摘要:

This 8‐week double‐blind placebo‐controlled trial investigated the relative efficacy and safety of alprazolam and buspirone in the treatment of panic disorder. Alprazolam (mean ± SD dose 5.2 ± 2.6 mg) produced a rapid and sustained improvement in panic attacks, anxiety, phobias, and disability and was superior to buspirone (mean ± SD dose 61 ± 26.5 mg) and placebo on all of these measures on completer (n= 85) and endpoint analysis (n= 92). Although higher doses of buspirone were used in this study than in previous trials, buspirone was not superior to placebo on any of the outcome measures. The results were disappointing in light of buspirone's benign side effect profile and low abuse

ISSN:0001-690X    

DOI:10.1111/j.1600-0447.1993.tb03405.x

出版商:Blackwell Publishing Ltd    

年代:1993

数据来源: WILEY

摘要:

Ninety men between the ages of 20 to 65 were studied to investigate the relationships between stress, depression and psychogenic pain. Three groups (the coronary heart disease (CHD) group; the left‐sided psychogenic chest pain (LPCP) group; and the control group) comprising 30 patients per group, each completed the Social Readjustment Rating Scale (SRRS), as a measure of stress; the Schedule of Recent Experience, to document the recency of actual life events experienced as listed in the SRRS; and the Beck Depression Inventory, as a measure of the severity of depression. Separate analyses of the variables stress and depression failed to yield significant stress differences in the 3 groups, but the LPCP group was significantly more depressed than the CHD and control groups. Factor analysis, however, indicated that the stress profiles were significantly different in each of the 3 groups. This study indicates that the condition of LPCP shares a similar depressive profile to other psychogenic pain conditions and further lends support to the hypothesis linking psychogenic pain to depressive disorder

ISSN:0001-690X    

DOI:10.1111/j.1600-0447.1993.tb03406.x

出版商:Blackwell Publishing Ltd    

年代:1993

数据来源: WILEY

摘要:

To elucidate the influence of total sleep deprivation (TSD) on catecholaminergic neurotransmission, which is assumed to be disturbed in depression, 9 depressive patients collected consecutive 24‐h urine samples prior to (baseline), during (TSD) and following total sleep deprivation (post‐TSD). Urine samples were analysed for total MHPG (3‐methoxy‐4‐hydroxyphenylglycol), conjugates of MHPG (glucuronide and sulfate), excretion of HVA (homovanillic acid) and VMA (3‐methoxy‐4‐hydroxymandelic acid). TSD increased the urinary excretion of MHPG‐sulfate as a marker of the central norepinephrine metabolism and the excretion rates of VMA and HVA as indices of the peripheral catecholamine metabolism. Patients with higher VMA values prior to TSD reacted worse, and the VMA increase due to TSD was positively correlated with the response. The results demonstrate that TSD, besides acting as a stimulus on the peripheral sympathetic nervous system, influences central nervous noradrenergic neurotransmission, as reflected by the increas

ISSN:0001-690X    

DOI:10.1111/j.1600-0447.1993.tb03407.x

出版商:Blackwell Publishing Ltd    

年代:1993

数据来源: WILEY

摘要:

By means of the Stockholm County inpatient care register we identified all cases treated with a diagnosis of cannabis dependence and psychosis, not necessarily at the same occasion, during 1971–1983. By scrutinizing medical records, we evaluated the diagnosis according to DSM‐III‐R and we assessed the history of substance abuse as well as the psychiatric history and clinical course. We identified 229 cases during the follow‐up; 112 of these cases (49%) fulfilled the DSM‐III‐R criteria for schizophrenia. The majority of the schizophrenics had prominent positive symptoms and a sudden onset of disease, and 69% of the cases had a record of heavy cannabis abuse at least 1 year before onset of psychotic symptoms. The high number of verified DSM‐III‐R cases of schizophrenia in this cohort and the temporal relation between cannabis abuse and schizophrenia further support the hypothesis that cannabis abuse may be a risk factor for schizophrenia. We confirmed previous observations that cannabis‐associated schizophrenia often has a sudden onset and prominent

