Fainting in animals

Fainting (syncope) is unconsciousness due to insufficient cerebral circulation in the context of a temporary failure of the systemic circulation. This paper firstly aims to discuss fainting in animals, and secondly to discuss animal physiology to broaden the understanding of human fainting.Of the three major syncope types (cardiac, orthostatic and reflex syncope), only cardiac syncope occurs in animals as in man, through arrhythmia or output failure.Mans orthostatic fainting tendency has been blamed on his upright posture. A comparison with animals shows that giraffes, treeclimbing snakes, and animals that quickly raise and lower their heads face more serious gravitational circulatory challenges than man, but do not appear to faint. Merely carrying the brain above the heart does not explain a fainting tendency, as the human heart-to-brain height is smaller than that of many mammals with similar blood pressure. Two evolutionary novelties may be to blame: the proportion of cardiac output going upwards to the brain is much larger than in apes, and mans large legs suggest that the volume lost to venous pooling is also larger.Emotional factors play a role in many reflex syncope events. Tonic immobility (feigning death,playing possum) is not a good model, as it concerns immobility as a survival strategy of an attentive brain, rather than unconsciousness due to circulatory breakdown. Whether orienting and defense responses form a valid model remains to be proven. Emotional fainting may be uniquely human; how mental processes can shut down the circulation and thereby the brain needs serious study, as it may hold the key to syncope prevention.     

Apolipoprotein E co-localizes with newly formed amyloid β-protein (Aβ) deposits lacking immunoreactivity against N-terminal epitopes of Aβ in a genotype-dependent manner

Different types of amyloid -protein (A)-containing plaques occur in brains of Alzheimers disease (AD) patients. Diffuse plaques seen during early stages of AD differ from neuritic plaques in later stages both with respect to the length of the A peptides and the presence of other proteins, e.g., apolipoprotein-E (apoE). Since apoE is involved in A transport and clearance, and the 4-allele of the apolipoprotein-E gene (APOE) is a major risk factor for sporadic AD, it is plausible to speculate that apoE plays a pathophysiological role in the initiation of A deposition. To address the issue of whether binding of apoE to A is involved in initial A deposition, we studied the human medial temporal lobe of 60 autopsy cases encompassing the full spectrum of AD-related pathology. In temporal lobe regions, which become involved for the first time at a given stage of -amyloidosis, all plaques represent newly formed plaques, and these were studied with immunohistochemical methods. ApoE was present in 36 cases, and was frequently co-localized with newly formed A deposits detectable with anti-A₄₂ but not with antibodies raised against N-terminal epitopes of A. In 10 additional cases, immunoreactivity against apoE was completely lacking in newly formed plaques, which, at the same time, displayed immunoreactivity against N-terminal epitopes of A. The failure of N-terminal epitopes of A to co-localize with apoE in newly formed plaques indicates that these deposits presumably contain apoE-A complexes, in which the N-terminal epitopes of A are often concealed after complexing with apoE, thus preventing subsequent binding of antibodies. Moreover, apoE-positive newly formed plaques were seen more frequently in APOE 4/4 cases than in non-APOE 4/4 individuals, thereby underlining the potentially crucial role of apoE for the development of A deposits.     

Mental Hygiene of the Special Schools Teachers in Kerman,Iran

The goal of this research is to identify and study the mental hygiene and its related factors (individual, family, organizational) in the Kerman special schools teachers. 266 teachers of the special schools of the cities of the province Kerman were chosen as the research sample. The necessary data were obtained by questionnaire which its validity and reliability were determined. The statistical analysis of the research findings (by Spearman coefficient test) Man-Whithey and Kruskal wallis tests showed that there was a positive and meaningful relationship between Level of education, service of record the number of the members of teachers family, income, dwelling-place, economic power, acceptance of the teachers job in their family, leadership style, suitable educational possibilities, suitable educational space, job satisfaction with the mental hygiene of the teachers. The results of the research also showed that the Kerman special schools teachers enjoyed a relatively desirable mental hygiene.     

