Biomedical subjects
P Sirota
Publications and source records attributed to P Sirota.
[Seroquel in a resistant schizophrenic with negative and positive symptoms].
Refractoriness to treatment is a common problem in management of schizophrenics. Conventional pharmacotherapy is usually effective in controlling positive symptoms of the disease, such as delusions and hallucinations. However, they have restricted ability to affect negative symptoms (flat affect, social withdrawal) and to reverse functional disability and behavioral deviance. Furthermore, typical neuroleptics produce adverse effects, such as extrapyramidal symptoms and tardive dyskinesia. A new generation of antipsychotic agents with a low profile of side-effects and good tolerance has recently been developed and actively investigated. Seroquel (ICI 204-636), a dibenzoth azepine derivative, is a novel, putative, potential, atypical neuroleptic; it is a combined dopamine/ serotonin receptor antagonist. We report a 54-year-old man suffering from chronic therapy-resistant schizophrenia, with both positive and negative symptoms, who was successfully treated with Seroquel during 1 year.
No evidence for autoimmunity in schizophrenia.
We studied parameters of cellular immunity in 23 schizophrenic patients and compared them to 16 matched healthy controls and to 12 patients with rheumatoid arthritis (RA). None of the patients was receiving neuroleptic drug treatment before the study. We used highly sensitive methods to examine the interferon system by determination of the interferon-induced enzyme 2'-5' oligo-adenylate synthetase [2-5A] in peripheral blood mononuclear cells. Tumor necrosis factor alpha (TNF-alpha) production was measured in the plasma and in vitro by bioassay of supernatants of stimulated blood cells and of unstimulated cells (spontaneous TNF secretion). In addition, we determined cell-mediated (spontaneous) cytotoxicity, major T cell subsets (CD3, CD4 and CD8 positive cells) and serum neopterin levels. No statistically significant differences could be found between the patients with schizophrenia and the control group in any of the tests used, and no particular subgroup of patients could be identified. In contrast, RA patients had increased serum neopterin and TNF levels, increased LPS-induced TNF production in vitro, increased 2-5A levels and a decrease in CD8 cells associated with an increase in CD4 cells. Thus, in the group of patients studied, we could find no substantiation for the presence of either autoimmune or occult viral cofactors in the pathogenesis of schizophrenia.
The effect of chlorpromazine and haloperidol on DNA transcription.
The ability of human cells to repair DNA damage can be indirectly assessed by measuring transcriptional activity relating to active genes, a process referred to as RNA synthesis. This study was carried out to investigate the effects of chlorpromazine and haloperidol on the transcriptional activity of actively transcribed genes as an expression of DNA damage and repair. Three cultured human fibroblast lines were used: two were "normal" in previous RNA recovery testings and one was abnormally sensitive to UV irradiation. In the "normal" line, recovery of RNA synthesis occurred within 1 hour of UV after exposure to three concentrations of chlorpromazine (125, 250 and 500 ng/ml) and haloperidol (5, 10 and 20 ng/ml). Following treatment with the same concentrations of chlorpromazine and haloperidol, the UV-sensitive cell line showed markedly depressed recovery of RNA synthesis at 1 and 4 hours. Complete recovery was not reached even after 24 hours. Our results suggest that neuroleptics widely used in clinical practice adversely affect cell lines that are sensitive to DNA-damaging agents.
Neuroleptic-resistant schizophrenia treated with clozapine and ECT.
Despite advancement in psychopharmacology, treatment-resistant schizophrenia still poses a challenge to modern psychiatry. We present four patients with schizophrenia treated with clozapine and ECT. One patient who developed neuroleptic malignant syndrome (NMS) on conventional neuroleptics experienced no complications with this combination.
Psychoneuroimmunology: searching for the main deteriorating psychobehavioral factor.
Psychoneuroimmunology has become an independent science with a broad experimental basis. However, its theoretical basis is still very vague and ambiguous. There are many contradictions in the experimental data that have not been integrated into a united conception, and some accepted paradigms that remain doubtful. The present critical review suggests a conceptual approach to the problem based on the proposition of two opposite types of behavior (search activity and renunciation of search) with attempts to integrate experimental results by avoiding contradiction. The analysis of the literary data confirms that every behavior that includes search activity prevents psychoimmunological disorders, whereas renunciation of search displays a general predisposition to such disorders. Such an approach makes possible new solutions of paradoxes and broadens the possible interpretations of the alteration of immune functions in depression, anxiety, and stressful events.
