ISSN:0885-6230    

DOI:10.1002/gps.930030102

出版商:John Wiley&Sons, Ltd.    

年代:1988

数据来源: WILEY

摘要:

AbstractOrganic solvents have a wide range of adverse effects on cerebral functioning: the acute narcotic consequences of ingestion are well recognized and have been used to produce intoxication for thousands of years. A minority of such chemicals are proven neurotoxins and are hazardous even in low concentration. Since the late 1960s concern has been expressed that working men exposed to low levels of solvents, for example painters using oil‐based products or white spirit, consistently develop varieties of psychological illness which in their severest form have been described as a ‘dementia’. An examination of the literature, however, suggests that whatever long‐term adverse effects solvents may have, they do not appear to be characteristic, in either presentation or course, of dementing il

ISSN:0885-6230    

DOI:10.1002/gps.930030103

出版商:John Wiley&Sons, Ltd.    

年代:1988

数据来源: WILEY

摘要:

AbstractDexamethasone suppression test (DST) were performed in patients with dementia of the Alzheimer type and multiinfarct dementia. Test–retest reliability was found to be high in dementia patients if they were inpatients and environmental factors were dept stable. In this group 14% were non‐suppressors. If outpatients were investigated, admitted to hospital for only a few days, the test–retest reliability was low. In these patient groups 39–56% were non‐suppressors.Treatment with the serotonergic (5‐HT) uptake inhibitor citalopram significantly reduced the postdexamethasone cortisol levels as well at 08.00 am as at 03.00 pm the day after intake of 1 mg dexamethasone (after 10 h and 17 h respectively). Citalopram treatment also caused significant reduction of the cerebrospinal fluid (CSF) levels of 5‐hydroxyindolacetic acid (5‐HIAA) and 3‐methoxy 4‐hydroxyphenylglycol (HMPG). A correlation was seen between the citalopram‐induced reduction of 5‐HIAA levels in CSF and the degree of dexamethasone‐induced suppression of cortisol concentrations after the treatment period. Treatment with the 5‐HT uptake inhibitor alaproclate, with a regional selectivity principally to the limbic system, had little effect on the postdexamethasone cortisol levels. The results suggest a relation between the abnormal DST in dementia and a disturbed

ISSN:0885-6230    

DOI:10.1002/gps.930030104

出版商:John Wiley&Sons, Ltd.    

年代:1988

数据来源: WILEY

摘要:

AbstractNinety‐six per cent of mentally ill elderly persons who are not in the community reside in nursing homes, yet the mental health care they receive here is minimal or unavailable. Data are presented from the 1984 pretest of the National Nursing Home Survey. Five hundred and twenty‐six patients in 112 nursing homes in four US metropolitan areas were sampled. Overall, the prevalence of mental disorder was found to be 68%; 39% of the patients had a diagnosis of organic brain syndrome (OBS) and 29% had other mental disorders (OMD). Only about one‐third (31%) of residents had no mental disorder. These three patient groups, those with OBS, those with OMD, and those with no mental disorder, were compared on demographic, clinical, and treatment characteristics. The authors conclude that the balance between the Federal and State roles in financing care for the mentally ill in nursing homes needs to result in a more equitable system of care which does not discriminate against the mentally ill. Further, the mental health service system needs to assume greater responsibility for this population. While signnificant attention is given to residents' physical needs, behavioural and emotional problems are seriously negl

ISSN:0885-6230    

DOI:10.1002/gps.930030105

出版商:John Wiley&Sons, Ltd.    

年代:1988

数据来源: WILEY

摘要:

AbstractNumbers of serotonin (5‐HT) recognition sites of total 5‐HT1, 5‐HT1Aand 5‐HT2subtypes have been measured in frontal, temporal and parietal cortex from human brain postmortem, using binding of [3H] 5‐hydroxytryptamine (5‐HT), [3H] 8‐hydroxy‐2‐(di‐n‐propylamino) tetralin and [3H] ketanserin, respectively. A comparison has been made between 11 patients with Alzheimer's disease (AD) and 20 matched controls. Significant disease‐related differences were observed only in the parietal cortex for total 5‐HT1and 5‐HT2recognition sites. Age‐related decrease in numbers of 5‐HT2recognition sites was seen in the controls, whereas an age‐related increase in the numbers of the same site was seen in AD patients. These changes are discussed in relation to disease severity and cortical

ISSN:0885-6230    

DOI:10.1002/gps.930030106

出版商:John Wiley&Sons, Ltd.    

