Showing papers in "World Journal of Biological Psychiatry in 2005"
TL;DR: These guidelines for the biological treatment of schizophrenia were developed by an international Task Force of the World Federation of Societies of Biological Psychiatry to reach a consensus on a series of practice recommendations that are clinically and scientifically meaningful based on the available evidence.
Abstract: These guide lines for the biological treatment of schizophrenia were developed by an international Task Force of the World Federation of Societies of Biological Psychiatry (WFSBO). The goal during the development of these guidelines was to review systematically all available evidence pertaining to the treatment of schizophrenia, and to reach a consensus on a series of practice recommendations that are clinically and scientifically meaningful based on the available evidence. These guidelines are intended for use by all physicians seeing and treating people with schizophrenia. The data used for developing these guidelines have been extracted primarily from various national treatment guidelines and panels for schizophrenia, as well as from meta-analyses, reviews and randomised clinical trials on the efficacy of pharmacological and other biological treatment interventions identified by a search of the MEDLINE database and Cochrane Library. The identified literature was evaluated with respect to the strength of evidence for its efficacy and then categorised into four levels of evidence (A-D). This first part of the guidelines covers disease definition, classification, epidemiology and course of schizophrenia, as well as the management of the acute phase treatment. These guidelines are primarily concerned with the biological treatment (including antipsychotic medication, other pharmacological treatment options, electroconvulsive therapy, adjunctive and novel therapeutic strategies) of adults suffering from schizophrenia.
355 citations
TL;DR: In this paper, the central issue raised in this paper is: can stress cause depression? Phrased more precisely, can stress causes brain disturbances thought to underlie (certain forms of) depression or particular components of the depressive syndrome.
Abstract: The central issue raised in this paper is: can stress cause depression? Phrased more precisely: can stress cause brain disturbances thought to underlie (certain forms of) depression or particular components of the depressive syndrome. Focussing on 5-HT and the stress hormones, this question was answered in the affirmative, based on the following two considerations: (1) changes in the 5-HT and stress hormone systems produced by sustained stress, mimic to a substantial extent the disturbances in these systems that may be observed in depression; (2) substantial evidence indicates that the 5-HT and stress hormone disturbances in depression are of pathophysiological significance and not merely a consequence of the depressed state or a product of stress generated by the depressed state. Furthermore, the question was raised whether a depression type could be identified particularly stress-inducible. This question, too, was answered in the affirmative. The depression type in question was named anxiety/aggression-...
163 citations
TL;DR: In this paper, a review of recent reports regarding progress in neurochemical pre-mortem diagnosis of dementias is discussed with a focus on an early and differential diagnosis of AD, e.g., fluorescence correlation spectroscopy and surface enhanced laser desorption/ionization time-of-flight mass spectrometry (SELDI-TOF MS).
Abstract: Aging of population, and increasing life expectancy result in an increasing number of patients with dementia. This symptom can be a part of a completely curable disease of the central nervous system (e.g, neuroinflammation), or a disease currently considered irreversible (e.g, Alzheimer's disease, AD). In the latter case, several potentially successful treatment approaches are being tested now, demanding reasonable standards of pre-mortem diagnosis. Cerebrospinal fluid and serum analysis (CSF/serum analysis), whereas routinely performed in neuroinflammatory diseases, still requires standardization to be used as an aid to the clinically based diagnosis of AD. Several AD-related CSF parameters (total tau, phosphorylated forms of tau, Abeta peptides, ApoE genotype, p97, etc.) tested separately or in a combination provide sensitivity and specificity in the range of 85%, the figure commonly expected from a good diagnostic tool. In this review, recently published reports regarding progress in neurochemical pre-mortem diagnosis of dementias are discussed with a focus on an early and differential diagnosis of AD. Novel perspectives offered by recently introduced technologies, e.g, fluorescence correlation spectroscopy (FCS) and surface enhanced laser desorption/ionization time-of-flight mass spectrometry (SELDI-TOF MS) are briefly discussed.
119 citations
TL;DR: A review of research on the link between cholesterol and Alzheimer's disease finds evidence that statins inhibit enzymes involved in the endogenous synthesis of cholesterol and evidence is mounting that they also affect enzymes in Aβ metabolism, thereby promoting the non-amyloidogenic pathway.
