Utbredelsen av stoffbruk hos unge menn i Norge i 1972–1973

Two methods of providing an educational intervention for families of patients with schizophrenia in Finland were compared. The aims of the intervention were to improve relatives' level of knowledge about the illness, and change the level of expressed emotion (EE), objective burden and psychological distress. Sixty-nine persons participated in the oral presentation groups comprising eight sessions and 128 persons participated in the video education comprising six sessions. The education led to significant knowledge gains and to an increase in the psychological well-being of the participants, but there were no significant changes in objective burden or EE status after intervention. Furthermore, there was only one difference between the two methods of information delivery. The participants in the video groups felt more often that the lessons were useful to them than did the participants in the oral presentation groups. The evidence suggests that brief educational intervention can yield significant benefits in meeting the needs of family members. Better designed, randomized studies investigating the efficacy of brief educational interventions are needed.     

Människosyn och terapi i psykiatrin

The aim of the study was to compare the subjective quality of life of persons with severe mental illness in inpatient settings and two types of supported housing, small congregate community residences and independent living with support. Seventy-six persons living in three types of housing were interviewed using the Lancashire Quality of Life Profile. Analysis showed no differences in subjective and objective quality of life or in clinical and socio-demographic data between individuals living in the two types of supported community residences. Greater satisfaction in four life domains, living situation, social relations, leisure activities and work and two global measures, was registered by individuals in the pooled ratings from the two types of supported community residences as compared to those in inpatient settings. The former were also more satisfied than their counterparts were in inpatient settings concerning specific aspects of the living situation domain. It is concluded that differences in housing settings impact specifically on the living situation life domain but also on other life domains as well as on global quality of life, despite few differences in objective quality of life indicators. There was no evidence to support the concept of the quality of life gradient across housing settings.     

Nuria Durany i Pich (1961–2010)

Obituary

Nuria Durany i Pich (1961–2010)     

Remoxiprid versus haloperidol i behandlingen af skizofreni En dobbelt-blind sammenlignende undersøgelse af remoxiprid og haloperidol i behandlingen af skizofreni

A multicenter, double-blind controlled study was carried out, using haloperidol as a reference drug to evaluate the antipsychotic efficacy and adverse reactions of remoxipride, a benzamide derivative. Seventy-two patients fulfilling the DSM-III criteria for schizophrenia or schizophreniform disorder were included, 39 patients in the remoxipride and 33 in the haloperidol group. No significant differences in efficacy were found between the two treatments. Treatment-emergent extrapyramidal symptoms, such as akathisia and rigidity, and drowsiness and increased sleep were significantly more frequent during treatment with haloperidol than during treatment with remoxipride. Thus, remoxipride seems to be as effective as haloperidol after 6 weeks of treatment and has fewer side effects     

Does evidence-b(i)ased psychiatry have its limitations?

Evidence-based medicine (EBM) is an algorithm that integrates information technology and the results of outcome research into clinical work. EBM, if well understood, is a valuable and critical bottom-up method that promotes a dialectical process by which the practitioner is able to arrive at an informed treatment choice; the method starts from the individual patient and involves discussion with the patient and critical reading of the relevant literature. However, there is a risk that EBM will become an ideology unless we are aware of its assumptions and epistemology. It is not valuefree, but is driven by an implicit objectivist view of man. EBM attaches greater value to biomedical sciences that to the humanities, to empiricism than to hermeneutics and to quantitative research than to qualitative research. EBM focuses on internal validity, but is in danger of neglecting factors such as qualitative changes that are difficult to measure, ecological validity and effectiveness and may hinder the generalisation of research results to clinical practice. The limitations of EBM are even more poignant in psychiatry, because psychiatry is highly sensitive to context and values. EBM is a blessing if we use it critically and remain aware of its limitations and underlying philosophy and if we supplement it with strategies such as value-based medicine (VBM). EBM, however, does not teach us what is useful or valuable, whereas VBM helps us to explain and weigh up the values that are at stake.     

