摘要:

Suicide rates were obtained for New Zealand from 1889 to 1988. The overall rate for women has been stable since the 1930s, and the male rate showed marked peaks in the early 1930s and in the 1980s. Analysis of rates by age group revealed that the 1930 male peak was due to increases among the middle‐aged and elderly men, and the current peak is due to increases among young men. Possible explanations for fluctuations in suicide rates over the last century are discusse

ISSN:0001-690X    

DOI:10.1111/j.1600-0447.1993.tb03334.x

出版商:Blackwell Publishing Ltd    

年代:1993

数据来源: WILEY

摘要:

Poor neuroleptic response is a major unresolved clinical problem. Precise data concerning the frequency of poor neuroleptic response are not available. The implementation of treatment modalities that are specifically recommended for non‐responders (such as clozapine) increases the desirability of such data. This study evaluated the proportion of acutely exacerbated schizophrenics who remained unimproved by consecutive administration of haloperidol, chlorpromazine and perphenazine, in randomly determined order. The overall improvement rate was 95%. The frequency of good responses to the first, second and third drug were 67%, 55%, and 67% respectively. Differences in receptor affinity profile might explain the added beneficial effect of a second or third dru

ISSN:0001-690X    

DOI:10.1111/j.1600-0447.1993.tb03335.x

出版商:Blackwell Publishing Ltd    

年代:1993

数据来源: WILEY

摘要:

Lithium has been reported to induce polyuria in up to 35% of patients receiving it. It has been suggested that polyuria may be reduced by using single rather than multiple daily dosing. However, this information is based on non‐randomized studies, which used higher serum lithium levels than are currently used. In fact, the incidence of polyuria may be lower at currently used lithium levels, and the benefits of a single daily dose regimen on urine volume at these levels have not been assessed. We conducted a prospective randomized study to test the hypothesis that switching patients from multiple daily dose lithium to single daily dose lithium would significantly lower urine volume. Twenty‐four patients previously stabilized on multiple daily dosing were randomly allocated to either single or multiple daily dose lithium. Twenty‐four‐hour urine volume, serum creatinine, creatinine clearance and serum lithium were measured at study entry and completion. Switching to single daily dose lithium did not significantly reduce the 24‐h uri

ISSN:0001-690X    

DOI:10.1111/j.1600-0447.1993.tb03336.x

出版商:Blackwell Publishing Ltd    

年代:1993

数据来源: WILEY

摘要:

The five‐year follow‐up results of 28 first‐contact schizophrenic patients are compared with an older patient series of 53 patients from the same district. The treatment of the new series followed the principles of the need‐adapted model. The emphasis was on immediate initial crisis‐oriented family interventions. The treatment of the old series followed psychodynamic principles with an emphasis on individual and milieu therapy. The patients in the new group manage better with half the number of hospital days and less outpatient treatment. The differences are most clear in men. The crisis orientation caused failure in sustaining longer treatment relationships. This was harmful for patients and families with a more chronic development. In future, better continuity of treatment must be e

ISSN:0001-690X    

DOI:10.1111/j.1600-0447.1993.tb03337.x

出版商:Blackwell Publishing Ltd    

年代:1993

数据来源: WILEY

摘要:

Three patients with treatment‐resistant rapidly cycling bipolar disorder were studied with multiple sleep deprivations (SD) during several depressive episodes to assess the effect of phase or duration of a depressive episode on SD response. There was little response to SD early in a depressive episode, but responses were often robust late in an episode, sometimes triggering its termination. In 2 subjects, the duration of antidepressant response to SD increased linearly as time into episode increased. Neither the number of SD given in an episode nor the medication status of the patients appeared to account for the observed increases in antidepressant response. These results suggest that the neurobiological substrates underlying depression may change over the course of an episode, resulting in an increased responsivity to sleep deprivation later compared with earlier in the course of an episode in rapidly cycling patients. The generalizability of these findings to unipolar patients remains to be explore

ISSN:0001-690X    

DOI:10.1111/j.1600-0447.1993.tb03338.x

出版商:Blackwell Publishing Ltd    

年代:1993

数据来源: WILEY

摘要:

The monthly distribution of completed suicide and parasuicide by Israeli soldiers was analyzed during the 7‐year period of 1984–1990. Although parasuicide in general showed a constant incidence throughout the year, the monthly rate of suicide as well as parasuicide through firearms varied during the year in a similar way. The seasonal pattern of completed suicides, the vast majority of which occur with firearms, was correlated with the seasonal pattern of parasuicides through firearms. The combined variability of the two seasonal patterns was found to be significantly different from a pattern of a constant monthly incidence with a peak in December and a nadir in October. The monthly incidence of suicide and parasuicide through firearms was found to be negatively correlated with the duration of the daily photoperiod, when the latter was phase‐advanced by 1–2 months. This unique pattern of seasonal incidence of suicide and parasuicide through firearms is different from most of the patterns reported in the Northern Hem

