bluuebunny/crossref_metadata_2025_split huggingface dataset:
Risk factors in neuroleptic malignant syndrome. A case–control study
Authors: Viejo L. F. , Morales V. , Puñal P. , Pérez J. L. , Sancho R. A. 
Published: March 2003

Objective: To determine whether environmental temperature, agitation, neuroleptic use, mental retardation, and affective disorders were risk factors for neuroleptic malignant syndrome (NMS).Method: Cases and age‐ and sex‐matched psychiatric controls admitted to a regional acute psychiatric unit over a 10‐year period.Results: Both uni‐ and multivariate analysis revealed statistically significant differences between patients with NMS (n=15) and controls (n=45) with regard to the presence of mental retardation, psychomotor agitation, and a number of variables relating to neuroleptic use (newly introduced or increased, intramuscular administration, and dosage). We found no differences between NMS patients and psychiatric controls in respect of changes in environmental temperature.Conclusion: Our study supports the need for caution when using intramuscularly administered, abruptly increasing, high‐dose neuroleptics, particularly in mentally retarded or agitated patients, regardless of environmental temperature.
Differences in fMRI and MRS in a monozygotic twin pair discordant for schizophrenia (case report)
Authors: Španiel F. , Hájek T. , Tintěra J. , Harantová P. , Dezortová M. , Hájek M. 
Published: March 2003

Objective:  This paper presents functional magnetic resonance imaging (fMRI) and magnetic resonance spectroscopy (MRS) findings in a monozygotic twin pair discordant for schizophrenia.Method:  Functional magnetic resonance imaging was used to determine hemispheric lateralization for speech and proton MRS (1H‐MRS) was employed to assess the extent of putative insult to anterior hippocampus.Results:  Despite concordant right handedness, subject with schizophrenia displayed bilateral activation in areas subserving speech with greater extent of the total activated area compared with the healthy twin. The affected twin displayed relative bilateral decrease in N‐acetylaspartate/creatin concentration in the anterior hippocampus compared with the healthy one.Conclusion:  This is an evidence for non‐genetic impairment of cerebral lateralization in monozygotic twin with schizophrenia.
The abnormal development of drive and guidance mechanisms in the brain: the pathogenesis of schizophrenia
Authors: van Hoof J. J. M. 
Published: March 2003

Background:It remains a mystery as to how genetic and environmental factors cause schizophrenia.Objective:To develop a pathophysiological model of schizophrenia that has greater explanatory power than existing hypotheses of the disorder.Method:Published findings on schizophrenia are integrated with more recent data from human and animal studies of striatal and cerebellar functions.Results:The analysis shows that during phylo- and ontogenesis two primarily motor-control mechanisms are applied at the intentional (limbic) level of functioning to organize emotional and cognitive behavior: one for initiating and dosing (drive) and the other for the representational guidance (guidance) of both movements and intentions. The intentional drive and guidance mechanisms are organized through a ventral, respectively, a dorsal cortical–subcortical circuitry.Conclusions:A deficient implementation of these mechanisms at the limbic domain manifests itself as schizophrenia, whereby the heterogeneity in symptomatology is explained by the extent of the remaining cerebral activity and by the degree of indirect activation of these systems. In general, activation manifests itself as positive symptomatology and the absence of such activation as negative symptomatology. The model provides a more comprehensive explanation for existing clinical and epidemiological data than do the current alternatives. It is compatible with the major prevailing views on the illness, such as the theories that regard this as a progressive neurodevelopmental, or a connectivity disorder, or one resulting from a deficient cerebral lateralization, or an interrupted cortico–thalamo–cerebello–cortical circuitry. The model fits with recent theories in evolutionary psychology and evolutionary psychiatry.
Effects of age and gender on the classification and phenomenology of unipolar depression
Authors: Maes M. 
Published: March 2003