Padaczka oporna na leczenie – epidemiologia i aktualny stan badań

In the last years interest in epileptology has focused on determining the cause and pathomechanism of farmacoresistance in epilepsy. According to epidemiology, the problem of pharmacoresistance concerns about 30% of patients suffering from epilepsy, mainly temporal epilepsy coexisting with hippocampal sclerosis. Drug-resistant epilepsy is frequently based on static or dynamic organic brain damage. Furthermore, those morphological changes and related clinical/psychological dysfunctions lead to intellectual and social consequences as well as to an increase of the mortality rate.Pharmacoresistant epilepsy afflicts various patients with the same form of epilepsy and concerns many antiepileptic drugs with different mechanisms of action. Thus, the genetic conditioning of this state was considered. So far, the multidirectional investigations have proved the importance of interleukin IL-1β gene polymorphism, prodynorphin, GABA receptors and the APOE∑4 allele in pharmaco-resistant epilepsy. Moreover, further factors such as transport protein gene polymorphism (ABCB₁, RLIP76/RALBP₁), genetically modifying receptor changes within the activating/inhibiting system (SCN1A – sodium channels, KV₇ – potassium channels) and drug metabolizing enzyme gene polymorphism (UG T1 A1*28) are also considered important.     

Metodikk ved tilretteleggelse av behandlingsforsök med nye medikamenter i psykiatrien

Background: Obsessive–compulsive disorder (OCD) is a frequent and clinically heterogeneous disorder. The complex clinical presentation can be summarized using a few consistent and temporally stable symptom dimensions. Only few studies in children and adolescents have examined the importance of symptom dimensions. Aims: This retrospective study was undertaken to describe the relation between symptom dimensions, pattern of comorbidity and family disposition, in a sample of Danish children and adolescents with OCD assessed in a naturalistic setting. Methods: A retrospective study of children and adolescents (n=83) diagnosed with OCD in the period 1998–2004, at the Psychiatric Hospital for Children and Adolescents, Risskov, Denmark. Information from clinical records was systematically collected and Children's Yale–Brown Obsessive–compulsive Scale (CY-BOCS) scores and symptom checklists were obtained. Results: High scores on the symmetry/ordering dimension were related to OCD in first-degree relatives and high scores on the aggressive/checking dimension were associated to comorbidity with tic disorders. We showed a correlation between limited insight and younger age. Conclusion: This is one of the first studies to examine symptom dimensions in children and adolescents in naturalistic settings. The results were comparable with those in adult studies, showing an association between the occurrence of the symmetry/ordering dimension and family OCD and the occurrence of the aggressive/checking dimension and comorbid tic disorders. In small children, insight into symptoms may be limited.     

Modulation of ultra-low-molecular-weight heparin on [Ca²⁺]i in nervous cells

Heparin is an effective competitive antagonist of inositol 1,4,5-trisphosphate receptors (IP(3)Rs). It binds to IP(3)Rs and affects calcium homeostasis. Ultra-low-molecular-weight heparin (ULMWH) is heparin's derivative, the present study was designed to test the effects of ULMWH on intracellular calcium concentration ([Ca(2+)]i) in primary cultured neurons. [Ca(2+)]i was measured by Multilabel Counter Victor-1420 using Fura-2/AM as the calcium fluorescent probe. The results indicated that ULMWH decreased the resting [Ca(2+)]i with or without extracellular Ca(2+). They had no effects on high K(+)-induced elevation of intracellular Ca(2+) level indicating that ULMWH had no effect on external Ca(2+) influx mediated by voltage-dependent calcium channels. However, they partially reduced the increase in [Ca(2+)]i induced by glutamate. Furthermore, ULMWH significantly inhibited the inositol 1,4,5-trisphosphate (IP(3))-induced increase in [Ca(2+)]i both in cellular and subcellular level. These results suggest that ULMWH may reduce [Ca(2+)]i in neurons through suppressing Ca(2+) release from IP(3)-sensitive stores.     

Whose life am i living? Relatives living in the shadow of depression

BACKGROUND: Families living with mental illness experience added burden and need information and support. AIM: This aim of this study was to explore the experiences of families living close to a depressed individual. METHODS: Eighteen persons were interviewed individually or in focus groups. Data was analysed using a grounded theory-inspired methodology. RESULTS: Most participants expressed a feeling of not living their own life, struggling to balance relationships, adapting to and re-evaluating their life circumstances, and struggling to voice their ill relatives' and their own needs. CONCLUSIONS: More can be done to help and sustain hope in the relatives of persons with depression.     

