bluuebunny/crossref_metadata_2025 huggingface dataset:
Psychiatric hospital care of children and adolescents in Sweden
Authors: Östman O. , Östmanf O.
Published: August 2007

ABSTRACT— In Sweden in‐patient psychiatric care of children and adolescents is in decline. At the same time the out‐patient care is increasing. These findings stem from a study of the annual patient statistics provided by the National Board of Health and Welfare. There are considerable differences among the counties in Sweden. In certain counties more than four times as many children and adolescents receive hospital care as in other counties. The distribution between child and adolescent psychiatry and adult psychiatry also varies considerably. However, it is usual that from the age of 18 years care is given in adult psychiatric clinics. Among patients with a diagnosis of psychosis and when compulsory care is necessary, adult psychiatric clinics are also responsible for patients 16 and 17 years old. Care of children at mental hospitals, still common in the 1960's, is nowadays no longer existent. The study is a starting‐point for a discussion about how to attain better co‐operation between child and adolescent psychiatry and adult psychiatry.
Sedative effects of maprotiline and amitriptyline
Authors: Holmberg G.
Published: August 2007

ABSTRACT— By means of critical flicker fusion measurements and subjective estimation of drowsiness, experiments with 12 healthy subjects over periods of 8 h showed that maprotiline caused less than half the amount of sedation compared to amitriptyline, both drugs given in single doses of 50 mg. The experiments were blind, randomized and placebo controlled. Implications for clinical use are discussed.
What are the prerequisites and indications of the therapeutic community proper?
Authors: Karterud S.
Published: August 2007

ABSTRACT— Is the therapeutic community model appropriate for short term psychiatric wards with catchment area responsibility and emergency obligations? A comparative study of group dynamics, measured by Group Emotionality Rating System and Group Focal Conflict Analysis within three different therapeutic community wards, revealed that the short term ward contained extreme fight/flight groups and pseudo‐groups unable to deal with the delegated responsibility presupposed by the therapeutic community model. The intermediate ward functioned fairly well, while the long term ward for psychotherapy of schizophrenia and personality disorders also functioned badly from a therapeutic community proper point of view. The author discusses these findings in light of previous literature and concludes that the therapeutic community proper is predominantly a treatment model relevant for personality disorders and severe neuroses, and not adequate for the multiplicity of emergency tasks facing a short term psychiatric ward.
Insulin‐like growth factors and somatomedin B in the cerebrospinal fluid of patients with dementia of the Alzheimer type
Authors: Tham A. , Sparring K. , Bowen D. , Wetterberg L. , Sara V. R.
Published: August 2007

ABSTRACT— Cerebrospinal fluid levels of radioreceptor assayable insulin‐like growth factors (RRA‐IGFs) and immunoreactive somatomedin B (SMB) (RIA‐B) were determined in apparently healthy individuals and in patients with dementia of the Alzheimer type (AD). The CSF levels of RIA‐B and RRA‐IGFs did not alter from the healthy controls. After being acidified, the CSF from the controls and from the presenile ADs were separated over a G‐50 fine Sephardex. The RRA‐IGFs activity eluted in three peaks. The results indicate that the major constituent of CSF RRA in both AD patients and controls is an IGF binding protein. The two minor peaks eluted at approximately 9 K and 6 K, corresponding to the elution possitions of “big” IGF‐2 and IGF‐2.
Female independence in Portugal: effect on suicide rates*
Authors: de Castro E. Ferreira , Pimenta F. , Martins I.
Published: August 2007

The greater incidence of suicide among males could be ascribed to the distinct roles still attributed to each sex. Progress towards female independence could reduce this different incidence. We analysed the following in Portugal: male and female suicide rates; profiles; and male/female suicide ratio before (1955–1969) and after the development of a movement for women's independence (1970–85). Concomitant with progress towards female independence there is a significant rise in female suicide and a decrease in male/female suicide ratio. The highest rates are among professional/technical women living in urban areas. In professional groups there is significant correlation between deaths caused by suicide and by liver cirrhosis. It is concluded that alcoholism often leads to suicide; in women, taboos about alcoholism and suicide explain a higher incidence of suicide among culturally freer professional groups; female independence will catalyse a rise in alcoholism, which together with other factors resulting from that independence will lead to a predictable increase of suicide among Portuguese women and a reduced difference in rates of suicide between the sexes.
A comparison between patients admitted to psychiatric hospitals in Botswana and South Australia
Authors: Ben‐Tovim D. I. , Boyce G. P.
Published: August 2007

Cohorts of patients admitted to psychiatric hospitals in Botswana and South Australia were compared. The psychiatric hospital in Botswana was used almost entirely for the care of patients with psychotic disorders, whilst one third of the patients in South Australia had either a neurotic or personality disorder diagnosis. A higher proportion of patients in Botswana than South Australia had had only a brief period of illness prior to admission. Violence was equally common amongst Tswana and Australian patients, but was directed outwards towards property and other people in Botswana and inwards towards the self in Australia. It was tentatively concluded that in both countries there was a group of severely ill patients who could not be handled without containment.
Suicidal behavior, impulsiveness and serotonin
Authors: Roy A. , Linnoila M.
Published: August 2007

