Serum lipids : new biological markers in depression ?

Several studies suggest that a low cholesterol concentration is associated with depression. The authors sought to determine whether an association exists between serum lipid concentrations and depression. 28 drug-naive patients of major depression diagnosed according to DSMlll- R criteria were included in the study and severity of depression was measured on Hamilton Rating Scale for Depression. Suicidal intent was assessed on Suicidal Intent Questionnaire. 28 normal healthy controls were selected and matched for age, sex and body-mass index with the depressives. Serum lipid estimations were done in each subject after 12 hours overnight fasting. The main finding of the study is that total serum cholesterol, serum triglycerides and serum LDL cholesterol are decreased while serum HDL cholesterol is increased in depression and these changes were more marked in depressed subjects with definite suicidal intent. On regression analysis, total serum cholesterol was the most important predictive variable of the severity of depression.

Active platelet 5-ht uptake in depressives treated with impramine and ect

Several studies have reported decreased platelet 5-HT uptake in patients of major depression. The present study was undertaken with the aim to study the active platelet 5-HT uptake in depressed patients and effect of treatment with imipramine/ECT on platelet 5-HT uptake in these patients. 30 patients of major depression and equal number of age and sex-matched controls were included in the study. The depressives received imipramine (N=15) or ECT (N=15). Pretreatment active platelet 5-HT uptake was lower in depressives. Treatment with imipramine resulted in significant decrease in 5-HT uptake while with ECT there was significant increase. The serotonergic mechanisms are discussed.

Psychiatric sequelae of amputation : ii long term effects

Psychiatric sequelae present after 6 months to 2 years following amputation were studied in a group of 25 subjects. The subjects were screened on SCID, HRSD and HARS. The most common diagnoses were depressive disorder NOS (20.6%) and major depressive disorder (10.3%). Patients having right sided amputation were more psychiatrically ill than those with loss of a left limb. Phantom limb was seen in about two-thirds of the total sample-more in the sick group (about 88%) than in the non-sick group (about 55%). Pain in the phantom limb was seen more in the sick group, but telescopy and movement were more frequently complained of by subjects of the non-sick group.

Psychiatric sequelae of amputation : I immediate effects

Twenty-five subjects, who had undergone amputation within last 6 weeks, were studied for psychiatric complications, including phantom limb phenomena. The patients were interviewed on SCID, HRSD and HARS. Out of a total of 25 subjects, 8 (34.6%) developed psychiatric disorders - PTSD and major depression. The whole sample was thus divided into 2 groups-sick and nonsick. Phantom limb was seen in 88% subjects. No significant difference was present between the two groups with regard to presence of phantom, its associated phenomena of pain, telescopy and movement. A statistically significant difference was seen in psychiatric sickness in relation to upper and lower limb.

Ect and platelet 5ht uptake in major depression

Several studies have reported decreased platelet 5-HT uptake in patients of major depression. The mechanism of antidepressant action of ECT is not clear. The present work was undertaken with the aim to study the active platelet 5-HT uptake and the effect of ECT on it in patients of major depression. 15 patients of major depression (DSM-lll-R) and equal number of age and sex-matched controls were included in the study. Active platelet 5-HT uptake was determined before ECT, after a course of ECT and 7 days after last ECT. Platelet 5-HT uptake was. significantly lower in der essives than normal controls. After ECT treatment there was significant increase in 5-HT uptake which came down to pretreatment level after 1 week of last ECT. The effect of ECT on serotonergic system is discussed.

Psychosocial aspects of amputation

Twenty-five subjects were studied who had undergone amputation 6 months to 2 years prior to the time of assessment. The sample was divided into sick (those having psychiatric illness) and non-sick (those without any psychiatric illness) groups, and then compared for various life events following the amputation. It was seen that those who were labelled as psychiatrically sick had more work impairment, change in job, socioeconomic difficulties and social avoidance. The latter two factors were also significantly more in right upper limb amputees than the left upper limb amputees; no such difference existed between the upper and lower limb amputees.

