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Biomedical subjects

R D Alarcon

Publications and source records attributed to R D Alarcon.

At least 37 records · Page 2Linked to original sources
PubMed1986

Abnormalities of one-carbon metabolism in psychiatric disorders: study of methionine adenosyltransferase kinetics and lipid composition of erythrocyte membranes.

Two independent lines of inquiry have implicated some disturbance of one-carbon cycle metabolism in affective disorders. Folic acid deficiency commonly leads to depression, and S-adenosylmethionine has been reported to have antidepressant properties. Methionine adenosyltransferase has been reported to be underactive in depression and schizophrenia and overactive in mania. This study reports the effects on erythrocyte methionine adenosyltransferase (MAT) kinetics (Vmax) of a 2-week treatment in a population of patients housed on a psychiatric research ward. The drug-free schizophrenic patients and depressives had, upon admission, low Vmax values, and the drug-free manic patients had high Vmax values on admission. After 2 weeks of appropriate treatment, the values for all three patient samples showed significant normalization (i.e., the levels rose in schizophrenics and depressives and fell in manics). We have further shown that pretreatment low levels of erythrocyte membrane phosphatidylcholine in depressives and high levels in manics show statistically significant normalization following 2 weeks of pharmacotherapy. The significance of these results is discussed.

Bipolar Disorder↗
PubMed1986

Effects of bipolar affective disorder and lithium administration on the cholinergic system in human blood.

Several processes relating to the cholinergic system that are present in human blood were measured in samples obtained from patients with bipolar affective disorder, both before and during treatment with lithium, and from controls. The biochemical measurements include RBC and plasma choline concentrations, the kinetics of RBC choline uptake, plasma non-specific cholinesterase and RBC and plasma acetylcholinesterase. The RBC choline level is increased and the Vmax of the RBC choline uptake system is decreased in samples from lithium-free bipolar patients during manic episodes. There are no differences from control in the plasma choline levels or in the acetylcholinesterase enzyme activities in blood samples from the lithium-free or lithium-treated patients. Plasma non-specific cholinesterase is below control levels in all patients. Lithium treatment increases the RBC choline concentration to more than ten-times control levels and reduces the Vmax and the affinity for choline of the RBC choline transport system. In vitro addition of lithium does not replicate the effects of in vivo administration of lithium. Possible mechanisms for these effects of lithium are discussed.

Acetylcholinesterase↗
PubMed1986

Interactions between depression and borderline personality disorder. A pilot study.

Although many nosologists advocate the autonomy of borderline personality disorder (BPD), its heterogeneity led to demands that it be absorbed into the affective disorder spectrum. This study attempted to determine if (a) BPD and affective disorders overlapped and (b) if BPD characteristics were differentially associated with specific Axis I, DSM-III diagnoses. Forty-three BPD inpatients were rated retrospectively on 29 variables, including BPD characteristics from Gunderson's diagnostic interview for borderlines (DIB). chi 2 analyses were performed for each of 28 variables in 56 contingency tables whose independent variables were dysthymia/other Axis I diagnoses or depression/no depression. BPD inpatients with dysthymia had more impaired occupational functioning and greater use of splitting. Also, depressed BPDs were in general more dependent, empty and bored, and suicidal.

Adjustment Disorders↗
PubMed1986

Medication effects on one-carbon metabolism in schizophrenia, mania, and major depression.

Erythrocyte methionine adenosyltransferase (MAT) activity (Vmax) and phosphatidylcholine (PC) levels previously have been found increased in manic patients and decreased in depressive and schizophrenic patients. To evaluate whether these abnormalities were the result of medication effects, erythrocyte MAT activity (Vmax) was assayed for paired samples from 29 schizophrenic, 16 manic, and 12 depressive patients, an erythrocyte PC levels were obtained for paired samples from 13 schizophrenic, seven manic, and seven depressive patients. Patients were medication free for at least 3 weeks. Vmax was significantly increased in schizophrenic and depressive patients (p less than 0.01; p less than 0.01) and significantly decreased (p less than 0.01) in manic patients after 2 weeks of psychotropic medication. Similar trends were found in PC levels. The findings of those one-carbon metabolism tests following medication are generally opposite to those reported to be related to specific disorders and tend toward normalization. Moreover, in vitro preincubation of erythrocytes of three normal subjects with the most commonly used neuroleptics had no consistent effects of MAT Vmax. These findings confirm previous studies that showed similarities in one-carbon metabolism of schizophrenic and depressed patients as opposed to manic patients and suggest that medications tend to correct or minimize rather than induce such abnormalities.

Antidepressive Agents↗
PubMed1985

Cholinergic processes in blood samples from patients with major psychiatric disorders.

Cholinergic processes were measured in plasma and red blood cells (RBC) obtained from patients with mania, depression, and schizophrenia. RBC choline levels were elevated in manic patients, and lithium treatment led to a further increase. RBC choline transport was below normal in manic patients, and lithium treatment further reduced choline transport in addition to reducing the apparent affinity for choline. RBC acetylcholinesterase was low in depressed and schizophrenic patients, but not in manic patients, whereas plasma acetylcholinesterase was reduced only in depressed patients. Plasma nonspecific cholinesterase was below normal in all groups of patients. These results indicate unique patterns of differences from controls in the cholinergic system in blood samples from patients with different psychiatric illnesses.

