning, therefore, appeared phase‐specific and subject to evolution, obviating generalizations across all phases. Implications for theory, prognosis, current research, and future study are presented.
Neuropsychological functioning in schizoaffective disorder, depressed type
Authors: Maj M.
Published: August 2007

Neuropsychological functioning in schizoaffective disorder, depressed type, was tested by two parallel studies. In Study 1, the Luria‐Nebraska Neuropsychological Battery (LNNB) was administered to samples of patients meeting Research Diagnostic Criteria (RDC) for schizodepressive disorder, major depressive disorder or schizophrenia, and to a normal control group. In Study 2, the same test battery was used in patients with a former RDC diagnosis of schizodepressive or major depressive disorder, examined from 2 to 4 years after the index episode, during a phase of remission. Study 1 showed that the performance of schizodepressives on LNNB is, on average, intermediate between those of depressives and schizophrenics, which finding is compatible with the view that RDC schizoaffective depression encompasses a heterogeneous group of syndromes, some of which are related to major depression and some to schizophrenia. Study 2 showed that the mean scores on the LNNB scales Memory and Intellectual processes are significantly higher in patients with a former diagnosis of schizodepressive disorder, which supports the idea that the outcome of these patients is worse, on average, than that of “pure” depressives.
Research and society
Authors: May Philip R. A. , Serafetinides E. A. , Cohen Jerome
Published: August 2007

Research has had profound beneficial effects on all spheres of human endeavor, yet research values, benefits, risks, and priorities have become the subject of concern, characterized by vehement expressions of opinion and a paucity of systematic scientific study. For a variety of reasons, there is a need to develop better ways to assess the potential value to society of projects that are proposed, and to identify and describe their potential benefits in a practical, comprehensive, and convincing way. An understanding of social values and of attitudes to different types of research is essential. Systematic study is preferable to unresearched commentary and it seems prudent to address these issues in a scientific and constructive manner. Description and assessment of potential benefits to society may be a formidable task but it is not impossible.
Research and society
Authors: Serafetinides E.A. , Cohen Jerome , May Philip R. A.
Published: August 2007

The uncertainties surrounding research, and the way such uncertainties and other characteristics of the research process complicate research cost benefit analysis, are discussed. Issues such as measurement of research costs, adverse research effects, benefits of research (political and otherwise) and the dimensions of research social costs, benefits and utility are examined. Aspects of the theory and practice of this type of analysis are considered, including assessment of the risk associated with conducting, or not conducting, any particular type of research and evaluation of its non‐measurable aspects.
Allocating the research budget
Authors: Scott Alex
Published: August 2007

There is a substantial economic literature on the allocation of R&D resorces. This paper reviews the relevant parts of this literature, paying particular attention to those studies which have estimated the social value of research. An important issue is whther government should allocate research resources, since the market may be able to do so; the potential reasons for market failure are reviewed, together with the case for government intervention in the market for research. Finally, the contribution which economic concepts can make to the decision making process is reviewed.
Perceived values of research among non‐researchers and various types of researchers
Authors: Serafetinides E.A. , Dow Ronald
Published: August 2007

A comparison was made of the ratings of researchers versus nonresearchers, as well as of the responses of different types of researchers. Non‐researchers on the whole gave higher ratings of social value to the projects, with variables such as PHYSICAL and MENTAL HEALTH particularly appreciated. Among the researchers, basic researchers gave the highest ratings and applied researchers the lowest.
Project ratings by influencers and persons with different degrees of political activity
Authors: Calltorp Johan , Harnois Gaston P. , Boulougouris John C.
Published: August 2007

An analysis was carried out to determine differences between influences and non‐influences, as well as between raters with different degrees of political activity, in their perceptions of the social benefits of the six research projects. The general distribution of a research budget has done quite similarly by the groups. Comparisons of ratings of the six projects reveals no systematic differences. A pattern of only minor differences is found.
Research values and priorities rated by psychiatric patients
Authors: Dencker Sven J , Boulougouris John , Greist John
Published: August 2007

