Correlation between vasopressin baseline and TSH-blunting in depressives

A blunted thyrotropin (TSH) response is a predictor of a good response to antidepressant drug treatment in depressives and neuroleptic treatment in paraphrenic patients (Larger et al 1986). The aim of the following study was to elucidate possible relationships between different endocrine systems and to shed light on the pathogenetic hypotheses of TSH-blunting. In order to evaluate especially hypothalamic activity in severe depression we were interested in the vasopressin system as another hormonal system underlying hypothalamic control. Thirty-four patients who met the criteria for major depression according to DSM-III-R were subjected to the thyrotropin-releasing hormone (TRH) test. We also took baseline readings of the cortisol, neurophysinI (hNpI, reflecting vasopressin plasma levels), and neurophysinII (hNpII, reflecting oxytocin plasma levels) levels. Likelihood ratio tests were done with logistic regression models to analyze the phenomenon of TSH-blunting. We observed that the likelihood of a blunted TSH response increases with higher levels of hNpI and low levels of cortisol, but is unrelated to hNpII levels.

The tridimensional personality model: influencing variables in a sample of detoxified alcohol dependents. European Fluvoxamine in Alcoholism Study Group

C.R. Cloninger proposed a biosocial model for personality, linking personality traits to patterns of responses to various external stimuli, including alcohol. The Tridimensional Personality Questionnaire (TPQ) was administered in a multicenter study to detoxified alcohol-dependent patients (N = 521). The objectives of the study were to evaluate (1) the expression of the three personality dimensions, novelty-seeking (NS), harm avoidance (HA), and reward dependence (RD), of the TPQ in this sample, and (2) the influence of different variables on these personality dimensions. The following variables were selected for a multiple and a stepwise regression analysis: sex, family history for major psychiatric disorders, marital status, occupation, age at study enrollment, age of onset of alcoholism, serum cholesterol level, intake of neuroleptics or benzodiazepines for detoxification, and severity of depression and anxiety. In comparison to Austrian normative data, both sexes of detoxified alcohol addicts scored higher in HA. The variables examined explain 23% of the variance of NS and 35% of HA. Only one variable, namely age of onset, is significantly influencing NS (19% explained variance). HA is significantly influenced by three variables: anxiety state, anxiety trait, and sex (32% explained variance). RD is not influenced by any of the variables examined.

Normal CAG repeats in the Huntington gene in a family with benign familial chorea

Benign familial chorea (BFC) is a rare neurological disease with an autosomal dominant transmission. The disorder is characterized by its early onset in childhood, a non-progressive course of choreatic movements and the absence of intellectual impairment. There is one study describing an expanded (CAG)n repeat in the gene IT15 (Huntington) on chromosome 4p (causative for Huntington's chorea) in a family reported to have BFC that was diagnosed on the basis of onset and non-progressive course. We failed to find an expansion of the (CAG)n repeats in an Austrian family having BFC. The three affected individuals of the family had 18-25 CAG repeats. These results indicate that the diagnostic criteria for BFC should include a normal result in the analysis of the (CAG)n repeat region of the Huntington gene.

Schizophrenia and the dopamine-beta-hydroxylase gene: results of a linkage and association study

Alterations in dopamine neurotransmission and disturbed norepinephrine activity have been implicated in the pathogenesis of schizophrenia. We considered the dopamine-beta-hydroxylase (DBH) gene located on the long arm of chromosome 9 (9q34.3) as a candidate gene for schizophrenia. DBH catalyzes the synthesis of norepinephrine from dopamine in noradrenergic neurons. In addition to DBH we used in the linkage study DNA markers ABL (centromeric) and D9S114 (telomeric). The aim of this study was to test linkage and association between PCR-based genotyped markers and schizophrenia. A simulation was done to investigate the power of our sample. In 34 Austrian families we could not detect linkage between schizophrenia and schizophrenia spectrum disorders and the three genetic markers. We could not find any significant deviation in allelic or genotypic distribution from expectations. Based on our results we conclude that the DBH gene seems to have no strong contribution in the etiology of schizophrenia.

Mental and behavioural disorders due to use of psychoactive substances (F1). Results from the ICD-10 field trial of the Diagnostic Criteria for Research in German-speaking countries

The results of the ICD-10 Diagnostic Criteria for Research (DCR) field trial in German-speaking countries concerning section F1 (mental and behavioural disorders due to use of psychoactive substances) show a comparatively sufficient level of acceptance. The subjective assessment of the diagnostic process and the chance-corrected interrater reliability (kappa = 0.70) are below average but quite acceptable, which is possibly due to the study design as well as the high comorbidity of disorders in this field. However, interrater reliability based on the strictly defined operationalized criteria of the DCR improved markedly compared to earlier ICD-10 field trials in German-speaking countries.

