Prolonged residual catatonia or prolonged neuroleptic-induced Parkinsonism following catatonic stupor in a patient with manic-depressive illness.
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Antipsychotic Agents↗
Biomedical subjects
Hiroo Matsuoka
Publications and source records attributed to Hiroo Matsuoka.
Association study of putative promoter polymorphisms in the neuroplastin gene and schizophrenia.
A previous study revealed a number of methamphetamine (METH) and phencyclidine (PCP)-reactive tags in a rat brain through serial analysis of gene expression. The present study extends this previous study by investigating whether two genes, which deduced from METH/PCP-reactive tags, were identified as those encoding human transmembrane proteins of the immunoglobulin (Ig) superfamily, neuroplastin (NPTN) and basigin (BSG), confer genetic susceptibility to schizophrenia by analyzing single nucleotide polymorphisms (SNPs). There were nominally significant differences between the two groups in their allelic frequencies (T Ins/Del, chi2=4.910, d.f.=1, P=0.040) and genotypic distributions (T/T or T/Del, chi2=5.116, d.f.=1, P=0.036) of rs3840846 in the 5'-upstream of NPTN. The two groups differed significantly also in their allelic frequencies (G/T, chi2=4.229, d.f.=1, P=0.044), but not genotypic distributions of rs3743500 in the 5'-upstream of NPTN. The haplotypes constructed from the three SNPs (rs3840846, rs3826047 and rs3743500, in order) in the 5'-upstream of NPTN showed a significant association with schizophrenia (permutation P=0.036), in that T-G-T (permutation P=0.028) and del-G-G (permutation P=0.040) were under-represented and over-represented, respectively, in schizophrenia. A reporter construct driven by the 5'-upstream region containing any haplotype consisting of the three SNPs had substantial transcriptional activity. Notably, a reporter construct containing a haplotype T-G-T had significantly lower transcriptional activity as compared with one having a haplotype T-G-G or T-A-G. There was no significant difference between the two groups regarding allelic frequencies, genotypic distribution or the adopted SNP-combinatory haplotype for BSG. These results suggest that NPTN may be involved in genetic susceptibility to schizophrenia.
Adult↗
The quality of life among persons with severe mental illness enrolled in an assertive community treatment program in Japan: 1-year follow-up and analyses.
BACKGROUND: Toward effective community care for persons with severe mental illness and deinstitutionalization in Japan, we assessed the impact of the first trial of an assertive community treatment program on the lives and subjective perceptions of persons with mental illness without closing hospitals. METHODS: Forty-three subjects were enrolled from the newly admitted patients of a hospital, who met our criteria of problematic hospital use, severity of psychiatric disorders, and behavioral problems. The intervention team aimed to intensively support them in various life domains in their communities to decrease clients' admissions. The Quality of Life Interview was administered at baseline and after 12 months. Data were analyzed to assess the pre-post changes in their QOL, and were explained in association with other descriptive variables. RESULTS: The objective changes included increase in persons whose longest residence in a year were in communities, increase in income, and decrease in family contacts. Most subjective items were not changed except the decrease in satisfaction with family relationships. Satisfaction with family relationships was negatively correlated with hospital days at 1 year follow-up after controlling for symptoms, but was not so at baseline. Also, correlation between satisfaction with family relationships and global well-being was attenuated. A change in the positioning of family by clients and the autonomy of clients were suggested. However, previous studies showed that dissatisfaction with family relationships predicted rehospitalizations independently from symptoms, and our findings suggest our subjects' characteristics and a possible improvement in community-based care. CONCLUSION: Our program predominantly fulfilled the primary goal, but it must be further refined to reflect the detailed characteristics of the target population and resource distribution. Assessing subjective perceptions, or the QOL of clients is useful for evaluating the program localization.
Journal Article↗
Catatonic stupor superimposed on hereditary spinocerebellar degeneration resolved with electroconvulsive therapy.
