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Organic disorders as risk factors for neuroleptic malignant syndrome (NMS)
88S
Biological psychiatry
BIOL. PSYCHIATRY 1997;42:15-297S
from 2-6 hz and 14-30 hz the multisource problem of localizing spontaneous activity was handled by the Dipol Density Plot (DDP), a temporal Integration of results showing concentrations of dipoles in a standardized form. The DDP results were Inserted in form of isocontour lines of the activity's distribution Into MRI slices using a transformation obtained by a contour fil algorithm. Results: In male patients the center of the slow and the fast activity were in most cases (7 of 9 n%) In close topographical relation to the temporoparietal region of the left and right hemisphere. The localisation of slow and fast wave activity in female patients and in the control group was widely distributed over both hemispheres including the temporoparietal region, but also in the frontal, occipital and central region. Conclusion: The concentration of slow and fast waves in the temporopari• etal region In male schizophrenics was significantly correlated to the earlier first onset and the longer duration of illness.
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137-61 and Psychopathological aspects of huntington's disease correlations with motor and cognitive Impairment: A study of patients and relatives L Barina' , C. Nespolo 1, L Barzaghl 2 , R. Alberti' , M. Longhinl' , M.L. Manzone', B.lappacosta 3, F. Girotti 3, M. Mantero '.4, T. Caraceni 3 , G. Penatl'. '/nstilute of Psychiatry. University of Milan. IRCCS Ospeda/e Maggiore. Milan, Italy. 4 A. USSL 38, Milan, 3 National Neurological Institute "C. Besta". Milan, Italy. 21nstilute of Psychiatry. University of Modena, Italy Huntington'S Disease (HD) is a degenerative disorder of the central nervous system, Involving structures of the basal ganglia (caUdate nucleus and putamen), transmitted as an autosomal dominant disease and characterized by choreic movements, progressive dementia and psychiatric disorders, such as psychosis, depression and personality changes. In this study we analysed the relations between motor-eognitive disorders and psychiatric symptoms In a group of patients suffering from HD and a group of healthy relatives, at risk for HD. Statistical analysis was carried out by means of Pearson's correlation. Our population consisted of 60 subjects, divided In the two groups of patients (38) and their relatives (22). Every subject received a motor and cognitive evaluation, by means of a series of tests, both neurological and neuropsychological. Psychiatric assessment involved: 1. Brief Psychiatric Rating Scale (BPRS); 2. Hamilton Anxiety Scale (HAM-A); 3. Hamilton Psy• chiatric Rating Scale for Depression (HAM-D); 4. Scale for the Assessment of Positive Symptoms of Schizophrenia (SAPS); 5. Scale for the Assessment of Negative Symptoms of Schizophrenia (SANS). The results show, within the group of patients, a significative direct correlation between motor impairment and anxiety degree and moreover an Inverse correlation between cognitive performances and the degree of anxiety, depression and negative symptoms of schizophrenia.
137.71 Organic disorders as risk factors for neuroleptic malignant syndrome (NMS) St. Theodoropoulou, D. Chryssovergi ' , K. Karetsou, C. Leotsakou, A. Valdakls, J. Economidou '. Department of Psychiatry. , Department of Immunology and Histocompatibility. Evangelismos Hospital, Athens, Greece NMS is a rare but potentially fatal reaction associated with antipsychotic drugs. Review of clinical observations of patients with NMS allows for systematic analysis of critical clinical issues as well as for exploration of risk factors of the syndrome. Ten (n = 10) medicated psychotic patients
referred to our consultation-liaison psychiatric service and diagnosed witIh NMS (according to Levenson criteria) were enrolled In our study. Patients receiving antipsychotics, manifesting extrapyramidal side effects and having elevated serum creatine kinase (CK) levels were excluded. Of the ten patients with NMS, five were found to have an underlying organic disorder. One suffered from anaemia and malnutrition, two were found to have a cerebral disorder (Parkinson's disease and frontal lobe hygroma), and In the other two immunological abnormalities were detected (autoantibodies and decreased serum IgA levels). Conclusion: The coexistence of NMS and an organic dlsonder In half of our patients suggests that the latter Is likely to predispose patients under neuroleptic treatment to this life-threatening syndrome.
