"Difficult to place" psychiatric patients.
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Attitude to Health↗
Biomedical subjects
M Maj
Publications and source records attributed to M Maj.
Long-term outcome of lithium prophylaxis in bipolar patients.
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Bipolar Disorder↗
Lateralization patterns of event-related potential and performance indices in schizophrenia: relationship to clinical state and neuroleptic treatment.
In a previous study we assessed lateralization patterns of verbal stimuli processing, by means of behavioural and neurophysiological measures, in a sample of drug-free schizophrenics and one of normal controls. The main findings obtained were the following: (1) a right visual field (RVF) advantage on reaction time (RT) and late positive complex (LPC) peak of the ERPs in normal subjects but not in schizophrenics; (2) a left visual field (LVF) significant advantage on P360 and slow wave (SW) amplitude in schizophrenics but not in controls; (3) a significantly longer RT and smaller P360 and SW for RVF stimuli in schizophrenics as compared to normals; (4) a significant contralateral effect of visual field on N180 at both the left and the right parietal site in normal controls and only at the right parietal site in schizophrenics. As a further step of this investigation we re-tested 9 schizophrenics after 28 days of haloperidol treatment. The post-treatment lateralization pattern of verbal stimuli processing was characterized by a RVF advantage on LPC peak amplitude and no visual field effect on P360 and SW, resembling the normal group pattern. Moreover, the N180 amplitude was found to be reduced. Relationships between lateralization pattern and clinical picture changes induced by haloperidol treatment are discussed.
Adult↗
CEEG mapping in drug-free schizophrenics. Differences from healthy subjects and changes induced by haloperidol treatment.
A topographic CEEG investigation was carried out in 20 drug-free, DSM-IIIR diagnosed schizophrenics and in a group of matched healthy controls. The effects of acute and chronic haloperidol treatment were then assessed in the patient group. On the baseline recording, schizophrenics showed a widespread increase in delta, theta 1 and beta 3 amplitude. Acute haloperidol administration produced a decrease in delta and an increase in slow beta amplitude. After 28 days of treatment, delta and fast beta were reduced while theta 2 and alpha 1 were increased. CEEG abnormalities in schizophrenic subjects appear, therefore, to be reduced by chronic neuroleptic treatment.
Adult↗
Psychological problems of families and health workers dealing with people infected with human immunodeficiency virus 1.
The psychological problems of the families of human immunodeficiency virus 1 (HIV-1)-infected people, and of the health workers taking care of them, have been addressed in a few empirical studies and in several anecdotal reports and theoretical contributions. Apparently, HIV-1 infection and acquired immunodeficiency syndrome (AIDS) are able to elicit a wide range of emotional reactions, from rejection and refusal to provide care to immersion in the infected person's needs and burnout. Since irrational fears and attitudes play an important role in conditioning these reactions, education may not be sufficient to change behaviour. Counselling sessions and mutual support groups are often the most appropriate contexts where fears and concerns can receive an individually tailored response, and where formal and informal caregivers can be helped to manage stress.
Adaptation, Psychological↗
Failure of single electroconvulsive shock to affect daytime melatonin production in rats.
It has been reported that, in the rat, different types of stressful procedures increase daytime melatonin production. Electroconvulsive shock (ECS) has been shown not to affect daytime pineal melatonin in rats killed 9 hr after its administration. It is possible that the long-lasting interval between the ECS administration and the sacrifice of the animals obscured an effect of the stressful procedure. In the present study, the effects of acute ECS on daytime melatonin production were evaluated in both ECS- and sham-treated rats killed 30, 60, 120, and 240 min after treatment. As compared with the sham-treated animals, rats receiving acute ECS (80 mA, 0.5 sec) did not show any significant difference in either pineal or serum melatonin levels at any time point after treatment. These data indicate that single ECS does not affect daytime melatonin production in the rat and suggest that the pineal gland may respond differently to the various stressful procedures.
Analysis of Variance↗
A family study of DSM-III-R schizoaffective disorder, depressive type, compared with schizophrenia and psychotic and nonpsychotic major depression.