Abstract: A leading hypothesis on the pathophysiology of Alzheimer's disease (AD) is the mis-metabolism of amyloid precursor protein. This mis-metabolism causes the 42-amino acid form of A beta(Abeta42) to form oligomers that in turn start a chain of events leading to the accumulation of amyloid plaques. Vascular factors such as hypertension, hypercholesterolemia and diabetes as well as the inheritance of the epsilon4 allele of the ApoE gene are risk factors for AD. These risks are thought to promote the production of beta-amyloid (Abeta). An association between cholesterol and the development of AD was suggested in 1994 and since then, research has confirmed a link between cholesterol and the development of AD. A high cholesterol level in mid-life is a risk for AD and statins i.e. cholesterol-lowering drugs, reduce this risk. Statins inhibit enzymes involved in the endogenous synthesis of cholesterol and evidence is mounting that they also affect enzymes in Abeta metabolism i.e. beta-secretase. This normalises the breakdown of the precursor of Abeta, amyloid precursor protein, thereby promoting the nonamyloidogenic pathway. This review focusses on the link between cholesterol and Alzheimer's disease.
65 citations
TL;DR: Three cases of severe lithium-induced side effects while patients underwent ECT without complications and lithium serum levels were still subtherapeutic are reported, taking previous studies, animal studies and an additional reported clinical case into account.
Abstract: Bipolar disorders as well as recurrent major depressive episodes can be most effectively treated with electroconvulsive therapy (ECT). Since continuation/maintenance ECT is not well established, prophylactic therapy in recurrent illnesses is more commonly carried out using antidepressive medication alone or more often in combination with lithium. In case of relapse the clinically important question of discontinuation of lithium versus the concurrent use of ECT and lithium may arise. The safety of concurrent use has also to be balanced when lithium treatment is started within an ECT course. Since recent studies have reported no negative interactions with concurrent use, we here report three cases (one case of a prolonged seizure, a serotonin syndrome and a focal seizure) of severe lithium-induced side effects while patients underwent ECT without complications and lithium serum levels were still subtherapeutic. Clinical consequences are discussed and disturbances of the blood brain barrier system as a speculative cause are hypothesized taking previous studies, animal studies and an additional reported clinical case into account.
58 citations
TL;DR: In this paper, the authors acquired two 18F-deoxyglucose positron emisssion tomography (PET) scans on seven unmedicated pathological gamblers, at least 7 days apart.
Abstract: We acquired two 18F-deoxyglucose positron emisssion tomography (PET) scans on seven unmedicated pathological gamblers, at least 7 days apart. Following an injection of 5 mCi FDG, subjects carried out a computer blackjack task for 35 min under two different reward conditions: monetary reward and computer game points only. Relative FDG metabolic rate was obtained from regions of interest in the prefrontal cortex, cingulate, striatum and visual cortex. Monetary reward blackjack was associated with significantly higher relative metabolic rate in the primary visual cortex (Brodmann area 17), the cingulate gryus (Brodmann area 24), the putamen and prefrontal areas 47 and 10, compared to blackjack playing for points only. No area tested showed a significant decrease. This pattern suggests heightened limbic and sensory activation in the gambling for money condition with increased emotional valence and greater risk and reward, and confirms the salience of monetary reward in the development of pathological gambling.
58 citations
TL;DR: Depressive symptoms are a common feature of schizophrenic disorders, a fact that has become increasingly apparent over the last two decades, and the introduction of standardized rating scales in cross-sectional and longitudinal investigations played an important role in the recognition of the relevance of depressive symptoms.
Abstract: Depressive symptoms are a common feature of schizophrenic disorders, a fact that has become increasingly apparent over the last two decades. Apparently the introduction of standardized rating scales in cross-sectional and longitudinal investigations played an important role in the recognition of the relevance of depressive symptoms. They can be interpreted as being cosyndromal or comorbid, depending on the conceptual perspective applied. This is not simply a difference in terminology but is of great aetiopathogenetic relevance. Of particular clinical relevance is the observation that schizophrenic patients with concomitant depressive symptoms have a greater risk of suicidality or an unfavourable disease course. For this reason it is important that sufficient attention is paid to the diagnosis and treatment of depressive symptoms occurring during schizophrenic psychoses. Besides treatment with antidepressants, modern neuroleptics are of great importance in this context as they are more efficacious than classical neuroleptics in treating depressive symptoms.
