Search PubMed⌕ Search

Biomedical subjects

J van Os

Publications and source records attributed to J van Os.

119 records · Page 7Linked to original sources
PubMed1994

Caring for mentally ill people.

Despite legislation to harmonise mental health practice throughout Europe and convergence in systems of training there remains an extraordinary diversity in psychiatric practice in Europe. Approaches to tackling substance misuse vary among nations; statistics on psychiatric morbidity are affected by different approaches to diagnosis and treatment of psychiatric disorders; attitudes towards mental illness show definite international differences. Everywhere, though, mental health care for patients with psychotic illnesses is a "cinderella service," and there is a general move towards care falling increasingly on the family and the community.

Attitude to Health↗
PubMed1994

The influence of life events on the subsequent course of psychotic illness. A prospective follow-up of the Camberwell Collaborative Psychosis Study.

Fifty-nine psychotic patients with acute onset of illness, who had been interviewed about their experience of stressful life events before the episode, were followed up for an average of 42 months. Thirty patients (51%) had experienced a stressful life event in the 3 months immediately before onset (EV+), 29 had not (EV-). In patients with an RDC diagnosis of affective disorder or unspecified functional psychosis, the presence of stressful life events was associated subsequently with milder symptom severity, less time spent in hospital, more treatment for depressive symptoms and less for psychotic symptoms. In schizophrenia, differences were less apparent, but patients with event associated episodes had less need of anti-psychotic maintenance medication over the follow-up period and tended to have spent more time in complete remission. EV+ schizophrenic subjects also had higher morbid risk for schizophrenia in their first degree relatives, and tended to be female and to have less typical symptoms than EV- schizophrenic patients.

Adult↗
PubMed1994

An association study of debrisoquine hydroxylase (CYP2D6) polymorphisms in schizophrenia.

The cytochrome P450 mono-oxygenases are a group of enzymes that metabolize a variety of exogenous and endogenous compounds, some of which are potentially toxic. Individual variations in the metabolism of potential toxins could influence susceptibility to disorders having genetic and environmental components, such as schizophrenia. The frequency of two common mutant alleles of the gene for the cytochrome P450 enzyme debrisoquine-4-hydroxylase (CYP2D6) was determined in 264 Caucasian schizophrenic patients and 217 controls, using the polymerase chain reaction and restriction enzyme digestions. The patient and control samples showed no significant deviation from Hardy-Weinberg equilibrium and the frequency of each mutant allele (CYP2D6A and CYP2D6B) did not differ between patients and controls.

Alleles↗
PubMed1993

Schizophrenia sans frontieres: concepts of schizophrenia among French and British psychiatrists.

OBJECTIVE: To compare the first admission rates for schizophrenia in England and France, and to compare the concept of schizophrenia held by practising British and French psychiatrists. DESIGN: Comparative study of incidence rates in England and France; and postal questionnaire survey of a sample of about 1 in 30 psychiatrists in the United Kingdom and in l'Aquitaine, France. SUBJECTS: All first admissions for schizophrenia to psychiatric hospitals in England and France 1973-82; 92 psychiatrists in the United Kingdom and 69 in France. MAIN OUTCOME MEASURES: Age adjusted first admission rates for schizophrenia between 1973-82; and opinions on the aetiology, diagnosis, and management of schizophrenia. RESULTS: First admission rates were much higher in France than in England before the age of 45, but lower after that age. Rates were falling in England over the 10 year period, while they were rising in France. In the questionnaire study English and French psychiatrists showed prominent differences of opinion for 31 out of 38 statements. The French sample did not diagnose schizophrenia after the age of 45 and endorsed psychoanalytical concepts. CONCLUSIONS: British and French psychiatrists use different diagnostic criteria and contrasting methods of treatment for schizophrenia. Differences in diagnostic criteria probably contribute towards the disparity in administrative incidence rates and time trends for schizophrenia in the two countries. Doctors in the European Community can now work in any country. Further work is needed to ensure psychiatrists are talking a common language.

Adolescent↗
PubMed1989

[2 families with meningococcal infection and a hereditary disorder of the 5th component of the complement system].

Within a period of six months, a 20-year-old female with a homozygous deficiency of the C5 component of complement developed meningococcal meningitis twice (different serogroups). Additional C5 deficiencies were not found in relatives. Homozygous deficiency of C5 was also present in another family in which a 16-year-old female and an 18-year-old sister suffered from meningococcal meningitis. Some characteristics of meningococcal disease in patients with C5 deficiency differed from meningococcal disease in patients with a normal complement system: meningitis occurred at a relatively advanced age, was associated with serogroups W-135, B and X and recurred in two of three patients.

Adolescent↗
PubMed1985

Dosimetry of cytostatics in hyperthermic regional isolated perfusion.

During the period from February to October 1983, 21 patients with malignant melanoma of the extremities were treated by hyperthermic regional isolated perfusion with L-phenylalanine mustard (melphalan). The melphalan dose for each patient was determined by the tissue volume of the perfused region, using a dose of 10 mg/l perfused tissue. Despite an average increase of melphalan dosage of 18% above the maximum for iliac perfusions recommended in the literature, no increase in toxic tissue reactions was observed after hyperthermic iliac perfusions. The same dose of 10 mg/l perfused tissue was used in hyperthermic axillary perfusions, resulting in an average decrease of melphalan dosage of 14% below the minimum recommended in the literature. By applying a constant dose per unit tissue volume, a standardization of treatment is achieved. This excludes variations like body weight, age, type of complexion, and hair color, which so far have determined dosimetry.