Unconscious Confusion

Abstract Background Imprecise definitions of syncope and related conditions appear common in the medical literature. To investigate the scope of the problem we systematically searched for definitions in high-ranking medical journals. Methods Literature review of articles on syncope, neurocardiogenic syncope, neurally mediated syncope, orthostatic intolerance, and orthostatic hypotension with these keywords in the title, mainly published in the ten journals with the highest impact in the fields of cardiology, internal medicine, and neurology. Results Syncope, neurocardiogenic syncope, neurally mediated syncope, orthostatic intolerance, and orthostatic hypotension were defined in only 41%, 34%, 26%, 38%, and 48% of papers respectively. Definitions, when given, differed considerably among papers. Orthostatic hypotension was most frequently defined, with an increase in number and consistency of definitions after publication of a consensus in 1996. Conclusions Syncope and related conditions proved to be infrequently and inconsistently defined in current medical literature. The lack of consistent terminology is likely to harm medical education, research, and patient care. There is a strong need for a systematic terminology for syncope and related conditions.     

Life events and syndromes of depression in the general population

Summary Brown and Harris (1978) contend that life events have causal significance for both psychotic and neurotic depression. This contradicts the psychiatric tradition. Neurotic depression has been regarded as a consequence of life-stress, while psychotic depression has been regarded as a consequence of processes intrinsic to the organism. Empirical evidence is presented to support the view that life events have a differential effect, within the general population. It is argued that Brown and Harris's (1978) conclusion follows from an inappropriate approach to classification. It is argued further that their data lend support to the traditional view. It is noted that their approach may inhibit the development of explanatory models linking life-stress, vulnerability factors and depression.     

Relationship of maternal parenting behaviors to preschool children's temperament

Mothers of 182 preschool nursery school children rated their own parenting responses on a Parent's Report questionnaire. At the same time the mothers responded to the Behavior Style Questionnaire (BSQ) from which scores were determined for nine categories of temperament. On the basis of category scores the children were grouped into one of five temperament clusters i.e. easy, difficult, slow to warm up, high intermediate, low intermediate. The children's membership in BSQ clusters was independent of sex, age, birth order, and mothers employment status but there was a significantly higher ratio of easy children from higher socioeconomic classes I and II. Mothers of children grouped in either the difficult or slow to warmup clusters were more likely to use guilt inducing and temper-detachment parenting styles than mothers of children grouped in the easy cluster.     

Prostaglandin F2α levels in human cerebrospinal fluid in normal and pathological conditions

Summary Prostaglandin F₂ concentrations in cerebrospinal fluid (CSF) from normal human subjects and patients with various pathological disorders of the central nervous system (CNS) were measured by radioimmunoassay. The mean PGF₂ level in 54 controls with no evidence of organic CNS disease was 67 pg/ml (range: 25–150 pg/ml). A significant increase of PGF₂ levels was demonstrated in most samples from patients with CNS diseases. Extremely high values were found in patients with stroke and subarachnoid hemorrhage when samples were collected shortly after the cerebral attack. With the regression of clinical symptoms and radiological findings a decrease of PGF₂ levels was demonstrated in this group of patients. In 32 patients with cerebral transient ischemic attacks a mean PGF₂ concentration of 170 pg/ml (range: 35–355 pg/ml) was found. Increased PGF₂ levels were found in patients with epilepsy when samples were collected within a few days after a convulsion. PGF₂ levels of four patients with slow progredient forms of multiple sclerosis without clinical symptoms at the time of sample collection were not different from normal controls while the mean PGF₂ level of all other patients with multiple sclerosis was 152 pg/ml (range: 55–325 pg/ml). Moreover, increased values could be demonstrated in patients with cerebral tumors and inflammatory processes.

