bluuebunny/crossref_metadata_2025 huggingface dataset:
Fat in animal products: facts and perceptions
Authors: Gibney M. J.
Published: July 2016

Early research in man at the end of the fifties and beginning of the sixties indicated that the composition of dietary fat influenced plasma cholesterol levels. In effect this research showed that plasma cholesterol was raised by saturated fatty acids (SFA), was lowered by polyunsaturated fatty acids (PUFA) and was not influenced by monounsaturated fatty acids (MUFA). Within the SFA it was also observed that the greater the chain length, the lesser the cholesterol raising effect. A quantitative relationship between the change in blood cholesterol (ΔC) resultant from changes in the percentage energy from SFA (ΔS) and PUFA (ΔP) was established as ΔC = 1.3 (2ΔS − ΔP). For the ensuing tivo decades this association dominated nutrition education programmes with the message that ‘saturates or animal fats raise blood cholesterol and polyunsaturates or vegetable oils lower blood cholesterol’.

In the 1980s it became evident that the two main fractions of blood cholesterol yielded different risks for coronary heart disease. Low-density lipoprotein (LDL) cholesterol raised the risk and high-density lipoprotein (HDL) cholesterol lowered the risk. Earlier work on the qualitative effect of dietary fat was now repeated to examine the direction of change of the LDL and HDL subfractions of plasma cholesterol. Broadly speaking these data showed that SFA raised LDL cholesterol and had little effect on HDL cholesterol. PUFA lowered LDL cholesterol but when the intake was high, also lowered HDL cholesterol. Whilst this summarizes events leading up to current thinking on dietary fats and blood cholesterol, it is likely in the near future to be linked to another area of research involving the antioxidant vitamins and pro-vitamins (vitamin E, vitamin C and β-carotene). A growing body of data in the literature indicates a protective effect of antioxidant vitamins in epidemiological trials.

Notwithstanding these findings, it is likely that dietary advice will continue to seek a lowering of SFA intake. PUFA intake will be capped and MUFA intake will be a more acceptable alternative. However, with increasing emphasis on antioxidant vitamin status, such advice is likely to be coupled with advice on increased consumption of fruit and vegetables.
The marketing reality of alternative production systems
Authors: Guy R.
Published: July 2016

The establishment by the Real Meat Company of a new ‘brand’ of meat where the quality, purity and welfare are worked up to a standard rather than down to a price is the embodiment of an ‘alternative production system’ for livestock. Any production system needs a market. As a fully independent as well as new company, expansion, development and occasionally survival have depended entirely on how this market can best be served.

It is possible to create a secure alternative production system. What is more difficult is to identify correctly the size, loyalty and expectations of the market and find a route to serve them that is convenient. The modern shopper likes easy shopping. No customer likes to take negative attributes into account when choosing a product. Invariably perceived by many as a green get-rich-quick scheme, the controls, attention to detail, complexities of the few retail routes for meat and then portrayal of the ‘message’ to the public have made the Real Meat Company trail at times slow and always arduous. Tor those who support the concept, including the founders, the progress, however difficult, is always rewarding.
Current pig production systems
Authors: Smith A. T.
Published: July 2016

Current pig production systems reflect management decisions taken over a period of many years. The range of constraints on pig producers has grown rapidly and priorities are in the process of change. On the basis of the available evidence, the following conclusions may be made.

Less than half the pig breeding enterprises in the United Kingdom use sow housing which involves individual confinement and more than half provide dry sows with bedding. At present, there is a strong current interest in group housing systems.

In the parturition and lactating stages, farrowing crates are used in the vast majority of herds and the main current practical interest is in improving crate and pen design and husbandry techniques to assist in minimizing piglet mortality.

Less than half of the herds use fully slatted accommodation for newly weaned pigs and nearly one-third provide bedding. In the follow-on stage, less than one-fifth of herds use fully slatted floors and ‘fully controlled environment’ type accommodation.

There is strong current interest in fully slatted finishing housing but so far less than one-tenth of herds use it. Nearly two-thirds of herds use finisher houses which are not in the ‘controlled environment’ category.
Climate control systems and equipment — building design, ventilation and air cleaning
Authors: Carpenter G. A.
Published: July 2016

The design of a building affects control of climate in several ways. Its thermal insulation can be impaired by inadequate thickness of insulating material, faulty installation, settling, condensation and destruction by vermin and insects. Also its design interacts with the ventilation system which must take into account not only location, size and shape of the building, but also details such as air leakage, deflection of air jets by obstructions and dimensional changes such as occur in a timber structure. In contrast, a smooth or rough surface can respectively enhance or impede the throw of a jet as required. A permeable floor in a building may help to remove sedimented dust.

A ventilation system needs to be matched to the class of livestock. Systems can be classified and described, namely, glass-fibre ceiling, high-speed jet, polythene ducts, recirculation (both damper and twin fans), hybrid (two systems combined), down-jet, Udiflo tent, and automatically controlled natural ventilation. Cyclical timing of fans gives close control of very low ventilation rates for batch rearing. Kennelled accommodation needs improved control for stock and stockman.

