Temperament and character inventory and pharmacotherapeutic outcome in bulimia nervosa.

OBJECTIVE: To assess the relationship between the personality dimensions measured by the temperament and character inventory (TCI) and pharmacotherapeutic outcome in bulimia nervosa (BN). METHODS: Thirty female BN patients aged 19.5+/-2.9 years were enrolled to receive 12 weeks' treatment with fluoxetine or buspirone and assessed using the Polish version of the TCI. The personality dimensions of the patients with good and poor treatment responses were compared. RESULTS: The subjects with a good outcome had a higher self-directedness and lower harm avoidance score; this difference was more pronounced in the fluoxetine-treated subjects. At multiple regression analysis, only self-directedness predicted a good outcome. DISCUSSION: The results indicate that self-directedness is associated with a good pharmacotherapeutic outcome in BN. This seems to confirm the results of previous studies of the pharmacotherapy of depression and cognitive-behavioural therapy (CBT) in BN.

[The level of self-esteem in patients with anorexia nervosa]. / Poziom samoakceptacji u chorych z jadlowstretem psychicznym.

The aim of this work was to measure the self-acceptance level in patients with anorexia nervosa. The obtained results indicate that patients with anorexia nervosa have lower self-acceptance level in comparison with the control group.

[Genetic factors in the etiology of anorexia nervosa]. / Czynniki genetyczne w etiologii jadlowstretu psychicznego.

Anorexia nervosa (AN) is a disease of complex ethiopatogenesis. Population genetics studies suggest a significant role of genetic factors in the morbidity risk. Family and twin studies allow for the estimation of the heritability--the influence of genetic factors on the specific phenotype--of the anorexia nervosa in 50-80%. Due to the low prevalence of the disease, the adoption studies have not been performed. The rapid development of the molecular biology methods gives possibility for the searching of the specific genes increasing the risk of anorexia nervosa. Linkage studies are based on scanning the whole genome for loci associated with susceptibility to a certain disease. In the preliminary studies, no linkage was found between anorexia nervosa and the markers on the chromosomes 1-5, 13 and X. In the association studies, relationship between vulnerability to AN and polymorphism in 5-HT2a receptor and uncoupling proteins gene were reported. These results need further confirmation.

[Detection of anti-Borna disease virus antibodies in patients hospitalized in psychiatric hospitals located in the mid-Western region of Poland]. / Przeciwciala prezeciwko wirusowi choroby Borna u pacjentów hospitalizowanych w szpitalach psychiatrycznych na terenach województw lubuskiego i wielkopolskiego.

Borna Disease Virus (BDV) is single stranded RNA virus, which may infect a wide range of animal species. Manifestations of the experimental BDV infection show some resemblance to psychopathological symptoms of mental disorders in humans. Several reports suggest the higher prevalence of anti-BDV antibodies in psychiatric patients than in healthy controls. However, the seroprevalence of anti-BDV antibodies varied due to the different serological methods used in the previous studies. Electrochemiluminescence Immunoassay (ECLIA) is a recently developed, highly specific method of detecting antibodies directed toward two BDV proteins: p24 and p40. We used the ECLIA method for the assessment of seropositivity in 946 psychiatric patients hospitalized in the psychiatric hospitals in the western part of Poland. All patients were clinically diagnosed with ICD-10 criteria. Anti-p40 antibodies have not been found in the studied sample. We found anti p-24 antibodies in 23 cases, which give the seroprevalence rate of 2.4%. This result is consistent with the outcome of Japanese population assessment, done with the same methodology. The seropositive cases did not show diagnostic specificity. We did not find statistically significant gender differences in rate of seropositivity. The seroprevalence of anti-BDV antibodies was not significantly different in patients of urban and rural residence, and in patients of different age groups. This is the first demonstration of anti-BDV antibodies in the Polish population of patients hospitalized in psychiatric hospitals.

[Disturbances of the thyroid function in patients with anorexia nervosa]. / Zaburzenia czynnosci tarczycy u chorych z jadlowstretem psychicznym.

There are clinical similarities between anorexia nervosa (AN) and hypothyroidism. Previous reports have shown decreasing fT3, increasing rT3, sporadically decreasing fT4 and normal levels of serum TSH. To asses thyroid function in 36 patients with AN (4 boys, 32 girls, the subjects ages ranged from 12 to 18 years) serum levels of fT4, fT3, rT3, TSH were measured. We examined activation of the hypothalamic - pituitary- thyroid axis by using TRH test (TRH i.v. 0,2 mg, measured TSH at 0', 30', 60', 90') in 30 patients out of this group. 67% (24) patients of the examined group resulted in low level of fT4 (0,75-0,97 ng/dcl), but low decreasing fT3 (=0,67 pg/ml) was only found with 1. The level of rT3 were normal. The level of TSH were low (0,87-0,97 micro IU/ml) in 25% (9) of patients, but 6 of them also manifested low decreasing fT4 (0,87-0,97 ng/dcl). A hyporesponse of TSH to TRH was noted in 17% (5) of patients, a delayed TSH response to TRH was seen only in 1. Thyroidal dysfunction in AN was basically expressed by low decreasing fT4, and also by the disturbances of the TRH-TSH secretion.