The authors review the accumulating evidence from preclinical, clinical and postmortem studies suggesting that abnormality in serotonin systems may be associated with both attempts at suicide and aggression towards others and inanimate objects. Although these behaviors are multidetermined they often involve poor impulse control, which may reflect low central serotonin turnover. The need for further studies of possible peripheral biological markers for suicidal and impulsive behavior is discussed.
Relationships between clinical symptoms and monoamine metabolite concentrations in biochemically defined subgroups of depressed patients
Authors: Nordin C.
Published: August 2007

In 28 patients with primary depression, relationships were sought between rating scores on the Montgomery‐Åsberg Depression Rating Scale and the concentrations of the monoamine metabolites 5‐hydroxyindoleacetic acid (5‐HIAA), homovanillic acid (HVA) and 4‐hydroxy‐3‐methoxyphenylglycol (HMPG) in cerebrospinal fluid (CSF). Among the single items in the rating scale, reported sadness correlated negatively with HMPG. No other significant relationships were found in the total group of patients. However, in subgroups with low or high concentrations of monoamine metabolites, several significant relationships were found, such as a negative correlation between inner tension and concentration difficulties, respectively, and 5‐HIAA in the low‐HMPG subgroup. Curvilinear relationships were found between pessimistic thoughts and 5‐HIAA in the high‐5‐HIAA subgroup and between apparent sadness and 5‐HIAA in the low‐HMPG subgroup. Suicidal thoughts tended to correlate in a curvilinear way with the ratio of HMPG/5‐HIAA in the low‐HVA and the high‐HMPG subgroups, but the curves were mirrored. The results indicate that relationships between clinical symptoms and monoamine metabolite homeostasis in CSF are qualitatively and quantitatively different in defined high‐and low‐monoamine subgroups of depressed patients.
MORBIDITY RISK OF PSYCHIATRIC DISORDERS
Authors: Newman S. C. , Bland R. C. , Orn H.
Published: August 2007

Lifetime morbidity risks and percentiles of the age of onset distribution are given for a series of psychiatric disorders based on data collected as part of a community survey in Edmonton, Canada. The Diagnostic Interview Schedule (DIS) was used to gather information from 3,258 community residents between January 1983 and May 1986. Using a recently developed method of estimating morbidity risks from survey data, the lifetime morbidity risks for depression (male 16.4%, female 22.3%), schizophrenia (male 1.2%, female 1.0%), and other disorders were calculated. These results are consistent with previously published reports.
On The Possibility of Ethological Explanations of Psychiatric Disorders
Authors: McGuire Michael T.
Published: August 2007

This paper discusses: previous ethological and evolutionary explanations of psychiatric disorders; a behavior‐physiology interation framework for explaining the frequency and course of selected psychiatric illnesses; atypical behavioral capacities among persons with psychiatric disorders; behavioral mechanisms; and ethological explanations of the behavior of patients suffering from psychiatric illnesses. The importance of behavior‐physiology interactions is emphasized. Possible consequences of current taxonomic systems (DSM‐III) are considered. It is concluded that ethology has a vital role in increasing our understanding of psychiatric disorders through identifying: characteristics of disorders; selected causes; degree and type of compromised mechanisms; and, intervention effectiveness.
Child‐Rearing Practices of Chinese Parents and their Relationship to Behavioural Problems in Toddlers
Authors: Kong D S G , Wong S T , Goh C W , Lam S L , Chua K L , Kok L P
Published: August 2007

ABSTRACT The aim of this study was to examine the relationship between behavioural deviance and parental involvement in childrearing and disciplinary practices in a sample of 401 toddlers. Mothers of each subject were interviewed to assess for the degree of parental involvement and the disciplinary methods used with the child. A Behavioural Screening Questionnaire (BSQ) was used to assess for behavioural deviance in the toddlers. Results indicated that father involvement in childrearing was significantly lower than mother involvement (p = 0.0001). Although consistent with cultural expectations, both low paternal involvement and punitive types of discipline were significantly related to behavioural deviance.
Child rearing patterns in Brazil
Authors: Gorayeb R.
Published: August 2007

ABSTRACT Perceived childrearing patterns have been studied in Brazilian samples of college students, normal population and depressives. Furthermore comparisons were made with the origibal Swedish normative sample, showing the Brazilian parents and more tolerant, affectionate, performance oriented and punitive. As concerns the depressed patients they experienced their parents among others as more guilt engendering, more depriving and less affectionate. The implications of these findings for clinical work are also discussed.
Hosts to adversity
Authors: Surtees P. G.
Published: August 2007

This article examines the relationship between event rates, demographic and psychosocial factors and the onset of psychiatric disorder according to Research Diagnostic Criteria in the context of a longitudinal general population survey of women. Life events were classified according to ratings of their severity and dependence. Analyses revealed the extent to which case inception was associated with risk factor status, as determined from respondents when psychiatrically well, and the complex interrelationship between the factors according to powerful statistical modelling techniques.
Ranking of needs: a new method of assessment for use with chronic psychiatric patients
Authors: Waismann L. C. , Rowland L. A.
Published: August 2007

An instrument to measure the relative importance that individuals attribute to needs is presented. This device employs a methodology especially designed for use with individuals who often have difficulties in concentrating when faced with the more traditional methods of assessment. The instrument was tested on both psychiatric patients and individuals with no psychiatric history. The results showed its satisfactory psychometric properties and its suitability for use with severely disabled psychiatric patients.
Relationship between psychiatric distress and alcohol use: findings from the Eastern Baltimore Mental Health Survey
Authors: Dryman A. , Anthony J. C. , DePaulo J. R.
Published: August 2007

