bluuebunny/crossref_metadata_2025 huggingface dataset:
Changes in quality specifications for different markets
Authors: Kilkenny J. B.
Published: July 2016

There are three major markets for lamb — retail and catering domestic markets, and the export market. Most of the latter is within the European Community (EC) and as 1992 approaches the differences between the domestic and EC export markets will become less distinct. The basis of specifications for all of these markets, and sectors within them, is weight range, fatness and conformation. The majority of lamb is sold to the consumer (whether retail or catering) in a ‘bone-in’ form and weight range is therefore critical for many cuts, for example chops and leg joints, in determining either weight at sale (and price of pack) or portion size.

In the domestic market major multiple supermarkets are gaining market share at the expense of independent butchers. With their purchasing power they can and do impose increasingly tight and sophisticated specifications. All, for their majority of ‘bone-in’ cuts, specify a carcass weight range of 16 to 20 kg. It is estimated by the Meat and Livestock Commission (MLC) that around 8% of lamb is now sold retail in a boneless form (boneless joints, lamb steaks, cubed lamb and minced lamb) and that this is a growing sector of the lamb market. Lamb is a small carcass unit (in comparison with beef and pork), has a high bone content and thus the cost of boning-out lamb carcasses is high. To reduce costs there is advantage in buying heavier lambs (but only if they are lean) and the premium specification for lambs for producing boneless cuts (and other forms of products) are increasingly in the range 20 to 24 kg.

Fatness continues to be the primary consumer negative about lamb. For ‘bone-in’ cuts it is difficult to trim, for boneless cuts extra trimming is possible but at the cost of reduced yields. There is a common specification for fatness in terms of MLC carcass classification — fat class 2 or 3L with increasing preference for the former. Conformation is the least important aspect of domestic market specifications. Nevertheless, for ‘bone-in’ cuts, particularly the important leg joint, shape is considered by many meat buyers as being important and most will be specifying carcasses of at least average shape, i.e. carcass class R. The export market is more complicated in terms of basic specifications. For the major market in northern and central France the specification is more or less identical to that of the major supermarkets in the domestic market. In south Europe requirement is for a much lighter lamb, 8 to 12 kg, very lean, fat class 1 and 2, and shape is almost irrelevant. Belgium and Germany require heavier lambs (18 to 22 kg) and this reflects usage in catering and processing.

There is growing interest in quality assurance schemes for lamb in the UK based on various carcass, slaughterhouse, storage and distribution factors.
Challenges to English-medium instruction (EMI) for international students in China: A learners' perspective
Authors: He Ji-Jun , Chiang Shiao-Yun
Published: July 2016

According to the Institute of International Education, China has become a major receiving country of international students, like the United States, United Kingdom, Australia, and Canada. The rapid development of international education in China evidences a major progress in the infrastructure of Chinese higher education. While internationalization creates unprecedented opportunities for the knowledge economy in China, it simultaneously poses unparalleled challenges for Chinese higher education (An & Chiang, 2015) and one of these challenges is the medium of instruction (MOI). While English has been widely taught in China since 1978 (McArthur, 2005), it was not until the turn of the century that English was endorsed as the medium of instruction for the so-called Chinese-English bilingual education.
Drug-induced psychosis in Parkinson's disease (II): atypical
neuroleptics
Authors: Wolters E.CH. , Tissingh G. , Kuiper M.A. , Zwaan W.A. , Horstink M.W.I.M.
Published: July 2016

In this second part of a review on drug-induced psychosis in Parkinson's disease, the characteristics of typical and atypical neuroleptics will be compared and the therapeutic efficacy and the extrapyramidal side-effects of ‘atypical’ antipsychotic drugs will be discussed. These drugs affect serotonergic, adrenergic as well as dopaminergic neurotransmission and are best distinguished from the typical neuroleptics on the basis of the relationship between strong 5-HT2 and weak D2 affinities. Their succes may rely on this spectrum of effects. Clozapine, being the first choice, will be discussed in more detail.
Psychofarmacotherapy: history
Authors: Hoes M.J.A.J.M.
Published: July 2016

A survey of the history of psychopharmacotherapy is presented.

In Antiquity some psycho-active plant extracts were already known . Since the rise of chemistry in early nineteenth century, sedative drugs were synthesized first. Since the fifties of this century the four groups of psychotherapeutic drugs proper, anxiolytics, hypnotics, antipsychotics and antidepressants have been discovered.

