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A study on the relationship between circulating-NK-cell and personality characteristics in neurotic patients
199
P Poster Presentations syndrome,the percent of CD3+cells was reduced as comparedto negative syndrome group(p < 0.05) and controls (p < 0.05) respectively, whilethe percent of CD8+ cells was lowered (p < 0.05) as compared to controls. In summary, these results indicate that altered immunity does not appear to be a specific biologic correlate of the major mental illnesses but may occur as an epiphenomenon.
I P-21-21
A Studyon the Relationship Between Circulating-NK-Cell and Personality Characteristics in Neurotic Patients
D.E. Park, C.H. Lee, J.K. Lee, K.H. Lee. Department of Neuropsychiatry, Chung Ang University Hospital, Seoul, Korea This study is based on the hypothesis that not only the stress itself but the personality -traits or coping style of the individual who receives such stress affects the immune system. Thus, we concentrated on the relationship between the personality traits/coping style and the immune system using the already-widely-used NK cell as an indicator to show potential changes in the immune system. The subjects of this study consisted of those neurotic inpatients who admitted to Chung Ang university hospital and Yong San hospital between 1/9/94 and 31/]/95. The patient population consisted of 40 males and 40 females. And the Normal Control Group consisted of 40 males and 40 females. To assess the circulating-NK-cells level, blood samplings were done. And then, after having been kept at a room temperature for two hours, the quantitative analyses were done on these samples using BectonDickinson FACS system. For each of the Normal Control Group and the Neurotic Patients Group, the percentage of circulating-NK-cells in serum was measured once. And to assess the personality characteristics of the subjects a questionnaire containing such questions as depression scale, anxiety scale, repression sensitivity scale and life-stress-coping style scale was given to them. The collected data was processed through SPSS program and analyzed through t-test. The results were as follows. The first, the percentage level of the circulating-NK-cells of the Neurotic Group was lower than that of the Normal Control Group. The second, the levels of circulating-NK-cells were negatively correlated with the scores of repression-sensitivity scale and maladaptive coping scale. The study showed that the immune function was lower in the Neurotic Group compared to the Normal Control Group. While personality traits of the Normal Control Group did not seem to have been affected, those of the Neurotic Group seem to have been affected. In NeuroticGroup, maladaptive coping style and repression of emotions contributed to lowering of the immune function of the subjects.
IP-21-31 Concurrent Treatment with Verapamil Decreases
Immune Response to Cannabimimetic Anandamide
A. Sulcova. Department of Pharmacology, Faculty ofMedicine, Masaryk University, Brno, Czech Republic
Cellular effects of cannabinoids include an influence on immunity [I J and inhibition of calcium channels [2]. Therefore, the present study investigated kinetics of the intensity of zymosan-induced luminol-aided chemiluminescence of mouse leukocytes (reflecting their phagocytic activity) after the I week treatment with the endogenous cannabimimetic anandamide [3] or calcium channel blocker verapamiland their combination. Anandamide elicited a biphasic dose-related effect on phagocytosis: the significant stimulation at the dose of 0.01 mglkg and inhibition at the dose of 10.0 rng/kg, Verapamil alone at the dose of I mg/kg did not change phagocytosis, however, when given concurrently with anandamide it prevented both, the stimulatory and inhibitory effects of anandamide.The molecular bases of this antagonistic interaction as well as of anandamide biphasic action are not clear yet, likewisethose found similarly in behaviouraltesting [4]. [I] Friedman H, er al.. in Psychoneuroimmunology, ed: Ader R, et al., Academic Press (1992) 936-953 [2] MacKie K, er al., Mol. Pharmacol. 44 (1993) 498-503 [3] De Devane WA, er al., Science 258 (1992) 1946-1949 [4] Sulcova A, et al., Behav. Pharmacol. 6 Supp!. I (1995) 92
I P-22-1 I Patients Selection in Clinical Trials with Antipsychotics M. Hummer, R. Huber, T. Walch, WW Fleischhacker. Dept. of Biological Psychiatry, lnnsbruck; Austria
Many schizophrenic patients, who are screened for trials with investigational antipsychotics cannot be included into these studies. Recent phase III trials have reinforced the concern that the patients included in these studies represent a highly selected population. These would make generalizability of the results obtained doubtful. In order to characterize a potential selection bias we are currently investigating all schizophrenic patients admitted to our inpatient units. Reasons for non-eligibility for a clinical trial (f.i. acuity of symptom, suicidal ideation, non-response to ~tipsychotics, concomitant illnesses) are documented. This group of patients IS then compared to another one, which can be included into a clinical trial. Demographic and illness related variables are used to analyse group differences.
