摘要:

ABSTRACTMaximum nocturnal serum melatonin level (MTmax) in relation to some clinical variables was studied in 32 patients with a major depressive episode and in 33 healthy subjects with reference to the outcome of the dexamethasone suppression test (DST). Significant regressions were found between MTmaxlevels and clinical rating scores in CPRS, interpreted as retardation symptoms. Four healthy subjects with disposition for dysthymic reactions had subnormal MTmaxlevels, which differed from MTmaxlevels in subjects without such disposition. Patients but not the healthy subjects, who reported parental loss before 17 years of age, had subnormal MTmaxlevels and differed from patients with no reported parental loss. Patients with no reported suicidal behaviour in clinical history had significantly lower MTmaxlevels than patients with reported suicide attempts. No relations were found between low MTmaxlevels and diagnoses, duration of illness, reported inheritance for depressive illness or sleep disturbances. A hypothetical low melatonin syndrome in depression is proposed: 1) low nocturnal melatonin, 2) abnormal dexamethasone suppression test, 3) disturbed 24‐h rhythm of cortisol, 4) less pronounced daily and annual cyclic variation in depressive symptomatolog

ISSN:0001-690X    

DOI:10.1111/j.1600-0447.1985.tb02531.x

出版商:Blackwell Publishing Ltd    

年代:1985

数据来源: WILEY

摘要:

ABSTRACTAn association between premenstrual dysphoric changes and depressive disorders is demonstrated in 170 women. Each woman underwent an evaluation for current and life‐time diagnosis using the Research Diagnostic Criteria (RDC). Premenstrual dysphoric changes were evaluated with the Premenstrual Assessment Form (PAF). Criteria for PAF Full Depressive Syndrome were met by 57 % of women with a life‐time diagnosis of Major Depressive Disorder. Only 14 % of the Never Mentally 111 women met these PAF criteria. Eighty‐four percent of those who had PAF Full Depressive Syndrome also had RDC Major Depressive Disorder while only 9 % were Never Mentall

ISSN:0001-690X    

DOI:10.1111/j.1600-0447.1985.tb02532.x

出版商:Blackwell Publishing Ltd    

年代:1985

数据来源: WILEY

摘要:

ABSTRACTTwo hundred and fifty female patients about to undergo elective gynaecological surgery, were randomly allocated to a single oral dose of either 5, 15, 30 mg Org 3770, placebo, or 10 mg diazepam the evening before operation. Assessment of sleep quality next morning using self‐rated questionnaires showed that both Org 3770 and diazepam were significantly better than placebo in enhancing sleep. In addition, a dose‐response effect was seen with Org 3770, 15 mg seeming optimal. Assessment of pre‐surgery anxiety, again using self‐rated questionnaires, showed that 15 mg Org 3770, and 10 mg diazepam were significantly more effective than placebo at reducing anxiety. None of the medications produced any troublesome side effects nor did they have an effect on blood p

ISSN:0001-690X    

DOI:10.1111/j.1600-0447.1985.tb02533.x

出版商:Blackwell Publishing Ltd    

年代:1985

数据来源: WILEY

摘要:

ABSTRACTRenal function was examined in 153 manic‐depressive patients treated with lithium for more than 5 years, mean 10 years. No significant change was detectable in plasma creatinine. Giomerular filtration rate (GFR) decreased slightly, but significantly, and not until afier 17 years of treatment did the regression line reach the lower confidence limit in the reference material. GFR was generally only moderately decreased. Renal concentrating capacity was significantly reduced during the whole investigation period and did not change with time. GFR was independent of the dosage pattern. The diuresis did not differ markedly in patients given one or three daily doses. In a two‐dose group predominantly treated with slow‐release tablets, the diuresis was somewhat higher in 75 % of the patients but much higher for the rest of the group. Since the prophylactic effect of lithium was the same in the one‐dose group (mean dosage 21 mmol/day) as in the two‐dose and three‐dose groups (mean dosage 27–28 mmol/day), our data indicate that generally employed lithium doses may be reduced somewhat without loss of prophyla

ISSN:0001-690X    

DOI:10.1111/j.1600-0447.1985.tb02534.x

出版商:Blackwell Publishing Ltd    

年代:1985

数据来源: WILEY

摘要:

ABSTRACTPrevious publications have given the impression that phobic states do not exist, or are very rare, in Africa south of the Sahara. This study has shown that this impression is erroneous. One of the explanations for this stems from the fact that African psychiatric patients tend to present with predominantly somatic complaints. These complaints mask the underlying illness making diagnosis very problematic. In an in‐depth study of a sample of psychoneurotic patients, in Nigeria, phobic states were found to account for the complaints made by a substantial number of the patients. The type of objects to which fears tend to be bound in African patients are not often the same as those in Western society. This offers another explanation why identification of phobic states might have been missed by the previous writers. The socio‐cultural and psychodynamic aspects af this illness in the African are discussed, as well as the effects which such factors may have on the physician‐patient relationship, their relevance in diagnosis‐making and in successfully implementing psychotherapy for the p

ISSN:0001-690X    

DOI:10.1111/j.1600-0447.1985.tb02535.x

出版商:Blackwell Publishing Ltd    

年代:1985

数据来源: WILEY

摘要:

ABSTRACTResults are presented on the current prevalence rates of psychiatric disorder in 2,588 non‐institutionalized persons aged 65 and older who were drawn from a probability sample of New Haven, Connecticut, and 12 surrounding towns in South Central Connecticut. Based on the Diagnostic Interview Schedule (DIS), 6.7 % of the respondents had a psychiatric diagnosis (DSM‐III), and based on the Mini‐Menial Status Exam (MMS), 3.4 % had severe cognitive impairments during the past 6‐month period. Therefore, more than 10 % currently had either a psychiatric or a severe cognitive problem. Overall, these rates of psychiatric disorders are lower than those found in adult populations under age 65. As with younger samples, anxiety and affective disorders were among the most common psychiatric problems. The majority of elderly reported themselves in good emotional and physical health and felt they had sufficient finances to meet their needs. The rate of severe cognitive impairment did not increase until after age 79. Among those 80 years and older, cognitive impairments were more common in women than men, probably due to differential survival rates. Since less than 6 % of the elderly sample are living in institutions these results among non‐institutionalized elderly point to the relative psychiatric well‐being of the majority of the elderly. However, in view of the longer life expectancy, the next decade will see an increase in the absolute number of persons with cognitive

ISSN:0001-690X    

DOI:10.1111/j.1600-0447.1985.tb02536.x

出版商:Blackwell Publishing Ltd    

年代:1985

数据来源: WILEY

摘要:

ABSTRACTOne hundred and fifty‐one patients (140 females ‐ 11 males) with anorexia nervosa (AN) from three departments (child psychiatry, psychiatry, and internal medicine) were re‐examined 4–22 years (average 12.5 years) after their first contact with the Rigshospital in Copenhagen. During the years 1960–76 the number of referrals was on the increase, and relatively more patients were treated in the psychiatric departments at the end than at the beginning of the period. Mean age was 16.6 years at onset, 19.0 years at primary contact. Mean weight loss was 32 %. Mean duration of treatment was 12 months. Differences between the three departments concern especially age, sex, and duration of treatment. Mean age at follow‐up was 31.0 years (range 16–63 years) for surviving probands. Follow‐up information originated from semi‐structured personal interviews (in 80 % of surviving probands) together with register data on all probands, supplemented by extensive hospital data. Nine patients (6 %), including six who committed suicide, died on the average 7.3 years after primary contact (average age 27.1 years). The mortality rate was 0.5 % per year. At follow‐up one fourth of the surviving probands had AN and one fourth suffered from other psychiatric disorders, while one half were free from mental illness. There were no significant differences in outcome between the three departments. As a whole, the group experienced a social decline. It is concluded that a substantial part of this group of AN patients had a poor prognosis with a tendency towards chronicity, despite relatively long and intensive treatment, but, on the other hand, about one half of the probands seemed to be healthy a

ISSN:0001-690X    

DOI:10.1111/j.1600-0447.1985.tb02537.x

出版商:Blackwell Publishing Ltd    

年代:1985

数据来源: WILEY

摘要:

ABSTRACTIn order to apply the Comprehensive Psychopathological Rating Scale (CPRS) to psychiatric clinical practice in Japan we have made a preliminary Japanese version and examined the doctor to doctor and doctor to nurse inter‐rater reliability. Compared with the high reliability of the items of reported psychopathology, the coefficients of correlation of observed psy‐chopathology were considerably scattered. Education and training of the rater may improve the reliability. It is considered that the CPRS will become a very useful psychiatric rating scale in Ja

ISSN:0001-690X    

DOI:10.1111/j.1600-0447.1985.tb02538.x

出版商:Blackwell Publishing Ltd    

年代:1985

数据来源: WILEY

摘要:

ABSTRACTThis longitudinal study of primiparous women concerns factors related to the quality of the marital relationship 4 1/2 years after the birth of the first child. Information was independently collected from the women, their husbands and children. A poor relationship to the partner and impaired mental health in the women post partum were associated with marital disharmony at follow‐up. In disharmonious marriages more often than in others parents were estimated to have a rejecting attitude towards their child and the child to have a rejecting attitude towards its parents. Further, in these marriages poor parental relationships of boys were more common than those of girls and socially immature boys as compared to socially immature girls overrepresente

ISSN:0001-690X    

DOI:10.1111/j.1600-0447.1985.tb02539.x

出版商:Blackwell Publishing Ltd    

年代:1985

数据来源: WILEY

摘要:

ABSTRACTThe present study comprises all deaths in Norwegian psychiatric hospitals in 1950–74 with the diagnosis of non‐organic (functional) psychosis: 5106 deaths. Mortality declined in both sexes as did excess mortality which is now 1.7 times the general population in the male, and 2.3 times in the female sex. However, a significant rise in unnatural deaths (suicides and accidents) took place in both sexes during 1963–74, as mortality increased 2–3 times in comparison with 1950–62. This rise in unnatural deaths is probably directly related to the introduction of drug therapy, which created an increased need for protection of the hospital population. A challenge which the accompanying changes in the hospital environment have failed to meet. Cardio‐vascular mortality increased considerably during 1963–74 in both sexes. The rise is most likely the combined result of an adverse effect of drug therapy in individual patients (obesity, physical inactivity, increased smoking habits), the reduced stress‐relieving effect of hospitalisation through shorter stays in hospital and the liberalisation policy. We may not yet have experienced the total adverse effect on mortality of the increase in behavioural risk factors in psychiatric patients. It is suggested that future mortality studies include psychiatr

ISSN:0001-690X    

DOI:10.1111/j.1600-0447.1985.tb02540.x

出版商:Blackwell Publishing Ltd    

年代:1985

数据来源: WILEY