SEARCH · Search PubMed
Search indexed PubMed citations on genomics, clinical trials, systematic reviews and public health. Explore titles, authors and supplied subject terms, then open the PubMed record.
Quote a phrase for an exact phrase match. Source license links do not imply unrestricted reuse.
Two types of exponential and clinico-statistical correlations which determine the time-course of endogenic psychoses have been analyzed. On the basis of this analysis the author proposes a new probability theory explaining these correlations by the presence in endogenic psychoses of protective stabilizing (rather than pathologic) processes.
Examination of 145 epileptic patients revealed the clinical characteristics of the formation of psychoses with the predominance of catatonic disturbances. The latter correlated with a paroxysmal and chronic course of psychosis. When catatonic symptomatology was combined with chronic affective-delirious disorders the outcome was usually more favourable than in paroxysmal psychoses.
The authors report the results of an open trial which aims at specifying the clinical profile of responders to carbamazepine among a population of twenty patients aged from fifteen to seventy, suffering from endogenous, schizophrenic, affective psychoses and paranoid states according to the criteria of the ICD 9. The trial points out a proof of Kishimoto's criteria and a preferential acting of the molecule on schizo-affective psychoses and mixed affective states. The results are interpreted according to psychopathological concepts from the Vienna school that highlight the clinical profile of the responders.
The authors studied the characteristics of the hereditary aggravation in probands with schizophrenia first manifested with acute delirious or acute verbal hallucinosis. They also considered the incidence of manifest and latent forms of schizophrenia and the rate of personality anomalies in families of probands with the differentiation of schizoid anomalies by the predominance of sthenic and asthenic features. The frequency of coincidence of the patterns of schizophrenic process among relatives was determined and the data obtained were compared with those in probands from each group. The comparative analysis has shown that the familial background of the studied group of probands reflects the following regularities characteristic of schizophrenia; an increase in the frequency of psychoses of the schizophrenic spectrum as against that in the general population, accumulation of homonomous types of the schizophrenia course and the presence in relatives of abnormalities of the schizophrenic nature. This justifies the referral of the studied forms of psychoses to schizophrenic diseases.
The clinical findings obtained during an examination of 98 epileptic patients make it possible to outline some criteria of occupational prognosis in diseases running with transitory, paroxysmal and chronic psychoses of the complicated structure. The variability of the outcomes of these psychoses is explained by the differences in their psychopathological structure and duration as well as in the degree of the productive symptomatology at different stages of the epileptic process.
An analysis of a representative epidemiological sample of patients with endogenic psychoses (schizophrenia and MDP) revealed statistical distribution of some parameters of the disease (risk of the development of the disease in relation to age, a number of previous attacks, as well as distribution of patients by the duration of paroxysms and remissions). The authors believe that a collation of the tabulated data with the known mathematical models makes it possible to come to understanding some aspects of the pathogenesis of endogenic psychoses.
A clinico-statistical analysis covers 825 psychotic patients who applied to the Amanuel mental hospital in Addis-Abeba over the first 3 months of 1983. The population of patients had the following characteristics associated with cultural factors: a considerable predominance of males, a dramatic reduction in the number of both male and female patients with an increasing distance between their place of residence and the hospital, a large percentage of non-working individuals, single men and divorced women. Among the entire number of mental patients primary patients constituted 67.1%; 42.9% of all patients were hospitalized. A total of 6.7% of patients could not be hospitalized because of overcrowding in the hospital. As regards diagnoses, the patients were distributed in the following way: schizophrenia 46.1%, reactive psychoses 19%, intoxicational 15.6%, organic 3.9%, involutional 2.8%, senile 2.5%, epileptic 2.3%, manic-depressive 2.1%, unspecified psychoses 4.8%. The identified characteristics of the local psychopathology in Ethiopia are discussed.
The present paper describes three juveniles affected with epilepsy, who suffered from episodic psychoses. Such disorders are a very rare occurrence in young persons. The patients had grand mal epilepsy with "secondary temporalization". Clinical and electroencepholographic aspects are discussed by reference to these particular cases. Also, the authors deal with questions of classification and etiopathogenesis. Finally, possible causes producing such psychoses and giving rise to the psychopathological character thereof are pointed out within the framework of a multiconditional approach.
