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.     

Types of authority and two problems of psychiatric wards

This paper concerns the relationship between authority structures and two problems reported in the literature as common to milieu or therapeutic community wards. Psychiatric wards with rational-legal and charismatic authority structures are found more likely to experience mood and morale swings on the part of patients and staff and to spend excessive time and energy changing ward rules.     

“On-off” phenomenon in Parkinson's disease: Correlation to the concentration of dopa in plasma

Summary To investigate the relation between on-off fluctuations in symptomatology and bioavailability of dopa in patients with Parkinson's disease, five Parkinsonian patients with pronounced on-off symptoms were studied. Continuously during the study the degree of disability in the patients was registered. Every one hour, and in addition, whenever there was a change from on to off or vice versa, a blood sample was collected for dopa determination. Since dopa is transported from plasma into the brain by a saturable carrier for which it has to compete with endogenous large neutral amino acids (LNAA), the concentrations of these competitors were measured too.In four of the patients there were considerable oscillations in the plasma dopa concentration during the day; in one of these patients the highest value was as much as 12 times higher than the lowest value. These dramatic fluctuations in the absolute concentration of dopa in plasma had a major influence on the relative dopa concentrations (calculated as the ratio dopa/sum of LNAA) as the fluctuations in the concentrations of LNAA in plasma were much less pronounced. Consequently, the absolute and the relative concentrations of dopa in plasma were highly parallelled.In four of the five patients on-periods began within one hour after a peak in the concentration of dopa in plasma and in the fifth patient five out of seven on-periods were preceded by a rise in plasma dopa concentration within the same time interval.From the present data it could be concluded that the on-off phenomenon in Parkinson's disease, at least partly, is due to oscillations in the concentration of dopa in plasma. A reduction in the variations of the concentration of dopa in plasma seems to be necessary to overcome the on-off problem. The introduction of a slow release preparation of dopa is therefore urgently warranted. The concentration of LNAA in plasma must, however, also be considered in this context.     

Obsessive-Compulsive Disorder in Popular Magazines

To examine what the general public is learning about Obsessive-Compulsive Disorder (OCD) through popular magazines, all articles listed in the Reader's Guide to Periodical Literature under the topic headings of obsessive-compulsive behavior or obsessive-compulsive disorder between 1983 and 1997 were read and rated. Only 31 of the 107 articles under these headings dealt explicitly with OCD, and these were found to be reasonably accurate in their presentations of symptoms, causes, and treatments. Many of the other articles under the target headings, however, focused on incidents of stalking of famous people by obsessed fans. The implications of the content patterns of these articles for understanding and misunderstanding of OCD are discussed.     

The Diverse Roles of Anticonvulsants in Bipolar Disorders

Anticonvulsant drugs (ACs) have diverse antiseizure, psychotropic, and biochemical effects. Carbamazepine and valproate have mood-stabilizing actions, benzodiazepines and gabapentin have anxiolytic actions, lamotrigine is useful in rapid cycling and acute treatment and prophylaxis of bipolar depression, and topiramate and zonisamide can yield weight loss. Limited controlled data suggest the carbamazepine keto derivative oxcarbazepine has antimanic effects. A categorical approach to the diverse roles of ACs in bipolar disorders is proposed, using broad categories of ACs, on the basis of their predominant psychotropic profiles. Thus, some ACs have sedating profiles that may include sedation, cognitive difficulties, fatigue, weight gain, and possibly antimanic and/or anxiolytic effects. In contrast, some newer ACs have activating profiles that may include improved energy, weight loss, and possibly antidepressant and even anxiogenic effects. Still other newer ACs have novel mixed profiles, combining sedation and weight loss. A categorical–mechanistic extension of this approach is also presented, with hypotheses that sedating profiles might be related to prominent potentiation of gamma-aminobutyric acid (GABA) inhibitory neurotransmission, activating profiles could be related to prominent attenuation of glutamate excitatory neurotransmission, and for mixed profiles, sedation and weight loss might be related to concurrent GABAergic and antiglutamatergic actions, respectively. The categorical approach may have utility as an aid to clinicians in reinforcing the heterogeneity ACs, and recalling psychotropic profiles of individual ACs, but is limited as it fails to address the etiology of the heterogeneity of AC psychotropic effects. The categorical–mechanistic extension strives to address this issue, but requires systematic clinical investigation of more precise relationships between psychotropic profiles and discrete mechanisms of action to assess its merits.     