Valproatenzephalopathie nach i.v.-Aufsättigung bei nonkonvulsiven Status epileptici

The case of a valproate-induced encephalopathy with rapid onset occuring after i.v. administration of valproate in the treatment of a nonconvulsive status epilepticus is reported. The clinical signs of valproate-induced encephalopathy and nonconvulsive status epilepticus were similar. Only the EEG examination established the correct diagnosis.     

UF1000i尿有形成分分析仪在脑脊液细胞计数中的应用

目的探讨UF1000i尿有形成分分析仪用于脑脊液细胞计数的可行性.方法分别用UF1000i尿有形成分分析仪和普通光学显微镜180份脑脊液标本进行白细胞计数,并进行相关性研究.结果 UF1000i尿有形成分分析仪检测的白细胞与镜检法相关性好.结论 UF1000i尿有形成分分析仪可用于脑脊液细胞计数.     

Hvor stor en del af en psykiatrisk kliniks patienter kommer i beskæftigelsesterapi

Holmberg G. Minor and unspecific depressions.

The old term “neurotic depression” is no longer useful. In the new classification system DSM-III-R the concept of dysthymia is more clearly defined and delimited. It is there defined as a chronic mood disorder, particularly characteristic in cases with an early onset. Coexisting personality disturbance is relatively common. Dysthymia is a common kind of mood disorder. Often the symptoms are heterogeneous. In about one-third of the cases there are superimposed episodes of major depression, called double depression. As a result of the chronic course of dysthymia, dependence on alcohol or other substances is common. Double depression is relatively well suited to antidepressive treatment, whereas “pure” dysthymias, the mildest case in particular, show little response to antidepressant drugs. The concept of reactive depression is discussed. In DSM-III-R this is at present not included under mood disorders (but is found under adjustment disorders). There is no obvious reason why it should not be considered an additional kind of mood disorder.     

核型为46,x,i(xq)伴发精神障碍一例报告

患者女性,40岁,已婚,高小文化、素性开朗,病程2年余。因和乡亲争吵而诱发,表现发呆、失眠、少语、不敢出门,坐立不安,跺脚,敏感多疑,不能料理家务来我院就诊,门诊以精神分裂症收住院。住院诊断为神经症。精神状态:意识清楚,接触主动,定向力完整,未引出幻觉及感知综合障碍,无明显的思维障碍,表情痛苦,情感协调,智能尚可,自知力存在。个人史:幼年体健,8岁上学,学习成绩一般,24岁结婚,夫妻     

糖皮质激素对单个大鼠肾上腺髓质嗜铬细胞（Ca^2＋）i的快速作用

为探讨糖皮质激素（glucocorticoids,GC）快速地抑制肾上腺髓质嗜铬细胞（adrenalmedullarychromaffincells，AMCcells）受刺激时分泌儿茶酚胺的机制，用Fura-2作Ca(2 )指示剂．用Spex阳离子测定系统检测单个AMC细胞，观察了对AMC细胞的［Ca(2 )］．的影响。发现皮质酮（B．corticosterone）对AMC细胞静息［Ca(2 )］i无影响，但B可以抑制AMC细胞从无钙介质换到含钙介质时［Ca(2 )］i的升高，可以抑制ACh、Nico（nicotine）、Muse（muscarine）及高钾引起的[Ca(2 )]i升高，RU38486可以部分阻断B对ACh刺激引起的[Ca(2 )]i升高的抑制作用。B还可抑制在无钙介质中Musc引起的［Ca(2 )]i升高。Dex（dexamethasone）与B有相似的作用，而E2(17β-estradiol）、P（progesterone）、Ald（aldosterone）和Andro（androstenedion）无作用。     

