摘要:

The hypnotic effect of flunitrazepam (Ro 5‐4200), nitrazepam and a placebo was studied in 117 outpatients using hypnotics for at least 3 months prior to the study. They obtained various neurotropic drugs and this and other treatments were unchanged throughout the trial period of 13 weeks. This consisted of 3 weeks on the previously used hypnotic, 3 weeks on a test drug (during the first of these a doubling of the dose was permitted if the initial dose of 1 mg flunitrazepam, 5 mg nitrazepam or one tablet of placebo was not satisfactory) and 4 weeks' observation after a request to stop medication with the test drug. The effects were evaluated every week by self‐ratings. Also noted were: the frequency of dose increase after 1 week of the test period, number of drop‐outs in the test period, and failure in the attempt to stop taking the test drug. A “psychological concentration test” was done, as was a follow‐up interview. The self‐ratings had a good reliability and showed that more patients experienced shorter sleep induction, longer sleep time, better sleep quality and a subjective feeling of having had a better rest with flunitrazepam than with either nitrazepam or placebo. There were no differences between the nitrazepam and the placebo groups. Tiredness was the most common side effect and appeared in the same frequency in all groups. The number of patients who increased the dose after 1 week's medication, as well as the number of drop‐outs, was significantly higher in the nitrazepam and placebo groups than in the flunitrazepam group. There was no difference in the ability to discontinue the medication between the test groups or between groups having previously used different hypnotics. The “psychological concentration test” did not reveal any differences between groups. It was concluded that withdrawal of a hypnotic in chronic users was not facilitated by the use of a placebo. This was interpreted as due to a strong psychological dependence upon the hypnotics and their lack of pharmacological effects during

ISSN:0001-690X    

DOI:10.1111/j.1600-0447.1978.tb06915.x

出版商:Blackwell Publishing Ltd    

年代:1978

数据来源: WILEY

摘要:

To investigate the occurrence of different psychogenic needs or groups of needs, 118 consecutive out‐patients with previous depressive disorders were asked to complete the Cesarec and Marke Personality Inventory; 103 completed it. Strict diagnostic criteria were used in subgrouping the series which thus consisted of unipolar depressive psychosis (UP), 26 patients; bipolar depressive psychosis (BP), 16; unclassified depression (NUD), 8; and reactio neurotico‐depressive (RND), 15. BP distinguished themselves from the other groups by a tendency to have a reduced need of approval, dependency, guilt feelings and ego conflicts and a stronger wish to dominate and lead. These results are in line with earlier findings. The NUD group was small but tended to have extreme scores, i.e. a particularly weak need to dominate and to be in the centre but also to be cared

ISSN:0001-690X    

DOI:10.1111/j.1600-0447.1978.tb06916.x

出版商:Blackwell Publishing Ltd    

年代:1978

数据来源: WILEY

摘要:

A nationwide study of psychiatric in‐patients driving motor vehicles and involved in accidents causing bodily injury in the years 1972–74 was undertaken.Compared with drivers in general involved in accidents causing bodily injury, drivers with a psychiatric record were characterized by an over‐representation of women. A preponderance of psychiatric drivers in the age group 25–54 was observed. About 3% of drivers with a psychiatric record were involved in two or more accidents during the period studied.A greater proportion of the psychiatrically diseased group drove stolen vehicles, without valid licences, and were found not to have used safety belts at the time of the accident.Occurrence of injury was more frequent among the diseased drivers. They were more frequently alcohol intoxicated and with a higher blood alcohol level.The most commonly encountered diagnostic groups were personality disorder and transitory re

ISSN:0001-690X    

DOI:10.1111/j.1600-0447.1978.tb06917.x

出版商:Blackwell Publishing Ltd    

年代:1978

数据来源: WILEY

摘要:

Self‐mutilation in non‐human mammals is a well‐established, although not a widely known phenomenon, which has been reported under zoo and laboratory conditions. In macaque monkeys, laboratory rearing and isolation are important predisposing factors, and the more serious self‐injury is initiated by some immediate stimulating event. It is commonly accompanied by behaviour normally shown by the animal in a flghting context. Lower mammals are also known to mutilate themselves under laboratory conditions after administration of drugs which probably cause increased sympathetic activity. The implications of this behaviour for an understanding of states of self‐injury in man are

ISSN:0001-690X    

DOI:10.1111/j.1600-0447.1978.tb06918.x

出版商:Blackwell Publishing Ltd    

年代:1978

数据来源: WILEY

摘要:

Life events at the onset of primary affective illness were assessed in 183 patients with primary affective disorder who were attending a research lithium clinic. About 50% of patients recalled significant life events in the 3‐month interval preceding their initial affective episode. Family history data of those patients who reported life events were not significantly different from those who did not report life events at onset. Furthermore, there were no significant differences among patients classified as bipolar or unipolar regarding reporting of life events at onset of illness. These data suggest that the delineation of a subgroup of patients with “reactive” primary affective illness is not supported by a decreased familial load for affective disorder in their rela