ABSTRACT— This study examined the nature and strength of relationships between levels of alcohol use and concurrent psychiatric distress among adults in the community aged 18–64 years. Data for this project were gathered by standardized interview methods during the 1981–1982 Eastern Baltimore Mental Health Survey. The 2558 survey respondents were initially selected by means of multistage probability sampling of adult household residents in eastern Baltimore, Maryland. This project's findings indicated gender differences in the relationships under study. There was a moderate degree of association between heavy alcohol use and psychiatric distress among women; at moderate levels of alcohol use, a modest association was also noted. In contrast, for males, the results suggested a small positive association between heavy alcohol use and concurrent psychiatric distress, although these findings were not conclusive.
Working ability of mentally ill people in times of social crisis
Authors: Kecmanović D. , Trogrančić Ž. , Cerić I.
Published: August 2007

ABSTRACT— In Yugoslavia a special commision evaluates the working abilities of insured ill people. In the last 14 years the number of people referred to this commision has increased. For people assessed as being unable to work the most frequent diagnoses have been psychiatric and cardiovascular diseases. All individual requests for retirement on partial or full pension based on mental disorder (n = 1563) made in 1982 in Bosna and Herzegovina were studied. People who were awarded pensions were also followed up. The results obtained indicated that the willingness to retire is widespread among insured people, quite often regardless of the actual impairment of their working abilities. Data are interpreted in the light of the severe socioeconomic crisis Yugoslavia has been experiencing through the last decade.
Cerebral perfusion inhomogeneities in schizophrenia demonstrated with single photon emission computed tomography and Tc99m‐hexamethylpropyleneamineoxim
Authors: Bajc M. , Medved V. , Basic M. , Topuzovic N. , Babic D.
Published: August 2007

ABSTRACT— Cerebral blood flow was measured in relative terms with Tc99in‐hexamethylpropyleneamineoxim (HMPAO) and single photon emission computed tomography (SPECT) in 28 female schizophrenic patients (20 acute and 8 chronic) classified according to DSM‐III. Eleven normals served as controls. The acute patients were classified according to positive and negative symptoms. Patients with predominantly positive symptoms showed by and large normal and homogeneous cerebral isotope uptake. Those with negative symptoms, and the chronic patients, showed inhomogeneous tracer uptake with multiple regions of hypoperfusion in slices 4–6 cm above the orbitomeatal line. The findings support in principle the notion that schizophrenia with negative or chronic symptoms does not affect the whole brain homogeneously. Brain imaging with Tc99m‐HMPAO and SPECT might be used to distinguish various types of schizophrenia.
The dexamethasone suppression test and negative symptoms of schizophrenia
Authors: McGauley G. A. , Aldridge C. R. , Fahy T. A. , Eastment C.
Published: August 2007

ABSTRACT— The dexamethasone suppression test (DST) was administered to 28 subjects who met DSM‐III criteria for chronic schizophrenia and shared similar environments. Samples were assayed for both plasma cortisol and dexamethasone levels. After controlling for other factors, the mean postdexamethasone cortisol level (MPDC) was correlated with the patients’ score on the Scale for the Assessment of Negative Symptoms (SANS). A significant relationship emerged between these 2 parameters, suggesting that the social deterioration seen in chronic schizophrenia is at least partly related to a biological disease process as reflected by the DST. The importance of quantifying the level of dexamethasone in the DST is discussed.
Social relationships reflected by depressive inpatients
Authors: Richter G. , Richter J.
Published: August 2007

ABSTRACT— In a study of 100 inpatients suffering from depressive symptoms, the influence of cognitive characteristics (negative automatic thoughts and dysfunctional attitudes) and of the severity of depression on the emotional reflections of social relationships were investigated at admission, discharge and 3 months follow‐up. The reflections of strained relation and rejection in the family or partnership were significantly determined by negative cognitive patterns and severity of depression. The prognostic aspects of the assessed psychological characteristics and the psycho‐therapeutic implications of the results are discussed.
Why do fatal overdose rates vary between antidepressants?
Authors: Farmer R. D. T. , Pinder R. M.
Published: August 2007

Age specific death rates for poisoning with different antidepressant drugs, based on mortality statistics and the numbers of prescriptions dispensed, were calculated for England and Wales 1979–1985. There are marked varitions in mortality associated with different drugs; the highest rates are found with amitriptyline and dothiepin whereas the lowest were associated with mianserin and clomipramine. For all drugs considered, the calculated mortality rates for the over 65 year olds, though still substantial, were lower than those in patients under 65 years of age, probably because of a diminished detection rate of poisoning in this older age group. A high proportion of the fatal overdoses implicating amitriptyline and dothiepin involved more than one substance. The rank order of mortality rates from antidepressants was identical in the different age groups.