57 citations
TL;DR: Meningitis during childhood significantly increased the risk of schizophrenia in particular in adulthood, and of psychosis in general.
Abstract: Objective: We investigated the hypothesis that a meningitic infection in childhood may increase the risk of a psychiatric disorder in adulthood. Method: We conducted a follow-up study of 190 individuals affected by a meningitis infection the first 4 years of life, during an epidemic in Sao Paulo, Brazil, between 1971 and 1974. As a control group, we investigated 156 siblings of the meningitis patients who were not affected by meningitis at childhood. Results: In the 190 cases of meningitis, we found eight (4.2%) cases of schizophrenia against none in the controls, and 40 (21.0%) cases of life occurrence of psychotic symptoms compared to 12 (7.6%) cases in the control group (P<0.001). We found no differences between the two groups regarding the occurrence of other psychiatric disorders and of neurological soft signs. Conclusion: Meningitis during childhood significantly increased the risk of schizophrenia in particular in adulthood, and of psychosis in general.
50 citations
TL;DR: Overall, there is no strong evidence that use of antidepressants in bipolar disorder increases the risk of (hypo)mania, but there is an urgent need for adequate studies of sufficient size to determine the extent to which a mood stabilizer may be protective.
Abstract: Objective: The literature cautions against the induction of (hypo)mania owing to the use of antidepressants in bipolar disorder. Objectives of this review are to examine: (1) the evidence for this assumption; (2) underlying risk factors; and (3) the extent to which a mood stabilizer may be protective. Method: A systematic literature review was conducted. Results: Thirteen relevant studies were included. All of them had methodological shortcomings. Overall, there is no strong evidence that use of antidepressants in bipolar disorder increases the risk of (hypo)mania. Possible, although unreplicated, risk factors are: a short allele of the promoter region of the serotonin transporter gene SCL6A4, substance abuse or dependence, multiple antidepressant trials, lower number of previous manias, less delusions during illness, depressive polarity at illness onset, and rapid cycling that has, however, been contradicted by another study. Subtype of bipolar disorder (I or II) has been considered in four studies, with...
39 citations
TL;DR: The hypothesis that ionizing radiation is a risk factor for schizophrenia spectrum disorders can be tested using data from the Chernobyl accident aftermath, and the results of experimental radioneurobiological studies support the hypothesis of schizophrenia as a neurodegenerative disease.
Abstract: The neural diathesis-stressor hypothesis of schizophrenia, where neurobiological genetic predisposition to schizophrenia can be provoked by environmental stressors is considered as a model of the effects of exposure to ionizing radiation. Analysis of information from electronic databases (MEDLINE, PsycINFO, EMBASE, Current Contents, Elsevier BIOBASE) and hand-made search was carried out. There are comparable reports on increases in schizophrenia spectrum disorders following exposure to ionizing radiation as a result of atomic bombing, nuclear weapons testing, the Chernobyl accident, environmental contamination by radioactive waste, radiotherapy, and also in areas with high natural radioactive background. The results of experimental radioneurobiological studies support the hypothesis of schizophrenia as a neurodegenerative disease. Exposure to ionizing radiation causes brain damage with limbic (cortical-limbic) system dysfunction and impairment of informative processes at the molecular level that can trigger schizophrenia in predisposed individuals or cause schizophrenia-like disorders. It is supposed that ionizing radiation can be proposed as a risk factor for schizophrenia spectrum disorders. The hypothesis that ionizing radiation is a risk factor for schizophrenia spectrum disorders can be tested using data from the Chernobyl accident aftermath. Implementation of a study on schizophrenia spectrum disorders in Chernobyl accident victims is of significance for both clinical medicine and neuroscience.
36 citations
TL;DR: Functional neuroimaging techniques, including single photon emission computed tomography (SPECT), positron emission tomography and functional magnetic resonance imaging (FMRI), providing an in vivo assessment of the expression and function of neuroreceptors, transporters and enzymes, seem to be particularly promising for a better understanding of ‘real’ drug resistance.