It may be possible to reduce dust by optimizing the many factors listed that predispose towards lower dust levels. An alternative solution is to use an internal air cleaner. This can be an electrostatic precipitator, a wet scrubber or a dry filter. The latter appears to be the most appropriate and a design that discharges filtered air downwards at a speed of 0–4 m/s towards the stock has been developed and tested in a flat-deck piggery.
Pig housing and the environment — future perspectives
Authors: English P. R.
Published: July 2016

In relation to desirable future developments in the provision of suitable climatic conditions and accommodation for the pig, consideration has been given to the established physiological and behavioural requirements and the extent to which current systems fail to cater for these needs. Suggestions are made for improving the provisions for pigs at various stages of the production process including breeding, pregnancy, parturition and early lactation, weaning and in the growing-finishing period. In formulating future perspectives for accommodating pigs at all stages of the production process, an attempt has been made to maintain an appropriate balance between the objectives of catering more effectively for the requirements of the pig, acceptability from the welfare aspect of both pigs and stockmen, ease of management and cost-effectiveness.
Cerebrospinal fluid analysis for diagnosis of noninflammatory, dementive and psychiatric diseases
Authors: Reiber H. , Otto M. , Bechter K.
Published: July 2016

CSF analysis contributes to differential diagnosis of noninflammatory diseases by: 1) exclusion of a chronic or acute inflammation. 2) detection of particular brain-derived proteins, surrogate markers, corresponding to the suggested diagnosis (tumor, dementia, brain hypoxia, hemorrhage, autoimmune disease, psychiatric disease, metabolic disorder, rhinorhea, Table 1) and 3. differential cell count in CSF.

Interpretation of brain-derived proteins in CSF uses absolute concentrations (in contrast to CSF/serum quotients for blood-derived proteins) and must discriminate between different sources: Neuronal or glial proteins like NSE, or tau protein are evaluated using their absolute concentrations in CSF for maximal sensitivity without reference to QAlb. The leptomeningeal proteins like beta trace or cystatin C are evaluated as absolute concentrations with reference to QAlb.

As application examples we review the group of dementive and psychiatric diseases.

Alzheimer's disease, Parkinson's disease dementia, Lewy-body disease and frontotemporal dementia are the major causes of neurodegenerative memory impairment and dementia. Combined analysis of Tau-Protein and Beta Amyloid 1-42 in CSF represent the classic approach, meanwhile extended with further surrogate markers. In 15% of psychiatric patients with schizophrenic or affective disorders an inflammatory process could be detected which points to a brain-organic involvement. In 24% of these patients with a psychiatric disease a moderately increased albumin quotient was observed as the only unexplained pathological sign. In psychiatric diseases it has to be regarded as a serious deficit not to make at least once a CSF analysis in the patients which could modify the diagnosis (in 6%).
EEG-based brain imaging techniques in psychiatry
Authors: Volpe Umberto
Published: July 2016

Electroencephalography has probably represented the first modern and scientifically sound attempt to functionally explore the in vivo activity of the human brain and it has, since ever, attracted attention of psychiatrists, from both the clinical and the research viewpoint.

Probably due to the limitations implied by their traditional low spatial resolution, the use of psychophysiological techniques in psychiatry has been not continuous over the last century; however, the availability of newer EEG-based brain imaging techniques has recently renovated some interest (1)). Furthermore, recent theories proposed that psychopathology may result from the failure to integrate the activity of different areas involved in cognitive processes, rather than from the impairment of one or more brain areas (2)); within this view, a reliable brain imaging tool should be able to explore the dynamics of complex interactions among brain regions, with high sensitivity to the subtle deviation in complex processes that last fractions of seconds; psychophysiological techniques, indeed, offer the possibility to explore the functional correlates of major psychiatric illnesses, as well as to understand of the effects of psychotropic drugs on the central nervous system, with incomparable time resolution. Finally, the recent technical possibility to combine different brain imaging approaches has further fostered a renovated enthusiasm to ward the use of EEG-based techniques in psychiatry.

This contribution will provide an historical overview of the EEG-based brain imaging techniques and an update on some recent advances concerning the use of such techniques within the psychiatric field. Finally, some examples of psychophysiological and ''multimodal'' imaging investigations in subjects with different psychiatric conditions will be provided.
Differences in cholesterol and metabolic syndrome between bipolar disorder men with and without suicide attempts
Authors: Vuksan-Ćusa Bjanka , Marčinko Darko , Nad Sanea , Jakovljević Miro
Published: July 2016

Patient with mental illnesses such as schizophrenia and bipolar disorder have an increased prevalence of metabolic syndrome (MetS) and its components compared to general population. Among psychiatric disorders, bipolar disorder ranks highest in suicidality with a relative risk ratio of completed suicide of about 25 compared to the general population. Regarding the biological hypotheses of suicidality, low blood cholesterol level has been extensively explored, although results are still conflicting. The aim of this study was to investigate whether there were differences in the serum cholesterol levels in hospitalized bipolar disorder men patients with history of suicide attempts (n= 20) and without suicide attempts (n= 20). Additionally, we investigated if there were differences in the prevalence of MetS according to NCEP ATP-III criteria in these two groups of patients. Results of the study indicated significantly lower serum cholesterol levels (P = 0.013) and triglyceride levels (P = 0.047), in the bipolar disorder men with suicide attempts in comparison to bipolar disorder men without suicide attempts. The overall prevalence of MetS was 11/40 (27.5%). On this particular sample it was higher in the non-attempters 8/20 (40.0%) than in attempters 3/20 (15.0%) bipolar men group, but without statistical significance. Lower concentrations of serum cholesterol might be useful biological markers of suicidality in men with bipolar disorder.
Correlations between molecular and clinical data in Huntington's disease and implications for predictive testing
Authors: Claes S. , Decruyenaere M. , Dom R. , Malfroid M. , Evers-Kiebooms G. , Baro F. , Godderis J. , Fryns J-P. , Cassiman J-J.
Published: July 2016