The implications of these findings are discussed. It is concluded that the variations in mortality rates are mostly due to variations in the inherent toxicity of the drugs (particularly their cardiovascular effects) and only in part due to possible differences in compliance. It is suggested that when antidepressant drugs are prescribed, the risk of death from overdose should be taken into account. Tricyclic drugs, particularly amitriptyline, dothiepin, doxepin, trimipramine and maprotiline, should be avoided in patients at risk of suicide, whatever the age of the patient.
The stressors and the post‐traumatic stress syndrome after an industrial disaster
Authors: Weisæth Lars
Published: August 2007

ABSTRACT ‐Acute and subacute post‐traumatic stress reactions are reported among 246 employees of an industrial factory which was severely damaged by an explosion and fire. Sixty‐six A‐subjects had narrow escape experiences (high stress exposure group), while 59 B‐subjects were less severely exposed (medium stress exposure group). The 121 C‐subjects were not present at work when the explosion occurred (low stress exposure group). A response rate of 97.6% was achieved at the primary examination, and a 100% response at the 7 months follow‐up.

The frequency and intensity of post‐traumatic stress reactions were linked to the severity (A,B,C) of the stress exposure; specific post‐traumatic anxiety reactions reported by more than 80% of A‐subjects. The reactions appeared immediately or within hours, only 5% of A had delays of a few weeks. While 24.3% of A had State Anxiety Inventory scores 1 week post‐disaster higher than 60, 8.5% of B and 2.5% of C had similar scores. Depressive reactions, social withdrawal, guilt, shame and irritability were less frequent, and appeared nearly always concommittant with anxiety symptoms. While the anxiety symptoms made up a tight knit syndrome, the less frequent non‐anxiety symptoms were linked to the post‐traumatic anxiety syndrome. The subjects' fears reflected the trauma, they feared inanimate objects, and there were hardly any paranoid ideations.

The disaster exposure of the A and B but not of the C group members constituted a stressor which fulfilled the PTSD stressor criterion of the DSM III R. A minority of the C group developed a post‐traumatic stress syndrome. After 7 months, all 30 post‐traumatic stress reactions were more frequent and severe in the A than B group which again differed from the C group. Irritability was the only post‐traumatic stress reaction that increased in frequency and intensity during the 7 months observation period. The findings represent evidence that supports the face validity, descriptive and construct validity of the PTSD diagnosis.
Approaches for finding new types of antipsychotic compounds
Authors: Sedvall Göran
Published: August 2007

There is strong evidence that pharmacological interaction with central dopamine transmission at several levels may induce antipsychotic effects in psychiatric patients. All the pharmacological principles interacting with other systems have so far not been established with regard to antipsychotic potential. Besides the dopamine system pharmacological manipulation of central serotonergic, gabaergic and noradrenergic mechanisms may also be of therapeutic value in schizophrenia. The interaction of peptidergic mechanisms and central dopaminergic mechanisms is another avenue for further exploration regarding to pathophysiology of psychosis and its treatment. Elucidation of the heterogeneity and molecular structure of central dopamine receptors seems the most rational approach for creating new dimensions for further development of drug design for pharmacotherapy of psychosis. The detailed mapping of afferent and efferent systems coupled to central dopamine neurons is also an approach that may give guide‐lines for finding new types of antipsychotic drugs.
Neuroleptic‐induced marching‐in‐place
Authors: Frost L. , Lal S. , Yassa R.
Published: August 2007

ABSTRACT Marching‐in‐place (MIP) was observed in 12 out of 133 (9%) chronically hospitalized psychiatric patients and in none of 60 hospital staff controls. The prevalence was similar in both sexes. MIP was associated with tardive dyskinesia or parkinsonism or both but did not occur alone. Counting the number of steps per minute provides a reliable method to quantify MIP and may permit a simple objective method for investigating the neuropharmacology of this phenomenon. Preliminary observations suggest that anticholinergic agents may improve MIP in some patients but worsen it in others.
Epileptic schizophrenia: clinical features and outcome
Authors: Oyebode F. , Davison K.
Published: August 2007

ABSTRACT– The aim of this study was to investigate the clinical characteristics and outcome of epileptic schizophrenia. A total of 106 patients with combined diagnoses of epilepsy and psychiatric disorder were identified; 20 were excluded and 70 agreed to participate. They were interviewed using the Schizophrenia and Affective Disorders Schedule ‐ Lifetime Version and psychiatric diagnoses were assigned based on Research Diagnostic Criteria. Thirty‐two subjects with additional diagnosis of schizophrenia were identified and compared with 31 functional schizophrenic patients matched for age. Both groups shared third person auditory hallucinations most in common, and delusions of passivity least; delusions of passivity occurred significantly more in functional schizophrenia. The global outcome was worse in epileptic schizophrenia and there was also evidence of significantly worse performance on the Mini‐Mental State Examination by the same group.
Availability of psychotropic drugs and suicidal self‐poisoning mortality in Belgium from 1971–1984
Authors: Moens G. F. G. , van de Voorde H.
Published: August 2007

