Risk factors for orofacial and limbtruncal tardive dyskinesia in older patients: a prospective longitudinal study

Although there is a consensus that orofacial and limbtruncal subtypes of tardive dyskinesia (TD) exist and may represent distinct pathophysiologic entities, few studies have examined the incidence of and risk factors associated with the development of these TD subtypes. Two hundred and sixty-six middle-aged and elderly outpatients with a median duration of 21 days of total lifetime neuroleptic exposure at study entry were evaluated at 1- to 3-month intervals. Using mild dyskinesia in any part of the body for diagnosis of TD, the cumulative incidence of orofacial TD was 38.5 and 65.7% after 1 and 2 years, respectively, whereas that of limbtruncal TD was 18.6 and 32.6% after 1 and 2 years. Preclinical dyskinesia was predictive of both orofacial and limbtruncal TD. History of alcohol abuse or dependence was a significant predictor of orofacial TD only whereas tremor was a significant predictor of limbtruncal TD only. Findings support suggestions that orofacial and limbtruncal TD may represent specific subsyndromes with different risk factors.     

Prevalence survey of movement disorders, epilepsy, hypertension and smoking habit in Vejer de la Frontera, Southern Spain-I. Methodology

A prevalence survey of movement disorders, epilepsy, hypertension and smoking was undertaken in Vejer de la Frontera, Southern Spain in 1988. A validated screening instrument designed for door-to-door tracing of specific disorders was used. Neurological diagnoses were based on: (1) direct anamnesis and examination by a senior neurologist; (2) perusal of existing medical records; and (3) in a proportion of cases, a hospital-based complementary study. This experience suggests that, while door-to-door surveys of neurological disorders have focused on multiple major outcomes: (1) scientific and logistic reasons can exist for screening for specific neurological disorders, and (2) scientific and public health-related interventional objectives can be combined advantageously when such costly investigations are conducted.     

Reduced platelet MAO activity in healthy male students with blood group O

The association between the two genetic markers of affective disorders, ABO blood group system and platelet MAO (monoamine oxidase) activity was studied in 70 healthy young males. The platelet MAO activity of subjects with blood type O was significantly lower than that of subjects with blood type A and with blood types A + B AB + B together. This finding could constitute a "bridge" between the two genetic approaches to affective disorders.     

A psychophysiological evaluation of female urethral syndrome: Evidence for a muscular abnormality

This is a preliminary investigation into a recently defined urological disorder occurring in a subgroup of women with urethral syndrome suggestive of pelvic floor muscular (PFM) dysfunction. Symptoms include straining to void, urgency, frequency, hesitation, incontinence and/or retention, and subpubic pain. Finding neither bladder nor urological abnormalities, urologists may consider these women emotionally unstable without organic cause for their symptoms. However, their distress may be a consequence rather than a cause of their voiding problems. Sixteen female urological patients were matched with 16 asymptomatic controls to investigate PFM functioning, psychological status, and symptomatology. Results showed heterogeneity of symptomatology and little elevation of depression or anxiety when comparing patients with controls. Hypotheses of muscular abnormality were confirmed. Patients evidenced poor control over tensing and relaxing PFM, elevations of PFM activity under various conditions, and chronic pain as a prominent symptom. Treatment approaches specifically designed to address PFM dysfunction are discussed.     

Cognitive impairments of aphasics in picture sorting and matching tasks

On the basis of earlier experiments showing a differential deficit of aphasics in picture sorting and matching tasks, two experiments were conducted to test the conjecture of a specific deficit of aphasics in the analytical appraisal of individual features. Broca's and Wernicke's aphasics-according to clinical diagnoses and the Aachener Aphasie Test-were compared with patients having right-hemisphere lesions or left-hemisphere lesions without aphasia. Both groups of aphasics differed from the control groups in the sorting task, irrespective of the sorting criterion, but the differences were small. The picture matching task did not discriminate between groups. Obviously, the basic assumption has to be modified with respect to specific conditions of task requirements. The experimental literature is reviewed.This research was supported by a Research Grant from the Deutsche Forschungsgemeinschaft.The research was conducted at the following clinics and rehabilitation centers. We are grateful for their support: Abteilung Neurologie der Med. Fak., RWTH, Aachen. Poliklinik für Stimm-und Sprachkranke, Universitätsklinikum Steglitz, Freie Universität Berlin. Neurologisches Rehabilitationszentrum Godeshöhe e. V., Bonn. Rheinische Landesklinik für Sprachgestörte, Bonn. Neurologische Klinik der Universität Ulm, Dietenbronn. Kliniken Schmieder, Gailingen und Allensbach. Max-Planck-Institut für Psychiatrie, München. Neurologiches Krankenhaus, München. Neurologisches und Hirneverletzten-Versorgungskrankenhaus, Tübingen.We are also most grateful for the kind help of K. Willmes, Aachen, in carrying out the discriminant analyses to classify the aphasics on the basis of the Aachener Aphasie Test.     

