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PubMed1991

Coronal reconstruction images of glucose metabolism in Alzheimer's disease.

Coronal images of position emission tomography (PET) by 18F-labelled deoxyglucose reconstructed from interpolated scan in Alzheimer's disease clearly indicated suppression of glucose metabolism in the parietal lobe and lateral part of the temporal lobes, compared to normal controls. The medial part of the temporal lobes in Alzheimer's disease did show a mildly lower glucose metabolic rate than that in normal controls; therefore it is suggested that the parietal and lateral parts of the temporal lobes are primary affected regions in Alzheimer's disease, not the medial part of the temporal lobe, including the hippocampus.

Adult↗
PubMed1991

Miliary tuberculosis presenting as fever and jaundice with hepatic failure.

A 58-year-old male patient with miliary tuberculosis presenting as jaundice and hepatic dysfunction was reported. He was admitted to the Miyazaki Medical College Hospital, Miyazaki, Japan, because of fever and jaundice. Chest x-ray revealed a calcified primary affect of tuberculosis in the left upper lung field and miliary shadows throughout both lung fields. Liver function tests showed indications of obstructive jaundice and hepatic dysfunction. He rapidly deteriorated and died 3 days after admission. Autopsy revealed disseminated miliary tuberculosis in all major organs. Many miliary tubercles were densely distributed in the liver, especially in and near the portal tracts. The intestine was free from tuberculous lesions. Miliary tuberculosis with jaundice is rare and its pathogenesis is discussed.

Fever↗
PubMed1980

Effects of isoproterenol and chlordiazepoxide on drinking and conflict behaviors in rats.

Isoproterenol, a beta-adrenergic agents, induced drinking in water-satiated rats. Isopropeternol exhibited significant anti-conflict activity on water-deprived rats in the Shock-induced Suppression of Drinking (SSD) procedure. Chlordiazepoxide (CDP), at the highest dose tested, also increased drinking in non-deprived naive rats. As expected, CDP demonstrated highly significant anti-conflict activity in thirsty rats (SSD test). These results suggest that in conflict procedures, where food or water is used as a reward, agents that affect the consumatory drive mechanisms could show up as "false positives." Moreover, agents that affect primary drives (e.g., CDP), in addition to their anti-anxiety activity, could show additive activity in such conflict procedures.

Animals↗
PubMed1980

Psychiatric illness in the adult offspring of bipolar manic-depressives.

Forty-eight of the 50 living adult offspring of 16 bipolar patients were interviewed. Data was available on the 2 other offspring, who had previously suicided. One half of the offspring met criteria for psychiatric illness, the majority of which was either primary affective or other affective disorder. The mean age of onset of illness was middle to late adolescence, earlier than that generally reported elsewhere. Female offspring were 3 times as likely to be ill as male offspring, in spite of being equally represented in the sample. Reasons for this were examined.

Adolescent↗
PubMed1982

Monoamine metabolites in cerebrospinal fluid of depressed patients during treatment with mianserin or amitriptyline.

A group of 20 inpatients with moderate to severe primary affective disorder received 14 days of placebo treatment and were then randomly allocated to receive mianserin 10 mg 3 times daily or identical amitriptyline 25 mg 3 times daily for 1 week followed by 60 mg mianserin or 150 mg amitriptyline daily for a second week. Patients were rated for side-effects and depression (Hamilton Depression Scale) on days 0, 7, 14, 21 and 28. Probenecid 100 mg/kg was administered in 3 divided doses on days 13/14 and on days 27/28 of the trial, followed by collection of CSF. Blood samples for determination of antidepressant levels were collected on day 27. Both mianserin and amitriptyline produced a significant decrease in CSF levels of 3-methoxy-4-hydroxyphenylglycol (MHPG), but only amitriptyline significantly lowered CSF levels of 5-hydroxyindole-3-acetic acid (5-HIAA). Neither drug affected CSF levels of homovanillic acid (HVA). Both mianserin and amitriptyline produced significant but indistinguishable improvement in mean Hamilton scores over 2 weeks of treatment. There was no relationship between therapeutic response and either plasma antidepressant levels or pre-treatment CSF monoamine metabolite levels in his small group of patients. The reductions of CSF levels of metabolites of NA (MHPG) and 5-HT (5-HIAA) are consistent with the known effects of amitriptyline on amine uptake. Mianserin may reduce CSF MHPG levels as a result of its effects upon NA release and/or uptake, but it appears to be devoid of influence upon central 5-HT metabolism.