Aim:The aim of the present study was to examine the effects of age and gender on depressive classification and phenomenology in unipolar depressed in-patients.Methods:The authors have assessed 14 items relevant to depressive symptomatology from the Structured Clinical Interview for DSM-III (SCID) and the Hamilton Depression Rating Scale (HDRS) in 180 depressed in-patients.Results:Melancholia was significantly more prominent in older depressed patients (≥ 55 years), whereas minor depression (i.e. adjustment disorder with depressed mood and dysthymic disorder) in younger (< 55 years) depressed subjects. Older depressed subjects exhibited significantly more anorexia/weight loss, non-reactivity, depressed mood, loss of interest, early morning awakening, loss of energy, somatic anxiety, loss of insight, psychotic symptoms and retardation than younger depressed people. Male depressed subjects showed significantly more loss of interest, suicidal ideation and agitation than their female counterparts. Psychomotor disorders, a distinct quality of mood and early morning awakening were characteristics of older depressed males, while diurnal variation occurred more frequently in older depressed females.Conclusion:It is concluded that increasing age in unipolar depression may be accompanied by an increase in severity of illness, increased frequency of some melancholic symptoms, particularly in men and a higher frequency of major depression in women and of melancholia in men.
Treatment of interictal psychiatric disorder in epilepsy. II. Chronic psychosis
Authors: van der Feltz-Cornelis Cm 
Published: March 2003

Background:Interictal psychosis is a serious comorbid condition in epilepsy patients that would benefit from treatment with psychotropic medication.Objective:This paper gives an overview of the pathophysiology, symptomatology and treatment of the schizophrenia-like psychosis of epilepsy. Use of the term ‘interictal chronic psychosis’ is suggested, to conform to current DSM-IV classification of schizophrenia.Methods:Literature review supplemented by clinical experience. There is a lack of randomized control trials (RCTs) concerning effectiveness and side-effects of neuroleptics in epilepsy patients.Results:Hypotheses concerning the pathophysiology of the interictal chronic psychosis are discussed. The concept of forced normalization and alternative psychosis is based on case descriptions, and was not substantiated by systematic research. The kindling hypothesis seems promising, but was never confirmed in humans. A third theory, supported by some studies, suggests that inhibitory cerebral mechanisms enhance psychotic symptoms in epilepsy patients. Treatment strategies are based on case studies and open studies by lack of RCTs. Treatment should consider the optimalization of the dosage of antiepileptics in combination with one or two antidepressants, mood stabilizers and/or atypical neuroleptics. Surgery plays no significant role in the treatment of treatment-refractive epilepsy with interictal chronic psychotic symptoms.Conclusion:There is a prominent role of antidepressant or double antidepressant treatment strategies in patients with epilepsy and interictal chronic psychosis compared with treatment guidelines of chronic psychotic patients in general psychiatry.
Affect regulation in borderline personality disorder: experimental findings from psychophysiology and functional neuroimaging
Authors: Herpertz S. C. , Dietrich T. , Werth U. , Qunaibi M. , Lukas G. , Schuerkens A. , Kunert H.-J. , Freese R. , Flesch M. , Mueller-Isberner R. , Osterheider M. , Sass H. 
Published: March 2003

Background:Intense and rapidly changing mood states are a major feature of borderline personality disorder (BPD), which is thought to arise from affective vulnerability.Objective:There have been only a few studies investigating affective processing in BPD, and particularly neither psychophysiological nor neurofunctional correlates of abnormal emotional processing have been identified so far.Methods:Studies are reported using psychophysiological or functional neuroimaging methodology.Results:The psychophysiological study did not indicate a general emotional hyperresponsiveness in BPD. Low autonomic arousal seemed to reflect dissociative states in borderline subjects experiencing intense emotions. In the functional magnetic resonance imaging study enhanced amygdala activation was found in BPD, and it is suggested to reflect the intense and slowly subsiding emotions commonly observed in response to even low-level stressors.Conclusions:Implications for psychotherapy are discussed.
Catatonia: the rise and fall of an intriguing psychopathological dimension
Authors: van der Heijden F. M. M. A. , Tuinier S. , Pepplinkhuizen L. , Verhoeven W. M. A. 
Published: March 2003

