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PubMed1981

[Comparative characteristics of the preventive properties of short-acting and delayed-action lithium carbonate in endogenous affective psychoses].

The use of prolonged-action lithium carbonate preparations (quilonormretard and micalite) in 53 patients with manic-depressive psychosis and schizophrenia has shown that those drugs possess pronounced prophylactic properties. An open, two-stage control examination of 35 patients has demonstrated an advantage of the prolonged-action lithium carbonate preparations over instant-action ones in preventing relapses of affective and schizoaffective psychoses. Peculiarities of the prolonged-action lithium carbonate preparations on the quantitative and qualitative characteristics of the disease course are discussed.

Adult↗
PubMed1981

Tuberous sclerosis in the aetiology of the so-called idiopathic epilepsies and psychoses.

Ten suspected cases of tuberous sclerosis seen over a period of 4 1/2 years are described. Investigations were carried out in a general practice setting. The place of tuberous sclerosis in the so-called idiopathic and functional psychoses is discussed and an additional aetiological mechanism is postulated. A skin test is suggested to determine the presence of this condition in a shorter period of time.

Adult↗
PubMed1983

[Clinico-epidemiologic characteristics of endogenous psychoses with depressive episodes].

A randomized sample of patients with endogenous psychoses marked by depressive attacks was examined by the clinicoepidemiological method. A comparative analysis of the major clinico-statistical characteristics, constituting this group of diagnostic forms, was carried out, showing a considerable homogeneity of the underlying pathogenetic mechanisms. Such clinical signs as the premorbid personality make-up of the patients, the age at the onset of the disease, the character of the premanifest period, the structure of the depressive syndrome, and the sex of the patients were disclosed to be of prognostic value.

Adult↗
PubMed1981

[Present trends in biological psychiatry research on psychoses (author's transl)].

Most of the present biological hypothesis postulate biogenic amines disorders in schizophrenia: transmethylation and dopaminergic theory. Other systems which can modulate this neuro-transmitter, specially in the mesolimbic dopaminergic system, may be concerned: nor-epinephrine, serotonin or endorphins. A dysfunction in arousal and cerebral dominance has been described by the quantitative electroencephalography. Other electrophysiological studies are consistent with these results; they indicate an impairment of the level of arousal to which the disorders of attention and adaptation could be related. In affective psychoses the major hypothesis bear on norepinephrine or serotonin disorders. But other substances may have a role: acetylcholine and dopamine as well as electrolytic modifications of cell membranes or immunological or neuroendocrine disturbances. This biological and physiological fundamental research has numerous practical consequences as the discovery of compounds with a more specific effect, the research of biological and biochemical diagnostic indices, or the drawing up of biological indices for neuroleptics, antidepressants or lithium sensitivity.

Affective Disorders, Psychotic↗
PubMed1982

[Under what conditions can further course research still be expected to produce new knowledge on endogenous psychoses?].

Exhaustive follow-up studies of schizophrenia from Zürich, Bonn and Lausanne have produced strikingly similar results, despite considerable methodological differences. These 'classical' modes of differentiating the endogenous psychoses are critically analyzed. In contrast, the application of the operational research criteria recently developed by American authors results in a narrowing of the concept of schizophrenia and a proportional broadening of the cyclothymic disorders. Use of the Viennese research criteria, the definition of an 'axial syndrome' of schizophrenia, has the identical nosological effect. While the American diagnosis is phenomenological and essentially 'atheoretical', the Viennese view is based on the hypothesis of a core disorder. Further comparative polydiagnostic studies are called for in order to determine the relative value of these various research instruments.

Diagnosis, Differential↗
PubMed1978

[The "inter" and the role (conditional analysis of endogenous psychoses)].

The relations of the individual to others and to the family are understood by the concepts "intersubjective" and "interfamiliar". This "inter" is always the origin of the relations of subjects. The "inter" is a reality which is of an atmospheric pneumatic nature respectively. Its creative power and its primateship for the word is clarified by a selection of examples from oriental and occidental cultures. On the other hand, the relations of the individual is determined by norms, in which the "objektive Geist" (Hegel) of a time is manifested. The individual is in this relation first of all a carrier of roles. A conditional analysis of psychotic disturbances has to proceed from a conception that the individual's psyche in both spheres, is not a "tabula rasa" (Locke), but always already conveys a selection of that which has been offered in the situation (Leibniz). Out of this result constellations of a conditional nature for the development of endogenous psychoses, exhibiting themselves in the Inter-shere and Role-sphere. These can only develop where a coherence of specific personality-structures with specific situations are present. What makes such situations pathogenic, is all a specific inference of meaning from peristatic precipitations. It is this that makes a situation into what it actually is for a certain type.

Humans↗
PubMed1978

[Significance of environmental factors for the development of schizophrenic psychoses].

