Age of onset in familial and sporadic schizophrenia

We have studied the gender and family history differences with regard to age of onset of schizophrenia. These differences have often been viewed as an important clue to the aetiology of the illness. Patients from three centres in Europe and Canada were included in the study. A sample of 1089 subjects was categorized according to the subject's sex, family history of schizophrenia, and the centre. The principal statistical method was analysis of variance. Patients with no family history of schizophrenia had a consistently higher average age of onset. This effect was seen in both male and female subjects across all three groups. These results support the relationship between familial risk and early onset, but no interaction of gender and family history was found.

Responses of indicator bacteria to forest soil amended with municipal sewage sludge from aerated and non-aerated ponds

The survival of faecal and total coliform bacteria and Streptococcus faecalis (indicator bacteria) were monitored in experimental plots receiving various amounts of biological or dephosphatation municipal sewage sludge. Biological sludge was applied on coniferous and mixed regenerative forest soils. The results show that except for total coliforms, there was little significant treatment effect on the indicator bacteria numbers in all of the sites. In most cases, there was a significant time effect, indicating that bacterial populations vary over time, according to environmental factors such as temperature, moisture or nutrient level conditions. In total coliform bacteria, populations varied over time but also in function of treatment levels. The present study suggests that even if the standards of Québec (Canada) for sludge application are respected, there may be some risk for bacterial contamination depending on the types of sewage sludge and forest habitat. Although there is only a short-term effect, high slopes can influence the movement of the indicator bacteria and may potentially cause some contamination problems.

An open trial of the D1 antagonist SCH 39166 in six cases of acute psychotic states

Six psychotic patients were included in a four-week study of the effects of the D1 selective antagonist SCH 39166 given as monotherapy. Four had a diagnosis of schizophrenia, and two suffered from a schizoaffective disorder. All presented with an acute psychotic exacerbation at the beginning of the trial. SCH 39166 was progressively increased from 50 mg/day to 600 mg/day. In the four schizophrenic patients, the BPRS worsened, and three out of the four failed to complete the study because of this. Three schizophrenic patients were aggressive or violent after abrupt discontinuation of treatment. In the two patients with schizoaffective disorder the BPRS improved during the trial, but they had an acute relapse immediately after treatment discontinuation. Extrapyramidal symptoms improved in three of the six patients, and worsened in one.

Risperidone in the treatment of pervasive developmental disorder

Elevated concentrations of blood serotonin have been documented in autistic children and mentally retarded adults. Antiserotonergic pharmacotherapy has been partially effective in treating a subgroup of children with autistic disorder. Therefore, the possibility is raised that an antiserotonergic treatment may be of value to adult psychiatric patients with a history of pervasive developmental disorder. Two such cases are described where the patients underwent psychiatric and neuropsychological examination before and after treatment with risperidone, a potent 5-HT2 antagonist with additional D2 antagonistic properties. Particular improvements were documented in both patients, despite long histories of cognitive compromise and high likelihood of damage to the central nervous system.

Anxiety disorders. Part 2: Pharmacotherapy with benzodiazepines

Anxiety disorders can be treated successfully with benzodiazepines. This paper focuses on dispelling the myths and prejudices that surround treatment with these medications.

Anxiety disorders. Part 1: Diagnosis and treatment

Anxiety disorders often take second priority in clinical practice because many physicians do not understand them or their treatment. This paper reviews the diagnostic groupings of anxiety disorders according to the American Psychiatric Association's Revised Diagnostic and Statistical Manual of Mental Disorders (DSM 3-R) and discusses differential diagnosis and treatment.

A Canadian multicenter placebo-controlled study of fixed doses of risperidone and haloperidol in the treatment of chronic schizophrenic patients

In a double-blind study, 135 inpatients with a diagnosis of chronic schizophrenia were randomly assigned to 8 weeks of treatment with one of six parallel treatments: risperidone (a new central 5-hydroxytryptamine2 and dopamine D2 antagonist), 2, 6, 10, 16 mg/day; haloperidol, 20 mg/day; or placebo, after a single-blind placebo washout period. Doses were increased in fixed increments up to a fixed maintenance dose reached after 1 week. On the Clinical Global Impression-Severity of Illness and Improvement, all active medications were superior to placebo except for risperidone (2 mg) on the Clinical Global Impression-Improvement. On the total Positive and Negative Syndrome Scale (PANSS) score and positive subscale, superiority to placebo was observed for all treatment groups except for haloperidol and risperidone (2 mg), which tended to be superior to placebo on total PANSS and the positive subscale, respectively. On the PANSS negative subscale, only risperidone (6 mg/day) was significantly better than placebo. Risperidone (6 mg) was superior to haloperidol on the total PANSS, General Psychopathology, and Brief Psychiatric Rating Scale subscales. Although there was a linear increase in parkinsonism with increasing risperidone dosage, there were no statistically significant differences between risperidone (2, 6, and 16 mg/day) and placebo. At doses of 6 to 16 mg, risperidone displayed a marked antidyskinetic effect compared with placebo. This effect was more pronounced in patients with severe dyskinesia. By contrast, haloperidol produced significantly more parkinsonism than placebo and risperidone (2, 6 and 16 mg), with no effect on tardive dyskinesia. These data suggest that risperidone, at the optimal therapeutic dose of 6 mg/day, produced significant improvement in both positive and negative symptoms without an increase in drug-induced parkinsonian symptoms and with a significant beneficial effect on tardive dyskinesia.