ISSN:0001-690X    

DOI:10.1111/j.1600-0447.1993.tb03339.x

出版商:Blackwell Publishing Ltd    

年代:1993

数据来源: WILEY

摘要:

The purpose of this study was to assess the tolerability and efficacy of 150–600 mg remoxipride (predominantly a DA2receptor antagonist) in an open long‐term (1 year) multicentre trial in chronic schizophrenic patients. The mean duration of illness before entering the study was 21 years and the pre‐study neuroleptic dosage in chlorpromazine equivalents was 930 mg/day. The clinical efficacy was measured with the Brief Psychiatric Rating Scale and the Clinical Global Impression scale. The adverse events were recorded by a 26‐item Adverse Symptom Checklist and by the Abnormal Involuntary Movements Scale. Forty‐five patients were included in the study. The mean daily dose of remoxipride during the last week of treatment was 378 mg. Eighty percent (36 patients) withdrew prematurely (<1 year). The main reasons for withdrawal were: ineffectiveness (n= 15), treatment refusal (n= 12) and adverse events (n= 8). The most frequently reported adverse events were insomnia (n= 20) and tiredness (n= 7), whereas only a few (n= 6) extrapyramidal symptoms were reported. There was no relationship between remoxipride plasma concentrations and clinical efficacy nor was any relationship found between the ratio of pretrial chlorpromazine equivalent to last remoxipride dose and the therapeutic effect. Remoxipride alone seemed to have an insufficient neuroleptic efficacy in these chronic and treatment‐resistant schizophrenic patients but was wel

ISSN:0001-690X    

DOI:10.1111/j.1600-0447.1993.tb03340.x

出版商:Blackwell Publishing Ltd    

年代:1993

数据来源: WILEY

摘要:

A test of validity of the psychiatric diagnoses obtained by the psychological autopsy procedure is described in a consecutive series of 67 adolescent suicide victims. Family history of mental illness in first‐degree relatives of subjects was obtained blind to subject diagnosis using the family history method. It was hypothesized that subjects with a given diagnosis, compared with subjects without this diagnosis, would show an increased rate of this disorder among first‐degree relatives. This hypothesis was supported insofar as specific associations between subject diagnosis and familial rates of illness were demonstrated for major depression, bipolar illness, conduct and antisocial disorder and substance abuse. These results provide further support for the validity of diagnoses obtained through the psychological autopsy proced

ISSN:0001-690X    

DOI:10.1111/j.1600-0447.1993.tb03341.x

出版商:Blackwell Publishing Ltd    

年代:1993

数据来源: WILEY

摘要:

A prospective study was carried out in a general hospital in Reykjavik to evaluate the prevalence of delirium and dementia among 331 patients 70 years and older who were admitted as an emergency to the medical department. Cognitive function was screened with Mental Status Questionnaire (MSQ) and Mini‐Mental State Examination (MMSE) and diagnosed according to DSM‐III‐R for delirium and dementia. Other information obtained included social and demographic factors, drug consumption, the main condition underlying the delirium and outcome. Severe cognitive dysfunction was present in 32% of all acutely admitted patients 70 years and older, which were diagnosed further as delirium 14% and dementia 18%. At follow‐up, concurrent dementia was found in 70% of the delirium patients. The main causes for delirium were cardiac failure 27%, stroke 22% and sepsis 16% and the mortality rate was 32% compared with 8% in dementia alone. The prognosis of patients with delirium and dementia depends on detecting these disorders, and the clinical skills of physicians working with acutely ill elderly patients can be improved by relatively simple screening questionnaires such as the MSQ a

ISSN:0001-690X    

DOI:10.1111/j.1600-0447.1993.tb03342.x

出版商:Blackwell Publishing Ltd    

年代:1993

数据来源: WILEY

摘要:

In 103 schizophrenic patients we investigated the extent of practice needed in the use of the Brief Psychiatric Rating Scale (BPRS) to enable its reliability to be assessed. The agreement level of the 7 raters was analysed. Generally, the lowest mean agreement found was for the negative symptoms of the BPRS schizophrenia subscale. A high degree of agreement was attained both for the positive symptoms of the BPRS schizophrenia subscale and for the symptoms of the depression – and of the mania subscale. The degree of disagreement observed was due to both individual differences in assessment ability and the rating procedure. These results indicate that it is necessary to state the degree of agreement achieved in studies in which several raters are taking par

ISSN:0001-690X    

DOI:10.1111/j.1600-0447.1993.tb03343.x

出版商:Blackwell Publishing Ltd    

年代:1993

数据来源: WILEY