Abstract: Drug resistance in schizophrenic disorders treated with an antipsychotic medication is highly problematic, lacking sound criteria to define it, and to discriminate between drug response and clinica...
TL;DR: Although most results are rather weak and not convincing enough to promote TMS as evidence-based antidepressive therapy, they show a measurable action that should not be ignored and efforts should continue with emphasis on increasing homogeneity and reproducibility in data.
Abstract: Transcranial magnetic stimulation (TMS) is a patient-friendly stimulation technique of the brain with interesting perspectives. In clinical psychiatry, limited data are available on activity in psy...
TL;DR: Several methodological issues of classification of psychiatric disorders are addressed and the advantages and disadvantages of the syndromatological and nosological classifications are broadly described.
Abstract: Several methodological issues of classification of psychiatric disorders are addressed. Beside some historical aspects and basic characteristics of the classification of mental disorders, the advantages and disadvantages of the syndromatological and nosological classifications are broadly described. Finally the current situation of the international standardisation of psychiatric classification and particuarly the improvement of reliability by using operationalised procedures is discussed.
TL;DR: About half of patients with recurrent major depression have normal EF, and a neuropsychological investigation could help to ensure optimal treatment in patients with recurring major depression.
Abstract: Major depression is associated with impairment of cognitive functions, and especially higher-order cognitive processes referred to as executive functions (EF). Whether this is a general finding is unclear. Patients without EF impairment may have different treatment needs than patients with EF impairment, and will probably have a better everyday functioning. Thus, it is important to identify the prevalence and characteristics of depressed patients without EF impairment. Forty-three patients with recurrent major depressive disorder (19-51 years) and 50 healthy controls were included in the study. The subjects were assessed with neuropsychological tests selected to measure central areas of EF, and screened on clinical and demographic variables. Within the depressed group, a total of 56% were defined as EF unimpaired. These patients were characterised by higher intellectual abilities and fewer depression episodes than the subgroup of patients with EF impairment. The subgroups were similar in age at debut of illness, severity of depression, general psychopathology and global level of functioning. In conclusion, about half of patients with recurrent major depression have normal EF. Since cognitive impairment and depressive symptomatology seem to be distinct dimensions, a neuropsychological investigation could help to ensure optimal treatment in patients with recurrent major depression.
TL;DR: The results support the idea that serotonin seems to play an important role during early brain development and drug-related modulation of the noradrenergic system during brain maturation seems to cross-influence the serotonergic system.
Abstract: Interactions of the serotonergic and noradrenergic system at different sites of the brain may be important for efficacy and side effects of antidepressant drugs. Further, serotonin and noradrenaline play a critical role in the development of neurons during brain maturation. To gain further insight how brain maturation and the two monoaminergic systems are influenced by drug treatment during early postnatal development, this animal study investigated possible effects on the noradrenaline and serotonin transporter density of the frontal cortex very early in postnatal life. Rats were treated from postnatal day 2 to 5 either with fluoxetine (5 mg/kg per day s.c.) or with reboxetine (10 mg/kg per day s.c.). At day 90 the serotonin and noradrenaline transporter density in the frontal cortex was measured by ligand binding assay. Fluoxetine treatment led to a significant long-lasting increase of serotonin (not noradrenaline) transporter density (Bmax = 1231 +/- 34) in the frontal cortex (compared with saline-treated controls (Bmax = 1112 +/- 58)). Reboxetine treatment (surprisingly) led to an even more enhanced serotonin transporter density (Bmax = 1322 +/- 46), while noradrenaline transporter density seemed to be unaffected. There were no significant differences for KD values. The results support the idea that serotonin seems to play an important role during early brain development. Moreover, drug-related modulation of the noradrenergic system during brain maturation seems to cross-influence the serotonergic system.
TL;DR: Findings may partly support subtyping of AD in BP- II, on the basis of its frequent clustering of hypomanic symptoms, and its different family history, which may impact on treatment of BP-II depression.
