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D L Copolov

Publications and source records attributed to D L Copolov.

At least 73 records · Page 4Linked to original sources

The diagnostic validity of paraphrenia.

It remains a matter of conjecture as to whether a schizophrenia-like syndrome commencing in old age differs from the early-onset disorder in any substantial way. This article reviews both the historical background to the concept of defining paraphrenia as a distinct entity, as well as the current controversies concerning whether it should remain a separate entity: the latter is important as paraphrenia has not been included in the DSM III-R and ICD 10 classification systems. Clinical parameters and aetiological factors relevant to an understanding of the syndrome are discussed under the rubrics of descriptive and construct validity. Of particular importance are the role of cerebral organic factors and the pathoplastic effect of the ageing process and how both interface with the development of psychotic symptoms. Whilst the course of this syndrome has been considered relatively benign, outcome studies have yet to establish consistent features that provide a basis to determine predictive validity.

Aged↗

Comparison of participants and nonparticipants in a neuroendocrine investigation of psychosis.

Of all neuroleptic-naive, acutely psychotic subjects admitted to hospital over a 2-year period (n = 62), 27 participated in a neuroendocrine study and 35 did not participate (51% refused consent, 19% were incapable of consent and 31% started neuroleptics immediately). However, all nonparticipants agreed to psychopathological evaluation, thus allowing comparison between participants and nonparticipants. The 2 groups were similar in most respects, except that more nonparticipants were hostile. Among subjects with schizophrenia, 47% of nonparticipants had the paranoid subtype vs 8% of participants. There was also a trend towards longer illness duration in nonparticipants. These results underline the need for neurobiological studies of psychosis to consider sample bias as a confounding variable.

Adult↗

Inhibition of [3H]dopamine uptake by platelets by the dopamine-D2 receptor agonist RU 24926.

We have examined the effect of the dopamine-D2 receptor agonist RU 24926 (N-n-propyl-di-beta(3-hydroxy-phenyl)-ethylamine HCl) on [3H]dopamine uptake by human platelets. RU 24926 reduced the uptake of [3H]dopamine by platelet-rich plasma and this affect was not reversed by the dopamine-D2 receptor antagonist haloperidol, or the dopamine-D1 receptor antagonist SCH 23390 (8-chloro-2,3,4,5-tetrahydro-3-methyl-5-phenyl-1H-3-benzazepine-7-ol). These data suggest that RU 24926 reduces [3H]dopamine uptake by platelets by competing for the dopamine uptake mechanism on the platelet and not by activation of the dopamine-D2 receptor.

Benzazepines↗

Forskolin-induced immunoreactive atrial natriuretic peptide (ANP) secretion and pro-ANP messenger ribonucleic acid expression of hypothalamic neurons in culture: modulation by glucocorticoids.

In the present studies the chronic effects of glucocorticoids and drugs activating cAMP-dependent pathways on the production and secretion of immunoreactive (ir) ANP from long term monolayer cultures of neonatal rat hypothalamic neurons were examined. Forskolin treatment increased ir-ANP release in a time-dependent and dose-related manner, with an EC50 of approximately 30 microM; at a lower dose of 10 microM, forskolin doubled ir-ANP release (P less than 0.01) compared to that in control cultures (mean +/- SEM, 9.6 +/- 0.3 pg/well; n = 4). While dexamethasone (DM) alone did not affect basal secretion of ir-ANP, 10 nM of the glucocorticoid significantly enhanced the effect of forskolin (10 microM) by raising ir-ANP release approximately 3 times that induced by forskolin alone (P less than 0.001). This potentiation of DM was both time dependent and dose responsive, with an EC50 of 1 nM; this effect was significantly suppressed by 100 nM RU38486, a glucocorticoid or type II receptor antagonist, but not by RU28318, a mineralocorticoid receptor antagonist. In addition, forskolin (10 microM) or DM (10 nM) alone significantly increased ir-ANP production approximately 1.4 times (P less than 0.05) and 1.3 times (P less than 0.05) over that of control cultures, respectively, whereas concurrent treatment with forskolin and DM increased ir-ANP production by approximately 1.8 times (P less than 0.01). These changes were reflected by a corresponding increment in the abundance of pro-ANP mRNA in the cultures, as demonstrated by Northern blot analysis. We conclude from the present findings that glucocorticoid- and cAMP-dependent pathways may modulate the function of ANP neurons in rat hypothalami by regulating the secretion and production of the neuropeptide at the genomic level.