Astute clinical or preclinical observation and the understanding of coincidences, serendipity, has been the basis of these discoveries. Since the prototypes were discovered, no real breakthroughs have been achieved.
Behavioral neurology versus biological psychiatry: intellectual origins of their position within neuropsychiatry. Part I. Academic neuropsychiatry versus alienistic psychiatry in the late 19th century
Authors: van den Bergh W.
Published: July 2016

The intellectual roots of the schism between neurology and psychiatry are discussed. The opposition between the 19th century academic neuropsychiatry and the alienistic psychiatry is discussed. The evolution of aphasiology is discussed as a paradigm of neuropsychiatry.
Alternative treatment strategies for lithium in bipolar disorder
Authors: Bouvy P.F.
Published: July 2016

Indications for lithium in the treatment of bipolar disorders are acute mania, depression and preventive treatment. In the case of insufficient efficacy or adverse effects the first alternative for lithium in acute mania is carbamazepine. However, the role of carbamazepine in preventive treatment is still uncertain. Well designed prospective research is hardly done. Clearly positive reports on the efficacy of carbamazepine concern specific lithium-resistant groups such as the ‘rapid-cyclers’. Valproic acid has been found effective in a few studies in bipolar disorders, especially in acute mania. Clonazepam is sometimes mentioned as a possible alternative, however recent research seriously questions the efficacy of clonazepam in bipolar disorders. Calcium-antagonists, especially verapamil, may have some efficacy in the treatment of acute mania, their role is still very uncertain.
Evidence for enhanced sensitivity for pentagastrin in panic disorder patients
Authors: van Megen H.J.G.M. , Westenberg H.G.M. , Boer J.A. Den
Published: July 2016

We studied the effects of pentagastrin, an analogue of the cholecystokinin tetrapeptide (CCK4), in 15 patients with panic disorder and 15 healthy controls. Three different intravenous dosages of pentagastrin (0.1, 0.3 and 0.6 μ/kg) and placebo (saline) were investigated. Subjects were randomly allocated to two of the four dosage groups and tested on two separate occasions, one week apart, using a double-blind incomplete block design. A total of 59 intravenous injections were carried out. The panic rate with pentagastrin, irrespective of the dosage, was 55% (12/22) for patients and 5% (1/22) for controls. None of the subjects panicked with saline. The frequency of panic attacks between the three pentagastrin doses in patients was not different. One control subject had a panic-like attack at the highest dose of pentagastrin. These findings concur with previous studies on the panicogenic effect of CCK4 and pentagastrin and suggest a greater sensitivity for CCK agonists in patients suffering from panic disorder than in healthy controls.
The TRH-test in depression: a review
Authors: Christiaens F. , Maes M.
Published: July 2016

The TRH-test in depression: a review

This paper reviews the literature on the thyrotropin releasing hormone (TRH)-test in depressive patients. The TRH-test appears to exhibit some use as an external validating criterion for the clinical diagnosis of major depression and, in particular melancholia versus minor depression once the clinical diagnosis depression is made. However, the clinical use of this test is hampered by the low sensitivity (±50%) and by the fact that abnormal tests occur in non-depressive states such as borderline personality disorder, schizophrenia, and anxiety disorders. The TRH-test may be used as a predictor for a positive response to biological therapies. In addition, the test has some value for the outcome of a depressive episode. The pathophysiology underpinning an abnormal TRH-test may be determined by noradrenergic (central and peripheric) or serotonergic (central) dysfunctions, thyroid hormone and cortisol hypersecretion, phenomena that are pertinent to severe depression. Recently, it has been established that an abnormal depression-linked TRH-test reflects lower basal thyroid secreting hormone (TSH) secretion. The determination of basal TSH may, in the future, replace TRH-testing.
Cognitive neurobiology of schizophreni
Authors: van den Bosch R.J.
Published: July 2016

Schizophrenia is a neurobiological developmental disorder of basic neuro-integrative functions, resulting in failures of cognitive selfregulation. Neurophysiological and psychophysiological dysfunctions should be considered in connection with the ubiquitous cognitive dysfunctions. Schizophrenic patients have problems with the integration of information, resulting in deficits of perceptual organization, and in ‘metacognitive’ deficits of executive functions in the area of behavior and experience. The biological basis of these cognitive functions is in the frontal cortex, but the primary dysfunction seems to be a subcortical one. Negative symptoms can be understood as a secondary exhaustion mechanism, and partly as an adaptive process, corresponding with energetic deficits in information processing. Psychophysiological studies of regional cerebral blood flow, positron emission tomography, electrophysiological recordings and measures of eye tracking point to frontal dysfunction and hypoactivation in patients with negative symptoms. This agrees well with the results of cognitive studies. Psychophysiologists and cognitive psychologists are studying different aspects of the same systems disorder.
Treatment with depressions in Parkinson's disease
Authors: Smit R.A.V.
Published: July 2016

People with Parkinson's disease often suffer from depressions. Treatment of these depressions requires the use of antidepressants. The advanced age of most patients, however, can put limitations on the range of suitable antidepressants. Moreover, the drug should not aggravate Parkinson's disease. Many patients suffering from Parkinson's disease are currently prescribed selegiline. This drug is commonly considered to be a contraindication for antidepressants.

