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PubMed1992

[Use of plasmapheresis in the complex treatment of patients with endogenous psychoses].

The results of the use of plasmapheresis in multimodality treatment of patients with endogenous psychoses are provided for the first time. The use of plasmapheresis was shown to be highly effective in overcoming resistance to psychotropic agents as well as in the treatment of lingering and chronic extrapyramidal neuroleptic disorders. The beneficial effect on the mental and neurologic status of the patients is coupled with pronounced immunocorrective action of the procedure.

Adult↗
PubMed1992

["Endogeniform" affective psychoses and normal pressure hydrocephalus].

Four patients with neuroradiological evidence of normal pressure hydrocephalus and psychiatric diagnosis of affective psychoses with major depression--like characteristics are presented. Three patients underwent shunting operations following an observation period of 2 to 6 years. During the post-operative follow-up of 3 to 7 years, resp., no clinical changes were noted. In our opinion, and following critical evaluation of the available literature, major depression--like affective disorders in normal-pressure hydrocephalus are not influenced by shunting operations, unless they occur simultaneously as an additional symptom in an Adams-Hakim syndrome with definite progression.

Affective Disorders, Psychotic↗
PubMed1992

[Structural changes in the brain in schizophrenia and affective psychoses].

Kraepelin (1896) and Bleuler (1916) were convinced that schizophrenia has an anatomical basis. Evidence is provided now by visualization methods made in vivo and stereometric methods used in neuropathology. Schizophrenia is associated with enlargement of the lateral and the third ventricle, widening of the sulci between gyri of the cerebral cortex, a decline of the weight of the brain, volume of the cerebral cortex and central gray matter. Histological examination reveals reduction of the parahippocampal gyrus thickness, changes in the hippocampus are controversial. Numerical atrophy of neurons was found in the mediodorsal nucleus of the thalamus, amygdaloid nucleus, prefrontal cortex, impaired pattern of neuronal modules were found in the g.cinguli. Some anatomical changes correlate with differences revealed by neuropsychiatric examination, positron emission tomography and examination of evoked potentials. Schizophrenia can be at least in some instances the consequence of developmental disorder of the brain. The problem of continuity of schizophrenia and affective psychoses is discussed.

Affective Disorders, Psychotic↗
PubMedDate not supplied

[ICD-9 versus DSM-III in the psychoses: anamnestic and catamnestic implications].

We pretend with our study to compare the DSM-III diagnostic criteria with ICD-9 diagnostic criteria for psychotic episodes and to look for the diagnostic stability for both classifications. We studied 79 first psychotic episodes following ICD-9 and retrospectively we applied the DSM-III diagnostic criteria to the same patients. The mean follow up time was 46.6 +/- 6.7 months. In the ICD-9 the schizophrenic psychoses represented the main diagnostic group, not only the day they were discharged from the hospital 31.6% but also in the follow up 39.2%. On the other hand in the DSM-III, in the discharge day the schizophreniform disorder was the more frequent diagnostic 24%, while in the follow up the schizophrenic disorder came to the first position 32.9%. In the ICD-9 there was a 15.1% of diagnostic changes and in the DSM-III nearly the double 30.3%. In both classifications the unspecified and the atypical suffered a great diagnostic mobility; in both nosologies the schizophrenia was the most unchangeable diagnosis, no patient discharged with this diagnosis changed to another in the follow up. ICD-9 could be said that has a great sensitivity and an acceptable specificity for this entities, and DSM-III would have a moderate sensitivity but a very diagnostic specificity for these disorders.

Adult↗
PubMed1992

[Differential neuroleptic treatment of schizophrenic psychoses in puerperium: advantages of the atypical neuroleptic clozapine].

Clozapine is an atypical neuroleptic drug characterised by specific pharmacological properties and clinical side effects, which are different from those observed with conventional neuroleptics such as drugs of the phenothiazine or butyrophenone classes. This report suggests a new clinical indication for clozapine, based on its negligible influence on plasma prolactin levels: the pharmacotherapy of schizophrenic psychoses in the post-partum period and in patients suffering from acute mastitis.

Adult↗
PubMed2004

[Immunological indices in schizoaffective and affective psychoses].

Proliferative activity of peripheral blood lymphocytes has been studied in patients with schizoaffective (18) and affective (24) psychoses in 4 experimental variants: cultivation of blood lymphocytes isolated by centrifuging in the density gradient with fetal (1st variant) or autologic serum (2nd variant); cultivation of lymphocyte obtained in plasma sedimentation with fetal (3rd variant) and autologic serum (4th variant). A level of functional lymphocyte activity was significantly decreased in patients. The data obtained suggest that different mechanisms underlie this decrease. In schizoaffective psychosis, a disturbance of cell cooperative interaction in immune response was observed. In affective psychosis, the determining factors were a decrease of the ability of lymphocytes to respond to mytogenic stimulation and a presence of the factor inhibiting a functional activity of lymphoid cells in patient's blood. Besides, it was shown that in patients with schizoaffective psychosis, lymphocyte proliferative activity inversely correlates with the disease duration and in affective patients the direct correlation between these indices was detected.

