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359. Attempted suicide. Risk factors and profiles
108S
Saturday Abstracts
BIOLPSYCHIATRY 1998;43:1S–133S
true ratio ‘test/reference’for bioequivalencestudies.Results: C_ of rnirtazapinewas 30%lowerin males than in females;and increasedby the co-administrationof srnhriptyline,whilein femalespharmacokinctic parametersremainedunchanged.Cm= and AUC of arnitriptylinewere decreased in female volunteers (23% and 13%, respectively) after co-administrationof rnirtazapine,while Cm= was increasedin males (23%).Conclusion: The observedeffectsmainlypertainto differencesin the rate of absorptionof both drugs,whichare consideredto be of no clinicalrelevance.
358. SERIAL DISCONTINUATION OF SSRI TREATMENT FOR PMDD K.A. Yonkers, L.K. Barrtett, T. Carrnody & A.J. Rush Universityof Texas,SouthwesternMedicalCenterat Dallas,Drdlss, Texas There is increasing evidence that premenstrual dysphoric disorder (PMDD) is selectively responsive to antidepressantsthat block the reuptakeof scrotonin(SSRIS).Eftlcacyhas been shownin acute phase studies,the majorityof whichhavepersistedfor 3 monthsof treatmentor less. Thus,less is knownaboutthe longtermefficacyof SSRItreatment for PMDD.In this studywe randomizedwomento double-blindplacebo controlleddiscontinuationof sertrsline after 3, 6 or 9 monthsof daily treatmentwiththe SSRI,sertratine.All womenprospectivelycorrtirrned a diagnosis of PMDD with two cycles of daily ratings. Symptom evaluationswere conductedeach lttteal phase with the HRS-D, the Inventoryof Depressive Symptomatology,the PremenstmalTension Scale,ClinicalGlobalImprovementScale (CGI)and the SocialAdjustment Scale. Openlabel sertmlinewas institrrtedand titrated to 150mg daily.Remissionwas definedas a CGIof 1 or 2 andrecurrenceas a CGI of 4. Twentythree womenhave been enteredto date. All womenwere switchedto placeboby 9 months.Therates of recurrenceamongwomen blindlydiscontinuedto placebowere 66%,66%and 60%stter 3, 6 and 9 cycles respectively.The correspondingrates of recurrencein women continuedon activetreatmentwere 107oafter 3 and 14%after 6 cycles of treatment.Thisstudysupportslongtermefilcacyof SSRISfor PMDD and suggests that a subset of women may be able to successfully discontinuetreatmentafter severalmonthsof therapy.
359. ATTEMPTED SUICIDE. RISK FACTORS AND PROFILES J. Irurita, M. Irurita, P. Betancor, P. Saavedra & R. LOS&mtos HospitalEl Pino,Universidadde Las Pslmas de Gran Canari%35004 Spain Suicidal behavioris ubiquitousyet controversial.Individualinstarttaneous vulnerabilitydepends on the interplay of personality traits, stressful situations,endurance,and family backgrounds.To determine the prevalenceand importanceof risk factors in suicidal conductwe studied203 randomsuicideattempts(SA) in a generalhospital.Semistructrrrcdpatientand familyinterviewsfocusingon qualityof life and psychosocialstressscalesprovided75parametersto srrrdyzestatistically. The meanage was 31 years old; 58%were females.Qualityof life was influencedby bothpersonaland familystressors.Anxiety,sadness,low self-esteemand hopelessnessprevailedon “subjectiveemotionalfmtc-
tion”. The typicalprofile of a first SA was a youngwomanwith poor socioeconomicand academic status, low self-esteem, irritability and untreated anxiety. The first SA was often triggered by a family or relationshipcrisis, and the methodchosenwas the ingestionof various pharmacologicalagents. Based on a multidimensionalanalysis model, the absenceof impulsivity,personalor family psychiatrichistory and overdose methods showed significant association with a first SA. Conversely,a previousrecordof psychiatricdisorders,familyhistoryof suicidal behavior, impulsive conduct and psychotic symptomswere related to repeated SA and a tendency towards violent procedures. Accordingto our logistic regression model, impulsivebehavior and familyhistoryof suicidalconductwere the most powerfulindependent predictorsof subsequentsuicidalbehavior.Risk factors and quality of life may be useful in the evaluation of human behavior and the developmentof specifictreatmentssod preventionstrategies.