In this article, criteria for the choice of a suitable psychofarmacon are discussed. In particular suggestions are offered for the treatment of patients who are already taking selegiline.
Influence of Propofol on the Mood - a comparative study
Authors: Keyzer P.J. De , D'haese J. , D'haenen H.A.H. , Camu F.
Published: July 2016

The influence of propofol on mood was evaluated, considering the potential use of propofol as an anesthetic for electroconvulsive therapy. The mood state of 80 psychologically healthy subjects was assessed before and from 1/2 hour till 4 hours after surgery under anesthesia with either propofol or methohexitone. The mood was assessed with the Profile of Mood States (POMS). The propofol group was more elated from one hour until 4 hours after anesthesia (p<0,01 )(factor 1). 1 hour after anesthesia the propofol group was continuously more composed than the methohexitone group (p<0,01) (factor 4) and after two hours the propofol group was more agreeable (p<0,05) (factor 2). Moreover, patients, who received propofol, were less tired (factor 3) and confused (factor 5). It can be concluded that, compared with methohexitone, propofol has a favorable influence on different aspects of mood.
Hospital treatment and the control of violent behaviour
Authors: van Marle H.J.C.
Published: July 2016

Violent behaviour between inpatients and wardpersonnel is seen from a relational viewpoint. The reactions of the staff show a strong similarity with regressive transferences from the patients. Limit-setting as a method should be employed to contain the individuel behaviour of the patient as also so further the social climate on the ward. The method of limit-setting involves the reality testing of the patient, the transference reactions between patient and staff, clarity in decision-making and regulations, and architectural arrangements. These four levels of influence are separately discussed.
The crossroads of anticipatory attention and motor preparation. I
Authors: Brunia C.H.M.
Published: July 2016

This series of papers suggests that processes underlying anticipatory attention and motor preparation share a common control mechanism. Both functions are of utmost importance for an optimal adaptation to our environment. While the posterior part of the cortex is aimed at the analysis of incoming information, both from the outer world and our own body, the anterior part is involved in action and reaction. If we know when in the near future we will be confronted with relevant information, and how this has to be responded upon, modality specific sensoric and motoric information channels have to be open in order to guarantee an adequate response. The anterior and posterior parts of the cortex are activated from the thalamus and the information transmission is influenced via the reticular nucleus (RN) of the thalamus. The RN itself is under a double control: excitatory from the prefrontal cortex and inhibitory from the neostriatum. It is suggested that selection in anticipatory attention and motor preparation is realized in a comparable way via the RN. In Part I the relevant anatomical structures are described. In Part II the model for anticipatory attention and motor preparation is presented. In Part III the supporting neuropsychological evidence is presented, after which psychophysiological experiments will be discussed having lead to the formulation of the model.
Focus II: Is there agreement between DSM-IV and ICD-10?
Authors: Hoes M.J.A.J.M.
Published: July 2016

Gedurende de laatste jaren zijn nieuwe edities van twee grote classificatiesystemen uitgebracht. De American Psychiatric Association heeft in 1994 de vierde editie van de Diagnostic and Statistical Manual of Mental Disorders (DSM-IV) gepubliceerd en de Wereldgezondheids-organisatie in 1991 de tiende editie van de International Classification of Diseases (ICD-10). Van de laatste is hier het vijfde hoofdstuk (V of F) over psychische stoornissen van belang.

Vergeleken met de DSM-III (-R) uit 1980 (1987) is de DSM-IV qua structuur niet veranderd. Vergeleken met de DSM-III-R zijn er wel quantitatieve verschillen: 105 veranderde categorieën op as-I, 3 veranderde op as-II, 9 nieuwe voorstellen voor klinische aandacht, 13 nieuwe diagnoses, terwijl 8 classificaties verwijderd zijn en as-IV anders is gestructureerd, naar type belasting in plaats van ernst van belastende factoren.
Lithium als adjuvans bij een therapie-resistente depressie: een casus
Authors: Dirkx J.
Published: July 2016

Lithium was added to imipramine in case of a 55-year old depressed woman who didn't respond to imipramine alone. There was a clear improvement within a few days on 900 mg lithium carbonate a day (lithium plasmalevel 0.9 mmol/l). However when after two weeks the lithium dose was reduced to 600 mg a day (lithium plasmalevel 0.5 mmol/l), an almost immediate relapse followed. On resuming lithium in the old dose the depression disappeared again. After four weeks the second attempt at reducing and eventually stopping the lithium appeared to be successful. Half a year after cessation of lithium imipramine was also stopped. More than a year afterwards there hasn't been a depression again.

In this case, after a fast potentiation of imipramine by lithium, a relapse followed when the lithium dose was reduced. It seems to be that even a high and successful starting dose of lithium needs to be continued for some time in order to prevent a relapse.
Neuropsychiatry of corticosubcortical relations Aphasia and depression as paradigms
Authors: van den Bergh W.
Published: July 2016

In an introduction the evolution of a neuropsychological and neuropsychiatrie approach in the two last decades is discussed. The role of the basal ganglia, the thalamus and their cortical connections in aphasia is discussed. This review is given as a paradigm to demonstrate a neuropsychiatrie approach of psychiatric disorders. The role of corticosubcortical relations in depression is discussed.
The tyramine conjugation test and depression
Authors: Storosum J.G. , de Jonghe F. , Schalken H.F.A. , Huyser J. , Sno H.N.
Published: July 2016

In this article the value of the tyramine conjugation test (TCT) as a predictor of the response to antidepressive medication is reviewed. The TCT seems of little discomfort for the patient, is easy to perform and is suggested to have a high sensitivity and specificity. In addition, there are indications that a decreased tyamine conjugation could be a traitmarker for the vulnerability of depression. Hypotheses concerning the, as yet unclear etiology of the decreased tyramine are reviewed.
Immune disturbances in severely depressed patients: relationship with Cortisol secretion
Authors: Maes M. , Bosmans E. , Suy E. , Minner B. , Rausn J.
Published: July 2016

