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PubMed2001

[Pharmacokinetic behavioral changes of methamphetamine in methamphetamine-sensitized animal model].

There has been an increased population of users and abusers of amphetamines, including methamphetamines (METH), in the past two decades, and this has become a crucial social problem in Japan. METH abusers show a paranoid schizophrenia-like syndrome, including paranoid hallucination and delusion, and repeated exposure to these drugs will enhance their effects; i.e. the behavioral and reinforcing effects of abusing drugs became progressively and irreversibly developed (behavioral sensitization) in humans and in experimental animals. Although numerous neuropsychopharmacological/neurochemical studies on behavioral sensitization were conducted, few reports are available to understand the pharmacokinetic aspect of METH, including the brain penetration of METH, in this phenomenon. The present report reviews previous pharmacokinetic studies for METH and our findings in rats having behavioral sensitization to METH, especially from the point of view regarding the relationship of drug transporters.

Animals↗
PubMed1975

Dynamic content analysis.

An experiment was performed to demonstrate that methods of linguistic content analysis suitable for the study of intra-interview processes are both possible and practicable. Six hundred thirty-eight randomly selected psychiatrist were sent rating protocols of machine-mediated interview transcripts (transcripts of interviews conducted by means of remotely located teletypes) and were asked to rate each patient communication on one or more of 13 diagnosis-related rating dimensions. Rank correlation statistics on the raters' levels of agreement were found to be significantly high in 11 of the 13 dimensions. In contrast to the commonly held opinion that psychiatrist lack consistency in their application of diagnostic terms, this study suggests that psychiatrists generally agree in their usage of these terms, provided that the behavioral samples being evaluated are appropriately delimited.

Humans↗
PubMed2000

Studies of amphetamine or methamphetamine psychosis in Japan: relation of methamphetamine psychosis to schizophrenia.

There exist clinical characteristics of methamphetamine (MAP) psychosis in the Japanese population. MAP psychosis involves paranoid-hallucinatory states indistinguishable from paranoid schizophrenia, with residual volitional disturbances (e.g., loss of spontaneity and idleness). Paranoid-hallucinatory states persist after the pharmacological effects of MAP have worn off and readily reappear upon a reinjection of MAP. Individuals with a history of MAP psychosis further undergo spontaneous recurrence of their paranoid-hallucinatory states in response to stress. The development of MAP psychosis might therefore be related to persisting brain damage or changes in brain metabolism induced by repeated MAP use, and thus studies of the clinical course and neurological basis of MAP psychosis could provide insights into the pathophysiology of schizophrenia. Accordingly, psychiatrists have studied the clinical characteristics of MAP psychosis and examined the neurobiological basis of MAP-induced behavioral sensitization, using animals. MAP-induced behavioral sensitization might well be related to dopamine supersensitivity; however, the contribution of presynaptic autoreceptors remains controversial, and other hypotheses should be considered. Recently, the process that triggers spontaneous recurrence of MAP psychosis (flashbacks) and corresponding peripheral neurotransmitter functions has been studied. Stress sensitization associated with noradrenergic hyperactivity, involving increased dopamine release, appears to be crucial in the development of flashbacks. Overall, MAP-induced susceptibility to paranoid-hallucinatory states and to abnormal behavior (e.g., stereotyped behavior) in animals is examined as a model for predicting relapses of paranoid schizophrenia. Further extensive studies on the neurobiological and molecular mechanisms of this susceptibility are required.

Amphetamines↗
PubMed1993

An emerging schizophrenic syndrome.

This case history describes a 16-year-old adolescent male who developed schizophrenia with prominent negative symptoms. For the previous 6 years his diagnosis had been oppositional defiant disorder or conduct disorder. The clinical presentation, differential diagnosis, and management are discussed. The case exemplifies issues addressed in DSM IV.

Adolescent↗
PubMed1997

Characteristics of 36 subjects reporting compulsive sexual behavior.

