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Body composition, food intake, and brown fat thermogenesis in pregnant Djungarian hamsters.

Strategies for balancing energy storage and expenditure during pregnancy were examined in the Djungarian hamster. In expt 1, pregnant hamsters lost nearly 50% of their body lipid stores, even though they showed significant increases in body weight and food intake during the latter half of pregnancy. The increase in body weight was accounted for by the growth of the uteri, fetuses, and placentas. The water and fat-free dry contents of the maternal carcasses did not differ from those of the unmated controls. In expt 2, brown fat cytochrome-c oxidase activity (mitochondrial content) was significantly lower in the late- but not early-pregnant females relative to the nonpregnant controls. Specific GDP-binding levels did not differ significantly among these groups. Thus an overall decrease in total thermogenic activity in brown fat would be expected during late pregnancy. The loss of carcass lipid, despite decreased brown fat thermogenesis and increased food intake, suggests that substantial increases in energy expenditure occur in pregnant females that are not related to heat production in brown fat. The present results are not consistent with traditional models of energy balance during pregnancy. Some of the inconsistencies may be related to differences between hoarding and nonhoarding families of rodents, whereas others may be due to the fact that the traditional model is based on a possibly exceptional species, the laboratory rat.

Adipose Tissue↗

A case-controlled study of repetitive thoughts and behavior in adults with autistic disorder and obsessive-compulsive disorder.

OBJECTIVE: The purpose of this study was to investigate the types of repetitive thoughts and behavior demonstrated by adults with autistic disorder and compare them with those of age- and sex-matched adults with obsessive-compulsive disorder. METHOD: Fifty consecutive patients admitted to the Yale Adult Pervasive Developmental Disorders (Autism) Clinic with a primary diagnosis of autistic disorder (DSM-III-R and DSM-IV) completed the symptom checklist of the Yale-Brown Obsessive Compulsive Scale. Types of current obsessions and compulsions were evaluated. The comparison group consisted of 50 age- and sex-matched adults with obsessive-compulsive disorder (without tics) (DSM-III-R and DSM-IV). RESULTS: Direct discriminant function analysis showed that the patients with autistic disorder could be distinguished from those with obsessive-compulsive disorder on the basis of the types of current repetitive thoughts and behavior that they demonstrated. Compared to the obsessive-compulsive group, the autistic patients were significantly less likely to experience thoughts with aggressive, contamination, sexual, religious, symmetry, and somatic content. Repetitive ordering; hoarding; telling or asking (trend); touching, tapping, or rubbing; and self-damaging or self-mutilating behavior occurred significantly more frequently in the autistic patients, whereas cleaning, checking, and counting behavior was less common in the autistic group than in the patients with obsessive-compulsive disorder. In addition, a specific subset of seven obsessive-compulsive variables from the Yale-Brown Obsessive Compulsive Scale symptom checklist was identified that reliably predicted membership in the autistic group. CONCLUSIONS: These results suggest that the repetitive thoughts and behavior characteristics of autism differ significantly from the obsessive-compulsive symptoms displayed by patients with obsessive-compulsive disorder. Future studies are warranted to assess the treatment response and neurobiological underpinnings of repetitive thoughts and behavior in patients with autism and obsessive-compulsive disorder.

Adolescent↗

Factor analysis of the Cohen-Mansfield Agitation Inventory in three large samples of nursing home patients with dementia and behavioral disturbance.