吗啡成瘾性大鼠脑内核团神经细胞[Ca 2+]i变化的研究

目的 研究吗啡成瘾对大鼠脑内与成瘾相关核团神经细胞[Ca 2 ]i的影响.方法 将50只SD大鼠随机分成吗啡成瘾组和对照组,观察成瘾后的戒断症状;应用对Ca2 敏感的探针Fluo-3与Ca2 络合后被激光激发发出荧光的特性,利用激光共聚焦显微镜观察伏核、海马、内侧额前皮质神经细胞[Ca 2 ]i变化,并用图像分析软件进行处理.结果 吗啡成瘾大鼠脑内伏核、海马及内侧额前皮质神经细胞[Ca 2 ]i和对照组比较明显增高(P<0.01).结论 长期使用吗啡可明显增高伏核、海马和内侧额前皮质神经细胞[Ca 2 ]i.     

种植体表面处理与骨结合效应：3i种植系统的临床应用★

背景：种植义齿已逐渐成为牙列缺损或缺失的常规修复方式，目前国内外采用的种植系统众多，在临床应用效果上各有特点。 目的：观察经双重酸蚀或Nano Tite表面处理的3i种植系统对牙列缺损或缺失的修复效果。 方法：95例患者植入双重酸蚀的OSSEOTITE种植体150枚(植入后1~3个月行永久修复)，植入Nano Tite种植体7枚(植入后1个月行永久修复)。随访观察24个月，行临床检查及影像学检查对临床效果进行评价。 结果与结论：157枚种植体骨结合良好，种植体根周未见X射线透射区；随访期内，所有种植体均未见松动、脱落，留存率100%，成功率100%，无种植体宿主不良反应。提示经双重酸蚀或Nano Tite表面处理的种植体有利于引导成骨细胞趋化，修复效果满意。     

Sulpirid versus haloperidol i behandling af skizofreni: En kort,prsæliminær rapport

Twenty-eight patients with schizophrenia were included in this double-blind crossover study and were randomly assigned to treatment with either sulpiride or haloperidol. The study has demonstrated an antipsychotic effect of sulpiride, not significantly different from that of haloperidol. The dose level used for treatment varied from 800 to 3200 mg sulpiride. Even high doses of sulpiride appeared to induce very few extrapyramidal side effects. The observation of good antipsychotic effect of sulpiride, a neuroleptic that selectively binds to a subpopulation of D-2 dopamine receptors, may call for consideration of the relationship between the dopamine receptors and the antipsychotic mechanisms of action of neuroleptic drugs.     

甘草黄酮对脂多糖诱导小胶质细胞i NOS表达和NF-кB活化影响

目的研究甘草黄酮对脂多糖诱导的BV-2小胶质细胞诱导型一氧化氮合酶(inducible nitricoxide,iNOS)表达影响和对核因子-kB(nuclear factor-kappa B,NF-kB)活化的影响。方法将BV-2细胞随机分为四个组:Control组、脂多糖组、3μg/mL和5μg/mL甘草黄酮处理组。采用免疫荧光染色法定性分析iNOS在BV-2细胞的表达;采用免疫蛋白印迹法定量分析甘草黄酮处理前后胞浆iNOS蛋白表达量和胞核NF-кB p65蛋白含量变化。结果各组i NOS阳性BV-2细胞数量(F=8.09,P0.01),胞浆iNOS蛋白表达量(F=7.89,P0.01)和胞核NF-кB p65蛋白含量(F=6.12,P0.01)差异均有统计学意义。被脂多糖刺激后,大量BV-2细胞呈iNOS阳性(P0.01),部分细胞胞体变圆钝,突起变粗短;胞浆iNOS蛋白表达量较对照组急剧增多(P0.01),同时伴有胞核NF-кB p65蛋白含量的显著增加(P0.01)。而经两种浓度脂多糖处理过的BV-2细胞,在脂多糖刺激后,iNOS阳性细胞数量则均较脂多糖组有明显减少(P0.01),同时细胞胞体缩小,突起增多;胞浆iNOS蛋白表达量也均较脂多糖组有明显降低(P0.01),同时伴有胞核NF-кB p65蛋白含量的降低(P0.01)。结论甘草黄酮可抑制脂多糖诱导的小胶质细胞iNOS表达,其机制可能与调节NF-кB活化有关。