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Biomedical subjects

D Kemali

Publications and source records attributed to D Kemali.

At least 55 records · Page 3Linked to original sources
PubMed1986

Minimum plasma lithium levels required for effective prophylaxis in DSM III bipolar disorder: a prospective study.

Four groups of DSM III bipolar patients, whose plasma lithium levels were maintained at 0.30-0.45 (group A), 0.46-0.60 (group B), 0.61-0.75 (group C), and 0.76-0.90 (group D) mEq/l respectively, were followed-up for two years. The mean number of affective episodes and the mean total morbidity during the lithium treatment period were significantly decreased in all groups except group A when compared with the pre-lithium period. Moreover, in group A, the mean total scores on CPRS depressive and manic items during the interepisodic periods were significantly higher than in each of the other groups. As a result of the low scores of patients in group A and the high scores of patients in group D on the side effect checklist, the frequency and intensity of side effects differed significantly among the four groups. These data suggest that, in the prophylactic treatment of bipolar patients, plasma lithium levels should, as a rule, be adjusted to the range 0.46-0.75 mEq/l.

Adult↗
PubMed1986

Research on schizophrenia in Southern European countries.

The research on schizophrenia during the last 50 years in the Latin language countries of Southern Europe is briefly surveyed. Particular emphasis is given to the contributions of French authors to the diagnostic concept of schizophrenia, as well as to the phenomenological studies concerning the "essence" of schizoidia/schizophrenia, and some initial schizophrenic "Erlebnisse." The development of biological, psychological, and sociological theories concerning the etiology of schizophrenia is outlined, and contributions such as the "aminotoxic theory" of V. M. Buscaino and the theoretical principles of "alternative psychiatry" are examined in detail. Lastly, the role of French, Italian, Spanish, and Portuguese psychiatrists in the introduction and improvement of somatic treatments is described.

Family↗
PubMed1985

Clinical and neuropsychological correlates of cerebral ventricular enlargement in schizophrenia.

A comprehensive assessment of computed tomography (CT) with respect to clinical, historical and neuropsychological variables has been carried out in a sample of DSM III schizophrenics fairly heterogeneous with respect to duration and severity of illness and in a normal control group matched for sex, age and educational level. The mean value of ventricular brain ratio (VBR) was significantly higher in schizophrenics than controls. Seven patients (21.2%) who had VBRs exceeding 2 SD of the control mean showed a significantly longer duration of illness than the other schizophrenics with significantly higher scores on the subscales alogia, effective flattening and attentional impairment of SANS, on the scales self-care and behaviour in crises and emergencies of DAS, on the scales rhythm, tactile, visual, reading, arithmetic, memory and left hemisphere of LNNB, and on the subtests arithmetic, digit span, digit symbol and block design of WAIS. These results confirm earlier reports of an enlargement of lateral cerebral ventricles in a subset of schizophrenics, and its association with a higher degree of cognitive and neuropsychological impairment, social maladjustment and defectual symptomatology. Moreover, they suggest that the neuropathological process likely to underlie the increase of cerebral ventricular size progresses during the course of the illness rather than predating its onset.

Adolescent↗
PubMed1985

Factors associated with response to lithium prophylaxis in DSM III major depression and bipolar disorder.

The relationship of some clinical, personality and biological variables to the outcome of lithium prophylaxis was investigated in two patient samples fulfilling, respectively, the DSM III definitions of "major depression, recurrent" and "bipolar disorder". In major depressives, the presence of psychomotor retardation and melancholia during the index episode was associated with a favorable response to treatment, whereas the presence of mood-incongruent psychotic features during the same episode, a high score on the "anxiety" and "phobic" subscales of the Middlesex Hospital Questionnaire and a high score on the "neuroticism" subscale of the Eysenck Personality Questionnaire were related to a poor response. These findings are discussed in the light of the heterogeneity of DSM III major depression and of the reported common occurrence of an "anxiety-phobic" personality profile in unipolar depressives. In bipolar patients, a family history of bipolar affective illness and a high lithium ratio were associated with a good response to treatment, and the presence of the HLA-A3 antigen with an unfavorable response. These findings seem to support a role of pharmacogenetic factors in conditioning response to lithium prophylaxis.