OBJECTIVE: Limited work has addressed the construct validity of the Cohen-Mansfield Agitation Inventory (CMAI) in nursing home patients. The authors tested the CMAI factor structure by use of data from three samples of nursing home patients categorized a priori as having at least mild behavioral and psychological symptoms of dementia. METHODS: CMAI data were from the baseline assessment of three randomized, placebo-controlled trials of risperidone for treating elderly nursing home patients. Exploratory factor analyses were conducted on two trials (N = 304; N = 344), and the results of these exploratory factor analyses were then tested with confirmatory factor analysis by use of data from a third trial (N = 617). RESULTS: Principal-components analysis suggested the presence of four factors: 1) Aggressive Behavior (hitting, kicking, scratching, biting, pushing, grabbing, throwing things, cursing or verbal aggression, spitting, tearing things/destroying property, hurting self or others, screaming); 2) Physically Non-Aggressive Behavior (pacing, trying to get to a different place, general restlessness, inappropriate dressing or disrobing, handling things inappropriately, performing repetitious mannerisms); 3) Verbally Agitated Behavior (complaining, constant requests for attention, repetitive questions, negativism); and 4) Hiding and Hoarding. Confirmatory factor analysis indicated that the four-factor solution was a reasonable fit to the data. CONCLUSION: Four factors emerged on the CMAI in nursing home patients with behavioral and psychological symptoms of dementia. The results obtained converge reasonably with previous publications concerning the factor structure of the CMAI, which, taken together, suggest a fairly robust factor structure for the instrument.

Aged↗

Eating disorders and shoplifting--a study in two settings.

Two groups of female shoplifters drawn from a specialist out-patient service (52) and a Magistrates' Court (50) are compared for their level of eating disorder. Only one person knew of a previous diagnosis of eating disorder. Their levels of eating disorder and general psychopathology are high in both settings but particularly those referred for psychiatric assessment. Those with an eating disorder had significantly higher levels of psychiatric disturbance, depressive illness and hoarding behaviour.

Adult↗

Development and validation of the Schedule of Compulsions, Obsessions, and Pathological Impulses (SCOPI).

This article describes a factor analytically derived, self-report instrument-the Schedule of Compulsions, Obsessions, and Pathological Impulses (SCOPI)-using data from college students, adults, psychiatric outpatients, and patients with obsessive-compulsive disorder (OCD). The five SCOPI scales all are internally consistent (with coefficient alphas of .80 and higher) and are strongly stable across a 2-month interval (with retest correlations ranging from .79 to .82). They also show good convergent and adequate discriminant validity (a) when correlated with other OCD measures and (b) in analyses of self-ratings versus spouse ratings. Additional analyses indicate that three scales-Obsessive Checking, Obsessive Cleanliness, and Compulsive Rituals-assess core symptoms of OCD. The two remaining scales-Hoarding and Pathological Impulses-appear to tap different (but related) constructs.

Adult↗

The pharmacologic stability of 35-year old theophylline.

The propensity to preserve and to hoard drugs over the years at home is a well-known phenomenon and offers the possibility for intentional and accidental drug poisoning in man. We report a case of acute theophylline poisoning in an 80-year old women after ingestion of 'Asthmo-Kranit', a 35-year old combined preparation containing theophylline and aminopyrine as the main ingredients. The patient developed the typical clinical picture of a symptomatic theophylline poisoning with flush, tremor, tachycardia, hyperventilation, hypotonia, and hyperglycaemia. The clinical course after treatment with beta-blockers was without complications. The determination of theophylline in tablets showed stability of 90% of the labelled amount of the drug 30 years beyond the expiration date. The case illustrates the prolonged shelf stability and pharmacological potency of some pharmaceuticals and points to the risk of long-outdated prescriptions. Physicians should primarily not underestimate drug toxicity in consequence of old-age pharmaceuticals.

Adrenergic beta-Antagonists↗

Vaccination and systemic lupus erythematosus: the bidirectional dilemmas.

Vaccination has been perhaps the most important achievement in medicine of the last century. A hoard of infectious diseases that used to claim the lives of many, especially children, have been prevented and some even eradicated. However, it is possible that within this gift there is hidden a 'Trojan Horse'. During the last decade increasing numbers of reports regarding possible autoimmune side effects of vaccination, have been published. The existing data does not link the vaccines and the autoimmune phenomena observed in a causal relationship, nevertheless a temporal connection has been described. In this article we wish to address in particular the possible link between vaccines and systemic lupus erythematosus (SLE), namely two aspects of this inter-relationship: the occurrence of SLE following vaccination and outcome of immunization of known SLE patients.