The relation of social class to the characteristics and treatment of parasuicide

Summary The subjects for study were all parasuicides admitted to the Regional Poisoning Treatment Centre between 1968 and 1973. The parasuicides were divided into four social class groups: Registrar General's Classes I and II; Class III; Class IV; Class V. The characteristics and disposal of parasuicides from each class were compared. A large number of items showed a significant difference across class. Lower class parasuicides were more often characterised by a variety of social problem items including overcrowding, trouble with the law, debt, unemployment and violence in interpersonal relationships. They were more often diagnosed as personality disorders whereas higher class parasuicides were more likely to be diagnosed as depressive. The latter were also more frequently referred to the R. P. T. C. by a medical agent. For higher class patients, after-care more often took the form of in- or out-patient psychiatric treatment; lower class patients were more commonly recommended for social work on discharge. The association between social class and type of after-care was maintained when the diagnostic groups were considered separately. Patients of higher social class within the categories personality disorder only, depression only, depression with personality disorder, other psychiatric illness with personality disorder were markedly more likely to receive a psychiatric referral.     

Psychomotor disturbances in psychiatric patients as a possible basis for new attempts at differential diagnosis and therapy

Summary This study investigates the existence and course of psychomotor symptoms in schizophrenic patients (n = 57, both treated and untreated with antipsychotic drugs) as compared to 25 healthy controls. Previous psychometric studies had suggested the existence of a psychotic motor syndrome (PMS) both in (untreated) schizophrenic and endogenous depressed patients, consisting of disturbances of lip and tongue movements, fine and gross movements of the dominant right hand and impaired complex motor coordination of the extremities. We confirmed the existence of the PMS in this study. There was no correlation of the PMS with the psychopathological status of the patients, or with extrapyramidal side-effects of the drugs used, perhaps indicating an independent basic syndrome (Basisstörung). Factorial analyses revealed similar structures both in schizophrenic and healthy persons; the differences in motor performance may be due to an impairment of the first factor general motor ability in schizophrenic patients. The PMS did not disappear parallel to the psychopathological improvement of the patients, nor in the symptom-free remission interval. The role of the PMS as possible independent biological marker syndrome for schizophrenia can consequently be further supported, with its implications towards the differential diagnostic and therapeutical values of this syndrome.Supported in part by the Deutsche Forschungsgemeinschaft (DFG Gu 207/2-1).     

Intrafamilial phenotype variation in Friedreich's disease: possible exceptions to diagnostic criteria

Summary Three families are described which include members with typical Friedreich's disease (FD) and others who are ataxic but do not satisfy all the diagnostic criteria for that disease. In family A two patients have an early-onset, rapidly progressive FD, while two others have a late-onset, more benign form. In families B and C one member has typical FD, and another has a similar ataxic syndrome, except for preservation of knee jerks. Laboratory evaluation is consistent with the diagnosis of FD in all cases. FD diagnosis appears justified in secondary cases with late onset or preserved tendon reflexes, provided that the index case fulfils all diagnostic criteria. Whether the diagnosis of FD is tenable in sporadic atypical cases remains to be seen. Echocardiographic and neurophysiological examination may be valuable in classifying such cases.     

Willingness of Nigerian University students to accept psychological treatment

Summary This study assesses the effects of the stated purpose of treatment on University students' willingness to be involved in treatment for emotional problems. The study involved 26 male Nigerian undergraduate students evidencing severe examination anxiety. These students were randomly assigned to one of three groups with different treatment goals (a mind change group, a behaviour change group, and a No Goal group). All subjects received the same treatment — a combination of systematic desensitization and a process of gradual habituation. Differences between the groups in willingness to participate in treatment were assessed on the basis of the actual frequency of attendance at scheduled treatment sessions by subjects in each group. The results indicated that the subjects in the behaviour change group attended significantly more treatment sessions than the subjects in the other two groups. This finding suggests the need for awareness of the possible effects of the stated or implied treatment goals on the acceptance of psychological treatment among university-level educated clients.     

Golgi-like demonstration of “dark” neurons with an argyrophil III method for experimental neuropathology

Summary A silver method is proposed for the selective, well-contrasted and reproducible demonstration of dark neurons in frozen, vibratome and paraffin sections cut at a thickness of 5 to 200 m from aldehyde-fixed brains. The Golgi-like staining of the dendrites enables asorting of dark neurons according to characteristic neuron classifications. The staining procedure includes an esterification with 1-propanol, a treatment with diluted acetic acid and development. The esterification strongly increases the argyrophilia of both dark neurons and mitochondria. Unwanted co-staining of mitochondria is suppressed by the acetic acid treatment, while a special developer is used to render the staining controllable. The applicability of the method to experimental neuropathology is demonstrated by Golgi-like staining of dark neurons in rat brains exposed, before transcardial perfusion-fixation and delayed autopsy, to various pathological conditions including ischemia, hypoglycemia, trauma, status epilepticus, deafferentation and poisoning with kainic acid, colchicine and sodium azide, respectively.     

