Serotonin neurons project to small blood vessels in the brain.

Electrolytic lesions of the nucleus raphe dorsalis and medianus reduce the concentration of serotonin (5-hydroxytryptamine) within rat brain intraparenchymal blood vessels. The concentration of serotonin within these vessels increases or decreases after the administration of drugs that modify the biosynthesis and degradation of serotonin or destroy nerve terminals by an uptake-dependent mechanism. These studies provide evidence for the existence of a serotonin-containing pathway seemingly analogous to the neuronal projection that terminates on small parenchymal blood vessels from noradrenergic neurons of the locus coeruleus.

Sleep patterns in three acute combat fatigue cases.

A preliminary report is presented on the sleep patterns of three combat fatigued patients with recurrent nightmares, insomnia, low frustration thresholds and impotence. All the patients had undergone acute partial sleep deprivation prior to their breakdown. The results show severe deficiency in REM sleep and absence of stage 4 sleep. EMG was usually high with numerous body movements and bursts of tachycardia throughout the night. Nightmares occurred in stage 2. Total effective sleep time was between 129' and 250'. Most of the sleep was in stage 2, and patients woke up with the feeling that "they had not slept at all." It is hypothesized that acute partial sleep deprivation prior to breakdown was an important predisposing factor, and that chronic partial sleep deprivation was a constant aggravating factor of combat fatigue. Replacement therapy for the specific deficient sleep states is proposed.

Olfactory system damage and brain catecholamines in the rat.

Although a number of studies have reported that bulbectomy results in a fall in telencephalic norepinephrine (NE) content, the present study is the first to examine the relationship between the locus and extent of olfactory system damage and the depletion of telencephalic catecholamines after olfactory system surgery. Our findings indicate that the often reported depletion of telencephalic NE after olfactory bulb ablation is not due to removal of the olfactory bulbs per se, but instead is the result of incidentally produced destruction of tissue, caudal to the bulbs, through which noradrenergic fibers ascend on their way to various regions of the telencephalon.

Influence of PCPA, shock level, and home-cage conditions on shock-induced aggression.

In a series of experiments, the effect of parachlorophenylalanine (PCPA) on shock-induced fighting was assessed rats raised and maintained under either a 12-hr alternating light-dark cycle (LD) or constant light conditions (LL). PCPA increased shock-induced aggression only in LL groups when testing was accomplished using a 2 mA shock; PCPA resulted in increased aggression in groups from the LD condition only when testing was done at 1 mA. A procedure that used castrated and intact cagemates to manipulate home-cage social experience provided evidence for a role for social experience in determining differences between LL and LD reared rats in shock-induced aggression. However, these data also suggested that home-cage social experience was not a factor in the lighting condition influence on the effect of PCPA on shock-induced aggression. Finally, a separate experiment demonstrated that diurnal rhythms in shock-induced aggression were disrupted by handling and vehicle injection in the control procedures, so the possible role of serotonin in diurnal rhythms of aggression behavior could not be assessed.

Temperature responses in rats after acute and chronic administrations of caffeine.

Acute administrations (IP) of caffeine produced dose-dependent changes in the body temperature of rats. Low doses (12.5 and 25 mg/kg) induced hyperthermia soon after drug administration, while high doses (50 and 100 mg/kg) produced maximal hypothermia approximately 2 hr later. The acute effects of caffeine were also dependent on ambient temperature. The hyperthermic and hypothermic responses were attenuated and blocked, respectively, in rats maintained at 32 degrees C. At 4 degrees C, the hypothermic response was exacerbated, and the hyperthermic response was absent. Tolerance rapidly developed to the hypothermic actions of caffeine when rats were administered the drug over 28 days. Following the emergence of tolerance, hyperthermia was observed in rats given 50 mg/kg of caffeine. The hyperthermic responses to the low doses of caffeine were not altered by the frequency of drug administration. Both the acute and chronic effects of caffeine on thermoregulation are not unlike those found for morphine. Possible mechanisms of action underlying the thermoregulatory effects of caffeine are discussed.

Phenylthiocarbamide (PTC) tasting in paranoid and nonparanoid schizophrenic patients.

The present study reports on the association between Phenylthiocarbamide tasting for paranoid and nonparanoid schizophrenic patients. The incidence of PTC tasting is highly variable, and tasters and nontasters are frequently associated with some pathological states. 25 paranoid and 25 nonparanoid schizophrenic patients were examined for their PTC taste sensitivity. Frequency of paranoid tasters resembles the distribution of the normal population, whereas the nonparanoid patients are significantly different in their taste thresholds, with a higher incidence of nontasters. The members of this latter group have twice the incidence of psychiatric illness in their family histories as those of the former group. The significance of these findings is discussed as related to vulnerability for schizophrenia.