Huntington's disease (HD) is an autosomal dominant disorder of the central nervous system, characterised by neurological, cognitive and psychiatric pathology. Recently the causative genetic defect was discovered. We present a retrospective study of 59 HD patients, investigating correlations between molecular and clinical data.

The correlation between CAG-repeatlength and age at onset is confirmed. No correlations between this biological marker and other clinical features are found (symptoms at onset, mode of progression of the disease).

The consequences of these findings for predictive testing are discussed. Furthermore, a short overview of the predictive testing procedure in the Center for Human Genetics in Leuven (Belgium) is given.
Focus III: Psychogeriatrics and the vulnerable brain
Authors: Sipsma D.H.
Published: July 2016

In een vergrijzende bevolking neemt de prevalentie van psychogeriatrische patiënten toe. Die toename hangt onder meer samen met de met de leeftijd toenemende kwetsbaarheid van het brein. Deze beschouwing gaat over die samenhang.

In 1972 is door de Wereldgezondheidsorganisatie het begrip ‘psychogeriatrie’ omschreven als een tak van de psychiatrie die zieh bezig houdt met die psychische stoornissen die zieh voor het eerst op oudere leeftijd manifesteren en duidelijk oorzakelijk samenhangen met de maatschappelijke, geestelijke en lichamelijke veranderingen in de derde levensfase.
Variability of function during infancy and toddler's age
Authors: Touwen B.C.L.
Published: July 2016

An interactional model of brain function is postulated, in which activity and reactivity are basic properties of the central nervous system from the very beginning. Variability is an essential aspect of normal functioning. Primary or indiscriminate variability consists of the development of many strategies for the execution of motor acts. It is predominant during fetal age and infancy. Toddler age is characterized by secondary or adaptive variability, which reflects the ability to select the adequate strategy at the right moment. This is important for the development of proper planning of movement patterns and is a prerequisite for skill development. Recognition of the types and quality of variability helps to detect developmental disorders at an early age.
Parkinson's disease and depression
Authors: Leentjens A.F.G. , Broek W.W. Van Den
Published: July 2016

In this review article, based on a literature study, present ideas upon the relation between M. Parkinson and concomittant depression are dicussed. After a short introduction, it is demonstrated that epidemiological studies show that a common pathophysiological basis can be assumed. Briefly pheno-menological aspects are mentioned, whereafter the changes in the different neurotransmittersystems are discussed in greater detail. The ratio of dopaminergic and serotonergic activities in the basal ganglia constitute an important determinant for the severity of motor symptoms in Parkinson's disease. Reduced serotonergic metabolism may be a compensatory mechanism for the reduced dopaminergic activity. At the same time, a reduced serotonergic activity can predispose to a depression. Lower activities in parts of the dopaminergic, serotonergic and noradrenergic systems may each be responsible for part of the affective symptomatology in depressed Parkinson patients.
Lessons to be learnt from Freud; how to deal with the relations between somatic and mental processes
Authors: Panhuysen G.E.M.
Published: July 2016

In biological psychiatry, the biopsychosocial model is broadly supported. This does not mean a rejection of materialism, but of reductionism. Psychological (and social) psychiatry is deemed to be a necessary supplement to biological psychiatry.

This is one of the lessons made avalaible by Freud. In addition, there are other lessons to be taken from his work. From his view on the mind-body relationship a useful strategy for theory construction can be abstracted:

specify the relevant (neuro)physiologiocal mechanims,

specify the relevant mental mechanisms,

look for that output of the neurophysiological mechanisms that can also serve as the input of the mental mechanisms, and conversely. Especially the third directive will be of use for adherents of the biopsychosocial model.

We may also learn from Freud's mistakes. He rightly used his interactionistic but non-dualistic arguments for the vindication of a relatively autonomous psychological psychiatry. However, he wrongly delayed biological-psychiatric tasks to an indefinite future.
HPLC analysis and pharmacokinetics of the enantiomers of R,S-oxazepam and R,S-temazepam with their corresponding glucuronide conjugates in urine and plasma of man
Authors: Vree T.B. , Baars A.M. , Wuis E.W.
Published: July 2016

R,S-Oxazepam and R,S-temazepam can be separated in their enantiomers by means of a chiral AGP column. The corresponding R- and S-glucuronide conjugates can be separated on a normal reversed-phase C18 column. Man conjugates the S-enantiomer of oxazepam and temazepam both better than the R-enantiomer. The urinary recovery of the glucuronides following either R,S,-oxazepam or R,S-temazepam almost amounts to 100% of the dose administered.
Monoamines and CSF: relevance to neuropsychiatric disorders
Authors: Verhoeven W.M.A.
Published: July 2016