We report a 58-year-old woman with catatonic stupor superimposed on hereditary spinocerebellar degeneration (SCD) and psychotic depression. The catatonia and psychotic depression resolved with 11 sessions of electroconvulsive therapy (ECT). Early recognition of catatonia during the course of SCD is important for timely administration of ECT.
Affective Disorders, Psychotic↗
Catatonic stupor during the course of Parkinson's disease resolved with electroconvulsive therapy.
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Antiparkinson Agents↗
Resolution of SPECT-determined anterior cerebral hypoperfusion correlated with maintenance ECT-derived improvement in residual symptoms in a case of late-life psychotic depression.
A 70-year-old widow with recurrent psychotic depression was successfully treated with maintenance electroconvulsive therapy (ECT) for 4 years up to the present. Anterior cerebral hypoperfusion visualized by single photon emission computerized tomography (SPECT) before ECT persisted (second SPECT study 14 days after the last ECT session) despite a response to the first course of acute ECT. Only mild symptoms remained. Relapse occurred 2 weeks after the post-ECT SPECT study. The hypoperfusion improved after response to a second course of acute ECT (per SPECT 5 days after the last ECT session), and perfusion was normalized after 2-year maintenance ECT (per SPECT 14 days after the last ECT session). The normalization coincided with improvement in depressive symptoms remaining after the second course of acute ECT. We speculate that the effectiveness of maintenance ECT might have been in part the result of the improvement in residual symptoms and that resolution of the persistent anterior hypoperfusion, which might underlie medical refractoriness, illness chronicity, and relapse tendency in late-life depression, might have been associated with the improvement in residual symptoms achieved by maintenance ECT.
Affective Disorders, Psychotic↗
Hysteria presenting as a prodrome to catatonic stupor in a depressive patient resolved with electroconvulsive therapy.
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Catatonia↗
Adjusting the frequency of continuation and maintenance electroconvulsive therapy to prevent relapse of catatonic schizophrenia in middle-aged and elderly patients who are relapse-prone.
The purpose of the present paper was to study the effect of continuation electroconvulsive therapy (ECT) on the prevention of relapse in middle-aged and elderly patients with intractable catatonic schizophrenia. It was found that continuation ECT is efficacious to sustain remission for patients who suffer relapse after response to acute ECT despite continuation neuroleptics. However, three patients suffered relapse during continuation ECT, therefore the effect of adjusting the frequency of continuation ECT and maintenance ECT was investigated in these patients with catatonic schizophrenia who relapsed during continuation ECT. These patients with DSM-IV catatonic schizophrenia who relapsed during continuation ECT were treated with more frequent continuation ECT and subsequent maintenance ECT after response to acute ECT. The patients' Brief Psychiatric Rating Scale (BPRS) scores were prospectively evaluated until relapse. Patients were considered to be relapsers if they had a BPRS score >or=37 for 3 consecutive days. The three patients with catatonic schizophrenia who relapsed during continuation ECT were treated successfully with more frequent continuation ECT and subsequent maintenance ECT. No patient experienced a severe adverse effect from continuation or maintenance ECT. More frequent continuation ECT and maintenance ECT deserves consideration in middle-aged and elderly patients with intractable catatonic schizophrenia who suffer relapse during continuation ECT. Large-scale systematic studies are warranted to investigate the optimum use of continuation and maintenance ECT in patients with catatonic schizophrenia.
Aged↗
Epileptic seizures superimposed on catatonic stupor.
PURPOSE: Some patients with nonconvulsive status epilepticus are known to exhibit catatonic stupor. Thus it is necessary to rule out ictal catatonia by electroencephalography in patients with catatonic stupor. However, few reports are available on epileptic seizures superimposed on catatonic stupor. METHODS: We report three cases of epileptic seizures superimposed on psychiatric catatonic stupor without a prominent predisposing factor, including high fever or encephalitis. None of the patients had a personal or family history of neurologic disease, including epilepsy. RESULTS: In all three patients, catatonic stupor persisted after resolution of the epileptic seizures with administration of phenytoin. In two of the three patients, catatonic stupor resolved with electroconvulsive therapy, which caused no marked adverse effects. CONCLUSIONS: Because it is possible that catatonic stupor itself predisposes patients to the development of epileptic seizures, electroencephalographic examinations in patients with catatonic stupor are indispensable for early recognition not only of nonconvulsive status epilepticus but also of epileptic seizures superimposed on catatonic stupor. Electroconvulsive therapy deserves consideration when catatonic stupor persists after resolution of epileptic seizures.
