Showing papers in "Acta Psychiatrica Scandinavica in 1982"
TL;DR: The paper describes the development of the PAF and the three scoring Systems and illustrates the sensitivity of the individual items and scoring Systems in reflecting the great diversity of change manifested during the premenstrual period.
Abstract: The Premenstrual Assessment Form (PAF) is a new self report procedure designed to measure changes in mood, behavior, and physical condition during the premenstrual period. It reflects the great variability of premenstrual syndromes as opposed to the common practice of viewing these changes as a single entity. In comparison to commonly used procedures, the PAF 1) contains a broader variety and more specific descriptions of positive as well as negative changes; 2) provides Unipolar Summary Scales and Bipolar Continua which are sensitive measures for indexing levels of severity on various types of change; and 3) provides specific criteria for Typological Categories descriptive of different syndromes of change, especially those of mood and behavior. The paper describes the development of the PAF and the three scoring Systems and illustrates the sensitivity of the individual items and scoring Systems in reflecting the great diversity of change manifested during the premenstrual period.
303 citations
TL;DR: The results show that the differentiation between the major types of presenile dementia can be achieved by a systematic rating of the clinical features.
Abstract: Fifty-seven patients were studied for differential diagnosis between dementias. Three rating-scales were used for identification of Alzheimer's disease (AD), Pick's disease (PD) and multi-infarct dementia (MID). Their validity was tested against verified diagnoses in 28 patients. The rating-scale of ischemic score consisting of 13 items such as abrupt onset, stepwise progression, fluctuating course, history of strokes and neurological symptoms and signs, identifies patients with MID. This can also be achieved by the two rating-scales for diagnosis of AD (12 items) and PD (9 items), which, however, can also be used for the differentiation between these two dementias. The rating-scale for diagnosis of AD contains clinical features such as early spatial disorientation, apraxia, aphasia, agnosia, logoclonia and increased muscular tension. The rating-scale for PD contains i.a. early loss of insight, early signs of disinhibition, echolalia, mutism and amimia. The results show that the differentiation between the major types of presenile dementia can be achieved by a systematic rating of the clinical features.
158 citations
TL;DR: A CT study in 46 patients and 46 healthy volunteers found that twenty-eight of the patients fulfilled the Research Diagnostic Criteria for schizophrenia, and 19 had not been hospitalized for psychiatric reasons before.
Abstract: Evidence has been obtained by computed tomography (CT) that some chronic schizophrenic patients have enlarged cerebral ventricles and other brain abnormalities when compared to other patient groups and to healthy controls (Johnstone et al. (1976), Weinberger et al. (1979)). In order to investigate whether structural brain abnormalities can be demonstrated also in younger patients with acute psychosis we have undertaken a CT study in 46 patients and 46 healthy volunteers. Twenty-eight of the patients fulfilled the Research Diagnostic Criteria for schizophrenia. Nineteen had not been hospitalized for psychiatric reasons before.
The lateral and third ventricles were significantly wider in the patients than in the volunteers. In the volunteers there was a significant positive correlation between age and size of the lateral ventricles, whereas in the patients, particularly those fulfilling the criteria for schizophrenia, no such correlation was obtained. These results indicate that schizophrenia may be associated with pathophysiological processes which interfere with the normal age-related enlargement of the ventricles. Signs of cortical atrophy, CSF circulation disturbances and reversed asymmetry of the occipital lobes were more frequent in the patient group than among the controls. These results are in accordance with previously published findings and indicate that structural brain abnormalities can be found in relatively young patients with acute psychosis.
152 citations
TL;DR: When tested for consistency with multiple threshold hypotheses of genetic transmission, schizoaffective illness did not qualify as either a more extreme form of affective illness nor as a disorder that occupies an intermediate position between bipolar and unipolar disorders or is genetically milder than affective disorder.
Abstract: Data on schizoaffective illness, schizophrenia and affective disorders were gathered on first-degree relatives of schizoaffective probands and matched controls (bipolars, unipolars and schizophrenics). The familial pattern of affective and schizophrenic subtypes of schizoaffective disorder resembled the familial pattern of affective and schizophrenic probands, respectively. The overall risk for the spectrum of schizoaffective and affective disorders was higher among relatives of schizoaffective-manic as compared to relatives of schizoaffective-depressive probands, although the difference fell short of significance. When tested for consistency with multiple threshold hypotheses of genetic transmission, schizoaffective illness did not qualify as either a more extreme form of affective illness nor as a disorder that occupies an intermediate position between bipolar and unipolar disorders or is genetically milder than affective disorder. The implications of diagnostic subtyping for genetic research in the major psychoses were discussed.