Over the past 25 years much effort has been put into the research of the relationship between neuropsychiatric disorders and the concentrations of CSF-monoamine metabolites. Most of this research has beenfocused on the relation between CSF-concentrations of 5-hydroxyindoleacetic acid (5-HIAA) and homovanillic acid (HVA) and specific symptomatological entities, particularly schizophrenia, Alzheimer's dementia and endogenous depression. It appeared that specific relations between diseases and CSF-concentrations of monoamine metabolites cannot be longer maintained and that a more functional psychopathology should be considered as the future research strategy.
Psychofarmakologika IX
Authors: van den Bergh W.
Published: July 2016

Inleiding

In deze rubriek zal worden ingegaan op recente observaties betreffende de psychofarmakologie in de breedst mogelijke zin. Vaak zullen zaken uit de literatuur worden behandeld. De gekozen onderwerpen dienen altijd klinische relevantie te hebben. Ook zal deze rubriek gaan over gewoontes die in psychofarmakologische behandeling of in onderzoek zijn geslopen die volgens de auteur lang niet altijd logisch zijn. Soms zal deze rubriek een oproep bevatten om te reageren op een bijdrage gepubliceerd in dit of in een ander tijdschrift. Ook zal de lezer worden aangemoedigd hier zijn eigen ervaringen mee te delen. Het is niet de bedoeling in deze rubriek onderzoeken uitvoerig te rapporteren. Daarvoor staan andere pagina's van de Acta Neuropsychiatrica voor u open.
An ethological approach of depression
Authors: Bouhuys A.L.
Published: July 2016

Within the framework of interactional theories of depression it was examined whether the interaction of 31 severely depressed patients and a psychiatrist was related to the course of depression during hospitalization. Interactional processes were defined on the basis of directly observed behaviour displayed during an interview and by the use of ethological methods. The behavioural structure of such interaction could be described by 6-7 factors. Some of these factors could predict the clinical course of depression, over an interval of tien weeks. The patients who would not improve displayed before treatment (just after admission) more involvement (i.e., looking, gesticulating) coinciding with more general activation (leg and hand movements) than the patients who would improve. The psychiatrist displayed relatively high levels of involvement (encouragement: hm, hm, yes, yes, and yes-nodding) and low levels of general activation (hand movements) in his interaction with patients who would not improve. The results provide support for interactional theories of depression.
Preclinical evidence for the role of serotonin receptor-subtypes in depression
Authors: Olivier B. , Schipper J. , van der Heyden J.A.M. , van Hest A. , Mos J. , Tulp M.Th.M.
Published: July 2016

Serotonin (5-HT) plays an important role in depression and specific 5-HT reuptake blockers appear to be clinically important antidepressants. It is unclear however, which serotonergic mechanism is involved in the antidepressant effect, certainly when regarding the existence of at least seven 5-HT receptor subtypes. By testing different 5-HT ligands in two animal models of depression (forced swimming and DRL72-S test) and comparison with data from literature, evidence is provided for potential antidepressant qualities of 5-HT1A receptor-agonists and 5-HT1C receptor-antagonists. Compounds binding to 5-HT1B, 5-HT2 and 5-HT3 receptors do not have an antidepressant profile. Results of clinical research support the predicted antidepressive effects of 5-HT1A receptor-agonists.
Dystonie reactions and hallucinations: a rare adverse-effect?
Authors: Kaiser L.H.W.M. , Schols M.P.J.
Published: July 2016

Dystonie reactions and hallucinations: a rare adverse-effect? One of the intriguing side-effects of neuroleptics is the acute dystonie reaction like oculogyric crises. It is seldom mentioned that the dystonie reaction may be combined with hallucinations. This combination of acute dystonia with hallucinations may be explained by overstimulation of dopamine-receptors in the striatal neurons. Awareness of these hallucinations as a complication of neuroleptics is essential to prevent that neuroleptic dose will be increased; instead it must be lowered. Prevention of the dystonia is critical. These side effects may be suppressed with anti-parkinsonian drugs. Information to the patient in due time may prevent anxiety about the side effects.
Dementia and Amyotrophic Lateral Sclerosis
Authors: Verhey F.R.J. , Vreeling F.W. , Jolles J.
Published: July 2016

Dementia and Amyotrophic Lateral Sclerosis

The case-histories of two patients are presented with Amyo-trofic Lateral Sclerosis and dementia (ALS-D), followed by a discussion of recent literature on this topic. This condition can be considered as the interface between non-Alzheimer frontal lobe dementia and amyotrophic lateral sclerosis. The nosological classification of the ALS-D complex has not been established yet.
Chronic pain and the psychiatrist
Authors: Houdenhove B. Van
Published: July 2016

Chronic pain is a phenomenon with important psychiatric aspects from a diagnostic as well as a therapeutic point of view. The place of chronic pain in the different versions of the Diagnostic and Statistical Manual of Mental Disorders, and the differential-diagnosis are critically discussed. The comorbidity with depression, anxiety disorders, substance abuse and personality disorders is extensively treated. Finally, the essential role of the psychiatrist in the multidisciplinary therapeutic approach of these patients is emphasised.
Set-maintenance and set-shifting problems in schizophrenic subtypes: relationship to dysfunctions of the fronto-striatal loops
Authors: Lanser M.G. , Ellenbroek B.A. , Cools A.R. , Zitman F.G.
Published: July 2016