A heterogenous group of 35 psychiatric patients‐representing an interesting consumer group‐was compared with the non‐patients in the total material. In respect of background data the patients had a lower educational level, and fewer smokers and applied researchers. The hypothesis that the research values and priorities of the patient group would differ from those of the non‐patients was supported by the statistical analysis; three major categories differed statistically between patients and non‐patients. Fourteen percent of the items and subcategories differed statistically between patients and non‐patients showing significantly higher values in the patient group. POLICY had the greatest number of such differences followed by SMOKING and MITOCHONDRIA. Most significant differences were found for MENTAL and PHYSICAL HEALTH followed by WORK, EDUCATION, NON‐MATERIAL, SERVICES, SECURITY and OTHER KNOWLEDGE.
Characteristics of those with extreme opinions on research values and priorities and on project ratings
Authors: Wetterberg Lennart , Calltorp Johan
Published: August 2007

Comparison of the background characteristics of zero‐givers and high extremists indicates that, in our group, influencers and those involved in political activities tended more frequently to be zero‐givers as to research values and priorities, whereas patients tended more frequently to high extremes. Otherwise there were no significant differences between zero‐givers, high extremists, and middle‐of‐the‐roaders.
An examination fo differences between those who place high, low, and medium values on the desirability of assessing the potential social benefits of all research projects
Authors: May Philip R. A.
Published: August 2007

There were few significant background differences between those who felt it was desirable to assign the potential social benefits of all proposed projects and those who did not. The data do, however, suggest that differences of opinion as to the desirability of this kind of assessment may be associated with differences in attitudes as to the relative values of knowledge and more material benefits.
Cluster patterns in research priorities
Authors: Wetterberg Lennart , Calltorp Johan
Published: August 2007

A cluster analysis of the research priorities assigned by 270 raters identified five clusters. The largest cluster, comprising 75% of the group, were middle‐of‐the‐roaders who divided their priorites more or less equally amongst the different categories of research. Another cluster emphasized health and working conditions, another basic resources, and education and basic resources. One cluster had only one person, an extremist who gave absolute total priority to research on physical health.
The smoking project as evaluated by smokers and non‐smokers
Authors: Sainsbury Peter
Published: August 2007

The purpose of one of the projects, whose social benefits we invited people to rate, was to develop a treatment to deter smokers from smoking. It was therfore of interest to compare the assessments made by smokers and by non‐smokers. The findings indicate that it would seem that smokers are more concerned than non‐smokers about the discomfort their habits inflict on others, and that they are also more aware that a research project that led to fewer people smoking would bring benefits to their fellows.

Howerver, smokers and non‐smokers agreed very closely on the order in which they rank the potential social rewards of research into methods of stopping smoking: They both placed its potential benefits to physical health first and the benefits to educational programs and non‐material benefits second or third.

Non‐smokers tended to place more value on OTHER KNOWLEDGE and NON‐MATERIAL benefits, whereas smokers more often rated tangible and practical benefits highly, and this difference between them is evident for all projects. The other very manifest trend is for smokers to rate most items more highly than did non‐smokers.
Assessment of the potential benefits of research ‐ a study among politicians, administrators, and researchers in Sweden
Authors: Calltorp Johan
Published: August 2007

This article presents the design and some of the findings from a special Swedish substudy within the international project. A total of 65 persons‐belonging to three major action groups in health care (politicians, administrators, or active researchers)‐performed the ratings.

The results show a remarkable homogeneity between the three groups regarding both their research budget allocations and their assessments of the six projects. Some differences according to age, sex, level of education, and medical training could be traced.

The method and material used in this study could be a valuable instrument for communication between the three main action groups in health care. In general, they reacted positively to the attempt to develop better descriptions of the social value of research projects but the format for evaluation was regarded as more controversial.
Benzodiazepines in the treatment of sleep disorders: pharmacokinetic aspects
Authors: Dettli L.
Published: August 2007

ABSTRACT In order to avoid after‐effects during the day, slowly eliminated hypnotic agents should not be used in the treatment of sleep disorders. It has become customary to separate long‐acting from short‐acting benzodiazepines and to use the (terminal) half‐life as the principle of classification. This approach is only justified, however, in the case of quickly absorbed benzodiazepines that have no pharmacologically active metabolites and that exhibit one‐compartment disposition kinetics. In contrast, the duration of action of benzodiazepines characterized by marked two‐compartment disposition kinetics can only be estimated correctly when the potency and all relevant kinetic parameters of the drug preparation and its pharmacologically active metabolites are considered.
The bioavailability and pharmacodynamics of chlormethiazole in healthy young and elderly volunteers: preliminary findings
Authors: Jostell K. G. , Fagan D. , Björk M. , Broberg F. , Mitchell R. M. , Scott D. B. , Ulff B.
Published: August 2007