Background:For at least 125 years the discussion about the clinical relevance of catatonic symptoms in psychiatry continues. It started from the original description by Kahlbaum and was revived by modern factor analytical studies, that identified the catatonic dimension in about 10% of newly admitted patients.Objective:Over a period of 2 years, four patients with an acute episodic psychosis and prominent catatonic symptoms were examined.Methods:A clinical description is given of the psychopathology and classification is performed according to the various diagnostic instruments.Results:All patients showed a circular fluctuation of their psychoses, with motor symptoms ranging from the excited to the inhibited pole within one episode. Their clinical pictures also comprised mood swings and anxieties as well as hallucinatory and delusional experiences, whereas the course of disease was characterized by complete recovery without residual symptoms.Conclusions:The significance of catatonic symptoms is not recognized in the current taxonomies despite the fact that this has major pharmacological treatment implications.
Depression and Parkinson's disease: a conceptual challenge
Authors: Leentjens A. F. G. , Verhey F. R. J. 
Published: March 2003

Aim:To explore the relation between Parkinson's disease (PD) and depression from a conceptual point of view.Methods:Discussion of the relevant literature on the conceptual, phenomenological and therapeutical aspects of depression in Parkinson's disease.Results:Both semantic confusion and an erroneous belief in the mind-body distinction have contributed to some common misunderstandings of the nosology and etiology of depression in Parkinson's disease.Conclusion:The consequences of a different, integrated, neuropsychiatric approach for both diagnosis and treatment are discussed.
Stress, cortisol and memory as markers of serotonergic vulnerability
Authors: Riedel Wim J. , Sobczak Sjacko , Nicolson Nancy , Honig Adriaan 
Published: March 2003

Objective:In the present paper the association of stress-induced cortisol with memory impairment is discussedMethods:An experiment is described in which an attempt is made to block stress-induced cortisol by lowering 5-HT neurotransmission by means of acute tryptophan depletion (ATD). Forty-five healthy control subjects participated in the experiment.Results:Stress-induced peak cortisol and immediate memory performance were negatively associated. ATD tended to block stress-induced cortisol response. ATD also blocked the association between peak cortisol response and memory impairment.Conclusions:Stress-induced cortisol and its association with memory impairment is mediated at least partially by serotonin.
Influence of cognitive reserve on neuropsychological functioning in Parkinson's disease
Authors: Sánchez Juan L , Rodríguez Marina , Carro Juan 
Published: March 2003

Background:In recent years, attention has been drawn to the association between a low level of education and dementia, an almost generalized finding in the majority of studies on the prevalence of dementia where the level of education of the population was highly diversified. The protective effect of education is not limited to Alzheimer's disease but is also seen in other types of dementia, Parkinson's disease (PD), and even in the cognitive deterioration linked to agingObjective:To evaluate neuropsychological performance in (PD) subjects and to evaluate the influence of cognitive reserve (RC) on their neuropsychological performance.Subjects:An extensive neuropsychological battery of tests was applied to a total of 79 subjects, 33 of whom were diagnosed with PD.Measures:RC scores were based on a combination of years of education, a measure of occupational attainment, and an estimate of premorbid intelligence.Results:As regards the specific disturbances found in the clinical group subjects, a lower performance in memory, attention, visuospatial, visuoconstructive, and perceptive skills was seen. With respect to our second objective, our results showed that patients diagnosed with PD who had a high RC reached a higher neuropsychological level of performance than those subjects with a low reserve.Conclusions:Early neuropsychological impairments in PD are most evident in individuals with lower RC. As has been found in other neurological disorders, individuals with greater RC may be less sensitive to the initial clinical effects of the underlying neuropathological process.
Stress, work and mental health: a global perspective
Authors: deVries Marten W , Wilkerson Bill 
Published: March 2003

