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Urinary 3-methoxy-4-hydroxyphenylglycol and psychiatric diagnosis.

The authors examined the quantities of 3-methoxy-4-hydroxyphenylglycol (MHPG) in the urine of 11 schizophrenic female patients, 14 primary affective disorder (depressed type) female patients, and 10 healthy comparison women. The primary affective disorder patients had significantly less MHPG in their urine than did the comparison subjects. The schizophrenic patients when compared with the healthy subjects or the depressed patients did not excrete significantly different amounts of MHPG in urine. The variance in MHPG in schizophrenic patients was quite large; some had very low urinary MHPG. There was a significant positive correlation between agitation and urinary MHPG for schizophrenic but not depressed patients. The authors discuss theoretical and practical implications of these findings.

Adult↗

Primary relationships affect the psychological health of homosexual men at risk for AIDS.

Less is known about the effects of primary relationships on psychological health for homosexual men and women than for heterosexual men and women. Given the HIV/AIDS epidemic, the primary relationships of homosexual men are especially important to examine at the present time. Using questionnaire data collected from 259 homosexual men, this study examined the effects of status and quality of relationship on psychological health. Analysis indicated that homosexual men who are in primary relationships experience fewer depressive symptoms and greater well-being than other homosexual men but that being in a relationship does not predict changes in these outcomes over time. Men who report high quality of relationship show improvements over time in psychological health. These findings are discussed in light of the HIV/AIDS epidemic.

Acquired Immunodeficiency Syndrome↗

Suicide among U.S. women physicians, 1967-1972.

The authors examined AMA records of the deaths of 751 women physicians during 1967-1972. Forty-nine (6.56%) committed suicide. The suicide rate for women physicians (40.7 per 100,000 per year) was higher than for men physicians and about four times that for white American women of the same age. From the known morbid risk for suicide among women with primary affective disorder, the authors calculated that about 65% of American women physicians have primary affective disorder.

Adult↗

[Neurological decompression sickness].

We have examined 34 divers, mean age 30 years, after treatment for neurological decompression sickness. The initial symptoms often indicated mild sensory or motor involvement. After recompression treatment five of 19 divers with primary affection of the brain had slight hemiparesis or dysphasia. Nine of 14 divers with primary affection of the spinal cord showed signs of spinal cord dysfunction following treatment. Only 16 divers were recompressed within six hours after start of the neurological symptoms. It is concluded that neurological decompression sickness is a serious disorder with a high rate of residual findings. The condition should be treated with prompt recompression, administration of oxygen, and intravenous fluid.

Adult↗

Affective disorders in university student psychiatric patients.

Two hundred and sixty-four student psychiatric referrals were evaluated by the same interviewer using a detailed, precoded questionnaire based on the diagnostic critieria of Feighner et al. (1972). Female sex was associated with secondary and unipolar primary affective disorders. Greater age (over 23 years) was associated with the unipolar primary affective disorder. Race and marital status were not associated with affective disorders.

Adolescent↗

The borderline syndrome. II. Is it a variant of schizophrenia or affective disorder?

Recent studies question whether the borderline syndrome represents two entities: borderline schizophrenia (or schizotypal personality) as a variant of schizophrenia and borderline personality disorder as a variant of primary affective disorder. Relevant data are presented from the long-term follow-up of patients at the Chestnut Lodge, Rockville, Md, receiving systematic diagnoses by the retrospective application of diagnostic criteria. Studied were (1) diagnostic overlap at index admission, (2) diagnostic change over follow-up period, and (3) comparative long-term functional outcome between borderline samples and other diagnostic groups. Findings supported the hypothesis that schizotypal personality (as defined by DSM-III) is a variant of schizophrenia but borderline personality disorder (as defined by the DSM-III and Gunderson et al criteria) is not. An affiliation of borderline personality disorder with primary affective disorder is suggested although not conclusive.

Bipolar Disorder↗

Induction of ovulation in normo-androgenic women, affected by primary hypothalamic amenorrhea, with chronic pulsatile administration of GnRH, using an automatic portable pump (Zyklomat).