I P-22-21
Typical Antipsychotics: TheThreshold Doses Strategy
H.A. Ortega-Soto, E. Brunner, R. Apiquian, M.P.de la Torre, R.E. Ulloa. Division of Clinical Research, Mexican Institute of Psychiatry, Mexico D.F., Mexico
The efficacy of conventional neuroleptics in the treatment of schizophrenia is out of question. What is of relevant importance is to determine the minimum effective dose by which a patient will achieve the maximum therapeutic advantage with minimum or no side-effects. This strategy will favor treatment compliance and will eventually diminish the high social and personal cost of this disease. In order to explore if threshold doses (ie. minimal extrapyramidal symptoms, EPS;TD), sub-threshold doses (no EPS; STD) and convention~1 doses (CD) of ~ifluoperazine (TFZ) are equally effective, we carried out a double-blind clinical trial. We included patients with a DSM-III-R diagnosis of acute schizophrenia and who were free of neuroleptic treatment for at least 4 weeks prior to the study. The TD was determined for each patient starting with an initial dose of 5 mg/day of TFZ, increments were realized weekly until the first signs of EPS appeared (DiMascio's Scale), if a patient improved- i.e. 35% or greater disminution from their basal score of the PANSS - without clinical evidence of EPS, he or she continued in the study with this dose. Patients who reached their TD were randomly assigned to either 2 treatment groups: 30 mg/day of TFZ or identical capsules of placebo plus their TD. The duration of the clinical trial was 6 weeks, once the patient was assigned to any of the treatment groups he or she - could receive up to 12 mg/day of biperiden to treat EPS. A total of 20 patients received their TD, 20 patients received their TD plus TFZ and 57 patients were treated with their STD. Wefound no differences between groups in age (mean ± sd 30.4 ± 9.4 years, 29.8 ± 8.1, and 20.8 ± 6.3 respectively) or PANSS basal scores (31.0 ± 5.8, 33,6 ± 6.5, and 30.6 ± 4.5). For comparisons, repeated measures ANOVA and Student's "t" with Bonferroni's correction were performed. At the end of the trial we found no differencesbetween groups in psychopathology severitybut the scores in the DiMascio's Scale were significantly lower in the TD and STD groups. Our results indicate that TD and STD are as equally effective, but EPS are less severe. These dosing strategies appear to be a better alternativein the treatment of schizophrenic patients.
I P-22-31Interrater Reliability and the PANSS -
WhatDoes It Tell Us About Efficacy in Neuroleptic Trials?
TJ.R. Lambert. University Dept. Psychiatry, Mills Street CRU, Bentley, .
A~~
Thi.s study aimed to look at the assumption that changes in psychopathological symptoms of schizophrenia, the primary measure of efficacy in most neuroleptic trials, are measured reliably with use of the Positive and Negative Syndrome Scale (PANSS). PANSS training for atypical neuroleptic research in Australia has recently employed a series of local tapes with 'standard' ratings set by consensus between principal raters
P Poster Presentations syndrome,the percent of CD3+cells was reduced as comparedto negative syndrome group(p < 0.05) and controls (p < 0.05) respectively, whilethe percent of CD8+ cells was lowered (p < 0.05) as compared to controls. In summary, these results indicate that altered immunity does not appear to be a specific biologic correlate of the major mental illnesses but may occur as an epiphenomenon.
I P-21-21
A Studyon the Relationship Between Circulating-NK-Cell and Personality Characteristics in Neurotic Patients
D.E. Park, C.H. Lee, J.K. Lee, K.H. Lee. Department of Neuropsychiatry, Chung Ang University Hospital, Seoul, Korea This study is based on the hypothesis that not only the stress itself but the personality -traits or coping style of the individual who receives such stress affects the immune system. Thus, we concentrated on the relationship between the personality traits/coping style and the immune system using the already-widely-used NK cell as an indicator to show potential changes in the immune system. The subjects of this study consisted of those neurotic inpatients who admitted to Chung Ang university hospital and Yong San hospital between 1/9/94 and 31/]/95. The patient population consisted of 40 males and 40 females. And the Normal Control Group consisted of 40 males and 40 females. To assess the circulating-NK-cells level, blood samplings were done. And then, after having been kept at a room temperature for two hours, the quantitative analyses were done on these samples using BectonDickinson FACS system. For each of the Normal Control Group and the Neurotic Patients Group, the percentage of circulating-NK-cells in serum was measured once. And to assess the personality characteristics of the subjects a questionnaire containing such questions as depression scale, anxiety scale, repression sensitivity scale and life-stress-coping style scale was given to them. The collected data was processed through SPSS program and analyzed through t-test. The results were as follows. The first, the percentage level of the circulating-NK-cells of the Neurotic Group was lower than that of the Normal Control Group. The second, the levels of circulating-NK-cells were negatively correlated with the scores of repression-sensitivity scale and maladaptive coping scale. The study showed that the immune function was lower in the Neurotic Group compared to the Normal Control Group. While personality traits of the Normal Control Group did not seem to have been affected, those of the Neurotic Group seem to have been affected. In NeuroticGroup, maladaptive coping style and repression of emotions contributed to lowering of the immune function of the subjects.
