摘要:

Renal functional and structural changes were studied in rats treated with lithium for 5 months. The lithium was administered in two different ways: in the food or as a daily intraperitoneal injection. In the perorally treated rats serum lithium was relatively constant during the day. In the injected rats serum lithium reached a high peak value just after the injection followed by a decrease to very low values. In all rats an increased water consumption and a reduced renal concentration ability were seen during lithium treatment. Light microscopy showed focal degenerative changes in the distal convoluted tubule and collecting ducts. These changes comprised nuclear and cellular polymorphism and tubular dilatation. The functional as well as the structural changes were most pronounced in the rats treated with peroral lithium, and a correlation between the functional and morphological changes was present. It is concluded that lithium is more harmful to the kidney when the administrations give a relatively constant serum lithium level, such as in peroral administration, than when administration causes great variations, including peak values and very low minimum levels in serum lithium. The reason for this might be that a number of regenerative processes occur only in periods with low lithium concentrations.

ISSN:0001-690X    

DOI:10.1111/j.1600-0447.1981.tb00679.x

出版商:Blackwell Publishing Ltd    

年代:1981

数据来源: WILEY

摘要:

It is now generally recognized that dopamine receptors exist in the CNS as different subtypes: D1receptors, associated with adenylyl cyclase activity, and D2receptor, uncoupled to a cyclic AMP generating system. In order to understand the role of D1and D2receptors in the antipsychotic action of neuroleptics, we have performed subchronic treatment with haloperidol, a drug which acts on D2receptors, and sulpiride, a selective antagonist to D2receptors.Long‐term treatment with haloperidol does not induce significant supersensitivity of the D2receptors. In fact under these conditions3H‐(‐)‐sulpiride binding, which is a marker of D2receptor function, does not increase in rat striatum, while the long‐term administration of sulpiride itself produces supersensitivity of D2receptors. Moreover, sulpiride does not induce supersensitivity of the D1receptors, characterized by3H‐spiroperidol binding.These data suggest that both types of dopamine receptors may be involved in the clinical antipsychotic effects of neuroleptics.Unilateral lesion of the nigrostriatal dopaminergic pathway produces an increase of striatal dopaminergic receptors, measured either by3H‐spiroperidol and3H‐(‐)‐sulpiride binding. These findings suggest that D1and D2receptors are present in postsynaptic membranes while it is still not known whether they exist in the sam

ISSN:0001-690X    

DOI:10.1111/j.1600-0447.1981.tb00680.x

出版商:Blackwell Publishing Ltd    

年代:1981

数据来源: WILEY

摘要:

During the 12‐month period, 1 January 1978 to 31 December 1978, 690 people received 4,194 electroconvulsive treatments at the Psychiatric Hospital, Enugu. The diagnostic classifications of patients receiving this form of treatment included severe psychotic depression (and masked depression), catatonic schizophrenia (with marked withdrawal, mutism, or excitement); mania which has become unresponsive to major tranquillizers, some selected cases of acute delirium and the collective group “puerperal psychosis”. Bilateral ECT was generally used and the frequency of treatment was two ECTs per week. The method of anaesthesia used is described and mention is made of the few and mild complications which were encountered. ECT was found to have reduced the total duration of stay in hospital (for in‐patients). Considering the acute shortage of specialized manpower in the field of psychiatry in Nigeria, a suggestion is made for the establishment of community based psychiatric centres where, among other forms of therapy, ECT could be given in appropriate cases, on out‐patient basis. The wider use of this form of treatment in deserving cases in psychiatric hospitals is also re

ISSN:0001-690X    

DOI:10.1111/j.1600-0447.1981.tb00681.x

出版商:Blackwell Publishing Ltd    

年代:1981

数据来源: WILEY

摘要:

Two years after a survey of the kidney function in 237 patients given long‐term lithium treatment the patients were invited for re‐examination. Of 184 patients who came for the reexamination 147 had continued lithium treatment; in 37 patients the treatment had been discontinued. The lithium‐treated patients were compared with a group of 68 manic‐depressive patients who were about to be given prophylactic lithium treatment but who had not yet started.Neither the patients who continued nor the patients who had discontinued lithium showed any deterioration of glomerular filtration rate as assessed through determination of the 24‐h creatinine clearance and the serum creatinine concentration; mean values in the lithium‐treated patients were the same as mean values in patients not yet given lithium. Impairment of renal water reabsorption, revealed by increased 24‐h urine volume and decreased urine osmolality after DDAVP, had progressed in the patients who continued lithium treatment, and multiple regression analysis revealed the duration of treatment and the serum lithium level to be significant predictor variables. In the patients who had discontinued lithium the changes in renal water handling had decreased. The urine volume was the same as that found in the patients not yet given lithium; maximum urine osmolality had not become fully normalized.Side effects such as thirst, nycturia, tremor, diarrhoea, oedema, and weight gain were found with the same frequency at the second as at the first examination in the patients who had continued lithium. In the patients who had discontinued lithium they were infrequ

ISSN:0001-690X    

DOI:10.1111/j.1600-0447.1981.tb00682.x

出版商:Blackwell Publishing Ltd    

年代:1981

数据来源: WILEY

摘要:

The incidence of suicide in a consecutive series of 1,000 patients, who underwent Billroth II resection for duodenal ulcer, has been estimated. After an observation period of 21–29 years 13.7% of those who had died had committed suicide. The psychiatric morbidity in this ulcer group was found to be very high. Among the psychiatric diseases alcoholism was dominating, but also non‐psychotic conditions such as neurosis and psychopathy were frequent. Fifty per cent of the persons who had committed suicide were alcoholics, and the alcohol abuse seemed to develop after surgery.Gastric resection for duodenal ulcer may have pathogenetic importance in the development of alcoholism, which is known as a predictor of suicide. The importance of considering psychiatric disturbances in the postoperative follow‐up is str

ISSN:0001-690X    

DOI:10.1111/j.1600-0447.1981.tb00683.x

出版商:Blackwell Publishing Ltd    

年代:1981

数据来源: WILEY

摘要:

All psychiatric patients staying in hospital‐supervised boarding homes, and a random sample of 50 long‐stay patients in the wards of the only mental hospital in Newfoundland were surveyed to determine if certain premorbid factors predispose to institutionalism (‘institutional neurosis’). Three hundred and twenty‐four patients were examined. Low intelligence, poor education and disabilities in hearing, speech, locomotion and manual dexterity, were significantly associated with institutionalism. Extremes of age on first admission, celibacy, low occupational status in the patient, or his father, and visual disability did not prove to be associated with institutionalism. In conclusion: institutionalism may be found among patients in boarding homes; some patients are more susceptible to institutionalism than others; and institutionalism tends to be associated with those biological or social handicaps which affect communication and activity of th

ISSN:0001-690X    

DOI:10.1111/j.1600-0447.1981.tb00684.x

出版商:Blackwell Publishing Ltd    

年代:1981

数据来源: WILEY

摘要:

The paper is a report on results obtained in the course of a multicentre international study on depressive disorders in four countries, which was sponsored and co‐ordinated by the World Health Organization. A screen form was developed and tested in order to select depressive patients among psychiatric in‐patient and outpatient populations. The patients selected in this way were assessed clinically by experienced investigators using the WHO schedule for Standardized Assessment of Depressive Disorders (SADD). A total of 573 patients were evaluated in the five research centres, and the data were utilized in uni‐ and multivariate statistical analyses aiming to establish whether similar cases of depression could be found in different cultures, to describe their characteristics and to ascertain the extent to which diagnostic concepts and classification categories could be applied in different settings. The results point to a considerable degree of similarity in depressive symptomatology across the cultures if particular selection criteria are applied, and suggest that broad diagnostic groupings such as ‘endogenous’ and ‘psychogenic’ depressions could be used consistently by clinicians working in diffe

ISSN:0001-690X    

DOI:10.1111/j.1600-0447.1981.tb00685.x

出版商:Blackwell Publishing Ltd    

年代:1981

数据来源: WILEY

摘要:

The need of the judicial system for psychiatric and psychological examination of parents and children prior to decisions concerning custody and visiting rights is illustrated. Further, the possibility of establishing collaboration with legal authorities is discussed. Most child psychiatric and child psychological clinics in Denmark declared themselves willing to take part in the investigation carried out during 1975 and 1976. Within this period the legal authorities referred 232 cases.The indication for expert advice is discussed. Our suspicion that the parties in these selected cases often were suffering from serious mental disorders was confirmed. The difficulties of evaluating the child's views are described. The authors conclude that it is impossible to fix a lower limit for the age at which children are to be heard in court. The legal decision usually accorded with the conclusion drawn from the statement. The investigation resulted in the establishment of a more permanent collaboration of lawyers and psychiatric examiners with regard to custody and visiting rights.

ISSN:0001-690X    

DOI:10.1111/j.1600-0447.1981.tb00686.x

出版商:Blackwell Publishing Ltd    

年代:1981

数据来源: WILEY

摘要:

The relation between schizophrenia birth rates and environmental temperature was studied in patients born in England and Wales during 1921–1955 and first admitted there in 1970–1977. A methodological difficulty due to varying age‐incidence was avoided by the use of indices independent of yearly changes in rates.Birth rates in the second quarter and in the first half of the year showed high negative correlations with mean temperatures of the first quarter and first half of the year. Comparison of years with the coldest and with the warmest seasons showed the schizophrenia birth rate to be consistently higher in the coldest years. No comparable relations between birth rates and temperature were found for patients with affective psychosis, neurosis or personality disorder.The findings indicate an association between schizophrenia birth rates and temperature of a kind similar to that between infant death rates and temperature during the years 1921–55. Some implications are di

ISSN:0001-690X    

DOI:10.1111/j.1600-0447.1981.tb00687.x

出版商:Blackwell Publishing Ltd    

年代:1981

数据来源: WILEY

摘要:

Book reviews in this article:Mezzich, J. E.,&H. Solomon: Taxonomy and behavioral science.Robins, L. N., P. J. Clayton&J. K. Wing(eds.): The social consequences of psychiatric illness.

ISSN:0001-690X    

DOI:10.1111/j.1600-0447.1981.tb00688.x

出版商:Blackwell Publishing Ltd    

年代:1981

数据来源: WILEY