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PubMed2001

Saccadic disinhibition in schizophrenia patients and their first-degree biological relatives. A parametric study of the effects of increasing inhibitory load.

Several studies have reported that patients with schizophrenia and their relatives perform poorly on antisaccade tasks and have suggested that this deficit represents saccadic disinhibition. If this proposition is correct, then varying task parameters that specifically increase the difficulty with which unwanted saccades can be inhibited should exacerbate deficits. Forty-two schizophrenia patients, 42 of their first-degree biological relatives, 21 psychotic affective disorder patients, and 38 nonpsychiatric comparison subjects were given fixation and antisaccade tasks. The introduction of distracters and the presence of visible fixation stimuli were parameters used to vary the difficulty in suppressing unwanted saccades (inhibitory load). It is known that the presence of a fixation stimulus at the time when a saccade must be inhibited results in fewer reflexive errors on antisaccade tasks. Performance on fixation tasks without (low load) vs with distracters (high load) and antisaccade tasks that had fixation stimuli still visible (low load) vs already extinguished (high load) at the time when the reflexive saccade must be inhibited was compared. The schizophrenia patients and their first-degree biological relatives showed evidence of increased saccadic disinhibition that was most pronounced during high inhibitory load conditions. These data indicate that dysfunctional inhibitory processes, at least in the oculomotor domain, are associated with the liability to schizophrenia. Results also suggest that this genetic liability may be related to dysfunctional prefrontal cortical areas that provide top-down inhibitory control over reflexive saccade generation.

Adult↗
PubMed1978

PH-dependent behavior of erythrocyte membrane elevations. II Occurrence in moderate acidemic and alkalemic conditions.

Changes of the number of red cell membrane elevations revealed by freeze-etch electron microscopy are pH-dependent in vitro and in vivo. In healthy volunteers a decrease of the number of red cell surfaces with elevations was observed under moderate acidemic and alkalemic conditions. These changes were different in patients with Huntington's chorea and affective psychotic disorders. Elevations of the red cell membrane with the same diameter can be demonstrated in ultrathin sections, if sodium azide is added during the fixation procedure.

Erythrocyte Membrane↗
PubMed1991

The concept of cycloid psychosis: sensitivity and specificity of syndromes derived by multivariate clustering techniques.

A total of 154 patients admitted for the first time to hospital for a psychotic or affective disorder in 1925 were rediagnosed in accordance with DSM-III and Leonhard's diagnostic system. Symptoms were rated in accordance with a rating protocol containing 33 items based on Leonhard's descriptions of cycloid psychoses. The patients were followed up through parish registers and hospital records. Of 42 cases considered to be cycloid psychosis at index admission, 34 were prognostically verified. The symptom ratings of the 154 patients were analysed by K-means cluster analysis to test whether the patients with cycloid psychoses would separate from the rest of the material. With a 2-cluster solution, 30 of 34 cases (88%) were contained in the same cluster. The sensitivity of the ratings was therefore judged to be acceptable. Specificity was low, however, since 19 cases in the cluster were differently diagnosed. A subcohort of 64 patients, satisfying at least 5 items of the rating protocol, was then analysed by Q-factor analysis to test whether nuclear cases of cycloid psychosis differ from symptomatically related syndromes. No such differences could be statistically verified; no symptom profile specifically indicating cycloid psychosis could be found. Prominent confusion symptoms appear, however, to be prognostically favourable, whereas motility symptoms without confusion seem to indicate an unfavourable course.

Affective Disorders, Psychotic↗
PubMed1975

The bipolar unipolar dichotomy and the need for a consistent terminology.

A division of the major psychotic affective disorders into a bipolar (true manic-depressive) and unipolar (recurrent depressive or recurrent manic) group represents a clear advance in the classificatory work of affective illness which had been suffering from stagnation. Several investigations have already contributed provocative findings which support the heuristic value of this distinction. However, to be reliable a separation of bipolar from unipolar affective disorders must rely upon clear-cut definitions of the labels to be used in order to avoid inconsistency in terminology hampering the reliability of our findings.

Bipolar Disorder↗
PubMed1977

Prophylactic lithium and personality variables. An international collaborative study.