Adult↗
PubMed1984

Psychomotor retardation and agitation in depression. Relationship to age, sex, and response to treatment.

Patients with primary affective disorder who had either psychomotor agitation alone or psychomotor retardation alone were studied. Compared to psychomotor retardation, psychomotor agitation appears to be seen more frequently in women, older patients, and individuals who have a late onset to their illness. In addition, those with agitation alone appeared to have a better and faster response to electroconvulsive therapy.

Adult↗
PubMedDate not supplied

Secondary depression in panic disorder and agoraphobia. II. Dimensions of depressive symptomatology and their response to treatment.

Secondary depressive symptomatology in 435 subjects with panic disorder and phobic avoidance was studied before and after alprazolam treatment. No subject who had a primary affective disorder was included. Calculation of Hamilton Depression Rating Scale factor scores revealed that the agitation/anxiety, sleep disturbance, and somatization factors accounted for approximately 75% of the HAM-D total score; these all showed significant improvement with alprazolam treatment. There were few differences in dimensions of depressive symptomatology between those subjects with and those without major depression; the main difference was in the overall intensity of the depression.

Adolescent↗
PubMed1993

Dexamethasone suppression test and TRH-TSH test in subaffective dysthymia and character-spectrum disorder.

Based on Akiskal's criteria of subaffective dysthymia (SDT) and character-spectrum disorder (CSD) as the two, etiologically distinct forms of early-onset primary dysthymia, the authors investigated the dexamethasone suppression test (DST) in 18 patients with SDT and in 30 patients with CSD. TRH-TSH test was also investigated in smaller subsamples of the patients (n = 8, and n = 7, respectively). Fifty percent of the patients with SDT showed abnormal DST and TRH-TSH test results respectively, while the figures in the CSD patients were 7% and 0%. These findings suggest that SDT is a clinically diagnosable and biologically distinct subgroup within the broader category of early-onset primary dysthymia, which represents a symptomatically milder version of primary affective disorder.

Adolescent↗
PubMed1981

Age-related changes in sleep in depressed and normal subjects.

All-night electroencephalographic (EEG) sleep data were examined a function of age in normal control subjects and hospitalized, unmedicated depressed patients with primary affective illness. By analysis of variance, Total Sleep time, Delta Sleep, Sleep Efficiency, Rapid Eye Movement (REM) Sleep, and REM Latency decreased as a function of age, whereas Early Morning Awake time and Intermittent Awake time increased. Compared with normal controls, after the effects of age were covaried out, depressed patients had a greater Sleep Latency, Early Morning Awake time, Intermittent Awake time, Duration and REM Density of the first REM period, and average REM Density for the night, as well as less Sleep Efficiency, less Delta Sleep, and shorter REM Latency, Early Morning Awake time increased with age in depressives but not in normals.

Adolescent↗
PubMed1981

Urinary MAO inhibitor in psychiatric illness.

Normal human urine contains an endogenous monoamine oxidase inhibitor. We have now investigated its activity in urine samples from psychiatric patients in various diagnostic categories. Significantly higher values were observed in alcoholics recently withdrawn from ethanol, compared with controls. Inhibitory activity was not specifically related to primary affective disorders. Inhibitor output may be positively related to certain symptom clusters rather than to disease entities (i.e. alcohol withdrawal, agitation, and hyperkinesis). Significantly lower inhibitor output was also found in a small group of patients with chronic schizophrenia.

Adolescent↗
PubMed1989

Psychiatric diagnosis in cocaine abuse.

The Structured Clinical Interview for DSM-III, Axis I was administered to a consecutive series of 30 cocaine abusers entering outpatient treatment. Another mental disorder was diagnosed only if its onset occurred before the onset of any substance dependence disorder. Diagnoses were made on a lifetime basis without regard to hierarchy. Most cocaine abusers had one or more additional diagnoses. We propose a model of two subtypes of cocaine abusers: (1) a primary affective disorder group, which may be split into bipolar versus unipolar or into severely versus mildly depressed subgroups; and (2) a group with other drug dependencies. The small n, limited sample, and methodological problems with diagnosis in the setting of substance abuse make these findings tentative. Future research should combine larger diagnostic studies with treatment trials to test whether such diagnostic subtypes have prognostic or treatment implications.

