bluuebunny/crossref_metadata_2025 huggingface dataset:
Acute response to rape‐ a PTSD variant
Authors: Dahl Solveig
Published: August 2007

ABSTRACT The relationship between the acute response to rape and the symptoms of Post‐ Traumatic Stress Disorder (PTSD) was studied in 55 victims of rape and attempted rape during the first two weeks after the assault. The results show that in the majority of victims the reponse to rape within the first two weeks displays the symptoms of PTSD, although the criterion of duration is not fulfilled. Specific features of the response to rape, like shame, guilt and suicidal ideation are discussed. The importance of early detection to enable the administration of adequate treatment is emphasized and suggestions for further research are offered.
Torture of a Norwegian ship's crew
Authors: Weisæth Lars
Published: August 2007

ABSTRACT During the summer of 1984, 14 seamen, the entire crew of a Norwegian ship, were seized upon arrival in Libya. They were kept under arrest for 67 days and subjected to psychological and physical torture because they were suspected of being enemies of the Libyan state. Within the first few days of imprisonment one seaman had been murdered, another had been abducted and was believed to be dead, and a third had been severely physically maltreated.

The immediate reactions to the extreme stress were fear, depression and rage. Not a single seaman gave in to the torture.

Shortly after their release, all the seamen underwent thorough medical examinations. Six of them suffered from clear‐cut post‐traumatic stress disorder (PTSD) and one more seaman developed the disorder two months later. In spite of comprehensive treatment, the same seven sailors, or 54% of the crew, still suffered from post‐traumatic stress disorder six months after their release.

Used in conjunction with clinical interview, general mental status rating scales (GHQ 20, STAI, State Anxiety Inventory), and specific post‐traumatic rating scales (Amnesty Score, IES intrusion subscale, PTSS‐10) had a high sensitivity and specificity in discriminating between cases and non‐cases.
Helicopter crash in water: Effects of simulator Escape training
Authors: Hytten Karsten
Published: August 2007

ABSTRACT Findings are presented from an interview study of five crew members who survived helicopter crash. Four of the Five Surviving men had received simulated helicopter accident training prior to the Crash. One untrained crew member died. The four previously trained survivors claimed that the training appeared to be provision of confidence and thought control. The author discusses these as the development of a positive response‐outcome expectancy.
Accident Simulation as a New Therapy Technique for Post‐ Traumatic Stress Disorder
Authors: Hytten Karsten , Herlofsen Pål
Published: August 2007

ABSTRACT Data are presented from clinical interviews and psychological tests of a helicopter pilot who had survived a helicopter crash. Within a week, the pilot developed severe stress reactions after the crash, dominated by guilt feelings, nightmares and fear of not being able to fly. Helicopter‐accident training simulating a helicopter crashing into the water was used as part of the treatment. The therapeutic value and limitations of this type of treatment are discussed. The main benefit seemed to be the extinction of traumatic helplessness and the reestablishment of a positive response‐outcome expectancy. Existential conflicts were not covered by the simulator training.
A long‐term psychosocial follow‐up study of burned adults
Authors: Malt U. F. , Ugland O. M.
Published: August 2007

ABSTRACT A clinical psychiatric follow‐up study of 70 burned adults was performed 3–13 years after the burn injury. The majority of patients had minor injuries. Twenty‐three percent suffered from definite psychosocial problems at follow up. Patients with severe injuries more often had problems (44%) than patients with minor injuries (16%). Outcome was not related to premorbid psychopathology except for patients with more severe injuries. A combination of variables describing length of hospital stay, the presence of scars, premorbid psychopathology, experiencing death threat when injured and deviant behaviour during the hospital stay was found to be the best predictor of negative psychosocial outcome (positive predicting power 83%; sensitivity 94%).
Regional differences in mortality from dementia in Australia: an analysis of death certificate data
Authors: Jorm A.F. , Henderson A.S. , Jacomb P.A.
Published: August 2007

ABSTRACT Australian death certificate data were analysed to determine whether they can provide useful information on regional differences in the prevalence of dementia. Strong differences between the Australian states were found in the prevalence of dementing disorders at death. However, evidence indicated that death certification practices influenced the prevalence rates found: a) the reported prevalence of various dementing disorders at death has changed greatly over quite a short period; b) the prevalence of dementing disorders at death was more strongly influenced by place of death than by place of birth; and c) the differences between states were a result of very high rates in particular regions which, in one case, could be traced to the death certification practices of a single medical practitioner. It is concluded that death certificate data are not useful for investigating regional differences in the prevalence of dementia.
Characteristics of patients with major depression in combination with dysthymic or cyclothymic disorders
Authors: Alnæs R. , Torgersen S.
Published: August 2007

ABSTRACT The relationship between patients with acute major depression and chronic affective disorders was investigated in 298 nonpsychotic outpatients. The patients were categorized into 4 groups: major depression only, major depression with dysthymic or cyclothymic disorder, dysthymic or cyclothymic disorder without major depression and one group of other psychiatric disorders. The patients were interviewed about childhood losses, relationship to parents and siblings and family atmosphere, their personality characteristics as children, as well as precipitating events. The reports in the various diagnostic groups were compared. Patients in the mixed group reported somewhat more traumatic childhood experiences compared with patients in the pure major depression group and pure dysthymic‐cyclothymic group, and much more traumatic childhood experiences compared with patients in the group of other disorders. Precipitating events among patients in the acute major depression group consisted of more acute external stressors compared with the events of the patients in the group of chronic affective disorders. Patients with major depression in combination with pure dysthymic‐cyclothymic disorder generally remembered their childhood as having been more traumatic, with a less satisfying relationship to their parents.
An open, noncomparative study of amoxapine in borderline disorders
Authors: Jensen H. V. , Andersen J.
Published: August 2007