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Zusammenfassung Mittels Radioimmunoassay wurden PGF₂-Konzentrationen im Liquor cerebrospinalis von normalen Personen und von Patienten mit verschiedenen Erkrankungen des ZNS gemessen. Der mittlere Prostaglandin-F₂-Spiegel von 54 Normalpersonen betrug 67 pg/ml (Bereich: 25–150 pg/ml). Bei den meisten Erkrankungen des ZNS unseres Patientengutes konnten deutliche Erhöhungen der PGF₂-Konzentration im Liquor cerebrospinalis festgestellt werden. Auffallend hohe Werte fanden wir bei Patienten mit ischämischen und hämorrhagischen Insulten als auch bei Subarachnoidalblutungen, wenn die Liquorabnahme innerhalb weniger Tage nach der Attacke erfolgte. Mit zunehmender Besserung des klinischen und röntgenologischen Befundes zeigte sich bei dieser Krankheitsgruppe eine rasche Normalisierung der PGF₂-Konzentration im Liquor. Bei 27 Patienten mit transitorisch-ischämischen zerebralen Attacken fanden wir einen mittleren PGF₂-Spiegel von 170 pg/ml (Bereich: 35–355 pg/ml). Bei Patienten mit Epilepsie zeigte sich ein deutlicher Anstieg der PGF₂-Konzentration in Zusammenhang mit Krampfanfällen mit Normalisierung der Werte nach längeren, anfallsfreien Phasen.Bei 4 Patienten mit einer milden Verlaufsform einer Multiplen Sklerose ohne besondere klinische Symptomatik zum Zeitpunkt der Liquorabnahme wurden normale PGF₂-Spiegel gefunden, während der mittlere Spiegel aller 10 Patienten mit Multipler Sklerose mit 152 pg/ml doch deutlich erhöht war. Hohe PGF₂-Konzentrationen fanden wir auch im Liquor von Patienten mit Tumoren des ZNS und Meningitis bzw. Meningoenzephalitis.

     

The effect of oxidative stress on amyloid precursor protein processing in cells engaged in β-amyloidosis is related to apolipoprotein E genotype

The reduced antioxidative defense in allele 4 carriers is suggested to contribute to -amyloidosis in Alzheimers disease and Downs syndrome. We studied the effect of oxidative stress on accumulation of amyloid- peptide (A) in vascular smooth muscle cells (SMCs) that are engaged in production of amyloid- in vivo. Previously, we found that oxidative stress caused by ferrous ions induced accumulation of A-apolipoprotein E deposits in lysosomes and was associated with a greater oxidative protein damage in 4 carriers. Here, we demonstrate that ferrous ions induce formation of A deposits also in vascular tunica media in organotypic cultures of whole brain vessels, suggesting the role of oxidative stress in development of vascular -amyloidosis. Cellular accumulation of A in SMCs treated with ferrous ions was associated with a greater accumulation of C-terminal amyloid precursor protein (APP) fragments in 4/4 than in 3/3 myocytes and reduced the amount of soluble APP in 3/3, but not 4/4, cultures. Antioxidant vitamin E prevented these effects, and, when applied alone, diminished the amount of APP C-terminal fragments and increased the amount of secreted APP in 3/3, but not 4/4, cells. C-terminal APP-immunoreactive material was accumulated in lysosomes partly with A- and N-terminal APP immunoreactivities. These results suggest that the increased accumulation of APP and its fragments in lysosomes may yield additional amounts of cellular A, particularly in 4 carriers. We hypothesize that the altered processing of APP in SMCs locally exposed to oxidative stress facilitates cellular deposition of A and contribute to the increased risk of development of -amyloidosis in 4/4 carriers.     

Zur Ultrastruktur der π-Granula

Zusammenfassung Die Ultrastruktur der -Granula Reichs im Schwann-Zellcytoplasma der normalen menschlichen markhaltigen Nervenfasern wurde untersucht. Folgendes konnte festgestellt werden. 1. Die den -Granula entsprechenden pleomorphen, meist stäbchen-förmigen Körperchen finden sich perinucleär und sind bei älteren Individuen gehäuft zu finden, treten aber in geringer Zahl auch schon bei Jugendlichen auf. 2. Diese Körperchen sind membranbegrenzt und aus geschichteten Lamellengruppen mit einer Periodik von 52–63 Å aufgebaut. 3. Sie sind lysosomaler Natur und entstehen durch Speicherung und Strukturierung gewisser Lipide oder Lipidgemische. 4. Markscheiden und Axone, deren Schwannsche Zellen -Granula enthalten, zeigen normale Feinstruktur.Die -Granula sind nicht als Markabbauprodukte aufzufassen. Es wird angenommen, daß die -Granula aus nicht weiter metabolisierbaren Lipiden des physiologischen Myelinstoffwechsels bestehen. Über die konstituierenden Lipidbestandteile und die Bedingungen für die Pleomorphie der -Granula wird diskutiert.