Hepatitis B Vaccines↗

Patterns of benzodiazepine use in Great Britain as measured by a general population survey.

In a general population survey by Gallup in Great Britain of 4148 subjects, 7.7% had taken benzodiazepines within the last year (male:female ratio 106:212). Younger subjects tended to take anxiolytics for shorter periods compared with older subjects, who often took hypnotics chronically. This pattern was most marked among females. Dosage escalation, tolerance, high daily dose usage, and hoarding were not common. A substantial proportion of current users had experienced difficulty in stopping their medication. Withdrawal problems were associated with being older than 45 years and consuming benzodiazepines for over 12 months. This lends support to the idea of benzodiazepine dependency. However, the appropriateness of long-term therapy for chronic symptoms cannot be ruled out.

Adolescent↗

Self-neglect in adult life.

Two cases of self-neglect in adult patients with no psychiatric diagnosis are reported. The presentation included domestic squalor and hoarding of rubbish, with the patients living alone and having a history of schizoid and paranoid personality traits. Both refused all recommended help. A move to more protected accommodation was the only practical measure that led to a degree of improvement.

Activities of Daily Living↗

Prader-Willi syndrome, compulsive and ritualistic behaviours: the first population-based survey.

BACKGROUND: Obsessive-compulsive disorder has been reported in association with Prader-Willi syndrome. AIMS: To report the nature and prevalence of compulsive and similar symptoms associated with Prader-Willi syndrome in a population ascertained as completely as possible. METHOD: Attempted complete ascertainment of people with Prader-Willi syndrome in eight English counties. Administration of standardised rating scales and a structured interview. Comparison with people with learning disability and high body mass indices. RESULTS: Prader-Willi syndrome was associated with high rates of ritualistic behaviours, such as the need to ask or to tell something, insistence on routines, hoarding and ordering objects and repetitive actions and speech, compared with the control group, and was negatively correlated with IQ and socialisation age. Typical obsessive-compulsive symptoms, such as checking, counting and cleaning compulsions or obsessional thoughts, were not found. CONCLUSIONS: Ritualistic and compulsive behaviours occur more frequently in association with Prader-Willi syndrome than among people with intellectual disability and significant obesity.

Adolescent↗

Forced collectionism after orbitofrontal damage.

A collector is a person who collects things on purpose, either as a hobby or business, or for personal satisfaction, e.g., stamp, coin, or art collector. In such instances, the act of collecting things represents voluntary, controlled, goal-directed, selective searching. Pathologic patterns of collecting have been observed following brain damage, particularly frontal lobe damage, ranging from a tendency to grasp (prehension behavior) to an irrepressible need to seize surrounding objects and store them (hoarding behavior). These adnormal behaviors express an excessive adherence to environmental stimuli but in no way express a planned process directed toward specific items. In this article, we describe an unusual pattern of pathologic collecting behavior due to frontal lobe damage: involuntary irrepressible collecting that is goal-directed and selective. The authors report a patient who collected specifically household electrical appliances following a bilateral damage of orbito- and polar-prefrontal cortex. The patient had involuntary irrepressible collecting that was goal-directed and selective. This "forced collectionism" is different from that of the usual collectionism encountered in patients with frontal lobe lesions, as the latter is in no way a planned process directed toward specific items.

Adult↗

Resetting the path integrator: a basic condition for route-based navigation.

During short excursions away from home, some mammals are known to update their position with respect to their point of departure through path integration (dead reckoning) by processing internal (idiothetic) signals generated by rotations and translations. Path integration (PI) is a continuously ongoing process in which errors accumulate. To remain functional over longer excursions, PI needs to be reset through position information from stable external references. We tested the homing behaviour of golden hamsters (Mesocricetus auratus W.) during hoarding excursions following a rotation of the arena and nest. In continuous darkness, the hamsters returned to their point of departure at the rotated nest, and therefore depended on PI only. In other trials, the animals were briefly presented with visual room cues during or at the end of the outward trip, visual cues being pitted by 67 degrees or 98 degrees against the animal's current self-generated position vector. After a fix, the animals headed for the usual (unrotated) nest location, as defined by room cues, independent of the timing of the fix. These results were obtained in two different geometrical settings and showed that, after the fix, the animals update their position, and not merely their head direction or internal compass, in a new reference frame. Thus, episodic fixes on familiar external references reset the PI and therefore greatly enhance the functional signification of navigation that is based on feedback information from locomotion.