Background:The United Nations, WHO and the World Bank have called the current prevalence rate of neuro-psychiatric disorder approaches of 1 in 4 individuals worldwide and ‘unheralded public health crisis’. Rates are driven by an early onset, high impairment and high chronicity of these disorders. Most importantly, detection and treatment rates are low, estimated at les than 10% worldwide resulting in 500 million people underserved. The related economic costs soared in 1999 to 120 billion dollars in Europe and North America, with over 60 billion dollars assigned to stress related disorders. Contributing factors are bio-psycho-social and include rapid social change as well as the time compression of modern life resulting in the experience of increased work-life stress that parallels a decade long intensification of activities in the workplace. Coping with the requirements of the new economy of mental performance has lagged behind at many individual and social levels as we cling to adjustments made during the industrial economy of the last century. A climate of transition, and more recently, terror and fear have stressed the landscape of mental health and work already ravaged by the destructive forces of stigma.Aim:This presentation will examine the other side of prosperity from the point of view of stress in the workplace as two global problems converge at this time in history, the escalation of neuro-psychiatric disorders and the increasing dependence on the mental faculties of the world's citizens.In this paper we also discuss how the international community can work together to help reduce the burden of mental disorders worldwide and sketch the implications for research and policy.Conclusions:Ultimately the media will need to be enlisted to educate the public on the value of investments in mental health.
Prague women's drinking before and after the ‘velvet revolution’ of 1989: a longitudinal study
Authors: KUBIČKA LUDĚK , CSĚMY LADISLAV , KOŽENÝ JIŘÍ 
Published: March 2003

AbstractResults are presented of a follow‐up study in which a representative sample of 608 Prague women aged 20–49 years in 1987 at first interview was re‐interviewed in 1992 3 years after the revolution that ended the 41 years of the Communist era in Czechoslovakia. The average yearly consumption of alcohol in the followed‐up female sample increased between 1987–92 from a reported 3.6 litres to 4.8 litres. The percentage of heavier drinkers (with average daily consumption of over 20 g alcohol) increased from 7.2% to 14.0%. The women expressed increased tolerance of drunkenness in their attitudes to drinking. The consumption increase was mainly due to increased drinking frequency of spirits and to increased quantity of beer consumed per occasion. The consumption increase was largest in women working as free‐lance and the newly emerging self‐employed women; economically inactive women did not increase their consumption. Women who reported a positive impact of the socio‐political changes on their personal lives and an expansion of social contacts also reported larger than average consumption increases. A coincidence of stressful, possibly self‐inflicted, life events and increased alcohol use was observed and interpreted as probably a two‐way influence.
Administration mode bias in a school survey on alcohol, tobacco and illicit drug use
Authors: BJARNASON THORODDUR 
Published: March 2003

AbstractSchool surveys have become the most common method for determining the general level of tobacco, alcohol and illicit drug use among adolescents in a large number of countries. The two most commonly applied field procedures in school surveys are teachers ‘and researchers’ administration of questionnaires. The impact of the difference between these two modes of administration has not been determined, although it has been argued that central involvement of teachers in data collection may decrease the perceived anonymity of the survey among students, and should thus be avoided. In a split‐half random sample of 3017 urban, Icelandic 16–20‐year‐old students, no statistically significant differences were found in reported use of licit or illicit drugs, not in the stated willingness to be honest between these two modes of administration. These results suggest that when students return their responses in sealed envelopes, the two modes of administration produce equally valid results.
Self‐reports of HIV risk behavior by injecting drug users: are they reliable“
Authors: GOLDSTEIN MARJORIE F. , FRIEDMAN SAMUEL R. , NEAIGUS ALAN , JOSE BENNY , ILDEFONSO GILBERT , CURTIS RICHARD 
Published: March 2003

AbstractWhile most studies of AIDS risk behavior rely on self‐reports, few studies have assessed the reliability of these reports. The present study examines self‐reports of drug‐related and sexual risk behavior among pairs of injecting drug users (IDUs) recruited from the streets in New York City. Since both members of the pair were interviewed, it was possible to compare their responses in order to assess reliability. Subjects reported on their contacts' demographic data (age, gender, race/ethnicity) and on shared risk behaviors, including syringe sharing. Despite the private and/or illegal nature of AIDS risk behaviors, IDU subjects were generally reliable in their reports of both demographic and AIDS risk behaviors.
Risk functions for alcohol‐related problems in a 1988 US national sample
Authors: MIDANIK LORRAINE T. , TAM TAMMY W. , GREENFIELD THOMAS K. , CAETANO RAUL 
Published: March 2003