Animals↗

Evidence for atrial natriuretic peptide-(5-28) production by macrophages of the rat spleen: an immunochemical and nonradioactive in situ hybridization approach.

Atrial natriuretic peptide (ANP), a 28-amino acid peptide, is produced and secreted by cardiac atriocytes to modulate cardiovascular functions. Recently, biologically active receptors for ANP have been demonstrated in the spleen; we report here the production of ANP-(5-28) and its 15-kDa (K) mol wt (Mr) presumptive precursors by macrophages of rat splenic tissues. Splenic, hypothalamic, and heart tissues were collected from adult male Sprague-Dawley rats and acid extracted for ANP assay. The splenic content of immunoreactive (ir) ANP (mean +/- SEM, 428 +/- 68 pg/tissue; n = 7) was approximately a fifth of that found in the hypothalamus and about 4 orders of magnitude lower than that in the heart of the same animals. The Sephadex G-50 column profile of splenic extracts revealed two immunoreactive peaks; the major peak eluted in positions consistent with 15K Mr, while a minor peak coeluted with synthetic rat ANP-(1-28) of 3K Mr. HPLC analysis of the 3K Mr species showed a single peak of immunoreactivity, which eluted with a retention time similar to that of ANP-(5-28). In rat splenic sections, immunoperoxidase localization of ir-ANP revealed positive cells sparsely distributed in marginal sinuses and the red pulp of the tissue; employing a double staining technique, S22, a surface marker for macrophages, was colocalized on the same splenocytes. Furthermore, colorimetric in situ hybridization with antisense oligonucleotide probes labeled with digoxigenin, identified specific signals for pro-ANP mRNA in splenocytes of tissue sections. In monolayer cultures of vehicle-treated splenocytes, approximately 87% of the adherent cells stained positive for S22; this marker was colocalized with ir-ANP in approximately 15% of the cells. Twenty-four-hour treatment with lipopolysaccharide (50 micrograms/ml), a bacterial endotoxin, tripled the proportion of adherent cells (32 +/- 4%; P less than 0.01) staining positive for ir-ANP over that in control cultures (mean +/- SEM, 11 +/- 3%; 10(4) cells/sample; n = 5). Furthermore, an equivalent dose of lipopolysaccharide, but not Concanavalin-A (50 micrograms/ml), quadrupled ir-ANP content compared to that in vehicle-treated cultures (less than 5 pg/well). Thus, our findings suggest that ANP-(5-28) is produced by a small population of splenic macrophages and raise the possibility that the peptide may play a signalling role at the tissue level.

Animals↗

Atrial natriuretic peptide is a physiological inhibitor of ACTH release: evidence from immunoneutralization in vivo.

The brain is thought to exert a predominantly stimulatory action on ACTH secretion mediated mainly by corticotrophin-releasing factor-41 (CRF-41) and arginine vasopressin (AVP). Several data, however, also point to the existence of an ACTH-inhibiting factor. Atrial natriuretic peptide (ANP), at concentrations found in hypophysial portal blood, inhibits ACTH release in vitro. The aim of the present studies was to use ANP immunoneutralization to determine whether ANP does in fact inhibit ACTH release in vivo. Intracerebroventricular infusion (1 microliters/min for 30 min) of sheep anti-ANP serum into male rats anaesthetized with sodium pentobarbitone had no significant effect on jugular venous plasma concentrations of ACTH or LH but did decrease significantly the plasma concentrations of prolactin. Intravenous infusion of 0.8 ml sheep anti-ANP serum but not control (non-immune) sheep serum, through an indwelling intra-atrial cannula in conscious male rats resulted in a marked and significant increase in plasma ACTH and corticosterone concentrations. The ACTH and corticosterone response to a 30-s ether stress was not significantly potentiated in the same conscious rats infused with anti-ANP serum. Intra-atrial infusion of anti-ANP did not significantly affect plasma prolactin, LH, glucose or sodium concentrations or plasma osmolality. These results show for the first time that ANP is a potent inhibitor of ACTH secretion in the conscious male rat and that, therefore, ANP is a hypothalamic neurohormone which is likely to play an important inhibitory role in the neural control of ACTH release.

