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Clinical characteristics and phenomenology of psychosis in postpartum
120S
Poster session
BIOL. PSYCHIATRY 1997:42: 15-2975
139-1 70 I Double blind randomized comparative study of sertrallne and fluoxetlne In depressive outpatient: Medico economic aspect J.-M. Danion', P. Boyer 2 , S. Troy 3, J. Hotton 3 . ' Unite INSERM U405 Hopitaux Universitaires de Strasbourg, France, 2,NSERM Hopital Sainte Anne, Paris, France, 3 Pfizer, Orsay. France The aim of the study was to compare the medico economic impact of sertraline (50 to 150 mgld) to fluoxatine (20 to 60 mgld) in patients with major depressive disorder according to DSM IV. Methods: Patients were evaluated at baseline, 4 and 6 months. Assess• ments included MADRS and CGI. Use of medical services, absences from work and productivity losses were recorded for calculation of direct and indirect costs from both societal and sickness insurance perspectives.
139-1721
• Sickness insurance l.
• Social costs _
Costs differential between seltra/ine and fluoxetine.
Results: A total 236 patients was included (116 sertraline and 115 f1uoxatine) in the intent to treat analysis. Statistically significant clinical improvement from baseline was observed in both treatment group with no differences between groups. Cost comparison per patient favored sertraline treatment from both the societal and sickness insurance viewpoints with costs differentials of 926 FF and 288 FF, respectively. The total cost per patient, over a 6 months course of the trial, from the societal and sickness insurance perspective was respectively of 7780 FF and 2936 FF for sertraline and 8706 FF and 3224 FF for f1uoxetine.
139-171 1 Depersonalization and high decline In concentration In Sheehan's syndrome - A case report H. Hotta " Y. Nakamura 1, M. Hashimoto 2. ' Department of Psychiatry, Yamaguchi Central Hospital, Yamaguchi, Japan, 2 Department of Neuropsychiatry, Yamaguchi University School of medicine, Yamaguchi, Japan There are various understandings about the psychotic symptoms in Shee• han's syndrome. Report: A 32-year-old woman gave birth to her eldest daughter in normal delivery when she was 26. However, she later experienced two miscamages. Atter that, her vaginal bleeding pattem became irregular and hypogalactia and general fatigue arose. Furthermore, because depersonal• ization and confusion appeared, she visited our hospital on February 9th, 1996. Depersonalization disappeared by ingestion of sulpiride. However, high decline in concentration, blunted affect and indifference arose, and the feeling of deep sleep disappeared. Low basal growth hormone (GH) concen• tration with the examination of endocrine secretion was shown. And because of low luteinizing hormone, follicle-stimulating hormone and no GH secre• tion, the results of the examination were judged as partial hypopituitarism. Therefore, the patient was diagnosed as Sheehan's syndrome. Comment: It is possible that subclinical pituitary necrosis with partial hypopituitarism could have been the causative factor in this case.
case
Clinical characteristics and phenomenology of psychosis In postpartum
A. Damjanovic ' , C.D. Miljevic 2, V.A. Paunovic 1. 'Institute for psychialTy. Belgrade Clinical Center, Belgrade, Yugoslavia, 2 Special Psychiatnc hospital "dr L. Lazarevic· Belgrade, Yugoslavia In this study is presented clinical analysis of parameters in 30 WOfnIIn with first psychotic disorder in postpartum period. All these patients went treated in Department for Psychosis of Psychiatric Clinic University ClinicIII center in Belgrade. According to DSM-IV criteria affective psychosis went prevalent and they were registered in 21 (70%) patients, while sch~ pictures were evidently in only 3 (10%) of woman. In complex of postpartum psychotic disorders was separated a group of 6 (20%) patients with paranoid and depressive syndromes. All these psychotic disorders were registered during first four weeks of puerperal period. All patients were observed clinically during period of five years. Good remission is obtained in 8 (26.7%) patients and chronically course with recidivity of psychosis is evidenced in 22 (73.3) patients. These results that are presented in this study, are one more contribution to detailed perceive of mental disturbances in woman in puerperium.
