Archives of General Psychiatry

Koranyi, Erwin N.

doi: 10.1001/archpsyc.1977.01770220019001pmid: 911213

Abstract • During a three-year period 28 fatalities, twice the rate in the general population, were found in a sample of 2,070 psychiatric outpatients. Death occurred in these psychiatric patients approximately 20 years earlier than is expected. All three modalities of death: accidents, suicide, and natural causes, were higher than that in the population at large. Three suicides were thought to be preventable by psychiatric approaches. The importance of the patient's initial visits was stressed. At least four, and possibly five, cases of death were avoidable by appropriate medicosurgical means. The rate of physical illnesses in all three groups was more than 80%, of which one third were inadequately diagnosed by their referring physicians. The importance of the physical evaluation of psychiatric patients was emphasized. References 1. Malzberg B: Mortality Among Patients With Mental Disease . Utica, NY, New York State Hospital Press, 1934. 2. Ødegard O: The excess mortality of the insane . Acta Psychiatr Neurol Scand 27:353-367, 1952.Crossref 3. Claghorn JL, Kinross-Wright J: Death rates in psychiatric outpatients . J Nerv Ment Dis 145:163-167, 1967.Crossref 4. Rorsman B: Suicide among Swedish psychiatric patients . Soc Psychiatry 8:140-144, 1973.Crossref 5. Babigian HM, Odoroff CH: The mortality experience of a population with psychiatric illness . Am J Psychiatry 126:470-480, 1969. 6. Kolb LC: Year Book of Psychiatry and Applied Mental Health . Chicago, Year Book Medical Publishers Inc, 1976, p 402. 7. Freedman AM, Kaplan HI, Sadock BJ: Comprehensive Textbook of Psychiatry , ed 2. Baltimore, Williams & Wilkins Co, 1975, vol 1, p 408. 8. Koranyi EK: Physical health and illness in a psychiatric outpatient department population . Can Psychiatr Assoc J 17:109-115, 1972. 9. Kraft DP, Babigian HM: Suicide by persons with and without psychiatric contacts . Arch Gen Psychiatry 33:209-215, 1976.Crossref 10. Schmidt W, de Lint J: Mortality experiences of male and female alcoholic patients . Q J Stud Alcohol 30:112-118, 1969. 11. Rorsman B: Mortality among psychiatric patients . Acta Psychiatr Scand 50:354-375, 1974.Crossref 12. Flood RA & Seager CP: A retrospective examination of psychiatric case records of patients who subsequently committed suicide . Br J Psychiatry 114:443-450, 1968.Crossref 13. Plachta A: Asphyxia relatively inherent to tranquilizer therapy . Am J Psychiatry 12:152-158, 1965. 14. Hollister LE, Kosek JC: Sudden death during treatment with phenothiazine derivates . JAMA 192:1035-1038, 1965.Crossref 15. Bort RF: Catatonia, gastric hyperacidity and fatal aspiration: A preventable syndrome . Am J Psychiatry 133:446-447, 1976. 16. Leeman CP: Diagnostic errors in emergency room medicine: Physical illnesses in patients labeled "psychiatric" and vice versa . Int J Psychiatry Med 6:533-540, 1975.Crossref 17. Larsson T, Sjögren T: A methodological, psychiatric and statistical study of a large Swedish rural population . Acta Psychiatr Neurol Scand 89( (suppl) ):1-250, 1954. 18. Robin A: Rationing out-patients: A defence of the waiting list . Br J Psychiatry 128:138-141, 1976.Crossref 19. Garfield RS, Collen MF, Feldman R, et al: Evaluation of an ambulatory medical-care delivery system . N Engl J Med 294:426-431, 1976.Crossref 20. Pokorny AD, Kaplan HB: Suicide following psychiatric hospitalization . J Nerv Ment Dis 162:119-125, 1976.Crossref 21. Johnson DAW: A further study of psychiatric out-patient services in Manchester . Br J Psychiatry 123:185-191, 1973.Crossref 22. Hoenig J, Hamilton MW: Mortality of psychiatric patients . Acta Psychiatr Scand 42:349-361, 1966.Crossref