Adult↗
PubMed1985

Relationship between CSF noradrenaline levels, C-EEG indicators of activation and psychosis ratings in drug-free schizophrenic patients.

A significant increase of cerebrospinal fluid (CSF) noradrenaline (NA) levels, probably reflecting a rise of central noradrenergic activity, has been observed in a sample of acute schizophrenic patients as compared with a population of subjects without personal or family history of major psychoses. CSF NA levels have been found to be significantly correlated with computerized EEG (C-EEG) indicators of arousal (negative correlation with alpha relative activity and positive correlation with alpha barycentric frequency and beta relative activity in frontal and central leads). No significant relationship has emerged between CSF NA concentration and psychosis ratings on CPRS as well as platelet MAO activity. These findings seems to confirm the link between central noradrenergic hyperactivity and the condition of enhanced arousal of the schizophrenic patient, although the role of this condition in the pathophysiology of schizophrenia (primary phenomenon or non-specific consequence of the stress related to the illness?) remains to be elucidated.

Adolescent↗
PubMed1985

Application of the Psychiatric Reform Act in the city of Naples. A survey of requests for compulsory admission to the special unit at the University Psychiatric Department I.

One of the most patent inconsistencies in the application of the 1978 Psychiatric Reform Act in many areas of Southern Italy has resulted from the irrational choice, by regional governments, of the general hospitals in which Psychiatric Special Units had to be implemented, and from the inappropriate determination of territorial boundaries defining the competence of such Units. Thus, in the city of Naples, it was decided, in June 1978, to set up Psychiatric Special Units only in the two University Psychiatric Departments and in the Psychiatric Emergency Ward at S. Gennaro Hospital. These Units, equipped with an overall number of 39 beds, were put in charge with the whole province of Naples (about three millions inhabitants). Quite arbitrarily, it was established that University Departments had to admit patients coming from the city of Naples and S. Gennaro Hospital those residing in the rest of the province. By an equally arbitrary choice, female patients from the city of Naples were entrusted to the University Department I and male patients to the Psychiatric Department II. In the following years, from 1979 to 1983, some additional Units were set up in general hospitals of the Naples province. Nonetheless, available beds have not exceeded the overall number of 69, and the catchment areas of the three pre-existing Special Units have not been modified. The chaotic situation engendered by this incongruous application of the Reform Act is outlined, by means of an analysis of the requests for compulsory admission addressed to the Special Unit at the Psychiatric Department I of Naples University during the periods June 16, 1978-December 31, 1979 and June 16, 1982-December 31, 1983.

Commitment of Persons with Psychiatric Disorders↗
PubMed1985

Patients admitted for compulsory treatment to selected psychiatric units in Italy and in Sweden.

Eighty-five Italian and forty-nine Swedish patients consecutively admitted for compulsory treatment to either an Italian or a Swedish psychiatric unit in selected areas of the two countries have participated in an exploratory study aimed at assessing the main characteristics of compulsory admitted patients, and in particular, the immediate reason for admission. The two series proved to be quite similar as concerns most sociodemographic variables, and as concerns clinical diagnosis and severity of the morbid condition at admission as measured by means of a rating scale. More Swedish than Italian patients lived alone when admitted to hospital, and for more of them the request for admission was made by other people than relatives, and a larger proportion of them was accompanied to the hospital by medical or social welfare personnel. In both series the largest proportion had a low educational level and belonged to the lower social groups. The same proportion in the two series had previous admissions. The most common reason for admission was "odd or improper behaviour" for the Swedish patients, and "feared or manifest dangerousness" for the Italian patients. The Italian patients remained at hospital on average half the time than the Swedish patients.