Research with patients suffering from Parkinson's disease and frontal lobe lesions has shown that disturbances in the fronto-striatal loops in the brain can cause perseveration. Perseveration is a core symptom of schizophrenia, yet the cause is not known. For schizophrenic patients disorders of many parts of the fronto-striatal loops are found, for example disturbances of the prefrontal cortex and the striatum. Perseveration in schizophrenia can be explained with set-maintenance problems, related to dysfunction of the prefrontal cortex, or with set-shifting problems that are related to disorders in the striatum. These set-maintenance and set-shifting problems can be distinguished with neuropsychological tests. Regarding the bloodflow patterns for the different subtypes of schizophrenia three problems are expected as explanations for perseveration: set-maintenance problems concerning abstract information, set-maintenance problems shifting between stimuli and enhanced set-shifting with cues.
Management of psychiatric adverse events with immunotherapy with interferon-alfa
Authors: Van Gool A.R. , Kruit W.H.J. , Cornelissen J.J. , Berk L. , Eggermont A.M.M. , Bannink M.
Published: July 2016

Immunotherapy with interferon-alfa has become standard therapy in selected patients with viral hepatitis and chronic myelogenous leukemia. In addition, it is used in a variety of other diseases, both as standard therapy and in clinical trials. Its use is expected to expand in the following decade. Interferon can cause (severe) neuropsychiatric side effects. These side effects are discussed. Adequate management of these side effects is important, as is close collaboration between the oncologist and the psychiatrist. The cornerstone of management is patient education: this prevents interruption of therapy by patients who were not warned for neuropsychiatric side effects. Furthermore, patients should report in case of rapidly arising mood disorders. Interferon-alfa induced mood disorder is reported to be treatable. Three case descriptions illustrate this, but also illustrate some limits to successful treatment.
Searching for genes in Schizophrenia
Authors: Wildenauer D.B. , Schwab S.G. , Maier W. , Lerer B.
Published: July 2016

Decades of research into the etiology of schizophrenia on a phenotypic level, i.e. studies of neuroanatomy, neuropathology, neurophysiology and other areas such as immunology have yielded only fragmentary results. A contribution of genetic factors, has been consistently shown, however, beginning with E. Kraepelin's pioneering studies at the turn of the century. Evidence has accumulated from family-, twin-, and adoption studies. Identical twins have a 48% risk of developing schizophrenia if one of them is affected. In contrast, a 17 % risk is reported for nonidentical twins. These rates are similar to other complex genetic disorders such as diabetes, hypertension and asthma. Advances in the genetic analysis of complex traits as well as progress in the Human Genome Project should provide a basis for uncovering the molecular causes of schizophrenic disorders and for investigating the neuropathology of this individually and socially devastating neuropsychiatrie disorder. There is no doubt, that discovery of the genetic variation associated with the illness would help in identifying specific targets for development of more effective, targeted treatments.
Molecular players in the development and maintenance of mesencephalic dopamine systems
Authors: Burbach J.P.H. , Cazorla P. , Smidt M.P.
Published: July 2016

Several psychiatric diseases are considered to be neuro-developmental disorders. Amongst these are schizophrenia and autism, in which genetic and environmental components have been indicated. In these disorders intrinsic molecular mechanisms of brain development may be deranged due to genetic predispositions, or modified by external influences. Brain development is a delicate process of well-tuned cellular proliferation and differentiation of multipotent neural progenitor cells driven by spatiotemporal cues. One of the fundamental mechanisms is the interaction between external signals, e.g. growth factors, and internal regulators, e.g. transcription factors. An important transmitter system involved in behavioural and affective functions relevant for psychiatric disorders is the mesencephalic dopamine (DA) system. The mesencephalic DA system is organized in two anatomically and functionally different systems. DA neurons in the ventral tegmental area project to the mesolimbic system and are mostly related to control of behaviour. It has been implicated in drug addiction and affective disorders like dipolar disorder and schizophrenia. The dopamine system of the substantia nigra (nigro-striatal pathway) is implicated in movement control. Degeneration of this system, as in Parkinson's disease, or altered function in tardive dyskinesia have highlighted its importance in human disease. Recent findings in molecular neurobiology have provided the first clues to molecular mechanisms involved in developing and mature DA neurons. These may have clinical implications in novel therapeutic strategies.
Coping with genetic burden
Authors: Tibben A.
Published: July 2016

An increasing number of neurodegenerative diseases have been defined at the molecular level in recent years, making it possible to determine precisely the genotype before the onset of symptoms. Pre-symptomatic testing programs are available for Huntington disease (HD), hereditary cerebral haemorrhage with amyloid-Dutch type, inherited cerebral ataxia, myotonic dystrophy, and Alzheimer disease. Although treatment options such as gene therapy have no widespread application until now, and much has to be developed, the use of predictive DNA-diagnostics has become a clinical application for a number of hereditary diseases. For psychiatric disorders such as schizophrenia or bipolar disorders, there are indications for localisation of the genetic factors, but clinical use of genetics is still far from reality. Yet, the increasing knowledge about genetics will have far-reaching influence in most fields of modern medicine and in health care provisions.
Neurobiology of adaptation disorders
Authors: de Kloet E.R.
Published: July 2016

