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Biomedical subjects

S Levander

Publications and source records attributed to S Levander.

At least 55 records · Page 3Linked to original sources
PubMed1993

Sandra: successful psychotherapeutic work with a schizophrenic woman.

This presentation concerns a young woman who gradually developed a schizophrenic picture on the basis of a borderline personality, and who recovered after more than 20 years of incapacitating symptoms. Today she sees her psychotherapy as decisive for the outcome. The material was collected from case records as well as from interviews with the patient and her therapist. Special emphasis is laid on the attitude and working methods of the therapist as these were viewed retrospectively by the two participants in the therapeutic process.

Adult↗
PubMed1991

Peripheral antihistamine and central sedative effects of single and continuous oral doses of cetirizine and hydroxyzine.

The peripheral histamine-inhibiting and central sedative effects of single oral doses (SOD) and of repeated administration for one week (steady state, SS), of 20 mg hydroxyzine HCL and 10 mg cetirizine have been assessed in 12 healthy volunteers, in a double-blind placebo-controlled cross-over study. Peripheral H1-receptor antagonism was estimated as the reduction in the area of the flare and the duration of the itch after intradermal injection of histamine 0.1 and 1.0 micrograms. CNS effects were assessed by a battery of computerized neuropsychological tests and seven visual analogue scales. Drug compliance was ascertained by plasma level determinations. Cetirizine 10 mg (SOD) produced a more pronounced peripheral effect than 20 mg hydroxyzine, whereas hydroxyzine but not cetirizine, showed a significant sedative action in the relevant rating scales. These effects vanished during steady state, suggesting adaptation to the initial sedative effect of hydroxyzine in most of the subjects. No sedative effect of cetirizine was demonstrated. There was no impairment at group level in the neuropsychological tests after the SOD or SS treatment. However, six subjects who showed sedation in the analogue ratings after hydroxyzine, displayed significantly impaired performance after hydroxyzine SOD. The findings are discussed in relation to the individual characteristics of the study groups.

Administration, Oral↗
PubMed1991

Hypoglycaemic episodes during intensified insulin treatment: increased frequency but no effect on cognitive function.

Ninety-seven patients with insulin dependent diabetes mellitus (IDDM) were randomized to intensified conventional treatment (ICT, n = 44) or regular treatment (RT, n = 53). The mean HbA1c level (+/- SEM) was reduced from 9.5 +/- 0.2% to 7.4 +/- 0.1% in the ICT group (P less than 0.001), and from 9.4 +/- 0.2% to 9.0 +/- 0.2% (P less than 0.01) in the RT group. The difference between the groups was significant (P less than 0.001). During a period of 3 years, 57% of the ICT patients (95% confidence interval 44-73%) and 23% of the RT patients (95% CI, 11-34%) (P less than 0.001) had at least one episode of serious hypoglycaemia, with the need for third-party assistance or resulting in coma. Eighteen of the 32 ICT patients who initially had adrenergic symptoms during hypoglycaemia changed to predominantly neuroglycopenic symptoms. This was the case with only 8 of 38 RT patients (P less than 0.01). The change in symptoms was related to the increased frequency of serious hypoglycaemia, but neither symptoms nor frequency of hypoglycaemia bor any relationship to insulin dose, body mass index, duration of diabetes or autonomic nerve function. The results of several neuropsychological tests did not differ between the groups at baseline, and did not change during the study. There were no signs of deteriorating cognitive function in the patients with serious hypoglycaemic episodes.

Adult↗
PubMed1990

Permanent neuropsychological impairment after recurrent episodes of severe hypoglycaemia in man.

Seventeen Type 1 (insulin-dependent) diabetic patients with a history of recurrent and severe hypoglycaemia and Type 1 diabetic patients with no severe hypoglycaemia were compared as regarded performances in tests of neuropsychological functioning. To test the hypothesis that recurrent severe hypoglycaemia gives rise to permanent cognitive impairment, the study group was selected among those patients who had met with repeated attacks over the last three years or more as identified by a questionnaire among almost 600 insulin-treated diabetic patients. The comparison group without known severe reactions were comparable to the study group with respect to type of diabetes, sex, age, age at onset, duration of diabetes, socio-economic parameters, and prevalence of neuropathy and retinopathy. The results indicate that Type 1 diabetic patients with recurrent severe hypoglycaemia scored lower than those without severe hypoglycaemia in tests of motor ability, short-term and associative memory and visuospatial tasks assessing ability in general problem-solving. Type 1 diabetic patients with severe hypoglycaemia also displayed a higher frequency of perspective reversals suggesting frontal-lobe involvement. These data can be interpreted in two ways. One interpretation implies that the cognitive impairment of Type 1 diabetic patients with severe hypoglycaemia reflects a selection factor, the other that recurrent episodes of severe hypoglycaemia result in permanent cognitive impairment.

Cognition↗
PubMed1990

Differences in asymmetric perception of facial expression in free-vision chimeric stimuli and reaction time.

Two forms of a Chimeric Faces Free-Vision Task used to estimate cerebral asymmetry for perceiving facial expression were given to young male subjects, n = 60 in a first session and n = 40 in a retest session. Test-retest and split-half reliabilities were high. As expected from assumptions of right-hemisphere specialization for processing expression, faces with left-sided smiles were more frequently judged as looking happier than those with right-sided smiles in both forms. However, there were individual differences in direction and extent of bias, which were systematically related to reaction time, right visual field-biased subjects being slower. Differences in lateral bias as well as in reaction time are assumed to reflect individual patterns of hemispheric activation, whereas the average left bias in the present male group may reflect right-hemisphere specialization for processing of facial expression.

Adult↗
PubMed1990

Clonazepam and imipramine in the treatment of panic attacks: a double-blind comparison of efficacy and side effects.