61 patients - 28 suffering from bipolar, and 33 from unipolar psychotic affective disorders - completed two personality inventories, one before and one about 6 months after starting lithium treatment to prevent relapses. On the basis of empirical observations it had been assumed that personality characteristics would change more in bipolar than in unipolar patients and that these changes would concern mainly those personality characteristics which reflect sociability and impulsivity. The inventories used were the EPI and the MNT. The results were in agreement with the predictions. Moreover, a significant decrease in N-scores was found both in bipolar and unipolar patients. It is assumed that these changes reflect both the therapeutic effect of lithium and an effect upon the personality characteristics of patients who suffer from bipolar or unipolar affective disorders.

Adult↗
PubMed2002

Bariatric surgery in a patient with possible psychiatric contraindications.

Grade III obesity (BMI > 39.9 kg/m2) is considered a chronic disease where clinical and diet therapy show poor results, with high rates of relapse. The most consistent results are those obtained through surgical procedures. Several authors discuss the contraindications for the performance of anti-obesity operations. Psychiatric disorders are often considered contraindications to these operations, especially affective disorders, psychotic disorders and personality disorders. The authors report the case of a 37-year-old patient, with obesity history since the age of 12, and anorexiant abuse (amphetamine-derived substances) during 20 years, binge-eating episodes, purgative compensatory behaviors and recurrent depressive symptoms. She was submitted to anti-obesity surgery in August 2000 (BMI 40.2). The outcome is reported and a discussion of the possible psychiatric contraindications for the anti-obesity surgeries is proposed.

Adult↗
PubMed2005

[Multiprofessional care and mental health in pregnant women].

OBJECTIVE: To identify non-psychotic affective disorders in pregnant women, to intervene by means of psychoprophylactic groups, and to evaluate possible alterations following intervention. METHODS: One-hundred and three pregnant women (71 adults and 32 adolescents) were seen at a community program in the Paraisópolis neighborhood in the city of Sao Paulo, southeastern Brazil. We used the following instruments: Self Reporting Questionnaire and Beck Depression Inventory. Ten weekly two-hour meetings were held, addressing the link between mother and fetus and subjects related to mother and child, and answering mother's doubts. We used the chi-squared test (chi2) to compare mental health before and after the intervention, with a significance level of p<0.05. RESULTS: Affective disorders were found in 45 pregnant women (43.7%) before the intervention and in 23 (22.3%) after the intervention. The impact of the intervention on affective disorders was statistically significant (p=0.001). Twenty-one women (20.4%) showed depression before the intervention, and 13 (12.6%) after the intervention, a non-significant difference (p=0.133). CONCLUSIONS: Multiprofessional care can prevent, detect, and treat affective disorders during pregnancy in both adults and adolescents.

Adolescent↗
PubMed1985

[Sabbatai Zwi--a false Jewish Messiah. Case report on religious psychopathology].

The life of the Jewish heretical Messiah Sabbatai Zwi (1626-1676) presents several features suggesting a psychotic affective disorder. Particular political and socio-cultural conditions enabled him to arouse a state of rebellion in a large part of the Jewish population. This study investigates relations between the individual psychosis of Sabbatai Zwi and the reaction of the public. In addition relations between psycho-pathological and mystical-demonological terminology are considered.

Bipolar Disorder↗
PubMed1984

The differential diagnosis of multiple personality. A comprehensive review.

This review offers guidelines for the diagnosis of multiple personality disorder and other dissociative disorders and presents diagnostic criteria for psychotic disorders, factitious disorders, affective disorders, anxiety disorders, psychosexual disorders, and others that may or may not coexist with multiple personalities.

Adult↗
PubMed1993

Excluding personality disorders from the insanity defense--a follow-up study.

Examining the effects of Oregon's statutory reform excluding personality disordered individuals from the insanity defense, we previously identified a study sample of insanity acquittees, each of whom was given a primary diagnosis of a personality disorder during subsequent evaluation at the state hospital. In the present study we explore the relationship between that diagnosis and the pretrial psychiatric diagnosis presented to the trial court. By reading the forensic mental health evaluations used at trial we found that 50 percent of our study sample of 34 personality disordered patients were diagnosed with psychotic disorders, affective disorders, retardation, and organic brain disorders. In addition to investigating the diagnosis offered as evidence at trial, we performed assessments of 38 mental health reports using published standards for forensic evaluation reports. We found compliance rates in the various categories ranged from 8 to 84 percent with a mean of 45 percent. We question the value of the mental health input to these trials, and believe that the data tend to validate past aspersions of forensic practice.

