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Biomedical subjects

J P Selten

Publications and source records attributed to J P Selten.

At least 19 recordsLinked to original sources
PubMed2005

[Suicidal ideations and suicide attempts after starting on aripiprazole, a new antipsychotic drug].

In 5 patients, 3 women aged 30, 32 and 41 years and 2 men aged 36 and 56 years, serious side effects developed after starting aripiprazole, a new antipsychotic drug. 2 patients had not been treated with antipsychotic drugs before, while in 3 there was a switch in antipsychotic treatment. The side effects consisted primarily oftroubling feelings ofagitation, akathisia, insomnia and dysphoria. 3 of the patients made a suicide attempt and 2 developed suicidal thoughts. The patients had not previously attempted suicide and the suicidal thoughts disappeared after discontinuation ofaripiprazole. Suicidal tendencies have not been reported before as a side effect ofaripiprazole.

Adult↗
PubMed2005

[Bizarre somatic complaints as a manifestation of schizophrenia].

Three patients, men aged 50 and 32 and a woman aged 30 years, presented with bizarre somatic symptoms, i.e. that are anatomically and physiologically impossible. The first patient, for instance, thought that he could only walk while holding his forehead back with his hand; the woman thought that the skin of her neck and back was disconnected from the underlying tissues. The patients were preoccupied with their complaints and could not be convinced that there was no organic substrate for their symptoms. The presented patients had coenesthetic symptoms of schizophrenia: disturbances in the awareness of their bodily integrity. These symptoms occur frequently in patients with schizophrenia, but have not received much attention in medical literature. The patient's visit to a somatic or general physician is a good opportunity to refer him or her for adequate psychiatric treatment.

Adult↗
PubMed2003

First admissions for mood disorders in immigrants to the Netherlands.

BACKGROUND: The risk of developing schizophrenia is increased for immigrants to the Netherlands from Surinam, the Netherlands Antilles and Morocco, but not for immigrants from Turkey. We examined, in these groups, the risks of a first admission for manic-depressive psychosis. METHODS: The Dutch Psychiatric Registry provided two datasets. The first referred to first admissions for manic-depressive psychosis (MDP), manic or circular type, in the period 1990-1996, the second to first admissions for MDP, depressed type. MDP, depressed type, corresponds (broadly) to the DSM-IV category of major depressive disorder and MDP, manic or circular type, to the DSM-IV category of bipolar I disorder. The Dutch Central Bureau for Statistics provided yearly population figures. RESULTS: There were only small increases in the risks of a first admission for MDP, manic or circular type, for immigrants from Surinam (age- and sex-adjusted RR = 1.14; 95% CI: 0.97-1.33) and the Netherlands Antilles (RR = 1.41; 1.10-1.80). This risk was not clearly increased for immigrants from Morocco. The risks for MDP, depressed type, were increased for males from Morocco (age-adjusted RR = 2.17; 1.72-2.72) and Turkey (RR = 1.83; 1.46-2.30), and significantly decreased for females in all of the immigrant groups. CONCLUSION: We found no evidence for a large increase in the incidence of MDP, manic or circular type, in the immigrant groups, whereas an increase in MDP, depressed type, was observed only in selected groups. Female immigrants suffering from MDP, depressed type, may be underserved.

Adult↗
PubMed2001

Point prevalence of schizophrenia in immigrant groups in Rotterdam: data from outpatient facilities.