Adult↗
PubMed1985

Neurotransmitter metabolites and endocrine responses in depression.

Urinary 3-methoxy-4-hydroxyphenylethyleneglycol (MHPG), 3-4-dihydroxyphenylethyleneglycol (DHPG), 5-hydroxyindoleacetic acid (5-HIAA), plasma thyroid stimulating hormone (TSH), prolactin (PRL) and growth hormone (GH) were measured before and after the injection of thyrotropin releasing hormone (TRH) in healthy subjects and depressed patients with primary affective disorder. The TSH response to TRH did not differ in depressed compared with control subjects. A trend (.05 less than p less than .10) toward a lower PRL response appeared in male depressed compared with male control subjects. GH levels did not consistently change after TRH. In all subjects the TSH response correlated positively with pre- and post-TRH urinary MHPG. The PRL response correlated negatively with pre-TRH urinary 5-HIAA. Pre-TRH daytime urinary 5-HIAA levels were elevated in depressed subjects.

Adult↗
PubMed1986

Basal hypersecretion of cortisol in relation to abnormal dexamethasone suppression test response in depression.

The activity of the hypothalamus-hypophysis-adrenal axis was evaluated in a group of patients with primary affective disorder by correlation of basal cortisol hypersecretion and abnormal response to dexamethasone suppression test (DST). The increase in basal cortisol was not found to be responsible for suppression failure. Moreover, this biochemical abnormality was common in the groups of psychiatric patients studied, although the physiopathologic mechanisms involved are different. Further research is necessary to clarify the results.

Affective Disorders, Psychotic↗
PubMed1978

Electrographic analysis of the sleep cycle in young depressed patients.

Electrographic (EEG) patterns of nocturnal sleep were investigated in young psychiatric patients during unipolar depressive episodes. EEG-sleep data was recorded in 20 non-psychotic depressed patients all under 26 years old individually matched with a normal control group. All 20 subjects slept in the laboratory for 1-3 consecutive baseline nights from 12-8:00 a.m. During a subsequent extended condition 14 in each group were allowed to sleep ad-lib. Although the mean total time asleep on baseline nights was about the same between groups (greater than 7.1 hr), the depressives had a statistically significant reduction in REM time, increased transitions into stage 1, but most especially averaged: (a) less stage 4; and (b) more stage 1. Compared with the prior eight-hour night 27/28 subjects among both groups exhibited elevated time asleep during the extended condition, but the patients' mean total 10.3 hr sleep was significantly greater by 1.5 hr than the controls (X = 8.8 hr). Sleep exceeding 9 hr on the ad-lib night was a consistent phenomenon which occurred in significantly more (11/14) young depressed patients contrasted to 4/14 control subjects. These findings indicate that young persons with primary affective disorders do not exhibit nocturnal EEG disturbances of comparable severity to most older depressed patients such as reduced time asleep, increased wakefulness or lowered slow-wave (stages 3 and 4) sleep. Although no direct evidence of symptomatic 'hypersomnia' in these patients was provided, the present results demonstrated that some young persons with clinical depression have the capacity to sleep for sustained periods.

Adolescent↗
PubMed2005

Do social anxiety disorder patients belong to a bipolar spectrum subgroup?

BACKGROUND: It has been proposed that all forms of bipolar disorder-perhaps all primary affective disorders-are best conceptualized as a spectrum of related illness, clinically overlapping but not necessarily genetically uniform illnesses. We aim to describe with retrospective methodology the demographic, clinical, and therapeutic response in a group of social anxiety disorder (SA) patients who improves while taking antidepressants and compare them with bipolar II (B-II) patients. METHODS: 57 SA outpatients (DSM-IV) were diagnosed and naturalistic efficacious treated with selective serotonin reuptake inhibitors (SSRI). Their demographic, clinical features and therapeutic response were compared with 41 DSM-IV bipolar II patients in their starting evaluations in our outpatient clinic in the Federal University of Rio de Janeiro, Brazil. RESULTS: There is a sub-group of SA patients who improves while taking antidepressants and presents a clear hypomanic phase. Their improvement is identical to a mild/moderate hypomanic state. Without the antidepressant, the symptoms of SA return. The SA and B-II patients have a similar number of previous depressive episodes, alcohol abuse, suicide attempts, and family history for mood disorder. LIMITATIONS: It is a retrospective data description based on a naturalist follow-up. CONCLUSION: Some SA patients have demographic, clinical and therapeutic features similar to B-II patients and they might just be a Bipolar-III sub-group with a higher level of complains to social situations and without spontaneous hypomania during lifetime.