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Ultrastructure of the protagon ()-Granules

Summary The ultrastructure of the protagon ()-granules (Reich, 1903) in the cytoplasm of Schwann cells of normal human peripheral nerves was studied. The following results were obtained: 1. The structures which correspond to -granules appear in the perinuclear cytoplasme as pleomorphic, mostly rod-like shaped bodies. They are numerous in aged persons, less in young persons. 2. The bodies are membrane bound and consist of regularly arranged lamellar structure with a periodicity of 52–63 Å. 3. The bodies are of lysosomal nature and originate from storage and structuring of lipide or lipid mixtures. 4. Myelin sheaths and axons of -granules containing Schwann cells reveal a normal ultrastructure.-granules are not degradation products of myelin. It is suggested that the -granules consist of various nonmetabolisable lipids of the physiological myelin metabolism. The nature of the lipids and the causes of the pleomorphic appearence of the -granules are discussed.

Nach einem Vortrag, gehalten auf dem 1. Donau-Symposium für Neuropathologie, Mai 1969 in Wien     

A process analysis of Bender Gestalt Test performance in childhood emotional disorder: A single-case study

This study involves an analysis of the Bender Gestalt Test performance of a young, severely disturbed boy emphasizing the origins of and processes mediating the emergence of deviant responses. Deviant responses are considered to reflect a conflict between primitive motor impulses and an emergent, visually-mediated organization of the designs, corresponding to the several stages of sensory-motor adaptation. The manner of the resolution of visuo-motor conflict may prefigure later dispositional trends significantly embedded within aspects of childhood emotional disorder. Finally, analogy is drawn between specific aspects of performance and the boy's behavioral organization.     

Liquorkomplement und Multiple Sklerose

Zusammenfassung 1. In 239 Liquores, darunter 47 MS-Fälle und 91 normale Kontrollen, wurden Komplement und Komplementfaktoren (C₁, C₂, C₃ und C₄) bestimmt.2. Im normalen Liquor ist in der Regel keine Gesamtkomplementaktivität vorhanden. Dagegen ist die C₁- wie C₄-Aktivität praktisch immer und C₂-sowie C₃-Aktivität in über der Hälfte der Fälle zu finden. Das Komplementmuster im Liquor ist daher im Gegensatz zum Serum unvollständig.3. Bei erhöhtem Eiweiß zeigt der Liquor dagegen häufig Gesamtkomplementaktivität. Je höher das Liquoreiweiß ist, um so höher ist der Gehalt an C₂, C₃ und Gesamtkomplement. Diese Beziehungen zwischen Gesamteiweiß und Komplementaktivität gelten für normalen wie pathologischen Liquor einschließlich der MS-Fälle.4. Im MS-Liquor sind C₂, C₃ und Gesamtkomplement seltener zu finden als bei den Kontrollen. Bei den MS-Patienten ist C₂ und C₃ im akuten Schub herabgesetzt. C₃ nimmt im Verlauf der Erkrankung wahrscheinlich ab.5. Mit Antikomplementserum wurde _1C-Globulin, ein Teilfaktor von C₃, im Liquor von 55 MS-Patienten und 42 Kontrollen bestimmt. Es besteht kein Unterschied zwischen MS und Kontrolliquor. Auch bei akut entzündlicher MS ist _1C nicht vermindert.6. In der Diskussion wird auf widersprechende eigene Befunde über _1C-Inaktivierung im Serum während der akut entzündlichen MS-Phase hingewiesen.

