摘要:

ABSTRACTThe current categorical approach has not proved successful in resolving the problem of classifying patients with both affective and schizophrenic features. A dimensional approach is suggested; postulating two interacting factors; “dissociotaxia”, a neurointegrative abnormality; and “hyperactivation”, an abnormality in activation regulation. The latter factor can convert dissociotaxia to associative dyscontrol and produce mixed schizoaffective features. Clinical‐phenomenological, prognostic, genetic‐familial, treatment response and biological evidence is reconsidered from this standpoint; and the preferability of the dimensional approach is suggested, both for understanding the underlying psychopathology, and for constructing a different classification system, extensible to other areas of

ISSN:0001-690X    

DOI:10.1111/j.1600-0447.1987.tb02931.x

出版商:Blackwell Publishing Ltd    

年代:1987

数据来源: WILEY

摘要:

ABSTRACTThe assessment of endogenous depression by means of the Newcastle Scales (1965, 1971) has been validated by their correlation with biological findings in many previous studies. However, reliability and cross validation studies are lacking for these scales. We found the reliability of the Newcastle Scales to be sufficient or at least moderate in a sample of 70 inpatients with major depression. In order to cross validate both scales, the clinical classification according to ICD‐9 and the assessment of the Newcastle Scales have been performed independently in a sample of 112 inpatients with Major Depressive Disorder (RDC). The rate of agreement between clinical diagnosis and classification according to the Newcastle Scales of endogenous depression is only fair. However, a modification of the diagnostic algorithm applied to the items of the Newcastle Scales I (1965) improves the rate of agreement considerably. The Newcastle Scale I turned out to represent a heterogenous concept without sufficient transferability. Modifications of both scales are propose

ISSN:0001-690X    

DOI:10.1111/j.1600-0447.1987.tb02932.x

出版商:Blackwell Publishing Ltd    

年代:1987

数据来源: WILEY

摘要:

ABSTRACTRegional brain glucose metabolism was investigated in healthy volunteers (n= 10) and in drug free schizophrenic patients (n= 20). The metabolism was determined by positron emission tomography (PET) with11C‐glucose as the tracer. Diagnosis of schizophrenia was made according to RDC and DSM III. Eight patients had their first psychotic episode, four patients had a subchronic course and eight patients had a chronic course with an exacerberation of their illness. Computed tomography (CT) of the brain were made in all the subjects. Regions of interest (n= 35) were drawn on displayed CT images and the marked regions were transferred to the corresponding slice of the PET examination. The PET investigation was made in a dimly lit, quiet room with the eyes of the subject covered. The time course of the11C‐glucose uptake was measured by a four ring PET scanner (PC‐384‐7B).Metabolic rates of glucose varied greatly among the schizophrenic patients investigated. The variance was significantly greater than that of the controls in most regions. Decreases in mean levels of metabolic rates were related to patients with subchronic or chronic courses. Changes in metabolism were not related to previous duration of neuroleptic treatment of the patients. Left‐right asymmetries were found in the temporal lobe (area 22) and the basal frontal cortex (area 11), the metabolic rates of the patients being lower on the left side compared to the controls. Asymmetry of the metabolic rate of the amygdala in hebephrenic patients was the opposite of that found in paranoid patients and controls. Negative correlations between regional metabolic rates and autistic or negative symptoms were found. Thus, the lower the metabolic rate was, the more autistic the patient. Metabolic rates were not correlated to atrophic changes of the brain.No basis for a specific alteration in frontal cortical metabolism of schizophrenics was obtained. Changes in regional metabolic rates in schizophrenia are suggested to reflect disturbances in more general mechanisms which are of importance in neuronal

ISSN:0001-690X    

DOI:10.1111/j.1600-0447.1987.tb02933.x

出版商:Blackwell Publishing Ltd    

年代:1987

数据来源: WILEY

摘要:

ABSTRACTRegional brain glucose metabolism was studied with positron emission tomography (PET) in healthy volunteers (n= 9) and schizophrenic patients (n= 15). The patients were in an acute phase of the disease and drug free. Cerebral metabolic rate with11C‐glucose as the tracer (CMRgl) was determined in both cortical and subcortical structures. In the healthy volunteers significant correlations were found between metabolic rates of some regions, but no relationships were found between CMRgl of limbic cortical areas and that of neocortical or subcortical structures. In the patients, high and significant positive correlations were found between metabolic rates in the neocortical areas, the limbic cortical areas and the subcortical areas. The results indicate differences in the neuronal interplay between regions of healthy and schizophrenic subjects. It is proposed that neuronal systems guiding the specificity and diversity in neuronal functions between different brain regions, are abnormal in schizophrenic patients. Such a disturbance may be the basis for the diversity of psychiatric symptoms in schizophrenic

ISSN:0001-690X    

DOI:10.1111/j.1600-0447.1987.tb02934.x

出版商:Blackwell Publishing Ltd    

年代:1987

数据来源: WILEY

摘要:

ABSTRACTFifteen patients (51–78 yrs) with mild to moderately severe Alzheimer's dementia and 18 healthy subjects of the same age were examined by clinical rating scales and a battery of neuropsychological tests. Levels of the monoamine metabolites homovanillic acid (HVA), 3‐methoxy‐4‐hydroxyphenyl glycol (MHPG) and 5‐hydroxyindoleacetic acid (5‐HIAA) were determined in the lumbar cerebrospinal fluid (CSF). Correlations between clinical, psychological and biochemical measures were calculated in order to elucidate whether monoaminergic mechanisms are of importance for the maintenance of cognitive abilities in normal and pathological aging. The patients’ performance was severely impaired in all neuropsychological tests. The mean levels of monoamine metabolites, however, did not differ between patients and volunteers. The correlations between psychological test scores and CSF metabolite levels were generally low, but mostly negative, associating a poor performance to a high activity of brain monoaminergic neurons. Thus, among the volunteers high 5‐HIAA and MHPG levels correlated with poor performance in the Picture completion and the Trail making tests ‐ measures of visuo‐perceptual and visuo‐motor skills. In the demented patients poor performance in the memory tests was associated with high levels of HVA and 5‐HIAA. The results indicate that monoamine neuron acticity is not a primary determinant for cognitive abilities in healthy elderly subjects or in demented patients. The slight negative correlation between cognitive function and metabolite concentrations in the patients may reflect a disturbance in a dopaminergic‐cholinergic balance due to degenerative changes of cen

ISSN:0001-690X    

DOI:10.1111/j.1600-0447.1987.tb02935.x

出版商:Blackwell Publishing Ltd    

年代:1987

数据来源: WILEY

摘要:

ABSTRACTA new psychiatric report and rating scale assessing severity and frequency of aggressive behaviour is presented and evaluated. It is based on the staff's standardized reports of aggressive incidents. By using a special aggression report form, comprehensive and standardized information is obtained, thereby permitting scoring and further analysis of different aspects of aggressive incidents. The reliability of scoring is tested and found to be good as is the scale's capacity to discriminate between different patterns of aggressive behaviour in different groups of patients. As a result of this and because of the simplicity of the scale, it is thought to be a potentially useful tool in scientific research on aggressive behaviour from psychiatric inpatients.

ISSN:0001-690X    

DOI:10.1111/j.1600-0447.1987.tb02936.x

出版商:Blackwell Publishing Ltd    

年代:1987

数据来源: WILEY

摘要:

ABSTRACTWe hypothesised that there would be greater deficiencies in the quality and quantity of close personal relationship and social support in “neurotic” than in “endogenous” depressives, and that the relation between support and recovery would be stronger in the former. One hundred and thirty men and women who contacted hospital psychiatric services with depression were interviewed, and 119 (92%) reinterviewed after approximately 4 months. The association between the type of depression and deficiencies in social relationship was not impressive. However, differences were apparent in the prognostic implications of social relationship. For “neurotic” depressives, about half the social support variables assessed were significantly related to outcome, whereas the only significant predictor for “endogenous” cases was the presence of a close confidant. The results argue for further research on social support in clinical samples of a

ISSN:0001-690X    

DOI:10.1111/j.1600-0447.1987.tb02937.x

出版商:Blackwell Publishing Ltd    

年代:1987

数据来源: WILEY

摘要:

ABSTRACTThirty‐nine patients with bipolar illness preceded by organic factors were compared to age and sex matched bipolar controls. The patients with pre‐existing organic factors were older at onset of their bipolar illness, had fewer depressive episodes, less family history of affective disorder, and were symptomatically different in a number of respects. The nosology of such disorders is discussed and the literature revie

ISSN:0001-690X    

DOI:10.1111/j.1600-0447.1987.tb02938.x

出版商:Blackwell Publishing Ltd    

年代:1987

数据来源: WILEY

摘要:

ABSTRACTForty‐nine battered women attending a surgical emergency department were studied with regard to prior and current psychiatric morbidity, substance abuse and personality characteristics, and were compared with a control group. More battered women than controls had consulted a psychiatrist and half of them were classified as heavy consumers of alcohol. One third of the assaulted women were found to be depressed, compared to 6% of the controls. The groups also differed in respect of muscular tension, aches and pain, and autonomic distrubances, the battered women having more pronounced symptoms. It is important for psychiatrists to recognize the symptoms that battered women often exhibit. With better early diagnoses, these women could be offered more appropriate psychosocial therap

ISSN:0001-690X    

DOI:10.1111/j.1600-0447.1987.tb02939.x

出版商:Blackwell Publishing Ltd    

年代:1987

数据来源: WILEY

摘要:

ABSTRACTA group of 59 depressive in‐ and outpatients displayed statistically significantly subnormal electrodermal activity (EDA) according to the skin conductance level, the skin conductance response magnitude, the skin conductance response rate, and the index of nonresponding during neutral tone stimulation, compared to 59 mentally and somatically healthy subjects, individually matched for age and sex. Comparisons between 20 antidepressant medicated and 20 unmedicated patients, matched for age, and comparisons between 21 drug‐free patients and 10 patients medicated exclusively with antidepressants yielded no statistically significant difference in any EDA variable. However, all the electrodermal central values were somewhat lower in the medicated patients, possibly an effect of greater severity of symptoms. The present and previous findings offer strong support to the hypothesis of a subnormal function of the electrodermal activity in groups of depressive patie

ISSN:0001-690X    

DOI:10.1111/j.1600-0447.1987.tb02940.x

出版商:Blackwell Publishing Ltd    

年代:1987

数据来源: WILEY