The mitogen induced lymphocyte responses were measured in 33 depressed patients categorized according to the DSM-III into minor (300.40, 309.00), simple major (296.X2) and major depression with melancholia and/or psychotic features (296.X3, 296.X4). Three distinct mitogens were used, i.e. phytohemaglutinin (PHA), pokeweed mitogen (PWM) and concanavalin A (CON A). We found that major depressives with associated features showed significantly lower mitogen induced lymphocyte responses to PHA and PWM as compared to all other depressed patients. The severity of illness was significantly inversely related to the lymphocyte responses to PHA. Cortisol nonsuppressors exhibited significantly lower PHA and PWM induced lymphocyte responses as compared with suppressors. There were significant and negative correlations between the postdexamethasone Cortisol values and the PHA and PWM stimulated lymphocyte responses.
Frontal cortex reactivity differentiates between schizophrenic subtypes: auditory ERP-evidence
Authors: Sweden B. Van , Erp M.G. Van , Mesotten F. , Maes M.
Published: July 2016

Objectives: To extend the hypothesis that late auditory EP shifts represent pathophysiologcial markers in schizophrenia. Methods: Early negative (±100 μs) and late positive (>300 ms) auditory oddball and CNV responses are topographically compared in 3 medicated schizophrenic subtypes.

Results: Only late cortical responses differentiate between paranoid, residual and disorganised schizophrenia. Core features of the deficit residual state encompass low-voltage N2P3 responses and missing central initial CNV components. Both paranoid and disorganised schizophrenics show a distinctive reactivity of the frontal cortex. Paranoid schizophrenia is characterized by an extensive frontal spread of the task-related P3 response. Disorganised schizophrenia shows a specifically increased frontal CNV component indicating a nonspecific arousal reaction.

Conclusion: Combinations of late auditory EP-patterns fairly fit with the cognitive/behavioral status observed in schizophrenia spectrum disorders.
Verminderde vergrijzing en M. Korsakov; toeval of een voorbeeld van serendiptisme?
Authors: Doorakkers M.Ch. , Tuinier S. , Sijben A.E.S. , Wester A.J. , Meijer R.J. , Verhoeven W.M.A.
Published: July 2016

The clinical observation that patients with an alcohol amnestic disorder get grey hair at a higher age was investigated by comparing a group of Korsakov patients and patients with alcohol abuse with a reference sample from the literature. Korsakoff patients appeared to be significantly less grey than age-matched alcoholics and controls. Some putative etiological factors including the mechanism of apoptosis are discussed.
Brain 5-HT function in bipolar affective disorder
Authors: Young A.H. , Hughes J.H. , Ashton C.H.
Published: July 2016

Background: Previous studies suggest that brain serotonin neurotransmission may mediate the actions of lithium carbonate. Acute tryptophan depletion (ATD) reduces brain serotonin and allows the study of this neurotransmitter in patient groups. Serotonin modulates electroencephalographic (EEG) activity, which is abnormal in bipolar disorder, and EEG abnormalities persist in euthymic bipolar patients. The EEG may therefore be a sensitive marker of 5-HT function in bipolar disorder.

Aims: This study examined the effects of ATD on mood, suicidal ideation and EEG activity in bipolar patients who were symptomatically stable on lithium.

Methods: 19 subjects satisfying DSM-IV criteria for bipolar I disorder participated in a within-subject, double-blind, placebo-controlled random-order crossover study. Following acute tryptophan depletion (induced by a 100g amino acid drink following an overnight fast) symptoms were evaluated, quantitative power spectrum brain mapping and measurement of auditory evoked potentials were carried out.

Results: ATD produced a significant fall in the amplitude of N1P2 and P300 components of the auditory evoked potential, but no significant changes in the power spectrum. There was an 83% reduction in plasma tryptophan (p<0.05, paired t-test) after the depleting but not the control drink. No significant changes in mood or suicidally scores were recorded after ATD.

Conclusions: ATD attenuates auditory evoked potentials in bipolar disorder but does not reverse lithium's effects on mood and suicidally in bipolar disorder.
Are schizophrenics neuropsychologically impaired affected psychotics? Neuropsychological performance and personality traits in relatives
Authors: Murray R.M. , Gilvarry CM. , Russell A. , Hemsley D.
Published: July 2016

Neuropsychological deficits are found in both schizophrenic patients and their relatives, and some studies have shown similar, but less severe, deficits in affective psychotic patients and their relatives. We set out to establish – whether schizophrenia spectrum personality traits are more common in the relatives of schizophrenic patients than relatives of affective psychotic patients; – what is the relationship between spectrum personality traits and neuropsychological deficits in these relatives.

