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Biomedical subjects

B Spivak

Publications and source records attributed to B Spivak.

15 recordsLinked to original sources

Acute transient stress-induced hallucinations in soldiers.

Three cases of stress-induced hallucinations in young soldiers are described. The hallucinatory experience was not accompanied by gross psychopathology. The phenomenology and psychopathological implications of hallucinations following exposure to environmental stress are discussed.

Adolescent

Delayed amnesia and disorientation after electroconvulsive treatment.

Memory-related effects of electroconvulsive therapy (ECT) are known to appear immediately after the treatment. The case of a 39-year-old woman who underwent a course of ECT because of a recurrent major depressive disorder is described. After a symptom-free period of 48 hours, transient amnesia developed. Her condition appeared to be associated with the electroconvulsive therapy, thereby raising questions about its pathogenicity and management.

Adult

Haloperidol and lithium carbonate treatment did not influence serum immunoglobulin levels in schizophrenic and affective patients.

Serum immunoglobulin levels were studied in 153 psychiatric patients (87 schizophrenic, 48 bipolar and 18 unipolar patients), and 35 healthy controls. Psychotropic treatments (haloperidol in the schizophrenic patients and lithium in the bipolar affective patients) did not alter serum immunoglobulin levels. Decreased mean IgM serum level was detected in the major affective patients (unipolar and bipolar) compared with normal controls. Nonspecific environmental, infectious, autoimmune and emotional factors that can play a role in the alterations obtained in psychiatric patients are discussed.

Adolescent

True conversive hallucinations.

A case of true conversive hallucinations in a 19-year-old female soldier is described. This phenomenon is rare and should be distinguished from psychotic or dissociative states.

Adult

Cold agglutinin autoantibodies in psychiatric patients: their relation to diagnosis and pharmacological treatment.

BACKGROUND AND METHOD: The purpose of this study was to compare titers of cold agglutinins in schizophrenic patients with those in patients with major affective disorders and in normal healthy subjects. One hundred sixty-six psychiatric patients and 37 healthy comparison subjects were included in the study. Ninety of the patients suffered from schizophrenia, 54 from bipolar disorder, and 22 from major depression. Venous blood samples were obtained from all subjects between 8:00 and 10:00 a.m. and were immediately tested for cold agglutinin titers. RESULTS: A high frequency (42.2%) of positive cold agglutinin titers was detected in the schizophrenic patients, compared with the bipolar (11.1%) and unipolar (9.0%) patients and the comparison group (8.1%). The investigators did not find any pharmacological effect on these results. CONCLUSIONS: The findings suggest that, at least in this group, positive cold agglutinin titers are associated with schizophrenia. However, this observation cannot provide direct evidence for the involvement of viral or autoimmune factors in schizophrenia.

Adult

Paranoid schizophrenia in adolescence.

BACKGROUND: Paranoid schizophrenia is considered to be a rare condition in adolescence. Since this is contrary to the authors' clinical experience, they hypothesized that a controlled study would show that a significant number of adolescents would be diagnosed with paranoid schizophrenia and that scores from the childhood version of the Schedule for Affective Disorders and Schizophrenia (K-SADS) would differentiate between the paranoid schizophrenic adolescents and adolescents with other types of schizophrenia or with affective disorder. METHOD: The authors conducted a prospective study of 120 adolescents admitted consecutively to an adolescent psychiatric inpatient department. Patients were diagnosed on the basis of DSM-III after an 8-week period during which they were evaluated with a structured psychiatric history and psychiatric examination, the K-SADS, repeated nonstructured interviews, and extensive ward observations. RESULTS: Thirty-eight percent of the schizophrenic adolescents and 14% of the total hospitalized population met the DSM-III criteria for paranoid schizophrenia. The symptom profile of the paranoid schizophrenic adolescents clearly distinguished them from adolescents with other psychiatric disorders. CONCLUSIONS: Given the incidence of paranoid schizophrenia in an adolescent population, adolescent psychiatrists are likely to encounter this disorder. DSM-III-R should be used in future studies to further clarify the issue of the prevalence of paranoid schizophrenia in adolescents.

Adolescent

Neuroleptic malignant syndrome during abrupt reduction of neuroleptic treatment.

Development of neuroleptic malignant syndrome (NMS) following discontinuation of high-dose and high-potency neuroleptic agents is described. This case, although rare and atypical, should alert clinicians to consider the possibility of NMS as a complication of abrupt neuroleptic drug withdrawal. It is suggested that dopaminergic imbalance, as opposed to excessive dopaminergic blockade, may also play a role in the precipitation of NMS.

Adolescent

Prolonged fear of AIDS as an early symptom of schizophrenia.

A modern complaint--fear of AIDS--is making its way into the world of psychopathology and is becoming a symptom of a wide range of psychiatric disorders, including severe ones. We present a case of a young man who developed a pathological bizarre preoccupation of having AIDS and underwent various unnecessary medical procedures, until finally he was diagnosed as suffering from a paranoid schizophrenic disorder. With the high media profile that AIDS has achieved in recent years, it is expected that AIDS has become the object of psychopathological processes. However, the length of time elapsed between the onset of symptoms and the appropriate psychiatric diagnosis, despite being examined by other medical professionals, is surprising. The discussion focuses on the diagnostic questions and on issues related to primary and secondary psychiatric prevention.

Acquired Immunodeficiency Syndrome

Primary hyperparathyroidism, psychiatric manifestations, diagnosis and management.

Mental manifestations of primary hyperparathyroidism simulate a wide spectrum of psychiatric disorders. Definitive surgical treatment results in long-lasting full recovery. The 2 cases presented demonstrate this. The clinical diagnostic and therapeutic aspects of primary hyperparathyroidism, with an emphasis on neuropsychiatric manifestations, are discussed. Early diagnosis of hypercalcemia can prevent unnecessary and potentially harmful treatment with antidepressive, anxiolytic or antipsychotic drugs, which can further depress the cognitive state of the patients, and can aggravate the mental symptoms.

Aged

Cold agglutinin titers in psychiatric patients.

Cold agglutinin titers were obtained from the serum of 41 psychiatric patients. The 21 chronic schizophrenic patients tended to have positive cold agglutinin titers; the authors suggest that this immunological finding may be associated with long-term neuroleptic treatment.

Adult