137 81 depression Endocrine and behavioural responses to naloxone In 0
A. Barocka ' , E.S. Paykel 2 , J. Herbert 2, A. Grossman 3. ' University of Erlangen, Germany. 2 University of Cambridge, UK, 3 St. Bartholomew's Hospital, UK It has been hypothesised that opioidergic mechanisms are Involved in the hypothalamic-pituitary-adrenal hyperactivity among depressives. We there• fore, in a double-blind cross-over design, studied 10 drug-free In-patients with severe Major Depressive Disorder (ROC) and 10 matched controls, using 1 mglkg naloxone (or saline) as a challenge and cortisol (plasma and salivary) and ACTH as indicators of central opiodergic activity. Naloxone increased plasma cortisol levels significantly, both In patients and controls (F = 10.5, P < 0.001), reaching maxima at 60 minutes after Infusion. However. there was no significant difference between the two groups of subjects rj 0.27, P N.S.). ACTH also Increased significantly after naloxone (F. 2.7, P < 0.03); again there was no significant difference between patients and controls (F .. 0.4, P N. S.). In summary, these data on the effect of hlgh-close naloxone on the HPA axis of depressed patients do not show any clear difference In responsiveness from normal controls. Our study does not support the notion that changes In central oploid tone are demonstrable In patients with depressive illness.
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137-91 stress Ego defense mechanisms predicting posttraumatic disorder Ph. Blrmes, P.-A. Delpla, B. Wamer, Ph. Cadilhac, L. Schmitt. H6pital de Casselardit, CHU Purpan, Toulouse, France The aim of this abstract is to evaluate the Ego defense mechanisms predicting the developpment of PTSD. Methods: Victims of traumatic events were recruited from a QeneraI university hospital. 25 participants completed the Impact of Event Scale 01 Horowitz. According DSM-IV criteria and results of IES, 10 were diagnosed as PTSD and compared to 15 not considered as PTSD. All t1he subjects completed the Defense Style Questionnaire 40 (Andrews et at., 1993) in order to appreciate the different mechanisms ranked in three levels: mature, neurotic and immature. Results: Among PTSD subjects reaction formation appears significantly higher from non PTSD. Reaction formation Is Included In neurotic defenses. All other mechanisms, suppression, acting out and denial did not differ. These findings suggest that Ego defense mechanisms may be Indicative of risk for the development of posttraumatic symptoms after exposure. Further studies are Indicated in order to check correlations between defenses and psychophysiological responses to stress.
Biological psychiatry
BIOL. PSYCHIATRY 1997;42:15-297S
from 2-6 hz and 14-30 hz the multisource problem of localizing spontaneous activity was handled by the Dipol Density Plot (DDP), a temporal Integration of results showing concentrations of dipoles in a standardized form. The DDP results were Inserted in form of isocontour lines of the activity's distribution Into MRI slices using a transformation obtained by a contour fil algorithm. Results: In male patients the center of the slow and the fast activity were in most cases (7 of 9 n%) In close topographical relation to the temporoparietal region of the left and right hemisphere. The localisation of slow and fast wave activity in female patients and in the control group was widely distributed over both hemispheres including the temporoparietal region, but also in the frontal, occipital and central region. Conclusion: The concentration of slow and fast waves in the temporopari• etal region In male schizophrenics was significantly correlated to the earlier first onset and the longer duration of illness.
=
137-61 and Psychopathological aspects of huntington's disease correlations with motor and cognitive Impairment: A study of patients and relatives L Barina' , C. Nespolo 1, L Barzaghl 2 , R. Alberti' , M. Longhinl' , M.L. Manzone', B.lappacosta 3, F. Girotti 3, M. Mantero '.4, T. Caraceni 3 , G. Penatl'. '/nstilute of Psychiatry. University of Milan. IRCCS Ospeda/e Maggiore. Milan, Italy. 4 A. USSL 38, Milan, 3 National Neurological Institute "C. Besta". Milan, Italy. 21nstilute of Psychiatry. University of Modena, Italy Huntington'S Disease (HD) is a degenerative disorder of the central nervous system, Involving structures of the basal ganglia (caUdate nucleus and putamen), transmitted as an autosomal dominant disease and characterized by choreic movements, progressive dementia and psychiatric disorders, such as psychosis, depression and personality changes. In this study we analysed the relations between motor-eognitive disorders and psychiatric symptoms In a group of patients suffering from HD and a group of healthy relatives, at risk for HD. Statistical analysis was carried out by means of Pearson's correlation. Our population consisted of 60 subjects, divided In the two groups of patients (38) and their relatives (22). Every subject received a motor and cognitive evaluation, by means of a series of tests, both neurological and neuropsychological. Psychiatric assessment involved: 1. Brief Psychiatric Rating Scale (BPRS); 2. Hamilton Anxiety Scale (HAM-A); 3. Hamilton Psy• chiatric Rating Scale for Depression (HAM-D); 4. Scale for the Assessment of Positive Symptoms of Schizophrenia (SAPS); 5. Scale for the Assessment of Negative Symptoms of Schizophrenia (SANS). The results show, within the group of patients, a significative direct correlation between motor impairment and anxiety degree and moreover an Inverse correlation between cognitive performances and the degree of anxiety, depression and negative symptoms of schizophrenia.
