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Biomedical subjects

H Lauerma

Publications and source records attributed to H Lauerma.

At least 19 recordsLinked to original sources
PubMed2002

Structural magnetic resonance imaging in patients with first-episode schizophrenia, psychotic and severe non-psychotic depression and healthy controls. Results of the schizophrenia and affective psychoses (SAP) project.

BACKGROUND: Structural brain abnormalities are prevalent in patients with schizophrenia and affective disorders. AIMS: To study how regional brain volumes and their ratios differ between patients with schizophrenia, psychotic depression, severe non-psychotic depression and healthy controls. METHOD: Magnetic resonance imaging scans of the brain on first-episode patients and on healthy controls. RESULTS: Patients with schizophrenia had a smaller left frontal grey matter volume than the other three groups. Patients with psychotic depression had larger ventricular and posterior sulcal cerebrospinal fluid (CSF) volumes than controls. Patients with depression had larger white matter volumes than the other patients. CONCLUSIONS: Left frontal lobe, especially its grey matter volume, seems to be specifically reduced in first-episode schizophrenia. Enlarged cerebral ventricles and sulcal CSF volumes are prevalent in psychotic depression. Preserved or expanded white matter is typical of non-psychotic depression.

Adult↗
PubMed2001

Comparison of clinical and best-estimate research DSM-IV diagnoses in a Finnish sample of first-admission psychosis and severe affective disorder.

The purpose of this study was to investigate diagnostic agreement between clinicians and a research group in a sample of first-admission psychosis and severe affective disorder patients. Clinical DSM-IV discharge diagnoses and best-estimate DSM-IV research diagnoses were compared in 116 first-episode patients in the city of Turku, Finland. The best-estimate research diagnoses were made at consensus meetings by integrating longitudinal data; patients' medical records; and findings of a clinical interview, the structured SCAN-interview, and symptom severity ratings. Overall diagnostic agreement was moderate, with a kappa value 0.51 (95% confidence interval (CI), 0.39- 0.63). Of the diagnostic groups, schizophrenic disorders had the lowest kappa value of 0.44 (95% CI, 0.26-0.63). Clinicians had a tendency to miss depressive symptoms in psychotic patients; to overdiagnose psychotic symptoms in depressive patients; and to fail to discover earlier hypomanic or depressive episodes in depressive patients. In conclusion, hospital diagnoses were not reliable in first-episode patients. Inappropriate diagnoses may compromise both treatment and epidemiologic findings based on discharge diagnoses.

Adolescent↗
PubMed2000

Habituation of the blink reflex in first-episode schizophrenia, psychotic depression and non-psychotic depression.

OBJECTIVE: Electrophysiological recording of the electrically elicited blink reflex is the most reliable method of investigating habituation of the startle reflex. The purpose of this study was to compare the habituation and the late R3-component of the blink reflex between control subjects (N=19) and first-episode patients with schizophrenia (N=17), psychotic depression (N=23), and severe non-psychotic depression (N=25). METHODS: The blink reflex was evoked by electrical stimulation of the supraorbital nerve, and the deficient habituation of the R2i-component was measured with a computer-assisted integral area measurement. Prefrontal executive function of the patients was assessed with the Wisconsin Card Sorting Test. Current psychiatric symptoms were assessed with the Brief Psychiatric Rating Scale, the Hamilton Depression Scale, the Positive and Negative Syndrome Scale, and the Calgary Depression Scale. RESULTS: Deficient habituation of the blink reflex and occurrence of the late R3 component were associated both with a previous diagnosis of psychotic disorder and with the presence of current psychosis. The sensitivity and specificity of the abnormal habituation of the blink reflex in detecting psychotic disorder were 0.50 and 0.80, respectively. The abnormalities of the blink reflex were not associated with psychotropic medication. In schizophrenic patients, defective habituation of the blink reflex was associated with negative and cognitive symptoms, and in depressive patients with the presence of delusions. CONCLUSIONS: The deficient habituation of the blink reflex and occurrence of the late R3 component seem to be both trait and state markers of a psychotic disorder. The results suggest that schizophrenia and psychotic depression share some common neurobiological mechanisms involved in the modulation of the startle reflex.

Adult↗
PubMed2000

Akathisia masked by hypokinesia.

Here, we will discuss the concept of subjective akathisia and present a patient case. Our patient was suffering from neuroleptic-induced hypokinesia and akathisia at the same time. The typical motor manifestations of akathisia were masked by hypokinesia, which made the diagnosis difficult. However, the subjective symptoms of akathisia were evident and distressing. Although not observable to bare eye, the pathognomonic pattern of motor activity detected in akathisia was demonstrated by actometric recording. Changing the conventional neuroleptic to an atypical one brought relief to the subjective symptoms of akathisia and hypokinesia, while the motor activity was clearly diminished in actometric recording. Actometric recording may be useful in diagnosing akathisia masked by hypokinesia, but the typical subjective symptoms of akathisia should not be ignored, even when actometry is not available to demonstrate the missing motor component of akathisia. Not only akathisia defined by DSM-IV but also subjective akathisia should be adequately treated to relieve the subjective distress, and to diminish the unfavorable effects on psychotic symptoms, behavior, and drug compliance.

Adult↗
PubMed2000

Associations among dissociative experiences, handedness, and demographic variables in a nonclinical population.

Handedness is considered an indirect marker for bilateral language capacity in the brain. The Edinburgh Inventory for Handedness and the Dissociative Experiences Scale (DES) were administered to 297 nonclinical volunteers. Female sex, young age, and non-right handedness accounted for 24% of the total variance on the DES, including both pathological and nonpathological dissociative experiences. This is consistent with the hypothesis that cerebral lateralization indicating handedness is a predisposing factor for dissociative episodes especially in female subjects.