‐ A preliminary analysis of a study of the bioavailability and pharmacodynamics of chlormethiazole in healthy young and elderly volunteers has been performed. The bioavailability assessed by a stable isotope method and the pharmacodynamic effects assessed by psychometric tests were found not to differ between the two age groups.
The effects of chlormethiazole in EEG recorded sleep in normal elderly volunteers
Authors: Liljenberg B. , Almqvist M. , Broman J. E. , Hetta J. , Roos B. E.
Published: August 2007

‐ Chlormethiazole has sedative, hypnotic and anticonvulsant properties, and is used in the treatment of sleep disorders and confusion in the elderly. In this study we examined the effects of chlormethiazole on EEG recorded sleep in six normal volunteers aged 67‐74 years. After baseline registration, chlormethiazole (base), 384 mg p.o. (i.e. 2 capsules)*, was administered during 5 nights followed by one withdrawal registration. Sleep latency decreased from 52 to 27 min during the treatment period (P < 0.01) and increased to 57 min during withdrawal. Wakeful periods during sleep decreased from 106 to 62 min during the treatment period and increased during withdrawal to 104 min (P < 0.001). The sleep efficiency improved slightly during chlormethiazole treatment. The distribution of the sleep stages was essentially unaffected by chlormethiazole. According to subjective assessment the subjects rated their ability to fall asleep and their sleep quality as significantly better during the drug period. Based on sleep recordings and subjective ratings, there was no evidence of rebound insomnia on withdrawal. Psychoperformance tests revealed no evidence of hangover effects.
Metabolic and functional aspects of tolerance to chlormethiazole and cross‐tolerance to ethanol in the rat
Authors: Kalant H. , Khanna J. M.
Published: August 2007

‐ Adult male rats were used to study tolerance to, and physical dependence on, chlormethiazole and cross‐tolerance to ethanol. In sleeping time studies, chlormethiazole was given orally at a daily dose rising progressively from 100 to 175 mg/kg over a period of 1 month. The tolerance that developed appeared to be due to altered disposition of the drug rather than to decreased sensitivity of the CNS. In agreement with this conclusion, there was only minimal cross‐tolerance to ethanol, and no detectable withdrawal reaction. In studies with the moving belt test, the rats were given chlormethiazole subcutaneously in a total dose of 200 mg/kg daily for 69 days. This resulted in an equivocal manifestation of tolerance on the moving belt test and a small, but significant, tolerance to the hypothermic effect of chlormethiazole. Only an equivocal manifestation of physical dependence was found. These findings suggest that tolerance to the hypnotic and hypothermic effects observed with these chlormethiazole treatment regimens was due to altered pharmacokinetics rather than to functional tolerance of the CNS.
Functional tolerance to chlormethiazole and crosstolerance to ethanol in the rat: importance of test and mode of drug administration
Authors: Kalant H. , Khanna J. M. , Llewellyn M. , Rinkel G. J. E. , Woodworth I.
Published: August 2007

‐ Tolerance to the effects of chlormethiazole on circular maze performance, and cross‐tolerance to ethanol, were investigated in rats. Tolerance to chlormethiazole in the moving belt test was also measured in the same rats. Treatment with a total daily dose of subcutaneous chlormethiazole, 200 mg/kg, for 20 days produced clear tolerance to chlormethiazole and cross‐tolerance to ethanol in the circular maze test. This treatment, however, failed to produce tolerance to chlormethiazole in the moving belt test. No evidence of physical dependence was found.

In other studies, continuous intravenous infusion of chlormethiazole, 30‐50 mg/kg/h for 9 days, resulted in clear functional tolerance to chlormethiazole and cross‐tolerance to ethanol in the moving belt test. Similarly, chronic ethanol treatment, 4‐6 g/kg daily for 3 weeks, resulted in functional tolerance to ethanol and cross‐tolerance to chlormethiazole in the same test.