151 citations
TL;DR: During the first two periods pimozide almost significantly enhanced the weight gain induced by the behavior therapy program and beneficially influenced the patients attitude towards treatment.
Abstract: Eighteen female inpatients were included in a double-blind placebo-controlled cross-over study aimed at testing the hypothesis that dopamine blockade may enhance the effectiveness of behavior therapy in the short-term weight restoration of anorexia nervosa patients The patients were given a uniform contingency management program and, after a baseline period, they alternatingly (3- week periods) received pirnozide (4 or 6 mg) or a placebo During the first two periods pimozide almost significantly enhanced the weight gain induced by the behavior therapy program and beneficially influenced the patients attitude towards treatment
142 citations
TL;DR: The results show that the HDRS is a valid mea‐ sure in that it discriminates between depressed patients and normals and supports Hamilton's view that only the first 17 items of the scale are appropriate for computing the score.
Abstract: The Hamilton Rating Scale for depression (HDRS) has become the standard observer rating scale for depression, yet there are no adequate data from normal samples. The present study was carried out in northern Italy. The purposes were 1) to examine the ratings in normals and 2) to examine the scale's validity in the different language and culture. The scale was used in 40 normals and 40 depressives who were matched. Two self-rating scales of depression were administered: the Symptom Rating Test and the Symptom Questionnaire. The results show that the HDRS is a valid measure in that it sensitively discriminates between depressed patients and normals. The findings support Hamilton's view that only the first 17 items of the scale are appropriate for computing the score. The use of self-rating scales yielded additional information. The misclassification rate of the Symptom Rating Test was similar to that of the HDRS. The combined use of Research Diagnostic Criteria (RDC) and HDRS appears to be more reliable for the selection of depressed patients for research than the RDC only.
102 citations
TL;DR: Preliminary evidence that clonidine may be an effective alternative to neuroleptics is provided, particularly for patients for whom the dopaminergic blocking action of the neuroleptic drugs is undesirable.
Abstract: Antipsychotic effects of clonidine were evaluated in one schizoaffective and seven schizophrenic patients, using a double-blind, cross-over design to compare placebo, clonidine, and standard neuroleptic drugs. Mean improvement on clonidine and neuroleptics was equal, and improvement scores on the two treatments were closely correlated for individual patients. Clonidine was selected because it blocks noradrenergic but not dopaminergic neurotransmission. Patients were selected because of co-existing psychosis and tardive dyskinesia, a movement disorder thought to be caused by the antidopaminergic properties of the neuroleptics. For all patients, dyskinesia improved when neuroleptics were discontinued during clonidine and placebo periods of the study. The data provide preliminary evidence that clonidine may be an effective alternative to neuroleptics, particularly for patients for whom the dopaminergic blocking action of the neuroleptics is undesirable. The study also prompts re-evaluation of theories of a unique role for dopamine in schizophrenia.
88 citations
TL;DR: There is no direct relationship between psychoneurotic illness and IBS, but the presence of the former has an adverse effect on the shortterm outcome of the bowel disorder.
Abstract: Sixty per cent of the patients referred to two gastroenterological clinics and diagnosed as suffering from the irritable bowel syndrome (IBS), were found to have significant psychoneurotic morbidity on the basis of the General Health Questionnaire. A double-blind, completely randomised, placebo controlled comparison of treatment with a combined anxiolytic/antidepressant (Motipress) found a significantly better effect of Motipress than placebo on diarrhoea and abdominal pain. Detailed analysis of the results suggests that there is no direct relationship between psychoneurotic illness and IBS, but the presence of the former has an adverse effect on the short-term outcome of the bowel disorder.
83 citations
Journal Article•
77 citations
TL;DR: There was no statistical difference between controls and schizophrenics as regards cortical atrophy (as measured by the interhemispheric and Sylvian fissures and mean sulcal width) and highly significant differences were found regarding central atrophy.
Abstract: CT of the brain was carried out in 43 chronic schizophrenics of more than 5 years' duration and less than 60 years of age, and 39 normal controls matched for age, sex and education. There was no statistical difference between controls and schizophrenics as regards cortical atrophy (as measured by the interhemispheric and Sylvian fissures and mean sulcal width). Highly significant differences were found regarding central atrophy. Third ventricle measurements were normal in 9.3%, there was slight enlargement in 37.2%, moderate in 48.8% and extreme in 4.7% The cella media index denoting lateral ventricle dilatation showed changes in 46.5%, slight in 9.3% and the remaining 44.2% were normal.
