摘要:

In order to evaluate the tuberoinfundibular endogenous dopaminergic tone in alcoholic subjects, the inhibitory effect of an infusion of dopamine (3 µg/kg/min for 2 h) on PRL secretion was tested in 11 alcoholics after 4 weeks of abstinence. On different days alcoholics were tested with TRH to evaluate possible alterations in the PRL pituitary reserve. Age-matched normal men participated as controls. In addition, the status of cerebral structures, such as the frontal-subcortical area, where dopamine plays an important role as neurotransmitter, was evaluated in all subjects by radiological (CT scan) and functional (neuropsychological tests) studies. The PRL response to TRH was similar in the two groups. In contrast, dopamine-induced PRL decrement was significantly lighter in alcoholics than in controls. Neuroradiological and neuropsychological parameters were abnormal in alcoholics. These data suggest an alteration in dopaminergic activity involving the tuberoinfundibular and probably the frontosubcortical system in 4 weeks abstinent alcoholics

ISSN:0302-282X    

DOI:10.1159/000119350

出版商:S. Karger AG    

年代:1997

数据来源: Karger

摘要:

Forty-three schizophrenic patients participating in this study were serotyped for human leukocyte antigens (HLA-A, -B, -C, -DR, -DQ antigens). Thirty-six of them were hospitalised in two state mental hospitals and 7 in our general hospital, psychiatric unit. The patients from our unit were typed for HLA before commencing clozapine treatment whereas the patients from state hospitals were typed after commencing treatment. Three out of 43 patients developed agranulocytosis. One had a combination of both ‘high-risk’ haplotypes (HLA-B16(38,39), DR4, DQ3 and HLA-DR2, DQ1), another had HLA-DR2, DQ1, whereas the last had a totally different haplotype. Between non-agranulocytic patients 1 was found to carry the HLA-B16(38,39), DR4, DQ3 haplotype and 14 (out of 40) had the HLA-DR2, DQ1. Taking into account other factors supposed to be involved (a noxious metabolite, and the presence of a humoral cytotoxic factor) we must admit that despite the finding of a high-risk haplotye in Jewish populations there are other aspects of this question awaiting clarificat

ISSN:0302-282X    

DOI:10.1159/000119351

出版商:S. Karger AG    

年代:1997

数据来源: Karger

摘要:

In order to evaluate serotonergic function in obsessive-compulsive disorder (OCD), plasma cortisol response to d-fenfluramine (30 mg p.o.) was examined in 20 drug-free obsessive-compulsive patients (10 males and 10 females) and in 20 age- and sex-matched healthy subjects, under double-blind, placebo-controlled conditions. We found that: (a) baseline plasma cortisol secretion was significantly increased in patients with OCD; (b) in healthy subjects, the cortisol response to d-fenfluramine was evident in women, but no in men; (c) plasma cortisol response to the serotonergic challenge did not differ between patients and controls, but it was significantly reduced in female patients as compared to healthy women. These results demonstrate a hyperactivity of the hypothalamo-pituitary-adrenal axis in obsessive-compulsive patients and suggest a dysfunction of 5-HT transmission in female patients.

ISSN:0302-282X    

DOI:10.1159/000119352

出版商:S. Karger AG    

年代:1997

数据来源: Karger

摘要:

Several authors have investigated the presence of thought disorder in psychiatric patients using different reliable methods. Under the hypothesis of a genetic predisposition to thought disorder, the degree and quality of thought disorder have also been studied in populations at a high risk for psychosis, in particular for schizophrenia. As a result, an increasing incidence of throught disorder was detected in relatives of schizophrenics. To account for the thought disorder also found in normal subjects, researchers propose that thought disorder exists in normal subjects on a continuum with schizophrenic patients. In the following report, we evaluated the inherited component of thought disorder in normal subjects, using a sample of 25 normal twin pairs, 16 monozygotic and 9 dizygotic twin pairs. We applied the Thought Disorder Index (TDI) to assess disordered thinking, genetic estimates were made with classical methods, controlling for environmental sources of variability where possible. Our findings suggest a strong additive genetic component for the global TDI rating variable, with a heritability estimate approaching 80–90%. New approaches in neuropsychology and neuropsychiatry based on genetic methodologies should further define the cerebral physiology responsible for disordered thinkin