Treatment of acute and transient psychotic disorders with low and high doses of oral haloperidol

The apparent rationale for the popular use of high doses of neuroleptics in psychotic patients is to increase the degree and speed of therapeutic response .However, several recent reports have questioned these claims. The present study was undertaken with the aim to compare the efficacy of high and low oral doses of haloperidol in the treatment of acute and transient psychotic disorders. The sample comprised of forty patients of both sexes diagnosed as acute and transient psychotic disorder who were randomly assigned to high dose (20 mg/day) and low dose (5 mg /day) haloperidol groups with equal number of subjects (n=20) in both groups. Weekly assessment was done on Brief Psychiatric Rating Scale and Haloperidol Side-effects Check List (day 7, 14, 21, 28, 35 & 42). Both groups showed significant improvement in BPRS from baseline scores on all assessments. Comparison of the improvement rate in both study groups revealed no significant difference.

Csf 5 - hiaa in violent and non-violent suicide attempters

Many studies have reported involvement of monoamine neurotransmission in suicide through measurement of serotonin and its main metabolite, 5-HIAA, in brain of suicide victims and in CSF of suicide attempters. 23 non-depressed non-psychotic suicide attempters and equal number of controls were selected, and all the subjects were screened on Cornell Medical Index. Suicide attempters were assessed on Risk-Rescue Rating Scale and were divided into non-violent suicide attempters (N= 12) and violent suicide attempters (N= II). CSF of all subjects was collected by lumbar puncture and CSF 5-HIAA was measured by high performance liquid chromatography with electro-chemical detector. Risk-rescue rating score was significantly higher in violent suicide attempters as compared to non-violent suicide attempters. Mean CSF- 5- HIAA was significantly lower in suicide attempters as compared to normal controls. Mean CSF 5-HIAA was significantly lower in violent suicide attempters as compared to non-violent suicide attempters.

A comparative study of side-effects of lithium, carbamazepine and haloperidol in acute mania

In an open trial on manic patients, side-effects of carbamazepine, lithium and haloperidol were evaluated weekly over a 4-week period. The total side-effects with the three drugs were not significantly different, but the rate of amelioration of the same was best for lithium and least for haloperidol. It was indicative that lithium was better tolerated drug than the other two.

A study of comorbidity in psychoactive substance dependence patients

The study assessed the lifetime prevalence of comorbidity in forty three DSM III-R opioid and alcohol dependent patients. A total lifetime prevalence rate of 60.5% was found. The results are discussed axis wise and compared with previous relevant studies. There was no significant difference in comorbidity between the opioid and alcohol Dependent groups. Comorbidity on both Axis I and II were high, but there was no significant difference in the presence of Axis I disorders between patients with and without personality disorders. The paper also reports upon the temporal relationships amongst the co-occurring psychiatric disorders.

Evaluation of suicidal risk in depressives and schizophrenics : a 2-year follow-up study

A very high prevalence of psychiatric morbidity among the persons attempting or committing suicide has been observed by several investigators (Barraclough et al, 1974; Beck et al, 1990; Drake et al, 1985). In a study of attempted suicide Morgan et al. (1975) reported neurotic depression in 52%, personality disorder in 29% functional psychosis in 12% and alcohol addiction in 10%. Silver et al. (1971) found 80% of the attempters having depressive features. Likewise, Barracloughf1974) found 93% of the suicide being mentally ill, depression accounting for 70%.

Immunoglobulins and viral antibodies in depressive patients

Patterns of serum and C.S.F. IgG, IgA and IgM, and haemagglutination inhibiting (HI) antibodies and complement fixing (CF) antibodies against rubella and cytomegaloviruses respectively and total CSF protein were investigated in 30 depressives, 20 each in neurological and surgical patients. Significant changes in total CSF protein and immunoglobulins in depressives and neurological patients in comparison to surgical subjects indicate an etiological similarity between the two groups. Failure to detect antibodies in C.S.F. of these subjects and statistically insignificant seropositivity refute the claim of viral hypothesis for depression but similar alterations in these body proteins in depressives and neurological patients raise other aetiological possibilities.

POST DEXAMETHASONE PLASMA cortisol LEVELS AS INDICATOR OF TRICYCLIC RESPONSE IN MAJOR DEPRESSION

Present study suggest that changes in response to the post dexamethasone plasma cortisol levels in the patients of major depression receiveing anti depressants (Imipramine and Amitryptyline) might represent a laboratory marker of clinical progress. We estimated post dexamethasone plasma cortisol levels weekly in thirty hospitalized patients during pro-treatment, post-treatment and drug free post-treatment wash out period. In most of the cases normalization of the post dexamethasone cortisol levels coincided with clinical improvement and failure to normalize was often associated with poorer clinical recovery. No significant difference was observed in the treatment response between imipramine and amitryptyline based on post dexamethasone plasma cortisol levels.