This study shows that a large number of chronic schizophrenics have an associated central atrophy.
76 citations
TL;DR: Lithium may be more harmful to the kidney when the lithium administration gives a relatively constant serum lithium level than when the administration causes greater variations including peak values and low minimum levels in serum lithium.
Abstract: Renal structure and function were investigated in two groups of long-term lithium treated patients Lithium was administered in two different ways either in a one-dose per day schedule where the whole dose of lithium was given between 8 and 10 pm or in a schedule where the lithium dose was given, divided into two or three doses, during the day Kidney biopsy was performed, and structural changes in the kidney tissue were determined together with 24-h urine volume in the individual patients The functional as well as the structural changes were most pronounced in patients given their lithium in divided doses during the day Lithium may be more harmful to the kidney when the lithium administration gives a relatively constant serum lithium level than when the administration causes greater variations including peak values and low minimum levels in serum lithium The reason for this might be that a number of regenerative processes only occur in periods with low lithium concentrations
TL;DR: A cross‐sectional study on patients with different abstinence time was performed to describe long‐time biochemical and psychiatric changes due to withdrawal from heavy alcohol abuse, demonstrating the existence of a subacute withdrawal syndrome lasting for 4–6 weeks.
Abstract: A cross-sectional study on patients with different abstinence time was performed to describe long-time biochemical and psychiatric changes due to withdrawal from heavy alcohol abuse. Physical, neurological, psychiatric and biochemical parameters were measured in 70 patients with a withdrawal period ranging from 2-90 days. The various parameters changed over time in different manners. Fatigability, reduced sleep, reduced sexual interest, apparent sadness, hostility and global ratings of abstinence improved significantly with the duration of the recovery period. Symptoms related to brain hyperexcitability such as fatigability, inner tension, insomnia and pains persisted for approximately 5 weeks. Of the biochemical parameters, the transaminases were normal in patients with more than 10 days of abstinence, while the levels of gamma-glutamyltransferase and HDL-cholesterol remained high for longer periods. The essential fatty acid status, measured by the fatty acid composition of serum lecithin, appeared to be normal only in patients with long recovery time. MAO in platelets was significantly lower than in the controls. The highest values were seen in the early recovery phase, which may indicate a temporary increase. Since polyunsaturated fatty acids are important constituents of synaptic membranes and since platelet MAO may reflect brain MAO, we consider these co-existing findings important in the interpretation of the psychiatric symptoms. The study demonstrated the existence of a subacute withdrawal syndrome lasting for 4-6 weeks.
TL;DR: Although both agents were well tolerated, the zimelidine‐treated patients reported significantly less severe anticholinergic side effects and the amelioration score of either HRS and CPRS.
Abstract: In a comparative evaluation of zimelidine, a potent serotonin (5-HT) uptake inhibitor, and desipramine, a potent noradrenaline (NA) uptake inhibitor, 65 hospitalized patients with endogenous depression were evaluated for the following biochemical variables: 5-HT uptake in platelets, 5-HT concentration in whole blood, inhibition of the 5-HT and NA accumulation in rat hypothalamic synaptosomes incubated in the patients' plasma, the excretion of 4-hydroxy-3-methoxyphenyl glycol (HMPG) in urine and the pretreatment levels of the amine metabolites 5-hydroxyindoleacetic acid (5-HIAA), homovanillic acid (HVA) and HMPG in cerebrospinal fluid (CSF). results of the biochemical studies confirmed that zimelidine and desipramine have different profiles with respect to monoamine uptake. Thus zimelidine caused more marked inhibition of 5-HT uptake than desipramine, especially in rat brain synaptosomes incubated in the patient's plasma. Desipramine plasma was much more effective than zimelidine plasma in inhibiting NA uptake in the same preparation. The urinary excretion of HMPG decreased significantly during desipramine treatment but remained unchanged during zimelidine treatment. The combined clinical and biochemical results indicated that patients with low pretreatment levels of 5-HIAA and HVA in CSF responded significantly better to zimelidine than patients with high levels of 5-HIAA and HVA. On the other hand, patients with high levels of 5-HIAA and HVA. On the other hand, patients with high levels of HMPG in CSF tended to respond better to desipramine than those with low levels of this NA metabolite.