IP-21-31 Concurrent Treatment with Verapamil Decreases
Immune Response to Cannabimimetic Anandamide
A. Sulcova. Department of Pharmacology, Faculty ofMedicine, Masaryk University, Brno, Czech Republic
Cellular effects of cannabinoids include an influence on immunity [I J and inhibition of calcium channels [2]. Therefore, the present study investigated kinetics of the intensity of zymosan-induced luminol-aided chemiluminescence of mouse leukocytes (reflecting their phagocytic activity) after the I week treatment with the endogenous cannabimimetic anandamide [3] or calcium channel blocker verapamiland their combination. Anandamide elicited a biphasic dose-related effect on phagocytosis: the significant stimulation at the dose of 0.01 mglkg and inhibition at the dose of 10.0 rng/kg, Verapamil alone at the dose of I mg/kg did not change phagocytosis, however, when given concurrently with anandamide it prevented both, the stimulatory and inhibitory effects of anandamide.The molecular bases of this antagonistic interaction as well as of anandamide biphasic action are not clear yet, likewisethose found similarly in behaviouraltesting [4]. [I] Friedman H, er al.. in Psychoneuroimmunology, ed: Ader R, et al., Academic Press (1992) 936-953 [2] MacKie K, er al., Mol. Pharmacol. 44 (1993) 498-503 [3] De Devane WA, er al., Science 258 (1992) 1946-1949 [4] Sulcova A, et al., Behav. Pharmacol. 6 Supp!. I (1995) 92
I P-22-1 I Patients Selection in Clinical Trials with Antipsychotics M. Hummer, R. Huber, T. Walch, WW Fleischhacker. Dept. of Biological Psychiatry, lnnsbruck; Austria
Many schizophrenic patients, who are screened for trials with investigational antipsychotics cannot be included into these studies. Recent phase III trials have reinforced the concern that the patients included in these studies represent a highly selected population. These would make generalizability of the results obtained doubtful. In order to characterize a potential selection bias we are currently investigating all schizophrenic patients admitted to our inpatient units. Reasons for non-eligibility for a clinical trial (f.i. acuity of symptom, suicidal ideation, non-response to ~tipsychotics, concomitant illnesses) are documented. This group of patients IS then compared to another one, which can be included into a clinical trial. Demographic and illness related variables are used to analyse group differences.
I P-22-21
Typical Antipsychotics: TheThreshold Doses Strategy
H.A. Ortega-Soto, E. Brunner, R. Apiquian, M.P.de la Torre, R.E. Ulloa. Division of Clinical Research, Mexican Institute of Psychiatry, Mexico D.F., Mexico
The efficacy of conventional neuroleptics in the treatment of schizophrenia is out of question. What is of relevant importance is to determine the minimum effective dose by which a patient will achieve the maximum therapeutic advantage with minimum or no side-effects. This strategy will favor treatment compliance and will eventually diminish the high social and personal cost of this disease. In order to explore if threshold doses (ie. minimal extrapyramidal symptoms, EPS;TD), sub-threshold doses (no EPS; STD) and convention~1 doses (CD) of ~ifluoperazine (TFZ) are equally effective, we carried out a double-blind clinical trial. We included patients with a DSM-III-R diagnosis of acute schizophrenia and who were free of neuroleptic treatment for at least 4 weeks prior to the study. The TD was determined for each patient starting with an initial dose of 5 mg/day of TFZ, increments were realized weekly until the first signs of EPS appeared (DiMascio's Scale), if a patient improved- i.e. 35% or greater disminution from their basal score of the PANSS - without clinical evidence of EPS, he or she continued in the study with this dose. Patients who reached their TD were randomly assigned to either 2 treatment groups: 30 mg/day of TFZ or identical capsules of placebo plus their TD. The duration of the clinical trial was 6 weeks, once the patient was assigned to any of the treatment groups he or she - could receive up to 12 mg/day of biperiden to treat EPS. A total of 20 patients received their TD, 20 patients received their TD plus TFZ and 57 patients were treated with their STD. Wefound no differences between groups in age (mean ± sd 30.4 ± 9.4 years, 29.8 ± 8.1, and 20.8 ± 6.3 respectively) or PANSS basal scores (31.0 ± 5.8, 33,6 ± 6.5, and 30.6 ± 4.5). For comparisons, repeated measures ANOVA and Student's "t" with Bonferroni's correction were performed. At the end of the trial we found no differencesbetween groups in psychopathology severitybut the scores in the DiMascio's Scale were significantly lower in the TD and STD groups. Our results indicate that TD and STD are as equally effective, but EPS are less severe. These dosing strategies appear to be a better alternativein the treatment of schizophrenic patients.
I P-22-31Interrater Reliability and the PANSS -
WhatDoes It Tell Us About Efficacy in Neuroleptic Trials?
TJ.R. Lambert. University Dept. Psychiatry, Mills Street CRU, Bentley, .
A~~
Thi.s study aimed to look at the assumption that changes in psychopathological symptoms of schizophrenia, the primary measure of efficacy in most neuroleptic trials, are measured reliably with use of the Positive and Negative Syndrome Scale (PANSS). PANSS training for atypical neuroleptic research in Australia has recently employed a series of local tapes with 'standard' ratings set by consensus between principal raters