Schizophrenia Saturday,May 30, 5:00 PM-7:00 PM, Location:Pier 4 & 5 360. ELEVATION OF BOMBESIN BY SMOKING IS DECREASED IN SCHIZOPHRENIA A. Olincyl, S. Leonardl’2, D.A. Youngl, B. Sullivanl & R. Freedmanl’ 2 ‘Universityof ColorsdoHcstth SciencesCenter,DenverCO 80262; ‘DenverVeteransAdministrationMedicalCenter,Denver,CO 80220 Schizophrenicpatients,as a group,areextremelyheavytobaccosmokers. However,lower incidenceof lung cancer has ham observedin several epidemiologicalstudies, particularly in comparison to other heavy smokers.Theincreasedreleaseof hombesin-likepeptide(BLP)resulting fromproliferationof netrroendocrinetissuein the lungis a pre-cancerous responseto cigarettesmoke,whichcan be detectedby elevatedurinary levels of the peptide. The urinary BLP levels of 10 schizophrenic smokers,and 11schizophrenicnonsmokerswerecomparedto nonschizophrenic subjects matched for age and pack-years of smoking. The smokingnortschizophrcnicgrouphad BLPlevels that were higherthan either the nonsmokingnonschizophrcnicgroupor the smokingschizophrenic group. BLP levels in both the smoking and nonsmoking schizophrenicgroupswereno differentfromthe nonsmokingnonschizophrenicgroup.The mechanismof the differencein responseto cigarette smokingis unknown,but one possibilityinvolvesalterationin the a7 nicotirricreceptor,whichmediatesthe growthof some neurcendocrine cell lines in vitro.
361. THE DIFFERENT GENETIC BACKGROUND OF SCHIZOPHRENIC SPECTRUM PSYCHOSES E. Franzek & H. Beckmann Departmentof Psychiatry,Universityof Wuerzbnrg,Germany Manyof the contradictoryresults in schizophreniaresearch appear to be due to diagnostic heterogeneityof the samples investigated or to
Saturday Abstracts
BIOLPSYCHIATRY 1998;43:1S–133S
true ratio ‘test/reference’for bioequivalencestudies.Results: C_ of rnirtazapinewas 30%lowerin males than in females;and increasedby the co-administrationof srnhriptyline,whilein femalespharmacokinctic parametersremainedunchanged.Cm= and AUC of arnitriptylinewere decreased in female volunteers (23% and 13%, respectively) after co-administrationof rnirtazapine,while Cm= was increasedin males (23%).Conclusion: The observedeffectsmainlypertainto differencesin the rate of absorptionof both drugs,whichare consideredto be of no clinicalrelevance.
358. SERIAL DISCONTINUATION OF SSRI TREATMENT FOR PMDD K.A. Yonkers, L.K. Barrtett, T. Carrnody & A.J. Rush Universityof Texas,SouthwesternMedicalCenterat Dallas,Drdlss, Texas There is increasing evidence that premenstrual dysphoric disorder (PMDD) is selectively responsive to antidepressantsthat block the reuptakeof scrotonin(SSRIS).Eftlcacyhas been shownin acute phase studies,the majorityof whichhavepersistedfor 3 monthsof treatmentor less. Thus,less is knownaboutthe longtermefficacyof SSRItreatment for PMDD.In this studywe randomizedwomento double-blindplacebo controlleddiscontinuationof sertrsline after 3, 6 or 9 monthsof daily treatmentwiththe SSRI,sertratine.All womenprospectivelycorrtirrned a diagnosis of PMDD with two cycles of daily ratings. Symptom evaluationswere conductedeach lttteal phase with the HRS-D, the Inventoryof Depressive Symptomatology,the PremenstmalTension Scale,ClinicalGlobalImprovementScale (CGI)and the SocialAdjustment Scale. Openlabel sertmlinewas institrrtedand titrated to 150mg daily.Remissionwas definedas a CGIof 1 or 2 andrecurrenceas a CGI of 4. Twentythree womenhave been enteredto date. All womenwere switchedto placeboby 9 months.Therates of recurrenceamongwomen blindlydiscontinuedto placebowere 66%,66%and 60%stter 3, 6 and 9 cycles respectively.The correspondingrates of recurrencein women continuedon activetreatmentwere 107oafter 3 and 14%after 6 cycles of treatment.Thisstudysupportslongtermefilcacyof SSRISfor PMDD and suggests that a subset of women may be able to successfully discontinuetreatmentafter severalmonthsof therapy.
