RESUMO
Lesions in the temporal lobe are associated with psychiatric manifestations in multiple sclerosis. The authors describe this case of a young man with multiple sclerosis who presented with first-episode psychosis and had acute lesions in the temporal lobe. He was successfully treated with olanzapine and ß-interferon.
Assuntos
Agressão/fisiologia , Esclerose Múltipla/fisiopatologia , Transtornos Neurocognitivos/diagnóstico , Transtornos Neurocognitivos/fisiopatologia , Transtornos Paranoides/fisiopatologia , Lobo Temporal/patologia , Lobo Temporal/fisiopatologia , Violência , Adolescente , Ventrículos Cerebrais/patologia , Ventrículos Cerebrais/fisiopatologia , Diagnóstico Diferencial , Progressão da Doença , Dominância Cerebral/fisiologia , Lobo Frontal/patologia , Lobo Frontal/fisiopatologia , Humanos , Fatores Imunológicos/uso terapêutico , Interferon beta/uso terapêutico , Imageamento por Ressonância Magnética , Masculino , Esclerose Múltipla/diagnóstico , Esclerose Múltipla/tratamento farmacológicoRESUMO
An assessment of the efficacy and tolerability of zuclopenthixol dihydrochloride tablets in the treatment of acute psychotic episodes was undertaken in 63 patients in an open multi-centre study. Most patients prior to entering the study had received other neuroleptic drugs, but with inadequate effect. During the 10-week study, the dosage of zuclopenthixol dihydrochloride tablets could be adjusted to obtain optimum clinical benefit. The majority of patients received 20 to 75 mg daily (range 10 to 150 mg daily) at the start of the study and later, for most of those patients successfully treated, the dosage was 20 to 55 mg daily. Assessments before and during treatment utilized the BPRS and CGI rating scales and a check-list of side-effects. A successful response to treatment was achieved in 70% of 50 patients with schizophrenia or schizophreniform psychoses and in 69% of 13 patients with mania or hypomania. Almost half (30) of the patients studied had a successful response within 4 weeks of starting treatment and some after only 1 week of treatment. All patients but 1 had either no side-effects or side-effects not overtly affecting performance.
Assuntos
Clopentixol/uso terapêutico , Transtornos Psicóticos/tratamento farmacológico , Tioxantenos/uso terapêutico , Doença Aguda , Adulto , Transtorno Bipolar/tratamento farmacológico , Clopentixol/administração & dosagem , Clopentixol/efeitos adversos , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Escalas de Graduação Psiquiátrica , Esquizofrenia/tratamento farmacológico , ComprimidosRESUMO
A self-assessment scale has been developed and found to be a reliable instrument for detecting states of depression and anxiety in the setting of an hospital medical outpatient clinic. The anxiety and depressive subscales are also valid measures of severity of the emotional disorder. It is suggested that the introduction of the scales into general hospital practice would facilitate the large task of detection and management of emotional disorder in patients under investigation and treatment in medical and surgical departments.
Assuntos
Transtornos de Ansiedade/diagnóstico , Transtorno Depressivo/diagnóstico , Pacientes Ambulatoriais/psicologia , Pacientes/psicologia , Escalas de Graduação Psiquiátrica , Adolescente , Adulto , Idoso , Feminino , Humanos , Entrevista Psicológica , Masculino , Pessoa de Meia-Idade , Ambulatório Hospitalar , PsicometriaRESUMO
This study compares the diagnostic terminology used for 592 consecutive discharges from a psychiatric unit before and after teaching psychiatric trainees the use of the ICD-9 classificatory system. The results show a marked increase in specificity of diagnostic labels, with a decrease of diagnoses with the term 'not otherwise specified', and an increase in the diagnoses of organic psychoses, paranoid and hebephrenic schizophrenia and depressive neurosis. The implications of this for training about diagnosis, clinical practice and recording of data for national statistics are discussed.