A very controversial debate, concerning the treatment of schizophrenic psychoses by means of hemodialysis, started approximately in 1977, when American scientists reported outstanding successes with this method. Until now there is no clear evidence of the underlying principle of effectiveness of this method. According to present experiences there are three theories. Already in 1960 there were reports of successful application of hemodialysis in acute schizophrenic psychoses. The authors, among other things, assumed the filtration of a toxic blood substance to be the therapeutic principle. Later, however, changes in the blood circulation during dialysis, especially the improvement of cerebral perfusion, were seen as the real therapeutic factor. The recently reported findings of abnormal endorphin in the dialysate fluid of schizophrenics, brought back the theory of detoxification. At the same time there were claims by different authors, that the positive results were only due to a "changed psychological situation" of the treated patients. Which of these three theories is correct can not be decided yet. Whether blood purification methods have anything to offer for the treatment of some types of schizophrenic diseases requires further research.
The clinical and follow-up studies of 107 patients with 2-10 attacks of schizoaffective psychoses permiteed one to distinguish the main variants of development: cyclothymolike, typical schizoaffective and a variant nearer to shiftlike schizophrenia. In a cyclothymolike variant, the attacks resemble phases of a cyclothymic psychoses, but the development of the disease becomes atypical dissociated. The remissions are characterized by disthymical and somatopsychic disorders and personality changes. Typical schizoaffective variants have a development with attacks, mainly of the "acute schizophrenia" type. Following the attacks there is a stabilization of the process with minimal personality changes. In variants nearer to shiftlike schizophrenia, the affective disorders in the framework of the attack gradually lose their intensity, while the hallucinatory delusional symptomatology acquires a tendency towards a systematization. The remissions are short with more marked personality changes.
As the endogeneous psychoses do not show a Mendelian mode of inheritance, empirical risk figures have to be calculated. They are heterogeneous and nurture as well as nature have a share in the manifestation of illness. The genetic basis of the schizophrenias is demonstrated by twin and adoption studies. The concordance rate in monozygotic twins is four times the rate in dizygotic twins. Schizophrenia is to be found in the biological families of schizophrenic adoptees but not in the adoptive families. However, despite their genetic identity, monozygotic twins do not show 100% concordance but 60% only. Nongenetic factors must be considered. Obviously they are nonspecific and vary between individuals. The same principles apply to the affective psychoses. At present research is most interested in the problem of heterogeneity. Do pure depressive and manic-depressive disease form one genetic entity, or two different ones, or have they in common part of their genetic basis? Some remarks on genetic counselling are made.
The family-heredity findings serving as criteria for the classification of functional psychoses are discussed, presenting recent data. The global morbidity risk of the resp. psychosis showing secondary cases similar (homotypical) to the index case and no increased incidence of cases of the other type may be interpreted by the theory of two separated genetically transmitted diseases (schizophrenias and affective disorders). The classical schizophrenic subtypes differ in their global schizophrenia morbidity risk and show a tendency toward homotypical secondary cases. Monopolar and bipolar affective disorders were found to be very close together concerning family-genetic data-Schizo-affective psychotics were found to have among their relatives the highest incidence of all types of functional psychoses at all, a high rate of schizophrenics (esp. catatonic type) and affective psychotics and no homotypical secondary cases.
This article attempts to summarize our knowledge of the diagnosis and treatment of endogenous psychoses from the biological psychopharmacological aspect. Besides the results of pharmacological research which lead to the "amine hypothesis" of endogenous psychoses, results from psychoneuroendocrinology are referred to which show that a laboratory diagnosis of the endogenous depressions is not impossible in the long run. Schizophrenia research findings show that the disease picture of "schizophrenia" can be differentiated into at least two completely different disease entities. Finally the results of studies on the connection between the serum levels and clinical activity of antidepressives and the difficulties of method arising in the studies are reported.