Non-concordance by gender for schizophrenia and related disorders in sibships

We analysed gender-concordance rates among 29 prospectively sampled schizophrenic probands and their 39 affected and 71 unaffected siblings. We did not find any unusual concordance rates. We found no same-gender concordance particularly in siblings affected by schizophrenia and related disorders. We considered unaffected siblings in an additional attempt to make valid and unbiased comparisons between genders, but this reduced the number of informative sibships to 20. We stratified the siblings of probands by sibship and by the proband's gender in order to check gender distribution within families. The data do not support hypotheses that schizophrenia is pseudo-autosomal or male-female chromosomally transmitted.

The season of birth of schizophrenics and schizoaffectives

We examined the birth distribution of 2,450 schizophrenic and 682 schizoaffective patients first admitted between 1971 and 1992 to the University Hospital for Psychiatry in Vienna. Our data showed an excess of schizophrenic births in the first quarter of the year and a deficit in the third quarter compared with expectation from census data. The quarterly distribution of schizophrenic births seemed to be different from the one of of schizoaffective patients. In schizoaffectives an excess of births in the first quarter of the year was present, but no other deviation from expectation.

No proof of linkage between schizophrenia-related disorders including schizophrenia and chromosome 2q21 region

We examined linkage between schizophrenia and schizophrenia-related disorders and five genetic markers on chromosome 2 in fourteen families ascertained through affected probands in St. Louis and Vienna. The chromosomal region 2q21 was considered a candidate locus for schizophrenia because of a report of a balanced translocation 2;18 (q21;q23) in a schizophrenia family. Linkage analyses were conducted for three disease models: a narrow model including schizophrenia only; an intermediate model including a spectrum of schizophrenia-related disorders; and a broad model including major affective disorders. Multipoint linkage analyses excluded linkage across the region (about 50 cM) for the intermediate disease model. The same was generally true for the broad affection status model. None of the two-point and multipoint analyses showed definite linkage of schizophrenia to any marker. The most prominent positive association was between D2S44 and a broad affection status model, giving a two-point lod score of 1.71 at 0.20 recombination fraction.

Effect of dichloroacetate on mechanical performance and metabolism of compromised diaphragm muscle

We investigated the effect of dichloroacetate (DCA) on tension generation and carbohydrate metabolism of the rat diaphragm in vitro. Isolated diaphragms were placed in individual organ chambers and were hooked to force-displacement transducers. Net lactate production and glucose and lactate oxidation were measured in vitro. Diaphragmatic fatigue was precipitated by in vivo endotoxemic shock, by in vitro hypoxia, or by in vitro repetitive tetanic stimulation. In diaphragms isolated from endotoxemic rats, DCA increased tension generation by 30 and 20% at stimulation frequencies of 20 and 100 Hz, respectively. Associated with changes in mechanical performance, DCA reduced net lactate production by 53% after 60 min of incubation and increased glucose oxidation 54% but had no effect on lactate oxidation. During in vitro hypoxia, DCA reduced net diaphragmatic lactate production by 30% and increased glucose oxidation by 45% but did not attenuate hypoxic fatigue. DCA had no effect on tension generation during repetitive tetanic stimulation. We conclude that DCA improves in vitro diaphragmatic fatigue due to endotoxicosis but not due to hypoxia or repetitive stimulation.

The use of carbamazepine in the treatment of schizophrenic and schizoaffective psychoses: a review

This article reviews current literature on the clinical efficacy of carbamazepine (CBZ) administration in schizophrenic and schizoaffective psychoses. With respect to the use of CBZ in cases of aggression, overactivity and other behavioral dyscontrol syndromes, only a few, mainly open, studies have been conducted. Attention to the efficacy of CBZ in schizophrenia and related psychoses was rather late in developing, with most of the studies done since 1981. Although the results of the different controlled and uncontrolled experiments are very difficult to compare, the results generally indicate beneficial effects--particularly if CBZ is used as an adjunct to neuroleptic medication. Suggestions for future research strategies to maximize the usefulness of CBZ in schizophrenia and related disorders are given.

Three cases of severe mania successfully treated with high-dosage lithium-carbonate

Three female patients suffering from severe mania, who failed to respond to increasingly high dosages of highly potent neuroleptics, were put on a high-dose regime of lithium carbonate. With rapidly increasing daily doses of lithium carbonate, blood levels of approximately 1.3-1.51 mmol/l were achieved. When high lithium levels had been attained the patients showed a considerable improvement between 75 and 82 percent on the Bech-Rafaelsen Scale. At the same time it proved possible to reduce additional medication. Not toxic effects of lithium carbonate were observed. The consequences for clinical practice (e.g. shortened duration of hospitalization) are discussed.