ISSN:0302-282X    

DOI:10.1159/000119353

出版商:S. Karger AG    

年代:1997

数据来源: Karger

摘要:

Hypothalamic-pituitary-adrenal (HPA) axis activity and platelet 5-HT concentrations were determined before dexamethasone suppression test (DST) in 80 male schizophrenic patients with predominantly positive or negative symptoms. Significant differences in platelet 5-HT and no differences in baseline plasma cortisol concentrations among schizophrenic suppressors and nonsuppressors were found. A similar rate of nonsuppression (56% positive and 53% negative schizophrenic patients) was detected. Platelet 5-HT, but not plasma cortisol concentrations, could be used to differentiate positive and negative symptoms of schizophrenia.

ISSN:0302-282X    

DOI:10.1159/000119354

出版商:S. Karger AG    

年代:1997

数据来源: Karger

摘要:

Twenty-seven medicated chronic schizophrenic female patients were tested for right or left turning behavior. No substantial right or left asymmetry was found, nor did the addition of the indirect dopaminergic agonist amantadine influence these results. Previous studies demonstrated left circling preference in chronic unmedicated schizophrenics and it seems that this previous finding is abolished by neuroleptic treatment. However, our patients were all females and further research with a heterogenous group of schizophrenic patients is needed.

ISSN:0302-282X    

DOI:10.1159/000119355

出版商:S. Karger AG    

年代:1997

数据来源: Karger

摘要:

In the treatment of panic disorder double-blind controlled studies have demonstrated that imipramine (IMI) was effective at doses higher than 125 mg/ day. However a high rate of dropouts because of side effects has been reported in these subjects. In clinical settings, the administration of benzodiazepines (BDZ) in combination with IMI has been proposed to reduce the frequency and severity of side effects. In this naturalistic study, 49 patients affected by panic disorder with agoraphobia (n = 36) or without agoraphobia (n = 13) were treated with IMI plus lorazepam (LRZ) and followed for 12 months. The mean effective doses were 63.5 ± 35.5 mg/day for IMI and 2.4 ± 1.3 mg/day for LRZ. During the follow-up period, panic attacks disappeared in 75.5% of patients and 69.5% of agoraphobics were free of phobic avoidance. The patients with comorbid mood disorders and longer duration of illness required higher doses of both drugs. The combined treatment of IMI and LRZ allowed the use of low doses of the drugs, reduced the frequency and severity of the side effects and improved patient compliance. In fact, only 1 patient (2%) dropped out because of the severity of side effects. Furthermore, the patients who tapered LRZ treatment did not show BDZ withdrawal syndrom

ISSN:0302-282X    

DOI:10.1159/000119356

出版商:S. Karger AG    

年代:1997

数据来源: Karger

摘要:

Thirty six schizophrenic patients were randomly assigned to placebo or haloperidol treatment for 6 weeks. Blood samples to measure plasma alpha-one acid glycoprotein (AAG), haloperidol and reduced haloperidol concentrations were obtained at baseline and weeks 2, 4, and 6. Blood samples were obtained 10-12 h after the evening dose and prior to the morning dose. Haloperidol and reduced haloperidol was assayed by HPLC with electrochemical detection. Plasma AAG levels were assayed by radial immunodiffusion. Patients were clinically assessed by the Brief Psychiatric Rating Scale (BPRS) and Abnormal Involuntary Movement Scale at baseline and weeks 2, 4, and 6. BPRS scores did not significantly decrease during placebo treatment, although a slight drop in plasma AAG levels was found. Haloperidol produced a significant decrease in BPRS scores and plasma AAG levels. Mean plasma haloperidol levels were 12.9 ± 14.7 ng/ml at week 6. Significant correlations between decreasing BPRS scores and plasma AAG levels were not found with only a strong trend at week 2 (r = 0.445, p = 0.073). The role of AAG and psychotropic drug disposition in psychiatric patients requires further evaluation