ABSTRACT Five patients with borderline personality disorder (BPD) and 5 patients with schizotypal personality disorder (SPD) completed at least 3 weeks of treatment with amoxapine. The patients fulfilled DSM‐III criteria for borderline disorders and scored 7 points or more in Gunderson's Diagnostic Interview for Borderlines (DIB). The final median medication in patients with BPD was 200 mg amoxapine/day and 42 mg oxazepam/day. Duration of treatment averaged 28 days. In patients with SPD the corresponding figures were 250 mg amoxapine/day, 36 mg oxazepam/day and 39 days. The study suggests that amoxapine improves schizophrenic‐like and depressive symptoms in patients with schizotypal personality disorders (SPD). No effect could be shown in patients with borderline personality disorders (BPD).
Recent trends in methods of suicide
Authors: Moens G. F. G. , Loysch M. J. M. , Honggokoesoemo S. , van de Voorde H.
Published: August 2007

ABSTRACT– Trends in completed suicide by method were analysed for Belgium between 1968–972 and 1978–1981, using the information reported on death certificates. Around 1980, hanging was the most preferred method of suicide in both sexes, followed by firearms in males and poisoning by solid and liquid substances in females. Between 1970 and 1980, rates for all but one method (domestic gas) increased. The largest changes among men were seen for firearms and for poisoning, accounting respectively for 43% and 33% of the overall increase. For women, 48% of the rise was attributable to poisoning and 24% to drowning. The choice of method was seen to be influenced by age: hanging and drowning were the preferred methods for older people, whereas poisoning was the most popular among younger adults. The male‐female ratio decreased for firearms and was reversed for poisoning and drowning. These findings are compared with trends in other industrialized countries, and the possibilities for suicide prevention by reducing the firearms and poisoning rates are discussed.
Language of publication of journal articles on suicide and mental disorders
Authors: Barraclough B. M. , Noyes R.
Published: August 2007

ABSTRACT– English as the language of publication for articles on suicide in the medical literature increased from 58% of articles in 1966 to 79% in 1986. This increase occurred at the expense of all languages. These changes parallel those for the language of publication of articles on mental disorders and all medical subjects.
Long‐term course and outcome in unipolar affective and schizoaffective psychoses
Authors: Opjordsmoen S.
Published: August 2007

ABSTRACT– Of 301 first‐time admitted patients with delusional psychoses, 50 met DSM‐III criteria for major depressive disorder (MDD), 33 schizoaffective disorder, depressive type (SADD), and 94 schizophrenia. At personal follow‐up after 3–39 (mean 22) years, the SADD group was recorded in between on course and outcome variables, but closer to MDD. The findings in MDD and SADD were respectively: remission 66% vs. 42%, personality disorders 14% vs. 12%, anxiety disorder or alcohol abuse 2% vs. 6%, psychosis 18% vs. 36% (with bipolar development in 2% vs. 6%, paranoid disorder 2% vs. 3%, schizophrenia 4% vs. 3%). Chronic psychosis was recorded in 10% vs. 27%. No significant outcome difference was found between early onset MDD and SADD cases and those who fell ill at a higher age. The assumption that antidepressants may induce mania could not be confirmed. Normal premorbid personality seemed to predict a favourable course.
Clinical implications of determination of plasma haloperidol levels
Authors: Santos J. L. , Cabranes J. A. , Almoguera I. , Ramos J. A. , Vazquez C. , Angeles F.
Published: August 2007

ABSTRACT– The aim of this study was to analyze the clinical utility of monitoring plasma levels, since the utility of monitoring is not yet well established. After a washout period, 30 schizophrenic patients were given fixed doses of haloperidol for 3 weeks. A U‐shaped second‐grade polynomic relationship (R = 0.69) was found between steady state of haloperidol and percentage improvement in total score on the Brief Psychiatric Rating Scale. The interval of effective concentrations was between 12 and 59 ng/ml. Fourteen of the 15 patients who had a steady state of haloperidol within that therapeutic interval were responders: only 5 out of the 15 patients below the therapeutic interval were responders. None of the 5 patients who had concentrations below 8 ng/ml was a responder. Furthermore, responder patients showed a steady‐state level of haloperidol significantly higher than that of nonresponders. These data suggest that plasma levels of haloperidol are predictors of therapeutic response in schizophrenic disorders.
Personality and personality disorders among patients with major depression in combination with dysthymic or cyclothymic disorders*
Authors: Alnæs R. , Torgensen S.
Published: August 2007