Adult↗
PubMed1997

Current status in the treatment of orbital myositis.

PURPOSE: Orbital myositis is described as exquisitely sensitive to therapy with systemic corticosteroids. However, it may turn into a recurrent or chronic disease, requiring repeated courses or maintenance of corticotherapy that often is complicated with serious side effects. The authors conducted this study to evaluate their experience and the current status in the literature as to treatment of orbital myositis with corticosteroids and corticosteroid-sparing alternatives. METHODS: The clinical records and computed tomography scans of patients with orbital myositis who presented at the Orbital Center Amsterdam between 1977 and 1991 were studied for the clinical course and therapeutic outcome. Recurrences were defined as a new attack of the same or another extraocular muscle as the primary affected, in the same or the other orbit. RESULTS: The study group comprised 16 patients. All patients responded to initial treatment with oral corticosteroids (14/16) or nonsteroidal anti-inflammatory drugs (NSAID) (2/16). Of these 16 patients, 9 (56%) had 1 or more recurrences. Recurrences responded to repeated courses of corticosteroids, NSAID, or 20 Gy irradiation. Despite radiotherapy in six patients, recurrences continued to occur within a mean period of 2.7 years (range, 0.5 month-8.8 years). The mean follow-up after initial therapy in general was 9.7 years (range, 2.6-16.9 years), and after radiotherapy, in particular, was 7.4 years (range, 4.1-10.5 years). CONCLUSIONS: Orbital myositis responds well to oral corticosteroids, but recurs in 50% of the cases. Based on a long-term follow-up of six patients who received irradiation of 20 Gy, radiotherapy appears ineffective in stopping recurrent orbital myositis.

Administration, Oral↗
PubMedDate not supplied

Steroid psychosis: a review.

This review is built upon a time-framed perspective to unfold the growth of evidence and the shifting of focus from primary affective short-term reactions to later findings of cognitive deficits and possible permanent impairment linked to steroid treatment. An incidence related to dosage has been documented and delirium and withdrawal symptoms have been reported in later studies. A hypothesis of sensitization process with multiple course of steroids has been proposed with the reporting of recurrent cases. The issue of individual risk appears unsettled while management of psychiatric reactions to steroids has shifted toward prophylactic use of lithium.

Adult↗
PubMed1999

Different platelet aggregability during mental stress in two stages of essential hypertension.

To determine whether platelet response to mental stress is altered in essential hypertension, platelet aggregability and plasma beta-thromboglobulin were determined in 24 patients with essential hypertension (11 patients with World Health Organization (WHO) stage I and 13 patients with stage II) and 14 normotensive controls before and after a 10-min arithmetic stress (serial subtraction of 7 from 1000). In normotensive subjects, arithmetic stress did not affect primary aggregations to 1.0 micromol/L adenosine diphosphate (ADP) and to 2.5 micromol/L 5-hydroxytryptamine (5-HT), ADP threshold for biphasic aggregation and plasma beta-thromboglobulin level. In hypertensive patients with WHO stage I, these parameters were similar to those in normotensives before arithmetic stress, but the arithmetic stress test significantly increased primary aggregation to reagents and beta-thromboglobulin level, and decreased threshold of ADP for biphasic aggregation. In WHO stage II patients, platelet aggregability to reagents and beta-thromboglobulin level were already enhanced as compared with WHO stage I patients and normotensive subjects before arithmetic stress. However, the stress-induced changes in platelet function were less pronounced in WHO stage II patients compared with stage I patients. In conclusion, platelet aggregability and proaggregatory effect of mental stress differed depending on the severity of hypertension in patients with essential hypertension; the transient activation of platelet function during stress with no enhancement under the resting condition in the early phase of hypertension and the continuous activation of platelet function in the advanced phase with hypertensive organ damage.

Adenosine Diphosphate↗