TL;DR: The purpuse of this study was to test the hypothesis that addition of one year of communication‐oriented group therapy to a regime of neuroleptics and social skills training leads to greater improvement than neuroleptic treatment alone.
Abstract: The purpuse of this study was to test the hypothesis that addition of one year of communication-oriented group therapy to a regime of neuroleptics and social skills training leads to greater improvement than neuroleptics and social skills training alone.
The design was a controlled comparison over two years.
Diagnostic criteria were autism, thought disturbances and ego-disturbances and the patients’disorders were probably representative of a fairly broad spectrum of semi-chronic schizophrenic syndromes.
Eighty patients entered the study, and by randomization they were allocated to the therapy or the control group. Of the 40 patients in each group 34 completed the two-year study. Of the 34 patients in the therapy group 23 completed-the one year of group therapy.
Treatment started in residential care and continued in open care. All patients received fluphenazine depot and social skills training.
The assessment concerned symptoms and signs, social function in the community, life events, course of illness variables such as relapse rate, and a global evaluation of remission.
The effectivity of neuroleptics in reducing symptoms and signs in the acute episode was confirmed. The two year outcome showed that the addition of group therapy had increasd the improvement in factors and items related to emotional communication and anhedonia, increased free-time activities, and entries and reentries into the social field. There were more remissions in the therapy group among patients without continuous psychotic symptoms. In patients with continuous psychotic symptoms the remission rate was low in both groups. No adverse effects were shown. Despite absence of remission in more than half of the patients nearly all could be discharged.
Communication-oriented group therapy as used here, may be considered as an elementary, unsophisticated form of psychotherapy that can be applied at almost any psychiatric treatment center both in hospitals and outpatient care.
The outcome pattern suggests that this kind of group therapy cannot replace neuroleptic drugs, but increases the improvement from drugs and social skills training.
TL;DR: An English‐language version of the Swedish EMBU Inventory is presented, which has subscales measuring the degree to which each parent was abusive, depriving, punitive, shaming, rejecting, overprotective, overinvolved, tolerant, affectionate, performance‐oriented, guilt‐engendering, stimulating, favoured siblings, and favoured the subject.
Abstract: Despite the importance of measurement of parental rearing patterns in psychiatric research, there are almost no acceptable standardised inventories available. An English-language version of the Swedish EMBU Inventory is presented, which has subscales measuring the degree to which each parent was abusive, depriving, punitive, shaming, rejecting, overprotective, overinvolved, tolerant, affectionate, performance-oriented, guilt-engendering, stimulating, favoured siblings, and favoured the subject. Results indicate high and comparable reliability and item-factor structure. It would appear that the EMBU has both cross-cultural reliability and stable structure in the English translation.
TL;DR: The findings suggest that psychiatric patients who commit suicide, often are drug and alcohol abusers and neurotics with symptoms of depression, and after the initial contact they receive less outpatient treatment than controls.
Abstract: In order to find possible factors predicting suicide among psychiatric patients, a prospective study of 2,184 in- and outpatients treated at the Department of Psychiatry, Linkoping, Sweden, during 1976 was made. Information was obtained by semi-structured interview covering demographics, diagnosis, symptomatology, life events and received treatment, supplemented by officially registered information about annual income, public assistance, sick-leave and cause of death. During the period of observation (1-2 years), 34 patients had committed suicide. These were matched according to age, sex, diagnosis and in- or outpatient status with controls from the original census. The findings suggest that psychiatric patients who commit suicide, often are drug and alcohol abusers and neurotics with symptoms of depression. They often have made suicide attempts earlier in their lives, are often widowed and have suffered loss of key persons by death. After the initial contact they receive less outpatient treatment than controls. Their method of committing suicide is mainly by intoxication.
TL;DR: Positive correlations were found between the level of 5‐HIAA and the items: hallucinatory behaviour, grandiosity, and tension as rated on the Brief Psychiatric Rating Scale.