Adolescent↗
PubMed2000

[Restless legs].

Explore the source record for details and available documents.

Analgesics, Opioid↗
PubMed1999

Measuring neuroleptic-induced akathisia by three-channel actometry.

Three-channel actometry was used to study neuroleptic-induced akathisia (NIA), a common and often serious disorder in association of traditional neuroleptic therapy. The aim was to explore the diagnostic possibilities of actometry in NIA and to examine in detail the motor phenomenology of the disorder in detail. The actometers were attached to the ankles and waists of ten patients, suffering from NIA, and to ten matched healthy controls. Five of the patients were changed to olanzapine treatment, and these patients were re-examined during the no-NIA condition. NIA was associated with manyfold movement activity during controlled rest (sitting) but not with increased daily overall motor activity. Movement frequencies in NIA seemed to be pathognomonic. Actometry is promising for investigation and clinical assessment of NIA. Olanzapine proved to be an adequate treatment choice for NIA patients.

Adult↗
PubMed1999

The MMN amplitude increases in hypnosis: a case study.

The neural mechanisms associated with hypnosis were investigated in a single highly hypnotizable subject by measuring the mismatch negativity (MMN) component of auditory ERP, reflecting the preattentive discrimination of change in stimulus flow, in normal baseline state and under hypnosis. It has been proposed that the frontal inhibition associated with hypnosis can be measured as a decrease in MMN. ERPs were elicited using the passive oddball paradigm with standard and deviant sine tone stimuli of 500 and 553Hz, respectively. The measurement was repeated in five separate sessions. In hypnosis the MMN was significantly larger compared to baseline. The results indicate that hypnosis can give rise to altered information processing in the brain even at a relatively early, i.e. preattentive level and that the larger MMN measured under hypnosis does not support frontal inhibition theory.

Acoustic Stimulation↗
PubMed1999

Diagnostic efficiency of the Rorschach schizophrenia and depression indices in identifying first-episode schizophrenia and severe depression

We studied the diagnostic efficiency of the Rorschach schizophrenia (SCZI) and depression (DEPI) indices for detecting first-episode schizophrenia and severe depression with and without psychotic features using DSM-IV as a gold standard measure. Twenty-seven patients with first-episode schizophrenia, 13 with bipolar I disorder, 28 with psychotic depression, 29 with non-psychotic depression, and 60 healthy controls were recruited for the study. The SCZI was highly specific with a very low false positive rate. The lowest positive value of 4, however, may yield false positives, especially among manic patients. The DEPI identified severe non-psychotic depression but not psychotic depression, suggesting that these patient groups invoke different perceptual-cognitive processes in formulating and articulating their Rorschach responses. Anyway, both the SCZI and the DEPI based on the psychological organization and functioning that are known to play a clearly formulated role in schizophrenia and depression, respectively, provide a valuable addition for diagnostics characterized by overt symptoms.

Journal Article↗
PubMed1999

Visual distortions and dissociation.

Visual distortions may be a frightening experience. They are often incorrectly diagnosed and easily dismissed. The causes of visual distortions are poorly understood. The aim of this study was to investigate the link between visual distortions and dissociative experiences in a nonclinical population. A total of 297 nonclinical volunteers completed the Dissociative Experience Scale and answered questions concerning visual distortions. Our study suggests that visual distortions are quite common and that there is a clear link between visual distortions and dissociative phenomena. Literature indicates that this may be caused by disturbances in brain lateralization. Bilateral language capacity may interfere with abilities usually associated with the nondominant hemisphere. Research efforts attempting to shed light on the above matter may benefit our knowledge for dissociative phenomena. An interdisciplinary approach is needed.

Adolescent↗
PubMed1999

Seasonal affective disorders among rural Finns and Lapps.

We investigated the prevalence of seasonal affective disorder (SAD) and subsyndromal SAD (S-SAD) in rural populations in south-western and northern Finland by using the Seasonal Pattern Assessment Questionnaire (SPAQ). A total of 1710 SPAQs were analysed. The prevalences of overall SAD and S-SAD were 12.0% and 27.1%, respectively. Winter SAD (W-SAD) was the most common type, with prevalences of 9.5% for W-SAD and 18.4% for W-S-SAD. The prevalences of overall and winter SAD did not differ between Finns living in northern and south-western Finland. Among the Lapps, W-SAD cases were less frequent than among the Finns in Lapland. Overall seasonality correlated significantly with female gender, high body mass index, high level of education and young age.

Adolescent↗
PubMed1999

Treatment of restless legs syndrome with tramadol: an open study.

BACKGROUND: Tramadol is a central analgesic that seems to have fewer side effects and a lower abuse potential than classical opioids. Since the treatment of restless legs syndrome (RLS) with levodopa or classical opioids is problematic, new treatment possibilities would be valuable. METHOD: We treated 12 patients who fulfilled at least the minimal diagnostic criteria proposed by the International Restless Legs Syndrome Study Group as well as the criteria proposed by Gibb and Lees, some of them treatment resistant or prone to side effects of previous medications, with 50 to 150 mg of tramadol per day in an open study. The follow-up lasted from 15 to 24 months. RESULTS: Ten patients reported clear amelioration and 1 reported slight amelioration of their symptoms, while 1 reported no effect. Tramadol was described to be the most effective treatment and free of side effects when compared with several other treatments. No major tolerance against treatment effect emerged among those who needed only a single evening dose. CONCLUSION: Compared with other treatments for RLS, tramadol seems to be superior in some cases, possibly because of its unique pharmacodynamic profile. Controlled studies are needed. Meanwhile, we believe that tramadol should be considered before other opioids are prescribed. We recommend intermittent treatment and careful monitoring.

Adult↗