These results indicate that the demonstration of functional tolerance to chlormethiazole and cross‐tolerance to ethanol is dependent both on the sensitivity of the behavioural measurement tests employed, and on the degree of continuity of exposure of the central nervous system to the drug.

It is concluded that, for doses that are equipotent in acute log‐dose studies, chlormethiazole produces less tolerance and physical dependence than ethanol, perhaps because of a shorter half‐life.
Sleep disturbances and agitational states in the elderly. Therapeutic possibilities and limitations in West Germany
Authors: Kanowski S.
Published: August 2007

‐ Sleep disturbance is common in the elderly. The causes of sleep disturbance are varied, and no single treatment can be successful in all cases. Psychotropic drugs and hypnotics are the drugs most frequently prescribed to the elderly in West Germany. The indications for using benzodiazepines, chlormethiazole, butyrophenones and chloral hydrate are discussed. However, in all cases the underlying cause of the sleep disturbance should be sought rather than treating the symptoms in isolation.
The treatment of delirium tremens and of incomplete alcoholic delirium ‐ a brief history
Authors: Huffmann G. , Becker T.
Published: August 2007

Followinng the introduction of chlormethiazole for the treatment of delirium tremens a striking reduction in the death rate occurred. The mortality range in most statistics is 1‐4%. The patient's age and complications concerning various internal organs affect the clinical outcome and so does the time at which chlormethiazole treatment is initiated. However, this has given rise to the habit of prescribing chlormethiazole at the slightest suspicion of the early stages of delirium tremens. In some cases the use of the drug was no doubt unnecessary, but equally certainly this measure has often prevented the development of complete delirium tremens which is now seen far more rarely than it was 20 years ago.

The availability of this well‐tolerated and easily controllable drug has made the treatment of most cases of delirium tremens a manageable task for any reasonably experienced physician. However, it should never be forgotten that delirium tremens is a life‐threatening condition with many potential complications. Therefore, the initiation of any chlormethiazole therapy calls for careful monitoring by the physician.
The efficacy of early chlormethiazole medication in the prevention of delirium tremens. A retrospective study of the outcome of different drug treatment strategies at the Helsingborg psychiatric clincis, 1975–1980
Authors: Pålsson A.
Published: August 2007

A clinical analysis of 476 cases of delirium tremens is presented. The sample covers virtually all cases of delirium tremens that occurred in the Helsingborg Health Service District during the peirod 1975‐1980. A retrospective analysis of the incidence of delirium tremens over the observation period shows that there was an increase in the number and severity of cases developing delirum tremens when non‐cross‐tolerant drugs, such as carbamazepine and neuroleptics, were used as first‐line treatment for acute alcohol withdrawal. The results also show that when chlormethiazole (a drug exhibiting a certain degree of cross‐tolerance with ethanol) was used either as the first‐line treatment for all cases or as the first‐line treatment for predetermind “high risk” paitents, the incidence of delirium tremens was greatly reduced. The favourable findings when chlormethiazole treatment was initiated at an early stage in the “high risk” patients suggest that chlormethiazole has a protective action against delirium tremens. Moreover, in the occasional case in which delirium tremens occurred during chlormethiazole treatment, the disorder was milder and relatively easy to treat.
Chlormethiazole in the management of alcohol withdrawal
Authors: Shaw G. K.
Published: August 2007

When managing alcohol withdrawal the aim is to prevent the development of serious complications, such as fitting and delirium tremens. In alcoholics who are heavily chemically dependent, the rational use of sedative‐type drugs is generally necessary. Chlormethiazole is effective in preventing the development of serious complications. It is a safe drug and has the additional advantage of a short half‐life.
Comparative investigation of chlormethiazole and neuroleptic agents in the treatment of alcoholic delirium
Authors: Athen D.
Published: August 2007

A retrospective study comparing the efficacy of chlormethiazole and neuroleptic agents showed that a mortality rate of 0% was associated with chlormethiazole treatment and 6% with neuroleptic treatment (P< 0.005). Data from the literature support this result. Chlormethiazole treatment seems to be superior to the neuroleptic treatment of alcoholic delirium.
Schizophrenia in Denmark: Incidence and utilization of psychiatric institutions
Authors: Munk‐Jørgensen P.
Published: August 2007