Oro-dental pattern in mentally retarded

The study was carried out in 25 mentally retarded children and compared with equal number of normal children. They were subjected to detailed psychiatric evaluation and dental examination. The dental anomalies were corroborated with cephalometric analysis of lateral cephalograms. It was concluded that all mentally retarded children had some dental abnormality in them in form of dental malocclusion, wide inter dental spaces, absence of teeth etc. We suggest early dental management for such patients for reinforcing their neuromuscular coordination modifying the mastication power, swallowing, speech, stomatognathic function and above all their facial profile for better social acceptance.

Relationship of immunoglobulins with the number & duration of schizophrenic episodes

The relationship of serum and CSF immunoglobulins with the number and duration of schizophrenic episodes was assessed in 40 schizophrenics. The mean IgA was increased in patients having 3 or more episodes as compared with those having the first episode (P less than 0.001). IgM showed a moderate increase in patients with the second episode and those having 3 or more episodes. IgG/TP per cent (IgG/total protein %) was found to be significantly increased in CSF of patients having the first episode, as compared with those having 3 or more episodes (P less than 0.001). IgG was increased (although insignificantly) in the CSF of patients with illness of five years duration as compared to patients having illness of one year duration or for illness between 1-5 yr. IgG/TP per cent was found to be significantly increased in patients having illness for 5 or more years when compared to patients having illness for less than 1 yr (P less than 0.001) and for 1-5 yr (P less than 0.01).

Effect of imipramine and ect on platelet mao activity in depressives

Platelet monoamine Oxidase (MAO) activity was estimated in 30 depressed patients treated with Imipramine or EGT over a period of 5 weeks and pretreatment and post treatment values were compared. Imipramine and ECT caused significant reduction of platelet MAO, which after 7 days washout period comes to the pretreatment level while subjects clinical status l remained unchanged. The percentage blockade in platelet MAO values by Imipramine and ECT was 51.40±13.43 and 34.73±24.27 respectively.

Factors associated with the course and outcome of schizophrenia in India. Results of a two-year multicentre follow-up study

The paper describes the two-year follow-up results from 323 out of 386 patients fulfilling a modified version of Feighner's criteria for diagnosis of schizophrenia, in Lucknow, Vellore, and Madras. There was remission in 66% of cases. Short duration of illness, consistent compliance with medication, positive attitudes of relatives and neighbours, absence of economic difficulties, increase in religious activities on the part of patients, a rural background, and a non-schizoid pre-morbid personality were associated with good outcome. Features of depression, dangerous behaviour, and absence of agitation were associated with poor outcome.

Post dexamethasone plasma cortisol levels in depressives treated with imipramine and electroconvulsive therapy

Sixty patients of endogenous depression and thirty normal controls were studied to find out the relationship of post dexamethasone plasma Cortisol levels (PDPC) and clinical improvement of endogenous depression inpatients treated with electroconvulsive therapy and imipramine. The PDPC levels in both the group of patients showed significant decrease with clinical improvement (Pre and post treatment PDPC values of ECT group was 20.7 ug/dl and 13.6 ug/dl while it was 17.9 ug/dl and 12.7 ug/dl respectively for the Imipramine group). A significant correlation was also found between PDPC and severity of illness (p< 0.001) in the both groups which indicates that PDPC levels is independent of treatment modality used.

Dexamethasone supression test in depressives treated with ect

A cohort of endogenous depressives and normal controls were studied to examine the role of DST in depressives treated with ECT. Weekly DST estimation was done and depression was assessed on HRS-D. 73.6% patients were found to be non suppressors as compared to controls in whom 16.7% were non suppressors. 60% DST positive patients showed clinical improvement while 50% DST negative did not show improvement. This proves the notion that DST is a state dependent biological marker of endogenous depressed state.

Lithium and renal functions

Thirty patients of affective disorder who were on lithium for a year and thirty patients on antidepressant were studied in detail for renal functions. Our observation is that lithium therapy does not lead to any deterioration in kidney functions. The results are discussed.

