Tardive dystonia. Prevalence, risk factors, and comparison with tardive dyskinesia in a population of 200 acute psychiatric inpatients

In a population of 200 consecutive inpatients with a history of at least 3 months' total cumulative neuroleptic exposure, the prevalence of tardive dystonia (TDt) was 4%, higher than previously reported. The prevalence of tardive dyskinesia (TDk) was 22%. Patients with TDt did not differ in demographic or clinical variables from nondyskinetic patients. In comparison with patients with TDk, patients with TDt were significantly younger, had a more severe movement disorder, and had received neuroleptics for the first time fewer years before. Patients with TDk were significantly older than patients without tardive disorders, both when they were examined and when they had started their first neuroleptic treatment. Furthermore, they had started their first neuroleptic treatment more years before. These results support the distinction between TDt and TDk, and suggest that the previously reported prevalence of TDt might have been underestimated.

Neuroleptic malignant syndrome and catatonia. A report of three cases

In a series of 1007 consecutively admitted patients, 3 cases of neuroleptic malignant syndrome (NMS) were identified (0.3%). All three patients were affected by mood disorders with congruent psychotic features, had shown catatonia just before the onset of NMS, and had been treated with low neuroleptic doses. All of them presented low serum iron levels. The relationship between NMS and catatonia and possible therapeutic decisions are discussed.

[The violent patient]

The article examines the violence which falls within the domain of the physician. It describes the different patterns of aggressive behavior, the frequency of crimes among psychiatric patients, the violence-related diseases, the main risk-factors. Guidelines are suggested for the examination (interview technique, content of the evaluation, assessment of the danger of violence) and the treatment in the acute and long-term management of violent patients with a particular emphasis on pharmacologic therapy. The neurophysiological, pathological and neurochemical bases of aggression, inhibition and episodic dyscontrol are discussed as well as the most relevant socio-cultural factors.

Modification of liver and serum enzymes by paraquat treatment in rabbits

Paraquat (PQ) is known to cause progressive interstitial fibrosis in the lungs. Previous investigations have indicated that PQ acts by lipid peroxidation of the membrane. However, there are few reports on the action of PQ on hepatic enzymes. This work was carried out to investigate the modulation of various hepatic enzymes by PQ in rabbits. Paraquat was administered at a dose of 3, 6 or 12 mg/kg b. wt/day intraperitoneally to male rabbits for different periods of time. Administration of paraquat resulted in a significant decrease in plasma activities of transaminase enzymes, alkaline phosphatase and liver transketolase. No significant change was found in the activities of plasma and hepatic lactate dehydrogenase and alkaline phosphatase. A marked increase in blood glucose was noticed 48 hours after paraquat administration.

[Deficiency anemias in tropical countries]

Nutritional anaemias are common in tropical areas. The commonest cause is iron deficiency, which mainly arises from impaired absorption of iron from food. Substances which inhibit iron absorption in various diets play an important role in the pathogenesis of iron deficiency anaemia. Iron deficiency is further aggravated by blood loss in hook-worm infestation. Folic acid and vitamin B 12 deficiency are less important causes of nutritional anaemia. The efforts of the World Health Organization to supplement iron in food are described.