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Summary 1. Complement and complement factors (C₁, C₂, C₃ and C₄) were determined in 239 specimes of cerebrospinal fluid (CSF) including 47 cases of Multiple Sclerosis (MS) and 91 normal controls.2. In general, total complement activity is absent in normal specimens while that of C₁ and C₄ can be found practically always and that of C₂ and C₃ in more than half of the cases. Therefore, the pattern of complements in the CSF is incomplete as opposed to that of serum.3. In contrast, samples with increased protein content frequently yield total complement activity. The higher the protein content of CSF the higher the content of C₂, C₃ and total complement. This relationship between amount of total protein and complement activity applies both to normal and pathological CSF specimens including those from MS.4. In cerebrospinal fluid from patients with MS, C₂, C₃ and total complement are found less frequently than in that from controls. C₂ and C₃ are diminished in patients with an acute exacerbation of MS. C₃ decreases probably in the course of the disease.5. _1C-globulin, a component of C₃, was determined with anticomplement sera in specimens from 55 patients with MS and from 42 controls. There is no difference between CSF of MS and controls. Even in acutely inflammatory cases of MS, _1C is not diminished.6. Discussing his results the author points out discrepancies concerning the nactivation of _1C in serum during acutely inflammatory episodes of MS.

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Mit Unterstützung durch die Deutsche Forschungsgemeinschaft.     

The repetition of parasuicide in Edinburgh 1980–1981

Summary We prospectively studied all Edinburgh hospital-referred parasuicides admitted in 1980 until the end of 1981, with regard to their repetition of parasuicide. For those 259 who repeated during this time, parasuicide status at the key 1980 admission was significantly related to age group, the veterans being older than first-timers. Similarly, the total number of episodes of parasuicide in the follow-up period was significantly related to age-group and parasuicide status: those over 45 years and first-timers were less prone to repetition. Survival analysis of all 1980 admissions revealed that veterans were significantly more likely than first-timers to be admitted with a repetition from as little as 4 days after a given episode. This difference was maintained from then until the end of the follow-up period.     

Hypofrontality on topographic EEG in schizophrenia

Summary Topographic EEG was performed in 17 DSM-III-R schizophrenic patients and in 15 sex- and agematched healthy controls. Eleven patients were firstonset (neuroleptic naive) schizophrenics. EEG band power was compared with psychopathology, neuropsychology and neurological soft signs. The EEG was recorded at 14 topographic locations monopolarly and movements of the eye and of the lid were monitored by two bipolar electro-oculogram (EOG) derivations, one vertical and one horizontal. A multivariate correction of EOG artefacts was performed based on regression analysis with respect to EOG channels. Schizophrenic patients showed higher mean and median power in most bands. These differences were most marked in the delta band, in the fast alpha and beta bands, in particular at left frontal sites. Delta power at F7 was by far the best separating variable between schizophrenics and controls in a discriminant analysis. Significant positive correlations were found between the Brief Psychiatric Rating Scale scores Anxiety-depression and Activation and power in the fast bands and negative ones between Anergia and the beta bands. Positive significant correlations emerged between the total score in the Negative Symptoms Rating Scale and the amount of delta power, predominantly over the temporal region. Impairment in the Luria-Nebraska neuropsychological scores Rhythm and Memory correlated highly significantly with EEG band power. No correlations were found between neurological soft signs and EEG band power. Our results are in line with the hypothesis of a hypofrontality in schizophrenia. It is unlikely that these findings are an artefact of prior psychiatric treatment, as they were also observed in firstonset, neuroleptic naive schizophrenics. Moreover, our data suggest that these abnormalities are of clinical and functional relevance, as they correlated significantly with psychopathological and neuropsychological parameters.     

Effects of thyroid status on presynapticα2-adrenoceptor function andβ-adrenoceptor binding in the rat brain

Summary The effect of thyroid status on noradrenergic synaptic function in the mature rat brain was examined by measuring presynaptic2- and post-synaptic-adrenoceptors.Repeated triiodothyronine (T₃) administration to rats (100g/kg×14 days: hyperthyroid) caused an 18% increase in striatal-adrenoceptors as shown by [³H]-dihydroalprenolol binding with no change in membranes from cerebral cortex or hypothalamus. In contrast, hypothyroidism (propyl-thiouracil, PTU×14 days) produced significant 12% and 30% reductions in striatal and hypothalamic-adrenoceptors respectively with no change in the cerebral cortex. Presynaptic2-adrenoceptor function was measured in the two dysthyroid states using the clonidine-induced hypoactivity model. Experimental hyperthyroidism increased the degree of clonidine-induced hypoactivity, and suggests increased presynaptic2-adrenoceptor function compared with control rats, whereas hypothyroidism suppressed presynaptic2-adrenoceptor function. These results show firstly that changes in thyroid status in the mature rat may produce homeostatic alterations at central noradrenergic synapses as reflected by changes in pre- and postsynaptic adrenoceptor function. Secondly, there appear to be T₃-induced changes in-adrenoceptors in the striatum where changes in dopaminergic neuronal activity have previously been demonstrated.     