ABSTRACT– Personality traits and personality disorders in 298 consecutive outpatients with pure major depression, major depression with dysthymic or cyclothymic disorder, pure dysthymic or cyclothymic disorder and other disorders were investigated. Patients with dysthymic or cyclothymic disorder alone or in combination with major depression showed more self‐doubt, insecurity, sensitivity, compliance, rigidity and emotional instability. They were more schizoid, schizotypal, borderline and avoidant according to MCMI and had a higher prevalence of DSM‐III Axis II diagnoses, and more borderline, avoidant, and passive‐aggressive personality disorders, as measured by SIDP. All in all, dramatic and anxious clusters of personality disorders were more frequent among patients with dysthymic‐cyclothymic disorders in addition to major depression than among patients with major depression only. The findings elucidated the close connection between the more chronic affective disorders and the personality disorders, irrespective of any concomitant diagnosis of major depression.
Suicide in Israel: crossnational comparisons
Authors: Levav I. , Aisenberg E.
Published: August 2007

ABSTRACT– A comparison of rates of completed suicide is made among different national and religious groups in Israel. Rates are higher for Jews than for Arabs. Psychological and sociocultural hypotheses are used to attempt to explain these findings.
Mental disorder in youth suicide
Authors: Runeson B.
Published: August 2007

ABSTRACT– A 3‐year urban material of suicides in adolescents and young adults (age 15–29 years) was studied retrospectively by means of interviews with survivors (n= 58). Classification of mental disorders according to DSM‐III‐R showed that major depression was important as background to suicides in 41%, primary (22%) or secondary (19%) to other disorders. Adding major depression, depressive disorder, not otherwise specified, dysthymia and adjustment disorder with depressed mood gave a total of 64% depressive syndromes. Schizophrenia (14%) and borderline personality disorder (28%) constituted other relevant groups. Coexisting substance use disorder occurred in 47%. A majority of the subjects (72%) were known by psychiatric caregivers and 16% committed suicide during inpatient care.
Schizophrenia in users and nonusers of cannabis
Authors: Andréasson S. , Allebeck P. , Rydberg U.
Published: August 2007

ABSTRACT– In a previous longitudinal study of Swedish conscripts we have shown strong association between level of cannabis consumption at conscription and development of schizophrenia during 15 years of follow‐up. In this study we further analysed data from a subsample of the national cohort. Case records for all conscripts residing in Stockholm County who reported consuming cannabis on more than 10 occasions and who subseqently developed schizophrenia (n= 8) were compared with case records of a sample of conscripts who also developed schizophrenia but reported no cannabis consumption at conscription (n= 13). The relative risk of schizophrenia among cannabis users in Stockholm Country was 4.1 (95% confidence interval 1.8–9.3) compared with nonusers. No evidence was found of a significant role for any other narcotic drug in the emergence of schizophrenia among cannabis abusers. Further, there was no evidence of mental disorder prior to cannabis abuse, even if the role of personality traits could not be fully assessed. A different pattern of mental deterioration was found among cannabis users, with a more abrupt onset of schizophrenic symptoms than nonusers. There was no major difference between users and nonusers in heredity for schizophrenia or other mental disorder. Negative social background factors were more common among cannabis abusers. Although the number of cases in this study was small, the findings support the hypothesis that cannabis does play an aetiological role in schizophrenia.
Moclobemide and clomipramine in endogenous depression
Authors: Koczkas C. , Holm P. , Karlsson A. , Nagy A. , Ose E. , Pétursson H. , Ulverås L. , Wenedikter O.
Published: August 2007

ABSTRACT– The purpose of this study was to compare moclobemide and clomipramine in endogenous depression according to the Newcastle II classification. Sixty‐two patients were allocated to either 300 mg moclobemide or 150 mg clomipramine, both given in 3 daily doses. Improvements occurred over time but differences between treatments were never statistically significant. Dizziness, tremor and anticholinergic symptoms were significantly more frequent with clomipramine.
Moclobemide and clomipramine in reactive depression
Authors: Larsen J. K. , Holm P. , Høyer E. , Mejlhede A. , Mikkelsen P. L. , Olesen A. , Schaumburg E.
Published: August 2007

ABSTRACT– The purpose of this study was to compare moclobemide and clomipramine in reactive depression according to the Newcastle II classification. Sixty patients were allocated to either 300 mg moclobemide, 150 mg clomipramine or placebo, all divided in 3 daily doses. Improvements occurred over time, but differences between treatments and compared with placebo were never statistically significant. Dizziness, tremor and anticholinergic symptoms were significantly more frequent with clomipramine than with moclobemide and placebo.
A longitudinal study of mental health problems in a suburban population in Sudan
Authors: Cederblad M. , Rahim S. I. A.
Published: August 2007

ABSTRACT– A psychiatric study of 197 children living in villages outside Khartoum was made in 1964–1965. In 1983, 104 randomly chosen subjects were investigated again. All were interviewed by a psychiatrist and somatically examined. The overall psychiatric impairment was 14% (males, 18%; females, 8%) according to the psychiatric interview; the Self‐rating Questionnaire gave a higher figure (28%). The rate of somatic illness was similar: 14% according to the medical doctor, 22% according to the self‐rating of the subjects. Childhood data predicted 17% of the variance in adult mental health. Somatic state of health in childhood and traditional type of work by the father were the most important variables. Data from the life situation of the individual explained 67% of the variance in adult mental health.
History of separation anxiety in patients with panic disorder and depression and normal controls
Authors: Yeragani V. K. , Meiri P. C. , Balon R. , Patel H. , Pohl R.
Published: August 2007

