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Biomedical subjects

R Rimón

Publications and source records attributed to R Rimón.

At least 19 recordsLinked to original sources

Modified activity of the human auditory cortex during auditory hallucinations.

Previous reports have shown abnormalities in brain metabolism and evoked responses of schizophrenic patients with hallucinations. The authors recorded electric and magnetic auditory responses during transitory auditory hallucinations in two patients. Small but replicable response delays occurred during hallucinations. The results suggest that the effect of hallucinations on auditory cortex activity is similar to the effect of real sounds.

Acoustic Stimulation

Serum levels of mianserin and clinical outcome in elderly depressive inpatients.

Fifty-two elderly inpatients with moderate or severe depression underwent routine mianserin treatment with simultaneous measurements of 76 steady- state serum mianserin concentrations. These concentrations were correlated to the changes in the illness of the patients, who were divided into three classes according to the ratings by the Global Clinical Impression scale in steady-state and at two, four, and six weeks' intervals. Despite no significant differences in mean dosages, the serum mianserin concentrations of the patients with good clinical improvement were significantly higher than those of the patients with minimal clinical improvement, in six weeks of ratings. We conclude that some individual old patients have a correlation between good antidepressive effects and relatively high serum mianserin concentration.

Aged

Prolactin response to submaximal stimulation by TRH in nonaffective psychoses.

Nonaffective psychotic symptoms are heterogeneous and probably caused by mixed biopathology. A preliminary investigative tool to study pituitary dopamine activity, the prolactin response to submaximal stimulation by thyrotropin-releasing hormone (TRH) (mini-TRH test) was correlated in 20 subjects with nonaffective psychoses to positive psychotic symptoms as assessed by the Comprehensive Psychiatric Rating Scale psychosis subscale. A significant positive correlation was observed between the response and ratings of nonparanoid symptoms, especially nonparanoid delusions and disrupted thoughts. Because, in addition to pituitary dopamine activity, there is evidence to suggest that the response reflects extrapituitary dopamine activity as well, the results extend the evidence that nonparanoid acute productive psychotic symptoms may be associated with hypoactivity rather than with hyperactivity of brain dopaminergic systems.

Adult

Plasma concentrations of remoxipride and haloperidol in relation to prolactin and short-term therapeutic outcome in schizophrenic patients.

Plasma concentrations of remoxipride and haloperidol as well as prolactin (PRL) were determined in 20 patients with acute symptoms of schizophrenia. Ten patients received remoxipride and ten patients haloperidol for a period of 6 weeks. A significant linear correlation was found between the plasma level of remoxipride and the dosage applied (P less than 0.02) as well as between the corresponding haloperidol dosage and plasma concentration (P less than 0.05). In both patient groups a significant reduction in psychopathology was observed during the trial period (P less than 0.001). In the haloperidol group this was associated with a clearcut elevation of plasma PRL, whereas in the remoxipride group after an initial rise for 4 weeks, the mean PRL level returned to baseline at the end of the study.

Adolescent

Alprazolam and oxazepam in the treatment of anxious out-patients with depressive symptoms: a double-blind multicenter study.

In a four-week double-blind study comparing alprazolam with oxazepam, 62 outpatients suffering from anxiety with depressive symptoms were evaluated. The average daily doses of alprazolam and oxazepam were 1.48 mg and 44.4 mg, respectively. According to all rating scales applied, both alprazolam and oxazepam were effective in relieving anxiety associated with mild depression (p less than 0.01). Alprazolam proved somewhat more effective than oxazepam especially with regard to overall performance (p less than 0.05). Treatment-emergent adverse effects were few and mild for both compounds tested.

Adult

EEG and CT findings in patients with panic disorder.

Fifty-four patients with panic disorder were investigated using extensive electroencephalographic (EEG) recordings and computerized tomography (CT). Fifteen (28%) of these patients had previously been treated for temporal lobe epilepsy or were considered to have another neurological disorder. EEG recordings showed increased slow-wave activity in 13 (24%) patients and CT scan revealed incidental abnormalities in 6 (20%) of the 30 patients investigated. Taking into account the limitations of the methods applied, the present results indicate that clear-cut epileptic EEG patterns only rarely occur in panic disorder: the vast majority of panic patients exhibit normal EEG and CT findings.

Adolescent

Dynorphin A and substance P in the cerebrospinal fluid of schizophrenic patients.