Adolescent↗
PubMed1985

24-hour plasma levels of prolactin, cortisol, growth hormone and catecholamines in schizophrenic patients.

The 24-hour pattern of prolactin, cortisol and growth hormone (GH) secretion, and the diurnal variations of plasma catecholamine levels, were tested in a sample of DSM III schizophrenics and in a control population of patients hospitalized in the same ward and diagnosed as suffering from neurotic disorders. All subjects were acclimated to the ward and kept free from any drug for at least 2 weeks. No difference between schizophrenics and controls was observed with respect to the 24-hour profile of plasma prolactin and cortisol levels. The nocturnal peak of GH secretion was absent in 10 out of the 23 schizophrenics. These patients did not differ from the other schizophrenics with respect to the mean scores on any item of the Comprehensive Psychopathological Rating Scale. The mean plasma noradrenaline levels were significantly higher in schizophrenics than in controls during the wake period, but not during the sleep hours. A consistent decrease of the amine levels during the sleep period was observed in both groups. Since the nocturnal surge of plasma GH concentration has been associated with slow-wave sleep, which has been reported to be reduced in schizophrenic patients, the possibility is considered that this abnormality of sleep pattern can explain the alteration of GH release in schizophrenics. On the other hand, findings concerning plasma noradrenaline are interpreted as an indication that the state of increased autonomic arousal of schizophrenic patients is closely linked to daytime social interaction.

Adolescent↗
PubMed1984

Platelet monoamine oxidase activity in schizophrenia: relationship to family history of the illness and neuroleptic treatment.

Platelet monoamine oxidase (MAO) activity was determined in a large population of drug-free and haloperidol-treated schizophrenic patients and healthy controls and, in a second study, in a sample of schizophrenics after a wash-out period and at different times during treatment with haloperidol. Enzyme activity was significantly decreased in both acute and chronic haloperidol-treated schizophrenics, but not in drug-free schizophrenics, compared with normal controls. No significant difference was observed between drug-free schizophrenics with a family history of the illness and those without such history, and between healthy relatives of schizophrenic patients and normal controls without a family history of schizophrenia. MAO activity was significantly reduced after 14 and 21 days of haloperidol treatment, and such reduction did not correlate with response to treatment. These data strongly support the idea that neuroleptic intake may, at least in part, explain low MAO values repeatedly reported in schizophrenics.

Adolescent↗
PubMed1984

Drugs and the frog retina. Effect of dopaminergic agents on the pigment screening of light- and dark-adapted frogs.

This is a study, using the light and electron microscope, of the action of a dopamine agonist (apomorphine) and of a dopamine antagonist (haloperidol) on the retinal pigment screening (PS) of light- and dark-adapted frogs. Pigment screening is a phenomenon which consists of the migration of melanin granules into processes of the pigment epithelium that extend between photoreceptors, in response to changes in the conditions of illumination. In the light the pigment migrates vitreally , in the dark it aggregates sclerally . A single intravenous injection of apomorphine (0.15 mg/kg) and of haloperidol (1 mg/kg) did not induce substantial modifications in the pattern of pigment screening which was similar to that of controls both in light- and dark-adapted frogs. This suggests that dopamine is probably not directly involved in the phenomenon of pigment screening in the retina of the frog.

Animals↗
PubMed1984

Prediction of affective psychoses response to lithium prophylaxis. The role of socio-demographic, clinical, psychological and biological variables.