ABSTRACT– Trends in completed suicide by solid or liquid substances in Belgium were investigated for the period 1971–1984 in relation with data about sales of psychotropic drugs. Mortality rose sharply between 1973 and 1980 (from 21.1 per million population of 15 years and older to 52.2 in males and from 26.7 to 61.7 in females) and decreased slightly thereafter. No apparent coincidence with the availability of psychotropic drugs was found, and the increasing risk of suicidal persons dying at home suggested an increase in the severity of the attempts until 1980. However, incidence changes could also have affected these trends. The evolution in accidental and in suicidal hospital rates suggested that emergency care had improved. Although barbiturate sales decreased continuously (from 46.7 packages per year per 100 population in 1974 to 28.5 in 1984), these drugs still account for a high proportion of fatal self‐poisonings (23%) in Belgium. Possible shortcomings that could affect the validity of our findings are discussed.
Predictive value of the four good prognostic features in DSM‐III‐R schizophreniform disorder
Authors: Guldberg C. A. , Dahl A. A. , Hansen H. , Bergem M.
Published: August 2007

DSM‐III‐R divides schizophreniform disorder into 2 subtypes with and without good prognostic features. The 4 prognostic features have been selected based on the literature, and the presence of at least 2 should indicate a good prognosis. The predictive value of the good prognostic features was tested in a sample of 16 untreated patients with DSM‐III‐R schizophreniform disorder with known long‐term outcome based on personal follow‐up examination. No correlation between the presence of 2 or more features and favorable outcome was observed. Confusion, disorientation or perplexity at the height of the psychotic episode was the only feature consistently associated with a favorable outcome in this sample. The introduction of good prognostic features of schizophreniform disorder by DSM‐III‐R has been done without due consideration of the methodological problems of prediction research.
Leucocyte arylsulphatase A activity and subtypes of chronic schizophrenia
Authors: Heavey A. M. , Philpot M. P. , Fensom A. H. , Jackson M. , Crammer J. L.
Published: August 2007

Previous studies have suggested that arylsulphatase A (ASA ‐ the biochemical marker of metachromatic leucodystrophy) deficiency may be present in a sizeable proportion of patients with chronic psychosis. This study surveyed leucocyte ASA activity in a group of chronic psychotic patients and compared ASA activity in 3 subgroups fulfilling Research Diagnostic Criteria for schizophrenia (undifferentiated), paranoid schizophrenia and schizoaffective psychosis. Three of 45 patients had significantly reduced ASA activity but none had metachromatic leucodystrophy. Although ASA levels did not differ significantly between the groups, schizophrenics without a family history of schizophrenia had significantly lower ASA levels than those with. The implications of these findings are discussed.
Differential drug response of panic and agoraphobic avoidance in a case of panic disorder
Authors: Klein E. , Metz L.
Published: August 2007

A case is presented of a patient with severe panic disorder and agoraphobia in whom initial treatment with clomipramine resulted in complete elimination of panic attacks, with no improvement in agoraphobic avoidance. The addition of phenelzine to the pre‐existing clomipramine treatment resulted in rapid and complete disappearance of the agoraphobic avoidance. The possible implications of this case for our understanding of the neurobiological relationship between panic attacks and agoraphobia are discussed.
The prolonged benzodiazepine withdrawal syndrome: anxiety or hysteria?
Authors: Higgitt A. , Fonagy P. , Toone B. , Shine P.
Published: August 2007

In an attempt to establish whether prolonged withdrawal symptoms after stopping intake of benzodiazepines is caused by return of anxiety, hysteria, abnormal illness behaviour or the dependence process itself producing perhaps a prolonged neurotransmitter imbalance, a group of such patients suffering prolonged withdrawal symptoms (PWS) was compared on a range of psychophysiological measures with matched groups of anxious and conversion hysteria patients and normal controls. It was found that the psychophysiological markers of anxiety were not marked in the PWS group; nor were the averaged evoked response abnormalities found to be associated with cases of hysterical conversion in evidence. The PWS group were hard to distinguish from normal controls on the basis of psychophysiological measures and thus it was felt to be unlikely to be an affective disturbance. It was concluded that PWS is likely to be a genuine iatrogenic condition, a complication of long‐term benzodiazepine treatment.
Prolactin responses in dexamethasone suppression test in patients with anorexia nervosa
Authors: Tamai H. , Takii M. , Nozaki T. , Kiyohara K. , Kobayashi N. , Nakagawa T. , Benbarka M. M. , Jr R. M. Walter , Kumagai L. F.
Published: August 2007

In anorexia nervosa (AN), abnormalities are present in the hypothalamic‐pituitary‐adrenal axis, but the prolactin (PRL) response to dexamethasone suppression test (DST) has not yet been studied. In order to study the interrelationships between the various endocrine abnormalities, we investigated the responses of PRL and cortisol to DST (1 mg of dexamethasone at 2300) in AN patients. The subjects were 12 female inpatients with AN and 8 age‐ and sex‐matched healthy controls. The percentage suppression and absolute change in PRL levels before and after dexamethasone administration were significantly different in the 2 groups. In the control group PRL levels suppressed to 36.5 ± 3.7% of basal, while AN levels declined to 79.4 ± 8.9% of basal. When the percentage suppression of PRL was compared between patients with and without cortisol suppression, the mean PRL level was 68.9 ± 7.8% of the basal level for the cortisol‐suppressed patients and 100.4 ± 19.1% for the nonsuppressed patients. Hence in both groups, the percentage PRL suppression was significantly reduced compared with the control group, and indeed nonexistent in cortisol‐nonsuppressed patients. The finding that there was less PRL suppression in the cortisol‐suppressed patients than in the controls suggests that, in AN, there may be an abnormality in PRL secretion not related to the hypothalamic‐pituitary‐adrenal axis. Further work is needed to distinguish between the PRL response to stress and potential hypothalamic abnormality.
The late effects of Nazi persecution among elderly Holocaust survivors
Authors: Robinson S. , Rapaport J. , Durst R. , Rapaport M. , Rosca P. , Metzer S. , Zilberman L.
Published: August 2007