A fundamental issue in the neurobiology of adaptation disorders is how the hormones of the hypothalamic-pituitary-adrenal (HPA) axis protect the brain from such disorders, and how in a different context these very same stress hormones may enhance vulnerability. This contribution focuses on the corticosteroids which exert through two distinct nuclear receptor types control over gene networks underlying stress system activity in brain. The mineralocorticoid receptor mediates the pro-active mode of corticosteroid action involved in maintenance of basal stress system activity. The glucocorticoid receptor mediates the reactive feedback mode aimed to facilitate recovery from stress-induced disturbance. The balance between these pro-active and reactive modes of control is thought to be of critical importance for homeostasis, and thus for control of hormone-responsive genes which enhance vulnerability to stress-related affective and neurodegenerative disorders.
A comparison of the ‘Hamilton Rating Scale for Depression’ and the ‘Montgomery-Asberg Depression rating Scale’
Authors: Huijbrechts I.P.A.M. , Haffmans P.M.J. , Jonker K. , van Dijke A. , Hoencamp E.
Published: July 2016

Although the Hamilton Rating Scale for Depression (HRSD) is the most frequently used rating scale for quantifying depressive states, it has been criticized for its reliability and its usability in clinical practice. This criticism is less applying to the Montgomery-Asberg Depression Rating Scale (MADRS). Goal of the present study is to investigate the reliability and validity, and clinical relationship between the HRSD and the MADRS. For 60 out-patients with diagnosed depression (DSM IV296.2x, 296.3x, 300.40 and 311.00), the HRSD and MADRS were scored at baseline and 6 weeks later by an independent rater according to a structured interview. Also the Clinical Global Impression (CGI) was assessed by a psychiatrist. Satisfying agreement was found between the totalscores (r= .75, p>.000 en r=.92, p>.000 respectively, at baseline and 6 weeks later). Furthermore agreement was found between the items of both scales, and these agree with the clinical impression. The reliability of the MADRS is more stable than the reliability of the HRSD (α = .6367 and α =.8900 vs α = .2193 and α = .8362 at baseline and at endpoint respectively). Considering the ease of scoring both scales in one interview and the widely international use of the HRSD, scoring both the HRSD and the MADRS to measure the severity of a depression seems to be an acceptabel covenant.
Psychopathologie en Pathogenese van enkele behavioural phenotypes
Authors: Verhoeven W.M.A. , Tuinier S. , Curfs L.M.G.
Published: July 2016

Description of psychopathological symptoms in mentally retarded subjects is of great heuristic value because of the association with a known genetic disorder as well as the heterogenous and atypical phenomenology. The concept of behavioural phenotypes postulates a specific relationship between gene defect and behaviour, although considerable overlap between syndromes and differences within syndromes concerning behavioural manifestations are frequently observed. Since syndrome specific psychiatric disorders can be established too, the term psychopathological phenotype seems to be appropriate.
Antipsychotics, movement disorders and fine motor performances: new device for the measurement of bradykinesia and tremor
Authors: Jogems-Kosterman B.J.M. , Loonen A.J.M. , van Hoof J.J.M. , Zitman F.G. , Hulstijn W.
Published: July 2016

This article reviews the results of an exploratory study on the relationship between the ratings of bradykinesia, obtained by the Schedule for the Assessment of Drug-Induced Movement Disorders (SADIMoD), and the performances on writing and drawing tasks. The pen movements made during these tasks were recorded by means of an electronic digitizing tablet, a special electronic pen and a personal computer. This study was aimed at finding objective parameters for the severity of (antipsychotic-induced) bradykinesia. The results show that the writing tablet device is appropriate at finding movement variables that are related to the clinical ratings for bradykinesia: high scores for bradykinesia involved slowing on a number of duration measures during the execution of the writing and drawing tasks. We were also able to measure (postural) tremor by means of the writing tablet. However, an accelerometer seems to be more appropriate in this respect.
Evaluation of the application of carbohydrate deficient transferin in a general hospital; recommendations for use
Authors: Janssens P.M.W. , de Jonge N.I.S. , Bosch F.H. , Verwey B.
Published: July 2016

We performed a retrospective evaluation of the use of carbohydrate deficient transferrin (CDT) in a general hospital, for diagnosing alcohol abuse. The high specificity for the CDT test and lower sensitivity as reported in the literature were confirmed. Alcohol anamnesis proved rather often to be incomplete. In intensive care medicine, the CDT investigation could be used as a guide to diagnoses and treatment, especially for patients that are difficult to communicate with. For being of use here, results of the CDT determination should be available within a day. CDT proved to be of use also in psychiatric medicine, the test being of help in clarifying the patients acohol addiction.
Het cytochroom P450 enzymsysteem: wat is de relevantie voor de praktijk? Deel II, interacties.
Authors: Touw D.J. , Verhoeven W.M.A. , Noten J.B.G.M.
Published: July 2016