ISSN:0001-690X    

DOI:10.1111/j.1600-0447.1993.tb03408.x

出版商:Blackwell Publishing Ltd    

年代:1993

数据来源: WILEY

摘要:

The effect of pulse unilateral electroconvulsive therapy (ECT) on heart rate, blood pressure and the product of heart rate and systolic blood pressure, an index of myocardial oxygen consumption, was studied during 48 ECT sessions in 7 patients with major depression. Intraindividually, hyperventilation‐induced hypocapnia compared with normocapnia markedly augmented the ECT‐induced increase in heart rate (47%vs28%) and the product of heart rate and systolic blood pressure (82%vs60%). Over all ECT seizures, the maximum and increase in heart rate and the product of heart rate and systolic blood pressure were significantly correlated with seizure duration as determined by electroencephalography. However, significant correlations were only present for the seizures during hypocapnia and not during normocapnia. Combining measures of magnitude and length of ECT‐induced tachycardia to motor responses may increase the potential for clinical seizure evalu

ISSN:0001-690X    

DOI:10.1111/j.1600-0447.1993.tb03409.x

出版商:Blackwell Publishing Ltd    

年代:1993

数据来源: WILEY

摘要:

The lifetime prevalence of anxiety disorders was estimated in a study of the prevalence of mental disorders in Iceland. The survey instrument was an Icelandic translation of the US National Institute of Mental Health Diagnostic Interview Schedule. The cohort consisted of one half of those born in the year 1931. The participation rate was 79.3%. The overall prevalence of anxiety disorders was 44%, with phobia effecting 18%. The most common anxiety disorder was generalized anxiety, which had a prevalence of 22% and was more common among women. Simple phobia was the most common of the phobic disorders (8.8%), followed by agoraphobia without panic (3.8%), and social phobia (3.5%) The female‐male ratio for anxiety disorders was 2:1. Of those with simple phobia, the most common items were a fear of heights (41%); claustrophobia (34%); being on public transportation (31%); the fear of being in crowds and speaking in front of others (28%); of being alone (24%); of insects (22%); of bad weather (21%); and of being in water (aquaphobia) (20%). In addition, 17% of the respondents listed phobias not cited in the DSM‐III, and of those with the most common phobic disorder, only 9% had consulted a physician because of this condition. Post‐traumatic stress disorder was found to affect women exclusively. Comorbidity shows a mean of at least 3 additional diag

ISSN:0001-690X    

DOI:10.1111/j.1600-0447.1993.tb03410.x

出版商:Blackwell Publishing Ltd    

年代:1993

数据来源: WILEY

摘要:

The associations between the one‐month prevalence rates of mental disorders and sociodemographic characteristics were investigated for 18571 people interviewed in the first‐wave community samples of all 5 sites in the US National Institute of Mental Health (NIMH) Epidemiologic Catchment Area program. Men were found to have a significantly higher rate of cognitive impairment than women after controlling for the effects of age, race or ethnicity, marital status and socioeconomic status. Marital status was one of the most powerful correlates of mental disorder risk: the odds of separated or divorced people having any NIMH Diagnostic Interview Schedule disorder were twice that of married people after controlling for age, gender, race or ethnicity and socioeconomic status. The odds of those in the lowest socioeconomic status group having any Diagnostic Interview Schedule disorder was about 2.5 times that of those in the highest socioeconomic status group, controlling for age, gender, race or ethnicity and marital status. For all disorders except cognitive impairment, race or ethnicity did not remain statistically significant after controlling for age, gender, marital status and socioeconomic sta

ISSN:0001-690X    

DOI:10.1111/j.1600-0447.1993.tb03411.x

出版商:Blackwell Publishing Ltd    

年代:1993

数据来源: WILEY

摘要:

Several biochemical parameters such as monoamines and corticosteroids are considered to play a role in the underlying pathogenetic mechanisms in mood disorders. It has also been proposed that disturbances of the immune system may be responsible for mental disorders. Increased concentrations of plasma soluble interleukin‐2 receptor (S‐IL‐2R) reflect an activation of T‐lymphocytes. In plasma samples from medication‐free suicide attempters with various psychiatric diagnoses (mainly mood disorders), we found a median S‐IL‐2R concentration far above the range of healthy controls. No sex differences and no differences between diagnostic and suicidal subgroups were noted. In follow‐up samples, the S‐IL‐2R remained at high levels. In cerebrospinal fluid samples from patients, S‐IL‐2R levels were all below 200 U/ml. No samples from controls were available. We were unable to find pronounced associations between plasma S‐IL‐2R and various monoaminergic measures in plasma, 24‐h urine and cerebrospinal fluid. There was, however, a tendency of an association between S‐IL‐2R and the ratio of norepinephrine‐epinephrine in 24‐h urine, as well as plasma and cerebrospinal fluid 4‐hydroxy‐3‐methoxymethylglycol. There was no significant association between post‐dexamethasone plasma cortisol, 24‐h urinary cortisol and plasma S‐IL‐2R. Both when studied as medication‐free inpatients and during follow‐up as outpatients, there were no apparent associations between ratings of psychopathology and plasma S‐IL‐2R. This study clearly shows that an imbalance of the immune system was present in psychiatric patients studied after a suicide attempt. Furthermore, the immune dysfunction, sho

ISSN:0001-690X    

DOI:10.1111/j.1600-0447.1993.tb03412.x

出版商:Blackwell Publishing Ltd    

年代:1993

数据来源: WILEY

摘要:

Attitudes toward psychiatry were assessed in 490 medical students and 362 physicians from two universities in Venezuela: Universidad de Los Andes (ULA) and Universidad Centro‐Occidental Lisandro Alvarado (UCLA). A modified version of the Attitude Toward Psychiatry‐30 scale was used. The attitude toward psychiatry of all the students and physicians was moderately positive. Students from ULA displayed a more positive attitude than UCLA students, whereas physicians from UCLA displayed a more positive attitude than ULA physicians. The most negative attitude toward psychiatry was observed in students planning to select obstetrics and gynecology (ULA + UCLA), in physicians working in Surgery, obstetrics and gynecology (ULA + UCLA) and in basic sciences (ULA). Female students tended to display a more positive attitude than male students. The attitude toward psychiatry was similar in students with low and high academic achievement in the courses in psychiatry. A large number of years in the profession did not modify the attitude of the physicians. It is recommended to improve teaching and communication with the students and physicians that displayed the most negative attitudes toward psychia

ISSN:0001-690X    

DOI:10.1111/j.1600-0447.1993.tb03413.x

出版商:Blackwell Publishing Ltd    

年代:1993

数据来源: WILEY

摘要:

The onset of melatonin secretion under dim light conditions (DLMO) and the circadian temperature rhythm during a constant routine were assessed in 6 female controls and 6 female patients with winter depression (seasonal affective disorder, SAD) before and after bright light treatment. After sleep was standardized for 6 days, the subjects were sleep‐deprived and at bedrest for 27 h while core temperature and evening melatonin levels were determined. The DLMO of the SAD patients was phase‐delayed compared with controls (2310vs2138); with bright light treatment, the DLMO advanced (2310 to 2135). The minimum of the fitted rectal temperature rhythm was phase‐delayed in the SAD group compared with the controls (0542vs0316); with bright light treatment, the minimum advanced (0542vs

ISSN:0001-690X    

DOI:10.1111/j.1600-0447.1993.tb03414.x

出版商:Blackwell Publishing Ltd    

年代:1993

数据来源: WILEY