McIntyre, John S.;Romano, John

doi: 10.1001/archpsyc.1977.01770220029002pmid: 911214

Abstract • A survey was conducted in Rochester, NY, of the attitudes and practices of psychiatrists (both in private practice and fulltime academic settings), psychiatric residents, internists, and fourth-year medical students concerning physical examinations of psychiatric patients. Thirteen percent of the psychiatrists frequently perform an initial physical examination on their inpatients and 8% frequently do an initial physical examination on their outpatients. These percentages are much larger for the resident groups. A very high percentage of all respondents report that they feel a physical examination of psychiatric patients is important especially when the patient is receiving medication. The largest number of psychiatrists report that they omit the physical examination because the patient has been referred to them after a physical examination by another physician or they refer the patient for such an examination. A notable percentage of psychiatrists in this sample report that they do not feel competent performing a physical examination. References 1. Grinker RR: The sciences of psychiatry. Fields, Fences and Riders . Am J Psychiatry 122:367-376, 1965. 2. Torrey EF: The death of psychiatry . Radnor, Pa, Chilton Book Co, 1974. 3. Siegler M, Osmond H: Models of madness, models of medicine . New York, Macmillan Co, 1974. 4. Shagass C: The medical model in psychiatry . Compr Psychiatry 16:405-413, 1975.Crossref 5. Romano J: The elimination of the internship: An act of regression . A M J Psychiatry 126:1565-1576, 1970. 6. Romano J: Psychiatry and medicine . Ann Intern Med 79:582-588, 1973.Crossref 7. Engel GL: Is psychiatry failing in its responsibilities to medicine?, editorial . Am J Psychiatry 128:1561-1564, 1972. 8. Ludwig AM: The psychiatrist as physician, commentary . JAMA 234:603-604, 1975.Crossref 9. Sandifer MG: The education of the psychiatrist as a physician . Am J Psychiatry 134:50-53, 1977. 10. Maguire GP, Granville-Grossman KL: Physical illness in psychiatric patients . Br J Psychiatry 114:1365-1369, 1968.Crossref 11. Davies DW: Physical illness in psychiatric outpatients . Br J Psychiatry 111:27-33, 1965.Crossref 12. Johnson DA: Evaluation of routine physical examination in psychiatric cases . Practitioner 200:686-691, 1968. 13. Herridge C: Physical disorders in psychiatric illness . Lancet 2:949-951, 1960.Crossref 14. Marshal H: Incidence of physical disorders among psychiatric inpatients . Br Med J 2:468-470, 1949.Crossref 15. Roessler R, Greenfield NS: Incidence of somatic disease in psychiatric patients . Psychosom Med 23:413-419, 1961.Crossref 16. Mannino F, Wylie H: Evaluation of the physical examination as part of psychiatric clinic intake practice . Am J Psychiatry 122:175-179, 1965. 17. Mitchell Weir S: Address before the 50th annual meeting of the American Medico-Psychological Association . J Nerv Ment Dis 21:413-437, 1894.Crossref 18. Liberman R: Letter to the editor . Am J Psychiatry 124:1467, 1968. 19. Menninger K: A Manual for Psychiatric Case Study . New York, Grune & Stratton Inc, 1952. 20. Felix RH: Presidential address. Psychiatrist, medicinae doctor . Am J Psychiatry 118:1-8, 1961. 21. Wiener S, Nathanson M: Physical examination frequently observed errors . JAMA 236:852-855, 1976.Crossref 22. Engel G: Are medical schools neglecting clinical skills, editorial . JAMA 236:861-863, 1976.Crossref 23. Freedman AM, Kaplan HI: Comprehensive Textbook of Psychiatry . Baltimore, Williams & Wilkins Co, 1967. 24. Kolb LC: Modern Clinical Psychiatry . Philadelphia, WB Saunders Co, 1973. 25. Redlick FC, Freedman DX: The Theory and Practice of Psychiatry . New York, Basic Books Inc, 1966. 26. Cameron N: Personality Development and Psychopathology . Boston, Houghton Mifflin Co, 1963. 27. Slater E, Roth M: Mayer-Gross Clinical Psychiatry , ed 3. Baltimore, Williams & Wilkins Co, 1969. 28. Ewalt J, Strecker E, Ebaugh F: Practical Clinical Psychiatry . New York, McGraw-Hill Book Co Inc, 1957. 29. English OS, Finch SM: Introduction to Psychiatry . New York, WW Norton & Co, 1954. 30. MacKinnon RA, Michels R: The Psychiatric Interview in Clinical Practice . Philadelphia, WB Saunders Co, 1971. 31. Ewalt J, Farnsworth D: Textbook of Psychiatry . New York, McGraw-Hill Book Co Inc, 1963. 32. Roeske N: Examination of the Personality . Philadelphia, Lea & Febiger, 1972. 33. Meares A: The Medical Interview: A Study of Clinically Significant Interpersonal Reactions . Springfield, Ill, Charles C Thomas Publisher, 1957. 34. Stevenson I: The Diagnostic Interview , ed 2. New York, Harper & Row Publishers Inc, 1971. 35. Stevenson I: The Psychiatric Examination . Boston, Little Brown & Co, 1969. 36. White WA: Outlines of Psychiatry . Washington, DC, Nervous & Mental Disease Publishers, 1929. 37. Schuster DB, Freeman EN: Supervision of the resident's initial interview . Arch Gen Psychiatry 23:516-523, 1970.Crossref 38. Satloff A, Worby C: The psychiatric emergency service mirror of change . Am J Psychiatry 126:1628-1632, 1970. 39. Atkins R: Psychiatric emergency service . Arch Gen Psychiatry 17:176-182, 1967.Crossref 40. Babigian H, Gardner E, Miles H, et al: Diagnostic consistency and change in a follow-up study of 1,215 patients . Am J Psychiatry 121:895-901, 1965. 41. Sandt JJ, Schuster DB, Thaler OF: Clinical Supervision of the Psychiatric Resident . New York, Brunner/Mazel, 1972. 42. Mosher C: Wing R insures integrated care . Hospital 29:74-78, 1955. 43. Hampton JR, Harrison MJG, Mitchell JRA, et al: Relative contributions of history-taking, physical examination, and laboratory investigation to diagnosis and management of medical outpatients . Br Med J 2:486-489, 1975.Crossref

Tefft, Bruce M.;Pederson, Andreas M.;Babigian, Haroutun M.

doi: 10.1001/archpsyc.1977.01770220037003pmid: 911215

Abstract • This epidemeological study examines patterns of mortality for a population of suicide attempters, a psychiatric population without suicide attempts, and a general population without psychiatric histories in order to clarify earlier reports of differential risks of death associated with these groups. Mortality patterns were investigated over an 11-year period in terms of demographic characteristics and rates of death by various causes. Suicidal deaths were given special attention to identify variables that may have predictive validity for suicide. The results indicate that the suicide attempter group represents a distinctive demographic and mortality entity from either the psychiatric or general populations, and accounts for much of the increased risk of death previously attributed to the psychiatric population. Further, premature deaths due to suicide are strongly associated with the suicide attempter group. The psychiatric and general populations differ in relatively insignificant ways. These results suggest that a profitable approach to the prevention of suicide would be to focus on individuals who were at high risk within the suicide attempter population. Longerterm follow-up of these individuals is necessary if deaths due to suicide are to be prevented. Difficulties associated with implementation of preventive follow-up programs are also discussed. References 1. Babigian H, Odoroff C: The mortality experience of a population with psychiatric illness . Am J Psychiatry 126:470-480, 1969. 2. Malzberg B: Further studies of mortality among patients with mental disease . Acta Med Scand 145( (suppl 277) ):215-230, 1953.Crossref 3. Sims A: Mortality in neurosis . Lancet 2:1072-1076, 1973.Crossref 4. Tuckman J, Youngman W, Kreizman G: Multiple suicide attempts . Comm Ment Health J 4:164-170, 1968.Crossref 5. Pederson A, Awad G, Kindler A: Epidemeological differences between white and nonwhite suicide attempters . Am J Psychiatry 130:1071-1076, 1973. 6. Weisman A, Worden J: Risk-rescue in suicide assessment . Arch Gen Psychiatry 26:553-560, 1972.Crossref 7. Pederson A, Tefft B, Babigian H: Risks of mortality of suicide attempters compared with psychiatric and general populations . Suicide 5:145-157, 1975. 8. Miles H, Gardner E, Bodian C, et al: A cumulative survey of all psychiatric experience in Monroe County, N.Y. Psychiatr Q 38:458-487, 1964.Crossref 9. Gardner E, Miles H, Iker H, et al: A cumulative register of psychiatric services in a community . Am J Public Health 53:1269-1277, 1963.Crossref 10. Diggory J: Calculation of some costs of suicide prevention using certain predictors of suicidal behavior . Psychol Bull 71:373-396, 1969.Crossref 11. Litman R: Experiences in a suicide prevention center , in Waldenstrom J, Larsson T, Ljungstedt N (eds): Suicide and Attempted Suicide . Stockholm, Nordiska Bokhandelus Forlag, 1972.