Abstract: Study aim: To test diagnostic validity or utility of agitated depression (AD) in bipolar II disorder (BP-II).Methods: Three hundred and twenty BP-II major depressive episode (MDE) outpatients interviewed with the Structured Clinical Interview for DSM-IV, Hypomania Interview Guide (HIG), and Family History Screen. AD defined as MDE with psychomotor agitation. Mixed depression defined as MDE with ≥4 hypomanic symptoms. AD, non-AD, mixed-AD, non-mixed-AD, and mixed-non-AD were compared versus diagnostic validators.Results: AD was present in 35.0%, 75.8% of AD were mixed, while only 14.3% of non-AD were mixed (P=0.0000). AD (n=112), versus non-AD (n=208), had significantly higher age, more females, recurrences, bipolar I family history, and much more concurrent hypomanic symptoms. Mixed-AD (n=85), versus non-mixed-AD (n=27), was not significantly different, apart from more hypomanic symptoms (by definition), but there were clinically significant differences.Conclusions: Findings may partly support subtyping o...
TL;DR: The signs of improvement are slowly surfacing in the greater recognition of the efficacy of ECT, greater tolerance to its use, and in establishing treatment standards.
Abstract: The ethical principles of medical care are beneficence (doing good), non-maleficence (not doing harm), autonomy (right to refuse or accept treatment), and justice (equality of opportunity). The present practice of ECT meets standards for beneficence, non-maleficence, and autonomy. In many nations, however, the principle of justice is not respected, leading to unavailability of ECT, increased suffering and prolonged illness. The signs of improvement are slowly surfacing in the greater recognition of the efficacy of ECT, greater tolerance to its use, and in establishing treatment standards.
TL;DR: A large number of neurological and psychiatric diseases like Morbus Parkinson, amyotrophic lateral sclerosis, dementia, schizophrenia and probably also affective disorders show an enhanced production of reactive oxygen species and the differential effects of steroids on these systems in the central nervous system are focused on.
Abstract: A large number of neurological and psychiatric diseases like Morbus Parkinson, amyotrophic lateral sclerosis, dementia, schizophrenia and probably also affective disorders show an enhanced production of reactive oxygen species. Moreover, alterations of antioxidative systems and beneficial effects of antioxidative substances including steroid compounds such as estrogens have been described in several of these diseases. This review focuses on alterations of antioxidative systems in the course of neurological diseases and psychiatric disorders and on the differential effects of steroids on these systems in the central nervous system. Moreover, a possible clinical relevance of alterations of circulating steroids and of steroid treatment under these conditions is discussed.
TL;DR: It is concluded that cognitive neuropsychiatry is a fruitful and necessary supplement to biological psychiatry, and the discipline itself may benefit significantly from employing philosophical conceptual tools in the interpretation and construction of its cognitive models.
Abstract: Cognitive neuropsychiatry attempts to understand psychiatric disorders as disturbances to the normal function of human cognitive organisation, and it attempts to link this functional framework to relevant brain structures and their pathology. This recent scientific discipline is the natural extension of cognitive neuroscience into the domain of psychiatry. We present two examples of recent research in cognitive neuropsychiatry: delusions of control in schizophrenia, and affective disorders. The examples demonstrate how the cognitive approach is a fruitful and necessary supplement to the otherwise successful biological psychiatry paradigm, which tend to bypass the cognitive level. Philosophy concerns some of the core concepts involved in psychiatric illness, particularly concerning rationality, thought and action, reality testing, and the self. We present concrete examples that illustrate how philosophical conceptual tools can be particularly important for the construction and interpretation of the cognitive models relevant to the understanding of psychiatric illness. We conclude that cognitive neuropsychiatry is a fruitful and necessary supplement to biological psychiatry. Furthermore, cognitive neuropsychiatry itself may benefit significantly from employing philosophical conceptual tools in the interpretation and construction of its cognitive models. The cognitive and philosophical approaches may thus be further steps towards a scientific psychopathology.
TL;DR: The aim of this paper is to review the relationship between the depressive subtypes included in the DSM-IV (melancholic depression, atypical depression, bipolar depression, psychotic bipolar and dysthymia) and the efficacy of antidepressant treatment.