OBJECTIVE: Reports of an increased incidence of schizophrenia in some immigrant groups to The Netherlands are based exclusively on hospital data. THE AIMS OF OUR STUDY WERE: 1) to determine the treated point prevalence of schizophrenia at outpatient mental health services in Rotterdam and to compare the results for immigrants to those for natives; and 2) to compare groups born in The Netherlands and immigrant groups in terms of the proportions of patients with a previous hospital admission. METHOD: We included all patients aged between 20 and 64 who were treated for a non-affective psychosis at any of the outpatient mental health services in Rotterdam on October 1, 1994. The mental health professionals responsible reported on the socio-demographic and clinical characteristics of each patient. RESULTS: Seven hundred and thirteen patients with a diagnosis of schizophrenia (DSM-III-R) were identified (rate: 2.1 per 1000). The (treated) prevalence of schizophrenia in male immigrants from Surinam and Morocco and in female immigrants from Surinam, the Netherlands Antilles and Cape Verde was significantly higher than that in their native-born counterparts (odds ratios between 2 and 3). The (treated) prevalence was not significantly higher in immigrants from Turkey, female immigrants from Morocco or male immigrants from the Antilles. Proportions of patients with a previous hospital admission were similar in each ethnic group (81-93%). CONCLUSION: These findings are generally in line with earlier studies, based on the Dutch psychiatric registry, which has reported an increase in the (treated) incidence of schizophrenia in immigrants from Surinam and the Netherlands Antilles and in male immigrants from Morocco, and no increase in the (treated) incidence in immigrants from Turkey or female immigrants from Morocco.

Adult↗
PubMed2001

Incidence of psychotic disorders in immigrant groups to The Netherlands.

BACKGROUND: Previous reports on the incidence of schizophrenia in immigrant groups to The Netherlands were based on hospital data. AIMS: To compare the incidence of psychotic disorders in the immigrant groups to that in natives. METHOD: Two-year first-contact incidence study in The Hague. RESULTS: The risks of schizophrenia, schizophreniform or schizoaffective disorder (DSM-IV criteria) were increased for subjects born in Morocco (gender and age-adjusted relative risk=4.5; 95% Cl 1.4-8.5), Surinam (relative risk=3.2; 1.8-5.7), The Netherlands Antilles (relative risk=2.9; 0.9-9.5) and other non-Western countries (relative risk=2.4; 1.3-4.7). This risk was also increased for Moroccans (relative risk=8.0; 2.6-24.5) and Surinamese (relative risk=5.5; 2.5-11.9) of the second generation. The risks for Turkish immigrants, first or second generation, and for immigrants from Western countries were not significantly increased. CONCLUSIONS: This study indicates that the incidence of schizophrenia is increased in several, but not all, immigrant groups to The Netherlands. It is possible that factors associated with a process of rapid westernisation precipitate schizophrenia in people who are genetically at risk.

Adult↗
PubMed2000

Seasonality of schizophrenia and stillbirths in The Netherlands.

Studies from Denmark and the USA have reported a strong correlation between the seasonal pattern for stillbirths and the seasonal birth pattern for people who develop schizophrenia. It has been suggested that the correlation could be caused by a common seasonal factor (e. g. intra-uterine infections during the third trimester of pregnancy), which produces death in some fetuses and nonfatal brain changes in others, changes that are manifested in later life as schizophrenia. The aims of our study were (i) to assess the seasonal patterns for stillbirths and for pre-schizophrenic births in The Netherlands and (ii) to examine their relationship. The Dutch psychiatric registry provided data on all Dutch-born subjects who had been hospitalized at least once with a diagnosis of schizophrenia in the period 1970-1994. We selected data on patients born in the period 1926-1970 (n=29891). The government provided monthly numbers of live births and stillbirths in the latter period. Seasonality of birth was examined using Poisson regression analysis. The risk of an admission for schizophrenia was highest for people born in the months of May and June and lowest for those born in August and September. When the risk for subjects born in June was compared with the risk for subjects born in September, the Relative Risk was 1.14 [95% confidence interval (CI): 1.07 to 1.22]. The seasonal pattern of stillbirths was different, in that it showed a peak in the month of January. The low, however, as in schizophrenia, occurred in the months of August and September. The two seasonal patterns were found to be weakly correlated: Spearman's rank correlation coefficient rho=0.41 (95% CI: -0.22 to 0.80). This was the largest European study on birth seasonality in schizophrenia. The hypothesis that a common factor is responsible for a seasonal excess of stillbirths and for a seasonal birth excess of people who develop schizophrenia was not supported. The possibility remains, however, that a common factor explains seasonal (birth rate) deficits in these disorders.

