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Biomedical subjects

M Maj

Publications and source records attributed to M Maj.

At least 199 records · Page 11Linked to original sources
PubMed1984

The evolution of some European diagnostic concepts relevant to the category of schizoaffective psychoses.

The evolution of the German-Scandinavian concept of cycloid psychosis and of the French concept of 'bouffée délirante' is analyzed. It is stressed that they probably correspond to the same clinical entity, not overlapping with any of the American nosological categories, although sharing a number of features with the original Kasanin's picture of schizoaffective psychosis. Moreover, a survey is given of the evidence supporting the construct and predictive validity of the concept of cycloid psychosis.

Europe↗
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↗
PubMed1982

Increased noradrenaline levels in CSF and plasma of schizophrenic patients.

Noradrenaline (NA), dopamine (DA), and adrenaline (A) concentrations were determined by means of a specific and sensitive radioenzymatic method in plasma, CSF, and urine of schizophrenic patients and in a group of age- and sex-matched controls without history of mental disorder. NA levels were found to be significantly increased both in plasma and CSF of schizophrenics, particularly in paranoids. The increase in plasma NA concentration can probably be ascribed to the higher unspecific arousal level of these patients, whereas the increase of CSF NA levels probably reflects a rise of central noradrenergic activity. The physiopathological significance of this overactivity, however, is questionable.

Adult↗
PubMed1981

Blood levels of S-adenosylmethionine in unmedicated schizophrenic and depressive patients.

S-Adenosylmethionine blood levels have been estimated by a specific radioenzymatic method in 52 schizophrenics and 12 depressives, diagnosed and subtyped according to ICD-9 and compared with 38 normal controls. Previous reports of significantly lower levels of blood SAMe in acute schizophrenics in comparison with normal subjects could not be confirmed in this study. Indeed, acute schizophrenics showed higher mean SAMe blood levels as compared both with chronic and with normal controls. No significant difference has been found comparing both schizophrenics as a whole and depressives with normal controls. This investigation aims to bring a contribution to the recently started critical revision of transmethylation hypothesis of schizophrenia.

Adolescent↗
PubMed1981

Cell membrane predictors of response to lithium prophylaxis of affective disorders.

HLA antigens and RBC/plasma lithium ratio were studied in a sample of 49 patients, diagnosed as bipolar affective psychotics (n = 22), unipolar depressive psychotics (n = 18) and cycloid psychotics (n = 9), receiving prophylactic lithium for 1-4 years and maintained at lithium plasma levels of 0.6-1.2 mEq/1. Mean values of the ratio were found to be significantly higher in patients who responded to treatment when compared with non-responders, whereas the frequency of the HLA-A3 antigen was significantly higher in non-responders. The only 6 patients with a lithium ratio above the median and the absence of the HLA-A3 antigen coexistent with bipolarity and a family history of the illness were all good responders to treatment. Further research in this field will probably bring about the isolation of a subgroup of lithium-responsive patient with well-defined clinical and biological features. When patients were divided into two subgroups according to their lithium ratios (above and below the median), the HLA-A3 and Aw26 antigens were found to be significantly more frequent in those with ratios below the median. It can be hypothesized tha these antigens disturb transport in some way, leading to low lithium ratio values.

Adult↗
PubMedDate not supplied

Response to the dexamethasone suppression test in schizoaffective disorder, depressed type.

Response to the dexamethasone suppression test (DST) was tested in 20 patients fulfilling the Research Diagnostic Criteria (RDC) for schizoaffective disorder, depressed type, and in 52 patients meeting RDC for major depressive disorder. Non-suppression was observed in 25% of the schizodepressives and in 40.4% of the depressives. No significant difference between suppressor and non-suppressor schizodepressives was found with respect to demographic, historical and clinical variables. These results do not support the usefulness of the DST for the identification of a homogeneous subtype of schizoaffective disorders.

Adult↗
PubMedDate not supplied

Lithium prophylaxis of schizoaffective disorders: a prospective study.

