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PubMedDate not supplied

The relationship of obsessive-compulsive disorder to putative spectrum disorders: results from an Indian study.

The relationship between obsessive-compulsive disorder (OCD) and putative obsessive-compulsive (OC) spectrum disorders is unclear. This study investigates the prevalence of putative OC spectrum disorders in OCD subjects in a controlled clinical design. The putative OC spectrum disorders studied included somatoform disorders (body dysmorphic disorder [BDD] and hypochondriasis), eating disorders, tic disorders (e.g., Tourette's syndrome [TS]), and impulse control disorders (e.g., trichotillomania). Only those disorders that are commonly noted to be possibly related to OCD are studied. Included in this study were 231 subjects with a diagnosis of OCD according to DSM-IV criteria and 200 controls who were not screened for psychiatric morbidity. The subjects and controls were assessed in detail by extensive clinical and semistructured interviews by expert clinical psychiatrists. The lifetime diagnoses were made by consensus of two psychiatrists. Prevalence of tic disorders, hypochondriasis, BDD, and trichotillomania was significantly greater in OCD subjects compared to controls. However, the prevalence of sexual compulsions, pathological gambling, eating disorders, and depersonalization disorder was not greater in the OCD subjects compared to controls. The findings of this comorbidity study suggest that tic disorders, hypochondriasis, BDD, and trichotillomania are perhaps part of the OC spectrum disorders. There is a need to evaluate evidence from other sources such as epidemiological, neurobiological, and family studies to further our understanding of the concept of OC spectrum disorders.

Adult↗
PubMedDate not supplied

The predelusional state: a conceptual history.

The predelusional state (PDS) is defined as the set of psychopathologic events preceding the crystallization of delusions, and includes strange cognitions, moods, conations, and motor acts that may be fleeting and defy description. This review exclusively deals with the historic aspects of PDS. It is noted that during PDS the patient is expected to report experiences for which, on account of their novelty, he may not even have a name. Thus, it is quite likely that according to culture and personal codes and to the conceptual brief of the interviewer, similar experiences might be reported as depersonalization, bodily sensations, dysphoria, changes in perception of reality or time, dissolution of "ego boundaries," etc. It is therefore not surprising that since the 19th century, PDS has been considered a disorder of cognition, emotions, volition, and consciousness.

Consciousness Disorders↗
PubMedDate not supplied

Comparison of dissociative identity disorder with other diagnostic groups using a structured interview in Turkey.

Twenty patients with dissociative identity disorder (DID), 20 with schizophrenic disorder, 20 with panic disorder, and 20 with complex partial epilepsy were evaluated with the Dissociative Disorders Interview Schedule (DDIS) and the Dissociative Experiences Scale (DES). Subjects with dissociative identity disorder were more frequently diagnosed as having somatization disorder, past or concurrent major depressive episode, borderline personality disorder, depersonalization disorder, and dissociative amnesia than other groups. They reported Schneiderian symptoms and extrasensory perceptions more frequently. In their anamnesis suicide attempts, trance states, sleepwalking, and childhood traumas were more frequent than those in comparison groups. The secondary features of dissociative identity disorder and the DES score differentiated these patients from comparison groups significantly. DID has a set of clinical features different from that of schizophrenic disorder, panic disorder and complex partial epilepsy. The differences are similar to those yielded previously in studies from North America.

Adult↗
PubMed2006

[Post-traumatic psychosis: the contribution of an acute post-immediate trauma to a dynamic theorization].