ABSTRACT– The frequency and severity of separation anxiety for subjects with panic disorder and major depression was compared with that for normal controls. The subjects were diagnosed according to DSM‐III criteria. Each subject completed a questionnaire consisting of 9 items derived from DSM‐III criteria for separation anxiety disorder. The incidence of separation anxiety and its severity were significantly higher for the panic disorder subjects than for normal controls but there was no significant difference between depressed and panic disorder subjects. Panic disorder subjects with a history of separation anxiety disorder had a significantly earlier onset of panic attacks.
Fluoxetine treatment of depression
Authors: Mårtensson B. , Nyberg S. , Toresson G. , Brodin E. , Bertilsson L.
Published: August 2007

ABSTRACT– In an open study of depressed inpatients, the effects of the selective serotonin uptake blocker fluoxetine on 5‐hydroxyindoleacetic acid (5‐HIAA), homo‐vanillic acid (HVA), 4‐hydroxy‐3‐methoxyphenyl glycol (HMPG) and N‐terminally extended substance P (SP) in cerebrospinal fluid (CSF) were measured. Thirteen unmedicated patients who met the DSM‐III criteria for major depressive episode were included, and 9 completed the study. During treatment the 5‐HIAA concentration decreased by 46%. The HVA and HMPG concentrations also decreased significantly, but to a lesser degree. The mean level of N‐terminally extended SP was unaffected by fluoxetine treatment, but the pretreatment level correlated significantly with the pretreatment level of HMPG. The pretreatment level of HVA was the only biochemical variable that appeared to predict therapeutic outcome. The plasma concentrations of both fluoxetine and its metabolite norfluoxetine increased significantly between 3 and 6 weeks. Plasma and CSF levels of both the parent drug and its active metabolite were correlated.
An epidemiologic investigation of alcohol‐dependent schizophrenics
Authors: Pulver A. E. , Wolyniec P. S. , Wagner M. G. , Moorman C. C. , McGrath J. A.
Published: August 2007

ABSTRACT–Most clinicians agree that alcoholism is frequent in schizophrenic patients. However, little is known about the clinical or familial characteristics of this group. We compared alcoholic schizophrenics and nonalcoholic schizophrenics with respect to sociodemographic and clinical characteristics and the rate of various psychiatric illnesses among their first‐degree relatives. The only difference in the sociodemographic characteristics was a higher proportion of males among the alcoholic schizophrenics. Clinically, the alcoholic schizophrenics were more likely to report experiencing hallucinations, depressive episodes, manic episodes (females only) and multiple substance abuse (males only). In addition, the male alcoholic schizophrenics were younger at first hospitalization than the male nonalcoholic schizophrenics. This effect was reversed for females. The relatives of alcoholic schizophrenics were 2.6 times more likely to be alcoholic than the relatives of the nonalcoholic schizophrenics. The morbidity for other psychiatric disorders was similar in the two groups.
Urinary phenylacetic acid in panic disorder with and without depression
Authors: Sabelli H. C. , Javaid J. I. , Fawcett J. , Kravitz H. M. , Wynn P.
Published: August 2007

Phenylacetic acid (PAA) excretion was measured in 39 patients who met criteria for panic disorder; 9 of these also had major depression, and 30 did not. Patients with panic and depression excreted 66 ± 23 mg/day of PAA, an amount significantly lower than in normal controls; patients with panic disorder but without depression excreted 104 ± 23 mg/day of PAA (not significantly lower than controls). The results support previous studies indicating that PAA excretion is a marker for depressive disorder.
Who commits patricide?
Authors: Singhal S. , Dutta A.
Published: August 2007

The authors studied 10 men charged with patricide, including 2 men charged with both patricide and matricide and compared them with 10 schizophrenic patients who did not commit any crime. Eight patients who committed patricide were diagnosed as suffering from schizophrenic illness and 2 patients received a diagnosis of personality‐disorder. Seven schizophrenics who committed patricide and both personality‐disordered patients had a cruel and unusual relationship with their father. All were single at the time of patricide. The EMBU inventory revealed fathers to be more punitive than mothers and fathers favoured siblings more than the patients. Mothers were more overprotective and tolerant than fathers. Patricide patients’ fathers were more punitive and shaming than control patients’ fathers, and control patients’ fathers were more stimulating and depriving than patricide patients’ fathers. Patricide patients’ mothers were more overinvolved and tolerant than control patients’ mothers. A sense of relief was felt following the patricide rather than remorse. In contrast, the majority of patients in the control group described their father and mother as kind and affectionate. The EMBU inventory did not reveal any significant difference between father and mother.
Cerebrospinal fluid levels of somatostatin, corticotropin‐releasing hormone and corticotropin in alcoholism
Authors: Roy A. , DeJong J. , Gold P. , Rubinow D. , Adinoff B. , Ravitz B. , Waxman R. , Linnoila M.
Published: August 2007

Reduced brain and cerebrospinal fluid (CSF) levels of somatostatin, corticotropin‐releasing hormone (CRH) and corticotropin (ACTH) have been reported among neuropsychiatric patients with cognitive dysfunction. Alcoholism is a disorder in which associated neuropsychiatric disorders occur. Therefore, we compared CSF levels of somatostatin, CRH and ACTH in alcoholics (n= 100) and normal controls (n= 30). There were no significant differences between the groups in concentrations of the 3 peptides. Moreover, there were no significant correlations between concentrations of the peptides in CSF and computed tomographic measures of the size of brain ventricles. There were, however, significant correlations between CSF concentrations of CRH and ACTH and between CSF concentrations of CRH and somatostatin in both the alcoholic and control groups.
Patient interactions in four psychiatric wards
Authors: Sandford D. A. , Elzinga R. H.
Published: August 2007