Various factors of environment are analyzed by means of literature with regard to their significance for the development of schizophrenic psychoses. These factors are classified as follows: family situation, ecological factors, stress situations, professional situations, transcultural points of view, extraordinary circumstances. Although there are a great number of analyses, they partly come to different, even opposite results. Yet most authors agree in recognizing the influence of factors of environment on the development of schizophrenias.

Cross-Cultural Comparison↗
PubMed1978

[Lithium in the prevention of manic-depressive and schizo-affective psychoses].

The brilliant results obtained with lithium carbonate in the prophylactic treatment of manic-depressive (MDP) and schizoaffective (SAP) psychoses over almost five years are reported. The series includes 53 patients, 46 of them suffering from MDP and 7 from SAP. In the majority of cases, the lithium dose used was 900 mg/die and lithaemia was 0.564 +/- 0.0632 mEq/1. The parameters considered were the number of attacks, their intensity and duration; therapy, if any, with traditional psychodrugs (neuroleptics and antidepressants); the number of hospitalizations and their duration. Results were valuated by comparing an equal period of time before and during therapy with lithium. In MDP the number of attacks fell 74.25% and their duration by 83.14%; severe attacks responded better to treatment, with a reduction of 94%. The quantity of traditional psychodrugs used was reduced by 66.42%. The number of hospitalizations fell 75% and days admitted by 80%. In SAP the results were even better: the number of attacks fell by 87.5% and their duration by 94.7%; serious attacks disappeared completely and the quantity of traditional psychodrugs used fell by 57.06%. The number of admittances fell 75% and days in hospital by 97%.

Adult↗
PubMed1980

[Genetic markers of atypical phasic psychoses].

The 93 patients of the present study resemble each other in their psychosis by phasic course and complete recovery. Frequently the attacks showed an anxious and paranoid syndrome in monopolar repetition or in bipolar change with ecstatic symptoms. Rarely an incoherent state of agitation or stupor could be observed. Considering the distribution of simple inherited serum groups, there is a significant increase of Gc 1-1 and Hp 2-2 in the patient collective. Evidently these serum groups are risk components in a multifactorial hereditary system possessing with Gc 1-1 a marker of the schizophrenic disposition and with Hp 2-2 a determinating trait for affective psychoses. A selective interaction is discussed for both serum groups regarding the vitamin D transport of the Gc fraction with their relation to enuronal function and the possible role of Hp 2-2 in a transport or regulatory system.

Adult↗
PubMed1980

[Intensive therapy of endogenous psychoses].

A reduction of hospital stay facilitates the readaptation of mental patients. One of the conditions for implementing short hospitalization is the intensity of biological treatment: intravenous drip administration of drugs with a rapid increase of doses, rapid neuroleptization, and combination of psychotropic drugs with methods of a general biological influence. A study of 100 patients treated by the routine way demonstrated that intensive therapy significantly reduces the time of hospitalization and promotes remissions. The studies showed that intensive therapy is desirable only in acute psychoses and during the early stages of its development.

Acute Disease↗
PubMed1980

[Features of the clinical picture and course of schizoaffective psychoses in adolescents].

The clinical follow-up study of 181 adolescent patients, suffering from so-called schizoaffective psychoses allowed 3 main variants to be singled out on the basis of the clinical symptoms and features of the disease course: in the first variant the clinical picture and disease course were very similar to those of the manic-depressive syndrome; in the second one the clinical symptomatology was characterized from the disease onset by the presence of the depressive-paranoid syndrome, and the third variant was characterized by delusional symptomatology in a bipolar circular disease course.

Adolescent↗
PubMed1995

Orphans of the 'Real': II. The future of object relations theory in the treatment of the psychoses and other primitive mental disorders.

Objective relations theory is a broad, multifaceted concept that covers a number of differing paradigms. The author highlights the historical development of this concept. Originally developed by Freud and Abraham, it gradually became a shibboleth that identified both the Kleinian and the Independent schools in Great Britain and the object relations school within the American school of ego psychology. The two British schools differed between each other and from the American school. Among these schools of thought, two major paradigms have emerged: (1) the one-person psychoanalytic model, and (2) the two-person model. More recently, derivatives of the two-person model have emerged as the schools of relationism, self psychology, and intersubjectivity. In addition, the contributions of the Lacanian school have altered concepts about the fundamental nature of object relations. What is consequently at issue in terms of the psychoanalytic conception and treatment of psychoses and primitive mental disorders (with patients suffering from being "orphans of the 'Real'") is (1) the differing conceptions of what is meant by internal objects, part-objects, selfobjects, and object-representations, and (2) the differing conceptions of unconscious mental life.

Freudian Theory↗
PubMedDate not supplied

[Diagnosis and differential diagnosis of endogenous psychoses].

