Current status of late onset delusion in the elderly]

In the field of chronic delusions, authors make synthesis of the delusion with late emergence in the elderly. This delusion is at once replaced in the history of its nosographic position, then defined in its presentation. The question of its refer with depression and its place in the limits of dementia are approached. Authors outline the importance of biological, psychological and sociological factors in induction of this particular delusion to clarify the means for its management.     

The bicentennial volume of the British Journal of Psychiatry: the winding pathway of mental science

The Asylum Journal, first published in 1853, is now, as the British Journal of Psychiatry, in its 200th volume. It has changed greatly in its breadth and scope, but its core values and concerns--professional respect, removal of stigma, delivery of care, understanding of pathology, and informed treatment--have remained at its heart throughout. We predict some changes for the future, but not dramatic ones, and conclude that the impinging advances of science will elucidate and refine, but not remove, the need for a journal that is proud to represent psychiatry or, in the words of John Bucknill, its first editor, 'to render prominent its characteristics and to stamp it as a specialty'.     

The Oedipus Complex: Comments on 'The Case of Little Hans

The author addresses the question of the misrepresentation of psychoanalysis and psychoanalysts in the media and suggests that Freud's theory of man's psyche has, at its center, the inevitable and subversive contradiction that all knowledge undermines the narcissistic certainty of the knower; specifically, the unconscious mind constantly works to unseat that which is available to consciousness. This truism, which is the theoretical and clinically demonstrable position of psychoanalysis, produces resistance and aversion to the discipline, its practice, and its practitioners. The author argues, with brief references to three works of art, that paradoxically, by virtue of this misrepresentation of psychoanalysis—of its ideas and praxis, its very worth, and its contribution to society and to culture—the discipline of psychoanalysis is convincingly upheld.     

Narcissism: its normal evolution and development and the treatment of its disorders

Narcissism has become a construct attracting increasing attention in mental health. Its precise definition, its normal and abnormal developmental features, its assessment, the pathogenesis of its aberrations, and the treatability of its pathological manifestations merit continuing study and clarification. This overview outlines these relevant issues, and summarizes psychoanalytic psychotherapeutic investigations involving the detection and modification of narcissism as well as the limitations of this approach.     

Site-specific effects of tau phosphorylation on its microtubule assembly activity and self-aggregation

Microtubule-associated protein tau is abnormally hyperphosphorylated and aggregated into neurofibrillary tangles in brains with Alzheimer's disease. The phosphorylation sites of tau are mainly localized in the proline-rich (residues 172–251) and C-terminal tail (residues 368–441) regions, which flank the microtubule-binding repeats. Here, we investigated the effects of tau phosphorylation at these distinct sites/regions on its activity of stimulating microtubule assembly and its self-aggregation. We found that tau phosphorylation at the proline-rich region by dual-specificity tyrosine-phosphorylated and -regulated kinase 1A inhibited its microtubule assembly activity moderately and promoted its self-aggregation slightly. Tau phosphorylation at the C-terminal tail region by glycogen synthase kinase-3β increased its activity and promoted its self-aggregation markedly. Tau phosphorylation at both regions plus the microtubule-binding region by cAMP-dependent protein kinase diminished its activity (∼70% inhibition) and disrupted microtubules. These studies reveal the differential regulation of tau's biological activity and self-aggregation by phosphorylation at various sites/regions.     

Oligodendrocyte-myelin glycoprotein is present in lipid rafts and caveolin-1-enriched membranes

The oligodendrocyte-myelin glycoprotein is a ligand of the neuronal Nogo receptor and a potent inhibitor of neurite outgrowth, but its physiological function remains to be elucidated. The oligodendrocyte-myelin glycoprotein is anchored solely in the outer leaflet of the plasma membrane via its glycosylphosphatidylinositol anchor, and through its leucine-rich repeat domain, it likely interacts with other proteins. In the present study, we compare its buoyancy and detergent solubility characteristics with those of other myelin proteins. Based on its detergent solubility profile and membrane fractionation using established ultracentrifugation procedures, we conclude that the oligodendrocyte-myelin glycoprotein is a lipid raft component that is closely associated with the axolemma. Moreover, it associates with caveolin-1 and caveolin-1-enriched membranes. We postulate that, by virtue of its concentration in lipid rafts and perhaps through interactions with caveolin-1, the oligodendrocyte-myelin glycoprotein may influence signaling pathways.     