Radioimmunoassay procedures were used to assay levels of dynorphin A (DYN A) and substance P-like activity (SP) in cerebrospinal fluid (CSF) obtained from 10 schizophrenic patients before and after neuroleptic treatment, from 10 matched patients with other psychiatric disorders before and after treatment, and from 10 nonpsychiatric surgical controls. The highest mean concentration of CSF DYN A was found in the schizophrenic group on admission (significant vs. nonpsychiatric controls). The concentration remained almost unaltered after 4 weeks of zuclopenthixol treatment despite a highly significant decrease of overt psychopathology assessed by the Brief Psychiatric Rating Scale (BPRS). There was no significant difference between the mean CSF DYN A levels of the nonschizophrenic psychiatric patients and the surgical controls. When all psychiatric patients were pooled together, there was a significant correlation between the level of CSF DYN A and the BPRS total score. With regard to CSF SP levels, no statistically significant differences were observed within or between the groups studied. Neither was there a significant correlation between the concentration of CSF SP and overt psychopathology. Nevertheless, the mean CSF SP concentration of three patients with major depression was clearly higher than the corresponding mean concentration of the other patients in the nonschizophrenic group.

Adult

Cerebrospinal fluid monoamine metabolites and neuropeptides in patients with panic disorder.

Concentrations of homovanillic acid (HVA), 5-hydroxyindoleacetic acid (5-HIAA), 3-methoxy-4-hydroxyphenylglycol (MHPG) as well as somatostatin (SRIF) and beta-endorphin (beta-END) were assayed in the cerebrospinal fluid (CSF) of 34 patients with panic disorder and of ten neurological controls. No aberrations of the monoaminergic or peptidergic variables measured were found in the nonpanic state of patients with panic disorder. A modest correlation (P = 0.04) between total anxiety scores and CSF MHPG was observed.

Adult

Sulpiride and perphenazine in schizophrenia. A double-blind clinical trial.

Seventeen patients with acute schizophrenia and 30 with chronic schizophrenia were included in a randomized, double-blind parallel-group trial comparing sulpiride and perphenazine. Patients were evaluated using the 16-item Brief Psychiatric Rating Scale (BPRS) prior to the onset of treatment and 1 and 2 weeks, and 1, 2, 3, and 4 months thereafter. In patients with acute schizophrenia, total BPRS scores declined significantly at the end of the trial compared with pretreatment values in sulpiride-treated patients but not in schizophrenics treated with perphenazine. Differences in response between the groups did not reach statistical significance, however. For patients suffering from chronic schizophrenia, a statistically significant decline was observed in total BPRS scores at 4 months compared with pretreatment scores in both sulpiride and perphenazine groups. There was no significant difference in the treatment response between the groups. Sulpiride appeared to be somewhat more effective than perphenazine for treatment of acute schizophrenia. Efficacy of both compounds was less marked in chronic forms of schizophrenia.

Acute Disease

Long-term effects of alprazolam and imipramine on cerebrospinal fluid monoamine metabolites and neuropeptides in panic disorder.

Cerebrospinal fluid (CSF) homovanillic acid, 5-hydroxyindoleacetic acid, 3-methoxy-4-hydroxyphenylglycol, and somatostatin and beta-endorphin levels were measured in 12 patients with panic disorder before and after 7 months of treatment with alprazolam or imipramine. The concentrations of CSF monoamine metabolites and neuropeptides were at baseline of the same order of magnitude in panic patients and controls. Neither alprazolam nor imipramine changed metabolite or neuropeptide levels in CSF despite clinical improvement in both treatment groups. According to present CSF data, the antipanic actions of alprazolam and imipramine do not involve the monoaminergic or peptidergic systems studied.

Adult

Interrelationship of hypochondriacal, paranoid, depressive, and suicidal symptoms in Chinese psychiatric patients.

Data concerning 150 consecutive adult psychiatric patients treated by the authors in a general hospital psychiatric unit were analyzed. All patients with predominant hypochondriacal or paranoid symptoms were selected. The presence of depressed mood and suicidal ideas and their impact on prognosis were investigated. Finally, characteristics of patients with both hypochondriacal and paranoid symptoms were studied. We found that: (a) 79% of the patients with predominant hypochondriacal symptoms were depressed, but only 27% of these had suicidal ideas. These patients usually revealed a poor response to treatment. (b) Only 27% of the patients with paranoid symptoms only were depressed, but their suicidal risk was high. They usually had a good response to treatment. (c) Only 3% of the total sample exhibited both hypochondriacal and paranoid symptoms. They were all thought-disordered schizophrenics but had better prognosis than expected. The psychodynamic background of the results is discussed.