OBJECTIVE: To assess the validity of DSM-III-R schizoaffective disorder, the authors explored the morbid risks for schizophrenia and major affective disorders in the first-degree relatives of patients with schizoaffective disorder and relevant other diagnoses. METHOD: In addition to patients with DSM-III-R schizoaffective disorder, depressive type (N = 21), the probands included patients with mood-incongruent psychotic depression (N = 22), mood-congruent psychotic depression (N = 19), nonpsychotic depression (N = 27), or schizophrenia (N = 28) and normal subjects (N = 18). The patients were consecutively recruited from the outpatient facilities of a university psychiatry department; the normal subjects were students and nurses. All probands were directly interviewed, with the Schedule for Affective Disorders and Schizophrenia--Lifetime Version (SADS-L), by a psychiatrist blind to information about relatives. Consenting relatives were directly interviewed, with the SADS-L, by two psychiatrists blind to the probands' diagnoses. The direct interview was supplemented--or replaced, when an interview was not possible (24%)--by family history data from all available sources. Morbid risks in relatives were calculated according to the Weinberg method. RESULTS: The relatives of the schizoaffective patients had almost the same risk for schizophrenia as the relatives of the schizophrenic patients. In the relatives of the patients mood-incongruent psychotic depression, the morbid risk for major affective disorders was about one-half that of the relatives of the patients with mood-congruent psychotic depression and one-third that of the relatives of the patients with nonpsychotic depression, but these differences did not reach statistical significance. CONCLUSIONS: These results suggest that DSM-III-R schizoaffective disorder is close to schizophrenia and largely corresponds to mainly schizophrenic schizoaffective disorder in the Research Diagnostic Criteria, whereas DSM-III-R mood-incongruent psychotic depression is probably quite heterogeneous and should be studied further.
Adult↗
The World Health Organization's cross-cultural study on neuropsychiatric aspects of infection with the human immunodeficiency virus 1 (HIV-1). Preparation and pilot phase.
The WHO launched a multicentre study to explore the nature and prevalence of HIV-1-associated neurological, psychiatric, and neuropsychological abnormalities in persons living in different geographical and sociocultural contexts. The study is being conducted in Brazil, Germany, Kenya, Thailand, the United States of America, and Zaire. A comprehensive instrument for the collection of neuropsychiatric data (including a battery of neuropsychological tests suitable for cross-cultural use) has been developed, and the feasibility of the recruitment and assessment procedure designed for the main phase has now been demonstrated.
Attention↗
Chronic antidepressant drug treatment does not affect GH response to baclofen in depressed subjects.
The growth hormone (GH) response to baclofen, a specific GABAB agonist, was tested in 8 male depressed patients before and after chronic treatment with amitriptyline (100 mg/day). No difference was seen in plasma GH response before and 28 days after amitriptyline treatment, suggesting that chronic antidepressant drug treatment does not increase hypothalamic GABAB receptor sites in humans. These data suggest that further studies need to support the hypothesis of a GABA involvement in the mechanism of action of antidepressant drugs.
Adult↗
Physical exercise at night blunts the nocturnal increase of plasma melatonin levels in healthy humans.
The effects of physical exercise on nighttime melatonin secretion have never been investigated in humans. For this purpose, plasma melatonin levels were measured at different times during the day and the night in seven healthy men (aged 26-33 yrs), both in resting condition and before and after a physical exercise performed between 10.40 and 11.00 p.m.. The exercise consisted in bicycling on a bicycle ergometer at 50% of the personal maximal work capacity (MWC) for 10 min, followed by other 10 min of bicycling at 80% of the MWC. The results clearly showed that physical stress at night significantly blunts the nocturnal increase in plasma melatonin levels (group X time interaction: p less than 0.00001; two-way ANOVA with repeated measures). These findings, taken together with the data of the literature, suggest that the response of the pineal gland to provocative stimuli may depend on its level of activity when the stimulus is applied.
Adult↗
GABA, depression and the mechanism of action of antidepressant drugs: a neuroendocrine approach.
Recent evidence has suggested the involvement of the GABAergic system in depression and in the mechanism of action of somatic antidepressant treatments. In particular, GABAB receptors have been found to be increased in the rat frontal cortex following chronic antidepressant therapies. In the present study, the sensitivity of GABAB binding sites was assessed in nine healthy men and 10 depressed patients via the plasma growth hormone (GH) response to acute baclofen administration (20 mg p.o.). Depressed subjects were tested before and after 15 and 35 days of treatment with amitriptyline (100 mg/day), imipramine (100 mg/day) and fluoxetine (20 mg/day). GH response to acute GABAB receptor activation did not differ between depressed subjects and healthy controls. Moreover, chronic antidepressant treatment did not significantly modify this response, even when a clear therapeutic effect was obtained. These results do not support the idea that GABAergic mechanisms are involved in the pathophysiology of depression and in the mechanism of action of antidepressant drugs.