3H-spiperone binding in platelet membranes: a possible biological marker for schizophrenia

High-affinity-specific 3H-spiperone binding to platelet membranes was carried out in 30 schizophrenic patients, without prior antipsychotic medication, fulfilling the Research Diagnostic Criteria, and in 30 matched control subjects. The psychosis was rated on the Modified Brief Psychiatric Rating Scale. Compared with healthy subjects, schizophrenic patients had significantly higher 3H-spiperone binding due to a lower dissociation constant (38%), i.e. increased affinity. No significant difference was observed in the maximum number of binding sites (Bmax) between the two groups. It is our contention that 3H-spiperone binding to platelets may be a biological marker for schizophrenia.

Antianxiety effect of cannabis: involvement of central benzodiazepine receptors

The present work, involving clinical, behavioral, and biochemical studies, was undertaken to elucidate the probable mechanism of the observed antianxiety effects of cannabis. The population for the clinical study consisted of 50 male chronic cannabis users who were otherwise healthy and 50 matched controls. When evaluated on Taylor's Manifest Anxiety Scale (TMA), these subjects had low anxiety scores as compared with the controls. To explore the possible interaction of cannabis with the benzodiazepine receptors, behavioral and biochemical studies in mice were devised, involving acute and chronic cannabis administration. Behavioral study revealed that mice under chronic cannabis treatment scored significantly higher on foot shock-induced aggression, but this was significantly blocked by benzodiazepine receptor antagonist. Furthermore, chronic cannabis treatment significantly (p less than 0.001) increased the frequency of licking response periodically punished by shocks. This confirms the antianxiety effect of cannabis, which also appears to be mediated through a benzodiazepine receptor, as it was reduced significantly (p less than 0.001) by a benzodiazepine receptor blocker. Specific 3H-diazepam binding was carried out in frontal cortex to assess both the population and affinity of benzodiazepine receptors. Our results indicate that acute cannabis treatment has no significant effect, whereas chronic cannabis treatment significantly increased 3H-diazepam binding as compared with controls. Scatchard analysis further reveals that increased affinity is responsible for increased binding to these receptors. It is therefore our contention that the antianxiety effect of cannabis is mediated through central benzodiazepine receptors.

Dexamethasone suppression test for major depression

Overnight post dexamethasone plasma Cortisol levels were estimated in thirty patients of major depression and 30 controls. The cut-off point after which post dexamethasone plasma Cortisol level could be considered abnormal, in patients of major depression, has been worked out at 15 μg/dl in the present study. The results are discussed.

Platelet mao activity in chronic schizophrenia

Platelet MAO activity of 30 male drug free chronic schizophrenics (RDC), 30 male first degree relative of these patients and31 age matched male healthy controls was studied. Analysis of variance revealed that no significant differences existed between the three groups. There was high correlation between the enzyme activily of probands and first degree relatives. Presence or absence of auditory hallucinations, or paranoid features did not affect the enzyme activity significantly.

Lithium in affective disorders : a seven year observation of lithium clinic

Out of 692 patients registered in the lithium clinic, King George's Medical College, Lucknow, 122 patients suffering from affective disorders, receiving lithium for at least 6 months continuously, having had at least 5 serum lithium estimations done and having been evaluated at least once in 6 months while on follow-up, were analysed with a view to study the relapses. About one-third patients suffered no relapse while on lithium. The study revealed that longer the duration of lithium treatment lesser were the frequency, number, intensity and duration of manic/depressive relapses. Majority of patients were maintained on the lower side (0.5-0.8 mEq/L) of the usually recommended therapeutic range (0.6-1.2 mEq/L) for lithium prophylaxis. Commonly observed side effects include fine tremors, muscular weakness, polyuria, polydipsia and constipation. All the side effects were easily managed and none had a fatal sides-effect. A reappraisal in the light of existing literature of lithium prophylaxis on manic depressive psychosis is done.