Adrenocorticotropic Hormone↗

Basal and haloperidol-stimulated prolactin in neuroleptic-free men with schizophrenia defined by 11 diagnostic systems.

Forty-four male, neuroleptic-free, acutely psychotic patients with at least one diagnosis of schizophrenia among 11 diagnostic systems, and 28 healthy controls, underwent measurement of prolactin (PRL) concentrations before and after intravenous administration of haloperidol (0.5 mg). Basal PRL concentrations were lower in the patients with Research Diagnostic Criteria (RDC) DSM-III, Cloninger, and Taylor and Abrams schizophrenias than in controls. Compared with the controls, the PRL response to haloperidol was lower in the patients with schizophrenia defined by all diagnostic systems except those of Schneider and M. Bleuler. Neither basal nor stimulated PRL concentrations were correlated with positive symptoms, but basal PRL was correlated with the Brief Psychiatric Rating Scale (BPRS) depression-related subscore. This study lends further support for the presence of dopaminergic dysfunction in schizophrenia, and demonstrates the advantages and problems in the use of multidiagnostic psychopathological evaluation to categorize a disorder where there is major disagreement among diagnostic systems.

Acute Disease↗

Validation of a method to measure the uptake of [3H]dopamine by human platelets.

We have assessed the validity of using platelet-rich plasma (PRP) to measure dopamine uptake by platelets. In addition, we report on a pilot study comparing [3H]dopamine uptake by PRP from psychotic patients to that by PRP from healthy volunteers. Uptake of radiolabelled dopamine by PRP was related to the concentration of [3H]dopamine added and correlated with platelet number. [3H]dopamine uptake by PRP was not altered by varying pH (6.8 to 8.0) or by the time PRP was incubated prior to the addition of the radiolabelled dopamine. 11.7 +/- 0.34% (mean +/- SEM) of [3H]dopamine added to plasma was precipitated by polyethylene glycol (PEG) and appeared to be associated with a large molecular mass component of plasma. The amount of PEG precipitable [3H]dopamine did not correlate with dopamine uptake (r = 0.02) or differ between patients and controls. Uptake of [3H]dopamine by PRP from 52 volunteers (26 M, 26 F; age, 18-75 yr), expressed as the area under the dopamine uptake curve up to 60 min in arbitrary units, ranged from 72-285 for males and 59-455 for females. Comparing [3H]dopamine uptake by PRP from 15 psychotic patients to these sex-specific reference ranges 9 of 13 PRP from schizophrenic patients had [3H]dopamine uptake outside the normative values whereas the two non-schizophrenic patients did not differ from normal. Dopamine uptake by PRP may be useful in the study of diseases with altered dopaminergic activity in the CNS.

Adolescent↗

Prolactin response to low-dose haloperidol challenge in schizophrenic, non-schizophrenic psychotic, and control subjects.

Haloperidol was administered IV to 46 male psychotic inpatients and 28 male control subjects. A two-way analysis of covariance, with age as the covariate, revealed that DSM-III schizophrenics (n = 27) had a lower prolactin response to haloperidol than did the controls (n = 28). There were no significant differences between the prolactin responses in schizophrenics, patients with affective disorders (n = 7), and those with other psychoses (n = 12), which included patients with paranoia, schizophreniform, schizoaffective disorder, and atypical psychoses. These findings support the proposition that tuberoinfundibular dopaminergic dysfunction may occur in certain patients with DSM-III schizophrenia.

Adult↗

Royal Park Multidiagnostic Instrument for Psychosis: Part I. Rationale and review.

