摘要:

AbstractThe authors review the literature describing the neural symptoms induced by tricyclic antidepressants, especially tremor, seizures, akathisia, myoclonus, dyskinesia and delirium. Sedation, modifications of sleep, memory and appetite are also described. Tremor and myoclonus are the most frequent drug‐induced neural symptoms. Delirium is most often caused by high‐dosage treatments. The pathophysiology of akathisia and dyskinesia raises important questions concerning the mode of action of antidepressa

ISSN:0001-690X    

DOI:10.1111/j.1600-0447.1992.tb01465.x

出版商:Blackwell Publishing Ltd    

年代:1992

数据来源: WILEY

摘要:

AbstractA mental health survey was conducted in Palembang, Indonesia, to test the hypothesis that rapid socioeconomic and cultural change is detrimental to mental health. The 30‐item General Health Questionnaire, translated into Bahasa Indonesia, was administered to a probability sample of 1670 adults (94.9% of the target sample). The Present State Examination was conducted on a weighted subsample of 100, using a 2‐phase design. Overall morbidity rates were surprisingly similar to those in industrialized countries. A strong association was found between psychological symptoms and poverty. Persons belonging to communities that had progressed substantially in standards of living had fewer symptoms. The evidence points to a possibly beneficial effect of economic progress on mental health. Longitudinal data are needed to confirm t

ISSN:0001-690X    

DOI:10.1111/j.1600-0447.1992.tb01466.x

出版商:Blackwell Publishing Ltd    

年代:1992

数据来源: WILEY

摘要:

AbstractSixty‐four elderly patients who had been admitted to the St. George's Hospital Alzheimer's disease evaluation project during 1981–1989 were followed up to postmortem examination. Comparison between clinical diagnoses and neuropathological diagnoses indicated positive predictive values for the antemortem diagnoses of 50–67%. Existing clinical criteria may not be accurate enough to permit firm antemortem diagnosis of older people for either research or clinical pur

ISSN:0001-690X    

DOI:10.1111/j.1600-0447.1992.tb01467.x

出版商:Blackwell Publishing Ltd    

年代:1992

数据来源: WILEY

摘要:

AbstractThere is little information about hypothalamic‐pituitary‐adrenocortical (HPA) axis function in mania, particularly in mixed states. We therefore investigated HPA function and its relationship to clinical state in 19 hospitalized manic patients meeting Schedule for Affective Disorders and Schizophrenia ‐ Research Diagnostic Criteria for acute manic episodes, compared patients with and without a mixed presentation, and examined correlations between HPA activity and behavior. Data were available from 13–16 patients. Behavioral and biochemical analyses were conducted during a 15‐d placebo period. Patients with mania had elevated cerebrospinal fluid (CSF) and urinary free cortisol excretion compared with healthy subjects, and did not differ from depressed patients in any cortisol measures. Mixed manics had significantly higher morning plasma cortisol, postdexamethasone plasma cortisol and CSF cortisol than pure manics. Five of 7 mixed manics and 3 of 9 pure manics were dexamethasone suppression test (DST) nonsuppressors. Afternoon plasma cortisol and CSF cortisol correlated significantly with depressed mood; urinary free cortisol correlated with anxiety. None of the cortisol measures correlated with mania or agitation scores. These data suggest that increased cortisol secretion is a characteristic of the depressed state in mixed manics, although pure manics may also have increased DST nonsu

ISSN:0001-690X    

DOI:10.1111/j.1600-0447.1992.tb01468.x

出版商:Blackwell Publishing Ltd    

年代:1992

数据来源: WILEY

摘要:

AbstractMany large studies of psychotherapy show that the median patient drops out by the 5th session and most before the 10th session. Data from an effective behavior therapy clinic for the anxiety disorders showed that only 17% of patients failed to complete a median of 60 h of therapy. Patient characteristics were not associated with attrition. We examined 5 meta‐analytic treatment reviews and found the median drop‐out rate was 8% after 20 h of therapy. We suggest that low attrition is associated with effective, standardized treatment and as such, drop‐out rate may be a proxy variable that can indicate effective service del

ISSN:0001-690X    

DOI:10.1111/j.1600-0447.1992.tb01469.x

出版商:Blackwell Publishing Ltd    

年代:1992

数据来源: WILEY

摘要:

AbstractIn DSM‐III it is proposed that there are 11 personality disorders (PDs) that fall into 3 superordinate clusters: cluster A, labelled the odd or eccentric; cluster B, labelled the emotional, dramatic or erratic; and cluster C, described as the anxious or fearful. To check this proposal, data were obtained from a sample of 112 state hospital psychiatric inpatients via the Structured Interview for DSM‐III Personality (SIDP). Various statistical techniques were applied to the data, ranging from the least constrained method of multidimensional scaling to the most constrained and statistically rigorous approach of confirmatory factor analysis. In the latter approach, the models suggested by the various statistical approaches were contrasted directly. A 3‐cluster solution was accepted as the best representation of the data, although PD membership of the 3 clusters varied in some ways from those suggested by DSM‐III. An exploratory correlational analysis showed that many of the items were more strongly correlated with PDs other than the ones specified by DSM‐III, but generally items clustered within the 3 superordinate clusters. This issue deserves further inve

ISSN:0001-690X    

DOI:10.1111/j.1600-0447.1992.tb01470.x

出版商:Blackwell Publishing Ltd    

年代:1992

数据来源: WILEY

摘要:

AbstractThe relationships between symptoms and both prior suicide attempts and current suicidal thinking were examined in a sample of schizophrenics at 2 points in time. Fifty subjects meeting DSM‐III criteria for schizophrenia were assessed within 1 week of admission, and 41 were reassessed at a 6‐month follow‐up. On admission, prior suicide attempts were significantly associated with current depression, female sex, lower education and more frequent hospitalization. The association with depression remained significant at follow‐up. In addition, current suicidal thinking was associated with depression at both times but also with negative symptoms at time 1 and delusions and hallucinations at time 2. These findings confirm and strengthen prior reports of an association between depression and attempted

ISSN:0001-690X    

DOI:10.1111/j.1600-0447.1992.tb01471.x

出版商:Blackwell Publishing Ltd    

年代:1992

数据来源: WILEY

摘要:

AbstractThirteen patients with depression following minor head injury were matched with 13 functional depressives. Both groups were indistinguishable psychopathologically. Five of the functional group had a family history of affective disorder and none of the head‐injury group had such a history. Both groups were treated with amitriptyline, beginning with 100 mg daily, increasing to a maximum of 250 mg/d. There were significant differences in response between the 2 groups, with only 4 of the head‐injury patients improving. Our preliminary results suggest that this condition is relatively resistant to tricyclic ther

ISSN:0001-690X    

DOI:10.1111/j.1600-0447.1992.tb01472.x

出版商:Blackwell Publishing Ltd    

年代:1992

数据来源: WILEY

摘要:

AbstractForty‐four chronic schizophrenic inpatients participated in this multicentre 12‐week parallel‐group double‐blind trial. After a run‐in period of 2 weeks and a single‐blind placebo wash‐out of 1 week, they were randomly assigned to treatment with either the serotonin2and dopamine‐D2antagonist risperidone or haloperidol. Two patients were excluded from the efficacy analysis. Five patients dropped out in the haloperidol group and 1 in the risperidone group. At the end of the trial, the mean daily dose was 12 mg for risperidone and 10 mg for haloperidol. The risperidone group showed greater improvement on the Positive and Negative Syndrome Scale for Schizophrenia, the Schedule for Affective Disorders and Schizophrenia – change version, and the Nurses’ Observation Scale for Inpatient Evaluation. The improvement of negative symptoms was more pronounced in the risperidone group until week 8 of double‐blind treatment. The consumption of antiparkinsonian medication was 10 times lower with risperidone. Both drugs were well tolerated and the laboratory, endocrinological and cardiovascular safety parameters were comparable. This study suggests that risperidone is comparable to haloperidol as an antipsychotic, but that it ha

ISSN:0001-690X    

DOI:10.1111/j.1600-0447.1992.tb01473.x

出版商:Blackwell Publishing Ltd    

年代:1992

数据来源: WILEY

摘要:

AbstractThe ventricle‐brain ratio (VBR) of 42 chronic schizophrenic patients was compared with that of 42 age‐matched medical controls. For the schizophrenics, the relationship of various clinical parameters to the VBR was assessed, and the outcome of 12 weeks of double‐blind treatment with either risperidone or haloperidol. The results confirm that schizophrenic patients have slightly enlarged lateral ventricles compared with medical controls. Only for schizophrenics, an effect of age, but not of duration of illness, was noticed. This study does not support the validity of a clinical subdivision of chronic schizophrenic patients on the basis of the VBR. Neither negative, positive nor general psychopathological symptoms, as measured by the Positive and Negative Syndrome Scale for Schizophrenia (PANSS), were related to the VBR, nor were abnormal involuntary movements or extrapyramidal symptoms. No association between season of birth or a family history of major mental disorder and VBR could be demonstrated. Treatment response was predicted by the total PANSS score and the PANSS general psychopathology subscale score at baseline. There was a trend for patients with higher VBR to have a more favourable treatment outcome, independent of the treatment (risperidone or haloper

ISSN:0001-690X    

DOI:10.1111/j.1600-0447.1992.tb01474.x

出版商:Blackwell Publishing Ltd    

年代:1992

数据来源: WILEY