AbstractTo assess the relationship of alcohol use and three types of alcohol‐related problems (ICD‐10 dependence syndrome, work problems and drunk driving), risk curves were developed for average number of drinks per day during last year (volume) and number of days drinking five or more drinks during one day (5 +). Using data from the I98S National Health Interview Alcohol Supplement, risk curves were derived from data on 22 102 current drinkers who consumed at least 12 drinks in the last year. The emphasis in this analysis was on the proportion of drinkers at lower levels reporting different types of problems. The results indicate that even at lower levels of drinking (volume averaging one or fewer drinks/day) there is considerable risk for drunk driving and less risk for work problems and alcohol dependence. The risk for all types of problems at lower and moderate levels of drinking was significantly higher for respondents who had five or more drinks during one day in the last year. These findings underscore the importance of examining risk (physical and social) at lower levels of drinking and for using both overall volume and heavier quantity per occasion drinking measures when assessing risk for any alcohol‐related problem.
After antagonization of acute opiate overdose: a survey at hospitals in Vienna
Authors: SEIDLER DAN , STUHUNGER GEORG H. , FISCHER GABRIELE , WOISETSCHLAEGER CHRISTIAN , BERZLANOVICH ANDREA , SCHMID RAINER , HIRSCHL MICHAEL M. , LAGGNER ANTON N. 
Published: March 2003

AbstractThis study describes the clinical management and characteristics of people who, following acute opioid overdose, are taken to hospital after efficient antagonization by the pre‐hospital emergency service. In addition, it defines areas of interest for further research. Over a 4‐month period (September‐December 1993) we collected data by a structured protocol sheet on patients' characteristics, anamnestic data on abuse and emergencies, clinical presentation, treatment by specific antidote and routine laboratory investigations. Outcome leas verified by retrospective review of prehospital and forensic data. We studied 77 subjects, predominantly young males, who were involved in 83 emergencies, mostly occurring at weekends. In more than 60% of cases a single administration of specific antidote sufficed to stabilize the patients; 64% of patients left hospital against medical advice after an average stay of less than 6 hours; 46% denied daily opioid abuse and half the subjects, especially younger drug‐users, seemed interested in counselling. This hospital‐based study did not provide reliable data on the epidemiology of opioid overdose. Clinical management is determined by experience, pragmatism and beliefs. Efforts towards secondary prevention of drug problems at emergency departments might be warranted, and further research on pattern and management of opioid overdose is needed.
Agreement between DSM‐III, DSM‐III‐R, DSM‐IV and ICD‐10 alcohol diagnoses in US community‐sample heavy drinkers
Authors: HASIN DEBORAH , LI QUN , MCCLOUD STEPHEN , ENDICOTT JEAN 
Published: March 2003

AbstractDSM‐III‐R, DSM‐IV and ICD‐10 definitions of alcohol dependence were all developed from the concept of the Alcohol Dependence Syndrome, and thus have a common theoretical link. This link is not shared by DSM‐III, and no link exists between definitions of abuse in the different classification systems. The level of agreement on diagnoses produced by the different systems has practical as well as theoretical implications. We tested this agreement in 962 US household residents randomly sampled and screened for heavier than average drinking in the last 12 months. Agreement for most comparisons involving diagnoses of current dependence ranged from good to excellent, with no clear pattern of lower agreement for DSM‐III. However, agreement on past dependence was sharply lower for comparisons involving DSM‐III than those involving the other classification systems. This appeared to be due to the DSM‐III requirement for physiological dependence and the apparently emerging nature of the disorder in this relatively young, non‐treatment sample. Comparisons for abuse were generally poor for current as well as past diagnoses. Implications of the findings are discussed.