Out of 120 inpatients treated with long-acting neuroleptics (LANs) between May 1977 and May 1978, the authors have selected 43 patients with clear-cut acute psychotic symptoms and high doses or frequent injections of fluphenazine decanoate: 19 schizophrenics, 13 schizoaffective psychoses and 11 manics. The average single dosage was 32 to 37 mg depending on the diagnostic category; the average weekly dosage was 45 to 55 mg; the average frequency of injections was one every 5 to 7 days. Drug combinations could be greater reduced. On discharge, all long-acting treatments were discontinued in manics, against some 60% of schizophrenics and schizoaffective psychoses. Among the advantages of LANs, the authors mention optimum pharmacokinetics (hence, lower doses), increased compliance from the part of the patient (less hostility thanks to decreased administrations than with oral medications), avoidance of cases of intestinal malabsorption, lowered financial burden (less treatment units, fewer admissions, shorter duration of hospitalization, less polypharmacy.
The pharmacological actions of gamma-type endorphins show similarities to those of the neuroleptics. Two fragments of gamma-endorphin (beta-LPH 61-77) were therefore tested in patients with schizophrenic and schizo-affective psychoses who had shown an insufficient response to neuroleptics. The fragments were DT gamma E (beta-LPH 62-77) and DE gamma E (beta-LPH 66-77). Some of the patients studied responded favorably to this treatment. A number of criteria of differentiation between responders and nonresponders are discussed. The influence of DT gamma E on the central DA metabolism differs from that of the neuroleptics. It is therefore conceivable that gamma-type endorphins represent a different principle of action. The therapeutic efficacy of these compounds lends support to the hypothesis that disorders of central endorphin metabolism may play a role in the pathogenesis of psychoses of the schizophrenic type.
The discrimination of borderline syndromes from the psychoses is often a difficult task clinically. The problem most often arises in the acute setting in which a crisis has arisen--the typical example being that of acute hospitalization. The clinician's task is to assess the patient's apparently psychotic symptoms and behaviors to determine whether they are the manifestations of an underlying psychotic process, or whether they reflect a more or less transient regression from a somewhat higher level of habitual functioning. Some discrimination between these categories is possible even in the acute presentation, since borderline patients only exceptionally demonstrate Schneiderian first-rank symptoms or any other discriminating indices of psychosis. While the differentiation may be clear cut between the psychotic and the higher-order, better functioning borderline, there may be less precision in discriminating between the lower-order borderline forms or transient borderline states and psychoses. We have focused on this area of differentiation in this study. The discriminating indices are both short- and long-term. The differentiation cannot be adequately made without longer-term evaluation of the patient. Nonetheless, on a short-term basis, evaluation of the patient's behavior can point the diagnosis in one direction or other. The presence of a clear precipitant; the presence of intense (often verbalized) anger; the patient's attempts to engage the therapist in an intense, dependent, clinging and demanding relationship, usually in manipulative fashion; the partial, fragmentary, often circumscribed and ego-alien quality of the patient's psychotic productions; the marked tendency to act-out feelings, particularly anger, in a way that gains increased attention and concern from doctors, family, friends, or hospital staff; the persistence of some degree of reality testing and areas of significant realistic functioning; the transient nature of regressive manifestations and the ready reversal of regression in structured environments and with appropriate therapeutic management, particularly adequate limit-setting--all point toward a borderline diagnosis. Moreover, these factors carry an accumulative weight so that the more of these factors that can be validated, the more secure the diagnosis of borderline psychopathology. On a longer-term basis, beyond a few days, one would expect the above indices to be better discriminated. In addition, there is greater opportunity to study patterns of patient behavior--both his interaction with staff and other patients and with the therapist.(ABSTRACT TRUNCATED AT 400 WORDS)
Studies show that a hundred cases of puerperal psychoses can be divided into two major groups according to their symptomatology and their option to build recidives: those physically motivated with exogenous and endogenous symptoms and those caused by endogenous psychoses.
Beta-Phenylethylamine can be detected in the cisternal cerebrospinal fluid of healthy controls and acute endogenous psychoses. One group of the patients shows the same concentrations as the psychiatrically healthy controls. In the other groups beta-phenylethylamine was found to be elevated in some cases up to a very high level. The results suggest a link between a disturbance of the phenylethylamine pathway and certain endogenous psychoses.