Abstract— All first admitted in 1972 to Danish psychiatric institutions diagnosed schizophrenics at least once until September 1983 (310 males and 277 females) are followed up. The incidence of schizophrenics diagnosed at their first admission is 7.8 males and 3.4 females/100,000 inhabitants and when those diagnosed as schizophrenics only at a later admission are included the incidence is correspondingly 15.0 and 8.7. The number of in‐patient days is highest in the first year and stabilizes at a lower level in the last 7 to 8 years of the follow‐up. The patients spent proportionately more days in mental hospitals than in psychiatric departments in general hospitals. Hebephrenic schizophrenics predominate in mental hospitals. Schizophrenics diagnosed during their first admission spent 19.5% of the 10‐year follow‐up period in institutions, while schizophrenics diagnosed during a later admission spent 17.4% (NS). Males spent 19.7% of the 10‐year follow‐up period in institutions, females 16.0% (P < 0.05).
Psychiatric determinants of weight changes in jaw‐fixed obese patients
Authors: Jönsson B. , Björvell H. , Esprnark S. , Levander S. , Rössner S.
Published: August 2007

Abstract— Forty‐five severely obese patients were treated with jaw fixation as a means of initiating weight loss. Patients who reported eating for consolation showed significantly greater difficulties in maintaining the achieved weight loss than the others. This finding constitutes further evidence of a relationship between obesity and depression. Low capacity to experience feelings of aggressiveness also seems to be linked to poor treatment results.
Long‐term neuroleptic therapy in chronic anorexia nervosa complicated by tardive dyskinesia: A case report
Authors: Condon J. T.
Published: August 2007

Abstract— A patient is described with a 25‐year history of disabling, and at times life‐threatening, anorexia nervosa alternating with major depression associated with suicidal ideation. Repeated relapse occurred despite a variety of treatments until the institution of high‐dose neuroleptic therapy. On this regime, together with supportive psychotherapy, she experienced a sense of emotional well‐being, exhibited a good level of functioning and maintained a safe body weight. Multiple attempts to withdraw the medication resulted in relapse. Recently, the patient has exhibited signs of tardive dyskinesia. Possible mechanisms underlying her response to this form of treatment are discussed. The characteristics of the small subgroup of chronic anorexics, in whom the risklbenefit ratio may justify such a regime, are tentatively outlined.
Clinical methods in psychiatric genetics: I. Robustness of genetic marker investigative strategies
Authors: Gershon E. S. , Goldin L. R.
Published: August 2007

Abstract— Population stratification, secondary effects of illness or treatment, biological heterogeneity of a clinical syndrome, or complex biology underlying a syndrome (where only one component is measured) are conditions which may obscure the association of a genetic risk factor with a clinical syndrome. We consider several investigative strategies under each of these conditions. Only segregation‐based paradigms are robust to genetic heterogeneity and population stratification. But secondary effects on the risk factor produced by illness or treatment require other strategies for their detection.
Light treatment of seasonal affective disorder in Switzerland
Authors: Wirz‐Justice A. , Bucheli C. , Graw P. , Kielholz P. , Fisch H.‐U. , Woggon B.
Published: August 2007

Abstract— Seasonal Affective Disorder (SAD) has been characterised by two or more depressive episodes in autumn or winter (with remission the following spring or summer), decreased energy, increased sleep, increased appetite, weight gain and carbohydrate craving. SAD patients were identified in a Swiss‐German population; 22 participated in a light‐therapy protocol (1 week bright white light 2500 lux or dim yellow light 250 lux, from 06–08h and 18–20h). Both observer and self‐ratings indicated a significant diminution of depressive symptoms with both lights. One week after withdrawal from yellow light, depression ratings relapsed to previous values; remission lasted longer after bright white light. Global VAS self‐rating scales for “mood” and “well‐being” however, and the Hamilton scale for atypical SAD symptoms, differentiated clearly between bright and dim light: only bright light showed an improvement that persisted after withdrawal. These results suggest that even though a placebo effect cannot be excluded, 4 h explicit light exposure/day may not be a negligible quantity. Light treatment promises to be a useful non‐phar macological intervention in certain forms of depressive illness.
Selenium concentrations in blood and serum from patients with mental diseases
Authors: Alertsen A. R. , Aukrust A. , Skaug O. E.
Published: August 2007