Pulsatile administration of GnRH appears to be the most rational and physiological treatment of infertility in patients affected by hypothalamic amenorrhea. The authors conclude that the results obtained with this method of treatment in patients with severe hypothalamic amenorrhea suggest that the choice of pulsatile GnRH therapy is an effective and practical method for induction of ovulation.

Adult↗

Primary leiomyosarcoma affecting the ankle joint.

In a 50-year-old patient with a malignant tumor of the left distal tibia (stage la, according to Enneking) undermining the cartilage of the ankle joint, an extremely rare primary leiomyosarcoma of bone was diagnosed. The diagnosis of a primary leiomyosarcoma of bone is possible only after a secondary (metastatic) leiomyosarcoma has been excluded. Furthermore, typical histopathological features, including immunohistochemical staining results, are required for the diagnosis. Surgery is the therapy of choice. An R0 resection should always be attempted.

Adolescent↗

[Not Available].

In this piece of work the primary affects, as rage, fear, sadness and lacking of joy (anhedonia) are defined and discussed as specific causes for the development and outbreak of depressive states. Then conflicting primary emotions and depressive mental states are depicted to be followed by a discussion about the significance of emotion and situation-centered coping. Cognitive attribution models covering the development of emotions on the one hand as well as the exacerbation of depression on the other, are discussed on this background in a critical fashion.

Attachmen↗

Bipolar course in schizo-affective illness.

The authors undertook a chart review to examine the use of the diagnosis of schizophrenia, schizo-affective type, in clinical practice. Of 27 patients given this diagnosis over a 3-year period, 13 were found to have evidence of bipolar course in their illnesses. For both the bipolar and unipolar groups, the most striking finding in first-degree relatives was the prominence of affective conditions. The bipolar group had a statistically significant earlier age for first psychiatric treatment and previous number of hospitalizations. Symptoms noted on admission were mostly affective, and the schizophrenic symptoms reported were noted by authors to be considered overinclusive or unreliable by many clinicians. Both groups received treatment with antipsychotic and antidepressant medication. Six of 13 bipolar patients and no unipolar patients were treated with lithium carbonate. Five bipolar patients met research criteria of Feighner et al. (1972) for primary affective illness and another met the criteria for schizophreniform illness. One unipolar patient met criteria for probable primary affective illness and another met the criteria for probable schizophreniform illness. The authors concluded that the diagnosis of schizo-affective illness, as used in day to day clinical practice, does not identify a group of schizophrenic patients nor a homogeneous patient group, and when both affective and schizophrenic features appear in a patient with a bipolar illness, the diagnosis of manic-depressive illness, not schizophrenia, should be given first consideration.

Adolescent↗

[State of serotonin--monoamine oxidase and histamine--diamine oxidase systems in circulating blood in ischemic strokes].

The serotonin-monoamine oxidase and histamine-diamine oxidase systems in the arteria and venous blood of the brain were examined in 65 patients with ischemic cerebral stroke. The examinations have shown that in the acute period of the disease the metabolism of serotonin and histamine is disturbed, the degree and the character of these disturbances depending substantially on the stroke clinical manifestations, process localization and the disease outcome. In infarctions in the large hemispheres without the secondary stem syndrome, the changes of the amine metabolism are determined by the state of the enzymes inactivating them. In patients with the secondary stem syndrome, the monoamine oxidase content in the blood leaving the brain is lowered, the methylation processes are activated, and the histamine level decreased, while the serotonin level is high. In cases of primary affection of the brain stem and the lethal outcome of the disease the blood levels of serotonin and histamine are high. Use of serotonin antagonists in ischemic stroke and antihistaminic drugs in primary affection of the brain stem is substantiated.

Adrenocorticotropic Hormone↗

Prediction of response to stabilizing lithium treatment.