This paper describes development of concepts of diagnosis and differential diagnosis between endogenous psychoses: schizophrenia and depression. It explains the most important concepts of classification founded on different assumptions. Essential factors which influence diagnosis and differential diagnosis such as prognostic, psychopathology, drug response and anatomopathology were presented. Apart from concepts presuming exact differential diagnosis between schizophrenia and depression, more current resolution of the problem was presented: differential typology instead of differential diagnosis. The conclusion is that classification which closely relates diagnosis to clinical practice (treatment) is most valuable.

Diagnosis, Differential↗
PubMed1995

Efficacy of risperidone treatment for psychoses associated with schizophrenia, schizoaffective disorder, bipolar disorder, or senile dementia in 11 geriatric patients: a case series.

BACKGROUND: Clinical trials of risperidone, a recently approved novel antipsychotic, included elderly healthy patients, but more data are needed on the effects of risperidone in this population, especially those with comorbid medical illnesses. METHOD: Risperidone was used to treat 11 elderly hospitalized patients between 61 and 79 years of age who manifested signs of psychoses related to schizophrenia, schizoaffective disorder, bipolar disorder, or senile dementia. All patients had been treated previously with classic antipsychotics. Response was assessed by clinical observation of the patients' behavior. RESULTS: Eight patients responded to treatment, 1 did not respond, and 2 had treatment discontinued because of hypotension or dizziness. Positive and negative symptoms decreased markedly in 7 of the responding patients. Four patients had preexisting extrapyramidal symptoms (EPS) and symptoms of tardive dyskinesia that also decreased in response to risperidone treatment. In addition, 4 patients were able to discontinue anti-parkinsonian medications, and 2 were able to discontinue antihypertensive medications. Side effects related to blockade of dopamine, histamine, and serotonin were negligible. No adverse consequences occurred when electroconvulsive therapy, carbamazepine, or lithium was given concurrently. CONCLUSION: The reduction of both positive and negative symptoms of schizophrenia and the lack of significant EPS, tardive dyskinesia, sedation, and anticholinergic side effects indicate that risperidone is a safe and effective medication for the elderly.

Aged↗
PubMed1979

[Initial disorders and premorbid personality characteristics in delusional psychoses].

In compliance with a special list of standartized signs, the nozological and typical differences in initial and premorbid personality traits were studied. These symptoms were correlated in 407 patients with delusional psychoses in the framework of schizophrenia, symptomatic disorders and epilepsy. The signs were assessed in accordance to the degree of their probability. The report contains a description of the most probable traits having a prognostical and differential diagnostical significance.

Delusions↗
PubMed1993

Double-blind comparison of risperidone and haloperidol in schizophrenic and schizoaffective psychoses.

A double-blind eight-week study was carried out to compare the efficacy and safety of risperidone in relation to haloperidol. Sixty-two inpatients suffering from acute schizophrenic or schizoaffective psychoses diagnosed according to ICD-9 were treated with risperidone 2-20 mg daily or haloperidol 2-20 mg daily. The mean total BPRS scores were reduced from 45.5 to 32.4 in the risperidone group and from 43.1 to 28.5 in haloperidol group. There were no significant differences between the two treated groups with regard to the total BPRS score and the percentage of remissions achieved. No statistically significant difference was found between the groups in any of the factors or items except guilt feeling (p < 0.02), anxiety (p < 0.005), and factor I--anxiety/depression--(p < 0.02) in favour of haloperidol. Risperidone had the benefit of a lower incidence of extrapyramidal side-effects.

Adult↗
PubMed1995

Clozapine use in female geriatric patients with psychoses.

This study was undertaken to evaluate the clinical response of geriatric patients with psychoses to the atypical neuroleptic drug, clozapine. Records of patients over 60 years of age (n = 12, all female) who had received clozapine over a 30-month period from selected hospitals in Western Pennsylvania were reviewed. Among the six patients who were rapidly titrated (300 mg/day in 3 weeks), none are currently receiving clozapine, while four patients who received a slower titration and lower dosage (range, 25 mg/day to 300 mg/day; mean, 150 mg/day) remain clinically improved on stable doses of clozapine. Postural hypotension affected seven patients, and was the reason for discontinuation of clozapine in five patients. One patient experienced nonfatal agranulocytosis, and one subject experienced leukopenia. One patient died from causes unrelated to clozapine. This retrospective study suggests both a low-dose and slow-titration strategy for initiating clozapine among elderly patients, similar to the use of other psychotropic drugs in the elderly, as well as close attention to postural hypotension, agranulocytosis, and drug interactions.

Aged↗
PubMed1994

[The clinico-psychopathological differentiation of schizoaffective psychoses with a predominance of affective disorders].

Basing on the clinico-psychopathological analysis of 43 patients with an affect-dominant form of schizoaffective psychosis, their typological division has been suggested. The interrelations of clinical types of delusional disturbances with affective disorders, their polarity, congruent and noncongruent delusions were shown. The discussion covers differential-diagnostic characteristics of affective states in schizoaffective and affective psychoses.

Adult↗