Animals↗

Behavioural and neural bases of orientation in food-storing birds

Food-storing birds retrieve hoarded food by remembering the locations of large numbers of spatially dispersed caches. The basic patterns of spatial orientation in these animals have been established in research on two major groups of food-storing birds, chickadees and tits (Paridae), and jays and nutcrackers (Corvidae). Experiments using displacement of landmark arrays show that food-storing birds rely on visual information from nearby landmarks to locate concealed caches. The appearance of the cache sites themselves seems to be relatively unimportant in cache retrieval, perhaps because local features are subject to change during the lifetime of a cache. Under some conditions, food-storing birds use sun-compass information to orient their search for caches, but appear to integrate sun-compass information with landmark information. Lesions of the avian hippocampus disrupt cache retrieval and other spatial tasks in food-storing birds without disrupting the formation of simple associations. Comparative studies show that food-storing birds possess a hippocampus larger than that of non-food-storing birds, probably as an evolutionary consequence of their dependence on spatial orientation for cache retrieval. Experience with cache retrieval plays a role in the development of increased hippocampal size, and there are indications of seasonal variation in hippocampal size in food-storing species.

Journal Article↗

Maladaptive behavior differences in Prader-Willi syndrome due to paternal deletion versus maternal uniparental disomy.

Maladaptive behavior was compared across 23 people with Prader-Willi syndrome due to paternal deletion to 23 age- and gender-matched subjects with maternal uniparental disomy. Controlling for the higher IQs of the uniparental disomy group, deleted cases showed significantly higher maladaptive ratings on the Child Behavior Checklist's Internalizing, Externalizing, and Total domains as well as more symptom-related distress on the Yale-Brown Obsessive-Compulsive Scale. Across both measures, deleted cases were more apt to skin-pick, bite their nails, hoard, overeat, sulk, and withdraw. A dampening of symptom severity is suggested in Prader-Willi syndrome cases due to maternal uniparental disomy. Findings are compared to Angelman syndrome, and possible genetic mechanisms are discussed, as are implications for Prader-Willi syndrome and obsessive-compulsive behaviors.

Adolescent↗

Clarifying the convergence between obsessive compulsive personality disorder criteria and obsessive compulsive disorder.

In this study we examined the convergence between obsessive-compulsive personality disorder (OCPD) criteria and obsessive-compulsive disorder (OCD). Baseline assessments of 629 participants of the Collaborative Longitudinal Personality Disorders Study were used to examine the associations between OCPD criteria and diagnoses of OCD. Three of the eight OCPD criteria--hoarding, perfectionism, and preoccupation with details--were significantly more frequent in subjects with OCD (n = 89) than in subjects without OCD (n = 540). Logistic regressions were used to predict the probability of each OCPD criterion as a function of Axis I diagnoses (OCD, additional anxiety disorders, and major depressive disorder). Associations between OCD and these three OCPD criteria remained significant in the logistic regressions, showing unique associations with OCD and odds ratios ranging from 2.71 to 2.99. In addition, other anxiety disorders and major depressive disorder showed few associations with specific OCPD criteria. This study suggests variability in the strength of the relationships between specific OCPD criteria and OCD. The findings also support a unique relationship between OCPD symptoms and OCD, compared to other anxiety disorders or major depression. Future efforts to explore the link between Axis I and Axis II disorders may be enriched by conducting analyses at the symptom level.

Adult↗

Recreating the scene: an effective way to provide delayed punishment for inappropriate motor behavior.