This article describes the interactions between patients and between patients and staff in 4 psychiatric wards. Two of the wards are acute admission units and 2 are for long‐stay chronic patients. The hospital is diagnostically streamed so that not only does the average length of stay vary between wards but so, for one ward, does the predominant diagnostic group. Patient interactions were analysed in terms of 5 major interactional categories: individual verbal, individual nonverbal, group verbal, group nonverbal and physical. The results show that, although there was little change in the overall level of verbal interaction as a function of chronicity, there were large shifts in patient‐patient and staff‐patient interaction rates. Variations between the 4 wards on the 4 other interactional categories are explained in terms of the known diagnostic characteristics of the patients.
The experience of dysmenorrhea and its relationship to personality variables
Authors: Holmlund U.
Published: August 2007

The aims of this study were: to relate women's subjective experience of primary dysmenorrhea to psychogenic needs assessed longitudinally at the age of 15 and at the age of 25 in a nonclinical sample; to compare the psychogenic needs of women with severe primary dysmenorrhea with those of other women who never have experienced dysmenorrhea; and to examine whether women with severe dysmenorrhea were less conventionally feminine than women who never have experienced dysmenorrhea. At 25 years, 42% of the women experienced dysmenorrhea and 15% experienced pain that limited their daily activity. Differences in psychogenic needs according to the Cesarec Marke Personality Scedule and in psychological masculinity and femininity according to the Attitude Interest Schedule were found in women with severe primary dysmenorrhea compared with women who never experienced dysmenorrhea. The results indicate that women with severe dysmenorrhea have less self‐esteem at 15 years, but compensate for this at 25 years by being more achievement‐oriented and aggressive than women who never experienced dysmenorrhea. Further, women with severe dysmenorrhea are more conventionally feminine than women who never have experienced dysmenorrhea.
Coping styles to basic disorders among schizophrenics
Authors: Takai A. , Uematsu M. , Kaiya H. , Inoue M. , Ueki H.
Published: August 2007

Coping efforts to subjectively experienced basic disorders were investigated by self‐report in 60 chronic schizophrenics in Japan, and the relationships to clinical and demographic variables, intelligence, personality, and attitude toward their illness were analyzed. Self‐reports on coping efforts were obtained for more than half of all subjectively experienced basic disorders, and the predominant technique was reported to be the approach oriented towards problem‐solving. Within each coping style, the behavioral change, divertive problem‐solving approach correlated negatively with hospitalization and symptoms, and the struggle, problem‐solving efforts without any effective results correlated positively with symptoms. Suggestions regarding integration of these self‐efforts into psychosocial treatment of schizophrenia are discussed.
Disease consciousness and coping strategies of patients with schizophrenic psychosis
Authors: Dittmann J. , Schüttler R.
Published: August 2007

In 50 schizophrenic patients, semistructured interviews were carried out concerning disease consciousness, occupation with the disease and behaviour and coping in case of psychotic experiences; 72% of the patients occupied themselves with their disease. In 84% a disease consciousness was present; 38% gave a multifactorial explanation for their psychosis. In 94% the occasional appearance of psychotic experiences was acknowledged. In 86% specific changes of the individual behaviour for coping with these experiences were described. These changes included withdrawal, increasing of interpersonal contact, cognitive control, symptomatic behaviour and adjustment of the neuroleptic medication. The study shows that schizophrenic patients are not passive victims of their disease. In the majority of cases a disease consciousness is present. The patients try to cope with their psychotic experiences in individually different ways. It is assumed that a better knowledge of these strategies might enable the clinician to use these phenomena as an adjunct to pharmacotherapy.
The effect of the detoxification of domestic gas in Switzerland on the suicide rate
Authors: Lester D.
Published: August 2007

An examination of suicide rates in Switzerland during the period when domestic gas was detoxified indicated that, not only did the use of domestic gas for suicide decline, but so did the overall suicide rate, indicating that people did not switch to alternative methods for suicide, contrary to a claim made by the late Erwin Stengel.
Corticotropin, Cortisol and β‐endorphin responses to the human corticotropin‐releasing hormone during melancholia and after unilateral electroconvulsive therapy
Authors: Dored G. , Stefansson S. , D'Elia G. , Kågedal B. , Karlberg E. , Ekman R.
Published: August 2007

Previous research in neuroendocrinology has evidenced that hyperactivity of the hypothalamic‐pituitary‐adrenal axis (HPA) depends on hypersecretion of corticotropin‐releasing hormone (CRH). The aim of this study was to investigate the activity of HPA before and after recovery in depressed patients treated with electroconvulsive therapy (ECT). An h‐CRH‐stimulation test was performed on 2 occasions with examination of the HPA axis before ECT treatment during episodes of major depressive disorders with melancholia, and during the recovery phase after treatment. The results showed that patients during depression had significantly higher plasma levels of cortisol at 15 and 30 min after h‐CRH‐administration than after recovery. Depressed patients had significantly higher plasma levels of β‐endorphin 30 min after h‐CRH‐stimulation. The results are in agreement with previous studies, which have shown hypercortisolemia during depression. A possible hypersecretion of CRH may explain the effect on cortisol and β‐endorphin. No significant differences were found between cumulative responses of corticotropin, cortisol and β‐endorphin, calculated as the areas under the concentration curves.
The phenomenology of psychiatric hospitalization: the patient's experience and expectations
Authors: Gregoire P. A.
Published: August 2007