O'Brien, J. Patrick

doi: 10.1001/archpsyc.1977.01770220047004pmid: 911216

Abstract • At the Massachusetts General Hospital between 1964 and 1972, there was an estimated 118% increase in emergency ward admissions for drug overdose suicide attempts and an estimated 257% increase in such attempts by individuals in the 20- to 29-year age range. Approximately 67% of overdoses seen in 1972 and 1974 occurred in individuals under age 30. An increase in drug overdose suicide attempts by males was noted. By 1972, males were making approximately as many attempts as females. Based on extrapolations from the Massachusetts General Hospital drug overdose data, and not including an estimate of non-hospital-treated suicide attempts, an estimated annual (1972) suicide attempt rate of 337/100,000 (0.38%) was obtained for Boston. The estimated suicide attempt-completed suicide ratio for the Boston area was 39:1. These estimates should be interpreted as giving an approximate order of magnitude and not as specifying precise rates. References 1. Weissman MM: The epidemiology of suicide attempts, 1960 to 1971 . Arch Gen Psychiatry 30:737-746, 1974.Crossref 2. Smith JS, Davison K: Changes in the pattern of admissions for attempted suicide in Newcastle upon Tyne during the 1960s . Br Med J 4:412-415, 1971.Crossref 3. Stanley EJ: Attempted suicide and suicidal gestures . Br J Prev Soc Med 23:190-195, 1969. 4. Weissman MM, Paykel ES, French N, et al: Suicide attempts in an urban community, 1955 and 1970 . Soc Psychiatry 8:82-91, 1973. 5. Stewart RB, Forgnone M, May FE, et al: Epidemiology of acute drug intoxications: Patient characteristics, drugs and medical complications . Clin Toxicol 7:513-530, 1974.Crossref 6. Lyons HA, Sharma SK: Attempted suicide by self-poisoning . J Ir Med Assoc 65:435-438, 1972. 7. Worden JW, Sterling-Smith RS: Lethality patterns in multiple suicide attempts . Life Threatening Behav 3:95-104, 1973. 8. Annual Report of Vital Statistics of the Commonwealth of Massachusetts. Department of Public Health, 1964-1974. 9. Annual Report of the Massachusetts General Hospital. Boston, Massachusetts General Hospital, 1964-1974. 10. Drug overdose, MEDICAL GRAND ROUNDS . South Med J 65:859-867, 1972.Crossref 11. Whitehead PC, Johnson FG, Ferrence R: Measuring the incidence of self-injury: Some methodological and design considerations . Am J Orthopsychiatry 43:142-148, 1973.Crossref 12. Patel AR, Roy M, Wilson GM: Self-poisoning and alcohol . Lancet 2:1099-1102, 1972.Crossref 13. Monk M, Warshauer ME: Completed and attempted suicide in three ethnic groups . Am J Epidemiol 100:333-345, 1974. 14. Linne I: Attempted drug suicide in a Swedish city . Acta Med Scand 195:521-525, 1974.Crossref 15. Paykel ES, Myers JK, Lindenthal JJ, et al: Suicidal feelings in the general population: A prevalence study . Br J Psychiatry 124:460-469, 1974.Crossref 16. Oliver RG, Kaminski Z, Tudor K, et al: The epidemiology of attempted suicide as seen in the casualty department, Alfred Hospital, Melbourne . Med J Aust 1:833-839, 1971. 17. Smith AJ: Self-poisoning with drugs: A worsening situation . Br Med J 4:157-159, 1972.Crossref 18. Akers RL: On the prevalence of persons who have attempted suicide in Los Angeles . Bull Suicidol 8:7-8, 1971. 19. Pederson AM, Awad GA, Kindler AR, et al: Epidemiological differences between white and non-white suicide attempters . Am J Psychiatry 130:1071-1076, 1973. 20. Clendenin WW, Murphy GE: Wrist cutting: New epidemiological findings . Arch Gen Psychiatry 25:465-469, 1971.Crossref 21. Petersen H, Brosstad F: Tendenser i forgiftningsmonstret . Tidsskr Nor Laegeforen 94:1543, 1974. 22. Tullock JA: Self-poisoning . Scott Med J 17:278-281, 1972. 23. Wexler L, Weissman MM, Kasl SV: Suicide attempts 1970-1975: Updating a United States study and comparisons with international trends . Br J Psychiatry , to be published.

Frost, Nicholas R.;Clayton, Paula J.