OBJECTIVE: The authors describe the sociodemographic features, phenomenology, and psychiatric comorbidity of 36 subjects reporting compulsive sexual behavior. METHOD: Twenty-eight men and eight women who responded to advertisements for "persons ... who have a problem with compulsive sexual behavior" completed structured and semistructured assessments, including the Diagnostic Interview Schedule for DSM-III-R disorders (axis I) and the Structured Interview for DSM-III-R Personality Disorders, Revised (axis II). RESULTS: The typical subject was a 27-year-old man who reported experiencing compulsive sexual behavior for nearly 9 years. Sexual behavior was described as excessive and poorly controlled and was associated with either subjective distress or impairment in interpersonal or occupational functioning or as overly time-consuming. Fourteen subjects (39%) reported a history of major depression or dysthymia, 15 (42%) a history of phobic disorder, and 23 (64%) a history of substance use disorder. Personality disorders were quite frequent, particularly the paranoid, histrionic, obsessive-compulsive, and passive-aggressive subtypes. The compulsive sexual behavior was quite varied and included both paraphilic (e.g., cross-dressing) and nonparaphilic (e.g., compulsive masturbation) types. CONCLUSIONS: Compulsive sexual behavior may be a clinically useful concept, but it describes a heterogeneous group of individuals with substantial psychiatric comorbidity and diverse behavioral problems.

Adolescent↗
PubMed1979

Sex offenders: three personality types.

Analyzed by a Q-type factor analysis MMPI profiles of 92 sex offenders institutionalized for psychiatric evaluation, which yielded three basic MMPI profile types. Altogether 88 of the 92 Ss coult be categorized into one of three types characterized by profile peaks on F,Sc; Pd,MA; or D,PD. Analysis of background information, social history items, nature of present crime, primary diagnosis, and ward observations revealed significant differences among the types. Of particular interest was the finding that the primary diagnosis for 85% of the "F,Sc" MMPI type was "no mental disorder" in spite of the fact that this group showed significantly more disturbed behavior on the ward (anxiety, depression, suspicion, and manic excitement) and had uniquely degraded their victims. The fact that two-thirds of these persons who had F scores greater than or equal to 80 and 50% denied the crime may have inadvertently affected diagnostic decisions.

Adult↗
PubMedDate not supplied

Comparison of neuropsychiatric side effects in an observational cohort of efavirenz- and protease inhibitor-treated patients.

PURPOSE: To compare the extent of neuropsychiatric disturbances in two similar groups of HIV-infected patients treated for >4 weeks with either efavirenz (EFV) or protease inhibitors (PIs) as part of their antiretroviral therapy (ART). METHOD: A cross-sectional, questionnaire-based cohort of HIV patients who received two nucleoside reverse transcriptase inhibitors combined with either EFV (n = 75) or one or more PIs (n = 77) for at least 4 weeks and were tolerating therapy. The extent of neuropsychiatric disturbances was evaluated based on self-reported symptoms using the psychological evaluation test SCL-90-R. Treatment duration was broken down into quartiles of 30-198 days, >198-365 days, >365-637 days, and >637 days. RESULTS: In the first 6 months of therapy, significantly higher (worse) scores were seen in 39/75 (52%) of the patients receiving EFV. The EFV-treated group had significantly higher scores for somatization, anxiety, obsessive-compulsive behavior, the Global Severity Index, and the Positive Symptom Distress Index, with trends for higher scores in paranoid ideation and depression symptom subcategories. Over the following 6 to 12 months of therapy, the EFV group scored higher than the PI group in somatization, anxiety, obsessive-compulsive behavior, hostility, depression, the Global Severity Index, and the Positive Symptom Total, but the differences were not significant. After 12 months of therapy, the EFV group had significantly lower scores than the PI group for somatization, interpersonal sensitivity, Global Severity Index, and Positive Symptom Total. CONCLUSION: EFV-induced neuropsychiatric symptoms can last up to 200 days after treatment initiation. However, symptom severity appears to decline over time in EFV-treated patients versus patients treated with a PI-based ART.

Adult↗
PubMed1998

Characteristics of psychiatric inpatients who stalk, threaten, or harass hospital staff after discharge.

OBJECTIVE: The purpose of this study was to identify demographic and clinical characteristics of psychiatric inpatients who stalk, threaten, or harass hospital staff after discharge. METHOD: The authors retrospectively summarized the demographic and clinical characteristics of 17 inpatients who engaged in this type of behavior and a comparison group of 326 inpatients. RESULTS: The patients who stalked, threatened, or harassed staff after discharge were significantly more likely than the comparison patients to have a diagnosis of personality disorder and/or paranoid disorder, erotomanic subtype, and to have a history of physically assaultive or fear-inducing behavior. The data suggest that they were more likely to be male and never married and to have histories of multiple hospitalizations, suicidal or self-injurious behavior, and substance abuse or dependence. CONCLUSIONS: The findings reveal several risk factors that may be useful in identifying a subgroup of patients who pose a risk of directing aggressive behavior toward hospital staff after discharge.