137.71 Organic disorders as risk factors for neuroleptic malignant syndrome (NMS) St. Theodoropoulou, D. Chryssovergi ' , K. Karetsou, C. Leotsakou, A. Valdakls, J. Economidou '. Department of Psychiatry. , Department of Immunology and Histocompatibility. Evangelismos Hospital, Athens, Greece NMS is a rare but potentially fatal reaction associated with antipsychotic drugs. Review of clinical observations of patients with NMS allows for systematic analysis of critical clinical issues as well as for exploration of risk factors of the syndrome. Ten (n = 10) medicated psychotic patients
referred to our consultation-liaison psychiatric service and diagnosed witIh NMS (according to Levenson criteria) were enrolled In our study. Patients receiving antipsychotics, manifesting extrapyramidal side effects and having elevated serum creatine kinase (CK) levels were excluded. Of the ten patients with NMS, five were found to have an underlying organic disorder. One suffered from anaemia and malnutrition, two were found to have a cerebral disorder (Parkinson's disease and frontal lobe hygroma), and In the other two immunological abnormalities were detected (autoantibodies and decreased serum IgA levels). Conclusion: The coexistence of NMS and an organic dlsonder In half of our patients suggests that the latter Is likely to predispose patients under neuroleptic treatment to this life-threatening syndrome.
137 81 depression Endocrine and behavioural responses to naloxone In 0
A. Barocka ' , E.S. Paykel 2 , J. Herbert 2, A. Grossman 3. ' University of Erlangen, Germany. 2 University of Cambridge, UK, 3 St. Bartholomew's Hospital, UK It has been hypothesised that opioidergic mechanisms are Involved in the hypothalamic-pituitary-adrenal hyperactivity among depressives. We there• fore, in a double-blind cross-over design, studied 10 drug-free In-patients with severe Major Depressive Disorder (ROC) and 10 matched controls, using 1 mglkg naloxone (or saline) as a challenge and cortisol (plasma and salivary) and ACTH as indicators of central opiodergic activity. Naloxone increased plasma cortisol levels significantly, both In patients and controls (F = 10.5, P < 0.001), reaching maxima at 60 minutes after Infusion. However. there was no significant difference between the two groups of subjects rj 0.27, P N.S.). ACTH also Increased significantly after naloxone (F. 2.7, P < 0.03); again there was no significant difference between patients and controls (F .. 0.4, P N. S.). In summary, these data on the effect of hlgh-close naloxone on the HPA axis of depressed patients do not show any clear difference In responsiveness from normal controls. Our study does not support the notion that changes In central oploid tone are demonstrable In patients with depressive illness.
=
=
=
137-91 stress Ego defense mechanisms predicting posttraumatic disorder Ph. Blrmes, P.-A. Delpla, B. Wamer, Ph. Cadilhac, L. Schmitt. H6pital de Casselardit, CHU Purpan, Toulouse, France The aim of this abstract is to evaluate the Ego defense mechanisms predicting the developpment of PTSD. Methods: Victims of traumatic events were recruited from a QeneraI university hospital. 25 participants completed the Impact of Event Scale 01 Horowitz. According DSM-IV criteria and results of IES, 10 were diagnosed as PTSD and compared to 15 not considered as PTSD. All t1he subjects completed the Defense Style Questionnaire 40 (Andrews et at., 1993) in order to appreciate the different mechanisms ranked in three levels: mature, neurotic and immature. Results: Among PTSD subjects reaction formation appears significantly higher from non PTSD. Reaction formation Is Included In neurotic defenses. All other mechanisms, suppression, acting out and denial did not differ. These findings suggest that Ego defense mechanisms may be Indicative of risk for the development of posttraumatic symptoms after exposure. Further studies are Indicated in order to check correlations between defenses and psychophysiological responses to stress.