139-1731 Total Indir Direc Hosp Medi Para Medi Addit costs ect Is ita Is cal medi cines ional
n
Effect of tacrine on active avoidance in rata
D. Getova, V. Spassov' . Department Pharmacol. Taxicol., MBdicaJ University Plovdiv, BUlgaria, ' Department Pharmoco/., Faculty Human Medicine, Trakia University. Stars Zagors, Bulgaria Tacrine (Tacr) (9-amino-l,2,3,4-tetrahydroacridine hydrochloride) is well known drug used in treatment of Alzheimer's disease. We studied its effect using two way active avoidance (shuttle box) in rats. Method: Male Wistar rats (220-250 g) (8 per group) were used. Rats were injected with lacrine at doses of 0, 0.1, 0.5 and 1 mglkg i.p. 30 min before placing in a shuttle box. It was used the two-way PUnisllment reinforced active avoidance method (shuttle box). The training procedure by Gozzani and Izquierdo (1976) according to which the rats were trained in. conventional shuttle box (Ugo Basile) with 30 trials each day 5 days Ie8ming session and 7 days alter last training (12th day) a single retention S8S8icln with 30 trials was made. The stimulus employed was 6 sec light and buzzer (70 dB-Hl70 Hx) followed by 3 sec 0.4 mA footshock. We observed numbers 01: (1) correct responses, i.e. avoidances, (2) escapes from footshoacs., (3) footshocks, (4) Intertrial crossings, (5) latency of reactions. A ~ ANOVA was used for statistics. Results: The rats treated with tacrine at doses 0.5 and 1 mglkg signlficanlly increased the number of avoidances alter 3rd day of learning S88SIon compared to the controls. The number of escapes was not signiflcllnlly increased. In the retention session the group treated with 0.5 mglkg tacrine shown more avoidances than controls. We found dose-relationship in the effects of tacrine on leaming. Nevertheless it can be concluded that lhis compound is able to improve learning and memory retention in the aVOidance paradigm.
139-1741
Association between presenilin-1 (5182) gene polymorphism and Alzheimer's disease In the Spanish population
K. Beyer, J.1. Lao, MA Sellers, X.A. Alvarez, A. Cacabelos. EuroEspes Biomedical Research Center, BergOndo, La Coruna, Spain Alzheimer'S disease (AD) is a genetically heterogeneous disorder With four different genes implicated in its ethiopathogenesis: the APP gene on cromosome 21, the APOE gene on chromosome 19, Sl82 (ptesenilin 1 gene) on chromosome 14 and STM2 on chromosome 1 (presenilin 2 gene). Mutations in the presentlin 1 (PS-l) gene cause a significant proportion of earty-onset, autosomal dominant Alzheimer's disease. In this regard, an association between variation in an intronic polymorphism situated 3' of exon 9 of the P5·1 gene and late-onset AD (LOAD) was reported. In the PteSent study we studied the allele frequencies of both alleles described for the 5182 intronic polymorphism in the following groups: (1) Senile dementia (N = 203), and (2) age-matched healthy controls (N = 200). Dementia SUbtypes were: (1.1) earty-onset AD (N 49; age: 59.9 ± 6.2 years), (1.2) late-onsec AD (N 73; age: 72.3 ± 8.0 years), (1.3) Vascular Dementia (N 56' age' 73.1 ± 7.2 years) and (1.4) Mixed Dementia (N 25; age: 70.2 ± 5.9 ~): We conclude that allele 1 of the 5182 intronic polymorphism is associated with AD, but it does not seem to be linked to any other type of dementia.
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Poster session
BIOL. PSYCHIATRY 1997:42: 15-2975
139-1 70 I Double blind randomized comparative study of sertrallne and fluoxetlne In depressive outpatient: Medico economic aspect J.-M. Danion', P. Boyer 2 , S. Troy 3, J. Hotton 3 . ' Unite INSERM U405 Hopitaux Universitaires de Strasbourg, France, 2,NSERM Hopital Sainte Anne, Paris, France, 3 Pfizer, Orsay. France The aim of the study was to compare the medico economic impact of sertraline (50 to 150 mgld) to fluoxatine (20 to 60 mgld) in patients with major depressive disorder according to DSM IV. Methods: Patients were evaluated at baseline, 4 and 6 months. Assess• ments included MADRS and CGI. Use of medical services, absences from work and productivity losses were recorded for calculation of direct and indirect costs from both societal and sickness insurance perspectives.
139-1721
• Sickness insurance l.
• Social costs _
Costs differential between seltra/ine and fluoxetine.
Results: A total 236 patients was included (116 sertraline and 115 f1uoxatine) in the intent to treat analysis. Statistically significant clinical improvement from baseline was observed in both treatment group with no differences between groups. Cost comparison per patient favored sertraline treatment from both the societal and sickness insurance viewpoints with costs differentials of 926 FF and 288 FF, respectively. The total cost per patient, over a 6 months course of the trial, from the societal and sickness insurance perspective was respectively of 7780 FF and 2936 FF for sertraline and 8706 FF and 3224 FF for f1uoxetine.
139-171 1 Depersonalization and high decline In concentration In Sheehan's syndrome - A case report H. Hotta " Y. Nakamura 1, M. Hashimoto 2. ' Department of Psychiatry, Yamaguchi Central Hospital, Yamaguchi, Japan, 2 Department of Neuropsychiatry, Yamaguchi University School of medicine, Yamaguchi, Japan There are various understandings about the psychotic symptoms in Shee• han's syndrome. Report: A 32-year-old woman gave birth to her eldest daughter in normal delivery when she was 26. However, she later experienced two miscamages. Atter that, her vaginal bleeding pattem became irregular and hypogalactia and general fatigue arose. Furthermore, because depersonal• ization and confusion appeared, she visited our hospital on February 9th, 1996. Depersonalization disappeared by ingestion of sulpiride. However, high decline in concentration, blunted affect and indifference arose, and the feeling of deep sleep disappeared. Low basal growth hormone (GH) concen• tration with the examination of endocrine secretion was shown. And because of low luteinizing hormone, follicle-stimulating hormone and no GH secre• tion, the results of the examination were judged as partial hypopituitarism. Therefore, the patient was diagnosed as Sheehan's syndrome. Comment: It is possible that subclinical pituitary necrosis with partial hypopituitarism could have been the causative factor in this case.