SUMMARY: In his recent publication (2004), in which he favors the psycho-dynamic approach, M. Bertrand underlines the importance of traumatic matter at the heart of new clinical, methodological and epistemological challenges of psychopathology. TRAUMATIC PSYCHOSIS CONCEPT: Our contribution ("post-traumatic psychosis") comes within that prospect in reference to the semiology of traumas generated by extreme situations, such as the tsunami in South Asia (December 2004), the terrorist attacks in Madrid (March 2004) or the hostage taking in North Ossetia (September 2004). Four principle sets of themes lead us to suggest a traumatic psychosis when the person shows symptoms of a neurotic psychic structure: 1. There's no traumatic representation or psychic inscription of the event. Sideration (and its stupor-like confusion symptoms) or panic flight (together with hallucinations or acute delirious fits) often illustrate this first clinical aspect. 2. According to the psychodynamic frame of reference, psychic processes tend to ignore the pleasure/displeasure principle. They are governed by the "invasion" of affects of pain and compulsion to repeat. 3. The models of neurosis and psychic conflict are not efficient in the management of the "quota of affect" and the drive influence. 4. It would be necessary to add, from a psychopathological point of view, the appearance of temporary fits of mental confusion, self-destructive and autolysis behavior. CLINICAL FEATURES: The frame of reference of a DSM IV type "descriptive" psychopathology (ie acute Stress Disorder) seems to de inadequate to convey the implemented post traumatic stakes. If trying to soothe the symptoms is undeniably important, psychic disorganizations that generate a semiology that is essentially present in the symptomatology of the psychoses cannot be ignored. A first clinical approach makes it possible to specify the argumentation of our proposal: "a post-traumatic psychosis". It is supported by five main syndromic classes: 1) the symptoms are often more or less temporary delirious fits (delirious ideas or perceptions of a persecutory, cenesthetic or hypochondriac nature), mental confusion (oneiroid state, anxiety and stupor), phases of depersonalization and derealization, severe death pangs, serious physical disorders, divides close to schizophrenic-type dual personalities; 2) the adhesiveness marks the impossibility for the victims to keep away from a trauma. The objects are bound, persecuting and adhesive; 3) traumatic temporality imposes a factual and current omnipresence of the trauma. It destroys the temporal projections of the patient as well as an anamnesic reconstruction; 4) the "traumatic body" is not that of hysterical neurosis conversions. The somatic semiology marks operational-type functioning (P. Marty); 5) traumatic compliance doesn't work on the level of facilitations that lead to the formation of symptoms. The identity structure appears disorganized by the dismantling of the primary psychic envelopments. PSYCHOPATHOLOGICAL ASPECTS: A second theoretical approach makes it possible to promote this immediate psychotic-type post-traumatic psychopathology. Four considerations of fundamental psychopathology support our contribution: 1) Pictogramic inscription. The severe traumatism does not produce the polarity required for the process of "self-fathering" described by P. Aulagnier in connecting with original processes. Traumatic adhesiveness does not separate the victim from the trauma. It splits the necessary mediation spaces and distance for the emergence of representation processes. 2) Pain affect. The pain affect generated recalls the first experiences of the newborn, primitive agony and anaclitical collapse; the "narcissistic contract" is broken and the patient lives without a secure base or a sufficiently good and supporting psychic container (D.W. Winnicott). 3) Anxiety status. The anxiety is not of neurotic nature but truly annihilating. It is often similar to anxieties caused by disasters, psychoses due melancholy (H. Ey) or more "archaic" anxieties that have been observed in hebephrenic pathologies. 4) Body dismantling. The trauma results in "mute somatizations that cannot be symbolized" (M. Bertrand). They appear in sensory outward signs such as dermatosis, pruritus, diarrhea, hemorrhagic periods or persistent headaches for example. These two clinical and theoretical aspects of the severe forms of trauma confirm the unconscious traumatolytic aim of the victim's psychological destruction. The semiological forms most impervious to therapeutic processes seem to be, in reference to hostage-takings or terrorists acts, those where the patient was conformed with a trauma "that was not carried out" like mock hangings or executions. Suicidal dimension seems to be the ultimate recourse so as not to sink into insanity and to keep a subjective position when faced with barbarian figures.

Affect↗
PubMed2001

The burnout in nursing academicians in Turkey.