Birth Rate↗
PubMed2000

Borna disease virus and schizophrenia in Surinamese immigrants to the Netherlands.

Borna disease virus (BDV) has been suggested to play a role in the etiology of schizophrenia. We tested the hypothesis that markers of BDV infection are more frequent in Surinamese immigrants to the Netherlands, diagnosed with schizophrenia, than in Dutch-born healthy subjects. For reasons that are poorly understood there is an increased incidence of schizophrenia in this immigrant group. Blood was obtained from 29 male schizophrenic patients (DSM-IV criteria) and from 26 healthy males. For detection of anti-BDV antibodies an indirect immunofluorescence assay (IFA) was performed. A nested, reverse-transcriptase-PCR, using primers specific for the p24 and p40 BDV genes, was used to determine BDV-RNA in peripheral blood mononuclear cells. Contrary to our expectations, the frequencies of BDV markers in the group of healthy subjects, as determined by IFA and both PCRs, exceeded that in the group of patients. The results do not support an association between markers of BDV infection in blood and schizophrenia. It is unlikely that the high incidence of schizophrenia in Surinamese immigrants is caused by BDV, but the small number of subjects examined do not warrant definitive conclusions.

Antibodies, Viral↗
PubMed2000

Distress attributed to negative symptoms in schizophrenia.

The purpose of the study was to examine (1) to which negative symptoms schizophrenia patients attribute distress and (2) whether clinical variables can predict the levels of reported distress. With the help of a research assistant, 86 hospitalized patients completed a self-rating scale for negative symptoms. The 21 items of the self-rating scale were taken from the Scale for the Assessment of Negative Symptoms (SANS). A psychiatrist rated the patients on a number of scales, including the SANS. When patients reported particular symptoms, they were asked whether those symptoms bothered or distressed them. Answers to this question were highly dependent on the type of symptom involved. Distress was most often attributed to symptoms in the subscale avolition-apathy. Patients were also asked how much they were bothered or distressed. Again, high levels of distress were most often attributed to items in the subscale avolition-apathy. A summary score was developed for the level of reported distress: the distress score. Regression analysis showed that distress scores were not associated with the observed severity of negative symptoms or with the level of psychiatric disability. High distress scores were best predicted by the combination of high scores for depression and high scores for insight into positive symptomatology. However, this model explained only a quarter of the variance in distress scores.

Adult↗
PubMed1999

Prenatal exposure to the 1957 influenza pandemic and non-affective psychosis in The Netherlands.

Second-trimester exposure to the 1957 A2 influenza pandemic is a controversial risk factor for schizophrenia. Two earlier studies of the Dutch psychiatric registry failed to find an increased risk for exposed subjects, but diagnostic misclassification within the spectrum of non-affective psychoses has not yet been ruled out as an explanation for the negative findings. Using an enlarged data-set we examined not only whether second-trimester exposure to the epidemic is associated with an increased risk of schizophrenia (ICD:295), but also whether it is associated with an increased risk of paranoid states (ICD:297) or other non-organic psychoses (ICD:298). In this retrospective cohort study the risks of the above-mentioned disorders were compared for those exposed and unexposed to A2 influenza during the second trimester of fetal life. The risks for the exposed subjects were not significantly higher than the risks for the unexposed. The power of the study to detect a significant increase in the risk of schizophrenia was sufficient. If the relative risk of a lifetime hospitalization for schizophrenia for second-trimester exposed subjects (born January-April 1958) is assumed to be 1.3, the power of the study would be 0.97 (alpha=0.05; one-tailed testing). If the relative risk for subjects born five months after the peak of the epidemic (mid-February to mid-March 1958) is assumed to be 1.88, as reported for England and Wales, the power of the study would be close to 1.00. This was the largest study of its kind in Europe: 275 subjects were born in the period January-April 1958 and had a lifetime hospitalization for schizophrenia. This study indicates that there is no relation between second-trimester exposure to the 1957 influenza pandemic and risk of non-affective psychosis in the Dutch population. It adds to a growing body of work which does not support an association between maternal influenza and schizophrenia.