doi: 10.1001/archpsyc.1977.01770220054005pmid: 911217

Abstract • Two hundred forty-nine psychiatric inpatients were compared with 249 matched controls and with a psychiatric hospital survey group of 95 patients for incidence of recent bereavement. There were no significant differences between the groups for loss of a first-degree relative in six months and one year prior to admission. There was a preponderance of affective disorder among the psychiatric patients with recent loss. Severe subjective grief reactions were found in the four patients who had lost a spouse or a child and in some patients who had lost a parent, while loss of a sibling usually evoked a mild reaction. Patients with alcoholism tended to increase their drinking during the bereavement period, resulting in incapacitation and hospitalization or, in the case of a control patient, in severe trauma. References 1. Wershow HJ, Reinhart G: Life change and hospitalization-a heretical view . J Psychosom Res 18:393-401, 1974.Crossref 2. Holmes TH, Rahe RH: The social readjustment rating scale . J Psychosom Res 11:213, 1967.Crossref 3. Rahe RH, Arthur RJ: Life change patterns surrounding illness experience . J Psychosom Res 11:341, 1968.Crossref 4. Clayton PJ: Mortality and morbidity in the first year of widowhood . Arch Gen Psychiatry 30:747-750, 1974.Crossref 5. Clayton PJ, Halikas JA, Desmaris G: A study of normal bereavement . Am J Psychiatry 125:168-178, 1968. 6. Hudgens RW, Morrison JR, Barcha RG: Life events and onset of primary affective disorders . Arch Gen Psychiatry 16:134-145, 1967.Crossref 7. Morrison JR, Hudgens RW, Barcha RG: Life events and psychiatric illness . Br J Psychiatry 114:423-432, 1968.Crossref 8. Paykel ES, Myers JK, Dinelt MN, et al: Life events and depression . Arch Gen Psychiatry 21:753-760, 1969.Crossref 9. Parkes CN: Recent bereavement as a cause of mental illness . Br J Psychiatry 110:198-204, 1964.Crossref 10. Imboden JB, Canter A, Cluff L: Separation Experiences and Health Records in a group of normal adults . Psychosom Med 25:433-439, 1963.Crossref 11. Murphy GE, Robins E: Social factors in suicide . JAMA 199:81-86, 1967.Crossref 12. Hudgens RW, Robins E, Delong WB: The reporting of recent stress in the lives of psychiatric patients . Br J Psychiatry 117:635-643, 1970.Crossref

Goldstein, Avram;Hansteen, Ralph W.

doi: 10.1001/archpsyc.1977.01770220061006pmid: 199128

Abstract • In a double-blind study, intravenous injection of naloxone, at a dose sufficient to saturate the opiate (endorphin) receptors, had no effect on sexual arousal, penile erection, ejaculation, or orgasm in a human subject. Apparently, endorphins are not involved in these phenomena. References 1. Hughes J, Smith TW, Kosterlitz HW, et al: Identification of two related pentapeptides from the brain with potent opiate agonist activity . Nature 258:577-579, 1975.Crossref 2. Teschemacher H, Opheim KE, Cox BM, et al: A peptide-like substance from pituitary that acts like morphine. I. Isolation . Life Sci 16:1771-1776, 1975.Crossref 3. Cox BM, Opheim KE, Teschemacher H, et al: A peptide-like substance from pituitary that acts like morphine: II. Purification and properties . Life Sci 16:1777-1782, 1975.Crossref 4. Goldstein A: Opioid peptides (endorphins) in pituitary and brain . Science 193:1081-1086, 1976.Crossref 5. Holtzman SG: Behavioral effects of separate and combined administration of naloxone and d-amphetamine . J Pharmacol Exp Ther 189:51-60, 1974. 6. Belluzzi JD, Stein L: Enkephalin may mediate euphoria and drivereduction reward . Nature 266:556-558, 1977.Crossref 7. Jaffe JH: Drug addiction and drug abuse , in Goodman LS, Gilman A (eds): The Pharmacological Basis of Therapeutics , ed 5. New York, Macmillan Co, 1975, pp 284-324. 8. Grevert P, Goldstein A: Effects of naloxone on experimentally induced ischemic pain and on mood in human subjects . Proc Natl Acad Sci USA 74:1291-1294, 1977.Crossref

Brahen, Leonard S.;Capone, Thomas;Wiechert, Victoria;Desiderio, Dawn

doi: 10.1001/archpsyc.1977.01770220063007pmid: 911218

Abstract • The induction side effects of cyclazocine and naltrexone were compared in double-blind placebo-controlled studies involving 40 patients (20 for each drug). These studies were carried out with a twice-a-day dosage regimen. Naltrexone produced fewer side effects than cyclazocine. Naltrexone side effects fell to levels indistinguishable from those of placebo in the "induction after placebo" phase. In contrast, cyclazocine "induction after placebo" produced an even higher level of side effects than found in its induction. In no case was naltrexone discontinued because of side effects. On the other hand, three of 20 cyclazocine-treated patients discontinued the drug because of distressing side effects. No toxicity was noted with either agent. The controlled data reported supports the clinical impression that naltrexone produces fewer induction side effects than cyclazocine. References 1. Martin WR: The bases and possible utility of the use of opiod antagonists in ambulatory treatment of the addict , in The Addictive States . Baltimore, Williams & Williams Co, 1968. 2. Martin WR, Gorodetsky GW, McClane TK: An experimental study in the treatment of narcotic addicts with cyclazocine . Clin Pharmacol Ther 7:455-465, 1966. 3. Jaffe JH: Cyclazocine in the treatment of narcotic addiction . Curr Psychiatr Ther 7:147-156, 1967. 4. Freedman AM, Fink M, Sharoff R, et al: Cyclazocine and methadone in narcotic addiction . JAMA 202:191-194, 1967.Crossref 5. Laskowitz D, Brill L, Jaffe JH: Cyclazocine intervention in the treatment of narcotic addiction: Another look , in Brill L, Lieberman L (eds): Major Modalities in the Treatment of Drug Abuse . New York, Behavioral Publications, 1972, pp 85-106. 6. Martin WR, Jasinski DR, Mansky PA: Naltrexone: An antagonist for the treatment of heroin dependence . Arch Gen Psychiatry 28:784-791, 1973.Crossref 7. Schechter AJ, Grossman D: Experiences with naltrexone: A suggested role in drug abuse treatment programs. Read before the National Drug Abuse Conference, Chicago, March 30, 1974. 8. Resnick RB, Volavka J, Freedman AM, et al: Studies of EN-1639A (naltrexone): A new narcotic antagonist . Am J Psychiatry 131:646-650, 1974. 9. Brahen LS, Capone T, Wiechert V: Controlled studies of the narcotic antagonist cyclazocine and naltrexone in a narcotic dependence treatment program . Am J Drug Alcohol Abuse , to be published. 10. Kleber H, Kinsella KJ, Riordan C, et al: The use of cyclazocine in treating narcotic addicts in a low-intervention setting . Arch Gen Psychiatry 30:37-42, 1974.Crossref 11. Resnick R, Fink M, Freedman AA: Cyclazocine trypology in opiate dependence . Am J Psychiatry 126:1256-1260, 1970. 12. Freedman AM, Fink M, Sharoff R, et al: Clinical studies of cyclazocine in the treatment of narcotic addiction . Am J Psychiatry 124:1499-1504, 1968. 13. Brahen LS, Capone T, Wiechert V, et al: Nassau County pioneers work-release program for addicted inmates . Am J Corrections . (May-June) 1974, pp 16-18. 14. Brahen LS: A new treatment program for narcotic addicts . J Drug Educ 3:317-321, 1973.Crossref 15. Capone T: Antagonist inmate work-release program behavioral research design . J Drug Educ 3:331-338, 1973.Crossref 16. Wiechert V: Development of a nursing regime for an antagonist inmate work-release program . J Drug Educ 3:323-330, 1973.Crossref 17. Capone T, Brahen LS, Wiechert V: Personality factors and drug effects in a controlled study of cyclazocine . J Clin Psychol 32:489-495, 1976.Crossref