Astrocytes in hemangioblastomas of the central nervous system and their relationship to stromal cells

Summary Thirteen cases of CNS hemangioblastoma were examined with the immunoperoxidase technique for glial fibrillary acidic protein (GEAP) to determine if there were astrocytic elements among the stromal cells of these tumors.In six cases, including two leptomeningeal hemangioblastomas, none of the stromal cells were positive on GFAP stain. Seven cases, however, showed variable presence of GFAP positive cells, including clusters of heavily lipidized cells deep within cerebellar hemangioblastomas. These GFAP positive cells were indestinguishable by other stains from interstitial or stromal cells.Thus, it appears that in at least some hemangioblastomas of the CNS parenchyma, a few or many stromal cells are lipidized astrocytes. All stromal cells, however, cannot be of astrocytic origin, as proposed by Jakobiec et al. (1976), in view of our six cases where no GFAP-positive cells were found in the tumors.It is suggested that cells identified as stromal cells of hemangioblastomas on light microscopy are a heterogeneous group of cells including astrocytic as well as other elements and that they resemble each other on ordinary stains because of the equalizing effect of cell lipidization.     

Comparing Practice Patterns of Consumer and Non-Consumer Mental Health Service Providers

The practice patterns of consumer andnon-consumer providers of assertive community treatmentare compared using both quantitative and qualitativedata collected as part of a randomized trial. Activity log data showed that there were few substantivedifferences in the pattern of either the administrativeor direct service tasks performed by the two teams. Incontrast, the qualitative data revealed that there were discernable differences in theculture of the two teams. The consumerteam culture emphasized beingthere with the client while the non-consumer teamwas more concerned with accomplishing tasks.     

Utilization of acute inpatient psychiatric services: “Heavy users” in New York State

The severely and persistently mentally ill (SPMI) population are often forced to rely on emergency/acute inpatient services. The authors analyze Medicaid expenditures and state hospital utilization data to identify and describe the characteristics of heavy users of these services. Also described is New York State's intensive case management (ICM) initiative targeted at this heavy user group. It is postulated that ICM will alter the utilization patterns of participants from over-reliance on the most costly services and more effectively and efficiently serve the SPMI population, specifically the heavy user subpopulation.     

Etic and emic criteria for non-psychotic mental disorder: a study of the CISR and care provider assessment in Harare

The paper describes the relationships between the Revised Clinical Interview Schedule (CISR) and the assessment of psychiatric status by primary care providers in Harare. Primary care clinic (PHC) and traditional medical practitioner (TMP) clinic attenders (n=302) were interviewed with the Shona Symptom Questionnaire, the CISR and the Explanatory Model Interview. The PHC nurses and TMP were interviewed to elicit diagnostic formulation using the WHO Health Staff Rating codes. Etic cases were those who scored 12 or more on the CISR and emic cases were those whom the care provider had assessed as having a mental disorder. In all, 52% of subjects were classified as etic cases and 59% as emic cases. Overall agreement between the two criteria was 55%. Three-quarters of care provider false-positives were accounted for by a failure to take into account the varying reasons for consultation, such as social or spiritual problems. Most of the false-negative groups were symptomatic subjects, though with fewer symptoms than those who were definite cases. One etic conceptphobia-was not considered as a mental disorder and appeared to lack concept validity in this setting.     

“No-therapy”: A method of helping persons with problems

Groups, settings, and activities which are not labeled therapeutic but which are devoted to helping persons with problems seem to be quite effective. Persons involved in Alcoholics Anonymous, Synanon, and other similar groups are not therapists but yet attempt to deal with problems. No-therapy is proposed as a name for the activity which goes on. The relationship between therapist and patient and between no-therapist and person with a problem are quite different. No-therapy is particularly suited to help with problems of behavior and is not suited to help with problems of thought or emotion.     

Initiation of visual-guided random saccades and remembered saccades in parkinsonian patients with severe motor-fluctuations

Summary We studied the initiation of saccades to visual-guided random time and remembered targets in a group of nine Parkinsonian patients with severe motor fluctuations and in 9 age matched control subjects. In contrast to a marked skeletomotor improvement during the on condition, saccadic latencies for both visual-guided random saccades and remembered saccades were increased in the patients during the on condition compared to the off condition. This result of dissociation between skeletomotor and oculomotor function indicates that common concepts of saccadic initiation in parkinsonian patients do not hold true in patients with severe fluctuations since dopaminergic stimulation seems to increase saccadic latencies in these patients.     