The purpose of this study was to determine the level of burnout in nursing academicians in Turkey and to investigate the variables which are strongly correlated with the burnout nursing education settings in Turkey. The sample of the study consisted of the nursing academicians working in the schools of nursing at the different universities in Turkey. Although the total number of nursing academicians in Turkey was 179, the subjects who agreed to participate in the research was 135. The Maslach Burnout Inventory (MBI) was used to measure burnout, after having been statistically tested for its validity and reliability in nursing education settings in Turkey. The multiple regression analysis was carried out in order to determine the main variables correlated with burnout, namely "the predictors" of each of the three components (emotional exhaustion (EE), depersonalization (DP), personal accomplishment (PA)) of burnout. The results indicated that the most significant predictor of EE was work-setting satisfaction, of DP was job pressure, and of PA was job satisfaction in nursing education settings in Turkey. Finally, these findings were compared with of those previous studies in the field.

Adult↗
PubMedDate not supplied

The burnout of nursing staff working with challenging behaviour clients in hospital-based bungalows and a community unit.

The aim of this pilot study was to compare the burnout of nursing staff who worked with clients who displayed challenging behaviour in hospital-based bungalows and a community unit. Twenty-six and 12 nursing staff were randomly chosen from four hospital-based bungalows and a community unit. Staff assessed their clients' behaviour, using the Aberrant Behavior Checklist and were later interviewed, using a self-constructed Staff Questionnaire and the Maslach Burnout Inventory. The results showed that clients in the hospital-based bungalows were more severe in challenging behaviour than those in the community unit. The staff in the hospital-based bungalows were less satisfied with their salaries and enjoyed less their contact with clients. They complained more than the community unit staff and felt that their present training was inadequate. They were also more emotionally exhausted and experienced more depersonalization towards clients than the community unit staff. The level of personal accomplishment was, however, similar in the two groups. Correlations showed that there were significant associations between staff burnout and management issues rather than clients' behaviour, particularly in the hospital-based bungalow group.

Adult↗
PubMed1997

Perceived sources of work stress and satisfaction among hospital and community mental health staff, and their relation to mental health, burnout and job satisfaction.

This questionnaire study examined perceived sources of stress and satisfaction at work among 121 mental health staff members. Five factors were derived from principal component analysis of sources of work stress items (stress from: role, poor support, clients, future, and overload), and accounted for 70% of the total variance. Four factors were derived from the items related to sources of job satisfaction (satisfaction from: career, working with people, management, and money), accounting for 68% of the variance. The associations of these factors with sociodemographic and job characteristics were examined, and they were entered as explanatory variables into regression models predicting mental health, burnout, and job satisfaction. Stress from "overload" was associated with being based outside an in-patient ward, and with emotional exhaustion and worse mental health. Stress related to the "future" was associated with not being white. Stress from "clients" was associated with the "depersonalization" component of burnout. Higher job satisfaction was associated with "management" and "working with people" as sources of satisfaction, whereas emotional exhaustion and poorer mental health were associated with less "career" satisfaction.

Allied Health Personnel↗
PubMed1999

Natural killer (NK) cell activity and NK cell subsets in workers with a tendency of burnout.

The involvement of cellular immunity in the burnout syndrome remains to be elucidated. We assessed three components of burnout of the Maslach Burnout Inventory: emotional exhaustion; depersonalization (DP); and personal accomplishment, as well as natural killer cell activity (NKCA) and NK cell subsets in 42 male workers. Workers with a higher DP score showed a lower NKCA and a lower proportionality of CD57+CD16+ to total lymphocytes. There were no differences in any of the health behaviors (e.g., smoking, alcohol, or obesity) between workers showing higher burnout and those showing lower burnout. A stepwise multiple regressions analysis demonstrated that NKCA was closely correlated with DP, independent of other variables, including a stress index. These results suggest that the relationship between reduced cellular immunity and DP is not due to traditional work stress or health behavioral problems. Further studies on DP as a psychosomatic disorder as well as an occupational health problem should be performed in the future.

Adult↗
PubMed1996

Mental health of hospital consultants: the effects of stress and satisfaction at work.