Aged↗
Psychophysiological differences in identical twins discordant for schizophrenia: a critical index for the onset of schizophrenia.
It has been hypothesized that not only genetic but also environmental factors contribute to the onset of schizophrenia. We therefore conducted psychophysiological studies on a pair of identical twins discordant for schizophrenia, to differentiate non-genetic from genetic indexes possibly associated with this disease. The affected and unaffected twins were 28 year-old females. The affected twin was diagnosed as having schizophrenia based on the Diagnosis and Statistical Manual of Mental Disorders, third edition revised (DMS-III-R), whereas the unaffected twin had no psychiatric disorders. The brain potentials evoked by visual stimulation (visual event-related potential [visual ERP]) were recorded. The components of the visual ERP, which are believed to reflect pattern cognition, semantic processing and the failure to use preceding word information, were compared with normal subjects. Both twins showed abnormal semantic processing and similar failure to use preceding word information. Abnormality of semantic processing was marked in the affected twin. These results indicate that failure to use preceding word information might reflect only genetic factors, whereas abnormal semantic processing might reflect both genetic and non-genetic factors because the affected twin was considered to show accelerated deterioration after the disease onset. However, only the affected twin showed abnormal pattern cognition, which might be attributable to non-genetic factors such as an acquired vulnerability to schizophrenia. We suggest that the impairment of pattern cognition evaluated by visual ERP may be a critical index for the onset of schizophrenia.
Adult↗
Improvement of psychiatric symptoms after electroconvulsive therapy in young adults with intractable first-episode schizophrenia and schizophreniform disorder.
Schizophrenia is a serious psychiatric disorder that develops mainly in young adults. Electroconvulsive therapy (ECT) is known to be effective and safe in patients with schizophrenia with acute psychotic exacerbation. Because of the shortage of systematic studies, we conducted a prospective naturalistic study to examine the short-term effects of acute ECT and its safety in young adults with medically intractable first-episode schizophrenia. Subjects were seven consecutive patients, 15-35 years of age, with first-episode schizophrenia or schizophreniform disorder (Diagnostic and Statistical Manual of Mental Disorders, 4th edition; DSM-IV), who had failed to respond to neuroleptics. The seven patients were treated with a first course of ECT, and their clinical symptoms were evaluated on the basis of the Brief Psychiatric Rating Scale (BPRS) (18 items, rated 0-6) and Global Assessment of Functioning (GAF) Scale. The GAF Scale is presented in DSM-IV as a means of assessing global functioning of a psychiatric patient. Scores range from 1-100; the higher GAF score indicates the higher global functioning. Adverse effects resulting from acute ECT were also evaluated. The total BPRS score 1 week after the final session improved significantly compared to the total pre-ECT BPRS score. The GAF score also improved significantly compared to the pre-ECT GAF score. There were no adverse effects during the acute ECT course, except for mild delirium. We conclude that ECT may be an effective and safe treatment option for young adults with intractable first-episode schizophrenia.
Adolescent↗
Reduced word-repetition effect in the event-related potentials of thought-disordered patients with schizophrenia.
Repetition effect in event-related potentials (ERPs) was studied in 10 non-thought-disordered (non-TD) patients with schizophrenia, 8 thought-disordered (TD) patients with schizophrenia, and 10 normal control subjects while they performed a semantic categorization task with incidental word repetitions. All patients were in a stable or partially remitted stage. Although both healthy control and non-TD groups produced more positive ERPs to the repeated words than to the new words (ERP repetition effect) for 250-500 ms, the TD group did not show the ERP repetition effect. These findings suggest that the abnormal attenuation of the ERP repetition effect during semantic processing may be more prominent in schizophrenic patients with thought disorder than in those without the symptom.