Eighty‐six survivors of the Holocaust from a nonclinical population were interviewed to examine the recent mental state, coping and adjustment of elderly Holocaust survivors. Most of the interviewees suffered after the war and are still suffering from the results of persecution. Death camp survivors suffer more than survivors who were subjected to other forms of Nazi persecution. Despite the mental suffering, Holocaust survivors succeeded to cope and to adjust. They are successful at work and in society. They managed to raise warm families. They behaved and still behave as if fulfilling a testament to those who perished.
Drug treatment of panic disorder: early response to treatment as a predictor of final outcome
Authors: Albus M. , Lecrubier Y. , Maier W. , Buller R. , Rosenberg R. , Hippius H.
Published: August 2007

One of the core problems in clinical research is the detection of early changes in target symptoms that predict future therapeutic outcome. To analyze potential predictors of outcome, data of a multicenter study on patients with panic disorder were used. A total of 1010 patients were randomly allocated either to alprazolam, imipramine or placebo treatment. Early improvement in the number of spontaneous panic attacks within the first week of treatment predicted outcome exclusively in the alprazolam group. In contrast, placebo responders and nonresponders were differentiated by early changes in anticipatory anxiety intensity. For tricyclic antidepressants such as imipramine an evaluation period of more than one week is required to allow conclusions about outcome.
Parental rearing behaviour, family atmosphere and adult depression: a pilot study with psychiatric inpatients
Authors: Richter J. , Richter G. , Eisemann M.
Published: August 2007

In a sample of 72 depressed inpatients the relationships between severity of depression, emotional family atmosphere and perceived parental rearing were studied at admission, discharge and follow‐up. The results indicate that paternal rejection and overprotection might be of particular importance for developing social skills used to form close relationships, whereas maternal emotional warmth seems to have a preventive effect by promoting emotional stability.
Childhood vulnerability and adult invincibility*
Authors: Dahlin L. , Cederblad M. , Antonovsky A. , Hagnell O.
Published: August 2007

This study is salutogenic, focusing on the people who cope successfully with the handicapping background of a high‐risk childhood. Of those aged 0–15 in 1947 in a total population survey of 2 Swedish parishes, 221 persons with 3 or more childhood psychiatric risk factors were identified. Personal interviews were conducted with 148 of them in 1988–1989. Four measures were used: the Sense of Coherence Scale, the Symptom Distress Checklist, the Quality of Life Scale, and a qualitative overall measure of health status using all interview material. Data analysis focuses on stressing the considerable proportion who managed to overcome their handicapped backgrounds. The sense of coherence is proposed as a powerful explanatory variable in such success.
An investigation of dementia among elderly outpatients
Authors: Cunha U. G. V.
Published: August 2007

A total of 110 unselected demented outpatients aged 60 and over (mean age: 76.2 years), 69 women and 41 men, were prospectively investigated. A potentially reversible cause of dementia was found in 26 patients (normal pressure hydrocephalus 2, cerebral tumor 1, hyperthyroidism 2, hypothyroidism 4, vitamin B12 deficiency 13, pseudodementia 4). Follow‐up investigation showed that the only true reversible dementia in which improvement from abnormal to normal mental status occurred and was sustained for up to 2 years was 1 case of normal pressure hydrocephalus and 1 case of pseudodementia. In all cases of vitamin B12 deficiency, hypothyroidism and hyperthyroidism, despite proper treatment, mental status did not improve significantly and follow‐up in most cases showed persistant cognitive deterioration. It can be concluded that although true reversible dementias do exist, they do not seem as prevalent as previously reported. Most elderly outpatients with reversible causes of dementia do not revert to normal and continue showing progressive decline.
Biochemical pharmacology of the atypical neuroleptic remoxipride
Authors: Köhler C. , Hall H. , Magnusson O. , Lewander T. , Gustafsson K.
Published: August 2007

Abstract In vitro receptor ligand binding studies in the rat showed that remoxipride displaced different radioligands at the dopamine D2, but not the D1 receptor. Remoxipride did not block dopamine‐stimulated adenylate cyclase activity in vitro suggesting that it did not directly interact with the dopamine D1 receptor. Like other antipsychotic compounds, it increased dopamine turnover in the dopamine‐rich areas of the brain. It showed no affinity for a wide range of neurotransmitter receptors, with the exception of the opiate sigma receptor. The affinity of remoxipride for the D2 receptor was low in vitro, while in vivo, the affinity was relatively high. Remoxipride was far more potent in preventing [3H]raclopride‐binding than [3H]spiperone‐binding to the D2 receptor in vivo. When the D2 receptor was labelled with [3H]spiperone, remoxipride was shown to exert a preferential blockade of this binding in extrastriatal areas of the brain (for example, olfactory tubercle, septum, substantia nigra) in vivo. After the injection of high doses of remoxipride most if not all drug in the brain was identified as authentic remoxipride.