BACKGROUND: Burnout and psychiatric morbidity among gastroenterologists, surgeons, radiologists, and oncologists in the UK have been estimated by means of a questionnaire-based survey. The relationship between consultants' mental health and their job stress and satisfaction, as well as their job and demographic characteristics, were also examined. METHODS: Psychiatric morbidity was estimated using the 12-item General Health Questionnaire. The three components of burnout-emotional exhaustion, depersonalization, and low personal accomplishment-were assessed using the Maslach Burnout Inventory. Job stress and satisfaction were measured using study-specific questions. FINDINGS: Of 1133 consultants, 882 (78%) returned questionnaires. The estimated prevalence of psychiatric morbidity was 27%, with no significant differences between the four specialist groups. Radiologists reported the highest level of burnout in terms of low personal accomplishment. Job satisfaction significantly protected consultants' mental health against job stress. Three sources of stress were associated with both burnout and psychiatric morbidity; feeling overloaded, and its effect on home life; feeling poorly managed and resourced; and dealing with patients' suffering. Burnout was also associated with low satisfaction in three domains: relationships with patients, relatives and staff; professional status/esteem; intellectual stimulation. In addition, being aged 55 years or less and being single were independent risk factors for burnout. Burnout was also more prevalent among consultants who felt insufficiently trained in communication and management skills. INTERPRETATION: Consultants' mental health is likely to be protected against the high demands of medical practice by maintaining or enhancing job satisfaction, and by providing training in communication and management skills.

Adult↗
PubMed2004

[Hallucinations during treatment with hydrochloroquine].

INTRODUCTION: We report an unexpected cenesthetic hallucination-type neuropsychiatric side effect with hydrochloroquine (Plaquenil) in a patient treated for an erosive plantar lichen planus. OBSERVATION: A 75 year-old woman was hospitalized for a handicapping erosive plantar lichen. Treatment with hydrochloroquine (400 mg/day) was initiated, associated with topical corticosteroids and a short course of oral acorticosteroids (0.5 mg/kg/day of methylprednisolone). After 10 days of treatment, a short episode of temporo-spatial disorientation occurred, followed by a feeling of depersonalization and cenesthetic hallucinations with feelings in the body. These manifestations were preceded by nightmares. Hydrochloroquine was spontaneously stopped by the patient one week later and led to the progressive disappearance of the hallucinations and a return to a normal mental state within one month. Two and a half years later, no relapse of the psychiatric manifestations has been noted. DISCUSSION: Chloroquine and hydrochloroquine may be at the origin of severe psychosis-like psychiatric side effects. Such manifestations are exceptional, little known and principally described during treatment of malaria. The clinical presentation of the psychosis induced by synthetic ani-malarials is fairly homogeneous from one case to the next: onset in a patient without psychiatric past of manifestations such as delirium, hallucinations, maniac episodes or depression after an interval of a few hours to 40 days, usually regressing one week after suspension of the synthetic antimalarial. There is no relationship between the dose of synthetic anti-malarial administered and the onset of psychiatric problems. The triggering-off mechanism is unknown and appears to be an idiosyncratic reaction. Our case report draws the dermatologists' attention to the possibility of the occurrence of potentially severe psychiatric side effects.

Aged↗
PubMedDate not supplied

[Burnout syndrome: prevalence and associated factors among workers in a district hospital].

AIM: Burnout syndrome refers to a kind of occupational stress that can have psychosomatic, behavioral, emotional, familial, and social repercussions; it can also cause absenteeism and loss of efficacy at work. The aim of this study was to determine the prevalence of burnout among staff in a district hospital, as well as the personal and working characteristics associated with the syndrome. METHODS: A cross-sectional study was designed in which a representative random sample of 300 workers, stratified according to professional group, was given the Maslach Burnout Inventory to measure the degree of burnout. This questionnaire has three subscales: emotional exhaustion (EE), depersonalization (DP) and personal achievement (PA). RESULTS: A high degree of burnout was found for EE in 13.9% of the staff interviewed, in 11.1% for DP and in 6.6% for PA. None of the interviewees had high scores for all three scales while 27% had a high level of burnout in at least one of the scales. In the multivariate analysis, professional category and sex were statistically significantly associated with a high level of burnout. CONCLUSION: The prevalence of burnout in Mataró Hospital (Spain) is relatively low and depends mainly on sex and professional group.