Adult↗
PubMed1998

[Differential diagnosis of dissociative identity disorder (multiple personality disorder)].

Recently the concept of dissociative identity disorder (formerly known as multiple personality disorder) has attracted increasing public and scientific interest. However, it is rarely diagnosed in the clinical setting. the reported case of a 47-year-old woman with a history of child abuse demonstrates the problems of differential diagnosis. A number of psychopathologic symptoms pointed to a multiple personality disorder, but in the follow-up psychotic symptoms such as delusions, possible hallucinations and bizarre behavior clearly emerged. The differential diagnosis of dissociative identity disorder includes paranoid schizophrenia, as in the case described, borderline personality disorder, hysteria, simulation and the false memory syndrome. Finally, social and cultural factors have to be considered.

Child↗
PubMed2000

Stage-specific prevalence of behavioral symptoms in Alzheimer's disease in a multi-ethnic community sample.

The authors extended previous studies of the stage-specific prevalence of behavioral pathology to members of ethnic minority groups. Behavioral symptoms and their relationship to severity of Alzheimer's disease (AD) were examined in 125 heterogeneous minority elderly patients interviewed with a modified CERAD protocol, with behavioral symptoms scored on the caregiver-rated BEHAVE-AD Rating Scale. Behavioral disturbances were extremely common, occurring in 98% of the sample; the most common was activity disturbances (89%), followed by paranoid and delusional ideation (72%), aggressivity (64%), anxieties and phobias (61%), depressive symptoms (50%), sleep disturbances (43%), and hallucinations (34%). As in white patients, overall behavioral symptoms were most frequent among patients with moderate and severe dementia. Preliminary evidence supports the possibility of ethnic differences in behavioral profiles; Blacks showed lower affective, anxiety, and sleep symptoms than Asians and Hispanics, and lower total BEHAVE-AD scores than Hispanics. Inquiry in larger, population-based samples will be needed to determine whether the ethnic differences in behavioral symptoms of AD found here are robust and replicable.

Aged↗
PubMed1997

Delusional pregnancy with polydipsia: a case report.

We report a case of delusional pregnancy with polydipsia in a female patient with paranoid schizophrenia. The contribution of psychological and physiological factors in the development of the delusion of pregnancy and polydipsia and the possible interactions between the two phenomena are discussed.

Adult↗
PubMed2004

The role of subclinical paranoia on social perception and behavior.

The purpose of this study was to investigate the effects of subclinical paranoia on social perception and behavior. Two groups of participants, those high and low in subclinical paranoia, were identified based on extreme scores on the Paranoia Scale (PS). As expected, persons high in subclinical paranoia had greater depression, social anxiety, self-consciousness, and lower self-esteem compared to persons low in subclinical paranoia. In addition, persons high in subclinical paranoia performed worse than persons low in subclinical paranoia on laboratory measures of emotion perception and on an in vivo social perception task. Finally, behavioral differences between these two groups were revealed: Persons high in subclinical paranoia sat further away from the examiner and took longer to read the consent form than low-paranoia persons. These behavioral differences were not due to the group differences in clinical functioning, indicating that level of paranoia generally accounted for these findings.

Adult↗
PubMed1978

The effects of marijuana: a social psychological interpretation.

BECAUSE OF MARIJUANA'S apparent widespread and growing use, and possible future decriminalization, there is understandable concern about the effects of marijuana on behavior. However, in any serious deliberation about effects on behavior, two divergent views are equally unacceptable: that of the naive medical moralizer, who believes that marijuana turns people into vicious criminals; and that of the uncritical humanist, who holds that it affects everyone differently. The first position, characterized here as medical, moves from drug to behavior as though the latter were wholly physiological and a more or less predictably invariant function of the former. The second position, uncritical humanism, views the world as a composite of more of less free human elements which remain inscrutable and unpredictable, regardless of whether any individual is straight or high. Somewhere between these antipodal positions of absolute uniformity and absolute uniformity and absolute diversity lies the reality of patterned variability--i.e., types of users and types of effects of use. Situational factors such as when, where, with whom, and the like are admittedly important, but I propose here to limit attention to the user as social psychological actor in order to reduce analysis to a manageable number of parameters.