Adult↗
Histamine H1 receptors in schizophrenic patients measured by positron emission tomography.
Increasing evidence has shown that the histaminergic neuron system is implicated in the pathophysiology of schizophrenia. The aim of this study was to compare the distribution of histamine H1 receptors between schizophrenics and normal human subjects in vivo using positron emission tomography (PET). H1 receptor binding was measured in 10 normal subjects and 10 medicated schizophrenic patients by PET and [11C] doxepin, a radioligand for the H1 receptor. The binding potential (BP=Bmax/K(D)) of [11C] doxepin for available brain H1 receptors was calculated by a graphical analysis on voxel-by-voxel basis and compared between schizophrenics and normal subjects using the regions of interest (ROIs) and the statistical parametrical mapping (SPM99). BP values for H1 receptors in the frontal and prefrontal cortices and the cingulate gyrus were significantly lower among the schizophrenic patients than among the control subjects. On the contrary, there were no areas of the brain where H1 receptors were significantly higher among the schizophrenic patients than the control subjects. The results of our study suggest that the central histaminergic neuron system could be involved in the pathophysiology of schizophrenia, although further studies are needed to confirm this hypothesis.
Adult↗
Psychosocial liaison-consultation for the children who have undergone repair of imperforate anus and Hirschsprung disease.
OBJECTIVE: The aim of this study was to investigate the psychological status of Japanese children with congenital anorectal malformation and their mothers to develop appropriate psychiatric interventions. METHOD: The subjects comprised 50 children with congenital anorectal malformation aged 0 to 16 years and their mothers. The psychology of children aged 7 to 16 years was investigated by Kovacs' Children's Depression Inventory (CDI). The psychology of their mothers was assessed by Spielberger's State-Trait Anxiety Index (STAI) and Zung's Self-rating Depression Scale (SDS). RESULTS: Depression was more marked in the children aged 12 to 16 years than in those aged 7 to 11 years according to the CDI. The mothers of preschool children showed higher levels of anxiety and depression than those of school-aged children, according to the STAI and SDS. Significant correlations between the CDI score of the children and the STAI or SDS score of the mothers were observed only among children aged 7 to 11 years. CONCLUSIONS: The frequency of depression and anxiety among children with congenital anorectal malformation and that among their mothers was associated with the age of the child. Long-term postoperative psychosocial support for the children and their mothers may be required, taking into account the age of the child.
Adolescent↗
Successful use of continuation electroconvulsive therapy in a case of late-onset Leonhard's confusion psychosis.
A 56-year-old married woman with late-onset Leonhard's confusion psychosis was treated successfully with acute electroconvulsive therapy (ECT) after failing to respond to antidepressants, neuroleptics, and benzodiazepines. Symptoms relapsed within 1 year despite the combined use of olanzapine and paroxetine. The patient responded to a second course of acute ECT, but a second relapse occurred within 3 months despite her use of olanzapine and paroxetine. The symptoms resolved with continuation ECT and lithium combined with paroxetine after response to a third course of acute ECT. To date, relapse has been prevented for 2 years. Continuation ECT and lithium combined with paroxetine after response to acute ECT may be effective in maintaining remission of Leonhard's confusion psychosis.
Confusion↗
The role of cognitive-motor function in precipitation and inhibition of epileptic seizures.