Delusions

Relationship of migration to paranoid and somatoform symptoms in Chinese patients.

Among 162 consecutive adult Chinese new psychiatric patients, the proportion of Chinese immigrants was not significantly higher, compared with the 1986 by-census results. However, the proportion of immigrants with predominant somatoform symptoms was significantly higher (p less than 0.02), and that of immigrants with predominant paranoid symptoms was almost significantly higher (p = 0.052) than the corresponding proportions of immigrants without these symptoms. Evidence was given suggesting that the increased proportion of paranoid immigrants was probably due to social selection, while the increased proportion of somatoform immigrants could be explained by the social causation theory.

Adjustment Disorders

Viral antibodies and interferon in acute psychiatric disorders.

In a prospective study of 54 patients with acute psychiatric disorders, interferon and antibodies in serum and CSF were measured to 19 microbes by the complement fixation (CF) test and to 7 viruses by enzyme immunoassay (EIA). The CF test revealed a fourfold or greater change (p less than .001) in serum antibody titers in 20 patients, and EIA showed a twofold or greater change in CSF titers in 7 patients. Pathological serum/CSF antibody ratio by EIA was observed in 8 patients. The results suggest that viral infections and inflammatory processes have significance in the etiopathogenesis of acute psychiatric disorders.

Acute Disease

Serum and cerebrospinal fluid antibodies to cytomegalovirus in schizophrenia.

Antibodies to cytomegalovirus (CMV) were determined in the serum and cerebrospinal fluid (CSF) by complement-fixing (CF), enzyme immunoassay (EIA), and enhanced virus neutralization test (EVNT), in acute unmedicated schizophrenic patients and neurological controls. An elevated level of CF antibody was observed in three serum specimens from the schizophrenic patients and in one control specimen. No CF antibody was present in the CSF samples of the two patient groups tested. By EIA none of the serum or CSF specimens was positive for IgM antibody to CMV. By EVNT, 17% of the schizophrenic patients exhibited a CSF/serum ratio greater than 2 SD, whereas the corresponding figure for the control group was 4% (P greater than 0.05). The role of CMV in the etiopathogenesis of schizophrenia is discussed in the light of the present and previous negative findings.

Acute Disease

Myelin basic protein antibodies in catatonic schizophrenia.

Myelin basic protein (MBP) antibodies were determined by solid-phase radioimmunoassay in the serum and cerebrospinal fluid of 10 patients with catatonia, 10 patients with other forms of schizophrenia, and 10 psychiatrically healthy controls. The mean counts per minute (cpm) value of serum anti-MBP antibody of the catatonia group was significantly higher than that of the patients with other forms of schizophrenic psychoses (p less than .05). No significant differences were observed among the cpm values of the CSF specimens from the three patient groups. The hypothesis of a central virus-induced immunologic aberration in catatonic schizophrenia is discussed.

Adult

Serum and cerebrospinal fluid prolactin patterns during neuroleptic treatment in schizophrenic patients.

Serum and CSF prolactin (PRL) concentrations were determined during eight weeks of fluphenazine medication in 28 patients with acute symptoms of schizophrenia. In both sexes a good correlation between the serum and CSF PRL values was found (r = 0.57, p less than 0.01). Throughout the entire study, first admission (FA) patients had significantly higher levels of serum and CSF PRL than the re-entry (RE) schizophrenics (0.05 greater than p less than 0.001). In addition, in FA patients, a gradual increase of the serum and CSF PRL concentrations was observed, whereas in the RE group an adaptive secretion pattern of PRL could be detected. In both patient groups, female patients exhibited significantly higher PRL serum and CSF levels than the male patients (0.05 greater than p less than 0.001). The tolerance phenomenon in the RE groups was more marked in the female than in the male patients. No correlation between clinical outcome and PRL response to fluphenazine treatment was observed. The prognostic significance of the differences in the PRL secretion pattern is discussed.

Female

Altered white cell count, protein concentration and oligoclonal IgG bands in the cerebrospinal fluid of many patients with acute psychiatric disorders.

In a prospective study, an abnormal white cell count and/or elevated protein concentration in the cerebrospinal fluid (CSF) was observed in 14/54 patients (26%) with acute psychiatric disorders, but in none of the 46 control subjects (p less than 0.001). In addition, electrophoretic analysis of immunoglobulin G (IgG) showed an oligoclonal pattern in the CSF of 22 psychiatric patients (41%). No such pattern could be detected in the control group (p less than 0.001). These findings reinforce the value of lumbar puncture and CSF analysis in acute psychiatric disorders.

Acute Disease