Abstract— Blood and serum concentrations of selenium have been determined in a group of psychiatric patients and in 35 healthy controls. The psychiatric group consisted of 14 schizophrenics, seven paranoid disorders, six affective psychosis (manic‐depressive), four reactive psychosis, 11 dementia senilis, 17 with a diagnosis of neurosis and two with delirium tremens. Normal values were found in all groups except for delirium tremens where decreased blood and serum values were found.
Social epidemiology of mental disorders
Authors: Almeida‐Filho N. de
Published: August 2007

ABSTRACT— This paper reviews the literature about the relationships between cultural change and psychopathology produced by Latin American researchers. With the analysis of 22 epidemiological studies, the author shows how culture has been traditionally viewed by social psychiatric research in Latin America as an independent variable associated with the prevalence of mental disorders. Two basic approaches have been analyzed: one of anthropological origin and the other based on sociological explanations. The hypotheses of cultural shock, stress of acculturation and cultural marginalization belong to the first approach, while the second one is manifested by the notions of urban stress, life change, social support and goal‐striving stress. Methodological issues were brought about to evaluate the results on the association of cultural processes and psychopathology available in contemporary socio‐psychiatric research in Latin America.
Plasma levels and effects of nortriptyline in geriatric depressed patients
Authors: Kumar V. , Smith R. C. , Reed K. , Leelavathi D. E.
Published: August 2007

ABSTRACT— Pharmacokinetic, therapeutic effects, and side effects of nortriptyline were studied in geriatric depressed patients treated with a standard dose of 150 mg/day. Plasma levels and elimination half‐life of nortriptyline were no different in geriatric patients than younger patients. The antidepressant therapeutic effects of nortriptyline appeared to be similar in geriatric patients as in younger depressed patients. Geriatric patients experienced few subjective side effects of nortriptyline. Overall, the drug produced no clinically significant changes in several parameters of the EKG, and no geriatric patient experienced tachycardia on nortriptyline. Nortriptyline did induce significant orthostatic hypotension in the systolic component, but not in the diastolic component. However, the orthostatic hypotension produced by nortriptyline was not greater in geriatric patients than in younger patients treated with the same dose.
Do we still need beds for psychiatric patients?
Authors: Häfner H.
Published: August 2007

ABSTRACT— While the utilization of outpatient psychiatric care increased steeply in the last few decades, the number of beds in psychiatric hospitals declined continuously in most countries. The future need for psychiatric hospital beds is influenced by changes in psychiatric morbidity, the range of services offered by mental hospitals and the availability of alternative forms of care for the chronically ill. A prospective cohort study conducted in Mannheim showed that currently, at a favourable standard of complementary service provision, one quarter of the schizophrenic patients requiring institutional care for more than one year – schizophrenics are the largest group of mental patients in need of long‐term residential care – still need to be treated in mental hospitals. Beyond this threshold value the costs of alternative care exceed those of a continuous inpatient treatment, and, concurrently with them, the burden upon the people involved grows. Estimates of the future need can be made on the basis of field surveys, utilization data of a population and an analysis of long‐term trends by using case register data. Provided a well‐functioning system of alternative and outpatient mental health services is available, psychiatric bed ratios covering the actual needs in developed countries seem to range from 0.5 to 0.8 per 1000 population over 15 for the short‐stay group and from 0.3 to 0.6 per 1000 for long‐stay patients. The uncertainty inherent in the estimates requires a sufficient degree of flexibility in service planning and a continuous monitoring to make adjustments to changed conditions possible.
Serotonin (5‐HT) uptake by blood platelets in anorexia nervosa
Authors: Zemishlany Z. , Modai I. , Apter A. , Jerushalmy Z. , Samuel E. , Tyano S.
Published: August 2007

ABSTRACT— Platelet serotonin (5‐HT) uptake was determined in 15 underweight anorexia nervosa patients and a control group of 15 healthy individuals. The Vmax (picomoles/108 platelets/5 min) was 424 ± 103 in patients and 424 ± 69 in controls. The Km was 1.19 ± 0.2 μM in patients and 1.08 ± 0.17 μM in controls. The differences between the groups were not significant.

These findings do not support the hypothesis that serotonin metabolism is disturbed in anorexia nervosa.