ISSN:0302-282X    

DOI:10.1159/000119357

出版商:S. Karger AG    

年代:1997

数据来源: Karger

摘要:

Psychiatric patients on long-term lithium (Li) therapy frequently develop goiter and/or hypothyroidism. It has also been suggested that Li may trigger/ exacerbate thyroid autoimmunity. Previous studies provided evidence that underlying thyroid diseases represent important predisposing factors for the development of Li-induced thyroid dysfunction. The aim of the present paper was to assess the value of thyroid ultrasound – a simple and reliable tool to detect subtle thyroid abnormalities – in the longitudinal evaluation of 23 Li-treated psychiatric patients without evidence of biochemical thyroid abnormalities before therapy. For this purpose, thyroid ultrasound was associated with a clinical and laboratory (serum thyroxine, serum triiodothyronine, serum TSH, antithyroglobulin (AbTg), antithyroid microsomal (AbM) and antithyroid peroxidase autoantibodies) evaluation prior to and at 6- to 12-month intervals during Li treatment. On the basis of thyroid ultrasound before Li, patients were subdivided into two groups: group A (n = 15, 7 males, 8 females) with a normal echography and group B (n = 8, 5 males, 3 females) with mild ultrasound abnormalities. In group A the development of a small diffuse goiter was confirmed by physical examination during Li therapy; 2 patients displayed a transient increase of serum TSH concentration and none developed detectable serum antithyroid autoantibodies. Beside the small volumetric increase, no other ultrasound abnormalities were observed during the entire follow-up. In all group B patients a mild diffuse goiter was clinically detected before and on Li administration and no significant volumetric changes were observed during follow-up. Two patients developed high titers of AbM and AbTg 12 and 18 months after the beginning of Li, respectively; in 1 a persistent increase of serum TSH concentration was also observed. Thyroid echography before Li displayed different degrees of scattered or diffuse hypo-echogenicity and a further decrease in echogenicity was detected during Li therapy in 2 patients. In conclusion, we provided further evidence that long-term Li administration is not associated with de novo appearance of thyroid autoimmune phenomena in humans, but rather with an exacerbation of underlying thyroid autoimmunity. In addition to thyroid autoantibody and TSH measurements, thyroid echography appears to be a sensitive tool in the identification of patients at risk of developing autoimmune hypothyroidism during long-term Li ther

ISSN:0302-282X    

DOI:10.1159/000119358

出版商:S. Karger AG    

年代:1997

数据来源: Karger

摘要:

Effects of alertness and memory of a single dose of diazepam (10 mg) and the central stimulant methylphenidate (20 mg) were studied in healthy volunteers. It was questioned whether opposite effects of diazepam and methylphenidate are not only observed with respect to alertness but also with respect to memory. It was also questioned whether the two drugs equally affect the first (primacy) and last (recency) items in both the immediate and delayed recall of newly learned words. The experiment was performed in a double-blind, placebo-controlled way. 12 subjects were exposed to a subjective alertness scale and a verbal memory test: a 15-word test. Subjective alertness was found to be decreased after diazepam and increased after methylphenidate. Anterograde amnesia was found after diazepam in the memory test. More specifically, the primacy but not the recency effect was reduced during the immediate recall and both were reduced in the delayed recall. Methylphenidate had no effect on memory, however a ceiling effect might have obscured a putative drug effect. The results of a second experiment excluded this possibility. In all, the data demonstrate opposite effects of the two drugs on subjective alertness, suggesting opposite effects on vigilance. Opposite effects on memory were not established. This demonstrates that changes in alertness do not run in parallel with changes in memory. A scatter diagram, however, suggests a small effect of alertness on immediate recall. The effects of diazepam were also discussed in terms of the Atkinson and Shiffrin memory theory and it seems that diminished rehearsal processes are one of the key factors in explaining diazepam-induced amnesia.

ISSN:0302-282X    

DOI:10.1159/000119359

出版商:S. Karger AG    

年代:1997

数据来源: Karger