Patients admitted to a psychiatric hospital are confronted by complex and, at times, conflicting models and theories about the cause and treatment of their illness. The patient's understanding and experience of this process are analyzed in this phenomenological study. The need for patients’ increased understanding of the purpose and functions of hospitalization is underlined as well as the possible discrepancy between the patients’ and the hospital's perspectives on treatment objectives.
An American view of the ICD‐10 personality disorders
Authors: Blashfield R. K.
Published: August 2007

The 1986 version of the ICD‐10 diagnostic criteria for the personality disorders was analyzed. In one part of the study, clinicians in the United States were asked to assign the ICD‐10 criteria to the ICD‐10 categories. In a second part, the ICD‐10 criteria were assigned to DSM‐III‐R categories. In the first part, the face validities of the ICD‐10 criteria were highly variable. Thirty percent of the criteria were assigned to the correct parent category by over 80% of the clinicians. In contrast, 34% of the criteria failed to be correctly assigned by at least half of the clinicians. Concerning the correspondence between ICD‐10 and DSM‐III‐R categories, only anankastic (ICD) and obsessive‐compulsive (DSM) showed a high level of correspondence. The correspondences of anxious (ICD) with avoidant (DSM), impulsive (ICD) with borderline (DSM), and histrionic (ICD) with histrionic (DSM) were poor.
Ventricular enlargement in normal weight bulimia
Authors: Kiriike N. , Nishiwaki S. , Nagata T. , Inoue Y. , Inoue K. , Kawakita Y.
Published: August 2007

Cranial computed tomography (CT) scans of 17 patients with bulimia were compared with those of 21 age‐ and sex‐matched controls. The ventricular brain ratio (VBR) of the bulimics was 7.29, which was significantly greater than the 4.55 seen in controls. However, no correlation was found between VBRs and clinical variables, endocrine or metabolic parameters.
Predicting neuroleptic response from a combination of multilevel variables in acute schizophrenic patients
Authors: Bartkó G. , Frecska E. , Horváth S. , Zádor G. , Arató M.
Published: August 2007

A predetermined set of 22 sociodemographic, psychosocial, clinical, neurocognitive and biochemical potential predictor variables was tested in 98 schizophrenic patients admitted for relapse. The patients were treated with neuroleptics, mostly with haloperidol, for 28 d. Ten of the 22 variables correlated significantly with the neuroleptic response. Using stepwise multiple regression analyses, an optimal combination of 5 predictors was found to be in hierarchical order: disturbances of premorbid adjustment, intensity of positive symptoms at admission, family history of schizophrenia, working ability during the year before admission and serum dopamine‐β‐hydroxylase. The 5 best predictors explained 29% of outcome variance, and all 22 variables together explained 35%. Such neurological characteristics as neurological soft signs, handedness, abnormal voluntary movements, spontaneous blink rate and cognitive impairment did not predict the treatment response. Several psychopathological, psychosocial and clinical predictors known from the literature could also be confirmed by cross‐validation.
Pharmacokinetics of an oral controlled release formulation of remoxipride: a double‐blind, crossover comparison with conventional formulation in chronic schizophrenics*
Authors: Soni S D , Tench D. , Ashwood T J , Movin G
Published: August 2007

Abstract Twenty‐four stable, chronic schizophrenic inpatients were entered in a double‐blind, crossover study designed to compare single‐dose and steady‐state pharmacokinetics of remoxipride immediate release (IR) 200 mg twice daily and controlled release (CR) 400 mg once daily. The CR formulation showed a significantly delayed absorption of remoxipride from the gastrointestinal tract. At steady state there was significantly less fluctuation in plasma concentrations. The other pharmacokinetic variables studied showed no difference. The mean relative bioavailability with regard to the amount of remoxipride absorbed after administration in CR form as compared with the IR form was 97%. Both formulations were well tolerated and there was no difference in either the incidence or the severity of adverse events. It was concluded that, from a pharmacokinetic point of view, the CR formulation of remoxipride was suitable for a once daily dosage schedule.
Remoxipride and haloperidol in schizophrenia: a double‐blind multicentre study.
Authors: Ahlfors U. G. , Rimõn R. , Appelberg B. , Hagert U. , Harma P. , Katila H. , Mah‐lanen A. , Mehtonen O‐P. , Naukkarinen H. , Outakoski J. , Rantanen H. , Sorri A. , Tamminen T. , Tolvanen E. , Holm A.‐C.
Published: August 2007