Cannabis↗
PubMed1986

Enduring changes in brain and behavior produced by chronic amphetamine administration: a review and evaluation of animal models of amphetamine psychosis.

Some people who repeatedly use stimulant drugs, such as amphetamine (AMPH), develop an AMPH-induced psychosis that is similar to paranoid schizophrenia. There has been, therefore, considerable interest in characterizing the effects of chronic stimulant drug treatment on brain and behavior in non-human animals, and in developing an animal model of AMPH psychosis. A review of this literature shows that in non-human animals chronic AMPH treatment can produce at least two different syndromes, and both of these have been proposed as animal models of AMPH psychosis. The first syndrome is called 'AMPH neurotoxicity', and is produced by maintaining elevated brain concentrations of AMPH for prolonged periods of time. AMPH neurotoxicity is characterized by what has been termed 'hallucinatory-like' behavior, which occurs in association with brain damage resulting in the depletion of striatal DA and other brain monoamines. The second syndrome is called 'behavioral sensitization', and is produced by the repeated intermittent administration of lower doses of AMPH. Behavioral sensitization is characterized by a progressive and enduring enhancement in many AMPH-induced behaviors, and is not accompanied by brain damage or monoamine depletion. It is argued that the changes in the brain and behavior associated with the phenomenon of behavioral sensitization provide a better 'model' of AMPH psychosis than those associated with AMPH neurotoxicity. Much of the review involves a critical analysis of hypotheses regarding the biological basis of behavioral sensitization. Research on this question has focused on mesotelencephalic DA systems, and suggestions that behavioral sensitization is accompanied by: an increase in postsynaptic DA receptors; an increase in DA synthesis; an increase in DA utilization and/or release; and a decrease in DA autoreceptors, are evaluated. It is concluded that there is not convincing evidence for an increase in postsynaptic DA receptors or in DA synthesis in animals sensitized to AMPH. In contrast, there is strong evidence to support the notion that behavioral sensitization is due to enhanced mesotelencephalic DA release, especially upon re-exposure to the drug. The evidence that this enhancement in DA release is due to autoreceptor subsensitivity was found to be equivocal, and therefore other hypotheses should be entertained. Lastly, evidence is discussed in support of the idea that behavioral sensitization is not unique to the psychopharmacology of stimulant drugs, but may be produced by many environmental stimuli that directly or indirectly activate brain catecholamine systems.(ABSTRACT TRUNCATED AT 400 WORDS)

Amino Acids↗
PubMedDate not supplied

Assessment of behavioral and affective symptoms in Alzheimer's disease.

Noncognitive behavioral symptoms occurring during the prior week were studied in 34 Alzheimer's disease (AD) patients and 21 spousal control subjects via caregiver and patient interviews using the Behavioral Pathology in Alzheimer's Disease Rating Scale and the Cornell Scale for Depression in Dementia. Delusional or paranoid features were reported in 13 subjects (38%) and hallucinations in six (18%); patients with these psychoticlike symptoms had lower scores on the Folstein's Mini-Mental State Examination. Other behavioral symptoms reported in AD patients included anxiety (50%) and activity disturbances (44%). Six AD subjects (18%) and two controls (10%) showed mild to moderate symptoms of depression; AD subjects were more likely than controls to show behavioral signs and symptoms of depression, but the two groups did not differ in terms of mood-related, cyclical, or physical signs and symptoms.

Aged↗
PubMed1999

Roald Amundsen: a study in rivalry, masochism and paranoia.

The author suggests that Freud was intrigued by those who explored the still unknown regions of the globe; in 1928 he received a letter from a colleague who knew he was interested in the psychology of polar explorers, asking him to comment on some strange visualizations that had haunted Roald Amundsen, the great polar explorer, when during one of his Arctic expeditions he was attacked and nearly mauled to death by a polar bear. Freud emphasised the quality of resignation and surrender inherent in these peculiar imaginings, but he added that a deeper analysis would require Amundsen's associations. On the basis of relevant biographical data the author tries to make a further investigation of his strange visualizations. These are linked to an underlying masochistic phantasy in which conflicts involving rivalry, autonomy and separation-individuation problems are expressed. He attained the South Pole before Scott and his party, who perished. His triumph and survival on the polar ice evoked an unbearable sense of guilt. Being unable to gain insight into his conflicts, he regressed to a paranoid state. The relation between masochism, the desire to beat and be beaten and rivalry is discussed.

Competitive Behavior↗