Relatives were interviewed using the International Personality Disorder Examination (IPDE), and also completed the National Adult Reading Test (NART), the Trail Making Test (TMT: Parts A and B) and Thurstone's Verbal Fluency Test (TVFT). Spectrum personality traits were equally common in the 129 relatives of schizophrenic and 106 relatives of affective psychotic patients. Relatives of psychotic patients who themselves had high paranoid traits had lower NART scores than those without such personality traits (p=0.007);similarly, those with high schizoid personality traits took longer to complete the TMT, part B than those without such traits (p=0.0l); and relatives with high schizotypal traits generated significantly fewer words on the verbal fluency test than those without such traits (p=0.04).
Stabilization in the treatment of mania, depression and mixed states
Authors: Kupfer D.J. , Frank E. , Grochocinski V.J. , Luther J.F. , Houck P.R. , Swartz H.A. , Mailinger A.G.
Published: July 2016

While one major need for improved therapeutic approaches in bipolar disease is the development of long-term treatment strategies, a systematic approach during the acute phase of bipolar disorder is also required. In our own studies we have arbitrarily divided the initial treatment of subjects by the predominant polarity for which they are treated acutely: manic, depressed, or mixed/cycling.1 In this larger investigation of over 150 patients with bipolar disorder, we now demonstrated again that the time to initial stabilization is generally the shortest with a manic episode and the longest with a mixed/cycling episode with the depressed episode in the middle (although almost as long as the mixed/cycling episode). These findings indicate the difficulty of treating both the depressed phase and mixed/cycling episodes in bipolar disorder. It is also noteworthy that gender does not have a significant effect on time to stabilization. Such findings in the acute phase have profound implications in designing and carrying out long-term therapeutic strategies for this disorder.
Prevalence of psychopathology in children of bipolar parents
Authors: Wals M. , Hillegers M.H.J. , Reichart C.G. , Ormel J. , Nolen W.A. , Verhulst F.C.
Published: July 2016

The purpose of this study was to determine psychopathology in a large sample of adolescent children (N = 140) of parents (N = 86) with bipolar disorders, using multiple sources of information (child, parent, teacher). The main aims of the study were: 1) to compare parent, teacher and self reported problem behavior ratings of children of bipolar parents with those of children from the general population, and 2) to determine the prevalence of DSM-IV diagnoses in offspring of bipolar parents, and 3) to examine the possible association between gender of the bipolar parent and psychopathology among the offspring.
Benzodiazepines in perspective (II): The GABAA-Benzodiazepine Receptor Ligands
Authors: Vermeulen P.J.L. , Zitman F.G.
Published: July 2016

A huge number of natural and synthetic compounds modulate the function of the γ-aminobutyric acid type A receptor (GABAA-R) by interacting with several allosteric binding sites which may differ in the various GABAA-R subtypes. The benzodiazepine receptor (BDZ-R) is the most intensively studied allosteric site. It is the first allosteric modulatory site on a neurotransmitter receptor that has been found to mediate two opposite functions: facilitation and depression of GABAA-R function. The effects of BDZ-R ligands on behavior range from agonistic (anxiolytic, anticonvulsant, myore-laxant/ataxic and hypno-sedative effects) to inverse-agonistic (anxiety and panic, hypervigilance and convulsions). Of particular interest for the future are BDZ-R partial agonists, as they lack several of the undesired properties of classic full agonists. Furthermore the GABAA-R system shows a high plasticity. This polymorphism raises the possibility that ligands selective for distinct subtypes of BDZ-R may emerge as useful drugs. In both cases the possibility exists of achieving very subtle manipulations of GABAA-R function by using allosteric modulators.
Cytokines in de obsessief compulsieve stoornis en in anorexia nervosa: een overzicht
Authors: van West D. , Maes M.
Published: July 2016

The alterations in the inflammatory response system (IRS) appear to be quite different between OCD and anorexia nervosa and are also different from the changes observed in major depression. In anorexia nervosa, there is some evidence for increased production of monocytic cytokines, i.e. tumor necrosis factor-α (TNFα) and interleukin-6 (IL-6), and decreased production of Th-1 like cytokines, i.e. IL-2 and IFNγ. In the same patients there are also signs of immunosuppression, e.g. lowered numbers of CD4 and CD8 T cells and increased production of transforming growth factor-beta (TGFβ). The increased production of monocytic cytokines may be the consequence of the hyponutritional status of those patients. The diminished production of the Th-1 like cytokines may be the consequence of at least four different factors: 1) the deficiency in nutritional factors; 2) neuroendocrine disorders, such as increased Cortisol production; 3) the increased TGFβ production; and 4) lower serum dipeptidyl peptidase activity. In OCD no consistent or specific alterations in the IRS are observed. There is no evidence that IRS activation may play a role in the pathophysiology of OCD and anorexia nervosa.
Recent antipsychotics in the treatment of psychoses
Authors: Hoes M.J.A.J.M.
Published: July 2016

Antipsychotic drugs are effective in psychoses, whatever the etiology of the disorder. The positive symptoms tend to respond more readily. The need for developing new drugs arises from the refractoriness of the negative symptoms, the 10-25% of the patients that are treatment-resistant and the problems of short-, and long-term extrapyramidal side-effects. Thus far, six drugs, differing from the classical antipsychotics, have been licensedfor use: olanzepine, risperidone and quetiapine; the longest registration exists for sulpiride and clozapine while the most recent one is for amisulpride. This review starts with a brief introduction to symptomatology, and takes differences with the classical drugs in pharmacology, pharmacokinetics, clinical aspects and side-effects into consideration. Clozapine, risperidone and sulpiride may be considered for clinical use in refractory patients; these three, olanzapine and amisulpride when extrapyramidal side-effects cause a clinical problem. Amisulpride and sulpiride have a dual therapeutic acion: On negative symptoms at low dose, on positive symptomen at high doses.
Genotype-environment interactions and schizophrenia
Authors: Tienari P.
Published: July 2016

Nature and nurture are not separate. Instead it is important to investigate the interplay between genes and environment and how they influence on another. To an important degree, genetic effects on behavior come about because they either influence the extent to which the individual is likely to be exposed to individual differences in environmental risk or they affect how susceptible the individual is to environmental adversities.