A set of socio-demographic, clinical, psychological and biological variables was examined in 100 patients diagnosed according to Perris as bipolar affective psychotics or unipolar depressive psychotics, maintained on prophylactic lithium for 2 years and divided into responders and non-responders to this treatment on the basis of strict criteria. The results confirmed the potential role of four indices as predictors of response to prophylaxis: a positive family history of bipolar affective illness and a high red blood cell/plasma lithium ratio (positive predictors) and the presence of the HLA-A3 antigen and a high score on the Neuroticism Scale of the Eysenck Personality Questionnaire (negative predictors). A stepwise discriminant analysis showed that neuroticism score, lithium ratio and HLA-A3 antigen, taken together, correctly classified 74.6% of responders and 68.3% of non-responders. It is hypothesized that these variables as a group may be of practical value in predicting response to lithium prophylaxis, and that pharmacogenetic and, perhaps, personality factors may be involved in treatment failures.

Adolescent↗
PubMed1984

Plasma cortisol, catecholamine and cyclic AMP levels, response to dexamethasone suppression test and platelet MAO activity in manic-depressive patients. A longitudinal study.

Plasma cortisol, catecholamine and cyclic AMP levels, response to dexamethasone suppression test and platelet MAO activity have been determined in 15 patients suffering from bipolar affective psychosis, each examined during a depressive, a manic and an euthymic phase, and in 15 sex- and age-matched normal controls. Mean basal and post-dexamethasone cortisol levels have been found to be enhanced in patients during depression, but not during mania or free intervals. Non-suppression of cortisol secretion after dexamethasone has been observed in 46.7% of patients while in a state of depression, but in none of them during mania or euthymia. Mean plasma noradrenaline and adrenaline levels, which are thought to be the most reliable biochemical indices of emotional arousal, have been found to be increased in patients during mania, but not during depression. No significant difference has been observed between patients during any phase of their illness and controls with regard to mean plasma cyclic AMP levels and platelet MAO activity. These results confirm the state-dependent overactivity of HPA axis in endogenous depression, and suggest that it should not be regarded as a correlate of emotional hyperarousal. Moreover, they do not support the postulated role of plasma cyclic AMP as a state variable and of platelet MAO activity as a trait variable for manic-depressive illness.

Adult↗
PubMed1983

Low platelet MAO activity in chronic schizophrenics: a long-term effect of neuroleptic treatment?

Platelet MAO activity was determined, using 14C-tryptamine and 14C-beta-phenylethylamine as substrates, in two groups of schizophrenic patients and a normal control population. The first patient group consisted of 75 schizophrenics who had been medication-free for 2 weeks and had not been exposed to neuroleptic drugs for at least 2 months before the off-drug period. The second patient group comprised 55 schizophrenics who were on treatment with haloperidol for at least 2 months. The enzyme activity was found to be significantly decreased in both drug-free (using only tryptamine as substrate, P less than 0.05) and haloperidol-treated (P less than 0.001) chronic schizophrenics as compared with normal controls, and to be significantly lower (P less than 0.05) in haloperidol-treated than in off-drug chronic schizophrenics. An in vitro study confirmed the lowering effect of haloperidol on MAO activity. It is suggested that low platelet MAO values observed in chronic schizophrenics might be in part an effect of neuroleptic treatment.

Adolescent↗
PubMed1983

Modification of the pigment screening of the frog retina following administration of neuroactive drugs.

Pigment screening (PS) occurs in the retina of lower vertebrates and consists of the bidirectional migration (vitreally or sclerally) of melanin granules into processes of the pigment epithelium that extend between photoreceptors, in response to changes in the illumination conditions. We have studied the effect of some neuroactive drugs on the PS of frogs maintained under cyclic lighting conditions or dark-adapted. The drugs, administered intravenously were: lysergic acid diethylamide (LSD), mescaline, d-amphetamine, the LSD analogue lisuride and the LSD derivative 2-bromolysergic acid (BOL). All the drugs used--with the exception of mescaline--modify the bidirectional migration of the pigment induced by the two illumination conditions in a different way. This suggests that in general these substances interact in some way with those processes which normally produce the well-defined PS pattern. It has been possible to discriminate two opposite effects on the retinal PS induced by two chemically related substances (LSD and lisuride) only one of which (LSD) has potent hallucinogenic properties.

Animals↗