Dexamethasone suppression test and schizophrenia.
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Biomedical subjects
Publications and source records attributed to W F Tsoi.
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In a study of suicide in Singapore in 1980 there were 230 cases and the suicide rate for the general population was 9.5 per 100,000. The age-specific rates increased steeply after 50 years and there was a male preponderance especially in the age group 60 years and over. Comparing the three major ethnic groups in Singapore, the highest rate was seen in the Indians and Chinese, whereas the Malays had the lowest. Amongst the suicides there were 59 (25.7%) with mental illness, mainly schizophrenia, and they were of a younger age group, 20-39 years. The commonest method of suicide was jumping from high-rise flats.
This is a study to find out whether serum creatine phosphokinase activity (CPK) is raised in Oriental schizophrenic patients. CPK was found to be elevated in Caucasian schizophrenic patients more commonly during the acute period of the illness. The CPK involved is the skeletal isoenzyme CPK (MM) and not the brain isoenzyme CPK(BB). CPK elevation is associated with motor nerve and myoneural abnormalities. In this study of 150 patients the CPK activity varied from 12 to 902 mu/l with 78 patients having CPK activity above the normal range of 15-55 mu/l. This shows that Oriental schizophrenic patients may have similar pathophysiology. There is no relation between the CPK activities and the patients' age, duration of illness, presence of delusions or hallucinations, or abnormal behaviour. Such results support a genetic basis for the abnormality.
One hundred and twelve Chinese male patients suffering from schizophrenia were investigated for the distribution of A1A2BO, MN, Rhesus (genotypes) and Lewis(a) blood groups. The same genetic markers were investigated in 114 Chinese male blood donors. Two more published series--one on the distribution of ABO blood groups and the other on Le(a) blood groups in healthy Chinese males were also used as additional control series. The relative frequencies on these blood groups were examined between the schizophrenics and the control series. There was no significant association of ABO, MN and Rhesus blood groups in schizophrenia. However, a significant association was observed with the Le(a) blood groups with an excess of Le(a) positives in schizophrenia (p less than 0.02).
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A psychological investigation of 30 duodenal ulcer patients showed that their profile differed from that of the Western patients in that drinking, smoking, anxiety, depression and psychopathy were not more common than in the general population. Psychological stress as measured by recent life events was low, but 40% had complaints relating to their work. Their scores for Friedman's Type A Behavior as measured by the Bortner's Scale was low. They had a high Lie Score for the Eysenck Personality Inventory indicating a desire to project a socially desirable image.
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Twenty female transsexuals were assessed for sexual reassignment surgery in Singapore. This gives a prevalence of 1 in 36,000 for females aged 15 and above. The age ranged from 18 to 31 with the mean at 24.9 years. Fifteen had received secondary education and 19 were employed. There was no history of serious anti-social behaviour. They were closer to their mothers, some of whom encouraged their cross dressing behaviour during childhood. Their behaviour became more masculine as they grew older. All were unmarried. Eighteen had girl friends and 10 indulged in sexual activities with their girl friends. They sought the sex change operation because they wanted to live as males so that they could marry their girl friends. Eight are at present undergoing the multi-stage operation.