The current inability to explain or predict which genetically predisposed individuals will finally become schizophrenic has forced us to confront our ignorance of the precise mechanism and mode of the transmission of this disorder. Zubin's proposal to view the schizophrenic as a vulnerable individual who develops a temporary episode only under certain provocations can help place the controversy in proper perspective. Vulnerability (predisposition, diathesis) to schizophrenia can be defined as the individual's characteristic treshold beyond which stressful events produce decompensation manifest in the clinically diagnosable symptom picture.
The case for an Xq21.3/Yp homologous locus in the evolution of language and the origins of psychosis
Authors: Crow T.J.
Published: July 2016

The distribution of schizophrenia within populations bears upon the genetic nature of the disorder. From the World Health Organization Ten-Country Study of incidence Jablensky et al concluded that: Schizophrenic illnesses are ubiquitous, appear with similar incidence in different cultures and have clinical features that are more remarkable by their similarity across cultures than by their difference.

The WHO study included populations in Japan, India and Europe that have been separated for tens of thousands of years. Moreover illnesses with essentially the same characteristics are commonplace in the Australian aboriginal population that separated from other human populations 50,000 years ago.
Genes for Alzheimer Dementia
Authors: Theuns J. , Van Broeckhoven C.
Published: July 2016

Alzheimer disease (AD), the most common form of dementia in the elderly, is rapidly becoming a major health problem in developed countries where the number of elderly people continuously grows due to improved medical care. Consequently, the number of AD patients is increasing and thus far no effective therapies are available. Clinically the disease can be diagnosed with 90% reliability on the basis of neurological examination, neuropsychological testing and brain imaging techniques. A definite diagnosis, however, requires the post-mortem detection of senile plaques (SPs) and neurofibrillary tangles (NFTs) in the brain. The SPs are extracellular deposits mainly composed of amyloid P (Ap) surrounded by dystrophic neurites. NFT are intraneural inclusions of paired helical filaments composed of hyperphosphorylated tau.

Although age is the major risk factor for AD, population survey and family studies have provided substantial evidence that genetic factors are major contributors to the expression of AD.
Neuropsychiatrie of biologische psychiatrie; een toekomstvisie in historisch perspectief
Authors: Verhoeven W.M.A. , Tuinier S.
Published: July 2016

Neuropsychiatry or Biological Psychiatry There is an urgent need to reconsider the position of psychiatry within the neurosciences because of the exploding knowledge about the relationship between brain and behaviour and the delay in implementation of new findings due to the separation of neurology and psychiatry. Biological psychiatry and psychopharmacology originate from the discovery by chance of psycho-active compounds in the early fifties and have contributed to the scientification of psychiatry. The impact of biological psychiatry for the pathophysiology of psychiatric disorders, however, is limited as a result of its biased orientation on neurotransmitters and receptors. The neuropsychiatric paradigm integrates knowledge from several domains, such as functional neuroanatomy, genetics and endocrinology and opens new vistas for the involvement of neuronal circuits in the initiation and maintenance of behavioural disturbances. In addition, novel and more specific treatment modalities may emerge.
Atypical psychoses
Authors: Pepplinkhuizen L.
Published: July 2016

The European psychiatric literature is rich in descriptions and studies of atypical psychotic disorders. Most of these are finally deemed to be varieties of the affective or schizophrenic disorders, which in turn are regarded to be typical.

The acute polymorphic psychotic disorder according to the ICD-10, and the periodic catatonia of Gjessing, although hardly recognized and acknowledged, are good candidates to be considered as separate psychotic disease entities.
Neuropsychiatrie aspects of HIV infection
Authors: Timmerman L. , van Zonneveld Th. , van den Heuvel O.A.
Published: July 2016

Human immuno deficiency virus may cause a broad spectrum of psychiatric sequelae. In this review we discus the possible associations between HIV infection with psychosis, mild neurocognitive disorder and dementia. The cerebral reserve model gives an explanation why HIV infected individuals with low educational level and/or intravenous drug users are more vulnerable to direct and indirect neurotoxic effects of HIV.
Repliek op ‘Empirische indicatoren voor regressies en sprongen bij baby's’
Authors: Plooij F.X.
Published: July 2016

Deze repliek zal uit twee delen bestaan. Ten eerste zal ik mijn onderbouwde kritiek op de falsificatie onderzoeken van Van Geert & De Weerth (VG&DW) geven. Ten tweede zal ik de kritiek van VG&DW op de verificatie onderzoeken weerleggen.
Naturalistic assessments in psychiatry
Authors: Devries M.W. , Kaplan C.D. , Delespaul P.A.E.G.
Published: July 2016