Gross, Howard A.;Dunner, David L.;Lafleur, Dianne;Meltzer, Herbert L.;Muhlbauer, Helen L.;Fieve, Ronald R.

doi: 10.1001/archpsyc.1977.01770220071008pmid: 20867

Abstract • This article reviews the function of prostaglandins (PGs) in the nervous system and discusses the possible alterations in PG metabolism as relating to mental illness. The PGs are a unique group of cyclic fatty acids whose immediate precursors are thought to function postsynaptically by inhibition or facilitation of neurotransmission through cyclase inhibition or activation, and by means of a negative feedback loop to inhibit further release of neurotransmitter from the presynaptic nerve. A review of PGs in psychiatric conditions is presented as well as a discussion of the interaction of psychoactive drugs with the PGs. The concluding section of this review discusses possible future strategies to provide insight into PG physiology as it relates to synaptic transmission in normal and pathological conditions in man. References 1. Coceani F: Prostaglandins and the central nervous system . Arch Intern Med 133:119-129, 1974.Crossref 2. Wolfe LS: Possible roles of prostaglandins in the nervous system , in Agarnoff BW (ed): Advances in Neurochemistry . New York, Plenum Press Inc, 1975, pp 1-49. 3. Japelli G, Scafa GM: Sur les effets des injections intra-veineuses d'estrait prostatique de chien . Arch Ital Biol 45:165-172, 1906. 4. Kurzrok R, Lieb CC: Biochemical studies of human semen: II. The action of semen on the human uterus . Proc Soc Exp Biol Med 28:268-272, 1930.Crossref 5. Goldblatt MW: Properties of human seminal plasma . J Physiol 34:208-218, 1935. 6. Von Euler US: A depressor substance in the vesicular gland . J Physiol 84:21P-22P, 1935. 7. Bergström S, Sjovall J: The isolation of prostaglandin E from sheep prostate gland . Acta Chem Scand 14:1701-1705, 1960.Crossref 8. Bergström S, Ryhage R, Samuelsson B, et al: Prostaglandins and related factors: 15. The structure of prostaglandin E, F1α and F1β . J Biol Chem 238:3555-3564, 1963. 9. Lee JB, Crowshaw K, Takman BH, et al: The identification of prostaglandins E2, F2α and A2 from rabbit kidney medulla . Biochem J 105:1251-1257, 1967. 10. Corey EJ, Vlattas I, Andersen NH, et al: A new total synthesis of prostaglandins of the E, and F, series including 11-epiprostaglandins . J Am Chem Soc 90:3247-3248, 1968Crossref 11. erratum, 90:5947, 1968. 12. Schneider WP, Axe U, Lincoln FH, et al: The total synthesis of prostaglandins . J Am Chem Soc 90:5895-5896, 1968.Crossref 13. Samuelsson B: Quantitative aspects of prostaglandin biosynthesis in man , in Bergström S (ed): Advances in the Biosciences . New York, Pergamon Press Inc, 1973, pp 7-14. 14. Samuelsson B: Biosynthesis and metabolism of prostaglandins , in Prostaglandines: Seminaire: Institut nationale de la sante et de la recherche medicale . Paris, Inserm Press, 1973, pp 21-41. 15. Maddox IS: The role of copper in prostaglandin synthesis . Biochim Biophys Acta 306:74-79, 1973.Crossref 16. Granstrom E, Lands WEM, Samuelsson B: Biosynthesis of 9α, 15-dihydroxy-11-ketoprost-13-enoic acid . J Biol Chem 243:4104-4108, 1968. 17. Hamberg M, Wilson M: Structures of new metabolites of prostaglandin E. in man , in Bergström S (ed): Advances in the Biosciences . New York, Pergamon Press Inc, 1973, pp 39-47. 18. Horton EW: Prostaglandins at adrenergic nerve endings . Br Med Bull 29:148-151, 1973. 19. Silver MJ, Smith JB: Prostaglandins as intracellular messengers . Life Sci 16:1635-1648, 1975.Crossref 20. Goldberg ND, O'Dea RF, Haddox MK: Cyclic GMP . Adv Cyclic Nucleotide Res 3:156-223, 1973. 21. Von Euler US: Introduction , in Ramwell PW (ed): The Prostaglandins . New York, Plenum Press Inc, 1973, vol 1, p 4. 22. Stjarne L: Inhibitory effects of prostaglandin E2 on noradrenaline secretion from sympathetic nerves as a function of external calcium . Prostaglandins 3:105-109, 1973.Crossref 23. Hedgvist P: Prostaglandins as a tool for local control of transmitter release from sympathetic nerves . Brain Res 62:483-488, 1973.Crossref 24. Samuelsson B, Wennmalm A: Increased nerve stimulation induced release of noradrenaline from rabbit heart after inhibition of prostaglandin synthesis . Acta Physiol Scand 83:163-168, 1971.Crossref 25. Johnson DG, Thoa NB, Weinshilboum R, et al: Enhanced release of dopamine-B-hydroxylase from sympathetic nerves by calcium and phenoxybenazmine and its reversal by prostaglandins . Proc Natl Acad Sci USA 68:2227-2230, 1971.Crossref 26. Kadowitz PJ, Sweet CS, Brody MJ: Differential effects of prostaglandins E1, E2, F, α and F2α on adrenergic vasoconstriction in the dog hindpaw . J Pharmacol Exp Ther 177:641-649, 1971. 27. Wennmalm A, Hedgvist P: Inhibition by prostaglandin E of parasympathetic neurotransmission in the rabbit heart . Life Sci 10:465-470, 1971.Crossref 28. Marco LS, Coceani F: The action of prostaglandin E on frog skeletal muscle . Can J Physiol Pharmacol 51:627-634, 1973.Crossref 29. Park MK, Rishor C, Dyer DC: Vasoactive action of prostaglandins and serotonin on isolated human umbilical arteries and veins . Can J Physiol Pharmacol 50:393-399, 1972.Crossref 30. Grubb MN, Burks TF: Modification of intestinal stimulatory effects of 5-hydroxytryptamine by adrenergic amines, prostaglandin E and theophylline . J Pharmacol Exp Ther 189:476-483, 1974. 31. Samuelsson B: Identification of a smooth muscle stimulating factor in bovine brain . Acta Biochim Biophys 84:218-219, 1964. 32. Horton EW, Main IHM: Identification of prostaglandins in central nervous tissue of the cat and chicken . Br J Pharmacol 30:582-602, 1967. 33. Pappius HM, Rostworowski K, Wolfe LS: Biosynthesis of prostaglandin F2α and E2 by brain tissue in vitro, abstracted . Trans Am Soc Neurochem 5:119, 1974. 34. Ramwell PW, Shaw JE: Spontaneous and evoked release of prostaglandins from the cerebral cortex of anaesthetized cats . Am J Physiol 211:125-134, 1966. 35. Coceani F, Wolfe LS: On the action of prostaglandin E and prostaglandins from brain on the isolated rat stomach . Can J Physiol Pharmacol 44:933-950, 1966.Crossref 36. Ramwell PW, Shaw JE, Jessup R: Spontaneous and evoked release of prostaglandins from frog spinal cord . Am J Physiol 211:998-1004, 1966. 37. Siggins G, Hoffer B, Bloom F: Prostaglandins-norepinephrine interactions in brain: Microelectrophoretic and histochemical correlates . Ann NY Acad Sci 180:302-323, 1971.Crossref 38. Bradley PB, Samuels GMR, Shaw JE: Correlation of prostaglandin release from the cerebral cortex of cats with electro-cortigram following stimulation of the reticular formation . Br J Pharmacol 37:151-157, 1969.Crossref 39. Zatz M, Roth RH: Electroconvulsive shock raises prostaglandin F in rats cerebral cortex . Biochem Pharmacol 24:2101-2103, 1975.Crossref 40. Horton EW: Prostaglandins . Monogr Endocrinol 7:117-149, 1972. 41. 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Tamminga, Carol A.;Smith, Robert C.;Pandey, Ghanshyam;Frohman, Lawrence A.;Davis, John M.

