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PubMed1979

Action of d-propranolol in manic psychoses.

Six manic patients were treated with high doses of d-propranolol or d- and dl-propranolol in a double-blind, placebo controlled study. The following variables were measured: propranolol dosage, propranolol serum concentration, pulse frequency, blood pressure, and psychotic behavior. In all cases an improvement was noticed. High dosages were necessary to obtain sufficient effect. The antimanic property of d-propranolol was approximately 50% smaller than the antimanic property of dl-propranolol. We conclude that at least some part of the antimanic action of beta-blockers is independent from the beta-blocking property.

Adult↗
PubMed1982

[The EEG of patients with acute manic psychoses before, during and after treatment with high doses of d-propranolol and dl-propranolol (author's transl)].

Six manic patients, drug-free for at least 10 days, were treated with high doses (up to 3,000 mg/day, corresponding serum levels up to 1,600 ng/ml) of d-propranolol or dl-propranolol in a double-blind, placebo-controlled study. The EEG's of these patients were studied over a maximum period of 21 days. All 82 EEG's were normal, they showed neither epileptic patterns nor any other signs for hypersynchronisation, as a possible side-effect of propranolol, nor other abnormalities, due to the manic condition. Analysis by fast-fourier-transformation produced no difference between the effect of d-propranolol or dl-propranolol on EEG compared intra- and inter-hemispherically by power-spectra, cross-spectra, phase-differences and coherences. At high serum levels (more than 1,000 ng/ml) there was a corresponding increase of power and a drop in frequency of the alpha-activity, maximally--1.1 c/s, which probably depended on the serum level. This result is in agreement with the hypothesis of a direct antimanic effect of the drug and comparable to the clinical effect of lithium, which produces similar changes in EEG. A comparison of the propranolol-induced EEG changes with EEG changes usually induced by sedative drugs, contradicts the hypothesis that the antimatic properties of propranolol are caused by unspecific sedation.

Adult↗
PubMed1983

Anxiety in schizophrenic psychoses.

Anxiety and depression were assessed with self-rating and observer-rating scales on admission and at discharge in 225 inpatients with hebephrenic, catatonic, paranoid or residual schizophrenia. The control subjects were 104 patients with endogenous depression and 63 with anxiety neurosis. The results were also compared with findings for a reference group of 2493 inpatients with a wide range of psychiatric disorders and a representative sample of the general population consisting of 1952 persons. On admission the group of schizophrenic patients was markedly more anxious than the group of healthy persons, slightly less anxious than the psychiatric reference group and much less anxious than the group with endogenous depression and anxiety neurosis. Anxiety correlated significantly with acute paranoid symptoms, whereas depression dominated just prior to discharge, when the acute symptoms had subsided. This indicates that anxiety is a consequence of the underlying schizophrenic disorder and also that the psychotic symptoms may not be a defense against anxiety.

Adult↗
PubMed1985

Stability of psychotic symptomatology (delusions, hallucinations), affective syndromes, and schizophrenic symptoms (thought disorder, incongruent affect) over episodes in remitting psychoses.

A study was made on 140 schizophrenics, 40 schizoaffectives, 59 unipolar depressives, and 30 bipolar affective disorder patients in order to determine the quality of psychopathology over multiple episodes. The schizoaffectives were the most likely to have multiple episodes. Among the schizophrenics, there were few episodes that lacked psychotic symptoms, but almost half of the episodes for the schizoaffectives were associated with an absence of psychotic symptoms. Three-quarters of the patients with unipolar depression and bipolar illness showed no psychotic symptoms either congruent or noncongruent. There was a striking finding that all diagnoses were associated with a decrease in psychotic symptoms over time. These psychotic symptoms (delusions and hallucinations) became particularly more scarce among the schizoaffectives, unipolars, and bipolars. There was a 50% to 67% decrease of episodes with psychotic symptoms as more episodes occurred. For schizophrenia and schizoaffective disorder the first ten episodes were very similar to each other for affective syndromes, formal thought disorder and/or incongruent affect, and delusions and hallucinations. It was not until much time had passed that the symptom pictures changed.

Adult↗
PubMed1984

[Social integration and contacts to reference persons of the normal social environment in inpatient treatment in the psychiatric hospital. A prospective catamnestic study of patients admitted for the first time with schizophrenic and cyclothymic psychoses].

Fifty first-admission inpatients (27 women, 23 men; mean age 35.1 years) with schizophrenia (n = 35) or affective disorders (n = 15) participated in a standardized, half-open interview about contact with people outside the hospital. The frequency of contact was compared with outcome, as based on a 1-year follow-up. Nearly all patients (48 of 50) had "direct" contact with relatives and friends during the week (means = 3/week): 45 patients had visitors, 13 went home on weekends. Thirty-five patients had contact with the outside by telephone, and 21 by letter; only 12 patients indicated no "indirect" contact. The frequency of contact had no relationship to sex, age or diagnosis. The significant factors were: structure of the patient's family, his/her educational and occupational level, social network, means of admission, conditions of hospitalization, and length of stay. The distance between the patient's residence and the hospital markedly influenced the frequency of visits and weekend holidays. The importance of frequent interaction with the usual social environment was verified by follow-up: 11 patients with rare or only average contact had unfavorable results (readmission or suicide by 1 year after discharge or long-term hospitalization); on the other hand, none of the patients with frequent direct contact outside the hospital showed poor results. There is no reason for indiscriminate criticism of the relatives of psychiatric inpatients according to etiological hypotheses of "family research"; above all, patients without relationships with a family or friends have to be regarded as at risk.(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