PURPOSE: To examine the effects of cognitive-motor function on EEG discharges and the neuropsychological mechanisms of seizure induction in patients sensitive to cognitive-motor tasks. METHODS: Four hundred eighty patients with epilepsies were subjected to cognitive tasking, termed "neuropsychological EEG activation (NPA)." It consisted of reading, speaking, writing, written calculation, mental calculation, and spatial construction. Furthermore, patients showing a provocative NPA effect were subjected to a detailed NPA protocol to identify the possible precipitating factors, which consisted of simple hand movements, action programming requiring hand movement, and thinking activity not requiring hand movement. RESULTS: NPA had an inhibitory effect on EEG discharges in 133 (63.9%) of 208 patients with discharges in the awake EEG. Conversely, NAP had a provocative effect in 38 (7.9%) of 480 patients. In 32 of the 38 patients, the precipitating factor was action programming. Among them, five showed a precipitating factor restricted to linguistic activity, and the remaining 27 were affected by various action-programming factors including both linguistic and praxic activities. In four of 38 patients, the precipitating factor was thinking, predominantly linguistic tasks in one patient and spatial tasks in three patients. No patient had a precipitating factor identified as motor activity. CONCLUSIONS: These results suggest that cognitive-motor function has an inhibitory effect on EEG discharges in the majority of epilepsy patients and a provocative effect in some patients, and that seizures of the patients showing a provocative NPA effect are precipitated by action programming or thinking activity.
Adolescent↗
Behavioral and psychological symptoms of dementia characteristic of mild Alzheimer patients.
In order to clarify the characteristics of Behavioral and Psychological Symptoms of Dementia (BPSD) in patients with mild Alzheimer's disease (AD), BPSD among the severities of Clinical Dementia Rating (CDR) in 74 patients with AD were compared using the Neuropsychiatric inventory (NPI). The result, when compared between mild (CDR = 0.5, 1) and moderate or severe (CDR = 2, 3) AD, was a significant difference in frequency of euphoria, disinhibition and aberrant motor behavior, but no significant difference was found in frequency of delusions, hallucinations, agitation, dysphoria, anxiety, apathy and irritability. In addition, a significant difference was found in the mean scores of the composite score for euphoria, apathy, disinhibition and aberrant motor behavior, but no significant difference was found in the mean scores of the composite score for delusions, hallucinations, agitation, dysphoria, anxiety and irritability. That is, the mild AD groups (CDR 0.5 or 1) had delusions, hallucinations, agitation, dysphoria, anxiety, apathy and irritability as frequently as the moderate or severe AD groups (CDR 2 or 3), and had the equivalent level of composite scores to the moderate or severe AD groups (CDR 2 or 3) in delusion, hallucination, agitation, dysphoria, anxiety and irritability. Therefore, it was supposed that psychotic symptoms (delusion, hallucination) and emotional symptoms (agitation, dysphoria, anxiety, irritability) are important BPSD in patients with mild AD as well as those with moderate or severe AD, and there are needs for health, welfare and medical services for these symptoms.
Affective Symptoms↗
Factors associated with suicidal ideation in an elderly urban Japanese population: a community-based, cross-sectional study.
The objective of the present study was to evaluate the association between suicidal ideation and potentially related factors in an elderly urban Japanese population. This was a community-based, cross-sectional study. Urban community residents aged 70 years or more were interviewed regarding suicidal ideation and sociodemographic and health-related variables. Subjects with depressive symptoms underwent further evaluation by psychiatrists using criteria of the Diagnostic and Statistical Manual of Mental Disorders, 4th edition. Associations were evaluated using univariate and multivariate logistic regression analyses. Of the 1145 eligible participants, 52 (4.5%) reported thoughts of suicide. Of 143 subjects with depressive symptoms (Geriatric Depression Scale, 14+), 22 (15.4%) reported suicidal ideation over a 2-week period. After controlling for depressive symptoms, lack of social support and impaired instrumental activities of daily living were significantly associated with thoughts of suicide. After controlling for the potentially associated factors detected in the univariate analysis, depressive symptoms were strongly associated with thoughts of suicide. In the elderly with depressive symptoms, mental disorders, including depressive and alcohol-related disorders, were significantly associated with suicidal ideation over a 2-week period. In the urban community setting, screening for lack of social support, impaired instrumental activities of daily living, and depressive symptoms, followed by diagnostic evaluation for mental disorders, particularly for depressive syndromes and alcohol-related disorders, may provide a practical and effective means of identifying elders at high risk of suicide.
Aged↗