Chemotherapy, Cancer, Regional Perfusion↗
PubMedDate not supplied

Increased occurrence of depression in psychosis-prone subjects: a follow-up study in primary care settings.

A follow-up survey was performed with a network of general practitioners (GPs) to examine whether a higher proneness for psychosis predicts a greater incidence of depression in subjects with no history of mood disorder. At the first stage of the survey (T1), a self-report questionnaire exploring delusional ideation (Peters et al. Delusional Inventory [PDI-21]) was administered to the patients of the GPs. Information on psychiatric status at the baseline and conclusion of the 12-month follow-up period was provided by the GPs. The present study was restricted to 425 subjects with no lifetime history of depression. An incident depression was diagnosed in 18 subjects. Most items exploring delusional beliefs and hallucinations were more frequently endorsed by subjects with incident depression. Subjects with a PDI-21 score above the 90th percentile at T1 were nine times more likely to present with an incident depression during the follow-up period than those with PDI-21 scores below the 10th percentile. Psychosis proneness is associated with a greater risk for depression, suggesting that a continuum of vulnerability may exist between affective disorder and nonaffective psychosis.

Adult↗
PubMedDate not supplied

Association between cerebral structural abnormalities and dermatoglyphic ridge counts in schizophrenia.

Dermatoglyphic ridge counts (1) reflect ontogenic processes during the second trimester of pregnancy and (2) can be influenced by some of the factors that also affect cerebral development. Therefore, the demonstration of an association between dermatoglyphic and cerebral structural measures in patients with schizophrenia would give credence to the view that the structural brain abnormalities associated with this disorder have their origin early in development. Twenty-eight male subjects with schizophrenia and 19 male controls underwent magnetic resonance imaging (MRI) and dermatoglyphic analysis. The pattern of association between the ab-ridge count and nine MRI features was dissimilar in cases and controls for two measures. Associations between dermatoglyphic features, on the one hand, and the frontal CSF (r = .54, P = .004) and fourth ventricular volume (r = .38, P = .05), on the other, were larger in the cases versus the controls (test for interaction, P = .08 and P = .06, respectively). These findings, while in need of replication, support the view that the cerebral structural abnormalities found in patients with schizophrenia are the result of an early pathologic process affecting the development of fetal ectodermal structures.

Adult↗
PubMedDate not supplied

High expressed emotion: marker for a caring family?

"Expressed emotion" (EE) is considered a marker of dysfunctional family interaction in patients with schizophrenia. An alternative hypothesis, however, is that at least some of the different elements of EE really represent attempts on the part of carers to cope with and care for a relative with a psychiatric disorder. EE (criticism and emotional overinvolvement) was measured in relatives (n = 31) of patients with psychotic illness using the Five-Minute Speech Sample (FMSS). Level of EE was examined in relation to (1) patient-reported family involvement in care over the previous 2 years as indicated by medication monitoring, involvement in treatment decisions, and providing a substitute for institutional care; and (2) symptom severity and number of psychotic episodes. Presence of EE in the relative was strongly associated with the degree of family involvement in care (odds ratio [OR] over three levels: 3.2; 95% confidence interval [CI], 1.1 to 9.0). In addition, presence of high EE was associated with number of psychotic episodes in the previous 5 years in the proband (OR over 0, 1, or 2 episodes: 6.2; 95% CI, 1.2 to 31.9). The association with family involvement was confined to emotional overinvolvement (OR = 9.1; 95% CI, 2.0 to 42.2), whereas the association with previous psychotic episodes was confined to criticism (OR = 20.6; 95% CI, 2.8 to 149.3). Emotional overinvolvement may be a state marker for attempts on the part of relatives to be partners in the care for patients with psychotic illness. High level of criticism may be a trait marker in relatives associated with poor prognosis, but could also develop in reaction to a frequently relapsing illness.

Caregivers↗
PubMedDate not supplied

Hyperthermic regional perfusion using membrane- instead of bubble-oxygenators. An experimental and clinical study.

To achieve adequate tissue perfusion during hyperthermic regional perfusion, perfusion pressures should be maintained at near normal mean systemic arterial pressures. During experimental as well as during clinical perfusions however, unphysiologically high perfusion flows were needed to keep the perfusion pressure at the desired level. Since both high perfusion flows and high perfusion pressures have been associated with the post-operative complications such as severe edema and tissue damage, as well as with an increased leakage of perfusate to the systemic circulation, low perfusion flows have been used in regional perfusion. High perfusion flows in our previous experimental studies were attributable to a marked reduction in vascular resistance. This decrease is believed to be caused by the release of vasodilatory constituents of damaged blood cells, and it is the extra-corporeal circuit, and in particular the bubble-oxygenator that is thought to be responsible. The superior haemocompatibility of membrane-oxygenators over bubble-oxygenators has been established in cardio-pulmonary bypass. We compared the use of a membrane-oxygenator with that of a bubble-oxygenator in regional perfusion to see if more normal haemodynamics could be maintained and vasodilatation prevented. In the experimental as well as in the clinical perfusions the use of a bubble-oxygenator required unphysiologically high perfusion flows to maintain the perfusion pressure at the level required to obtain an adequate microcirculation. In contrast the use of a membrane-oxygenator permitted a nearly physiological perfusion flow to maintain an adequate perfusion pressure as well as an adequate micro-circulation.(ABSTRACT TRUNCATED AT 250 WORDS)

Animals↗