Acetylcholinesterase↗
PubMed1985

One-carbon metabolism disturbances in affective disorders. A preliminary report.

Methionine adenosyltransferase (MAT) activity (Vmax) and the relative amount of phosphatidylcholine (% PC) were measured in erythrocytes of up to 30 DSM-III diagnosed manic, 17 unipolar depressed patients, and 28 normal controls. Manic subjects had significantly higher and depressed subjects significantly lower MAT Vmax than normals. The relative amount of PC was in the low range for the depressives, and in the high range for the manics. Depressive patients present, in these tests, similar abnormalities to those seen previously in schizophrenic patients. Clinical and diagnostic implications of these findings are discussed.

Bipolar Disorder↗
PubMed1985

Inappropriate admissions to psychiatric wards.

Our seven clinical vignettes illustrate different mechanisms of inappropriate admissions to psychiatric wards and the circumstances and outcome of such admissions, with emphasis on the shared responsibility of psychiatric and nonpsychiatric physicians, the financial consequences, and the implications of such admissions on the profession's public image. Inappropriate admissions create undue tensions and demands on an already overworked psychiatric staff, and raise legitimate issues of quality of care, the need for clinical and administrative guidelines for consultation and transfer, the degree of communication between psychiatry and other specialties, and a host of psychodynamic considerations, somehow overlooked in recent years. The main issue in most cases is the level of communication between the psychiatric and nonpsychiatric camps. Clinical, epidemiologic, and actuarial studies are needed in this area.

Adult↗
PubMed1984

Personality disorder as a pathogenic factor in bereavement.

The impact of personality on the experience of grief is neglected in the literature, in spite of its obvious relevance. A case report in which a personality disorder complicates the clinical course of bereavement is presented. The report illustrates the notion that personality characteristics play a unique pathogenic role in the evolvement of the symptoms of pathological grief, the use of coping mechanisms, and the ätypical features of the clinical syndrome. The nosological autonomy of this entity vis à vis DSM-III's categories of affective disorders is examined. Understanding these factors becomes crucial for the nosological and psychotherapeutic approaches to pathological grief.

Adaptation, Psychological↗
PubMed1983

A Latin American perspective on DSM-III.

The author examines some of the basic postulates and initial accomplishments of DSM-III from a Latin American vantage point. The phenomenological approach taken by DSM-III has enjoyed a long and prestigious tradition in Latin America. The author cites some of the difficulties posed by the personality disorders section, the exclusion of cultural criteria and psychocultural syndromes, and the practical inapplicability of the axis IV and V specifications for Latin American patients. DSM-III, however, is a challenging stimulus for Latin American and Third World psychiatrists and a real test for the influence and consistency of American psychiatry across the world.

Attitude of Health Personnel↗
PubMed1982

The effectiveness of progressive relaxation in chronic hemodialysis patients.

An experimental group of 38 patients on chronic hemodialysis were presented a 30-min, self-instructional, color videotape on progressive relaxation (PR) exercises; and a control group of 23 patients viewed a neutral videotape. Both groups were given the State-Trait Anxiety Inventory while on the dialysis machine, before and after the actual viewing. The experimental group significantly reduced its state anxiety level while the control group remained the same. Patients who reported higher levels of state anxiety and experienced tension more frequently tended to achieve the greater benefit from the program. It is postulated that PR can be a useful resource to overcome the sometimes severe anxiety related to the stresses of chronic hemodialysis.

Adult↗
PubMed1982

Flashback phenomena. Clinical and diagnostic dilemmas.

The study of flashback phenomena has been neglected in recent years. A case study and a subsequent literature review examine areas about which conflicting opinions exist. Epidemiological studies have not arrived at universally acceptable classificatory schemes. Clinical approaches vary in accounts of phenomenology of the syndrome and the typology of personalities involved. Etiology remains unknown in spite of numerous theories, most of them not experimentally tested. Diagnostic studies may benefit from recent technological advances such as continuous electroencephalogram, computerized axial tomography scan, cerebral blood flow, and neuropsychological tests. The Diagnostic and Statistical Manual of Mental Disorders, 3rd Edition, does not seem to provide an adequate taxonomic niche for this disorder. Therapeutic interventions are examined and their results critically analyzed.

Adult↗
PubMed1976

Drug and psychotherapy interactions in depression.

The authors conducted a series of multiple regression analyses of data from depressed patients. They found that 8 factors consistently predicted treatment response: a lower initial level of distress, imipramine treatment, a positive attitude toward group psychotherapy, and a good employment history predicted lower posttreatment distress levels; estrogen maintenance treatment was related to better response to diazepam, and a low level of intelligence predicted better response to both diazepam and imipramine; and a low initial level of interpersonal sensitivity and a significant other's having an unfavorable attitude toward psychiatric treatment were associated with better response to group psychotherapy.

Anxiety↗