Adult↗
PubMed2005

[Psychoses in patients with Parkinson's disease; their frequency, phenomenology, and clinical correlates].

The frequency, phenomenology, and risk factors of hallucinations and delusions were investigated in 64 consecutive inpatients with Parkinson's disease. Fifty patients were admitted to our hospital with symptoms related to Parkinson's disease: psychiatric problems 27 (psychosis 22; anxiety 2; depression 2; mania 1): motor symptoms, 20 (wearing-off 5; akinesia 4; freezing 4; postural instability 4; dyskinesia 2; tremor 2; dystonia 1), and sensory symptoms, 3. Fourteen patients were admitted with other medical problems (pneumonia 4; cerebral infarction 3; bone fracture 3; lumbago 2; seizure 1; cat bite 1). Totally 49 patients had psychiatric problems. Psychosis was present in 43 patients, dementia in 10, depression in 8, mania in 1, anxiety in 10, agitation in 6, stereotypy in 2, and hypersexuality in 2. Of the 43 patients with psychoses, 40 presented with visual hallucinations, 18 with auditory hallucinations, and 23 with delusions. To determine what the clinical correlates with the severity of psychosis were, we divided the patients into 3 groups: the severe group, 22 patients admitted because of psychotic symptoms; the mild group, 21 patients admitted because of problems other than psychosis but presenting psychotic symptoms; and the control group, 21 patients who had no psychotic symptoms. Incidences of auditory hallucinations and delusions were higher in the severe group as compared to the mild group. Patients in the severe group had higher Hoehn-Yahr stages, lower Mini-Mental State Examination scores, decreased H/M ratios of cardiac 123I-MIBG uptake, and lower frequencies of background activity on electroencephalograms. There were no differences in age at admission, age at onset of Parkinson's disease, duration of illness, amounts of levodopa and dopamine agonists received, Hamilton's depression rating scores, and brain MR findings, including atrophy and ischemic changes. Emergence of psychotic symptoms in parkinsonian patients appears to be clearly associated with impaired cognitive function. Therefore, it may be associated with the disease process itself. Terms such as dopaminomimetic or levodopa-induced psychosis may not be appropriate when describing psychosis in Parkinson's disease.

Aged↗
PubMed2005

Psychoses in late life: evaluation and management of disorders seen in primary care.

As the ranks of Baby Boomers move into later life and develop age-related cognitive conditions, an increased incidence in the number of psychotic conditions is expected. When psychotic conditions occur after age 60, the causes and management pose challenges for clinicians caring for the older adult. This article will review the differential diagnosis and management of psychoses in late life.

Aged↗
PubMed2005

Guidelines for recognition and treatment of the psychoses associated with epilepsy.

Epilepsy and psychiatric diseases are frequent comorbidities. Psychoses in patients with epilepsy have special physiopathology and several clinical presentations and prognoses. Their treatments are also specific, according to the specific diagnosis. This paper represents the summary of a consensus meeting held in November 2003 by a Belgian French-speaking group of neurologists, neuropediatricians and psychiatrists and proposes guidelines for the recognition and treatment of those entities.

Antipsychotic Agents↗
PubMed2005

[Treatment of acute and chronic psychoses in childhood and adolescence].

Treatment of schizophrenic conditions in children and adolescents comprises a range of measures such as psychopharmacotherapy, individual psychotherapy, cognitive-behavioral therapy, family therapy, psychoeducation, group therapy, therapeutic pedagogy, and creative and ergotherapy. The objectives of pharmacotherapy are three-fold: (1) elimination of acute psychotic symptoms and anxiety/agitation, (2) restoration of psychophysical harmony in the remission phase, and (3) prevention of relapses and facilitation of postpsychotic rehabilitation. Atypical antipsychotic drugs represent a major advance in the treatment of schizophrenic psychoses in childhood and adolescence. Differences in the potency of the antipsychotic effect and in undesired side effects are determined by the different receptor binding profiles of the respective substances. The use of long-term treatment with appropriate neuroleptics in combination with family therapy can significantly reduce the relapse rate.

Acute Disease↗
PubMed2006

The development concept of "endogenous psychoses".

Several structural deviances in the brain in "endogenous psychoses" have been described over the last decades. The enlargement of the lateral ventricles and the subtle structural deficits in temporobasal and orbital frontal structures (hypofrontality) are reasonably well established in the majority of schizophrenic patients. We examined the cytoarchitecture of these important central structures, namely the entorhinal region and the orbitofrontal cortex (Brodmann area 11), which have been under meticulous investigation in our laboratories over the last few decades. In a new series of schizophrenic patients and normal controls, we made serial cuts of the whole rostral entorhinal cortex on both sides. For this report, we selected two cases with very different psychopathologies, and present the serial cuts through both hemispheres and the malformations found. We report on the differing magnitude of the heterotopic malformations (for definition see page 103), either bilaterally or unilaterally.

Animals↗
PubMed1991

[Therapeutic treatment with neuroleptics. I: State of research on mechanisms of action, effectiveness and compliance in treatment of psychoses].