A prospective study was carried out in order to provide an answer to the following questions. (1) Is lithium effective as a prophylactic agent in broadly defined schizoaffective disorders? (2) Taking for granted that schizoaffective disorders represent a heterogeneous group of conditions, in which schizoaffective patients is lithium effective? (3) Are there any clinical, historical or biological predictors of response to lithium prophylaxis in schizoaffective patients? (4) What are the minimum plasma lithium levels required for effective prophylaxis in schizoaffective disorders? The study confirmed the efficacy of lithium prophylaxis in broadly defined schizoaffective disorders, but showed that this treatment is relatively ineffective in schizoaffective patients with a prominent schizophrenic-like component in their clinical picture and in those diagnosed cross-sectionally as schizodepressive. The only successful predictor of response was a previous bipolar course of the illness (which was associated with a positive outcome of prophylaxis). Plasma lithium levels in the range of 0.45-0.60 mEq/l did not prove to be useful for prophylactic purposes in schizoaffective disorders.

Dose-Response Relationship, Drug↗
PubMedDate not supplied

Previous pattern of course of the illness as a predictor of response to lithium prophylaxis in bipolar patients.

The response to lithium prophylaxis was assessed in a sample of bipolar patients subdivided into the following groups on the basis of the previous pattern of course of their illness: MDI (sequence mania-depression-free interval), DMI (sequence depression-mania-free interval), CC-LC (continuous circular course with long cycles), CC-RC (continuous circular course with rapid cycles), IRR (irregular course). A significant reduction of the mean number of morbid episodes and of the mean total morbidity during lithium treatment was observed only in patients with a previous MDI or IRR course. The percentage of responders to prophylaxis was significantly different among the five groups, and the difference could be mainly ascribed to the high response rate in the MDI group and the low response rate in the DMI and CC-RC groups. These results suggest that the classification of bipolar patients according to the previous pattern of course of their illness may be useful for the prediction of lithium response.

Adult↗
PubMedDate not supplied

Reliability and validity of the DSM-IV diagnostic category of schizoaffective disorder: preliminary data.

BACKGROUND: Concerns have been expressed about the reliability and validity of the DSM-IV criteria for schizoaffective disorder, but no systematic study has been published up to now. METHODS: The Cohen's kappa for the individual items of the DSM-IV definition of schizoaffective disorder, manic episode and major depressive episode was evaluated in 150 patients independently interviewed by two psychiatrists using the Composite International Diagnostic Interview. The two-year outcome of patients with a consensus DSM-IV diagnosis of schizoaffective disorder was compared to that of patients with DSM-IV schizophrenia and schizophreniform disorder, using the Strauss-Carpenter Outcome Scale. RESULTS: The Cohen's kappa was 0.22 for the diagnosis of schizoaffective disorder, 0.71 for that of manic episode, and 0.82 for that of major depressive episode. Schizoaffective patients had a significantly better outcome than those with schizophrenia but a worse outcome than those with schizophreniform disorder. CONCLUSIONS: The inter-rater reliability of the DSM-IV criteria for schizoaffective disorder is not satisfactory. The better outcome of DSM-IV schizoaffective disorder compared with schizophrenia seems to depend more on the inclusion, in the definition of schizophrenia but not in that of schizoaffective disorder, of the six-month duration and functional impairment criteria than on the different symptomatological patterns of the two conditions. LIMITATION: The size of the sample of patients fulfilling DSM-IV criteria for schizoaffective disorder was small. CLINICAL RELEVANCE: The study suggests that the clinical implications of the currently problematic diagnosis of schizoaffective disorder may be modest.

Adolescent↗
PubMedDate not supplied

[The condition of families of patients with schizophrenia in Italy: burden, social network and professional support].

OBJECTIVE: This study aimed to describe: a) the interventions received by patients with schizophrenia attending Italian mental health services (MHS); b) the relatives' burden and social network and the professional support received by the families. DESIGN: The study has been carried out in 30 MHS, randomly selected and stratified by geographic areas and population density. 25 patients with a DSM-IV diagnosis of schizophrenia and 25 relatives were recruited in each MHS. Family burden was evaluated in relation to: a) geographic area; b) interventions received by the patients; c) social and professional support received by the families. MAIN OUTCOME MEASURES: a) patients: Brief Psychiatric Rating Scale (BPRS) and Disability Assessment Interview (AD); b) key-relatives: Family Problems Questionnaire (QPF) and Social Network Questionnaire (QRS); c) interventions received by the patients and their families: Scheda di Rilevazione degli Interventi--Pattern of Care Schedule (SRI). RESULTS: Data on 709 patients and their key-relatives were collected. In the two months preceding the data collection, 35% of patients attended rehabilitative programmes; 80% of the families were in regular contact with the MHS and 8% received family psychoeducational interventions. Family burden was higher in Southern than in Central and Northern Italy. This difference disappeared when rehabilitative interventions and family support were provided. CONCLUSIONS: This study highlights that the situation of the families of patients with schizophrenia is more burdensome in Southern Italy and is greatly influenced by the type of interventions provided by the MHS.