As lithium has a wide range of biological effects, it is not surprising that the benefit from lithium treatment has been observed in several types of psychiatric disorders. Mood stabilization has been seen in episodic disorders; antiaggressive effect has been reported in mental retardation and other illnesses, and some endocrine and hematological effects have been utilized in internal medicine and neurology. To date, however, only the stabilizing effect on recurrent mood disorders appears to be reliably predictable. The prediction is based primarily on the diagnosis, quality of free interval and frequency of episodes; and several associated indicators can also be helpful. Results of the presented series of studies on the response to stabilizing lithium treatment suggest that such a response is predictable for most patients. The epitome of an excellent lithium responder is a patient with a good quality of remissions, a moderate frequency of recurrences, and a diagnosis of primary affective disorder. If the MMPI profile taken at the patient's optimum is abnormal, the chances of stabilization on lithium alone are greatly reduced. In addition, the responders more frequently have a family history of primary affective disorder and a positive M antigen. It appears that in the present practice the assessment of patients for stabilizing lithium treatment may frequently not be comprehensive enough. As a result, lithium is at present probably overprescribed in North America, and possibly elsewhere as well.

Bipolar Disorder↗

G protein-mediated signal transduction is affected in primary biliary cirrhosis.

Primary biliary cirrhosis (PBC) is a chronic liver disease characterized by severe intraepatic cholestasis. Pruritus often occurs during the course of the illness. We designed a study aimed at assessing whether pruritus is associated with dysfunction of signal transduction. Seventeen female patients affected by PBC were enrolled into the study and divided in two groups according to severity of liver disease. Leukocytes were isolated from peripheral blood and Gi, Go and Gs protein expressions were evaluated by western blotting, while G protein function was assessed by measuring cyclic adenosine phosphate formation. The expression of all types of G proteins was increased in leukocytes of PBC patients. The basal adenylate activity was significally higher than control in patients with less severe liver disease, while it was lower than normal in those with severe liver disease. Incubation of patient leukocytes with guanosine triphosphate-gamma-S and Gs protein activators failed to enhance cAMP production, while N-formyl-met-leu-phe was more effective in reducing cAMP production. The expression of all G proteins was non-selectively increased in PBC leukocytes, while adenylate cyclase activity was significantly modified. However, the observed changes in G proteins expression and in adenylate cyclase activity are not related to the presence of pruritus.

Journal Article↗

A comparison of EMG and SCL in normal and depressed subjects.

Skin conductance level (SCL) and electromyograms (EMGs) recorded from three muscle sites were compared for 15 female hospitalized psychiatric patients meeting diagnostic criteria for primary affective disorder and 15 age-and race-matched controls. The depressed subjects had significantly lower SCL and significantly higher resting EMG levels recorded from one muscle site. Electromyogram and SCL were not found to be significantly correlated with each other or with measures of anxiety or depression for the patients with primary affective disorder. Normal controls, however, showed significant correlations between a measure of depression and both EMG and SCL. These results are discussed with suggestions for future research.

Adult↗

Stress applied during primary immunization affects the secondary humoral immune response in the rat: involvement of opioid peptides.

The effect of unpredictable, inescapable and uncontrollable electric tail shocks (ES) on the humoral immune response to bovine serum albumin (BSA) was investigated in the rat. Contributions of the procedures that accompany shock delivery, such as witnessing the ES procedure (stress witnessing, SW) and exposure to the apparatus for shock delivery (apparatus control, AC) to the changes in specific immunity induced by ES were also tested. All procedures were applied during primary and/or secondary immunization. It was demonstrated that exposure to ES during primary immunization with BSA significantly suppressed specific anti-BSA antibody production after secondary and tertiary immunization with the same antigen. Exposure to the SW procedure during primary immunization with BSA enhanced the specific antibody level after secondary immunization, while exposure to the apparatus alone did not influence the development of either the primary or secondary humoral immune response to BSA. Both ES-induced suppression and SW-induced potentiation of the humoral immune response were partially inhibited by prior treatment with the opioid receptor antagonist naloxone. Additionally, treatments with the opioid peptides methionine- and leucine-enkephalin decreased anti-BSA antibody level, mimicking to some extent the effects of ES. It is suggested that ES and endogenous opioid peptides had long-term effects on humoral immunity through mechanisms involving immunologic memory.

Animals↗