Abstract: Efficacy studies suggest that all kinds of treatment have similar efficacy. For instance, according to a meta-analysis from 102 randomised controlled trials in major depression, there is no overall...
TL;DR: The case of a patient with an SRI-resistant OCD who was successfully treated with a combination of citalopram and reboxetine and a selective noradrenaline reuptake inhibitor (SNRI) is described.
Abstract: While serotonin reuptake inhibitors (SRIs) are the first-line treatment of obsessive compulsive disorder (OCD), as many as 40-60% of patients fail to respond to adequate trials with these drugs. In this study, we describe the case of a patient with an SRI-resistant OCD who was successfully treated with a combination of citalopram (a selective SRI) and reboxetine (a selective noradrenaline reuptake inhibitor (SNRI)). This report suggests that future studies accessing the efficacy of the SRI SNRI combination in treatment resistant OCD are needed.
TL;DR: It is concluded that the complex lesion pattern may contribute to some of the behavioural changes seen in the patient after AC, supported by the neuropsychological deficits and the fact that the neuronal circuits, impaired by the lesions, are involved in addiction-specific behaviour.
Abstract: We report the case of a female patient who had undergone a unilateral stereotactical anterior cingulotomy (AC) 20 years previously because of refractory alcohol dependence. After AC, the drinking behaviour switched from a chronic to an episodic one with fast losses of control accompanied by abnormal oral impulse-control behaviour. Relapses were stress- but not cue-induced and followed by long-term intervals of abstinence. In addition to an intended lesion of the left dorsal anterior cingulate cortex (ACC), MR images showed additional lesions within the left caudate body and the dorsal medial thalamic nucleus. Applying a neuropsychological test battery, we found disturbed divided attention and impaired executive function. From this, we conclude that the complex lesion pattern may contribute to some of the behavioural changes seen in our patient after AC. This hypothesis is supported by the neuropsychological deficits and the fact that the neuronal circuits, impaired by the lesions, are involved in addiction-specific behaviour. This case report further emphasizes the key role of the ACC and its connections in the maintenance of dependent behaviour.
TL;DR: It is found that schizophrenic patients showed hypoperfusion in the frontal and temporal lobes and hyperperfusions in the basal ganglia, confirming a similar regional neuroanatomic dysfunction as in Western patients with the disease.
Abstract: Hypofrontality is a common finding in schizophrenia in many countries. To date, there have been few studies on Chinese patients with schizophrenia. We thus wondered whether hypofrontality exists in Chinese patients with schizophrenia. We investigated 45 patients with schizophrenia and 21 healthy controls using brain perfusion single photon emission computed tomography (SPECT). Subjects were also administered the Brief Psychiatric Rating Scale (BPRS), Scale for the Assessment of Positive Symptoms (SAPS), Scale for the Assessment of Negative Symptoms (SANS), Halstead-Reitan Neuropsychological Battery (HRNB) and the Wechsler Memory Scale-Revised (WMS-R). Images were analyzed using a semi-quantitative reading and a quantified region of interest analysis. We found that schizophrenic patients showed hypoperfusion in the frontal and temporal lobes and hyperperfusion in the basal ganglia. Schizophrenic patients with both negative and positive symptoms showed asymmetric perfusion in the temporal lobe. Schizophrenic patients with prominent negative symptoms also showed asymmetric perfusion in the prefrontal lobes. Negative symptoms showed a significantly negative correlation with regional cerebral blood flow (rCBF) in the left frontal lobe. Improved memory quotient (MQ) was significantly correlated with increased rCBF in the left temporal lobe. These findings from Chinese patients confirm a similar regional neuroanatomic dysfunction as in Western patients with the disease.
Journal Article•
TL;DR: Guidelines for biological Treatment of Schizophrenia, : Part 1: Acute Treatment ofschizophrenia and Part 2: Long-term Treatment ofSchizophrenia.
Abstract: Guidelines for biological Treatment of Schizophrenia, : Part 1: Acute Treatment of Schizophrenia and Part 2: Long-term Treatment of Schizophrenia
TL;DR: If psychiatrists will become ethically sensitive by reflecting and perhaps solving their current ethical dilemmas, they will be prepared to deal with forthcoming ethical issues in biological psychiatry.
