Failure of bromide psychosis to respond to ECT.
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Adult↗
Biomedical subjects
R Abrams
Publications and source records attributed to R Abrams.
Response to lithium carbonate.
We examined the clinical and research records of 29 acutely ill hospitalized patients with affective disorder who received only lithium carbonate during their first week of treatment. Nineteen patients (Group I) could be continued on lithium ion alone, while 10 patients (Group 2) needed additional somatic treatment. Compared with Group 1, Group 2 patients were significantly younger at illness onset, more severely ill on admission, clinically more "colorful" in dress and behavior, stayed more than twice as long in the hospital, and (although not statistically significant) had more than twice the morbidity risk for affective disorder in first-degree relatives. At discharge, both groups were equally improved, and 70% of Group 2 patients were receiving lithium alone. We did not confirm previous reports that nonresponders to lithium alone (Group 2) were more overactive or paranoid--destructive or less euphoric--grandiose than responders to lithium alone (Group 1). Our Group 2 patients had a more severe or penetrant form of illness than our Group 1 patients, requiring neuroleptic drugs or ECT in addition to lithium therapy. Eventually, however, they had a satisfactory outcome, suggesting therapeutic optimism and tenacity even in those patients who initially fail lithium alone and require polytreatment.
Affective Symptoms↗
Body fluid lithium measurements: severity of illness and prediction of outcome.
The authors measured lithium ion in saliva and serum 24 hr after a loading dose of lithium, and recorded the amount of lithium excreted in the urine during the 24-hr test period. Their results support previous work indicating a correlation between serum and mixed saliva lithium levels. On a subsample of manic patients, no correlation could be found between lithium retention and clinical outcome, age of onset, or pretreatment severity of illness. In addition, they were unable to confirm a prior report that the 24-hr postloading dose serum lithium level was a predictor of eventual therapeutic dosage.
Adult↗
Catatonia. Prevalence and importance in the manic phase of manic-depressive illness.
Of 123 acutely ill patients with bipolar affective disease, 28% exhibited clinical signs of catatonia. We were unable to differentiate manics with catatonic signs from manics without catatonic signs with regard to demographic characteristics, psychopathology, and the prevalence and pattern of psychiatric illness in their first-degree relatives. Our sample was similar to previously studied groups of manics. Although generally held to be associated with schizophrenia and of poor prognostic import, catatonic signs did not predict a poor treatment response in our manic patients. These data support the growing body of evidence demonstrating that catatonic signs are nonspecific and may be highly prevalent among patients with bipolar affective disease.
Adult↗
Influence of effectors on the rate of reaction of reduced ribonucleoside triphosphate reductase with N-ethylmaleimide.
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Dithiothreitol↗
Catatonia: prediction of response to somatic treatments.
The authors investigated predictors of somatic treatment response in 55 patients with one or more of eight catatonic motor features. Responders more often had good prognostic signs, rapid or pressured speech, and diagnosable affective disorder or alcoholism. Nonresponders were younger at age of onset of first illness and were more frequently disoriented; they included all patients diagnosed as schizophrenic. The authors suggest that treatment response in catatonia is a function of primary diagnosis and that the syndrome is diagnostically nonspecific but occurs most often in patients with affective disorders.
Adult↗
More on genetic transmission in schizophrenia.
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Adoption↗
Capgras' syndrome and cerebral dysfunction.
Two cases of Capgras' syndrome in association with coarse brain disease are presented. The authors suggest that prosopagnosia (face nonrecognition) may be the primary expression of a specific cerebral dysfunction which forms the basis for a delusional elaboration resulting in Capgras' syndrome.
Adult↗
Schizophrenia in a 46,XY male with the Noonan syndrome.
We report for the first time the case of a male patient with the Noonan syndrome (Turner phenotype with a normal karyotype) who also had a psychiatric disorder which satisfied research criteria for schizophrenia.
Adult↗
Depression, ECT, and erythrocyte adenosinetriphosphatase activity.
Erythrocyte membrane Na+-K+ ATPase and Ca++ATPase levels were investigated in 11 women treated with ECT for endogenous depression and 11 age-matched normal control subjects. Pretreatment ATPase levels in depressives were significantly lower than in controls, and increased to control levels after a course of ECT. These data are discussed in terms of the physiology of depressive illness and ECT.
Adenosine Triphosphatases↗
Catatonia. A prospective clinical study.
We studied 55 patients admitted during 14 months to two inpatient psychiatric units of a municipal hospital who exhibited one or more of the catatonic signs of mutism, stereotypy, posturing, catalepsy, automatic obedience, negativism, echolalia/echopraxia, or stupor. Only four of the 55 patients satisfied our research criteria for schizophrenia, whereas over two thirds had diagnosable affective disorders, usually mania. The eight catatonic motor signs were nonspecific and homogeneously distributed among the various research diagnostic groups, with the number and type of individual signs unrelated to short-term treatment outcome. A favorable treatment response was shown for the entire catatonic sample, with two thirds markedly improved or in remission at the time of discharge. These findings are consistent with those of other investigators of the catatonic syndrome for the past 100 years.
