Change of immunoglobulins and complement factors in patients with self-injurious behaviour.

OBJECTIVE: As stress activates the inflammatory response system, and attempted suicide is connected with severe stress, we hypothesized that patients hospitalized for self-injurious behaviour have changed immunocompetence. METHOD: The concentration of immunoglobulins IgG, IgA, IgM, and the complement components C3 and C4 in 73 patients hospitalized for self-injurious behaviour was compared with those of 122 healthy controls. The immunoglobulins and complement were quantified by nephelometric technique. RESULTS: The levels of IgG and IgM were significantly lower, and the complement C3 and C4 were significantly higher in self-injurious patients compared with controls. This was valid in both genders and the effects did not interact with gender. CONCLUSIONS: This controlled study showed that the concentrations of immunoglobulins were reduced and complement components were increased in patients who are admitted to hospital for self-injurious behaviour.

[Occurrence of anxiety and depression in cancer patients. An investigation at the Norwegian Radium Hospital]. / Forekomst av angst og depresjon hos kreftpasienter. En punktprevalensundersøkelse ved det Norske Radiumhospital.

The prevalence of anxiety and depression was evaluated in 716 unselected hospitalised patients and out-patients seen at the Norwegian Radium Hospital using the Hospital Anxiety and Depression Scale (HADS), the EORTC QLQ-C33 and an ad hoc designed questionnaire, the latter assessing socio-demographic data and disease-related parameters. The prevalence of anxiety and depression was 13% and 9%, respectively, as assessed with the HADS. In the logistic regression analysis, none of the disease-related factors remained independent parameters predictive for psychiatric distress, whereas a history of previous psychiatric problems and impaired social life were correlated both with anxiety and depression. Female gender, impaired physical activity and impaired social role function were additional predictive parameters for anxiety, whereas fatigue predicted depression. Careful attention should be paid to cancer patients displaying these significant problems in order to diagnose and treat depression and anxiety disorders of clinical importance.

Prevalence of anxiety and depression in cancer patients seen at the Norwegian Radium Hospital.

The aim of this study was to investigate the prevalence of anxiety and depression in cancer patients seen at the Norwegian Radium Hospital, using the Hospital Anxiety and Depression Scale (HADS), the EORTC QLQ-C33 and an ad hoc designed questionnaire. In addition, information about the patients' malignant disease and treatment was obtained. The prevalence of anxiety and depression among 716 evaluable patients was 13% and 9% respectively, as assessed with HADS. In hospitalised patients, the risk of psychiatric distress was approximately twice that of patients in the outpatient clinic. Female patients reported significantly more anxiety than men. Patients < 30 or > 70 years old expressed less anxiety than all other patients. Age or gender had no influence on the occurrence of depression. Impaired ability to continue professional work and/or daily life activities, impaired social life and previous psychiatric problems were significantly correlated with anxiety and depression as were impaired physical function, fatigue and pain. The prevalence of depression, but not anxiety, increased in the presence of distant metastases, with less than a month since diagnosis, and with relapse or progression. In the logistic regression analysis, a history of previous psychiatric problems and impaired social life were correlated with both anxiety and depression. Female gender, impaired physical activity and impaired social role function were additional predictive parameters for anxiety, whereas fatigue predicted depression. Careful attention should be paid to cancer patients displaying these problems in order to diagnose and treat depression and anxiety disorders.

Inappropriate placement of residents in psychiatric nursing homes in Bergen, Norway.

The mental and physical capacities of all residents in psychiatric nursing homes in Bergen were studied. It was found that 95% were moderately or severely mentally impaired and 53% received antipsychotic medication regularly. By objective criteria, 47.9% were considered improperly placed. These patients typically had had a long stay in the institution, were immobile, and were given antipsychotic drugs infrequently.

Zuclopenthixol and melperon in the treatment of elderly patients: a double-blind, controlled, multi-centre study.

A double-blind study was carried out in 53 elderly patients in 6 geriatric nursing homes to assess the effectiveness of the neuroleptics, zuclopenthixol and melperon (flubuperone), in the relief of restlessness, aggressiveness and other such symptoms. The initial daily dose was 4 mg zuclopenthixol or 75 mg melperon, increased if necessary over the treatment period of 4 weeks. Assessments were made on entry and after 1, 2 and 4 weeks of treatment of the overall severity of illness and of individual symptoms. The results showed that there was significant improvement in the condition of patients in both treatment groups and a significant reduction in mean total as well as in the main single symptom scores. These changes were already apparent after 1 week of treatment. Although there was a tendency for faster improvement in the zuclopenthixol group, there were no significant differences between the groups in any of the parameters assessed. Side-effects were few and generally mild and transient.

Dementia and work load evaluation of the elderly.

Dementia and work load were estimated in 4736 elderly home-nursed or institutionalized persons. Mental status was estimated by means of the Clinical Dementia Rating scale (CDR), and work load by means of a traditional work load scale. Approximately one third of elderly over 85 years were living in an institution. 4.6% of the population over 65 years of age were moderately to severely and 1.8% mildly demented. Work load increased with increasing dementia. In homes for the aged 40% and in nursing homes 85% of the residents create a heavy work load. 14.5% of the estimated population are considered misplaced, the majority of whom should be transferred to a higher care level. Dementias cause a major problem on every care level. Services which are lacking for this group and necessary rehabilitation facilities should be provided.