In the management of schizophrenic psychoses, drug medication with neuroleptics occupies a central position and is in fact a first-choice treatment. The considerable side effects and late sequelae of this treatment are known to impair the quality of life of the patient and have comne to the fore once again in recent years as the starting points of controversial discussions among specialists and among those who are engaged in matters concerning psychiatric policies or "politics". The cornerstones of this debate are demonstrated and explained on the basis of the present clinico-psychiatric state of research in respect of effectivity predictors, types of mechanisms of action. Long-term courses of treatment with neuroleptics, and different dosage schedule strategies.

Antipsychotic Agents↗
PubMed1991

The current unsatisfactory state of relapse prevention in schizophrenic psychoses--suggestions for improvement.

The current state of relapse prevention in schizophrenic psychoses is very unsatisfactory. Although in the form of neuroleptics a very efficient means of relapse prevention has been available for almost 40 years, approximately 50% of the schizophrenic patients still suffer a relapse within the first year after their most recent episode. Seventy percent of the hospitalized schizophrenic patients are readmissions, and the noncompliance rate for neuroleptic relapse prevention is 75%. An important factor contributing to these high rates of noncompliance and relapse seems to be the fact that, 40 years after the introduction of neuroleptics, there is still no consensus on how these drugs are to be used in relapse prevention. An inquiry among Austrian and German psychiatrists revealed unacceptably high discrepancies concerning their recommendations for indication and duration of neuroleptic relapse prevention. To overcome this unsatisfactory situation, an international consensus meeting on guidelines for neuroleptic relapse prevention was organized by the author in April 1989. Precise guidelines on indication, duration, and dosage of neuroleptic for relapse prevention that resulted from that meeting are presented.

Antipsychotic Agents↗
PubMedDate not supplied

Open clinical study of Clopixol-Acuphase (zuclopenthixol acetate) treatment followed by Clopixol Depot in acute psychoses with long-term course tendency.

The evolution of 28 patients displaying acute forms of psychoses (schizophrenia, mania, exacerbation of psychosis in chronic cases) was studied under the treatment with Acuphase Acetate continued with Clopixol Depot. In both therapies a tioxantenic neuroleptic is involved for the acute form of the illness (Acuphase) and for the maintenance treatment (Clopixol Depot). The assessment of the results was carried out on individual observation files using Global Rating Scale (G.R.S.), B.P.R.S. and paraclinical measurement to appreciate the biological tolerance. Favourable effects of treatment were evident in the first 4 days and in six cases even within the first 24 hours. The whole group of patients showed a significant decrease of morbidity evolving from a high severity to a medium and reduced one. The biological tolerance was very good, 6 to 12 months' care.

Acute Disease↗
PubMed2006

[Therapy of endogenous attack-like adolescent psychoses: main principles and approaches].

Basing on the results of the treatment of 297 patients and the follow-up study of 278 patients aged 16-25 years, with endogenous attack-like adolescent psychoses main principles of the therapy are formulated as follows: (1) therapeutic alliance between the psychiatrist and a patient as well as between a psychiatrist and parents of the patient; (2) timely neuroleptic therapy; (3) priority of using antipsychotics with high efficacy and low frequency of development of side-effects and complications; (4) orientation on long-term supportive and preventive therapy; (5) complex treatment as a combination of psychopharmacotherapy with rehabilitation measures.

Adolescent↗
PubMed2006

[Psychoses and epilepsy. A case study].

Over the last few decades much research has been done into the raised level of psychiatric comorbidity in epilepsy. On the basis of a case study of a patient suffering from post-ictal psychoses we explain the psychiatric differential diagnosis within the framework of epilepsy and we investigate the frequent psychiatric side-effects of anticonvulsants. It is concluded that the links between epilepsy and psychiatric symptoms are complex and that the neuropsychiatry of epilepsy is concerned with syndromes that are unique and do notfit into modern psychiatric classification systems.

Adult↗
PubMed1991

"Les psychoses passionnelles" reconsidered: a review of de Clérambault's cases and syndrome with respect to mood disorders.

While de Clérambault's name has been linked to erotic delusions, he attempted to describe "pure" erotomania as a paradigm of a broader group of delusions. His own cases and a large number in the English and French literature seem to indicate that severe mood disorder, most likely bipolar affective disorder, is responsible for a portion of the erotomanic delusions. The concept of "les psychoses passionnelles" in the context of French psychiatry is reviewed.

Affective Disorders, Psychotic↗
PubMed1991

[The structural-dynamic characteristics of the reactive psychoses in persons subjected to ionizing radiation exposure as a result of the accident at the Chernobyl Atomic Electric Power Station].

Thirty case histories were examined of patients who participated in liquidation of sequels of the Chernobyl disaster or inhabiting contaminated territory during the first months after the catastrophe. Of them eleven showed reactive states accompanied by psychopathological disorders. The psychotic disorders in these subjects were simple and concrete by their clinical course, developed mainly during the first 2-4 months after the disaster when the stressogeneity was maximal. This conclusion is confirmed by the fact that of 148 persons subjected to radiation effects and treated at a Kiev Mental hospital from 1986 through 1990 reactive psychoses were observed only in 11 cases.

Accidents↗