Adolescent↗
PubMed1996

Clinical experience with electroconvulsive therapy at the Instituto Mexicano de Psiquiatría.

Electroconvulsive therapy (ECT) is a useful option for the treatment of certain psychiatric illnesses. Its efficacy and few side effects make it an important therapeutic alternative in the management of the patient with major depression. This study describes the clinical experience with ECT at the Instituto Mexicano de Psiquiatría. We retrospectively evaluated the clinical records of patients treated with ECT during the period of April 1990 to June 1994. A total of 55 patients were included in the analysis, the mean age was 42.4 +/- 17.2 years old. Diagnostic categories treated were major depression (43.6%), non-affective psychotic disorders (30.9%), mania (12.7%) and other diagnoses (12.7%). A positive response to ECT was found in 74.5% of patients. Subjects with major depression and mania responded significantly better than the rest of the patients (p < 0.01). Psychotic depression was not a predictor of better response. Only 18.1% of subjects had minor complications, all transitory. ECT is a highly effective therapeutic option in the treatment of psychiatric illness, especially in major depression and mania. The use of ECT in a tertiary psychiatric unit in Mexico reflects similar results as described in the international literature.

Academies and Institutes↗
PubMed1998

Lower left temporal lobe MRI volumes in patients with first-episode schizophrenia compared with psychotic patients with first-episode affective disorder and normal subjects.

OBJECTIVE: Magnetic resonance imaging (MRI) studies of schizophrenic patients have revealed structural brain abnormalities, with low volumes of gray matter in the left posterior superior temporal gyrus and in medial temporal lobe structures. However, the specificity to schizophrenia and the roles of chronic morbidity and neuroleptic treatment in these abnormalities remain unclear. METHOD: Magnetic resonance (1.5-T) scans were obtained from 33 patients with first-episode psychosis and 18 age-matched normal comparison subjects, all right-handed. Sixteen of the patients were diagnosed with affective disorder and 17 with schizophrenia. RESULTS: Quantitative volumetric analysis showed that the patients with first-episode schizophrenia had significantly smaller gray matter volume in the left posterior superior temporal gyrus than did the patients with first-episode affective psychosis or the comparison subjects, with a significant left-less-than-right asymmetry. The schizophrenic patients also showed a smaller gray matter volume of the left posterior amygdala-hippocampal complex than the comparison subjects. Both the patients with schizophrenia and those with affective psychosis had significant left-less-than-right asymmetry of the posterior amygdala-hippocampal complex. CONCLUSIONS: These findings suggest that temporal lobe abnormalities are present at the first hospitalization for schizophrenia and that low volume of the left posterior superior temporal gyrus gray matter is specific to schizophrenia compared with affective disorder.

Adolescent↗
PubMed1987

[Psychoses and dementia in epilepsy (clinical picture, syndromokinesis, prognosis)].

Using clinical, biographic and social parameters the authors analyzed the results of long-term observation on a group of patients (n = 450) with epilepsy accompanied by psychotic disturbances. Prognostic signs of a favourable variant included the predominance of homogeneous attacks and an affective structure of psychotic disorders. In cases with a moderately severe variant paroxysmal manifestations were presented by an array of temporal and unfolded convulsive forms. Psychotic disorders of the hallucinatory-delirious type serve as signs of a late exacerbation of the epileptic process. An unfavourable variant was characterized by polymorphic attacks with predominance of postural and psychomotor components, frequent states of decompensation, an increase in signs of epileptic dementia and a wide spectrum of psychotic disturbances, ranging from overworship ideas to affective-delirious and catatonic-delirious psychoses.

Affective Disorders, Psychotic↗
PubMed2001

Cigarette smoking and psychotic symptoms in bipolar affective disorder.

