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Biomedical subjects

M V Seeman

Publications and source records attributed to M V Seeman.

At least 73 records · Page 4Linked to original sources
PubMed1988

Psychosis and positron tomography.

The new technology of positron emission tomography (PET) offers hope in developing objective biological indices and correlates of various psychotic states, including schizophrenia. PET is of the order of a million to a billion times more sensitive than MRI (magnetic resonance imaging) and is now successfully measuring the densities of various brain neurotransmitter receptors in health and disease. PET data in schizophrenia patients confirm that delusions and hallucinations are controlled by neuroleptics when the D2 dopamine receptors are specifically blocked. D1 receptors are not involved. The elevation of D2 receptors as a possible basis for psychotic symptoms needs additional investigation because of technical difficulties which need to be resolved. The rapid development of PET indicates its promise for differential diagnosis as well as its value in treating the psychoses.

Affective Disorders, Psychotic↗
PubMed1988

Toward mastery of psychotic symptoms: a group phenomenon.

This paper describes a long-term, weekly, outpatient group for the management of recurrent psychotic manifestations. Emphasis is on the development of individual strategies that attenuate symptom distress and reinforce the sense of mastery. Illustrations are drawn from events occurring over the course of the life of the group.

Adult↗
PubMed1987

Sexual misconduct.

Explore the source record for details and available documents.

Ethics, Medical↗
PubMed1986

Current outcome in schizophrenia: women vs men.

This article reviews the 1980's literature on gender differences in schizophrenia outcome. Neuroleptic response, long-term course, and housing, appear to be superior in women. Mortality ratios are advantageous to schizophrenic men. After menopause, women may require higher neuroleptic doses than men and are more at risk for severe tardive dyskinesia. The antidopaminergic effects of estrogens appear to be responsible for some of the outcome differences.

Adult↗
PubMed1985

Younger man/older woman: a cautionary tale.

This is a single case study of a parallel relationship between (a) the patient and his romantic partner and (b) the patient and his therapist. While parallels such as these are not unusual in therapy and may, in fact, be universal, coincidences of age and duration facilitate the understanding of some of the competitive aspects of the patient-therapist-significant other triangle.

Adult↗
PubMed1985

Clinical and demographic correlates of neuroleptic response.

This paper presents evidence that the positive symptoms of schizophrenia respond best to neuroleptics, as do patients with hyperdopaminergic activity (high blink rates, low prolactin levels). Those schizophrenics with defect states, intellectual and neurological impairment, brain atrophy, neuropsychological impairment, and poor school and social premorbid adjustment do not respond as well to dopamine blockers. It has been suggested that this group of schizophrenics do not suffer from a dopamine disturbance. There is also evidence for the relatively superior response of women, especially premenopausal women. This may be due to several factors but appears to be related to estrogen levels, especially since psychotic symptoms appear, in some women, premenstrually and post-partum, when estrogen levels drop. There is now substantial evidence that estrogens antagonize dopamine in the brain.

Age Factors↗
PubMed1983

Fluspirilene neuroleptic depot injections and indurations.

Local reactions at injection sites have limited the use of depot fluspirilene, an otherwise effective treatment for chronic schizophrenia. Thirty-nine reports of fluspirilene-treated patients were analyzed and the patients were examined for indurations. It was found that patients with indurations were given significantly higher doses and volumes of the drug. The mean number of high volume injections (over 3ml) at each site was the most significant differentiating factor between the two groups: 19 such injections over a twelve month period for those with indurations, as compared to 3 for those without. None of the following variables were significant; age, sex, allergies, or total length of time on the drug. Previous administration of other forms of depot neuroleptics did not differentiate the two groups. Biopsy showed serous atrophy of subcutaneous fat, prominent blood vessels and hemosiderin laden macrophages.

Adult↗
PubMed1982

Treating depression in schizophrenic patients.

Successful intervention in the depressive reactions of schizophrenic patients depends on accurate diagnosis, careful observation, the use of many modalities of treatment, and the maintenance of therapist optimism. Therapy needs to be pragmatic and focused on the special needs of the individual patient.

Adjustment Disorders↗
PubMed1982

Gender differences in schizophrenia.

men with schizophrenia have an earlier age of onset, a somewhat inferior response to treatment and a generally poorer prognosis than women. These findings can perhaps be explained by the existence of two distinct forms of the illness, one with early onset, primarily affecting men, and one with later onset, primarily affecting women. There is not much evidence for this first view. Alternatively, non-specific cumulative stress factors may impinge selectively on the male, reaching the threshold of demonstrable illness at an earlier age. A third possibility is the existence of specific biological protective factors in the female, such as relatively bilateral representation of left hemisphere functions or relative dopaminergic inhibition by estrogens.

Adult↗
PubMed1982

Co-therapy in a clinic for schizophrenia.

In the outpatient treatment of schizophrenia, the routine practice of providing each patient with two co-therapists results in several benefits: reduced dependency, increased expertise, objective monitoring, added support and morale for the therapists, more obvious and therefore more reversible countertransference, more obvious and therefore more treatable "splitting" and "projecting." Despite these benefits, problems arise in the two-therapist arrangement. They are discussed under the following headings: loyalty conflicts; limit setting; crisis management; family work. The authors report on techniques of co-therapy problem prevention and problem resolution. Though not always successful, co-therapy continues to be a useful model of service delivery to schizophrenic outpatients.

Ambulatory Care↗
PubMed1981

Pharmacologic features and effects of neuroleptics.

Neuroleptic drugs reduce the severity and prevent the recurrence of symptoms of schizophrenia. Recent studies indicate that these drugs probably produce their antipsychotic effects by blocking dopamine receptors in the brain, although they also block acetylcholine and norepinephrine receptors. The potency of commercially available neuroleptics in blocking dopamine receptors varies widely, being related to the compound's lipid solubility. Neuroleptics predispose the patient to short-term and long-term medical hazards that must be weighed against the benefits of reduced symptom intensity, shortened psychotic episodes and lessened likelihood of recurrence of acute schizophrenic epidoses. The side effects associated with short-term therapy are either extremely rare or are treatable by dose change, medication change or the use of additional drugs. In long-term therapy the risks are more problematic in that they are sometimes irreversible. These include tardive dyskinesia, skin discoloration and corneal deposits. The clinician must consider the pattern aand severity of each patient's present and past psychotic episodes before deciding whether maintenance therapy with neuroleptics is justified. If it is, doses should be re-evaluated frequently and kept as low as possible. Concomitant administration of anticholinergic agents should be avoided if possible. Most important, the long-term administration of neuroleptics should be prescribed only for patients with schizophrenia and not for those with conditions that respond to other treatments.

Adrenergic alpha-Antagonists↗