doi: 10.1001/archpsyc.1977.01770220081009pmid: 911219

Abstract • A study of the tuberoinfundibular dopamine tract was undertaken in chronic schizophrenic patients with and without tardive dyskinesia. Biochemical evidence of the purported dopamine receptor supersensitivity in tardive dyskinesia was sought by demonstrating a hyperresponse of growth hormone and prolactin to dopamine agonists. Contrary to this prediction, no endocrine supersensitivity occurred in the tardive dyskinesia patients. Rather, a significantly decreased response to dopaminergic stimualtion was demonstrated in the total chronic schizophrenic group. References 1. Rubovitz R, Klawans HL: Implications for amphetamine-induced stereotyped behavior as a model for tardive dyskinesia . Arch Gen Psychiatry 27:502-507, 1972.Crossref 2. Gerlach J, Reisby N, Randrup A: Dopaminergic hypersensitivity and cholinergic hypofunction in the pathophysiology of tardive dyskinesia . Psychopharmacologia 34:21-35, 1974.Crossref 3. Smith RC, Tamminga CA, Haraszti J, et al: Effects of dopamine agonists in tardive dyskinesia . Am J Psychiatry 134:763-768, 1977. 4. Klawans HL: The pharmacology of tardive dyskinesia . Am J Psychiatry 130:82-85, 1973. 5. Kobayashi RM: Drug therapy of tardive dyskinesia . N Engl J Med 296:257-260, 1977.Crossref 6. Cannon WB, Rosenblueth A: The Supersensitivity of Denervated Structures: A Law of Denervation . New York, Macmillan Co, 1949. 7. Trendelenburg U: Supersensitivity and subsensitivity to sympathomimetic amines . Pharmacol Rev 15:225-276, 1963. 8. Fleming WW, McPhillips JJ, Westfall DP: Postjunctional supersensitivity and subsensitivity of excitable tissues to drugs . Ergeb Physiol 68:55-119, 1973. 9. Sharpless SK, Halpern LM: The electrical excitability of chronically isolated cortex studied by means of permanently implanted electrodes . Electroencephalogr Clin Neurophysiol 14:244-255, 1962.Crossref 10. Ungerstedt U: Postsynaptic supersensitivity after 6-hydroxydopamine induced degeneration of the nigrostriatal dopamine system . Acta Physiol 367( (suppl) ):69-93, 1971. 11. Iversen SD, Creese I: Behavioral correlates of dopaminergic supersensitivity , in Calne DB, Chase TN, Barbeau A (eds): Advances in Neurology . New York, Raven Press, 1975, pp 81-92. 12. Brown GM, Garfinkel PE, Warsh JJ, et al: Effect of carbidopa on prolactin, growth hormone and cortisol secretion in man . J Clin Endocrinol Metab 43:236-239, 1976.Crossref 13. Smith RC, Davis JM: Behavioral supersensitivity to apomorphine and amphetamine after chronic high-dose haloperidol treatment . Psychopharmacol Comm 1:285-288, 1975. 14. Smith RC, Davis JM: Behavioral evidence for supersensitivity after chronic administration of haloperidol, clozapine and thioridazine . Life Sci 19:725-732, 1976.Crossref 15. Moore KE, Thornburg JE: Drug-induced dopaminergic supersensitivity , in Calne DB, Chase TN, Barbeau A (eds): Advances in Neurology . New York, Raven Press, 1975, pp 93-104. 16. Frohman LA, Stachura ME: Neuropharmacologic control of neuroendocrine function in man . Metabolism 24:211-234, 1975.Crossref 17. DeWied D, deJong W: Drug effects and hypothalamic-anterior pituitary function . Ann Rev Pharmacol 7:389-412, 1974. 18. Kleinberg DL, Noel GL, Frantz AG: Chlorpromazine stimulation and L-dopa suppression of plasma prolactin in man . J Clin Endocrinol Metab 33:873-876, 1971.Crossref 19. Friesen H, Guyda H, Hwang P, et al: Functional evaluation of prolactin secretion: A guide to therapy . J Clin Invest 51:706-709, 1972.Crossref 20. Saito S, Abe K, Nagata N, et al: Effect of L-dopa on anterior pituitary hormone release in man . Endocrinol Jap 19:435-442, 1972.Crossref 21. Brown WA, Van Woert MH, Ambani LM: Effect of apomorphine on growth hormone release in humans . J Clin Endocrinol Metab 37:463-465, 1973.Crossref 22. MacLeod RM: Regulation of prolactin secretion , in Martini L, Ganong WF (eds): Frontiers in Neuroendocrinology . New York, Raven Press, 1976, pp 169-194. 