Adolescent↗
Mania and schizo-affective disorder, main type: a comparison.
The authors report data gathered from a consecutive sample of 88 psychiatric inpatients who were diagnosed as having either manic disorder or schizo-affective disorder, manic type, according to Research Diagnostic Criteria (1) similar to those proposed for DSM-III. There were no differences between diagnostic groups on clinical psychopathological or demographic variables, individual or family history, or treatment response.
Adult↗
Diencephalic stimulation and the effects of ECT in endogenous depression.
We compared conventional bilateral ECT treatment electrode placement with simultaneous unilateral electrode placement to both sides of the head (dominant/nondominant unilateral ECT) in 20 patients with endogenous depression. Under double-blind random assignment conditions we found that six bilateral ECT were significantly more effective than six dominant/nondominant unilateral ECT in reducing depression rating scale scores. In the light of data from intracerebral ECT current distribution studies we interpret our findings to support our previously advanced hypothesis that diencephalic stimulation is requisite for the therapeutic benefit of bilateral ECT in endogenous depression.
Adult↗
Concentration of 5-hydroxyindoleacetic acid, homovanillic acid, and tryptophan in the cerebrospinal fluid of depressed patients before and after ECT.
Cerebrospinal fluid (CSF) levels of 5-hydroxyindoleacetic acid (5HIAA), tryptophan (TRYP), and homovanillic acid (HVA), were determined prior to electroconvulsive therapy (ECT) and after an average course of 6.7 ECT in six endogenous depressed patients. Depression rating scale (DRS) scores were also obtained by a "blind" research psychiatrist before and after ECT at the time of each lumbar puncture. ECT markedly reduced DRS scores but did not significantly alter CSF levels of 5HIAA, TRYP, or HVA. We found no correlation between ECT-induced DRS score reductions and changes in any of the CSF constituents studied, or between the absolute DRS score and the corresponding CSF concentration of any of the compounds. These data are consistent with those previously reported for ECT and do not suggest that ECT alters cerebral amine metabolism in depressed patients. Neither do they provide any evidence for direct amine mediation of the depression-relieving effects of ECT in man, nor for any relation between severity of depressive illness and CSF concentrations of 5HIAA, TRYP, or HVA.
Adult↗
Acute mania. Clinical and genetic study of responders and nonresponders to treatments.
We examined the relationships among family history of psychiatric illness, demographic and historical variables, clinical course and presentation, and treatment response for 58 patients satisfying research criteria for mania. Nearly two thirds of the group had excellent responses to somatic treatment, particularly lithium ion, while one third had poor responses to lithium carbonate, neuroleptics, or electric convulsive therapy. Responders frequently exhibited euphoric moods, grandiose delusions, and tended to have cyclothymic premorbid personalities. Nonresponders were rarely euphoric, frequently exhibited incomplete auditory hallucinations, and tended to hve formal thought disorder and depressive-withdrawn premorbid personalities. Responders tended (nonsignificant) to have greater genetic loading for affective illness and alcoholism. We could not distinguish the two groups by their age at illness onset, duration of illness, or number of illness episodes per ill patient year.
Acute Disease↗
The circulating plasma volume of the foetal lamb as an index of its weight and rate of weight gain (g/day) in the last third of gestation.
In a series of foetal lambs weighing between 1,100 and 5,228 g, the circulating plasma volume was estimated by the dye dilution method, using Evans Blue, to test the possibility that the plasma volume could be used as an index of foetal weight in chronic studies. The data, analysed by the method of least squares regression, indicate that plasma volume and foetal weight are closely correlated (R-2 equals 0.922) and linearly so in the range of data studied. There was no evidence that the relation differed for singlets and twins. A single equation, Y equals 71.8 plus 10.11 X--where Y is the estimated weight and X the plasma volume, can be used to predict the weight from plasma volume in both. Some results of the application of the method in chronic studies are presented.
Animals↗
A critique of the St. Louis psychiatric research criteria for schizophrenia.
The authors reviewed the research data for 89 hospitalized patients who were given a diagnosis of schizophrenia and 22 who were given a diagnosis of mania on admission. They found that 11 (12 percent) of the schizophrenic patients satisfied the St. Louis research criteria for schizophrenia and 10 (11 percent) satisfied the authors' criteria. Diagnostic agreement between the sets of criteria was shared in only 5 of these patients. On the basis of this finding and other studies of the St. Louis criteria, the authors suggest specific modifications that would broaden the utility of these criteria and minimize diagnostic disagreement.
Adult↗