Ninety‐two patients with schizophrenia were included in a double‐blind multicentre parallel‐group trial comparing remoxipride and haloperidol. The mean daily dose during the last week of treatment was 316 mg (range, 150–600 mg) in the remoxipride group and 8.7 mg (range, 5–20 mg) in the haloperidol group. The study period was six weeks with at least one day of washout. Both Clinical Global Impression (CGI) rating, and Brief Psychiatric Rating Scale (BPRS) total scores declined at the end of the trial compared with pretreatment values in both groups. No significant differences were found between the remoxipride and haloperidol groups with regard to the treatment outcome. Treatment‐emergent extrapyramidal symptoms were statistically more frequent and more severe during haloperidol than during remoxipride treatment. Haloperidol‐treated patients reported also significantly more concentration difficulties. Severe extrapyramidal side effects in the haloperidol group and clinical ineffectiveness in the remoxipride group were the most frequent reasons for premature discontinuation of treatment.
A placebo‐controlled clinical trial of remoxipride and chlorpromazine in newly admitted schizophrenic patients with acute exacerbation
Authors: Chouinard G.
Published: August 2007

Abstract We carried out a four‐week double‐blind placebo‐controlled study comparing remoxipride (n=20) to chlorpromazine (n=21) and placebo (n=21) in the treatment of newly admitted schizophrenic patients with acute exacerbation. Chlorpromazine was found to be significantly better than remoxipride on the dropout rate due to inefficacy, Clinical Global Impression (CGI) of severity of illness and Brief Psychiatric Rating Scale (BPRS). Chlorpromazine tended to be better than placebo on the dropout rate related to inefficacy, Nurse's Global Impression (NGI) of severity and on the BPRS measures of positive symptoms (hallucinatory behaviour and thinking disturbance factor). We were unable to detect a difference between remoxipride and placebo except that remoxipride was better in patients who had previously responded well to neuroleptics. Both drugs induced significantly more parkinsonism than placebo, but differently so: chlorpromazine induced both types of parkinsonism hypo‐ and hyper‐kinetic symptoms, whereas remoxipride induced hyperkinetic symptoms. Chlorpromazine caused more tachycardia, drowsiness, orthostatic dizziness, and dry mouth than the other two treatments, while patients on remoxipride suffered more from insomnia than those on the other two treatments.
Remoxipride and haloperidol in the acute phase of schizophrenia: a double‐blind comparison
Authors: Deo R. , Soni S. , Rastogi S. C. , Levine S. , PIant I. , Edwards J. Guy , Mitchell M. , Chanas A.
Published: August 2007

The efficacy and safety of remoxipride in the treatment of schizophrenia were compared with those of haloperidol in a multicentre double‐blind 6‐week study which was randomized with a parallel group design and was preceded by a washout period. Eighty‐nine consecutively admitted men and women meeting the Research Diagnostic Criteria for schizophrenia in an acute phase of the illness were treated with remoxipride 75–300 mg twice daily or haloperidol 5–20 mg twice daily. The efficacy assessments were the Brief Psychiatric Rating Scale, Krawiecka Rating Scale, and Clinical Global Impression. Both antipsychotic drugs produced clinical improvement with no significant differences between the efficacy of the two drugs. There were relatively few side effects. There were significantly fewer extrapyramidal symptoms and instances of blurred vision with remoxipride and less constipation with haloperidol. The results indicate that remoxipride is as effective an antipsychotic as haloperidol. Remoxipride has an advantage over haloperidol in respect to extrapyramidal side effects.
A double‐blind comparative multicentre study of remoxipride and haloperidol in schizophrenia
Authors: Lindström L. H. , Wiesekjren I.‐M. , Struwe G. , Kristjansson E. , Akselsorn S. , Arthur H. , Andersen T. , Lindgren S. , Norman Q. , Naimell L. , Stening G.
Published: August 2007

Abstract In a double‐blind multicentre study of parallel group design the efficacy and safety of remoxipride and haloperidol were compared in a total of 96 patients with acute episodes of schizophrenic or schizophreniform disorder according to DSM‐III. There were 48 patients in each treatment group; 27 men and 21 women in the remoxipride group, 33 men and 15 women in the haloperidol group. The median duration of illness was 7 years in both groups. The mean daily dose was 437 mg for remoxipride and 10.6 mg for haloperidol during the last week of treatment. No statistically significant differences in total BPRS scores were found between remoxipride and haloperidol. The median total BPRS scores at the start of active treatment were 26 in the remoxipride and 27 in the haloperidol group; these were reduced to 16 and 12.5, respectively, at the last rating. According to Clinical Global Impression (CGI), 43% of patients in the remoxipride group and 68% of those in the haloperidol group improved much or very much during treatment. This difference was not statistically significant. Treatment‐emergent extrapyramidal side effects such as akathisia, tremor, and rigidity occurred significantly more frequently in the haloperidol group; this group also made more frequent use of anticholinergic drugs. Neither of the trial drugs seriously affected laboratory or cardiovascular variables. It is concluded that remoxipride has an antipsychotic effect in a dose range of 150–600 mg per day comparable to that of haloperidol in doses up to 20 mg per day but with fewer extrapyramidal side effects.
A double‐blind multicentre study comparing remoxipride, controlled release formulation, with haloperidol in schizophrenia
Authors: Pflug B. , Bartels M. , Bauer H. , Bunse J. , Gallhofer B. , Haas S. , Kanzow W. T. H. , Klieser E. , Küfferle B. , Stein D. , Steinberger K. A. , Weiselmann G.
Published: August 2007