ISSN:0001-690X    

DOI:10.1111/j.1600-0447.1978.tb06919.x

出版商:Blackwell Publishing Ltd    

年代:1978

数据来源: WILEY

摘要:

The mean free‐thyroxine index value of a group of 25 psychotic depressive patients was found to be significantly lower than that of an age‐ and sex‐matched group of 20 neurotic depressives (P>0.01). These findings support the view that psychotic and neurotic expression, are differentiated not only with respect to their clinical expression, but also on account of their biological substrate.Comparison of free‐thyroxine index values of each group of patients with a group of 240 euthyroid subjects hospitalized for various somatic illnesses revealed a lower mean free‐thyroxine index value in the group of psychotic depressives (P>0.001). The neurotic depressives were not differentiated from the group of euthyroid subjects.The decreased thyroid activity in psychotic depression might be interpreted in the light of recent findings implicating catecholamines in both the release of hypothalamic hormones and the neurochemical mechanism of the affective

ISSN:0001-690X    

DOI:10.1111/j.1600-0447.1978.tb06920.x

出版商:Blackwell Publishing Ltd    

年代:1978

数据来源: WILEY

摘要:

A case history is reported of a 44‐year‐old man with a 6‐year history of psychomotor seizures. For the past year he had described persistent olfactory hallucinations of an unpleasant nature which he referred to himself. In many respects these symptoms conform to the pattern observed in the olfactory reference syndrome, a recently described but apparently quite discrete psychiatric disorder; there were, however, certain atypical features. At a later stage unilateral anosmia was noted. Radiological examination then demonstrated an arterio‐venous malformation in the right frontal lobe. The relationship between the malformation and the psychomotor seizures, and the implications that each has for the development of an olfactory reference syndrome are fully di

ISSN:0001-690X    

DOI:10.1111/j.1600-0447.1978.tb06921.x

出版商:Blackwell Publishing Ltd    

年代:1978

数据来源: WILEY

摘要:

Lithium concentrations in saliva, plasma and red blood cells were measured in: 1) six hospitalized patients under long‐term lithium therapy, at 2, 5, 9 and 24 hours after oral doses of 24 mEq Liacetate and 2 or 12 hours after 8 mEq Li acetate; and 2) 10 outpatients under chronic lithium treatment at two occasions 8 days apart.With changing plasma concentrations, [Li] saliva varied without any notable time lag. [Li]saliva was always much higher than [Li] plasma. The ratio [Li]saliva/ [Li]plasma wateraveraged 3.2 ± 0.2 in 62 determinations, but varied widely at different times after oral lithium in the same individuals and less widely between different individuals. “Prediction” of plasma lithium concentration from measured [Li] saliva appears hazardous, and may provide reliable indications only if [Li]saliva is measured repeatedly. Salivary lithium concentrations were not correlated with either potassium or sodium concentrations. Lithium concentrations in red blood cells were always lower than in plasma: [Li]red blood cell water/ [Li]plasma wateraveraged 0.37 ± 0.03. With changing plasma concentrations, rise and fall of red blood cell lithium lagged considerably behind plasma changes. This resulted in a rise of the red blood cell/plasma concentration ratio from a very low value 2 hours after an oral dose to a rather high value 24 hours after an or

ISSN:0001-690X    

DOI:10.1111/j.1600-0447.1978.tb06922.x

出版商:Blackwell Publishing Ltd    

年代:1978

数据来源: WILEY

摘要:

Functional coital impotence is not exclusive to men. It also occurs in two groups of women: those suffering from vaginismus and those with depressive episodes that give rise to a partner‐specific sexual phobia. The latter syndrome is by no means uncommon, yet it has not so far attracted the attention it deserves. This neglect may be largely due to the emotional complications which ensue from it and camouflage its depressive‐phobic background. It can be amenable to psychotherapeutic measures combined with antidepressant medicat

ISSN:0001-690X    

DOI:10.1111/j.1600-0447.1978.tb06923.x

出版商:Blackwell Publishing Ltd    

年代:1978

数据来源: WILEY

摘要:

Concentrations of homovanillic acid (HVA), 5‐hydroxyindoleacetic acid (5‐HIAA) and 3‐methoxy‐4‐hydroxyphenylglycol (MHPG) were measured in lumbar CSF from 33 patients with affective illnes and from 23 neurological controls. The group of patients with affective illness comprised 29 depressed and four manic patients. During illness, the concentration of HVA was higher in the depressed patients (P>0.001) than in the controls. Both unipolar and bipolar depressed patients had increased HVA levels (P>0.001 and P>0.05, respectively). The concentration of MHPG was greater than control values in the unipolar (P<0.001) and bipolar (P0.01) and normal levels of 5‐HIAA and MHPG. Sixteen of the 29 depressed patients had a second lumbar puncture after they had recovered. Compared with the pre‐recovery values, the concentration of HVA was reduced in the unipolar depressives (P0.02).The present findings suggest involvement of catecholamines in af

ISSN:0001-690X    

DOI:10.1111/j.1600-0447.1978.tb06924.x

出版商:Blackwell Publishing Ltd    

年代:1978

数据来源: WILEY