Adult↗
Patterns of course in patients with a cross-sectional diagnosis of schizoaffective disorder.
The authors conducted a longitudinal study on two samples of patients, fulfilling Research Diagnostic Criteria for schizoaffective disorder and for major affective disorder, respectively. The long-term course in patients defined cross-sectionally as schizoaffective was very heterogeneous. Ten different patterns of course were identified. In schizoaffectives showing a bipolar course with the occurrence of pure affective episodes, the outcome was not different from that in patients with a cross-sectional diagnosis of major affective disorder, whereas in schizoaffectives whose course was characterized by the occurrence of schizodepressive episodes only, or of schizodepressive and schizophrenic episodes, the outcome was significantly poorer than in patients diagnosed as affective.
Adult↗
Factors associated with increased noradrenaline levels in schizophrenic patients.
1. CSF NA levels were determined in a sample of DSM III-diagnosed schizophrenics and in a non-psychiatric control group. Schizophrenics with NA levels above and below the median were compared with respect to several clinical, historical, neuropsychological and biological variables. 2. Mean CSF NA levels were significantly higher in schizophrenics than in controls. 3. Schizophrenics with high CSF NA levels, as compared to those with low levels, had significantly higher scores on the CPRS subscale for positive symptoms. Moreover, in the former subgroup, C-EEG alpha relative activity was significantly lower and C-EEG beta relative activity was significantly higher in frontal and central leads. Two of the three patients who had been never treated with neuroleptics, and three of the six patients who had been neuroleptic-free for more than four weeks had high CSF NA levels. 4. These data support the relationship between increased CSF NA levels and the condition of overarousal of the schizophrenic patients, and suggest that prior neuroleptic treatment is not a major determinant of high CSF NA concentration in schizophrenics.
Adolescent↗
C-EEG brain mapping in DSM-III schizophrenics after acute and chronic haloperidol treatment.
A multi-lead C-EEG investigation was carried out, in order to evaluate changes induced by acute and chronic treatment with haloperidol in DSM-III-R schizophrenics. After the acute treatment the main C-EEG changes were (1) a significant decrease of delta relative power (RP) over all the explored leads and of theta 1 over the occipital leads; (2) an increase in alpha 2 and beta 2 RP, as well as a decrease of beta 3 RP confined to the anterior temporal leads (T3, T4). During chronic treatment, C-EEG changes observed were (1) a significant decrease of delta RP and an increase of theta 1 RP; (2) an increase of alpha 1 and alpha 2 RP; (3) a significant decrease of beta 1, beta 2 and beta 3.
Adult↗
Psychiatric aspects of HIV-1 infection and AIDS.
The literature on the psychiatric aspects of HIV-1 infection is reviewed. The whole range of psychiatric disorders described in HIV-1 infected subjects, from HIV-1 dementia to adjustment disorders, is covered, along with the AIDS-related psychopathology which may develop in subjects without HIV-1 infection.
AIDS Dementia Complex↗
Organic mental disorders in HIV-1 infection.
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AIDS Dementia Complex↗
Clinical prediction of response to lithium prophylaxis in bipolar patients: the importance of the previous pattern of course of the illness.
The response to lithium prophylaxis was evaluated in a sample of bipolar patients subdivided into groups, according to the previous pattern of course for 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). The percentage of responders to treatment was significantly different among the five groups, and the difference could be ascribed mainly to the high response rate in the MDI group and the low response rate in the DMI and CC-RC groups. These data suggest that the classification of bipolar patients on the basis of the previous pattern of their course of illness may be useful for predicting lithium response.
Adult↗
Major depression with mood-congruent psychotic features: a distinct diagnostic entity or a more severe subtype of depression?
The nosological status of major depression with mood-congruent psychotic features was explored by a cross-sectional demographic, clinical and biological assessment and a 7-year prospective follow-up of 2 samples of patients fulfilling, respectively, DSM-III criteria for this condition and for major depression without psychotic features. The 2 patient groups did not differ with respect to demographic and historical features, response to DST and outcome. The global severity of the index episode was greater in psychotics. All nonpsychotics and 69% of psychotics were treated with antidepressants alone or in combination with benzodiazepines, whereas the addition of neuroleptics was required only in 31% of psychotics. A tendency towards an interepisodic diagnostic stability was verified in nonpsychotics more than in psychotics, but was less pronounced than that reported by the authors advocating the nosological autonomy of delusional depression. These data support the view that major depression with mood-congruent psychotic features is not a distinct diagnostic entity, but rather a more severe depressive subtype.
Adult↗