[Genetic studies in autistic disorders]. / Badania genetyczne w autyzmie dzieciecym.

Since autism was first described by Leo Kanner the view on its etiology and pathogenesis has been changing. Recently there are more data on genetic and neurobiological background of autism. At the beginning it was noticed that autism appeared more frequently among boys, in population studies it was found that autism appeared more frequently among siblings, mostly among monozygotic twins. Many disorders like Tourett syndrome and tuberous sclerosis were reported in connection with autism. Recently research is focused mostly on chromosome abnormalities: chromosome 15 (locus 15q11-13), chromosome 7 (locus 7q), chromosome 16 (locus 16p) and gens of particular receptors (GABRB3, UBE3A/E6-AP, 5-HTT). These abnormalities may also be one of the causes of autism.

[Administration of moclobemide++ in children with attention deficit hyperactivity disorder ]. / Zastosowanie moklobemidu u dzieci z zespolem deficytu uwagi i nadruchliwosci.

ADHD is a frequent disorder that occurs among approximately 5-10% of school children. Treating this syndrome, pharmacotherapy with different forms of psychotherapy are applied. In many European countries and in the USA the primary medicines are the psychostymulative ones; in Poland, however, they are not registered in the Pharmacopeia. Thus, what seems to be important is seeking other drugs that can be useful in ADHD treatment. In the Child and Adolescent Psychiatry Clinic in Poznan, a group of 15 children (13 boys, 2 girls) at the age of 6-13 were recognised to have ADHD; they were administered moclobemid (Aurorix) in dose of 75-225 mg/d throughout the period of 8 weeks. The medicine efficacy was being estimated with psychometric, questionnaire, and experimental methods. After 4 weeks, the drug ceased to be administered to two children due to complete lack of improvement or deterioration in functioning. It was observed that in the rest of the children their attention and hyperactivity functioning improved significantly. It is essential that the medicine was well tolerated and undesirable symptoms occurred rarely.

Tissue toxicity of doxorubicin in first and second hyperthermic isolated limb perfusion--an experimental study in dogs.

The aim of this experimental study in dogs was to assess the tissue toxicity of doxorubicin (DOX) and the impact of dose and pharmacokinetics after double isolated limb perfusion (ILP). Fifteen beagle dogs were assigned to three groups of five animals each. In the first ILP 0.75 mg/kg bodyweight (bw) DOX was given to all animals. In the second perfusion after an interval of 6 to 8 weeks the dosage was 0.5 mg/kg bw in group I, 0.75 mg/kg bw in group II, and 1.0 mg/kg bw in group III. At the same dosage tissue toxicity increased in comparison to the first ILP. At the second ILP there was a dose-toxicity relationship. At a dose of 0.75 mg/kg bw pharmacokinetics of DOX in the perfusate showed no significant differences between first and second perfusion. The mean muscle tissue levels during the second ILP were lower than during the first perfusion. However, in contrast to the first perfusion, they showed a further increase after perfusate eluation. A disturbed microcirculation caused by intima proliferations in arteries and arterioles fter the first ILP may impair the removal of DOX from the intravasal and interstitial compartment and can be assumed as a reason for increased tissue toxicity. Therefore, we recommend a reduction of DOX dose in the second ILP for clinical use.

[Alprazolam in the treatment of anxiety disorders and mixed anxiety and depressive disorders. Results of multicenter clinical trial]. / Alprazolam w leczeniu zaburzen lekowych i lekowo-depresyjnych. Wyniki wieloosrodkowego badania klinicznego.

Alprazolam is one of the most commonly prescribed psychotropics drug all over the world. This suggests that alprazolam is very effective and safe. A multicentre clinical trial was carried out for assessing its efficacy and side effects. 130 patients suffering from anxiety disorders, mixed anxiety and depressive disorders and dysthtymia were involved in the trial. During 6 weeks they used to take from 1.5 to 2.5 mg. of alprazolam daily. Mental state has been assessed with Hamilton rating scales of anxiety and depression, Montgomery Asberg scale of depression and CGI scales. At the endpoint good recovery was found in 75% of the patients, mild recovery in 19%, and 6% got worse. The effect of treatment depends on individual patients' traits rather than on initial mental state. Adverse events were noted in a half of patients, were not severe and were going down during the treatment. 4.6% of patients dropped out because of adverse events, the others tolerated alprazolam well.

[Immunological system activity in anorexia nervosa]. / Czynnosc ukladu immunologicznego w jadlowstrecie psychicznym.