Adult↗
PubMed2002

Reproductive rights and the state in Serbia and Croatia.

The global reproductive rights movement arose in the late 1980s and early 1990s as a challenge to the population control paradigm that has dominated family planning policy for almost half a century. The essence of the challenge is to place women into the center of population discussions as subjects, not objects of policy, and to reorient family planning and health programs toward meeting the broad reproductive health needs of individuals, rather than the narrow population control objectives of states. Reproductive rights advocates argue that the use of family planning programs for developmentalist-oriented population control objectives is illegimate, and inevitably relegates women to the status of depersonalized policy "targets". The cases of Croatia and Serbia, the two dominant partners in the former Federal Republic of Yugoslavia, offer interesting twists on these reproductive rights issues. In Croatia and Serbia, unlike in many nations, the governments are deliberately seeking to increase rather than decrease fertility levels. Moreover, the objective concerns identity politics, more so than development: the governments have encouraged increased fertility to safeguard the survival of their nations and to strengthen national power amidst threatening internal and external environments of ethnic conflict. In this paper, we examine the dynamics of pro-natalist fertility policy in Croatia and Serbia. We do so with a view to explaining why, despite similarities, the two have followed divergent paths. While reproductive rights violations have occurred in both nations, they have been markedly higher in Serbia than Croatia. To explain this divergence we look at a series of sociopolitical factors, including the space available for groups to mobilize in each political system; the degree of nationalistic extremism present in the discourse of central political leaders; and perceptions of threats and opportunities in external geopolitical environments. In conducting this analysis we seek to drive home the point that a nation's reproductive rights situation and prospects cannot be understood divorced from its sociopolitical context. We also raise an additional impetus for promoting the reproductive rights agenda--one largely unexplored in the family planning literature-that emerges from low fertility nations facing identity issues. Women's bodies must be protected not only against those states seeking to use their reproductive capacities for developmentalist-oriented fertility control, but also against those wanting their bodies for nationalistic-oriented fertility promotion.

Authoritarianism↗
PubMed1996

Effect of individual and work characteristics of EMTs on vital sign changes during shiftwork.

This study examines the effects of demographics, lifestyle, and work characteristics on burnout in EMTs, and then determines the interaction of various EMT risk factors on cardiovascular changes. In phase 1, EMTs voluntarily completed a demographic data sheet and the Masslach Burnout Inventory (MBI). The MBI results were broken down into subgroups of Emotional Exhaustion (EE), Depersonalization (DP), and Personal Achievement (PA); these were then compared to national averages. Subgroup analysis was performed on the basis of sex, race, marital status, years with the service, smoking, and caffeine drinking habits. In phase 2, EMTs carried logbooks for 1 month, during which they recorded preshift and postshift blood pressure and pulse. Other information recorded for each shift was the amount of caffeine and cigarettes used, the number of advanced life support (ALS) and total runs, and whether the shift worked was day or night. Per-shift average caffeine use, average number of ALS and total runs, and average cross-shift changes in MAP (deltaMAP) and P (deltaP) were calculated for each EMT. The deltaMAP and deltaP were compared for discrete variables (sex, race, training levels, smoker v nonsmoker, marital status, and shift worked) and continuous variable (age, years with the service, total runs, ALS runs, and MBI subscale scores). Continuous variables were split into two groups using the median as a separator. Differences were detected at P < .05 by confidence interval analysis. Sixty-nine EMTs enrolled in phase 1. The EMTs scored significantly lower on the PA scale than the national average (28.1 v 34.6). The low PA score was only seen in the subgroup of EMTs with the service longer than 3 years (26.1 v 30.0). Forty EMTs completed phase 2 of the study. There were no significant differences in deltaMAP detected in any subgroup. There was a significant difference in deltaP based on marital status (single, -4.5 v married, 2.6), and age (younger than 32, -4.5 v older than 32, 0.6). There were no other detected deltaP changes. In conclusion, these results showed that PA is lower in our EMTs than in the general population; EMTs with the service longer than 3 years had the lowest values. There were no significant preshift to postshift changes in blood pressure in any subgroup. There was a statistically significant preshift to postshift decrease in pulse in unmarried EMTs and in those younger than 32 years of age. These results indicate little variation in stress between EMTs and the general population and do not indicate a need for more intensive intervention programs for the management of heart rate or pulse.