Psychiatric morbidity and criminality in ‘schizoid’ children grouwn-up: A records survey

A psychiatric and criminal records search was undertaken in young adult life for two groups of former child psychiatric patients: one given a diagnosis of schizoid personality in childhood and the other, matched for sex, age, IQ and socio-economic background, given other diagnoses. The prevalence of schizophrenia in the schizoid group was low but higher than in the controls and about ten times the expected population rate. The death rate from suicide was greatly raised. Adult criminality was higher than expected in bot groups but, while for men the rates were similar in schizoid and control cases, schizoid women wer more often and more seriously delinquent than their matched controls.

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Zusammenfassung Die psychiatrischen und strafrechtlichen Dokumentationsdateien junger Erwachsener, die ehemals kinder- und jugendpsychiatrische Patienten waren, wurden untersucht, wobei eine Einteilung in zwei Gruppen erfolgte: Die erste Gruppe umfaßte ehemalige kinder- und jugendpsychiatrische Patienten, dei die Diagnose einer schizoiden Persönlichkeit erhalten hatten. Die Kontrollgruppe umfaßte ehemalige kinder- und jugendpsychiatrische Patienten mit anderen Diagnosen, die für Geschlecht, Alter, IQ und sozioökonomischen Status parallelisiert wurden. Die Prävalenz von Schizophrenie in der schizoiden Gruppe war niedfrig aber höher als in der Kontrollgruppe und zehnmal häufiger als der Erwartungswert in der Allgemeinbevölkerung. Die Suizidrate war stark erhöht. Die Kriminalitätsrate war in beiden Gruppen höher als erwartet, wobei eine Geschlechtsdifferenz bestand: Bei Männern waren die Raten beider Gruppen ähnlich, hingegen hatten schizoide Frauen häufigere und schwerwiegendere Delike begangen als in der parallelisierten Kontrollgruppe.

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Résumé Une recherche concernant l'état psychiatrique et des actes criminels a été entreprise chez des jeunes adultes appartenant à deux groupes pour lesquels un diagnostic psychiatrique avait été posé dans l'enfance. L'un avait eu un diagnostic de personnalité schizoïde et l'aure apparié par le sexe. l'âge, le quotient intellectuel et l'environmennement socio-économique avait eu d'autres diagnostics Une prévalence de schizophrénes dans le groupe schizoïde était faible et plus importance que dans le groupe contrôle et environ 10 fois supérieur en taux à la population normale. Le taux de mort par suicide était fortement élevé. La criminalité adulte était plus haute que celle attendue dans les deux groupes mais, tandis que pour les hommes le taux était semblable pour le groupe schizoïde et le groupe contrôle, les femmes chizoïdes étaient plus souvent et plus sérieusement délinquantes que celles du groupe contrôle.

     

Histochemische Untersuchungen zur Verteilung und Aktivität hydrolytischer Enzyme in Gliomen

Zusammenfassung Es wird über Aktivität und Verteilung der -Glucuronidase, -Galaktosidase, -Glucosidase und Arylsulfatase in 49 Gliomen berichtet. Die höchste Aktivität in den Tumorzellen weisen die Glykosidasen auf. Mit zunehmender Malignität der Tumorart ist eine Zunahme der Glykosidasenreaktion festzustellen. Alle untersuchten Enzyme sind infolge Diffusion in zerfallenden Markscheiden und ihren Fragmenten nachweisbar.

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Summary Activities and distribution patterns of -glucuronidase, -galactosidase, -glucosidase and arylsulfatase were demonstrated histochemically in 49 gliomas. The activities of the glycosidases were higher than that of the sulfatase, and also higher in malignant tumors than in benign ones. The enzymes tested are seen within damaged and disintegrating portions of the myelin sheath.