Homicide, infanticide, and filicide

Homicidal behavior appears to be a heterogeneous phenomenon. Although the causative role of mental illness in relation to homicide remains a controversial and debatable issue, recent studies indicate that a significant number of homicidal adults suffer from serious mental illness, more specifically psychosis. Most reports that attempt to correlate the presence of identifiable risk factors and homicide yield inconclusive or unreplicated results. In addition to supporting the need for further research in the area of aggressive behavior and violence, prevention also should involve the use of a multidisciplinary approach in considering the multiple causes and solutions to this problem.

Adolescent murderers

Clinical, developmental and environmental factors were retrospectively studied in 14 adolescent murderers who had been referred to a forensic psychiatric clinic over an 11 year period. Results of these analyses were compared with findings from previous reports. The majority of subjects came from split families. There was a greater than expected degree of psychiatric illness in the adolescents. Previous psychiatric contact, antisocial behaviour and substance abuse were common among these adolescents. A tentative profile of adolescents who are likely to commit murder can therefore be drawn up, which may suggest direction for preventive action and rehabilitation.

Manic-like reaction induced by lorazepam withdrawal

The benzodiazepine withdrawal symptoms are presented here. The psychotic reactions to benzodiazepine withdrawal are seldom described in the literature. We report a case of acute manic-like reaction induced by sudden lorazepam withdrawal. The sudden release of catecholamines following abrupt cessation of short half-life benzodiazepine is suggested as underlying mechanism for such reaction.

Intracortical distribution of axonal collaterals of pyramidal tract cells in the cat motor cortex

Slow and fast pyramidal tract cells (Pt cells) from the cat motor cortex were identified antidromically and injected with horseradish peroxidase (HRP). The axonal collaterals of these cells were mapped following HRP histochemistry with benzidine di-hydrochloride. All cells, slow or fast, show a similar arrangement of their collaterals. A proximal axonal network of 0.5-0.8 mm in diameter delimits a local field of action for collaterals in layers V and VI. The tangential expansion of this local field corresponds to that of the basal dendritic domain of Pt neurons. Much longer collaterals running for millimeters in the lower gray or white matter were observed in all cells. They form at a cortical level a distal field of action for Pt neurons. Many of these long branches were traced to other regions of area 4 or toward other cytoarchitectonic areas. In one case a collateral was seen entering and dividing in area 3a. Due to limitations of the HRP technique most of these long branches could not be followed to their terminals. On the basis of the laminar distribution of Pt cell collaterals (mostly in layers V and VI) synaptic sites where recurrent excitation and inhibition are produced on Pt neurons are discussed.

Morphological characterization of slow and fast pyramidal tract cells in the cat

In adult cats the morphology of slow and fast pyramidal tract (Pt) neurons was studied following intracellular HRP injections and Golgi impregnation. Both types of neurons are pyramidal cells and their soma are all located in the fifth layer of the motor area. As a rule, fast Pt neurons have large somata and their basal and apical dendrites occupy a larger territory in the tangential plane. In layer I, terminal apical dendrites of fast Pt neurons are smooth and divide poorly while those of slow Pt neurons bear a moderate amount of spines and branch profusely. Midway between the pia and layer V, in the third layer, the apical shafts of both types of Pt cells run upward with little branching. These shafts are more numerous in fast Pt cells (7 to 16) and they are almost devoid of spines. Those of slow Pt cells in layer III number between 5 and 9 and are densely covered with spines. Oblique and horizontal branches of slow and fast Pt neurons extend in layer V and some of them invade the lower part of layer III. It is suggested that this zone corresponds to a true fourth layer in the motor area. In both types of cells oblique and lateral branches bear numerous spines. Within the basal dendritic territory of Pt cells, one has to distinguish two dendritic systems: a short and a long one. The former spreads downward obliquely and appears to remain within layer V. The latter is made up of long descending vertical (antiapical) and oblique dendrites (tap root). While both types of cells may have long antiapical dendrites that run down radially to the lower part of layer VI, tap root dendrites which expand laterally below the cell body for considerable distances are a distinctive feature of fast Pt neurons. Though basal dendrites of all Pt cells bear spines, their number, distribution and shape are very variable in fast Pt cells.

The comparative effectiveness of the "brown and blue reactions" for tracing neuronal processes of cells injected intracellularly with horseradish peroxidase

The comparative advantages and disadvantages of diaminobenzidine (DAB) and benzidine di--HCl (BDHC) procedures for tracing processes of cells injected intracellularly with horseradish peroxidase (HRP) have been studied. The DAB reaction gives a good definition of membranes and appears more suitable for visualizing the fine structure of dendrites. The BDHC procedure, being more sensitive, induces crystal formation and heavily filled processes appear frosted. This last procedure is, however, much more appropriate for tracing the axonal system of injected cells.

A comparative study of ventrolateral and recurrent excitatory postsynaptic potentials in large pyramidal tract cells in the cat

In acute cats deeply anesthetized with Nembutal, monosynaptic excitatory postsynaptic potentials (EPSPs) triggered by stimulation of the ventrolateral (VL) thalamic nucleus and the pes pedunculus were recorded in large pyramidal tract cells (PT cells). Deep anesthesia, low intensities of stimulation and an averaging technique were used in order to get VL and recurrent EPSPs free of polysynaptic potentials. Comparison of the time course of both EPSPs revealed a much faster rise time and shorter half-width for VL EPSPs than for recurrent EPSPs. This would suggest a more proximal location for VL synaptic contacts than for recurrent ones with respect to the soma of PT cells. The separation of the sites of origin of both EPSPs is further suggested by their almost perfect linear summation. It is suggested that VL EPSPs are produced on the apical dendritic tree, while recurrent EPSPs could originate on the basilar dendritic branches.