Data from 12 patients (in two control study groups) provide preliminary results of an ongoing double-blind comparison of clonazepam and imipramine in the treatment of panic disorder. In both treatment groups, the patients' global improvement was substantial over the first few weeks and persisted over the 6-month treatment period based on assessments by the therapist and the patient; side effects were mild. Faintness was slightly more prevalent among patients on clonazepam treatment but disappeared after the first few weeks. Mild, persistent tachycardia was reported among patients receiving imipramine. No tolerance emerged, and discontinuation was successful in 2 patients from each group after 6 months of treatment. Eight patients needed continued medication (25-50 mg/day of imipramine, 0.5-2.0 mg/day of clonazepam) to maintain substantial improvement. Findings confirm earlier reports from open studies that low doses of both drugs eliminate panic attacks (about 50 mg/day for imipramine and 1.5 mg/day for clonazepam).

Adult↗
PubMed1989

Smooth pursuit eye tracking and neuro-psychological performance in healthy volunteers. Exploring a possible genetic marker for vulnerability to schizophrenia.

Eye movement dysfunction (EMD) has been repeatedly found in schizophrenics and their first-degree relatives. In the present study, smooth pursuit eye tracking was measured in healthy subjects and related to performance on computerized neuropsychological tasks assumed to involve frontal or frontoparietal functions: monitoring perspective fluctuations (Necker cube), finger tapping, trail making, reaction time (RT) and a perceptual maze test. Poor trackers performed worse on tasks requiring parallel processing (trail making with letters and digits and RT with random auditory signals for response inhibition) and made more errors and cancellations on the mazes. Results are in line with our earlier EMD results on schizophrenics, showing poor performance on frontal tasks. However, their deficiency was more pervasive, whereas the present healthy EMD subjects only had difficulties with more complex tasks. The results are of interest in view of the recent evidence that EMD may be a genetic marker for vulnerability to schizophrenia.

Adult↗
PubMed1987

Community work as part of the psychiatric services of Nacka.

In psychiatry we often meet people presenting psychiatric symptoms rooted in social or psycho-social problems. Traditional treatment methods often fail, leading to a sense of failure in the therapist and an experience of being misunderstood or being "a hopeless case" in the patient. There is a need for developing new methods for problems belonging to the "grey zone", that is the area bordering on or covered by the three major care systems in our society: the social welfare, the primary care system and psychiatry. These methods should necessarily take into account the specific needs expressed in the symptoms and guarantee a more holistic perspective of the patient and his situation. The author gives some practical examples of work with immigrant women, an Information Bureau and a Cafe especially intended for chronically ill psychiatric patients.

Acculturation↗
PubMed1986

Skin conductance habituation and cerebrospinal fluid 5-hydroxyindoleacetic acid in suicidal patients.

The concentration of 5-hydroxyindoleacetic acid (5-HIAA) in the cerebrospinal fluid (CSF) and psychophysiologic variables, such as habituation of the skin conductance response, were measured in 35 drug-free, suicidal inpatients. Twenty-four patients were hospitalized after a suicide attempt, and another 11 had suicidal ideation. The suicide attempters were classified into nonviolent (drug overdoses taken orally, or a single wrist cut) and violent (all other methods). As in previous studies, the suicide attempters had significantly lower CSF concentrations of 5-HIAA compared with healthy, matched controls. The distribution of habituation rate was bimodal (slow and fast habituators). All violent attempters were fast habituators, as were all four patients who in a one-year follow-up were found to have completed a suicide (all by violent methods). The lowest frequency of fast habituators was found in the group of patients with suicidal ideation. There was no correlation between CSF 5-HIAA and habituation rate. A combination of these two variables yielded a highly significant correlation with type of suicide behavior, both retrospectively and prospectively.

Adult↗
PubMed1986

Personality traits predicting weight loss outcome in obese patients.

A personality inventory, the Karolinska Scales of Personality (KSP), was administered to a group of 28 severely obese patients before treatment with jaw fixation. Several items significantly predicted incapacity to maintain the achieved weight loss 1 year after treatment: anxiety, monotony avoidance, suspiciousness and a low degree of socialization. These personality traits constitute a syndrome of ego weakness or impulsivity which warrants further study.

Adult↗
PubMed1986

Psychiatric determinants of weight changes in jaw-fixed obese patients.

Forty-five severely obese patients were treated with jaw fixation as a means of initiating weight loss. Patients who reported eating for consolation showed significantly greater difficulties in maintaining the achieved weight loss than the others. This finding constitutes further evidence of a relationship between obesity and depression. Low capacity to experience feelings of aggressiveness also seems to be linked to poor treatment results.

Adult↗
PubMed1985

Peripheral antihistamine and central sedative effects of three H1-receptor antagonists.

The effects of single oral doses of three antihistamine compounds on histamine-induced itch and flare reactions were studied in 24 healthy volunteers by a double-blind balanced design. Central sedative effects were concurrently analyzed using a set of computerized neuropsychological tests and analogue ratings. Hydroxyzine 20 mg had a more pronounced inhibitory effect on the cutaneous response than 3 mg clemastine or 3 mg azatadine. Clemastine tended to cause more sedation than the other two drugs. A compound score, reflecting the balance between peripheral and CNS effects, showed hydroxyzine to have relatively more peripheral antihistamine effect and less sedative effect than the other two drugs. The independence of peripheral and CNS antihistamine effects was also suggested by correlation analysis. Subjects displayed individual sensitivity to the peripheral antihistamine effect of the three drugs; a marked antihistamine effect of one drug predicted a marked effect of the other two drugs. This was not the case for CNS sedation. The independence of peripheral and CNS effects should encourage development of new and more specific antihistamine compounds.

Adult↗