23. Brown GM, Seeman P, Lee T: Dopamine/neuroleptic receptors in basal hypothalamus and pituitary . Endocrinology 99:1407-1410, 1976.Crossref 24. Diefenbach WP, Carmel PW, Frantz AG, et al: Suppression of prolactin secretion by L-dopa in the stalk sectioned rhesus monkey . J Clin Endocrinol Metab 43:638-642, 1976.Crossref 25. Martin JB: Brain regulation of growth hormone secretion , in Martini L, Ganong WF (eds): Frontiers in Neuroendocrinology . New York, Raven Press, 1976, pp 129-168. 26. Spitzer RK, Endicott J, Robins E, et al: Preliminary report of the reliability of research diagnostic criteria applied to psychiatric case records , in Sudilovsky A, Gershon S, Beer R (eds): Predictability in Psychopharmacology . New York, Raven Press, 1975, pp 245-258. 27. Segal S: Nonparametric Statistics for the Behavioral Sciences . New York, McGraw-Hill Book Co Inc, 1956. 28. Cheung CY, Weiner RI: Supersensitivity of anterior pituitary dopamine receptors involved in the inhibition of prolactin secretion following destruction of the medical basal hypothalamus . Endocrinology 99:917-941, 1976.Crossref 29. Ettigi P, Nair NPU, Lal S, et al: Effect of apomorphine on growth hormone and prolactin secretion in schizophrenic patients, with or without oral dyskinesia, withdrawn from chronic neuroleptic therapy . J Neurol Neurosurg Psychiatry 39:870-876, 1976.Crossref 30. Chase TN, Holden EM, Brody JA: Leuodopa-induced dyskinesias . Arch Neurol 29:328-330, 1973.Crossref 31. Langer SZ: Denervation supersensitivity , in Iversen LL, Iversen SD, Snyder SH (eds): Handbook of Psychopharmacology . New York, Plenum Press, 1975, vol 2, pp 245-280. 32. Lal H, Brown W, Drawbaugh R, et al: Enhanced prolactin inhibition following chronic treatment with haloperidol and morphine . Life Sci 20:101-106, 1977.Crossref 33. Carlsson A, Lindquist M: Effect of chlorpromazine or haloperidol on formation of 3-methoxytryamine and hormetanephrine in mouse brain . Acta Pharmacol Toxicol 20:140-146, 1963.Crossref 34. Snyder SN, Banerjie SP, Yamamuia HI, et al: Drugs, neurotransmitters and schizophrenia . Science 184:1245-1254, 1974.Crossref 35. Pandey S, Garver D, Tamminga C, et al: Postsynaptic supersensitivity in schizophrenia . Am J Psychiatry 134:518-522, 1977. 36. Goldberg SC, Schooler NR, Hogarty GE, et al: Prediction of relapse in schizophrenic outpatients treated by drug and sociotherapy . Arch Gen Psychiatry 34:171-177, 1977.Crossref 37. Leff JP, Wing JK: Trial of maintenance therapy in schizophrenia . Br Med J 3:599-601, 1971.Crossref 38. Kornetsky C: Hyporesponsivity of chronic schizophrenic patients to dextroamphetamine . Arch Gen Psychiatry 33:1425-1428, 1976.Crossref 39. Rotrosen J, Angrist BM, Gershon S, et al: Dopamine receptor alteration in schizophrenia: neuroendocrine evidence . Psychopharmacology 51:1-7, 1976.Crossref 40. Friend WC, Brown GM, Lee T, et al: Neuroleptic receptors in pituitary and striatum. Read before the New Research Program of the 130th annual meeting of the American Psychiatric Association, Toronto, May 1977. 41. Wilson RG, Hamilton JR, Boyd WD, et al: The effect of long term phenothiazine therapy on plasma prolactin . Br J Psychiatry 127:71-75, 1975.Crossref 42. Kolakowska T, Wiles DH, McNeilly AS, et al: Correlation between plasma levels of prolactin and chlorpromazine in psychiatric patients . Psychol Med 5:214-216, 1975.Crossref 43. Beumont PJU, Gelder MG, Friesen HG, et al: The effects of phenothiazines on endocrine function . Br J Psychiatry 124:413-419, 1974.Crossref 44. Meitex J, Lu KH, Wutteke W, et al: Recent studies on functions and control of prolactin secretion in rats . Recent Prog Horm Res 28:471-483, 1972. 45. Frantz AG, Kleinberg DL, Noel GL: Studies on prolactin in man . Recent Prog Horm Res 28:527-590, 1972. 46. Carlson HE, Jacobs LS, Daushaday WH: Growth hormone, thyrotropin and prolactin responses to thyrotropin-releasing hormone following diethystilbesterol pre-treatment . J Clin Endocrinol Metab 37:488-491, 1973.Crossref 47. Buckman MT, Peake GT: Estrogen potentiation of phenothiazineinduced prolactin secretion in man . J Clin Endocrinol Metab 37:977-980, 1973.Crossref 48. Wiedemann E, Schwartz E, Frantz AG: Acute and chronic estrogen effects upon serum somatomedin activity, growth hormone, and prolactin in man . J Clin Endocrinol Metab 42:942-951, 1976.Crossref