Abstract: The monoamine metabolites 3-methoxy-4-hydroxyphenylglycol (MHPG), homovanillic acid (HVA) and 5-hydroxyindoleacetic acid (5-HIAA) were measured in the cerebrospinal fluid (CSF) of 16 psychiatrically healthy controls and in 28 schizophrenic patients. There was no difference in CSF MHPG and HVA levels between the group of patients and the controls. CSF levels of 5-HIAA were significantly lower in schizophrenic patients than in controls. Differential analysis of patients with and without neuroleptics revealed that these findings were not due to drug treatment. Positive correlations were found between the level of 5-HIAA and the items: hallucinatory behaviour, grandiosity, and tension as rated on the Brief Psychiatric Rating Scale. As 5-HIAA CSF data are controversial for nosological entities, the search for correlations between 5-HIAA and individual psychopathological variables could provide more specific indices for psychiatric diagnosis, treatment or prophylaxis.
TL;DR: The effect of bromocriptine – a dopamine agonist – was significantly better than placebo in ameliorating the following symptoms: anxiety, restlessness, depression, tremor, sweating and nausea as well as the total score of these symptoms.
Abstract: A 10-day random double-blind study on the effect of bromocriptine versus placebo in severe alcohol-withdrawal symptoms was conducted in 60 alcoholics. The effect of bromocriptine--a dopamine agonist--was significantly better than placebo in ameliorating the following symptoms: anxiety, restlessness, depression, tremor, sweating and nausea as well as the total score of these symptoms. Also in the evaluation of specific symptoms according to a symptom check list of psychiatric, behavioural and social aspects, and in a global evaluation, bromocriptine was clearly superior to placebo. Serum prolactin studied on the first and tenth day of the survey showed a significant increase occurring in the placebo-treated patients. Side effects related to the use of bromocriptine were negligible. Our findings support recent experimental evidence that alcohol-withdrawal symptoms, at least in part, are related to a transient dopaminergic dysfunction in the brain.
TL;DR: A history of psychiatric treatment increases the suicide risk more for women than for men, although male patients are still about twice as likely to commit suicide than are female patients, and the rate is greatest for the diagnosis of major affective disorder.
Abstract: Age-specific suicide rates are presented, based on 207 white patients of the Missouri Department of Mental Health who were identified as having committed suicide during 1972-74 Results, divided by age, sex, diagnosis and patient status, are compared with other studies Male inpatients are about five times more likely to commit suicide compared to the general population, while female inpatients are about 10 times more likely to do so In both sexes, the rate is greatest for the diagnosis of major affective disorder A history of psychiatric treatment increases the suicide risk more for women than for men, although male patients are still about twice as likely to commit suicide than are female patients A quantitative model is presented which describes the relative influence of age, sex and diagnosis on suicide rates Language: en
TL;DR: Life events and mental disorder in an urban female population in anUrban female population Acta psychiat.
Abstract: Samuelsson, B.S. Life events and mental disorder in an urban female population Acta psychiat. scand.
A comprehensive population study of women i n Gothenburg, Sweden was carried out in 1968-1969. Altogether 800 women participated in the psychiatric study. Four age strata were studied i.e. women born i n 1930, 1922, 1918 and 1914. The same women were re-studied in 1974-1975 (participation rate 84.6%) establishing (1) prevalence of mental disorder, (2) six-year incidence of mental disorder, (3) one-year incidence of mental disorder, (4) occurrence of undesirable life events and (5) connections between life events and one-year incidence of mental disorder.
The average prevalence rate was 13.4% for mental disorder with functional impairment, exceeded in lower social groups, by the divorced and the recently widowed. Depressive disorders were most common and autonomic disturbances were the most frequent symptoms. The six-year incidence of mental disorder with functional impairment was 19.5% with raised rate for the divorced and the childless. Undesirable life events increased with the number of children, and decreased with age. The one-year incidence rate decreased with increasing age. The one-year incidence of mental disorder was increased with the amount of undesirable life events.
TL;DR: The data suggest that the dysfunctions in anorexia nervosa patients in the hyporthalamo‐pituitary‐adrenal and ‐gonadal axis have little specificity for this disease and are mainly a consequence of nutritional factors and starvation.