case
Clinical characteristics and phenomenology of psychosis In postpartum
A. Damjanovic ' , C.D. Miljevic 2, V.A. Paunovic 1. 'Institute for psychialTy. Belgrade Clinical Center, Belgrade, Yugoslavia, 2 Special Psychiatnc hospital "dr L. Lazarevic· Belgrade, Yugoslavia In this study is presented clinical analysis of parameters in 30 WOfnIIn with first psychotic disorder in postpartum period. All these patients went treated in Department for Psychosis of Psychiatric Clinic University ClinicIII center in Belgrade. According to DSM-IV criteria affective psychosis went prevalent and they were registered in 21 (70%) patients, while sch~ pictures were evidently in only 3 (10%) of woman. In complex of postpartum psychotic disorders was separated a group of 6 (20%) patients with paranoid and depressive syndromes. All these psychotic disorders were registered during first four weeks of puerperal period. All patients were observed clinically during period of five years. Good remission is obtained in 8 (26.7%) patients and chronically course with recidivity of psychosis is evidenced in 22 (73.3) patients. These results that are presented in this study, are one more contribution to detailed perceive of mental disturbances in woman in puerperium.
139-1731 Total Indir Direc Hosp Medi Para Medi Addit costs ect Is ita Is cal medi cines ional
n
Effect of tacrine on active avoidance in rata
D. Getova, V. Spassov' . Department Pharmacol. Taxicol., MBdicaJ University Plovdiv, BUlgaria, ' Department Pharmoco/., Faculty Human Medicine, Trakia University. Stars Zagors, Bulgaria Tacrine (Tacr) (9-amino-l,2,3,4-tetrahydroacridine hydrochloride) is well known drug used in treatment of Alzheimer's disease. We studied its effect using two way active avoidance (shuttle box) in rats. Method: Male Wistar rats (220-250 g) (8 per group) were used. Rats were injected with lacrine at doses of 0, 0.1, 0.5 and 1 mglkg i.p. 30 min before placing in a shuttle box. It was used the two-way PUnisllment reinforced active avoidance method (shuttle box). The training procedure by Gozzani and Izquierdo (1976) according to which the rats were trained in. conventional shuttle box (Ugo Basile) with 30 trials each day 5 days Ie8ming session and 7 days alter last training (12th day) a single retention S8S8icln with 30 trials was made. The stimulus employed was 6 sec light and buzzer (70 dB-Hl70 Hx) followed by 3 sec 0.4 mA footshock. We observed numbers 01: (1) correct responses, i.e. avoidances, (2) escapes from footshoacs., (3) footshocks, (4) Intertrial crossings, (5) latency of reactions. A ~ ANOVA was used for statistics. Results: The rats treated with tacrine at doses 0.5 and 1 mglkg signlficanlly increased the number of avoidances alter 3rd day of learning S88SIon compared to the controls. The number of escapes was not signiflcllnlly increased. In the retention session the group treated with 0.5 mglkg tacrine shown more avoidances than controls. We found dose-relationship in the effects of tacrine on leaming. Nevertheless it can be concluded that lhis compound is able to improve learning and memory retention in the aVOidance paradigm.
139-1741
Association between presenilin-1 (5182) gene polymorphism and Alzheimer's disease In the Spanish population
K. Beyer, J.1. Lao, MA Sellers, X.A. Alvarez, A. Cacabelos. EuroEspes Biomedical Research Center, BergOndo, La Coruna, Spain Alzheimer'S disease (AD) is a genetically heterogeneous disorder With four different genes implicated in its ethiopathogenesis: the APP gene on cromosome 21, the APOE gene on chromosome 19, Sl82 (ptesenilin 1 gene) on chromosome 14 and STM2 on chromosome 1 (presenilin 2 gene). Mutations in the presentlin 1 (PS-l) gene cause a significant proportion of earty-onset, autosomal dominant Alzheimer's disease. In this regard, an association between variation in an intronic polymorphism situated 3' of exon 9 of the P5·1 gene and late-onset AD (LOAD) was reported. In the PteSent study we studied the allele frequencies of both alleles described for the 5182 intronic polymorphism in the following groups: (1) Senile dementia (N = 203), and (2) age-matched healthy controls (N = 200). Dementia SUbtypes were: (1.1) earty-onset AD (N 49; age: 59.9 ± 6.2 years), (1.2) late-onsec AD (N 73; age: 72.3 ± 8.0 years), (1.3) Vascular Dementia (N 56' age' 73.1 ± 7.2 years) and (1.4) Mixed Dementia (N 25; age: 70.2 ± 5.9 ~): We conclude that allele 1 of the 5182 intronic polymorphism is associated with AD, but it does not seem to be linked to any other type of dementia.
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