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Biomedical subjects

B Wistedt

Publications and source records attributed to B Wistedt.

At least 19 recordsLinked to original sources
PubMed2000

The effect of citalopram treatment on platelet serotonin function in panic disorders.

We investigated the effect of the selective serotonin reuptake inhibitor (SSRI) citalopram after 6-8 weeks and 6 months of treatment on clinical and peripheral indexes for central serotonergic function: platelet [14C]serotonin uptake and [3H]paroxetine- and [3H]LSD-binding to platelets membranes in 33 patients with panic disorder. Basal data from patients were compared with data from a control material consisting of 33 healthy volunteers. Bmax for platelet [3H]paroxetine binding was significantly lower in patients than in controls. There were no differences in serotonin uptake or [3H]LSD-binding between patients and controls. The degree of anxiety and depression was assessed using the Beck Anxiety Inventory (BAI) and Beck Depression Inventory self-assessment scales, and the Clinical Anxiety Scale and the Montgomery Asberg Depression Rating Scale for clinical evaluation. Complete remission was found in one third of the patients after 6-8 weeks and in two-thirds after 6 months of treatment. The reduction in assessment scores was parallelled with similar reductions in platelet 5-HT2-receptor density, [3H]LSD affinity variable (Kd) and Vmax for platelet [14C]5-HT uptake. Citalopram treatment did not alter Bmax and Kd for platelet [3H]paroxetine-binding. A positive correlation was found between Vmax for the platelet [14C]5-HT uptake and BAI after 6 months citalopram treatment. The present study shows that citalopram has a therapeutic effect in panic disorders. A prerequisite of responding to treatment might be plasticity in the serotonergic system.

Adult↗
PubMed1995

Changes in the pattern of aggressive behaviour among inpatients with changed ward organization.

Aggressive behaviour by psychiatric inpatients was investigated on the same ward during two separate 6-month periods before and after a 50% decrease in number of beds but without changes in catchment area. Character of the patient group, patient turnover and medical practices as well as total number of staff on duty on the ward was virtually the same during the two periods. It is therefore assumed that differences in aggressive behaviour are mainly explained by effects due to the decreased number of beds per se. It was found that the 50% reduction did not affect the overall aggression frequency. However, inter-patient violence increased while the number of more severe aggressive incidents towards staff members decreased.

Adolescent↗
PubMed1995

Involuntarily detained HIV-infected patients in Sweden: reasons for referral and psychiatric diagnoses.

The Swedish Communicable Diseases Act permits the isolation of an HIV-infected person if there is risk of disease transmission. The purpose is for the patient to receive the support needed to alter his or her attitude and behaviour so that the isolation can be terminated. This study describes the reasons for referral and the psychiatric diagnoses of 34 isolated HIV-infected patients. All patients who were isolated in Stockholm from 1986 to 1993 were included. Psychiatric data were collected from their psychiatric records. The most frequent reason for referral was unprotected sex with a partner who was not informed about the infection. The most common psychiatric diagnosis was amphetamine or opiate abuse. Drug users without delusions and immigrants with adjustment disorders or post-traumatic stress disorder had the shortest treatment periods. All patients belonged to underprivileged groups, were drug users or refugees. More effort is needed to teach these groups about HIV.

Adult↗
PubMed1992

Serotonin, panic disorder and agoraphobia: short-term and long-term efficacy of citalopram in panic disorders.

A serotonin-anxiety connection has been widely recognized. In panic disorder (PD), however, most researchers have emphasized noradrenergic mechanisms. Serotonin related findings in PD, e.g. the documented antipanic potential of selective serotonin reuptake inhibitors (SSRIs), are reviewed, lending support for a serotonergic deficit contributing to the pathophysiology of PD. Since citalopram is the most selective SSRI described, it was chosen as a tool for testing whether the serotonin reuptake inhibition per se is responsible for this antipanic effect. Twenty patients with PD with or without agoraphobia (DSM-III-R criteria) were treated openly with citalopram and assessed with CAS, MADRS, SCL-90 the Agoraphobia Scale, other self-ratings, and a panic diary. Thirteen of the 17 patients completing 8 weeks of treatment were judged as responders. The response seemed similar to or better than that seen with other antidepressants. The response covered broad aspects of morbidity, e.g. anticipatory anxiety, agoraphobia and somatization. In the first week, a transient increase of panic-related symptoms was observed. Sixteen of the patients were enrolled in a 15 months' study of long-term maintenance treatment; 11 patients completed this phase. The gains were maintained during this follow-up, and further improvement was observed. Side-effects were similar to those of other SSRIs and mostly mild. For instance, weight-gain was not associated with citalopram treatment. The results support the hypothesis that serotonin reuptake inhibition is essential for the antipanic effect of antidepressants as well as for the initial paradoxical increase of anxiety often seen with these drugs. Thus, an initial deterioration, possibly due to transient decrease of serotonin transmission, turns to improvement when serotonergic potentiation has occurred.