Abstract: Twenty-four anorexia nervosa patients participated in an inpatient broad spectrum behavior therapy program. The changes in body weight, anorectic behaviors and attitudes and endocrine variables (24-h plasma cortisol, dexamethasone suppression test, 24-h plasma luteinizing hormone) were measured. Data indicate that specific anorectic behaviors and attitudes showed significant improvement during inpatient treatment, while attitudes of a more general neurotic scope such as the feeling of insufficiency, general distress, (sexual) anxieties and anancasm did not. On admission 24-h plasma cortisol levels were elevated, episodic secretory spikes occurred at unusual times and the number was increased, cortisol plasma half-life was increased and non-suppression of cortisol secretion following the application of dexamethasone was observed. All these parameters normalized already after 10% weight gain. 24-h plasma LH pattern showed a close relationship with body weight. Our data suggest that the dysfunctions in anorexia nervosa patients in the hypothalamo-pituitary-adrenal and -gonadal axis have little specificity for this disease and are mainly a consequence of nutritional factors and starvation. The relationship between cortisol and HL-secretion, behavioral and attitudinal variables and weight gain was more complex than previously suggested by others and a positive relationship between the LH secretory pattern and anorectic symptomatology could be established.
TL;DR: Following lithium withdrawal tremor of hands, polyuria, general muscular weakness, polydipsia and dryness of mouth were significantly reduced and the possibility of a rebound phenomenon produced by lithium is considered.
Abstract: Prophylactic lithium was abruptly discontinued (under double-blind conditions and using placebo) in 18 manic-depressive patients for 15 days. Following lithium withdrawal tremor of hands, polyuria, general muscular weakness, polydipsia and dryness of mouth were significantly reduced. No withdrawal symptoms were noted. Three patients relapsed within 4 days of lithium discontinuation. The questions arising from these findings are discussed and the possibility of a rebound phenomenon produced by lithium is considered.
TL;DR: The response to ECT or no ECT at two levels of chlorpromazine was studied in a 2 × 2 factorial experiment on 60 acutely schizophrenic patients hospitalized for a period of 6 weeks.
Abstract: The response to ECT or no ECT at two levels of chlorpromazine was studied in a 2 × 2 factorial experiment on 60 acutely schizophrenic patients hospitalized for a period of 6 weeks. ECT enhanced the therapeutic response at the 300 mg level of chlorpromazine but neither of the ECT chlorpromazine combinations offered any significant therapeutic advantage over 500 mg of chlorpromazine.
TL;DR: Pneumoencephalography findings and clinical findings in these two groups are compared, and compared to corresponding findings in 101 chronic schizophrenics previously studied with the same method.
Abstract: Pneumoencephalography (PEG) was carried out in 50 patients of both sexes consecutively discharged from a psychiatric department with a diagnosis of acute schizophrenia. At clinical follow-up with a mean observation time of 8 years the diagnosis was verified in 38 patients, while 12 were considered to have had a reactive psychosis. The PEG findings and clinical findings in these two groups are compared, and compared to corresponding findings in 101 chronic schizophrenics previously studied with the same method. Linear measurements were used in estimating the size of the ventricular system, which was safely within normal limits in all but three of the 50 patients. Mean ventricular size did not differ significantly in the two groups of acute psychoses. No case of cortical atrophy was found. More than half of the chronic schizophrenics had abnormal PEG's, the typical finding being a bilateral enlargement of the ventricular system. The mean size of all parts of the ventricular system was significantly higher than in the acute schizophrenics. A close correlation was found between mental deterioration and ventricular enlargement. The most reasonable explanation of these findings is that schizophrenia is an inborn error of metabolism, disturbing normal brain function and in the long run leading to degenerative changes of the nervous tissue.
TL;DR: The studies make it clear that separable components of orientation recover at different rates following ECT, and modifications of electrode placement and electrical stimulus waveform result in a decrease in disorientation when compared to standard bilateral sinusoidal ECT.
Abstract: Studies which provide quantitative analyses of postictal disorientation following electroconvulsive therapy (ECT) are reviewed with emphasis on the variable of time since seizure induction as it relates to recovery of orientation. The studies make it clear that separable components of orientation (person, place, and time) recover at different rates following ECT. The length of disorientation tends to increase with increasing treatment number, but modifications of electrode placement (nondominant unilateral ECT) and electrical stimulus waveform (brief-pulse ECT) result in a decrease in disorientation when compared to standard bilateral sinusoidal ECT. Bilateral ECT may produce more disorientation than dominant unilateral ECT if more generalized seizures occur with the former than the latter treatment modality. Practical implications of these issues are discussed.
TL;DR: The patients were found to feel time passing slowly, and the subjective feeling of slow time flow reflects the depth of depressive state in general, which is nevertheless not specific to any diagnostic subcategory.