Research in psychiatry could speeden its progress by taking the manifest heterogenity and variability of symptom expression within diagnostic groups more fully into account. Since Kraepelin symptom variation has been recognized to have both biological and environmental roots. If investigated systematically, such variations in illness experience will yield new subtypes that will provide greater insight into the onset, course and vulnerability of mental disorders. Studies ranging from population surveys to the laboratory have demonstrated that psychopathology is not randomly distributed in a population, nor is it constantly present in the lives of individuals. At both the population and the person levels, psychopathology varies with time and place. At the population level, illness processes localize in risk groups, who often reside in specific neighbourhoods or social settings. The individual experience of psychopathology also fluctuates with time, place and culture. This variability requires methods for case detection and treatment planning that take this into account.
The prospect of new anxiolytic principles
Authors: Griez E.J.L.
Published: July 2016

Novel anxiolytics notwithstanding, in the latest fifteen years there have been no major innovations in the treatment of anxiety disorders. Fascinating research is going on, but real breakthroughs will require adequate models of disease, based on the disordered physiology of each type of pathological anxiety. In this brief overview, we will address both the field of potential anxiolytics in 1997, and the development of new experimental models of anxiety disorders.
Biological aspects of social phobia
Authors: van Vliet I.M.
Published: July 2016

In contrast to the research in panic disorder, not much neurobiological studies have been conducted in social phobia. In challenge-tests using lactate or pentagastrin general anxiety and anxiety symptoms were induced in social phobies, although not as frequent is in panic disorder patients, but no specific social phobic anxiety was induced. The role of neurotransmitters such as serotonin, dopamine and noradrenalin is, as yet, unclear. There are no indications for abnormal hypothalamic-pituitary-adrenal-axis activity or abnormal hypothalamic-pituitary-thyroid-axis activity in social phobia. To the present, preliminary findings in neuroimaging studies show no differences between patients and controls, except a possibly diminished and reversible metabolic activity.
Treatmentstrategies in refractory panic disorder
Authors: Timmerman L.
Published: July 2016

A considerable amount of patients with panic disorder (25 – 30%) is refractory for the first line of treatment, mostly antidepressants, and for psychotherapy. Augmentation and combination strategies are discussed; and a protocol for the treatment of refractory patients with panic disorder is proposed with consists of five steps.

No patients is considered treatment refractory until they have had a trial with monoamine oxidase inhibitors.
De ontwikkelingsneurologische theorie van schizofrenie: bewijsmateriaal betreffende structuur en neuropsychologic
Authors: Chua S.E. , Murray R.M.
Published: July 2016

Severe schizophrenics as a group show subtle abnormalities of cerebral structure. Cerebral ventricular enlargement is the best replicated finding, and this tends to be associated with impairment of neuropsychological performance. The idea that these abnormalities have a neurodevelopmental origin gains indirect support from the, admittedly less consistent, evidence of abnormalities of cerebral asymmetry and of neuronal migration in adult schizophrenics, as well as from the behavioural, psychomotor, and cognitive impairments reported in preschizophrenic children. However, the relationship between childhood and adult neuropsychological and brain structural findings has not been proven, and we do not know whether only some schizophrenics have a developmental origin, or whether patients differ only in the degree of developmental impairment that they show.
Sleep regulation: physiological models and hypotheses
Authors: Borbély A.A.
Published: July 2016

The elucidation of sleep regulation is not an easy task. On one side, there is a multitude of solid yet disparate data, on the other side, the topic is tempting for engaging in wild speculation, particularly with respect to the functions of sleep. Models may exert a moderating influence by mediating between the two extremes. However, also they navigate between the risk of banality in reformulating the obvious, and the peril of fancy in losing touch with empirical reality.
Spectral analysis of the sleep EEG of depressed patients before and after total sleep deprivation
Authors: Beersma D.G.M. , van den Hoofdakker R.H.
Published: July 2016

Sleep electroencephalography in depressed patients reveals many signs of disrupted sleep, like long sleep latency, frequent awakenings, reduced amounts of time spent in the sleep stages 3 and 4, and early morning wakefulness. Upon total deprivation of sleep for one night, many patients experience an unexpected alleviation of their depression, which usually lasts until the subsequent sleep period. Attempts have been made to explain these changes of mood to result from induced changes in sleep physiological mechanisms. Such attempts can roughly be categorized in two classes. One class of hypotheses concerns proposed disturbances in circadian sleep control (i.e. the timing of sleep is inappropriately controlled), the other class concerns postulated disrupted homeostatic sleep control (i.e. the intensity of sleep is inappropriately controlled). For both types of theoretical approaches data have been published which are consistent with the hypotheses as well as data which are not.
Circadian rhythms and sleep regulation in seasonal affective disorder
Authors: Wirz-Justice A. , Kräuchi K. , Brunner D.P. , Graw P. , Haug H.-J. , Leonhardt G. , Sarrafzadeh A. , English J. , Arendt J.
Published: July 2016

