ABSTRACT
In the past 25 years of forensic psychiatry in the Netherlands, there have been improvements in the quality of information made available for pre-trial assessments, changes in the psychopathological characteristics of the patient population, shifts in the treatment paradigm and an increase in scientific research.
Subject(s)
Forensic Psychiatry/trends , Mental Disorders/epidemiology , Prisoners/psychology , Social Behavior Disorders/epidemiology , Forensic Psychiatry/legislation & jurisprudence , Legislation as Topic , Mental Disorders/psychology , Mental Disorders/therapy , Mental Health Services/standards , Mental Health Services/trends , Netherlands , Prisoners/legislation & jurisprudence , Quality of Health Care , Social Behavior Disorders/psychology , Social Behavior Disorders/therapyABSTRACT
In extracerebral systemic lupus erythematosus (SLE), the complement system plays a prominent pathogenic role, and decreased serum concentration of the 4th component (C4) is a reliable indicator of systemic disease activity. In diffuse CNS-SLE, however, the pathogenic role of complement is less clear. In 12 patients with active diffuse CNS-SLE presenting with delirium (4), organic personality syndrome (3), or generalized seizures (5), we determined the CSF indexes of the complement components C3, C4, and factor B, and of IgG, IgA, and IgM. There was a significant increase of the C4 index in these patients compared with controls and a significantly higher CSF C4 index in patients with an increased IgM index. We conclude that intrathecal C4 is being produced in diffuse CNS-SLE.
Subject(s)
Central Nervous System/metabolism , Complement C4/cerebrospinal fluid , Lupus Erythematosus, Systemic/metabolism , Adolescent , Adult , Complement C3/analysis , Complement C3/cerebrospinal fluid , Complement C4/analysis , Complement Factor B/cerebrospinal fluid , Female , Humans , Immunoglobulins/cerebrospinal fluid , Lupus Erythematosus, Systemic/cerebrospinal fluid , Male , Middle Aged , Osmolar ConcentrationABSTRACT
Psychiatric manifestations of familial spastic paraplegia are rare and have been described only infrequently. A 35-year-old male is reported, who presented both hypomanic behaviour and gait disturbances as features of a previously undiagnosed familial spastic paraplegia. This association implies that the CNS manifestations of familial spastic paraplegia may overlap with the neurochemical or neuroanatomic substrata regulating mood.