Sexual behaviour in normal and neurotic females

Relationship of neurosis and sexual-behaviour has been a controversial issue to-date. This study was designed to explore (a) whether sexual dysfunctions are responsible for development of neurosis, (b) does neurosis affect sexual-behaviour. In the present study sexual-behaviour of 53 married female neurotics and 32 matched healthy controls was studied. Health subjects were screened by Corncell Medical Index. A sexual-behaviour questionnaire was administered to all subjects. Experimental subjects were enquired about the sexual behaviour at two periods (a) before the onset of neurotic illness, (b) after the co-commencement of neurotic illness. These observations were compared with those of healthy subjects as well as between the two periods. Sexual-behaviour of neurotics was no way different to that of healthy control before the onset of illness. However, after the commencement of illness experimental subjects showed significant decreases in sexual satisfaction (sexual adequacy) in comparison to their pre-illness sexual behavior as well as from that of healthy controls. These results tend to refute the first proposition of holding sexual disturbances responsible for development of neurotic-illnesses but support the notion of presence of sexual-disturbances during illness.

Immunoglobulin patterns in schizophrenic patients

Immunoglobulins G, M and A were estimated in serum and cerebrospinal fluid (CSF) of 30 schizophrenics, 20 neurological controls and 20 surgical controls. Significant increased levels of serum Ig A and M were detected in schizophrenics. An association was observed between increasing levels of serum IgA and IgM with the duration of disease and the number of episodes. CSF IgG/TP% was also significantly increased with the severity of the disease. On the basis of viral aetiology of schizophrenia it can be concluded that the increase in immunoglobulins synthesis might be due to the persistent antigenic stimulation.

Serum CPK levels in schizophrenics and their first degree relatives

Blood samples of 20 schizophrenic patients, 20 of their first degree relatives and 43 normal subjects, both male and female, were taken and serum CPK estimation was done by using colorimetric sigma procedure. The schizophrenics and their 1st degree relatives had shown a significantly higher mean +/- S.D. CPK levels of 31.25 +/- 21.6 and 16.15 +/- 4.7 Sigma Units respectively as compared to 11.16 +/- 3.38 Sigma Units in normals (Cal. t = 5.73, tab. t = 1.65 at df = 61 and P less than 05). A significant difference between the CPK levels of male and female of the three groups was found (P less than .05). The males of normal, Schizophrenics and 1st degree relatives had significantly higher mean +/- S.D. CPK levels of 12.65 +/- 3.05, 47.4 +/- 18.73 and 19.5 +/- 1.93 Sigma Units respectively as compared to levels of 9.45 +/- 2.94, 15.10 +/- 4.33 and 12.71 +/- 2.47 sigma units in females of the corresponding three groups (P less than .05). Males of the patients and 1st degree relatives had shown higher levels than the females. A highly significant and positive correlation was found between the mean serum CPK levels of Schizophrenic patients and their 1st degree relatives (Correlation coefficient (gamma yx) = 0.79).

Drug abuse in India: an overview with special reference to cannabis

The Indian literature related to drug abuse in general and Cannabis in particular has been reviewed and possible implications discussed. In this regard to solve the existing controversy, 50 pure chronic cannabis users were evaluated for their physical, mental, cognitive and socio economic functions and the results were compared with a matched control group. Results of this study did not reveal any impairment in these areas It is concluded that cannabis, in India, may not be as much injurious to health as has often been mentioned in Western Countries. Future areas of research have been suggested.

Neurosis and sexual behaviour in men

Relationship of neurosis and sexual behaviour has been a matter of dispute till date. In the present study sexual behaviour of 40 married neurotics and 22 matched healthy control males was studied. Sexual behaviour of neurotics was similar to control subjects before the commencement of neurotic illness. But after the onset of the neurotic illness subjects showed significant decrease in frequency of coitus, sexual satisfaction and sexual adequacy in comparison to their pre illness behaviour as well as from healthy controls.

Suicidal communication in psychiatric patients

In this enquiry a cross-sectional study of hospitalized psychiatric patients was undertaken to assess prevalence and nature of suicidal behaviour. We have been able to delineate these subjects into three categories i.e. non-communicators, partial communicators and definite communicators on the basis of their scores upon 31ucid.il intent questionnaire. A follow up study of these patients which is in progress may further provide knowledge about relationship between predictive criterion and their final outcome.

Psychiatric manifestations of cystecercosis : review of literature and case report

This article describes the report of a case of cerebral cystecercosis, diagnosed only after G. T. head scan, who presented primarily with a picture of an organic psychotic condition. The literature in relation to psychiatric aspects of cystecercosis is reviewed.