[Depression and epilepsy].
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[Evoked potentials in psychiatry].
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Increased interleukin-1 and interleukin-3 like activity in schizophrenic patients.
1. The interleukins play an important role in the development and maintenance of the immune system 2. Decreased cell mediated immunity measures were found in schizophrenic patients. 3. The purpose of the present study was to study the spontaneous production of interleukin-1 (IL-1) and interleukin-3 like activity (IL-3-LA) by human mononuclear cells from schizophrenic patients in comparison to healthy individuals. 4. Interleukin-1 was increased significant by schizophrenic patients as compared to controls. 5. Interleukin-3 like activity was slightly elevated in schizophrenic patients as compared to controls. 6. These findings support the hypothesis of an autoimmune dysfunction in some schizophrenic patients.
A comparison of two modalities of cognitive therapy (individual and marital) in treating depression.
Historically, depression was explained and treated intrapsychically and/or biochemically. In the 1970s theoretical propositions and treatment applications began to appear that offered that depression should be viewed cognitively (Beck 1963, 1974; Beck et al. 1979) or interpersonally (Coyne 1976a, 1976b; Klerman et al. 1984). Simultaneously, though more sporadically, marital interventions started to attract interest (Feldman 1976; Friedman 1975). The cognitive and interpersonal trends of thinking stimulated researchers to investigate the efficacy of these therapeutic modalities and to compare them with each other. Interest in these two treatments peaked with the publication of the study that emerged from the National Institute of Mental Health (NIMH) Treatment of Depression Collaborative Research Program (Elkin et al. 1989). This well-known research found that the two psychotherapies were similarly effective, but that the interpersonal approach was slightly more successful with more severely depressed patients.
[Self-castration].
Self-castration has been described in different eras and societies. It usually occurs in transsexualism, serious personality disorders and psychosis. It is not impulsive, but the result of long-standing conflicts, usually involving difficulties with male identity and inability to cope with sexual drives. Schizophrenics usually act under the influence of delusions and hallucinations. The medical and social attitudes to self-castration are never unequivocal. There are 60 case reports in the psychiatric literature. We describe a 35-year-old schizophrenic who castrated himself.
[Mental disorders in Marfan's syndrome].
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[Animal metamorphosis (lycanthropy) still exists].
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[Conversive hallucinations].
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Anticardiolipin antibodies are elevated in drug-free, multiply affected families with schizophrenia.
The objective of this study was to measure anticardiolipin antibodies in patients and healthy relatives in multicase families with schizophrenia. Twenty-eight (28) multicase families with schizophrenia were examined. One hundred three drug-free patients and 66 first-degree relatives consented to evaluation by DSM-III-R criteria. Criteria for patient definition included the following: age > or = 16, a confirmed hospital diagnosis of schizophrenia, knowledge of biological parents, and consent to participate. Additional data were drawn from family history and medical records. Serum samples were tested separately for IgG and IgM anticardiolipin by enzyme-linked immunosorbent assay (ELISA) and designated positive/negative by comparison to the reactivity of an age-matched control group. IgG anticardiolipin antibodies were significantly more common in both patients and relatives compared to controls. IgM anticardiolipin antibodies were significantly more common in patients. In 75% of families at least one member was anticardiolipin positive and this positivity correlated with patient positivity. The relevance of anticardiolipin antibodies in both patients and healthy relatives of some multicase families to the pathogenesis of schizophrenia is discussed.
Body esteem in Israeli university students.
Body-esteem is an important dimension in the general concept of body-image. The Body Esteem Scale (BES) was developed and tested in the USA. We tested young men and women in Israel all of whom were university students after their army service. Our results show that Israeli men score lower (feel more negative) on the virility reflecting subscale while Israeli women score higher (feel more positive) in the weight concern subscale--compared to their American counterparts. We discuss the possible explanations of this difference, focusing mainly on the impact of army discharge and the move to the academic field.
[Immigration and psychiatric morbidity].
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