Child and adult psychiatry: comparison and contrast.

Since its development from general psychiatry, child psychiatry has been influenced by its close involvements with the child guidance movement and pediatrics and by the age of its patient population. This has led it to evolve in ways quite distinct from adult psychiatry, so much so that at times the understanding and relationship between the two disciplines has been somewhat strained. This paper relates the development of child psychiatry to its history, its tasks and its patient population, highlighting some of the major differences between child and adult psychiatry. It then looks at why research in child psychiatry has lagged behind research in adult psychiatry. It concludes by discussing tensions between the two disciplines, and why it serves the interests of both professions as well as those of our patients, that a better understanding and collaboration between them be established.     

Brief Report: Should the DSM V Drop Asperger Syndrome?

The DSM IV defines Asperger syndrome (AS) as a pervasive developmental (autistic spectrum) disorder characterized by social deficits and rigid focused interests in the absence of language impairment and cognitive delay. Since its inclusion in the DSM-IV, there has been a dramatic increase in its recognition both in children and adults. However, because studies have generally failed to demonstrate a clear distinction between AS and autism, some researchers have called for its elimination from the forthcoming DSM V. This report argues for a modification of its diagnostic criteria and its continued retention in the diagnostic manual.     

Tian ma, an ancient Chinese herb, offers new options for the treatment of epilepsy and other conditions

Our purpose is to bring attention to the antiepileptic properties of the Chinese herb tian ma and its constituents, as well as to suggest the potential for the development of new antiepileptic drugs (AEDs) related to this herb. All available literature regarding the chemistry, pharmacology, animal data, and clinical use of tian ma and its constituents are reviewed, showing that tian ma, its constituents, and its symbiotic fungus Armillaria mellea have antiepileptic properties in in vitro and in vivo models. One clinical study reportedly demonstrated the AED effects of a component of tian ma, vanillin. Thus, tian ma, its constituent vanillin, and its symbiotic fungus armillaria hold promise as cost-effective and less toxic alternatives to standard AEDs. In addition, similar chemical compounds may be developed as AEDs.     

中枢神经细胞瘤相关研究进展

中枢神经细胞瘤(CNC)是位于脑室内的一种罕见的神经上皮肿瘤,目前起源尚不清楚,好发于中青年群体,其在影像学上有一定的特征性表现。但由于中枢神经细胞瘤的罕见性,目前临床上对其的认识仍然存在不足,治疗方式的选择及其预后相关的影响因素也存在着较大的争议。本文结合最近的文献报道就中枢神经细胞瘤临床及流行病学特征、影像及病理学特点、治疗方式的选择及其相关预后因素、与脑室外神经细胞瘤的关系等方面的研究进展作一综述。     

Evidence review and clinical guidance for the use of ziprasidone in Canada

While indicated for schizophrenia and acute mania, ziprasidone’s evidence base and use in clinical practice extends beyond these regulatory approvals. We, an invited panel of experts led by a working group of 3, critically examined the evidence and our collective experience regarding the effectiveness, tolerability and safety of ziprasidone across its clinical uses. There was no opportunity for manufacturer input into the content of the review. As anticipated, ziprasidone was found to be effective for its indicated uses, although its utility in mania and mixed states lacked comparative data. Beyond these uses, the available data were either unimpressive or were lacking. An attractive characteristic is its neutral effect on weight thereby providing patients with a non-obesogenic long-term treatment option. Key challenges in practice include the need for dosing on a full stomach and managing its early onset adverse effect of restlessness. Addressing these issues are critical to its long-term success     

The emergence of child psychiatry as an academic discipline

Child psychiatry has come a long way since its tenuous beginnings fifty years ago. A few of the pioneers are still around to remind us of our short history. Its development has not by any means been linear and, from time to time over the years, it has wandered off into nonmedical fields and practices that have impeded its incorporation into the body of medicine. Within the past two decades, it has relinquished its purely guidance role and has been trying, although in a small way, to generate its own specific theory and research. However, it has still some way to go before it can get itself less ambivalently accepted in the medical schools. In making its approach to orthodox medicine, it should continue to remember its own history and not relinquish the many skills it acquired and is still acquiring from the behavioral sciences.     