Visuoperception and visuospatial and visuorotational performance in Parkinson's disease

Summary Forty patients with Parkinson's disease were compared with 33 normal controls with respect to their performance in the Wechsler Adult Intelligence Scale subtests information, similarities, block design, and picture completion, in a test for visual neglect (Hamsher's line cancellation test) and in tests for visuospatial and visuorotational abilities (cube task from Amthauer's intelligence structure test and Rybakoff figure test, as revised by Meili). The findings show that the patients scored significantly worse than the controls (Mann-WhitneyU test,P=0.004) in the Rybakoff figure test, testing visual concept finding, imagination and visual rotation. In the other tests no significant differences were found between the patients and the controls. The deficit of the patients in the figure test of Rybakoff correlated significantly with tremor (P=0.013), akinesia (P=0.009), disability (P=0.043), and age (P=0.004, Spearman rank correlation).     

Social Patterns of Substance-Use Among People With Dual Diagnoses

An ethnography, part of the larger New Hampshire Dual Diagnosis Study, discovered in a small subsample (n = 16) that clients participated in 1 (or sometimes 2) of 4 distinct and different social patterns of substance-use. These 4 patterns, (1) the lone user, (2) the small, closed social clique, (3) the large, open user syndicate, and (4) the entrepreneurial drug provider, manifest important social functions of such substance-use. These social functions need to be taken into account as case managers attempt to persuade clients to abstain from using substances, because changing one's substance-use immediately affects one's participation in these user networks. Case managers can understand the social pressures toward certain patterns of substance-use by attending to the social patterning of that use. Many social functions provided by these social patterns must be continued by other means if clients, once persuaded to attempt abstinence, are to be effectively supported in their sobriety.     

Familial glioma: occurrence within the “familial cancer syndrome” and systemic malformations

Summary The family pedigree across eight generations is presented with an association of osteochondrodysplasia, other skeletal abnormalities, familial glial tumours in a father and his son, colonic and other adenomatous disease, and pigment changes. This family cluster of diseases is considered to be a dysontogenetic process with blastomatous features and grouped within the phakomastoses. A review of the literature indicates that some familial gliomas show additional malformations, thus resembling phakomatoses. Others are found to be members within a familial cancer syndrome. A trait of hereditary glioma apart from these syndromes is difficult to identify, especially if only sibships are considered which are likely to share common environmental factors.     

DL-lysine-H3 uptake in “light” and “dark” neurons of the inferior olivary nucleus of euthyroid and dysthyroidal rats

Summary Uptake of DL-Lysine-H³ into light and dark cells of the rat inferior olivary nucleus was studied by radioautographiy. Uptake in light cells was higher than in dark cells and appears to be possibly related to the greater frequency of relationship with glial satellites. Dysthyroidal states were also observed to increase uptake of radioactivity which was prominently observed in hypothyroid rats. Since dark cells appear to take up less lysine than normal cells and are less frequently closely associated with glial satellites it is suggested these cells may represent a less physiologically active unit than the light cells rather than being simply artifactually produced by the procedures employed.

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Zusammenfassung Die Aufnahme von DL-Lysin-H³ in hellen und dunklen Zellen im unteren Olivenkern der Ratte wurde mit Autoradiographie beobachtet. Die Aufnahme war höher in den hellen Zellen als in den dunklen, was möglicherweise mit einer größeren Häufigkeit von Glia-Satellit-Verbindungen in Zusammenhang gebracht werden könnte. Veränderungen im hormonalen Zustand der Schilddrüse konnten auch dazu beitragen, die Aufnahme von Radioaktivität zu erhöhen, was besonders bei Ratten mit niedriger Schilddrüsenaktivität hervortrat. Da dunkle Zellen offenbar weniger Lysin aufnehmen als normale Zellen, und sie seltener mit Glia-Satelliten verbunden sind, wird angenommen, daß diese Zellen möglicherweise eine weniger aktive physiologische Einheit darstellen als die hellen Zellen und daß es sich nicht einfach um ein Kunstprodukt handelt.

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This investigation was supported in part by a PHS research grant (NB-456802) from the division of Neurological Disease and Blindness and in part by Contract NONR 4018(01), (NR 101-592), between the Office of Naval Research, Department of the Navy, and the Research Foundation of the State University of New York.