Adult↗
PubMed2004

[Burn out among French general practitioners].

OBJECTIVE: Assess the extent of burn out among the general practitioners of the Loire region (France). METHODS: A questionnaire in 3 parts was sent to 480 general practitioners: the first concerned the socio-demographical variables such as the age of the practitioners, their marital status, time when the installed their practice, type of practice and quantification of their professional activity; the second corresponded to the French version of the Maslach Burn out Inventory (MBI) and the third part foresaw the eventual consequences of burn out, such as the wish for retraining, use of psychotropics or suicidal thoughts. RESULTS: 306 practitioners replied (response rate 64%). Mean scores on the three dimensions of burn out (emotional exhaustion, depersonalization, low personal accomplishment) were similar to those of other studies using the same instrument. Five per cent of the practitioners had high scores of burn out on the 3 subscales, but professional accomplishment remained high for a majority of physicians. More than 1 practitioner out of 2 had thought of retraining, 5.5% declared excessive drinking, 30% had taken psychotropics, and 13% have envisaged suicide. Emotional exhaustion was statistically associated with female sex, heavy workload, wish to retrain, drinking, psychotropics and suicidal ideation. The causes of burn out expressed by the practitioners were organizational and administrative (high workload, administrative demands, conflicts with social welfare organizations) but also relational (demands considered as excessive from their patients and families). DISCUSSION: Burn out among general practitioners is a reality. The quality of life of practitioners suffering from burn out appears significantly impaired, and published literature indicates that it may lead to deleterious consequences on the care provided to their patients.

Adult↗
PubMed1999

Attitudes toward euthanasia and physician-assisted suicide among Italian primary care physicians.

The public debate about euthanasia and assisted suicide is less pronounced in Italy than in other countries, and data about this topic are lacking. The aim of this study was to investigate primary care physicians' experience in requests for and opinions about euthanasia and/or assisted suicide for terminally ill patients and the relationship between attitudes and professional variables. Three-hundred thirty-six general practitioners completed the Euthanasia Questionnaire to assess attitudes toward euthanasia and/or assisted suicide and the Maslach Burnout Inventory to examine burnout symptoms. The rate of requests for euthanasia or assisted suicide was low (11% and 4.5%, respectively). Only a minority of the physicians endorsed euthanasia and/or assisted suicide. Agreement with the practice of euthanasia/assisted suicide was correlated with non-Catholic religious affiliation, inexperience in treating terminally ill patients, and the burnout dimension of depersonalization. The fact that professional as well as individual factors (e.g., inexperience, non-Catholic affiliation, burnout) were associated with favorable attitudes toward euthanasia and/or assisted suicide underscores the need to examine the problem as a complex phenomenon involving the dyadic patient-doctor relationship.

Attitude of Health Personnel↗
PubMed1998

Psychological and cardiovascular effects and short-term sequelae of MDMA ("ecstasy") in MDMA-naïve healthy volunteers.