A look at cultural psychiatry in the 21st century

Cultural psychiatry, as a subspecialty of psychiatry and thus medicine, has grown steadily and extensively in the 20th century, especially during the second part of this century. In this article, we look at the origins of cultural psychiatry; at its history through the centuries; at its role in the clinical, educational, and research domains; at its significance in today's conceptualization of the fields of psychiatry and mental health; and at its future perspectives within the realms of both medicine and psychiatry.     

The emergence of child psychiatry as an academic discipline

Child psychiatry has come a long way since its tenuous beginnings fifty years ago. A few of the pioneers are still around to remind us of our short history. Its development has not by any means been linear and, from time to time over the years, it has wandered off into nonmedical fields and practices that have impeded its incorporation into the body of medicine. Within the past two decades, it has relinquished its purely guidance role and has been trying, although in a small way, to generate its own specific theory and research. However, it has still some way to go before it can get itself less ambivalently accepted in the medical schools. In making its approach to orthodox medicine, it should continue to remember its own history and not relinquish the many skills it acquired and is still acquiring from the behavioral sciences.     

Neuropathies métaboliques : actualités 2011

Metabolic diseases constitute a frequent etiologic group of axonal and small-fiber neuropathies. Recent works in this field are dominated by diabetic neuropathy (clinical presentation, pronostic factors) because of its prevalence. Vitamin B12 deficiency aroused several studies in 2011. This renewed interest for this well known entity ensues from the lack of sensibility of its biological markers underestimating its prevalence, its clinical spectrum and therefore, access to its therapy. Finally, 2011 highlighted the growing interest of the measure of the intra-epidermic nerve fibers density by skin biopsy for some metabolic disorders such as infra-clinical hypothyroïdism, chronic renal failure or Fabry disease.     

Interpersonal factors in suicide attempts: a pilot study in Christchurch.

Attempted suicide is a behavioural pattern with complex psychological and sociological determinants, many of which have been extensively studied in recent years. The basic facts of its changing incidence, its demography, and its place within a broader spectrum of self-destructive behaviour are well established but authorities are still divided on many issues related to its aetiology, its function in the individual and the kinds of services required for its clinical management. (Kessel 1965, Anderson 1974, Weissman 1974, Henderson and Williams 1974). The study reported here was designed partly to define the characteristics of a group of patients for whom clinical services were being planned and partly as a pilot study to develop a methodology for a more extensive controlled study which we hope to carry out next year. The preliminary findings are sufficiently interesting to report now.     

Separation anxiety: a new category of anxiety disorders in children?]

The separation anxiety disorder is defined as an excessive anxiety when the child is separated from significant persons. It needs however to be distinguished from normal development separation anxiety because of the later age at onset, its persistence and general impact. We shall discuss the clinical aspects of this disorders, its complications and the issues raised by its outcome. The interesting characteristics of separation anxiety disorder are its frequency and different treatments available.     

Is psychiatry approaching a steady state?

The exciting developments in clinical psychiatry and its scientific basis during the last four and one half decades, amounting to a veritable explosion of new therapeutic techniques, heuristic theories, pragmatic models, surprising facts, and controversial attitudes, should give us cause to stop and reflect, not only on the present state of our branch of medicine, but also on the ground in which its roots are planted and the prospects for further growth in its immediate and more distant future. In the following article, I intend to present and defend the thesis that psychiatry has now come close to a steady state in its development and, as a consequence, can expect few, if any, revolutionary breakthroughs in its further growth.Lest there be a semantic misunderstanding, let me clarify that I am using the term “steady state” in the sense of a mature and dynamic state that is not stagnant and has not reached its limits, but represents a developmental stage in which most of its essential, conceptual, methodological, and instrumental principles have been brought into action—in the case of psychiatry, they have been brought to bear upon its scientific and clinical activities. If we liken psychiatry to a living person, one might say that it has now grown up and reached young adulthood, knowing and using most of its potentials, though still far from having exploited them fully or having learned how to always deploy them wisely.