     

Low temperature in the golden hamster accelerates the gonadal atrophy induced by short photoperiod but does not affect the daily pattern of melatonin secretion

Summary Male golden hamsters were exposed to short photoperiod at either 20C or 5C. After 4 weeks a complete gonadal inhibition was observed in animals kept at 5C while in animals kept at 20C such an inhibition was much less. No significant difference in the pattern of pineal and plasma melatonin concentrations was observed between hamsters kept at 20C and 5C. If in the golden hamster pineal melatonin secretion is implicated in the transduction of the photoperiodic information, it is probably not implicated in the transduction of thermal information.     

Antipsychotic treatment withα-methyltyrosine in combination with thioridazine: Prolactin response and interaction with dopaminergic precursor pools

Summary The antipsychotic effect of-methyltyrosine (-MT) in combination with thioridazine was investigated by means of rating scales for social behaviour and mental symptoms The clinical effect was also evaluated in relation to the serum concentrations of-MT and thioridazine and to the increase in prolactin secretion in response to the interaction with hypothalamic dopaminergic mechanisms. The interactions between the serum levels of-MT and those of the transmitter precursors phenylalanine and tyrosine were analysed. The results confirmed the ability of-MT (2g/day) to potentiate the antipsychotic effect of thioridazine, whereby the dose of neuroleptic drug required to control psychotic symptoms may be markedly reduced. None of the four patients who completed the trial showed side effects that could be ascribed to-MT. The antipsychotic effect of thioridazine, alone or in combination with-MT, correlated well with the prolactin response in the individual patient. No important interference with serum phenylalanine or tyrosine levels was noted during treatment with-MT.     

Hyperkinetic children: Early indicators of potential school failure

Hyperkinetic children are identified as a population-at risk upon admission to kindergarten. The etiology of hyperkinetic behavior is controversial. Organic driveness, hyperkinetic behavior disorder, postencephalitic behavior, brain damage with behavioral and conceptual deficit, Strauss syndrome, have all been used to label essentially similar symptom constellations. Bypassing the area of controversy, a study is reported that demonstrates that children who were identified as hyperkinetic (using behavioral criteria developed in an earlier study) were (1) absent from school more frequently, and (2) did remarkably less well on standardized tests of school readiness than their peers rated nonhyperkinetic. The implications are discussed and suggestions made for the development of intervention programs.An earlier version of this paper was presented at the Annual Meeting of the American Orthopsychiatric Association, March, 1967.     

Work and mental health

Abstract. Background: Studies investigating the psychological correlates of types of occupation have focused on such disorders as stress, depression, suicide and substance abuse. There have also been some models proposed to allow understanding of factors common to different types of occupations. We sought to provide an overview of research related to work and mental health and consider future research directions. Methods: A literature search was conducted using the Medline, PsycInfo, Embase and PubMed databases. The key words occupation or work were searched in combination with the key words mental health, risk factors, disorders, depression, suicide, trauma, stress or substance use. Results: Studies of stress tend to be more applicable to specific workplace issues. While some of the studies relating to onset of depression, suicide, substance abuse and trauma pertain to specific occupational issues and results are often not generalizable, they have progressed our understanding of risk factors to those disorders. There are workplace factors involving exposure to danger and crisis that lead to posttraumatic stress disorder (PTSD), substance abuse (including stimulants) and depersonalization. Workplace risk factors for depression involve situations promoting lack of autonomy, and involving caring for others as part of the work role, particularly where there is dependence on others for their livelihood. Risk factors for alcohol abuse include workplaces with access to alcohol and where use of alcohol is sanctioned. There appears to be a bi-directional relationship between personality and work, so that people are drawn to particular occupations, but the occupations then have an effect on them. An interactional model is proposed to consider this. Conclusion: The research questions pertaining to mental health are varied and will determine what mental health issues are of interest and the models of work applicable. There need to be more longitudinal studies and consideration of factors which the worker brings to the workplace (psychosocial issues, personality traits), as well as interpersonal issues and consideration of systemic, organizational, political and economic factors, including leadership styles.