摘要:

This study investigated the clinical course and outcome of 72 patients, diagnosed as suffering from schizoaffective psychosis (according to ICD‐9 criteria) who also satisfied Research Diagnostic Criteria for schizoaffective disorder. The current overall functioning of these patients was related to the number and frequency of episodes, regardless of the duration of the illness: the lesser the number or frequency of relapses, the better the overall functioning. In addition, there were no statistically significant differences in psychosocial impairment between bipolar and unipolar schizoaffective disorde

ISSN:0001-690X    

DOI:10.1111/j.1600-0447.1992.tb10313.x

出版商:Blackwell Publishing Ltd    

年代:1992

数据来源: WILEY

摘要:

The presence of mental disorder and cognitive functioning were examined in groups of 20 multiple sclerosis (MS) and homosexual acquired immunodeficiency syndrome (AIDS) ambulatory male outpatients matched for disability and demographic features. Patients who were somatically ill, had past central nervous system infection or tumours or abused intravenous drugs or alcohol were excluded. The groups significantly differed in mental symptoms and mental disorders (DSM‐III classification) seen currently and after the diagnosis of MS or human immunodeficiency virus‐I infection. AIDS patients had pre‐existing anxiety disorders that affected their current mental symptoms. MS patients showed more evidence of cognitive impairment than equally disabled AIDS patients. The differing neural and mental features are discussed in relation to the current concepts of subcortical and cortical diso

ISSN:0001-690X    

DOI:10.1111/j.1600-0447.1992.tb10314.x

出版商:Blackwell Publishing Ltd    

年代:1992

数据来源: WILEY

摘要:

Seventy‐three relatives of psychiatric patients aged 18–49 years admitted for the first time from a well‐defined catchment area were interviewed using the Social Behaviour Assessment Schedule to determine the distress elicted by the patients' illness. The patients were interviewed with the Present State Examination. 10th edition, development version. Regardless of sex and age, frequency of contact and relation to the patient, the relatives experienced distress from symptoms, lowered social performance and the adverse effects of the illness. Informant's social class, male sex of patient and duration of illness significantly predicted distress. No differences were found in a comparison of the level of distress between non‐organic psychotic disorders, mood disorders, anxiety disorders and psychoactive substance use disorders, but specific distressful areas within each disorder could be del

ISSN:0001-690X    

DOI:10.1111/j.1600-0447.1992.tb10315.x

出版商:Blackwell Publishing Ltd    

年代:1992

数据来源: WILEY

摘要:

Rapid eye movement latency (RL), delta max thyroid‐stimulating hormone (dmTSH) and 1600 (DST16) and 2300 (DST23) post‐dexamethasone cortisol values were determined in a group of 93 depressed patients who were assessed with the Newcastle Endogenous Depression Diagnostic Index (NEDDI). After the effects of age, gender and severity of illness were controlled for, stepwise multiple regression showed that depressive psychomotor activity and weight loss were the 2 NEDDI items most contributing to explain DST23 variance, as was depressive psychomotor activity for dmTSH variance. When the depressive sample was dichotomized according to the presence of these 2 items, the 2 groups had significantly different DST16, DST23, dmTSH and RL values. This suggests that weight loss, agitation and retardation could represent a core feature of a biologically mediated depressive subt

ISSN:0001-690X    

DOI:10.1111/j.1600-0447.1992.tb10316.x

出版商:Blackwell Publishing Ltd    

年代:1992

数据来源: WILEY

摘要:

Patients admitted for the first time with reactive psychosis have a greater mortality risk than the general population. This is caused by an increased risk of almost every cause of death, even cancer. However, the suicidal risk is increased considerably and suicide is the most frequent cause of death among men and women. Postpsychotic treatment that includes careful examination for somatic illness is recommended, and it is questioned whether the time has come to resolve reactive psychosis as a diagnostic term.

ISSN:0001-690X    

DOI:10.1111/j.1600-0447.1992.tb10317.x

出版商:Blackwell Publishing Ltd    

年代:1992

数据来源: WILEY

摘要:

This study investigated the effects of transferring patients on combined depot and oral neuroleptics to a single depot preparation; a secondary objective was to assess the effects of transferring patients from one depot neuroleptic to another. It was found that, whereas transferring from one depot preparation (flupenthixol) to another (fluphenazine) had no clear disadvantage for the patients, changing over from a combined oral and depot (fluphenazine) regimen to equivalent doses of depot alone resulted in an unacceptably high rate of relapse. The reasons for this may relate to either the unique pharmacokinetics of these drugs or subtle qualitative differences between them. It is suggested that caution is necessary whenever attempts are made to rationalize polypharmacy in schizophrenic patients.

