摘要:

Evolutionary biology has much to offer psychiatry. It distinguishes between ultimate and proximate explanations of behavior and addresses the functional significance of behavior. Subtheories, frequently voiced misconceptions, specific applications, testable hypotheses and limitations of evolutionary theory are reviewed. An evolutionary perspective is likely to improve understanding of psychopathology, refocus some clinical research, influence treatment and help integrate seemingly unrelated findings and theoretical explanations.

ISSN:0001-690X    

DOI:10.1111/j.1600-0447.1992.tb03234.x

出版商:Blackwell Publishing Ltd    

年代:1992

数据来源: WILEY

摘要:

The possibility of an involvement of peptidergic systems in schizophrenia has been under investigation for a number of years. Studies of the efficacy of des‐tyr‐gamma‐endorphin were equivocal; more recent studies with des‐enkephalin‐gamma‐endorphin have reported some activity but the peptide has only been investigated as an adjunct to neuroleptic medication, apart from one very small active reference comparator study. In the multicentre study reported here, 96 patients suffering from schizophrenia (DSM‐III with a current exacerbation if chronic) were allocated randomly to double‐blind treatment with either des‐enkephalin‐gamma‐endorphin (DE‐gamma‐E) (Org 5878) 10 mg given as a once daily intramuscular injection for 4 weeks, thioridazine 400 mg orally in 2 divided doses or placebo using a double‐dummy technique to preserve blindness. There was a significant advantage for thioridazine compared with placebo registered on all measures at weeks 3 and 4. There was no difference between DE‐gamma‐E and placebo. There was a significant difference between thioridazine and DE‐gamma‐E at weeks 3 and 4 registered on the MSS and at week 3 registered on the BPRS. The lack of efficacy of DE‐gamma‐E suggests that the theories that the endorphins have an important role in schizophrenia have to be revised. The need for well designed placebo controlled studies for assessing

ISSN:0001-690X    

DOI:10.1111/j.1600-0447.1992.tb03235.x

出版商:Blackwell Publishing Ltd    

年代:1992

数据来源: WILEY

摘要:

The pattern of drug use among 2183 young Kuwaiti conscripts was studied using the Drug Abuse Screening Test (DAST) and urine analysis. Drug misuse rates were low, compared with similar set‐ups elsewhere as independently confirmed by urine test (0.7% amphetamine and 2.8% other street drugs; alcohol was not detected in this sample) and self‐report (7.9% on DAST). This may be attributed to the influence of the Islamic traditions on lifestyles. Significant correlations were seen between self‐report of multiple drug use and positive urine results for both amphetamine and other street drugs, while positive urine amphetamine was associated with families seeking help for treatment, problems with family and/or work and having or being hospitalized for drug‐related medical problems. Amphetamine as the major identified individual misused drug was significantly associated with older age group but negatively correlated with marital status, higher education and employment. The discrepancy between self‐report of drug misuse‐related problems and objective proof of this may reflect the inappropriateness of some of DAST items to this sample, culturally desired respon

ISSN:0001-690X    

DOI:10.1111/j.1600-0447.1992.tb03236.x

出版商:Blackwell Publishing Ltd    

年代:1992

数据来源: WILEY

摘要:

Decreased binding of tritiated imipramine to platelets has been considered to be a potential biological marker of depression. However, it has been unclear how binding values alter during treatment and recovery. This study investigated imipramine binding parameters and depressive symptoms in 25 patients suffering from major depression at entry to the study and 1, 3 and 6 months later. Although the initial Bmaxvalues were significantly lower in the depressed patients than in healthy subjects, it was not possible to establish a clear relationship between recovery from depression and Bmax. The power of this study to detect an effect of at least 10% of the variance in Bmaxdue to factors related to recovery from depression was 0.78.

ISSN:0001-690X    

DOI:10.1111/j.1600-0447.1992.tb03237.x

出版商:Blackwell Publishing Ltd    

年代:1992

数据来源: WILEY

摘要:

The purpose of this study was to investigate the relationship between incidence rates of schizophrenia and residential features in Nagasaki City, Japan. Social features of residents in 259 areas in the Nagasaki City ecological structure were determined using the results of the 1980 national census. Six residential factors ‐ employment status, occupational and academic career, household status, length of residence, housing tenure and young male predominance ‐ were selected as factors that clearly reflect residential differentiation of residents. Contrary to the findings of many other studies conducted in Western cities, no statistically significant differences were observed, although it seemed that incidence rates were comparatively higher in the lower social classes. These results possibly reflect differences in cultural and social values and structu

ISSN:0001-690X    

DOI:10.1111/j.1600-0447.1992.tb03238.x

出版商:Blackwell Publishing Ltd    

年代:1992

数据来源: WILEY

摘要:

The premorbid psychosocial adjustment of 28 schizophrenic criminal offenders, 23 non‐criminal‐offender schizophrenics (ICD‐9) and 14 nonpsychotic criminals was compared by means of the Premorbid Adjustment Scale (PAS). The schizophrenic groups did not differ regarding age, marital status, diagnostic subgroup or length of illness. PAS scores showed highly significant differences between the schizophrenic groups and the controls on every subscale and on average scores. Yet, aside from 2 items (sociability/withdrawal in adulthood and education), no differences could be found between offender and non‐offender schizophrenics. Furthermore, the PAS scores showed a markedly better premorbid psychosocial adjustment in schizophrenics with offending behaviour (and convictions) before the onset of the psychosis than in schizophrenics without previous convictions, who committed one rather severe crime that was closely connected to psychosis

ISSN:0001-690X    

DOI:10.1111/j.1600-0447.1992.tb03239.x

出版商:Blackwell Publishing Ltd    

年代:1992

数据来源: WILEY

摘要:

The 24‐h rhythms of blood serotonin and serum melatonin were determined in 39 unmediated inpatients with nonseasonal affective disorder and in 14 healthy men and women after 7 days of morning bright‐light (2500 lx) or dim‐light (50 lx) treatment. Bright‐light treatment led to a more than 50% decrease in the Hamilton Rating Scale for Depression (HRSD) score in 4/19 patients and dim light in 1/17 patients. After light treatment the mesor (the daily mean estimated by cosinor analysis) of patients’ and subjects’ melatonin levels did not change significantly, nor was there a correlation between phase change and decrease in HRSD score. We observed after bright‐ and dim‐light treatment a consistent increase in blood serotonin in patients and healthy subjects, which differed significantly between healthy subjects and patients. These findings suggest the involvement of serotonergic mechanisms followin

ISSN:0001-690X    

DOI:10.1111/j.1600-0447.1992.tb03240.x

出版商:Blackwell Publishing Ltd    

年代:1992

数据来源: WILEY

摘要:

Specific sleep disturbances such as reduced slow‐wave sleep (SWS) and decreased serotonergic (5‐HT) activity have been observed in depressive disorders. Ritanserin, a specific 5‐HT2 receptor antagonist, has been shown to increase SWS in healthy subjects. This study explored the effects of a single dose or ritanserin (5 mg) on sleep electroencephalography in 18 major depressed patients and in 10 control subjects. Ritanserin affected SWS differently in the two groups. Although stage 3 increased significantly in the groups, in contrast to controls, there was no significant effect of ritanserin on stage 4 in depressed patients. In the depressed group, irritability and DSM‐III‐R melancholic type predicted 40% or the variance of stage 4 increment after ritanserin, as assessed by stepwise multiple regression. These results are in agreement with a potential 5‐HT disturbance, particularly at the 5‐HT2 receptor level, in some clinical forms

ISSN:0001-690X    

DOI:10.1111/j.1600-0447.1992.tb03241.x

出版商:Blackwell Publishing Ltd    

年代:1992

数据来源: WILEY

摘要:

A total of 149 patients in 7 centers in Denmark, Norway and Sweden entered a 6‐week double‐blind trial intended to assess the antidepressant effect and safety of citalopramvsplacebo in depressed elderly patients (65 years of age or older) who might also suffer from somatic disorders and/or senile dementia. Results of ratings on the Hamilton Rating Scale for Depression, the Montgomery‐Åsberg Depression Rating Scale and the Clinical Global Impression Scale provided consistent evidence that the citalopram‐treated patients improved more than the placebo‐treated patients. Results of ratings on the Gottfries‐Bråne‐Steen dementia rating scale indicated that both cognitive and emotional functioning improved significantly more in the citalopram‐treated subgroup of patients with dementia than in the placebo

ISSN:0001-690X    

DOI:10.1111/j.1600-0447.1992.tb03242.x

出版商:Blackwell Publishing Ltd    

年代:1992

数据来源: WILEY

摘要:

In an explorative study, a clinical sample of 53 schizophrenic patients was examined. The EMBU inventory was used for measuring perceived parental rearing practices, the AfS for rating the quality of relationship to key relatives and the U‐Scale for assessing social anxiety. The findings obtained were intercorrelated and compared with 3 selected parameters of disease severity: age at first hospitalization, number of treated episodes and length of hospital stay. The results suggest that the quality of contact with key relatives is determined to a larger extent by the schizophrenia than by parental rearing attitudes. Rearing behaviour more likely influences the age at first hospitalization and social anxiety, whereas considering the length of face‐to‐face contact, the quality of the relationships between patients and their key relatives can be assumed to be associated with the duration of hospital

ISSN:0001-690X    

DOI:10.1111/j.1600-0447.1992.tb03243.x

出版商:Blackwell Publishing Ltd    

年代:1992

数据来源: WILEY