Gardos, George;Cole, Jonathan O.;Brie, Richard La

doi: 10.1001/archpsyc.1977.01770220088010pmid: 911220

Abstract • Available assessment methods for tardive dyskinesia were reviewed under three headings: instrumentation, frequency counts, and rating scales. The more objective methods have better reliability but less certain validity, while for the clinical assessment techniques the converse tends to be true. The optimal assessment method for a given study depends on the research question asked. For most studies, the combination of one of the objective techniques with a rating method may be ideal. Research on prevalence and etiological factors would benefit from one of the multi-item rating scales, while in treatment studies a global scale may be necessary. Videotapes are invaluable for educational purposes and for training raters. References 1. Hall RA, Jackson RB, Swain JM: Neurotoxic reactions resulting from chlorpromazine administration . JAMA 161:214-218, 1956.Crossref 2. Sigwald J, Bouttier D, Courvoisier S: Les accidents neurologiques des medications neuroleptiques . 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Haines J, Sainsbury P: Ultrasound system for measuring patients' activity and disorders of movement . Lancet 2:802-803, 1972.Crossref 16. Leonard DP, Kidson MA, Shannon PJ, et al: Double-blind trial of lithium carbonate and haloperidol in Huntington's chorea . Lancet 2:1208-1209, 1974.Crossref 17. Klawans HL Jr: The pharmacology of tardive dyskinesias , in Klawans HL Jr (ed): The Pharmacology of Extrapyramidal Movement Disorder . Basel, Switzerland, S Karger, 1973, pp 64-70. 18. Klawans HL Jr, Rubovits R: Effects of cholinergic and anticholinergic agents on tardive dyskinesia . J Neurol Neurosurg Psychiatry 37:941-947, 1974.Crossref 19. Kazamatsuri H, Chien C-P, Cole JO: Treatment of tardive dyskinesia: I. Clinical efficacy of a dopamine-depleting agent, tetrabenazine . Arch Gen Psychiatry 27:95-99, 1972.Crossref 20. Kazamatsuri H, Chien C-P, Cole JO: Treatment of tardive dyskinesia: II. Short-term efficacy of dopamine-blocking agents haloperidol and thiopropazate . Arch Gen Psychiatry 27:100-103, 1972.Crossref 21. Kazamatsuri H, Chien C-P, Cole JO: Treatment of tardive dyskinesia: III. Clinical efficacy of a dopamine competing agent, methyldopa . Arch Gen Psychiatry 27:824-827, 1972.Crossref 22. Kazamatsuri H, Chien C-P, Cole JO: Long-term treatment of tardive dyskinesia with haloperidol and tetrabenazine . Am J Psychiatry 130:479-483, 1973. 23. Davis KL, Berger PA, Hollister LE: Choline for tardive dyskinesia . N Engl J Med 293:152, 1975. 24. Roxburgh PA: Treatment of persistent phenothiazine induced oral dyskinesia . Br J Psychiatry 116:277-280, 1970.Crossref 25. Fann WE, Lake R: On the coexistence of parkinsonism and tardive dyskinesia . Dis Nerv Syst 35:324-326, 1974. 26. Gerlach J, Thorsen K: The movement pattern of oral tardive dyskinesia in relation to anticholinergic and antidopaminergic treatment . Int Pharmacopsychiatry 11:1-7, 1976. 27. Crane GE, Paulson G: Involuntary movements in a sample of chronic mental patients and their relation to the treatment with neuroleptics . Int J Neuropsychiatry 3:286-291, 1966. 28. Brandon S, McClelland HA, Protheroe C: A study of facial dyskinesia in a mental hospital population . Br J Psychiatry 118:171-184, 1971.Crossref 29. Laterre EC, Foretemps E: Deanol in spontaneous and induced dyskinesias . Lancet 1:1301, 1975.Crossref 30. Pryce IG, Edwards H: Persistent oral dyskinesia in female mental hospital patients . Br J Psychiatry 112:983-987, 1966.Crossref 31. Edwards H: The significance of brain damage in persistent oral dyskinesia . Br J Psychiatry 116:271-275, 1970.Crossref 32. Crane GE, Smeets RA: Tardive dyskinesia and drug therapy in geriatric patients . Arch Gen Psychiatry 30:341-343, 1974.Crossref 33. Villeneuve A, Lavallee J-C, Lemieux L-H: Dyskinesie tardive postneuroleptique . Lav Med 40:832-837, 1969. 34. 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Arzneim Forsch 20:894-895, 1970. 48. Heinrich K, Wegener I, Bender H-J: Spate extrapyramidale Hyperkinesen bei neuroleptischer Langzeitherapie . Pharmakopsychiatr Neuropsychopharmkol 1:169-195, 1968.Crossref 49. Kennedy PF, Hershon HI, McGuire RJ: Extrapyramidal disorders after prolonged phenothiazine therapy . Br J Psychiatry 118:509-518, 1971.Crossref 50. Hershon HI, Kennedy PF, McGuire RJ: Persistence of extrapyramidal disorders and psychiatric relapse after withdrawal of long-term ohenothiazine therapy . Br J Psychiatry 120:41-50, 1972.Crossref 51. Reda FA, Scanlon JM, Kemp KF, et al: Treatment of tardive dyskinesia with lithium carbonate . N Engl J Med 291:850, 1974. 52. Escobar JI, Kemp KF: Dimethylaminoethanol for tardive dyskinesia . N Engl J Med 292:318, 1975. 53. Simpson GM, Zoubok B, Lee HJ: An early clinical and toxicity trial of Ex 11-582A in chronic schizophrenia . Curr Ther Res 19:87-93, 1976. 54. Gardos G, Cole JO: Papaverine for tardive dyskinesia? N Engl J Med 292:1355, 1975. 55. Gardos G, Sokol M, Cole JO, et al: Eye color and tardive dyskinesia . Psychopharmacol Bull 12:7-9, 1976. 56. Gardos G, Cole JO, Sniffin C: An evaluation of papaverine in tardive dyskinesia . J Clin Pharmacol 16:304-310, 1976.Crossref