A mediated punishment procedure that involved recreating a behavioral sequence by guiding the subject through the behavior in the situation in which it occurred was used to suppress several severe problem behaviors in two developmentally delayed children. The mediational procedure was first used with a 4-year-old autistic boy for biting and then for foot stomping. Next the procedure was used for stealing and hoarding behavior with a multiply handicapped 17-year-old girl. Results indicated that the procedure was effective and produced relatively rapid results. One advantage of the procedure is that it provides an opportunity for trained personnel to apply restrictive procedures to low frequency behavior that occurs in their absence rather than relying on less qualified staff to implement the procedure immediately after the behavior occurs.

Adolescent↗

Determinants of reinforcer accumulation during an operant task.

Responses by rats on an earn lever made available food pellets that were delivered to a food cup by responses on a second, collect, lever. The rats could either collect and immediately consume or accumulate (defined as the percentage of multiple earn responses and as the number of pellets earned before a collect response) earned pellets. In Experiment 1, accumulation varied as a function of variations in the earn or collect response requirements and whether the earn and collect levers were proximal (31 cm) or distal (248 cm) to one another. Some accumulation occurred under all but one of the conditions, but generally was higher when the earn and collect levers were distal to one another, particularly when the earn response requirement was fixed-ratio (FR) 1. In Experiment 2, the contributions of responses and time to accumulation were assessed by comparing an FR 20 earn response requirement to a condition in which only a single earn response was required at the end of a time interval nominally yoked to the FR interval. When 248 cm separated the earn and collect levers, accumulation was always greater in the FR condition, and it was not systematically related to reinforcement rate. In Experiment 3, increasing the earn response requirement with a progressive-ratio schedule that reset only with a collect response increased the likelihood of accumulation when the collect and earn levers were 248 cm apart, even though such accumulation increased the next earn response requirement. Reinforcer accumulation is an understudied dimension of operant behavior that relates to the analysis of such phenomena as hoarding and self-control, in that they too involve accumulating versus immediately collecting or consuming reinforcers.

Animals↗

Behavioural problems associated with dementia: the role of newer antipsychotics.

Behavioural disorders are a common feature in dementia, especially in the later stages of the disease. The most frequent disorders are agitation, aggression, paranoid delusions, hallucinations, sleep disorders, including nocturnal wandering, incontinence and (stereotyped) vocalisations or screaming. Behavioural disorders, rather than cognitive disorders, are the main reason why caregivers place patients with dementia in a nursing home. However, although behavioural disorders are important, there is still no international agreement with respect to the description and definition of symptoms and syndromes. This also holds true for the wide variety of scales for quantification and measurement of behavioural disorders. Drug therapy should be considered after possible underlying causes such as physical illness, drug adverse effects and environmental stressors have been ruled out, or specifically addressed, and a behavioural approach has also failed. This article briefly reviews the evidence for non-antipsychotic drug therapies, which include a variety of substances. However, antipsychotics are the group of drugs which have been most frequently studied for the treatment of behavioural syndromes in dementia. Drug responsive symptoms include anxiety, verbal and physical agitation, hallucinations, delusions, uncooperativeness and hostility, whereas wandering, hoarding, unsociability, poor self-care, screaming and other stereotyped behaviour seem to be unresponsive to all drugs. Although the use of classical antipsychotics is limited by extrapyramidal symptoms, anticholinergic adverse effects, sedation and postural hypotension, the newer antipsychotics offer the chance of a better risk:benefit ratio. This article reviews the small amount of data published on the use of the newer antipsychotics, and concludes that risperidone at low dosages (0.5 to 2 mg/day) seems to be especially useful for the treatment of behavioural symptoms in dementia because of its negligible anticholinergic adverse effects. The use of clozapine is limited by its anticholinergic activity, at least in dementia of the Alzheimer and Lewy body types. However, in patients with psychosis arising from Parkinson's disease it seems to be the drug of choice, and similar activity is likely for olanzapine. There are no published data on other newer drugs, such as sertindole, quetiapine or ziprasidone. Future studies should also address questions of dementia heterogeneity and should compare different drug treatments and treatment combinations.

Antipsychotic Agents↗