The Royal Park Multidiagnostic Instrument for Psychosis (RPMIP) is a validity-oriented assessment procedure developed for the acute psychotic episode using serial interviews and multiple information sources to construct a data base of clinical information. A number of sets of operational criteria, including 11 definitions of schizophrenia and several concepts of atypical, schizoaffective, and affective psychoses, are simultaneously applied to the data base to produce a diagnostic profile for each patient that can be linked to other variables. This article describes the rationale for the development of the RPMIP and contrasts it with other assessment and diagnostic procedures. A companion article (Part II) presents data on interrater reliability and procedural validity, together with an account of the structure and development of the instrument.

Humans↗

Royal Park Multidiagnostic Instrument for Psychosis: Part II. Development, reliability, and validity.

The Royal Park Multidiagnostic Instrument for Psychosis is a validity-oriented assessment procedure developed for the acute psychotic episode using serial interviews and multiple information sources. This article describes the development and structure of the RPMIP and reports the findings of an interrater reliability study (n = 50). In addition, results are presented from a study that examined aspects of the procedural validity of the instrument when contrasted with consensus diagnoses made by a team of clinicians applying operational criteria in a less formal way to a common sample of patients (n = 87). Finally, the role of assessment procedures of this type in research into psychiatric disorders is briefly discussed.

Adult↗

The influence of gender on the classification of psychotic disorders--a multidiagnostic approach.

A multidiagnostic approach was used prospectively to classify a sample of 176 psychotic patients. An excess of males was found with only one out of 11 systems of schizophrenia, the World Health Organization "flexible" system of schizophrenia, with an excess of females noted in 2 of 5 systems of schizoaffective disorder, the Kasanin schizoaffective system and the Feighner schizoaffective depressed category. Correlation matrices of the diagnostic categories were generated for men and women and multidimensional scaling was used to plot the distribution of diagnostic categories. In the male sample, patients appeared to cluster according to affective symptoms and the mood-congruence of psychotic symptoms. Four clusters were apparent, but were less evident in the female sample. This gender difference was given partial support by quantitative measures of concordance. It is suggested that women manifested a greater admixture of symptoms, especially mixed affective and psychotic symptoms, than men.

Acute Disease↗

Relationship of psychotic symptoms to haloperidol-stimulated prolactin release.

Prolactin (PRL) response to a single dose of intravenous haloperidol (0.5 mg) was measured as a marker of tuberoinfundibular dopamine (TIDA) activity in 24 neuroleptic-free, male, psychotic patients. The PRL responses were then correlated with psychotic symptoms measured with Andreasen's Scales for the Assessment of Positive and Negative Symptoms (SAPS, SANS). Correlation analyses revealed a significant inverse relationship between PRL response and the severity of delusional symptoms. There was no significant correlation between the symptoms of hallucinations, formal thought disorder, or global negative symptoms and PRL response to haloperidol, nor were there any significant correlations between basal PRL and symptom severity. These results suggest that among the positive and negative symptoms associated with psychoses, only delusions may be associated with TIDA overactivity.

Adult↗

Hypothalamic atrial natriuretic peptide secretion plasticity: differential modulation of alpha and beta adrenoceptors.

Increasing evidence suggests that atrial natriuretic peptide (ANP), a 28 amino acid peptide with biologically active 4-28 and 5-28 congeners, modulates salt-water homeostasis at both peripheral and central levels. In rats, immunoreactive (ir) ANP is found in hypothalamic (HT) neurons of preoptic and paraventricular regions rich in aminergic innervation. Employing a well-characterized perifusion model of rat HT explants, the acute effects of norepinephrine (NE) on HT release of irANP were examined. Pulsatile administration (20 min) of NE (10(-7) to 10(-5) M) induced a dose-related release of irANP. The stimulatory effect of 10(-5) M NE (2.66 +/- 0.54 pg/ml/HT, means +/- SE, n = 12) was abolished in the presence of 10(-7) M propranolol, a beta-antagonist, but was 50% higher when administrated with 10(-5) M phentolamine, an alpha-antagonist. Administration of equivalent doses of propranolol or phentolamine alone, consistently suppressed (40% below basal secretion rate, BSR) or stimulated (50% above BSR) irANP release, respectively. In addition, infusion of isoprenaline (10(-5) M), a beta-agonist, enhanced BSR by 45%, whilst phenylephrine (10(-5) M), an alpha-agonist, suppressed it by 25%. We conclude that in rat hypothalami (1) occupancy of the beta-adrenoceptor by its agonist stimulates irANP release, (2) alpha- and beta-adrenoceptors modulate irANP secretion in an opposing manner, and (3) the basal release of irANP is a product of the activation of alpha- and beta-adrenoceptors by their endogenous ligands.

