Temporal persistence of anomalous self-experience: A 5years follow-up.

BACKGROUND: The concept of self-disorders in schizophrenia has gained substantial interest and it has now been established empirically that self-disorders aggregate in schizophrenia-spectrum disorders but not in other mental disorders or in healthy controls. Yet, the issue of temporal persistence has not been addressed. AIM: The aim of this study is to examine the temporal persistence of self-disorders. METHODS: 96 first admission patients were thoroughly assessed for psychopathology including SD at baseline and again 5years later. We created a 25-item self-disorder scale which was used both at baseline and follow-up to assess self-disorders. The scale was a pre-cursor of the later published EASE-scale. Additionally, we examined the development of positive and negative syndromes and of the Global Assessment of Functioning (GAF). RESULTS: There was a high correlation between self-disorders at baseline and at follow-up, and the majority of the items in self-disorders scale showed equal proportions between baseline and follow-up. CONCLUSION: Self-disturbances showed a high level of persistence at 5-year follow-up.

Schizoaffective disorder-- the reliability of its clinical diagnostic use.

OBJECTIVE: Patients with psychoses often suffer from affective symptoms. The originally broad concept of schizoaffective disorder (SAD) has been significantly narrowed, transformed into a convoluted set of criteria both in the ICD-10 and DSM-IV. We examined the reliability of the clinical use of this diagnosis in university settings. METHOD: All patients discharged from two university hospitals in Copenhagen in year 2002 with a diagnosis of ICD-10 SAD (n = 59) were re-evaluated using the Operational Criteria (OPCRIT) checklist expanded by additional items and applied to hospital chart material. Diagnoses were allocated by OPCRIT algorithm and by consensus of two psychiatrists. RESULTS: No patients fulfilled the SAD lifetime diagnosis according to DSM-IV criteria and the raters diagnosed only six patients as possible ICD-10 SAD. CONCLUSION: A moratorium on the clinical use of the SAD diagnosis is suggested.

Single dose pharmacokinetics and pharmacodynamics of oral oxazepam during concomitant administration of propranolol and labetalol.

1. The oral kinetics of oxazepam after a single 15 mg oral dose was investigated in six healthy volunteers before and during concomitant administration of the beta-adrenoceptor antagonists propranolol (80 mg) and labetalol (200 mg) (racemates). 2. A possible pharmacodynamic interaction between oxazepam and the beta-adrenoceptor antagonists was examined using a simple reaction time test (SRT) and by measurement of postural sway. 3. The kinetics of oxazepam were not affected significantly by propranolol or labetalol, although oxazepam and labetalol share the glucuronidation pathway. 4. The SRT was increased by combination of both beta-adrenoceptor antagonists with oxazepam, with the greatest increase after the coadministration of oxazepam with propranolol. Administration of the beta-adrenoceptor antagonists alone had no significant effect. 5. Postural sway was affected significantly only by the combination of oxazepam and propranolol.

Atrial natriuretic factor during exercise in male endurance athletes: effect of training.

Nine male endurance runners were evaluated with bicycle exercise testing before a training break of 3 weeks duration, and 0, 2 and 4 weeks after resumption of training to assess the effects of training on resting and exercise plasma atrial natriuretic factor (ANF) measured at 50% and 100% of predetermined maximal workload. Maximal oxygen uptake and lean body mass (LBM) were calculated at each time point. Maximal oxygen uptake decreased during training break, but rose 4 weeks after resumption of training (P less than 0.01). LBM was unchanged after inactivity, but rose after resumption of training (P less than 0.01). Plasma ANF at rest did not change throughout the experiment. ANF levels rose after training break at maximal workload (P less than 0.05), and decreased 4 weeks after resumption of training, but only at submaximal workload (P less than 0.05). No correlations between systolic blood pressure, mean blood pressure or heart rate and ANF could be demonstrated. These results indicate that the haemodynamic changes associated with endurance training are reflected in plasma ANF levels during exercise, but not at rest. The full adaptation of ANF release to training probably requires more time than the 4 weeks reported for the haemodynamic adjustments.

The veteran athlete: an echocardiographic comparison of veteran cyclists, former cyclists and non-athletic subjects.

To determine the effects of prolonged endurance training on the heart, a comparison was made of veteran cyclists aged 41-51 years, former cyclists, and non-athletic subjects, including echocardiography, ECG, systolic and diastolic time intervals, and maximal oxygen uptake. The veterans had significantly larger diastolic diameter, systolic diameter, thickness of septum, posterior wall, and left ventricular mass. The enlargement of the left ventricle was found to be proportionate, as the ratio of diastolic diameter to wall thickness showed no change. In contrast to earlier reports, no indication of reduced cardiac function was found in the veterans, as echocardiographically measured function parameters, systolic, and diastolic time intervals were similar in the three groups. In the former athletes, whose previous training experience was similar to that of the veterans, no significant variation in cardiac structure and function was found in relation to the control group. This indicates that the physiological hypertrophy caused by physical training can be reversible.

Therapeutic doses of codeine have no effect on acetaminophen clearance or metabolism.

In nine healthy volunteers, the clearance and metabolism of acetaminophen 1000 mg i.v. was evaluated with and without two concomitant oral doses of codeine in order to investigate a possible interaction. Plasma acetaminophen was followed for 720 min and urine was collected for 24 h after each dose for determination of metabolites. When codeine was coadministered, the average total clearance of acetaminophen and its clearance by glucuronidation, sulphation and mercapturate formation were 0.58 to 1.12-times the control values. It is concluded that therapeutic doses of codeine do not influence the clearance or metabolism of acetaminophen.

Bioavailability and pharmacokinetics of oxazepam.

Six healthy volunteers received oxazepam 15 mg i.v. and orally at an interval of at least one week. The kinetic variables of i.v. oxazepam were: elimination half-life (t1/2 beta) 6.7 h, total clearance (CL) 1.07 ml.min-1.kg-1, volume of distribution (Vc) 0.27 l.kg-1 (0.21-0.49) and volume of distribution at steady-state (Vss) 0.59 l.kg-1. The intravenous disposition of unbound oxazepam was characterized by a clearance of 22.5 ml.min-1.kg-1 and a distribution volume of 12.3 l.kg-1. After oral oxazepam the peak plasma level was reached in 1.7 to 2.8 h. The plasma t1/2 beta at 5.8 h was not significantly different from the i.v. value. Absorption was almost complete, with a bioavailability of 92.8%. Urinary recovery was 80.0 and 71.4% of the dose after intravenous and oral administration, respectively. Renal clearance (CLR) of the glucuronide metabolite was 1.10 ml.min-1.kg-1 (0.98-1.52). Oxazepam was extensively bound to plasma protein with a free fraction of 4.5%.