Abstract A double‐blind multicentre study was undertaken to compare the efficacy and safety of remoxipride in a controlled release (CR) formulation given once daily with haloperidol twice daily in patients with schizophrenic illness. In total, 114 patients were included. All were diagnosed as schizophrenic or schizophreniform according to DSM‐III. Their mean daily dose of remoxipride CR during the last week of treatment was 385 mg. In the haloperidol group the corresponding dose was 17 mg per day. The intended study period was 4 weeks with at least a one‐day washout. No significant differences were found between treatments regarding efficacy variables. The median total Brief Psychiatric Rating Scale (BPRS) score was 40 in the remoxipride CR group at start of treatment and 21 at last valid rating. For the haloperidol group the corresponding figures were 40 and 22. Treatment‐emergent extrapyramidal symptoms (Simpson and Angus rating) occurred statistically significantly more frequently and were more severe during haloperidol than during remoxipride CR treatment despite a statistically significantly higher concurrent use of anticholinergic drugs in the haloperidol group.
Antipsychotics in the elderly
Authors: Rosen Jules , Bohon Scott , Gershon Samuel
Published: August 2007

Abstract Neuroleptics are commonly prescribed medications in the geriatric population and have a broader spectrum of indications than in younger patients. In spite of the frequent use of neuroleptics in elderly patients with organic brain syndromes, there are relatively few studies that use double‐blind, placebo‐controlled methodology. The results of these studies are conflicting; however, there is sufficient evidence that symptoms of agitation, be‐haviourial dyscontrol, and psychosis are often responsive to neuroleptic treatment. Elderly patients with schizophrenia or other psychotic disorders may also benefit from neuroleptic treatment. As there is a potential for overuse of these medications among the elderly, clear definition of checklist symptoms is imperative. Furthermore, periodic reduction of dose and possible discontinuation of the drug should be considered since many of the checklist symptoms in this age group are environmentally related and time‐limited. There has so far been little evidence to support the use of one neuroleptic over another. Side‐effect profiles suggest that low doses of the high potency agents are safer and better tolerated in the elderly. Both therapeutic effects and side effects should be assessed at regular intervals.
Pharmacokinetics of remoxipride in elderly psychotic patients
Authors: Movin G. , Gustafson L. , Franzén G. , Widerlöv E. , Soni S. D. , Tench D. , Nilsson T. , Yisak W.
Published: August 2007

Abstract The pharmacokinetics of remoxipride when given as single doses of 50 mg and repeated doses of 50 mg, 100 mg, and 200 mg twice daily to 10 elderly psychotic patients (71–89 years) were compared with the findings of two other studies to reveal any age‐related differences. The three studies comprised a total of 38 patients in three distinct age groups: elderly (71–89 years), middle‐aged (46–69 years) and young (19–36 years). AUC, Cmax and Cmin of both total and unbound remoxipride increased with increasing age. The unbound fraction was similar in the three age groups. The half‐life was prolonged in the elderly, most probably caused by a decrease in intrinsic clearance. A two‐fold increase in AUC of both total and unbound concentrations was observed in the elderly group compared to the young, suggesting that patients over 70 years in general require half the dose needed by young adult patients. In general, the pharmacokinetics of remoxipride in the elderly are linear.
Remoxipride versus thioridazine in elderly psychotic patients
Authors: Phanjoo A. L. , Link C.
Published: August 2007

Abstract A total of 18 hospitalized elderly psychotic patients in need of antipsychotic treatment took part in a double‐blind exploratory study concerning the safety, tolerability and efficacy of remoxipride and thioridazine. Their median age was 78 years (range 66–90 years). Over the study period of 6 weeks, 9 patients received remoxipride and 9 thioridazine. Both drugs were given in a dosage range of 50–200 mg/day. The median total score on the Brief Psychiatric Rating Scale at the start of active treatment was 18 in the remoxipride group and 24 in the thioridazine group. The scores were reduced to 6 and 7, respectively, at the last rating. The Clinical Global Impression at last rating showed 4 of the 9 remoxipride patients to be very much improved compared to 1 of the 9 thioridazine patients. Apart from three reports of severe drowsiness in the thioridazine group, the incidence of treatment‐emergent adverse effects was low in both groups. No clinically significant aberrations were seen in laboratory tests or cardiovascular data. In conclusion, remoxipride seemed to be well tolerated in this group of patients and its antipsychotic efficacy in the doses used is promising.
Tolerability of moclobemide, a new reversible inhibitor of monoamine oxidase‐A, compared with other antidepressants and placebo
Authors: Versiani M. , Nardi A. E. , Figueira I. L. V. , Stabl M.
Published: August 2007

Moclobemide, a new selective and reversible inhibitor of monoamine oxidase A (RIMA), has been compared with various tricyclic antidepressants (TCAs) in numerous controlled studies. Pooled data from these studies, comprising 1656 patients, as well as the consideration of individual trials, show that moclobemide is far better tolerated than the TCAs. Its side effects mainly comprise mild degrees of nausea and dizziness at the beginning of treatment in a small proportion of patients. Age and sex do not affect the tolerability of moclobemide: it is equally well tolerated by elderly patients. In 2300 patients treated with moclobemide in doses up to 600 mg/day, without dietary restrictions, there was no tyramine‐related hypertensive reaction. It is concluded that moclobemide may be the second‐generation antidepressant doctors were waiting for ‐ equally effective as the classical antidepressants but far better tolerated.