ISSN:0001-690X    

DOI:10.1111/j.1600-0447.1992.tb10318.x

出版商:Blackwell Publishing Ltd    

年代:1992

数据来源: WILEY

摘要:

Intermediates in the folate‐dependent methylation pathways may play a role in the etiology and treatment of such mental disorders as major depression. These pathways include a step dependent on a riboflavin (B2)‐derived coenzyme, flavin adenine dinucleotide (FAD), which is reportedly sensitive to thyroid status and to phenothiazine and tricyclic drug exposure. In a sample of 52 male and female acute psychiatric inpatients, 17% (n= 9) showed B2deficiency (i.e., insufficient FAD activity) on a functional red blood cell enzyme assay, but only one B2‐deficient individual showed deficiency in another B‐complex vitamin (folate). All patients with B2deficiency were women, who were also significantly younger than the rest of the sample. The B2‐deficient women had significantly lower thyroxine levels, even when controlling for sex and covarying for age. B2‐deficient patients exhibited a nonsignificant trend toward more unipolar depression (44%vs14%), but not toward bipolar or schizophrenic disorders. As in a previous study, drug exposure did not show a relationship to riboflavin deficiency in this sample. The findings suggest that B2(FAD) activity may serve as a sensitive marker of thyroxine status in certain female psychiatric inpatients and that B2deficiency may play an etiological role in defects of the methylation pathways in a subset of mentally ill

ISSN:0001-690X    

DOI:10.1111/j.1600-0447.1992.tb10319.x

出版商:Blackwell Publishing Ltd    

年代:1992

数据来源: WILEY

摘要:

In a double‐blind clinical study, antidepressant plasma levels, parameters of platelet serotonin (5‐HT) transport (Km, Vmaxand basal platelet 5‐HT content) and therapeutic response were measured in depressive patients treated with either paroxetine (30 mg/day) or amitriptyline (150 mg/day) for 6 weeks. No correlation could be found between paroxetine plasma levels and therapeutic outcome after 2, 4 and 6 weeks of treatment. In contrast to the amitriptyline group, a marked increase in Kmfrom baseline to week 2 was determined in paroxetine‐treated patients, with Kmincrease being correlated with paroxetine plasma levels at week 2. However, no significant relationship could be found between 5‐HT transport parameters and any of the outcome measures in either treatm

ISSN:0001-690X    

DOI:10.1111/j.1600-0447.1992.tb10320.x

出版商:Blackwell Publishing Ltd    

年代:1992

数据来源: WILEY

摘要:

Since 1986 psychiatrists and social workers of the Lund Suicide Research Center have investigated subjects admitted to the medical intensive care unit after a suicide attempt. Fifty‐nine of 79 deliberate self‐poisoners were interviewed 12 months after a suicide attempt. Twenty‐one had previously been interviewed 6 months after the index suicide attempt. We obtained minor information on 8 subjects. Two patients had committed suicide. Sixteen subjects (27%) of those who were interviewed showed repeated suicidal behavior (repeaters) during the 1‐year follow‐up, and their psychiatric diagnoses at the index attempt were most commonly alcohol abuse and dysthymia (DSM‐III, Axis I). Compared with nonrepeaters, repeaters had more often made previous suicide attempts, their index attempt was less serious and they were more often in psychiatric treatment at index. At follow‐up, repeaters more often than nonrepeaters expressed the need for professional mental health support. Two‐thirds of the patients were in treatment at follow‐up. About half had remained in continuous treatment and most in psychiatric care for more than 1 year. Repeated self‐poisoning occurred despite ongoing treatment. In view of the fact that numerous suicide attempters obviously remain in treatment for several years, we suggest further development and evaluation of long‐term

ISSN:0001-690X    

DOI:10.1111/j.1600-0447.1992.tb10321.x

出版商:Blackwell Publishing Ltd    

年代:1992

数据来源: WILEY

摘要:

Forty‐one male alcoholics suffering from alcohol withdrawal syndrome were investigated to assess the relationship between vasopressin (ADH), water homeostasis and alcohol withdrawal. During 10 d, we found a significant decrease in serum vasopressin, from 3.08 ± 0.61 to 1.71 ± 0.22 pg/nl. There were no concomitant changes in osmolality, so that a general dysregulatory state of vasopressin secretion during alcohol withdrawal cannot be assumed. Only patients with delirium tremens (8/41) had higher vasopressin levels despite lowered serum osmolalities. These findings support the hypothesis of an inappropriate rebound secretion of vasopressin in severe alcohol withdrawal. Furthermore, they may contribute to the pathogenesis of focal alcoholic brain damage, because rapid and/or profound changes in osmolality are suspected to cause circumscribed cerebral demyelinizat

ISSN:0001-690X    

DOI:10.1111/j.1600-0447.1992.tb10322.x

出版商:Blackwell Publishing Ltd    

年代:1992

数据来源: WILEY