Animals↗

Dopamine uptake by the human platelet: effects of dopamine receptor agonists.

The uptake of dopamine by human platelets has been shown to be temperature- and energy-dependent and not to occur as a result of dopamine binding to and then being internalised with the dopamine D-1 or D-2 receptor. However, occupancy of these receptors could affect dopamine uptake by platelets through their second messenger systems. We have therefore studied the effect of dopamine receptor agonists, which stimulate receptor second messenger systems, on dopamine uptake by platelets. Uptake of [3H]dopamine by human platelets was not affected by the dopamine D-1 receptor agonist SKF 38393 or the dopamine D-2 receptor agonists, quinpirole and bromocriptine. In contrast, the uptake of [3H]dopamine was decreased by the mixed dopamine receptor agonists dopamine and 2-amino-6,7-dihydroxy-1,2,3,4-tetrahydronaphthalene (ADTN). Furthermore, [3H]ADTN, like [3H]dopamine, was taken up by platelets. In conclusion ADTN, a compound structurally similar to dopamine appears to complete for the dopamine uptake system on the human platelet. Thus, our data further support the hypothesis that a selective dopamine uptake system is present on the human platelet and that this system is not influenced by the dopamine D-1 or D-2 receptor.

Blood Platelets↗

Specificity of the salivary cortisol dexamethasone suppression test across psychiatric diagnoses.

One hundred forty-eight psychiatric inpatients, 12 outpatients, and 17 normal controls were given the 1.0-mg overnight Dexamethasone Suppression Test (DST), with salivary cortisol concentrations being measured as the dependent variable. Based on the Structured Clinical Interview for DSM-III, the patients were diagnosed as having major depression with melancholia (n = 21), nonmelancholic major depression (n = 50), mania (n = 15), schizophrenia (n = 32), dementia (n = 6), substance dependence/abuse n = 18), and miscellaneous (n = 18). Neither the melancholic major depressives nor the entire group of major depressives had significantly higher salivary cortisol pre- or postdexamethasone as compared with all the other patients combined, nor did the melancholic patients have significantly higher cortisol than the nonmelancholic depressives. The inpatients as a group had significantly higher pre- and postdexamethasone cortisol values than the normal controls; cortisol values for the outpatients were intermediate between these two groups. Illness severity (in the depressives), length of time in hospital before the DST, and medication regimen were all unrelated to DST outcome. Thus, in this study, the salivary cortisol DST showed little clinical utility in discriminating major depressives with and without melancholia from other patients with a broad range of psychiatric diagnoses. The test did distinguish between hospitalized psychiatric patients and normal control subjects and between depressed inpatients and depressed outpatients, indicating that hospitalization-related variables contributed to DST outcome.

Adult↗

The predictive power of the salivary cortisol dexamethasone suppression test for three-year outcome in major depressive illness.

Seventy patients satisfying DSM-III and Research Diagnostic Criteria for major depression were given a salivary cortisol dexamethasone suppression test, with samples collected at 0700 h, 1500 h and 2300 h after dexamethasone. The patients were classified as nonsuppressors (mean post-dexamethasone salivary cortisol concentration greater than or equal to 2.0 ng/ml, N = 27) and suppressors (mean post-dexamethasone salivary cortisol concentration less than 2.0 ng/ml, N = 43). At 3-yr follow-up there was no difference in illness outcome as assessed by the life table method or by the length of rehospitalisation for several periods after the index episode. In multiple regression and discriminant function analyses, with outcome as the dependent variable (readmitted within 1 yr, readmitted between 1 and 3 yr, not readmitted), the mean post-dexamethasone salivary cortisol concentration was not significantly predictive of outcome.

Adult↗