After injection of [3H]remoxipride in smaller and larger doses, radioactivity was detected in all areas of brain examined, including cerebellum and neocortex. Most of the remoxipride‐derived radioactivity was found in the choroid plexus and circumventricular organs, while smaller amounts were recovered in the striatum, olfactory tubercle, and substantia nigra. Taken together, these findings suggest that remoxipride acts at both the central D2 and sigma receptors and that its affinity for the D2 receptor is relatively low in vitro. A regional preference for D2 receptors can be observed in vivo depending upon the radioligand used.
Clinical pharmacokinetics of remoxipride
Authors: von Bahr C. , Movin G. , Yisak W.‐A. , Jostell K.‐G. , Widman M.
Published: August 2007

Abstract The clinical pharmacokinetics of remoxipride, a pure enantiomer, have been studied in healthy volunteers and patients. After oral administration the drug is rapidly and almost completely absorbed with a bioavailability above 90%. Thus remoxipride is a low clearance drug, with a systemic plasma clearance of about 120 ml/min, and without any first‐pass metabolism. The apparent volume of distribution is 0.7 1/kg, about 80% being bound to plasma proteins (mainly alphai‐acid glycoprotein). Remoxipride has a plasma half‐life in the range of 4–7 h and is eliminated by both hepatic metabolism and renal excretion. Slightly more than 70% of the dose is recovered as urinary metabolites and about 25% is excreted unchanged. Steady‐state plasma levels are reached within 2 days, and they increase linearly with doses up to 600 mg daily. There is no evidence that active metabolites of remoxipride are present in the blood. Decreased renal function is associated with increased levels of remoxipride, whereas moderate cirrhosis of the liver only slightly affects elimination. There are no pharmacokinetic interactions between remoxipride and diazepam, ethanol, biperiden, or warfarin.
Tolerability and pharmacokinetics of remoxipride after intramuscular administration
Authors: Kahn J.‐P. , Yisak W. , Albaret C. , Nilsson L. , Zaar‐Hedin A. , Laxenaire M.
Published: August 2007

Abstract A study was undertaken in seven schizophrenic patients to evaluate the tolerability and examine the pharmacokinetics of intramuscularly administered remoxipride after a single 200 mg dose and at steady state following repeated doses of 200 mg twice daily for one week. Comparisons of AUC, t1/2 and tmax using the Wilcoxon's signed rank test showed no significant difference between single dose and steady state indicating that the pharmacokinetics of intramuscular remoxipride were linear. The steady‐state Cmax was found to be significantly larger than that after single dose and the increase was accounted for by the predicted accumulation factor, assuming linear kinetics. Although the inter‐individual variability in plasma concentrations was large, the intra‐individual variability was low as shown by the reproducibility of the single‐dose and steady‐state plasma curves. Remoxipride, administered intramuscularly, was well tolerated.
Effects of remoxipride on psychomotor performance, alone and in combination with ethanol and diazepam*
Authors: Mattila M. J. , Manila M. E.
Published: August 2007

The effects of remoxipride, alone and in combination with ethanol and diazepam, on sensory, cognitive, and neuromotor performance were studied in 12 healthy volunteers (7 men, 5 women). The study was of double‐blind, randomized, crossover design with each subject receiving six different single‐dose experimental treatments at six sessions. Tests of sensory, cognitive, and neuromotor functions were carried out, together with subjective assessments. Remoxipride alone seemed to have no effect on the sensory functions measured, but it affected cognitive and neuromotor functions to a limited extent. In general the effects of ethanol and diazepam alone were more pronounced than those of remoxipride. When remoxipride was combined with either ethanol or diazepam, there was a tendency for the effect to
A controlled dose‐ranging study of remoxipride and haloperidol in schizophrenia ‐ a Canadian multicentre trial
Authors: Lapierre Y. D. , Nair N. P. V. , Chouinard G. , Awad A. G. , Saxena B. , Jones B. , McClure D. J. , Bakish D. , Max P. , Manchanda R. , Beaudry P. , BIoom D. , Rotstein E. , Ancill R. , Sandor P. , Sladen‐Dew N. , Durand C. , Chandrasena R. , Horn E. , Elliot D. , Das M. , Ravindran A. , Matsos G.
Published: August 2007

Abstract The efficacy and side‐effect profile for three dose ranges of remoxipride were compared with haloperidol in 242 schizophrenic inpatients in 13 centres. All patients were in a productive phase of schizophrenia according to DSM‐III criteria. Relative efficacy of low dose (30–90 mg daily) vs middle dose (120–240 mg daily) vs high dose (300–600 mg daily) was compared with the standard dose of haloperidol (15–45 mg daily), as were the side effects. It was concluded that the therapeutic efficacy of remoxipride was comparable to that of haloperidol for acute episodes of schizophrenia; that the low dose range was significantly less effective than the higher ranges; that there was a clear advantage of remoxipride over haloperidol with respect to incidence and severity of extrapyramidal symptoms. The general I safety profile of remoxipride as assessed from clinical chemistry, haematology, and cardiovascular variables suggests that remoxipride in the dose ranges studied can be used safely for the treatment of schizophrenic patients.
Clinically relevant differences between antipsychotic compounds
Authors: Silverstone Trevor
Published: August 2007