3, 4-methylenedioxymethamphetamine (MDMA, "Ecstasy") is a recreational drug reported to produce a different psychological profile than that of classic hallucinogens and stimulants. It has, therefore, been tentatively classified into a novel pharmacological class termed entactogens. This double-blind placebo-controlled study examined the effects of a typical recreational dose of MDMA (1.7 mg/kg) in 13 MDMA-naïve healthy volunteers. MDMA produced an effective state of enhanced mood, well-being, and increased emotional sensitiveness, little anxiety, but no hallucinations or panic reactions. Mild depersonalization and derealization phenomena occurred together with moderate thought disorder, first signs of loss of body control, and alterations in the meaning of percepts. Subjects also displayed changes in the sense of space and time, heightened sensory awareness, and increased psychomotor drive. MDMA did not impair selective attention as measured by the Stroop test. MDMA increased blood pressure moderately, with the exception of one subject who showed a transient hypertensive reaction. This severe increase in blood pressure indicates that the hypertensive effects of MDMA, even at recreational doses, should not be underestimated, particularly in subjects with latent cardiovascular problems. Most frequent acute somatic complaints during the MDMA challenge were jaw clenching, lack of appetite, impaired gait, and restless legs. Adverse sequelae during the following 24 hours included lack of energy and appetite, feelings of restlessness, insomnia, jaw clenching, occasional difficulty concentrating, and brooding. The present findings are consistent with the hypothesis that MDMA produces a different psychological profile than classic hallucinogens or psychostimulants.

Adult↗
PubMed1999

5-HT modulation of dopamine release in basal ganglia in psilocybin-induced psychosis in man--a PET study with [11C]raclopride.

The modulating effects of serotonin on dopamine neurotransmission are not well understood, particularly in acute psychotic states. Positron emission tomography was used to examine the effect of psilocybin on the in vivo binding of [11C]raclopride to D2-dopamine receptors in the striatum in healthy volunteers after placebo and a psychotomimetic dose of psilocybin (n = 7). Psilocybin is a potent indoleamine hallucinogen and a mixed 5-HT2A and 5-HT1A receptor agonist. Psilocybin administration (0.25 mg/kg p.o.) produced changes in mood, disturbances in thinking, illusions, elementary and complex visual hallucinations and impaired ego-functioning. Psilocybin significantly decreased [11C]raclopride receptor binding potential (BP) bilaterally in the caudate nucleus (19%) and putamen (20%) consistent with an increase in endogenous dopamine. Changes in [11C]raclopride BP in the ventral striatum correlated with depersonalization associated with euphoria. Together with previous reports of 5-HT receptor involvement in striatal dopamine release, it is concluded that stimulation of both 5-HT2A and 5-HT1A receptors may be important for the modulation of striatal dopamine release in acute psychoses. The present results indirectly support the hypothesis of a serotonin-dopamine dysbalance in schizophrenia and suggest that psilocybin is a valuable tool in the analysis of serotonin-dopamine interactions in acute psychotic states.

Adult↗
PubMed2002

Schizotypal personality disorder inside and outside the schizophrenic spectrum.

The concept of schizotypal personality disorder has been heavily discussed since its introduction into the official classification of mental disorders in DSM-III. The aim of this study was to investigate the difference between schizotypal personality disorder within and outside the genetic spectrum of schizophrenia. Schizotypals with and without schizophrenic cotwins and first-degree relatives were compared, with individuals with other mental disorders and no mental disorders as controls. It appeared that only inadequate rapport and odd communication were more pronounced among schizotypals within, compared to schizotypals outside the schizophrenic spectrum. Schizotypals outside the schizophrenic spectrum, however, scored higher than schizotypals inside the schizophrenic spectrum on ideas of reference, suspiciousness, paranoia, social anxiety, self-damaging acts, chronic anger, free-floating anxiety and sensitivity to rejection. Interestingly, the four last features are seldom observed among schizotypals inside the schizophrenic spectrum. Monozygotic non-schizophrenic cotwins of schizophrenics score high on inadequate rapport, odd communication, social isolation and delusions/hallucinations. Monozygotic non-schizophrenic cotwins of schizotypals outside the schizophrenic genetic spectrum score high on illusions, depersonalization, derealization and magical thinking. Negative schizotypal features appear to be inside the schizophrenic spectrum, while positive borderline-like features are outside having another genetic endowment.

Adult↗