Abstract: Ethical issues in biological psychiatry are framed by (i) progress in the neurosciences, and (ii) a changing socio-cultural context With regard to forthcoming neurotechniques to modify specifically defined brain functions by pharmacological substances with selective effects, by activating neuroplasticity including neurogenesis, or by implantation of neuronal tissues or computer-brain interfaces, etc, ethical problems will develop (i) at the border between therapy of diseases and enhancement of abilities in healthy people with regard to effects on society (eg, social justice: equal access, loss of societal diversity) as well as on human value systems (eg, personality, efforts, conditio humana), and (ii) at the border between the medical system and the wellness market with regard to financing what by whom? Ethical dilemmas in psychiatry develop (i) between the individual's best and the common good (demanded from outside medicine), (ii) among different ethical principles (inside medicine), iii) if solutions are influenced by personal reasons without observing ethical principles Ethical guidelines are necessary for ethical orientation, but may protect against misconduct only (i) if psychiatrists are educated in ethics and (ii) if psychiatric acting is under continuous debate (by ethical review boards or the public) Thus, if we psychiatrists will become ethically sensitive by reflecting and perhaps solving our current ethical dilemmas we will be prepared to deal with forthcoming ethical issues in biological psychiatry
TL;DR: The results of a randomised, double-blind control-group study comparing a new antidepressant with the standard medication amitriptyline show that the average score on the Hamilton Depression Scale at the end of the 6-week treatment phase is 4 points higher in the group that received the new antidepressant than in the amitripyline group, although baseline values were comparable.
Abstract: Study 1. The results of a randomised, double-blind control-group study comparing a new antidepressant with the standard medication amitriptyline show that the average score on the Hamilton Depression Scale at the end of the 6-week treatment phase is 4 points higher in the group that received the new antidepressant than in the amitriptyline group, although baseline values were comparable. The difference is not statistically significant. A total of 40 patients were included in each group.
TL;DR: In this article, open access to scientific journals is discussed in the context of open access for medical journals, and the World Journal of Biological Psychiatry: Vol. 6, No. 1, pp. 60-60.
Abstract: (2005). Regarding open access to scientific journals. The World Journal of Biological Psychiatry: Vol. 6, No. 1, pp. 60-60.
TL;DR: Results could be interpreted as consistent with a cognitive dysfunction associated with PDA, probably at the level of representational mechanisms of the extrapersonal space.
Abstract: Twenty-five subjects suffering from Panic Disorder with agoraphobia (PDA) and 25 normal controls (NC) were asked to estimate distances of familiar places of their town and non-distance stimuli. PDA subjects also completed the Mobility Inventory for Agoraphobia (MIA). Subjects with PDA significantly overestimated distances as compared to NC, whereas no significant difference was found on estimates of non-distance stimuli. Within the PDA group, significant correlations were found between distance estimates and subsets of MIA concerning the ways of moving through the environment. Although with caution, given the small sample size and the preliminary character of this study, the results could be interpreted as consistent with a cognitive dysfunction associated with PDA, probably at the level of representational mechanisms of the extrapersonal space.
TL;DR: This non-exhaustive review of psychiatry genetics meets major difficulties that have hampered psychiatry taking advantage of the new technologies as compared to other fields, such as neurology.
Abstract: It has become obvious from epidemiological studies in families of patients affected or from twin studies, that most psychiatric disorders are in part genetically determined. Genetics have raised incredible hopes that the complex nature of psychiatric disorders might be unravelled. However, progress in psychiatry genetics have met major difficulties that have hampered psychiatry taking advantage of the new technologies as compared to other fields, such as neurology. In this non-exhaustive review, we propose an overview from the initial evidence to the expected future, through a critical statement on the current situation.
TL;DR: Atypical antipsychotics are associated with a much lower incidence rate of EPS than conventional agents, and although few directly comparative data are available, studies indicate that their risk of inducing EPS can be ranked in the following order: clozapine B/ quetiapineB/olanzapine /ziprasidoneB/risperidone.
Abstract: Despite recent advances in the treatment of schizophrenia and related psychoses, management of acutely ill patients in the hospital setting remains a significant challenge for clinicians. Patients ...