Seasonal affective disorder (SAD) is characterised by recurrent episodes in autumn and winter of depression, hypersomnia, augmented appetite with carbohydrate craving, and weight gain, and can be successfully treated with bright light. Circadian rhythm hypotheses (summarized in) have stimulated research into the pathophysiology of SAD, postulating that:

1.The illness is a consequence of delayed phase position,

2.It is correlated with diminished circadian amplitude, or

3.It results from changes in the nocturnal duration between dusk and dawn e.g. of low core body temperature or melatonin secretion. Light is considered to act directly on the circadian pacemaker (‘Process C’) and not on sleep dependent processes (‘Process S’). Thus successful treatment of SAD must act via mechanisms within known retinohypothalamic pathways. Conversely, emergence of SAD symptoms may reflect inappropriate neurobiological response to decreasing daylength.
A longitudinal study of sleep deprivation responses in depression; The variability is highly related to diurnal mood variability
Authors: Gordijn M.C.M. , Beersma D.G.M. , Bouhuys A.L. , Korte H.J. , van den Hoofdakker R.H.
Published: July 2016

Unequivocal results demonstrating a causal relationship between a disturbance in circadian rhythms and depression have not yet been reported (reviews). However, acute mood changes, such as the antidepressive effect of sleep deprivation, diurnal variations of mood and their interrelationship, are commonly put forward as evidence of the importance of circadian dysregulations in affective disorders. The purpose of the present study is to obtain more insight in the mechanisms underlying these mood changes. The results will be discussed in the context of a recently postulated non-chronobiological explanation.

Earlier studies have suggested that the relationship between diurnal variation of mood and the response to total sleep deprivation (TSD) is clear and unambiguous: improvement of mood during the day prior to TSD (a positive diurnal variation) is followed by a positive response (mood improvement) to TSD, while no improvement or deterioration of mood during the day prior to TSD (a negative diurnal variation) may result in no, or even a negative, TSD response (for references see Van den Hoofdakker). However, these conclusions were based on the results from cross-sectional studies, comparing single TSD effects across individuals. Comparison of sleep deprivation effects within individuals, however, revealed that the course of mood during the day prior to TSD is irrelevant for the TSD response. Accordingly, a favourable response to TSD appeared to be related to the patient's propensity to show diurnal mood variations per se, irrespective of their direction.
Acta Neuropsychiatrica; Tijdschrift voor een hedendaagse neuropsychiatrie
Authors: Verhey F.H.M.
Published: July 2016

Samenvatting

De psychiatrie benist op een evenwichtige combinatie van gedragswetenschappelijke (ontwikkelingspsychologische en sociale) en natuurwetenschappelijke (neuropsychiatri-sche) dementen. Ofschoon klinici werkzaam in de gezondheidszorg er vaak in slaagden dit evenwicht rede-lijk te handhaven, werd de officiële psychiatrie tot voor kort meestal nogal modieus gedomineerd door een van deze deelgebieden. Uitgroei tot volwassenheid van de psychiatrie vraagt in deze fase om een aanvulling van de in de laatste decennien sterk tot de verbeelding sprekende psychologische en sociale dementen met de verworvenhe-den van een nieuwe neuropsychiatrie. Geschetst wordt waar uit deze verworvenheden bestaan en hoe deze effectief in de psychiatrische gezondheidszorg onderwijs en onderzoek ingebouwd kunnen worden. Het binnen de psychiatrie tot ontwikkeling brengen van een toegepaste klinische psychofysiologie van essentieel belang.
Stressors and anxiety in dementia caregiving: multiple mediation analysis of rumination, experiential avoidance, and leisure
Authors: Romero-Moreno R. , Losada A. , Márquez-González M. , Mausbach B. T.
Published: July 2016

Background:

Despite the robust associations between stressors and anxiety in dementia caregiving, there is a lack of research examining which factors contribute to explain this relationship. This study was designed to test a multiple mediation model of behavioral and psychological symptoms of dementia (BPSD) and anxiety that proposes higher levels of rumination and experiential avoidance and lower levels of leisure satisfaction as potential mediating variables.

Methods:

The sample consisted of 256 family caregivers. In order to test a simultaneously parallel multiple mediation model of the BPSD to anxiety pathway, a PROCESS method was used and bias-corrected and accelerated bootstrapping method was used to test confidence intervals.

Results:

Higher levels of stressors significantly predicted anxiety. Greater stressors significantly predicted higher levels of rumination and experiential avoidance, and lower levels of leisure satisfaction. These three coping variables significantly predicted anxiety. Finally, rumination, experiential avoidance, and leisure satisfaction significantly mediated the link between stressors and anxiety. The explained variance for the final model was 47.09%. Significant contrasts were found between rumination and leisure satisfaction, with rumination being a significantly higher mediator.

Conclusions:

The results suggest that caregivers’ experiential avoidance, rumination, and leisure satisfaction may function as mechanisms through which BPSD influence on caregivers’ anxiety. Training caregivers in reducing their levels of experiential avoidance and rumination by techniques that foster their ability of acceptance of their negative internal experiences, and increase their level of leisure satisfaction, may be helpful to reduce their anxiety symptoms developed by stressors.