Adolescent↗
PubMed1999

Psychotic illness after prenatal exposure to the 1953 Dutch Flood Disaster.

We tested the hypothesis that maternal stress during pregnancy increases the risk of non-affective psychosis for the child. The concept of non-affective psychosis includes the ICD categories schizophrenic disorder, paranoid state and other non-organic psychosis. Data from the Dutch Psychiatric Registry were examined for an effect of the Flood Disaster of 1 February 1953. On this day, a gale caused a flood in the South-west of The Netherlands and 1835 people perished. Our study concerned the 19 villages where mortality exceeded 0.25%. The risk of non-affective psychosis for the cohort born in the period February-October 1953 was compared to the risks for the cohorts born in the corresponding periods of the previous and subsequent 2 years. The relative risk of non-affective psychosis for those exposed during gestation was 1.8 [95% Confidence Interval (CI): 0.9-3.5]. Thus, our study failed to demonstrate a significant association between prenatal exposure to maternal stress and risk of non-affective psychosis. The possible explanations for this finding are discussed.

Cohort Studies↗
PubMed1998

Prenatal exposure to influenza and schizophrenia in Surinamese and Dutch Antillean immigrants to The Netherlands.

There is evidence of an increased incidence of schizophrenia in Afro-Caribbean immigrants to the UK and in Surinamese- and Dutch Antillean immigrants to The Netherlands. We tested the hypothesis that second-trimester exposure to the 1957 A2 influenza pandemic, which swept through the Caribbean in the same period as it affected Western Europe, contributes to this phenomenon. The dates of birth of immigrants, discharged from a Dutch psychiatric institute with a diagnosis of schizophrenia, were examined for any effect of the pandemic. Individuals who were in their second-trimester of fetal life at the peak of the pandemic were at no greater risk of developing schizophrenia than controls.

Adult↗
PubMed1998

Urbanization and psychosis: a study of 1942-1978 birth cohorts in The Netherlands.

BACKGROUND: Urban birth is associated with later schizophrenia. This study examined whether this finding is diagnosis-specific and which individuals are most at risk. METHODS: All live births recorded between 1942 and 1978 in any of the 646 Dutch municipalities were followed-up through the National Psychiatric Case Register for first psychiatric admission for psychosis between 1970 and 1992 (N = 42115). RESULTS: Urban birth was linearly associated with later schizophrenia (incidence rate ratio linear trend (IRR), 1.39; 95% confidence interval (95% CI), 1.36-1.42), affective psychosis (IRR, 1.18; 95% CI, 1.15-1.21) and other psychosis (IRR, 1.27; 95% CI, 1.24-1.30). Individuals born in the highest category of the three-level urban exposure were around twice as likely to develop schizophrenia. Associations were stronger for men and for individuals with early age of onset. The effect of urban birth was also stronger in the more recent birth cohorts. CONCLUSIONS: There are quantitative differences between diagnostic categories in the strength of the association between urban birth and later psychiatric disorder. High rates of psychosis in urban areas may be the result of environmental factors associated with urbanization, the effect of which appears to be increasing over successive generations.

Adult↗
PubMed1998

Experience of negative symptoms: comparison of schizophrenic patients to patients with a depressive disorder and to normal subjects.