年代:1988

数据来源: WILEY

摘要:

AbstractWith the aim of detecting mild dementias, 94 elderly subjects who had been participating in a long‐term study since 1976 were studied by means of a new diagnostic instrument, the Alzheimer's Disease Assessment Scale (ADAS) (Rosenet al., 1984). Data available from intelligence tests performed during the course of the long‐term study were also analysed.On the basis of an independent clinical assessment, four subjects were rated as clearly demented, seven as possibly demented, and 83 as normal. A comparison of these three groups showed that the subjects classified as demented obtained significantly poorer scores on the ADAS than did the group of normal subjects. The cognitive section of the ADAS distinguished even better between the normal and the clearly demented subjects. On the other hand, there was no indication that the ADAS was specifically sensitive to degenerative types of dementia since the subject with the highest ADAS score was suffering from vascular dementia. There were significant correlations between the score on the ADAS and the subjects' previous or current intelligence level as assessed by means of two standard intelligence tests. However, no correlation was found between any deterioration in intelligence over time (8–10 years) and the ADAS score. The three groups did not differ significantly in intelligence quotient either at the beginning of the study (1976/78) or at its end in 1986; however, there were trends in this dire

ISSN:0885-6230    

DOI:10.1002/gps.930030107

出版商:John Wiley&Sons, Ltd.    

年代:1988

数据来源: WILEY

摘要:

AbstractEvidence for cerebral B12 deficiency was searched for in 16 patients (age range 54–94 years) with subnormal serum B12 values (<110 pmol/l) with or without anaemia using sequential regional cerebral blood flow measurement (rCBF). Three patterns of responses followed B12 substitution in 11/16 cases: marked increase of the cerebral blood flow after one week (1); complete or partial normalization of regional decreases after one week (2) or after 1–3 months (3). Mental disturbances were observed in 14/16 patients and abnormally slow EEG activity in 11/12 patients before B12 substitution. During substitution a parallel clinical improvement was observed in 5/7 cases, who could cooperate in a follow‐up study, and normalization or marked improvement of the abnormal EEG activity was observed in three cases. We propose that rCBF is a valuable tool for diagnosis and follow‐up of this deficiency state. In addition, our results indicate that prophylactic B12 substitution should be considered at serum B12 serum values above the lower normal value especially in aged patients with coexisting organic brain

ISSN:0885-6230    

DOI:10.1002/gps.930030108

出版商:John Wiley&Sons, Ltd.    

年代:1988

数据来源: WILEY

摘要:

AbstractTwo groups of patients suffering from Senile Dementia of the Alzheimer Type (S.D.A.T.) have been studied from first referral till death in hospital. The point of separation between the two groups was age — the younger group were aged 65–74 at the time of terminal admission and the older over 85.The variables studied were history of illness prior to referral, assessment on the Crichton Royal Behavioural Rating Scale at the time of terminal admission, duration of illness and duration of hospital stay. The last two factors were measured both in absolute terms and as features relative to life expectancy.The history proved unhelpful in identifying features capable of separating the two groups. Although in absolute terms the younger group survived longer, both from onset of illness and admission, in relative terms these patients fared considerably worse.The possibility that S.D.A.T. in the very elderly runs a more benign course is discus

ISSN:0885-6230    

DOI:10.1002/gps.930030109

出版商:John Wiley&Sons, Ltd.    

年代:1988

数据来源: WILEY

摘要:

AbstractKoro is an unusual phenomenon in non‐Asian peoples and the 22 cases previously reported in the psychiatric liteature are reviewed. A further example is described in a 81‐year‐old British male who maintained typical Koro symptoms for three months associated with major depre

ISSN:0885-6230    

DOI:10.1002/gps.930030110

出版商:John Wiley&Sons, Ltd.    

年代:1988

数据来源: WILEY

ISSN:0885-6230    

DOI:10.1002/gps.930030113

出版商:John Wiley&Sons, Ltd.    

年代:1988

数据来源: WILEY