BACKGROUND: An association exists between smoking and schizophrenia, independent of other factors and related to psychotic symptomatology. AIMS: To determine whether smoking is associated with psychosis in bipolar affective disorder. METHOD: Smoking data were collected from 92 unrelated patients with bipolar affective disorder. An ordinal logistic regression analysis tested the relationship between smoking severity and psychotic symptomatology, allowing for potential confounders. RESULTS: A significant relationship was detected between smoking/heavy smoking and history of psychosis (68.7%, n=44). Smoking was less prevalent in patients who were less symptomatic (56.5%, n=13) than in patients with a more severe psychosis (75.7, n=31). Prevalence and severity of smoking predicted severity of psychotic symptoms (P=0.001), a relationship independent of other variables (P=0.0272). CONCLUSION: A link between smoking and psychosis exists in bipolar affective disorder and may be independent of categorical diagnosis.

Adult↗
PubMed1986

A DSM-III family study of the nonschizophrenic psychotic disorders.

The authors conducted a blind DSM-III family study based on probands diagnosed from long-term follow-up information as having schizophreniform disorder, schizoaffective disorder, or psychotic affective illness. The pattern of psychopathology in relatives of schizophreniform probands closely resembled that found previously in relatives of schizophrenic probands. Relatives of schizoaffective probands had an excess risk for schizophrenia, other psychoses, and bipolar illness. The pattern of illness found in relatives of the probands meeting Research Diagnostic Criteria for mainly schizophrenic schizoaffective disorder appeared indistinguishable from that of relatives of schizophrenic probands. Relatives of probands with psychotic affective disorder had an excess risk for schizophrenia and for unipolar and bipolar affective disorder.

Depressive Disorder↗
PubMed1996

The treated incidence of psychotic and affective illness in twins compared with population expectation: a study in the Swedish Twin and Psychiatric Registries.

Twin studies of psychiatric illness assume that the genetic and environmental risk factors for psychiatric illness are similar in twins and non-twins and in monozygotic (MZ) and dizygotic (DZ) twins. To test this assumption, we examine whether the treated incidence of psychiatric illness in twins deviates from population expectations or differs between MZ and DZ twins. Using first admissions to the Swedish Psychiatric Registry for the years 1979-83 for all twins born 1886-1958 from the Swedish Twin Registries, we calculated Standardized Morbidity Ratios (SMRs) using national incidence rates together with individually computed person-years at risk in the twin cohort. The diagnoses examined, for which there was more than 393000 person-years of risk, were schizophrenia, other non-affective psychoses (ONAP), bipolar affective illness (BPAI), unipolar affective illness (UPAI) and neurotic depression (ND). The SMRs (and 95% Cls) for all twins were: schizophrenia 0.86 (0.69-1.06), ONAP 1.05 (0.88-1.24), BPAI 1.09 (0.90-1.32), UPAI 1.05 (0.85-1.29) and ND 0.99 (0.88-1.10). This pattern of results did not differ substantially when examined separately by gender or birth cohort. Relative risks for first admissions for MZ v. same-sex DZ twins or same v. opposite-sex DZ twins did not differ significantly from unity for any of the disorders examined. In Sweden, the treated incidence of psychotic and affective disorders in twins does not differ from that found in the general population and does not differ across zygosity groups. These results support the validity of the twin method for the study of psychotic and affective disorders.

Adult↗
PubMed1987

Frontal lobe degeneration of non-Alzheimer type. II. Clinical picture and differential diagnosis.

In a longitudinal prospective study of dementia, 158 patients were investigated post mortem. Sixteen patients were classified as frontal lobe dementia (FLD) of non-Alzheimer type and four cases as Pick's disease. Positive heredity for dementia was reported in 50% of these cases compared to 30% in a reference group of patients with Alzheimer's disease (AD). The typical clinical picture in FLD and Pick's disease was that of a slowly progressive dementia, at an early stage dominated by personality change, lack of insight, disinhibition, and later on stereotypy and increased apathy. There was also a progressive dynamic aphasia ending in mutism and amimia. Memory and spatial functions were comparatively spared. Disinhibition, oral/dietary hyperactivity, and echolalia were more consistently found in Pick's disease compared to FLD. The differential diagnosis against AD, cerebrovascular dementia, and other degenerative dementias and against affective disorders and psychotic reactions are discussed.

Adult↗