OBJECTIVE: Three hypotheses were tested: 1) schizophrenic patients would report more impairments on a self-rating scale for negative symptoms than normal subjects and attribute higher levels of distress to these impairments, 2) schizophrenic patients would report fewer impairments than patients with a depressive disorder and attribute lower levels of distress to these impairments, and 3) schizophrenic patients would attribute their impairments less often to mental illness than would patients with a depressive disorder. METHOD: A self-rating scale for negative symptoms was administered to 86 patients with schizophrenia, 20 patients with a depressive disorder, and 33 normal subjects. The scale items were derived from the Scale for the Assessment of Negative Symptoms (SANS). Two psychiatrists also rated all of the patients on the SANS. RESULTS: The hypotheses were supported. The differences between the two groups of patients in the rates of reported impairments and the levels of reported distress remained statistically significant after control for differences in age, sex, length of current admission, length of illness, dose of neuroleptic medication, use of clozapine, and severity of negative symptoms. CONCLUSIONS: The results suggest that a large number of schizophrenic patients are somewhat aware of negative symptoms but that they are less aware of these impairments and less concerned about them than are patients with a depressive disorder.

Adolescent↗
PubMed1998

Prenatal exposure to maternal stress and subsequent schizophrenia. The May 1940 invasion of The Netherlands.

BACKGROUND: It has been suggested that prenatal exposure to maternal stress increases the risk of subsequently developing schizophrenia. METHOD: The five-day invasion and defeat of The Netherlands by the German army in May 1940 constituted a severe, well-circumscribed national stressful event. Individuals exposed and non-exposed to this stressor in the first, second and third trimester of pregnancy were followed up for lifetime schizophrenia outcome through the National Psychiatric Case Register. REGISTER: Cumulative incidence of schizophrenia was higher in the exposed cohort (risk ratio (RR): 1.15, 95% CI 1.03-1.28), especially in those exposed in the first trimester (RR: 1.28, 95% CI 1.07-1.53). Significant interaction with gender was apparent in second trimester exposed cohorts (RR men: 1.35, 95% CI: 1.05-1.74; RR women: 0.83, 95% CI: 0.61-1.12). CONCLUSION: Maternal stress during pregnancy may contribute to the development of vulnerability to schizophrenia. The apparent longer window of exposure in male foetuses may be related to the slower pace of male early cerebral development.

Adult↗
PubMed1997

Schizophrenia in Surinamese and Dutch Antillean immigrants to The Netherlands: evidence of an increased incidence.

BACKGROUND: Reports of an increased incidence of schizophrenia in Afro-Caribbean immigrants to the UK are a matter of much debate. It is of interest, therefore, that in the 1970s and 1980s many immigrants from Surinam and The Netherlands Antilles have settled in The Netherlands. The purpose of our study was to compare the risk of a first admission for schizophrenia for Surinamese- and Antillean-born persons aged 15-39 years to that for their Dutch-born peers in the period 1983-1992. METHODS: We used data from the Dutch psychiatric registry. Age-adjusted relative risks were calculated using Poisson regression analysis. RESULTS: The risk for the immigrants was found to be three to four times higher than that for the Dutch-born. Age-adjusted relative risks were significantly higher for male than for female immigrants. CONCLUSIONS: The results provide evidence of an increased incidence in these immigrant groups and support similar findings on Afro-Caribbeans in the UK. Migration from Surinam was on such a large scale that selective migration of persons at risk for the disorder is unlikely to account entirely for these findings.

Adolescent↗
PubMed1995

Low prevalence of age disorientation in Dutch long-stay patients.

Studies in Great-Britain and the USA have established the prevalence of 'age disorientation', defined as a discrepancy between true and subjective age of five years or more, as approximately 25% in the population of long-stay patients with a diagnosis of schizophrenia. We examined all schizophrenic patients in long-stay wards of three mental hospitals and found a prevalence of 6% (95% CI: 0.9-10.6%). We have no definitive explanation for this finding. 'Age disorientation' may be the result of an interaction between a serious form of the illness and poor psychosocial treatment.

Adult↗