In man a great interindividual variability exists in the oxidative capacity to metabolize drugs. A major factor contributing to this phenomenon is the genetically determined hydroxyla-tion-capacity of the cytochrome P450 enzyme system. The cytochrome P450 system comprises of several isozymes. For several isozymes (CYP2D6, CYP2C) a genetically based hydroxylation capacity has been demonstrated. A frequency distribution of the clearance shows a bimodal distribution with poor and extensive metabolizers. Applying standard dosing schemes of the drugs that are predominantly metabolised by these isozymes, a considerable number of patients will be intoxicated because of poor metabolism. In general, cytochrome P450 capacity is limited and substrate-affinity is high. Henceforth cytochrome P450 isozymes are likely targets for pharmacokinetic interactions.
The contribution of biological factors to the pathogenesis of psychiatric disorders in the postpartum period: a survey
Authors: Claes M. , Maes M. , Jacquemyn Y.
Published: July 2016

Samenvatting

Aan de hand van literatuurgegevens wordt een overzicht gegeven van de rol van biologische factoren bij het tot stand komen van de drie belangrijkste psychiatrische stoornissen in het kraambed: ‘maternity blues’, postpartumdepressie en kraambedpsychose. Voorde blues en de postpartumdepressie worden vooral stoornissen in de stofwisseling van L-tryptofaan, progesteron en de endorfines beschreven maar zonder dat een duidelijk biopsychofysiologische verklaring van de ziektebeelden kan worden gegeven. Voorde kraambedpsychose wordt vooral aan dopamine en beta-enkefaline aandacht besteed.

Het blijkt dat over de bio-etiologie van deze aandoeningen vooralsnog geen consensus bestaat.
Prospects for a scientific psychiatry
Authors: Goodwin F.K. , Ghaemi S.N.
Published: July 2016

Herman van Praag has made major contributions to the scientific and conceptual development of psychiatry. Despite progress in delineating reliable diagnostic criteria, our classification system ignores clinical insights available from patients' subjective experiences of illness. Hence a ‘coarsening of diagnosis’ has occurred, weakening the nosologic infrastructure of scientific psychiatry. This paper will discuss these ideas and emphasize the central role of psychopharmacology in advancing psychiatry, with lithium's discovery as a paradigm.
rCBF-activatie en neuronale circuits gerelateerd aan visuele waarneming
Authors: de Jong B.M.
Published: July 2016

Three principles of neuronal interaction within cortically distributed networks are discussed. PET-rCBF activation methods provide an opportunity to acquire insight in the distribution of functionally related areas of the human brain in vivo. The distinction of visual areas, activated by either motion or color within an observed scenery, points at a segregation in neuronal information processing. Such a segregation extends into both a dorsal and a ventral route towards consequently the parietal and temporal cortex.

Simultaneous activation over the dorsal and ventral route, which for example occurs in relation to the perception of complex motion (optic flow), or motion perception after lesion of V5, suggests integration by means of cross-connectivity. The third principle, i.e. “top-down” integration, appears by analysis of V5-V1 interaction, attentional effects on V4, frontal activation in prosopagnosia, and by analysis of hallucinations. Such “top-down” integration indicates the presence of momentaneous effect on cortical areas, intimately related to the primary sensory cortex, by neuronal activity of remote “association” cortex, the latter being connected by direct (synaps-restricted) bypass from early stations of information processing.
Psychofarmakologika XIII
Authors: Quak J. , Korf J.
Published: July 2016

Inleiding

In deze rubriek zal worden ingegaan op recente observaties betreffende de psychofarmakologie in de breedst mogelijke zin. Vaak zullen zaken uit de literatuur worden behandeld. De gekozen onderwerpen dienen altijd klinische relevantie te hebben. Ook zal deze rubriek gaan over gewoontes die in psychofarmakologische behandeling of in onderzoek zijn geslopen die volgens de auteur lang niet altijd logisch zijn. Soms zal deze rubriek een oproep bevatten om te reageren op een bijdrage gepubliceerd in dit of in een ander tijdschrift. Ook zal de lezer worden aangemoedigd hier zijn eigen ervaringen mee te delen. Het is niet de bedoeling in deze rubriek onderzoeken uitvoerig te rapporteren. Daarvoor staan andere pagina 's van de Acta Neuropsychiatrica voor u open.
Unexplained somatic complaints in relation to paroxysmal EEG phenomena and localised abnormalities in the electroencephalogram
Authors: Van Bork J.J. , Boezeman E.H.J.F. , Duivenvoorden H.J.
Published: July 2016

A positive significant relationship (p<0,01) is found between a psychiatric judgement on autonomic nervous system complaints and a “blind” neurological judgement on paroxysmal EEG phenomena. Classification: Somatization Disorder (DSM-III-R; IV 300.81). Diagnoses: nervous functional complaints, hyperventilation syndrome, Da Costa's disease (irritable heart syndrome, neurocirculatory asthenia) and irritable bowel syndrome. A positive significant relationship (p<0,001) is found between a diagnosis of “Da Costa's disease” and a “blind” neurological judgement on PEF. A positive significant relationship (p<0,001) is found between a psychiatric judgement on neurasthenia (atypical headache and atypical tiredness) classified as dysthymia DSM-IH-R 300.40 and a neurological judgement on localised (cortical) abnormalities by “blind” EEG evaluation. No medication in the last half year. Logistic regression analysis (n=116) revealed that sex and age are of no importance. No medication in the last half year before EEG registration.
Cholesterol and psyche
Authors: Duits N. , Tilburg W. Van
Published: July 2016