Eight month follow-up of delinquent adolescents: predictors of short-term outcome

Clinicians working with young delinquents are concerned with finding methods to predict recidivism in these subjects. It has not been investigated yet to what extent psychiatric assessment can be of any help in this field. In this study, we investigated whether psychiatric assessment can help to predict recidivism in already delinquent adolescents. By means of semi-structured psychiatric assessment (Child Assessment Schedule), developmental interview of the parents and self-report instruments, we assessed the psychiatric status of 72 delinquent adolescents, adjudicated before the Juvenile Court of Antwerp (Belgium). A follow-up of criminal status after eight months was conducted. Self-report questionnaires by the subjects did not differentiate recidivists from non-recidivists, while parent questionnaires did. Through a semi-structured interview, we found that a diagnosis of conduct disorder significantly predicts recidivism, while subjects with ADHD and substance abuse show a tendency towards more recidivism. We were unable, however, due to the small number of subjects showing a psychiatric disorder (e. g. ADHA and PTSD) unrelated to conduct disorder, to assess the relative contribution of these disorders to the recidivism rate. This study found that psychiatric assessment of delinquent adolescents could be of help in predicting recidivism. The necessity of gathering information from parents and teachers is demonstrated. Future research should include a more extensive group of a delinquent adolescent and should focus on the effect of therapeutic interventions. Received: 29 June 1999 / Accepted: 1 February 2000     

Abnormalities of cAMP signaling in affective disorders: implication for pathophysiology and treatment

Objective: During the last decade, much attention has been given to the role of signal transduction pathways in affective disorders. This review describes the possible role of the cAMP signaling in such disorders.

Methods: Among the components of cAMP signaling, this review focuses on the cAMP-dependent phosphorylation system. We analyzed the basic components of the cAMP-dependent phosphorylation system and the preclinical evidence supporting their involvement in the biochemical action of antidepressants and mood stabilizers. The clinical data available until now, concerning the possible link between the cAMP-dependent phosphorylation system and the pathophysiology of affective disorders, are also reviewed.

Results: The studies herein presented demonstrated that the levels and the activity of cAMP-dependent protein kinase are altered by antidepressants and mood stabilizers. Furthermore, these medications are able to modify the phosphorylation state, as well as the levels of some of the cAMP-dependent protein kinase substrates. More recently, clinical studies have reported abnormalities in the cAMP-dependent phosphorylation system in both peripheral cells and the postmortem brain of patients with affective disorders.

Conclusions: Overall, these studies support an involvement of cAMP signaling in affective disorders. The precise knowledge of the findings has the potential to improve the understanding of pharmacotherapy and to provide directions for the development of novel biochemical and genetic research strategies on the pathogenesis of affective disorders.     

药品行政保护品种介绍:神经和精神系统药物(一)(待续)

文拉法辛缓释胶囊　通用名 :文拉法辛 (venla faxine)缓释胶囊。商品名 :怡诺思 (Efexor)缓释胶囊。化学名 :(R/S) 1 [2 (二甲胺 ) 1 (4 甲氧苯基 )乙基 ]环己醇盐酸盐。结构式见图 1。图 1　文拉法辛结构式　　　Fig 1　Structureofvenlafaxine　　申请日 :1999年 4月 16日。申请人 :荷兰AHP制药有限公司。申请号 :A NL 990 4 16 10。授权号 :B NL 9912 2 32 1。授权日 :1999年 12月 2 3日。法定行政保护期 :从授权之日起 7.5a ,到 2 0 0 7年 6月2 3日止。专利介绍 :欧洲专利第 0 12 2 6 6 9号。商标注册 :在我国注册的商标为怡诺…