Biomedical subjects
Bernard Lerer
Publications and source records attributed to Bernard Lerer.
Optimum Frequency of Electroconvulsive Therapy: Implications for Practice and Research.
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Electroconvulsive Shock and Brain Cholinergic Function: Role of Striatal Muscarinic Receptors.
Repeated administration of electroconvulsive shock (ECS) has been reported to reduce (3)H-quinuclidinyl benzilate ((3)H-QNB) binding to muscarinic cholinergic receptors in rat brain. ECS-induced muscarinic receptor subsensitivity may play a role in the therapeutic or adverse mechanisms of electroconvulsive therapy (ECT). In the present report, cataleptic responses to the muscarinic agonist, pilocarpine, were studied as a functional measure of brain muscarinic receptor sensitivity after ECS. Both single and repeated ECS administration attenuated pilocarpine-induced catalepsy, suggesting functional subsensitivity of the muscarinic receptors mediating this response. However, parallel changes were not observed in striatal muscarinic receptor binding. While repeated ECS induced a small but significant reduction in (3)H-ONB binding, single ECS marginally increased binding. The effect of pretreatment with a cholinergic antagonist (scopolamine) and with a cholinesterase inhibitor, diisopropyl fluorophosphate (DFP), on cataleptic responses was also studied. The findings demonstrated functional cholinergic subsensitivity after DFP administration and supersensitivity after scopolamine pretreatment. A clear relationship between functional alterations in muscarinic receptor sensitivity and radioligand binding parameters was not, however, established. Possible reasons for this discrepancy are discussed.
Sensitivity of ICD-10 diagnosis of psychotic disorders in the Israeli National Hospitalization Registry compared with RDC diagnoses based on SADS-L.
OBJECTIVE: The Israeli National Psychiatric Hospitalization Registry is a nationwide list of all psychiatric hospitalizations in the country and has been widely used as a source of data for psychiatric research. This study assessed the sensitivity of the diagnosis of psychotic disorders ( International Statistical Classification of Diseases, 10th Revision [ ICD-10 ] F20.0-F29.9) and schizophrenia ( ICD-10 F20.0-F20.9) in the Registry. METHOD: Registry discharge diagnoses of psychotic disorders ( ICD-10 F20.0-F29.9) and schizophrenia ( ICD-10 F20.0-F20.9) were compared with research diagnoses derived from best-estimate procedures based on Research Diagnostic Criteria (RDC) using structured clinical research interviews, hospital records, and family information. RESULTS: Out of 169 patients meeting RDC for psychotic disorder, 150 also had a diagnosis of psychotic disorders in the Registry, yielding a sensitivity of 0.89. Re-running this analysis for the narrow definition of schizophrenia identified 94 patients who were diagnosed with schizophrenia using RDC; 82 of those patients also had a diagnosis of schizophrenia in the Registry, yielding a sensitivity of 0.87. CONCLUSION: In 87% to 89% of cases with psychotic disorders or with schizophrenia, Registry diagnoses agreed with RDC diagnoses, a rate of agreement comparable with those of other, similar registries. Because a large number of analyses derived from this and similar national registries will be published in the coming years, this constitutes relevant information.