This paper reviews the relationship between cholesterol and psychological functioning. Possibly a relationship exists between the lowering of cholesterol, low serum cholesterol concentration and mood and/or impulse control disorders. This might be associated with a disregulated cerebral serotonin metabolism. These hypotheses are based on (meta-analyses of) epidemiologic research investigating the lowering of cholesterol. One of the findings was an increased mortality due to suicide, homicide and accidents. Much is still unknown about the matters mentioned above. However, recommendations for research and clinical psychiatric practice are formulated.
Psychological and neurophysiological dysfunctioning during wakefulness in narcolepsy
Authors: Beullens J. , van Sweden B.
Published: July 2016

Memory complaints and altered states of consciousness with automatic behaviour of narcoleptic patients indicate cognitive dysfunctioning. Although more problems arise while performing attention tasks than memory tasks, the neuropsychological test inquiry doesn't indicate one particular neuropsychological function as consistently impaired. They often perform well because they compensate impaired wakefulness by an increased willingness to respond. Neurophysiological research indicates that the sometimes occurring cognitive dysfunction is associated with a waxing and waning between wakefulness and sleep. The increased psychopathology is partly a reflection of, partly a reaction to the symptoms. The impact of hypersomnia on psychosocial functioning is more important than that of epilepsy in epileptics. In severe cases smoking and driving should better be dissuaded.
Response of human melatonin secretion to changes in nightlength (scotoperiod): Implications for seasonal affective disorder and other psychiatric illnesses
Authors: Wehr T.A.
Published: July 2016

Many of the dramatic seasonal changes that occur in animals are triggered by changes in the length of night. Changes in the duration of melatonin secretion, which usually occurs exclusively at night and therefore lasts longer in winter than in summer, often act as a chemical transducer of the effects of seasonal changes in night-length on animals' behavior and physiology. Cells in sites that regulate seasonal behaviors, such as those associated with breeding, appear to possess melatonin receptors and interval timing mechanisms that enable them to detect melatonin and measure the duration of the nightly interval when it is present. These sites then trigger changes that are appropriate for the season that is indexed by the measured length of the interval.
Stock volatility, return jumps and uncertainty shocks during the Great Depression
Authors: Mathy Gabriel P.
Published: July 2016

There are a multitude of explanations for the depth and length of the Great Depression, of which uncertainty has been proposed as one possible explanation (Romer 1990). The 1930s not only saw extreme declines in output and prices, but stock volatility was also at record highs (Schwert 1989). This high stock volatility was generated by a series of discontinuous jumps as news about uncertainty arrived regularly during the 1930s, as shown by applying the Barndorff-Nielsen and Shephard (2006) test for jumps in a time-series. To provide a more historical narrative for these jumps, I outline some key events during the Great Depression that generated a sense of uncertainty for businesses and households which occurred contemporaneously to these extreme jumps. While much of the literature has placed Roosevelt's New Deal as a primary source of uncertainty, I do not find much evidence for this hypothesis, and instead find that banking crises, the breakdown of the gold standard, popular unrest and uncertainty related to the brewing war in Europe were primarily responsible for both jumps in returns and the uncertainty of the 1930s.
How much psychological distress is experienced at home by patients with palliative care needs in Germany? A cross-sectional study using the Distress Thermometer
Authors: Küttner Stefanie , Wüller Johannes , Pastrana Tania
Published: July 2016

Objective:

The aims of the present study were (1) to describe the prevalence of psychosocial distress in palliative care patients living at home and the related factors, and (2) to test implementation of the Distress Thermometer (DT) within a home-based palliative care service.

Method:

Ours was a 15-month prospective study beginning in September of 2013 in western Germany with consecutive patients cared for by a home care palliative care service. The research was implemented during the first visit by the home care team. Patients were excluded if they were under 18 years of age, mentally or physically unable to complete the assessment questionnaires as judged by their healthcare worker, or unable to understand the German language. During the first encounter, the Distress Thermometer (DT), a Problem List (PL), and a structured questionnaire for evaluation were applied and sociodemographic and medical data collected.

Results:

A total of 103 patients (response rate = 70%; mean age = 67; female = 54%; married = 67%; oncological condition = 91%; Karnofsky Performance Status [KPS] score 0–40 = 34%, 50–70 = 60%, >80 = 6%) were included. The incidence of distress (DT score ≥4) was 89.3% (mean = 6.3 ± 2.5). No statistical association was found between level of distress and sociodemographic or medical factors. The five most reported problems were “fatigue” (90%), “getting around” (84%), “eating” (63%), “bathing/dressing” (60%), and “sleep” (57%). The number of problems reported correlated with level of distress (ρ = 0.34). The DT was comprehensible, and 80% considered its completion as unremarkable, while 14% found it “relieving.”

Significance of results:

A significant proportion of patients treated at home reported symptoms of distress. The most oft-mentioned problems were physical and emotional in nature. The findings of our study highlight the importance of creating new concepts and structures in order to address the psychosocial needs of patients in home care with palliative needs.