Abstract: Twenty-three depressive inpatients and the same number of matched non-psychiatric controls were examined on three occasions - following admission, 14 days after, and 28 days after the admission - by administering a self-rating questionnaire of time awareness and Hamilton's Rating Scale for Depression (HRS). The patients were found to feel time passing slowly. This was correlated with the severity of depression expressed as the total HRS score. No significant differences emerged between diagnostic groups, namely endogenous depression, neurotic depression, and schizophrenia or paranoid state with depressive symptoms. Correlations of the time awareness with symptoms listed in the HRS also denied a specific relationship of time awareness to specific diagnoses. The subjective feeling of slow time flow reflects, therefore, the depth of depressive state in general, which is nevertheless not specific to any diagnostic subcategory.
TL;DR: The results indicate that the elevation in PRL levels is a biochemical marker of the seizure activity during electroconvulsive therapy.
Abstract: Electroconvulsions have been reported to induce rapid elevations of serum prolactin (PRL) levels To further evaluate factors involved in the hormonal release an extended study was performed Blood samples for determination of PRL were withdrawn from depressed patients 5 min before and 15 min after administration of electroconvulsions Significant elevations of PRL levels were found in 35 of 37 patients Increase in PRl levels was significantly correlated to duration of seizures but not to duration of the electric stimulation The hormonal response to electroconvulsions was diminished with age Patients on lithium medication had significantly more pronounced rises of PRL levels than patients treated with other psychotropic drugs and otherwise untreated patients The results indicate that the elevation in PRL levels is a biochemical marker of the seizure activity during electroconvulsive therapy
TL;DR: It is concluded that psychosis is a rare complication but that in unclear psychotic states it is recommended to actively search for a cannabis psychosis, and a possible relationship between the two diseases is discussed.
Abstract: Eleven patients with a psychosis in connection with cannabis abuse admitted to two mental hospitals during 1 year were examined. Patients with a pre-existent psychosis or a mixed abuse were excluded. The patients were divided into three groups: acute, subacute and chronic. The features of the disease were essentially similar in all patients, with a mixture of affective and schizophrenia-like symptoms, confusion and a pronounced aggressiveness. The course as a rule was self-limiting leaving no residual symptoms. There was almost no heredity of severe mental disease. The symptoms were very similar to those seen in cycloid psychosis, and a possible relationship between the two diseases is discussed. As regards the widespread abuse of cannabis we conclude that psychosis is a rare complication but that in unclear psychotic states it is recommended to actively search for a cannabis psychosis.
TL;DR: It is indicated that hypospadiacs are more prone to neurotic (but not psychotic) disturbances than other young men and have more disturbed social relations.
Abstract: Aspects of mental health were investigated by means of interviews and register data in 34 men operated on for hypospadias in childhood and in 36 matched control subjects. Most hypospadiacs adjust well both in childhood and adult age. However, they reported more neurotic disturbances in their childhood than the controls. Shyness and enuresis were common troubles among the probands, and they had been more timid, isolated and mobbed. Similar although less striking differences in mental health were reported also in adult age. Depression and anxiety were dominating symptoms. The interviewer assessed the hypospadiacs to show more anxiety and to use more immature defence mechanisms and consequently to have less stress tolerance. The probands were further judged to have less capacity for social relations and their overall capacity to utilize existent psychological resources was small as compared to the controls. The findings indicate that hypospadiacs are more prone to neurotic (but not psychotic) disturbances than other young men and have more disturbed social relations. The need for psychological guidance for the boys and their parents is stressed.
TL;DR: Calcium, magnesium and phosphate metabolism was studied in lithium‐treated patients, using a metabolic balance technique, to establish a baseline level of magnesium, phosphate and calcium in the blood of patients who were to start or end lithium treatment.
Abstract: Calcium, magnesium and phosphate metabolism was studied in lithium-treated patients, using a metabolic balance technique. Two groups of patients participated in the study: 1) Patients who were to start on a prophylactic lithium treatment, and 2) Long-term lithium-treated patients whose treatment was to be terminated. Lithium treatment produced a positive balance in both calcium, phosphate and magnesium. By continuous lithium treatment the effect on magnesium wore off, whereas the effect on calcium and phosphate persisted. In urine, lithium induced a decrease in both calcium and phosphate excretion, whereas the excretion of magnesium was increased. Bone mineral content was measured by photon absorption, and lithium treatment resulted in a decrease in bone mineral content occurring within the first 6 months of lithium treatment. In the patients, bioavailability of the Li2CO3 preparation was found to be about 95%, and the patients contained about one 24-h dose of lithium just before the next dose of lithium was administered.