The immunological system of patients with anorexia nervosa seems to react in a non typical and, up to now, obscure way. We do not observe greater ability to catch infectious diseases while damage due to other reasons leads as a rule to breakdown of resistance mechanisms thus giving increased receptivity to infections. The works concerning the immunological functions in anorexia nervosa are not heterogeneous and concern small groups of patients. The research was made upon 29 female patients aged 12 to 20 with the diagnosis of anorexia nervosa due to DSM-IV criteria. The research was made before starting the treatment and 6 weeks after the withdrawal of all anorexia nervosa symptoms. The research results showed that in the female patients there were no essential disturbances in the scope of electrophoresis of serum protein. Testing the protein of acute phase CRP as well as the estimation of their main microheterogeneity did not show significant deviation from the norm, which shows any features of early and later activation of the immunological system. However, a slight decrease of CD3 and low coefficient CD 4/8 during the disease were observed. After the symptoms retreated the coefficient became normal. Summing up we can state that the immunological system in patients with anorexia nervosa, in spite of great cachexia, did not show significant changes. The stated specific dysfunctions may be connected with a subtype of disease and other neurotransmitter mechanisms, which still requires to be confirmed in further research.

[Intelligence quotient levels, aspiration and self-acceptance in patients with restricting and binge-eating type of anorexia nervosa]. / Poziom intelektu, aspiracji i samoakceptacji u chorych z restrykcyjna i bulimiczna postacia jadlowstretu psychicznego.

A group of 50 patients aged from 12 to 20 with anorexia nervosa was examined: 40 persons with a diagnosis of restricting type and 10 with binge-eating type according to DSM IV. The level of intelligence quotient (IQ) was estimated by using Wechsler Test, selfacceptation by SQ and aspiration by TAT and test of unfinished sentences. In the majority of patients IQ was stated on the average level. Independently of intellectual level all patients presented a high aspiration degree. In their own estimation the emotional motivation sphere was significantly more important in the patients with binge-eating type and intellectual in the patients with restricting type of anorexia nervosa.

[The assessment of regional cerebral blood flow using HMPAO-SPECT during depressive episode and in remission]. / Ocena przeplywu mózgowego krwi za pomoca HMPAO-SPECT u chorych w czasie fazy depresyjnej oraz po jej ustapieniu.

Twenty patients who met the DSM-IV criteria for major depressive disorder were investigated at rest using Single Photon Emission Computed Tomography (SPECT). Participation in the study required a minimum score of 18 points on the 17-item Hamilton Rating Scale. All patients were drug free for at least one week before the SPECT scan. Assessments were made twice during depression and after recovery. Regional tracer uptake was measured by a semiquantitative method. The reference region was delineated on the cerebellum. In remission a significant increase of 99m Tc-uptake in almost all regions of interest was observed what may point on the improvement of regional blood flow after recovery from depression. For most regions except right frontal and left parietooccipital there were no significant differences of tracer uptake between patients with bipolar and unipolar depression. The negative correlation between regional cerebral blood flow and Hamilton score was found in temporal areas and left temporo-parietal region. We did not find the influence of age on regional cerebral blood flow. In conclusion, during depression global reduction of brain metabolism was observed, which may point on the role of subcortical nuclei with diffuse cortical projection in pathogenesis of depression.

[Biochemical evaluation of atherosclerotic changes in the course of depressive syndromes in patients with cardiovascular disturbances]. / Biochemiczna ocena zmian miazdzycowych w przebiegu zespolów depresyjnych u osób ze schorzeniami ukladu sercowo-naczyniowego.

The paper analyses correlation between depressive syndromes and lipid metabolism and circulatory system disturbances. Two groups of patients with depression were compared. The first of them consisted of patients with an increased risk of atherosclerosis, in the other group there were patients with normal risk of atherosclerosis. It was found out that the most frequent parameter of lipid metabolism disturbances is cholesterol HDL fraction. Lipid metabolism disturbances in depression are larger in patients suffering from circulatory system disorders. The authors recommended to combine the treatment of depression with applying medicines counteracting lipid metabolism disturbances in patients having greater risk of atherosclerosis.

[Evaluation of clinical and neurophysiological markers of depressive disorder with symptoms of peripheral and brain circulation disturbance]. / Ocena wykladników klinicznych i neurofizjologicznych zespolów depresyjnych z objawami zaburzen w krãzeniu obwodowym i mózgowym krwi.

The evaluation of neurophysiological markers during imipramine treatment of 60 patients with endogenous depression was made. These markers were evaluated in 2 groups of patients: with cardio-vascular, and with brain circulation disturbances; both groups equal 30 subjects. During thymoleptic treatment of patients with circulation disturbances, elevated level of anxiety and statistically significant lower simple and complex reactivity of central nervous system were found. Such reactivity did not improve during the treatment in this group of patients. The lack of improvement of above mentioned parameters under imipramine may be the factor that elucidates the pathomechanism of chronic course of depression in old age. The improvement of circulation conditions, along with the thymoleptic therapy, should have the crucial importance for the therapeutic effect.