Adolescent↗
PubMedDate not supplied

[Family burden in schizophrenia: effects of socio-environmental and clinical variables and family intervention].

OBJECTIVE: Description of burden, attitudes and received professional support in a sample of relatives of patients with schizophrenia recruited in 8 Italian Mental Health Services (MHS), stratified by geographic areas and population density. DESIGN: Cross-sectional study on key-relatives of clinically stable patients with a DSM-IV diagnosis of schizophrenia. Evaluation of: a) relationships of family burden with patient's clinical characteristics, family's socio-demographic variables, relative's attitudes toward the patient, professional and social support received by the family; b) differences in the levels of burden, attitudes and support received by the family with respect to geographical area and population density. SETTING: 8 Italian MHS stratified by geographic areas (Northern, Central, Southern Italy) and population density (urban vs. rural areas). MAIN OUTCOME MEASURES: Patient's clinical status and social functioning: BPRS and ADC. Family burden, attitudes and support received by the family: FPQ. RESULTS: Data on 144 patients and their key-relatives were collected. Higher levels of burden were found among relatives referring to Southern MHS. The burden was found positively correlated with the levels of patients' BPRS positive and manic/hostility symptoms and disability, and with the number of daily hours spent by the relative in contact with the patient, and negatively correlated with the levels of professional support received by the family. CONCLUSIONS: The results of this study highlight the need to provide rehabilitative programmes for patients with schizophrenia as well as informative and psychoeducational interventions for their families.

Adolescent↗
PubMedDate not supplied

[Causes and psychosocial consequences of schizophrenia: the opinions of patient's relatives].

OBJECTIVE: Description of the opinions on schizophrenia and its psychosocial consequences in a sample of relatives of patients with schizophrenia, recruited in 30 Italian Mental Health Centres (MHC), stratified by geographic areas and population density. DESIGN: Cross-sectional study on key-relatives of clinically stable patients with a DSM-IV diagnosis of schizophrenia. Evaluation of relatives' opinions on schizophrenia and its psychosocial consequences, in relation to: a) patient's clinical and family's socio-demographic variables; b) geographic areas and population density. SETTING: 30 Italian MHC randomised and stratified by geographic areas (Northern, Central, Southern Italy) and population density (> 100,000 inhabitants; between 100,000 and 25,000 inhabitants; < 25,000 inhabitants). Main outcome measures--Patient's clinical status and social functioning: Brief Psychiatric Rating Scale (BPRS) and Disability Assessment interview (AD). Interventions provided to patient and his/her family: Scheda di Rilevazione degli Interventi--Pattern of Care Schedule (SRI). Relatives' opinions on schizophrenia and its psychosocial consequences: Questionnaire on the Opinions of the Family (QOF). RESULTS: Data on 709 patients and their key-relatives were collected. Relatives' pessimistic opinions on social competence of patients with schizophrenia were found to be associated with: high levels of patient's disability, hostility and negative symptoms, relatives' knowledge of patient's diagnosis of schizophrenia, residence in a medium or low population density area, low levels of relative's education. Relatives' pessimistic opinions on social restrictions imposed by schizophrenia were found to be associated with high levels of disability and high number of hospital admissions in the patient and older age in the relative. CONCLUSIONS: The results of this study emphasise the need to: a) provide families with educational interventions covering not only clinical aspects of schizophrenia, but also those concerning disability and psychosocial consequences of the disorder; b) plan educational campaigns on mental illnesses which take into account the socio-cultural characteristics of the target populations.

Adolescent↗