Adult↗
PubMed1991

Zuclopenthixol decanoate and haloperidol decanoate in chronic schizophrenia: a double-blind multicentre study.

Zuclopenthixol decanoate (ZPT-D) and haloperidol decanoate (HAL-D) were compared in the maintenance treatment of chronic schizophrenic patients. All patients were treated with either ZPT-D or HAL-D for at least 3 months and were then randomly allocated to treatment with either ZPT-D (100-600 mg every 4 weeks) or HAL-D (38-200 mg every 4 weeks) for 9 months. Sixty-four patients entered the study. Three patients were only assessed at baseline. Four patients in the HAL-D group were withdrawn because of deterioration. One patient in the ZPT-D group committed suicide. Fifty-six patients completed the trial. The assessment programme comprised Clinical Global Impressions by psychiatrists and nurses, the Brief Psychiatric Rating Scale (BPRS), Montgomery-Asberg Depression Rating Scale (MADRS), UKU Side Effect Scale and Simpson-Angus Scale, Ratings were made at baseline and after 12, 24 and 36 weeks of treatment. The severity of illness scores remained almost constant. The only between-group difference was recorded at month 6 in favour of ZPT-D. The BPRS total scores were reduced significantly in both groups with no between-group differences. The depression scores on the MADRS were very low. Both treatments caused few and mild side effects according to the UKU Side Effect Scale and the Simpson-Angus scale, and there were no significant differences between the groups. Both ZPT-D and HAL-D seem to be effective in the maintenance treatment of chronic schizophrenic patients and cause few side effects. The injections of ZPT-D and HAL-D can be given at 4-week intervals.

Adult↗
PubMed1991

The relationship of crowding and aggressive behavior on a psychiatric intensive care unit.

During a 25-week period, all incidents of aggressive behavior in a 19-bed psychiatric acute care unit were systematically recorded using the Staff Observation Aggression Scale. Forty-seven of the 163 patients admitted to the unit were aggressive on 119 occasions. Of these incidents, 100 were physical attacks on another person, and 95 were perpetrated by 23 patients. The patients were predominantly aggressive without visible provocation or were provoked by staff's denying a request. An increased number of patients on the ward significantly increased the likelihood of aggressive behavior, especially by patients with schizophrenia or schizophreniform disorder.

Acute Disease↗
PubMed1990

The development of an observer-scale for measuring social dysfunction and aggression.

Scales for measuring aggressive cognitions and behaviour have mainly been administered by nursing-staff or been self-ratings. During recent years we have made an attempt to construct an observer-scale for aggression analogous to the Hamilton scale for depression. The Social Dysfunction and Aggression Scale (SDAS) consists of 9 items (SDAS-9) covering outward aggression and 2 items (SDAS-2) covering inward aggression. The inter-observer reliability of the SDAS has been found adequate in terms of intra-class coefficients. In a pilot study on 82 inpatients from different centres in Denmark and Sweden the SDAS was compared to three-item scales for outward and inward aggression and to a global scale for outward aggression. The results showed that the SDAS-9 correlated positively with the other outward observer-scales, and the SDAS-2 with the other inward scale. A divergent validity was seen between the outward and inward scales, indicating that it is necessary to measure both dimensions. Preliminary ranks-according-to-frequency scores showed the following order of the nine outward items: irritability, dysphoric mood, social disturbances, nondirected verbal aggressiveness, negativism, directed verbal aggressiveness, physical violence towards staff, physical violence towards things, and physical violence towards persons other than staff.

Aggression↗