Abstract All currently available antipsychotic drugs in general clinical use for the treatment of schizophrenia have in common the pharmacological property of dopamine receptor blockade and it is upon this that their antipsychotic effects are thought to depend. Where they differ is in the spectrum of side effects they may produce, in their clinical profile, in potency, and in time course. Such differences reflect variations in pharmacological properties, both pharmacodynamic and pharmacokinetic. The substituted benz‐amides (sulpiride, remoxipride) are highly selective D2 receptor blockers and this pharmacological specificity confers important clinical advantages. In practice the choice of which antipsychotic drug to use in any given clinical situation depends on the degree of psychopathology present, the purpose for which treatment is being given, and the patient's age and general physical health.
A double‐blind comparative study of remoxipride and haloperidol in acute schizophrenia.
Authors: den Boer J. A. , Ravelli D. P. , Huisman J. , Ohrvik J. , Verhoeven W. M. A. , Westenberg H. G. M.
Published: August 2007

Abstract Seventy‐one patients were entered into a multicentre, double‐blind randomized study to compare the efficacy and safety of remoxipride with those of haloperidol in the acute treatment of schizophrenia or schizophreniform disorder. The patients, who were well‐matched regarding demographic characteristics, were aged 18–64 years. Four patients in the remoxipride group and 6 in the haloperidol group discontinued treatment prematurely. The mean daily doses during the last week of treatment were 363 mg remoxipride and 9 mg haloperidol. At this time 22% of patients on remoxipride and 66% of those on haloperidol were taking anticholinergics (p < 0.001). The clinical efficacy was similar in both groups as judged by Present State Examination (PSE) profile and Brief Psychiatric Rating Scale (BPRS) ratings. Several adverse symptoms occurred significantly more frequently during treatment with haloperidol than with remoxipride, particularly where extrapyramidal symptoms were concerned. No clinically relevant changes occurred in the laboratory tests in either group.
Some basic aspects of reversible inhibitors of monoamine oxidase‐A
Authors: Prada M. Da , Kettler R. , Burkard W. P. , Lorez H. P. , Haefely W.
Published: August 2007

A novel class of antidepressants is emerging with considerable therapeutic potential: reversible inhibitors of monoamine oxidase type A (RIMA). Moclobemide (Aurorix®) is a representative RIMA. It is a fully and rapidly reversible inhibitor of MAO‐A with a correspondingly intermediate duration of action in vivo. It is free of hepatotoxicity and produces a much weaker potentiation of the tyramine pressor effect than the classical irreversible MAO inhibitors. Interaction of MAO inhibitors and monoamine reuptake inhibitors with tyramine is discussed on the basis of experiments in conscious rats. The issue of tyramine content of foods and beverages has been reinvestigated and its relevance for treatment with RIMA antidepressants is discussed. Recently observed antihypoxic (neuroprotective) effects of moclobemide suggest new indications for this compound.
Moclobemide, imipramine and placebo in the treatment of major depression
Authors: Versiani M. , Nardi A. E. , Mundim F. D. , Alves A. , Schmid‐Burgk W.
Published: August 2007

Moclobemide was compared with imipramine and placebo in the treatment of major depressive episodes in 75 outpatients. The dosage of moclobemide (25 patients) was 300 mg daily for the first 5 days, after which it could be increased to 600 mg. Imipramine (25 patients) was given in a dosage starting with 33 mg and gradually increased to 100 mg/ day in the first 5 days, after which it could be further increased; 25 patients received placebo. Both drugs were equally effective as measured by the Hamilton Rating Scale for Depression, the overall assessment of efficacy and the Zung Self‐rating Scale, and clearly superior to placebo; there were no significant differences between the 2 active drugs. Moclobemide was better tolerated than imipramine, and was almost comparable to placebo in this respect.
Inpatient psychiatric adolescents function better than expected after discharge. A follow‐up study
Authors: Pelkonen M.
Published: August 2007

In order to evaluate and develop an inpatient program for adolescents, a follow‐up study was carried out based on interviews with 58 adolescents discharged from the inpatient unit on average 7 years before. The mental status of these patients had been poor on admission. At the time of follow‐up interviews, approximately 30% of patients appeared to have normal, socially varied lives. The results were better for patients whose treatment at the unit had lasted for more than 3 months and had included psychotherapy. Roughly 10% of the patients at the time of follow‐up interviews had severe problems. The prognosis was worst for the patients who needed to be transferred from the adolescent unit to adult psychiatric treatment units because of suicidal and violent behavior. Young patients with severe disturbances need an individualized, multidisciplinary treatment approach, including individual psychotherapy and vocational training. The treatment should continue uninterrupted on an outpatient basis.
Liaison psychiatry in general practice: the comprehensive collaborative model
Authors: Tyrer P. , Ferguson B. , Wadsworth J.
Published: August 2007

A model of liaison psychiatry in general practice is described and its impact assessed using data from the Nottingham psychiatric case register. The model incorporates a comprehensive network of general practice psychiatric clinics for both psychiatrists and other mental health professionals, associated with mainly informal liaison with general practitioners and others in the primary care team, and a reduction in psychiatric outpatient clinics. Following the introduction of this model, the proportion of new and rereferred patients seen in primary care settings rose from 1% to 18% in Nottingham over an 8‐year period. Over this period admission rates significantly fell in Nottingham compared with the rest of England and evidence is given that the growth of primary care psychiatry contributed significantly to this reduction.;