359. ATTEMPTED SUICIDE. RISK FACTORS AND PROFILES J. Irurita, M. Irurita, P. Betancor, P. Saavedra & R. LOS&mtos HospitalEl Pino,Universidadde Las Pslmas de Gran Canari%35004 Spain Suicidal behavioris ubiquitousyet controversial.Individualinstarttaneous vulnerabilitydepends on the interplay of personality traits, stressful situations,endurance,and family backgrounds.To determine the prevalenceand importanceof risk factors in suicidal conductwe studied203 randomsuicideattempts(SA) in a generalhospital.Semistructrrrcdpatientand familyinterviewsfocusingon qualityof life and psychosocialstressscalesprovided75parametersto srrrdyzestatistically. The meanage was 31 years old; 58%were females.Qualityof life was influencedby bothpersonaland familystressors.Anxiety,sadness,low self-esteemand hopelessnessprevailedon “subjectiveemotionalfmtc-
tion”. The typicalprofile of a first SA was a youngwomanwith poor socioeconomicand academic status, low self-esteem, irritability and untreated anxiety. The first SA was often triggered by a family or relationshipcrisis, and the methodchosenwas the ingestionof various pharmacologicalagents. Based on a multidimensionalanalysis model, the absenceof impulsivity,personalor family psychiatrichistory and overdose methods showed significant association with a first SA. Conversely,a previousrecordof psychiatricdisorders,familyhistoryof suicidal behavior, impulsive conduct and psychotic symptomswere related to repeated SA and a tendency towards violent procedures. Accordingto our logistic regression model, impulsivebehavior and familyhistoryof suicidalconductwere the most powerfulindependent predictorsof subsequentsuicidalbehavior.Risk factors and quality of life may be useful in the evaluation of human behavior and the developmentof specifictreatmentssod preventionstrategies.
Schizophrenia Saturday,May 30, 5:00 PM-7:00 PM, Location:Pier 4 & 5 360. ELEVATION OF BOMBESIN BY SMOKING IS DECREASED IN SCHIZOPHRENIA A. Olincyl, S. Leonardl’2, D.A. Youngl, B. Sullivanl & R. Freedmanl’ 2 ‘Universityof ColorsdoHcstth SciencesCenter,DenverCO 80262; ‘DenverVeteransAdministrationMedicalCenter,Denver,CO 80220 Schizophrenicpatients,as a group,areextremelyheavytobaccosmokers. However,lower incidenceof lung cancer has ham observedin several epidemiologicalstudies, particularly in comparison to other heavy smokers.Theincreasedreleaseof hombesin-likepeptide(BLP)resulting fromproliferationof netrroendocrinetissuein the lungis a pre-cancerous responseto cigarettesmoke,whichcan be detectedby elevatedurinary levels of the peptide. The urinary BLP levels of 10 schizophrenic smokers,and 11schizophrenicnonsmokerswerecomparedto nonschizophrenic subjects matched for age and pack-years of smoking. The smokingnortschizophrcnicgrouphad BLPlevels that were higherthan either the nonsmokingnonschizophrcnicgroupor the smokingschizophrenic group. BLP levels in both the smoking and nonsmoking schizophrenicgroupswereno differentfromthe nonsmokingnonschizophrenicgroup.The mechanismof the differencein responseto cigarette smokingis unknown,but one possibilityinvolvesalterationin the a7 nicotirricreceptor,whichmediatesthe growthof some neurcendocrine cell lines in vitro.
361. THE DIFFERENT GENETIC BACKGROUND OF SCHIZOPHRENIC SPECTRUM PSYCHOSES E. Franzek & H. Beckmann Departmentof Psychiatry,Universityof Wuerzbnrg,Germany Manyof the contradictoryresults in schizophreniaresearch appear to be due to diagnostic heterogeneityof the samples investigated or to