Zuclopenthixol acetate in viscoleo in acutely disturbed psychotic patients.

This report describes an open pilot study of ten acutely disturbed and agitated psychotic patients who received CPT-A zuclopenthixol injections. The dosage ranged from 50 mg to 100 mg. Sedative effects were noticed already after 2 hours, and the patients were all sleepy and sedated after 8 hours. There was a definite improvement in the CGI within 24 hours. The BPRS improved within 24 hours, having the greatest effect on activation, anxiety, depression, and hostile suspiciousness. These effects were sufficient to control these patients. The findings show a rapid onset of therapeutic effect, with no side effects, a duration of 2-3 days and a good local tolerability.

Psychiatric stigma and mental health professionals (stigmatizers and destigmatizers).

This article presents a definition of the term psychiatric stigma, its development, dynamics and role in society. The role that psychiatrists have played in the past and are playing in the present is described. The different factors that influence this role are elucidated culturally, professionally and economically. Examples are given of where psychiatrists act as destigmatizers and, on the other hand, as stigmatizers. The article stresses the point that psychiatrists should always be on the alert that in fulfilling their therapeutic role they can either stigmatize more or destigmatize their patients. Consideration should be taken in the overall approach so that the benefits to a patient are always more than his or her losses. Psychiatrists and mental health professionals must constantly be alert to ensure that they are acting in the best interest of the patient.

[Traffic violations in schizophrenics before and after hospitalization].

Many countries, including Israel, impose driving restrictions on schizophrenic patients. However, there are conflicting views as to the way these patients drive. Some studies suggest that compared to the nonpsychiatric population they violate traffic regulations more often, but other studies have found no differences between the 2 groups. In the present study (1980-81), the driving of schizophrenic patients was examined with regard to traffic violations and fines, 6 years before and 6 years after hospitalization. Of the 82 schizophrenic patients examined, 15 were paranoid. The schizophrenic patients did not accumulate more traffic violations or fines than the control group, nor was there any difference between paranoid and nonparanoid schizophrenic patients. Men had fewer traffic violations and fines after hospitalization, while in women there was no difference.

[Chest pain and anxiety-panic disorders in a primary care clinic].

Chest pain is one of the most common complaints in primary care clinics. About 10-30% of patients with chest pain diagnosed as suffering from angina pectoris have normal coronary angiograms. Some of them suffer from psychiatric disorders. We present a 47-year-old man with several risk factors for ischemic heart disease: smoker in the past, obesity, hyperlipidemia and family history of coronary disease. He had complaints typical of anginal syndrome and normal coronary arteriograms. After 1.5 years of unsuccessful medical treatment, he was referred to the psychiatrist in the primary care clinic who diagnosed anxiety and panic disorders with somatization. All cardiac drugs were stopped and psychopharmacological treatment and psychotherapy were started immediately. Within a month he was almost free of symptoms and was treated successfully for a year. Treatment was then stopped and he has remained symptom-free for the past 4 years. We conclude that in such atypical somatic cases, only the collaboration of general practitioner and psychiatrist will lead to quick diagnosis and successful treatment.

Problems in community psychiatry: difficulties, constraints and future considerations.

The difficulties and constraints of community psychiatry are reviewed from the feeling of omnipotence and false hopes it has engendered, to the problems posed for the psychiatrist (threat to status, unclear identity, conflicting demands and the necessity for increased training). Administrative problems and difficulties in providing effective care in the new system are outlined: isolation of community psychiatry from the mainstream of medicine due to reliance on the social rather than the medical model, necessity for decentralization leading to fragmentation of services, pressures from local interest groups, lack of continuity of service and disruption in the flow of information. The myriad of pressures to which the community psychiatry center is vulnerable are described: local groups seeking to politicize the center, conflict within the center as to most appropriate method of treatment, pressure to solve social problems such as crime and addiction, and the ever-present weight of setting priorities under conditions of limited financial and manpower resources. Means of dealing with many of these difficulties are discussed, and a model of a community psychiatry center is presented which minimizes the problems and maximizes service to the community and the individual.

Acute and chronic effects of caffeine on brain monoamine levels and endocrine function in the rat.

Caffeine was given to rats either acutely (1 injection) or chronically (28 daily injections). Both treatments increased brain levels of tryptophan (Trp), serotonin (5-HT) and 5-hydroxyindoleacetic acid in a dose-related fashion, but the apparent stimulatory actions of acute caffeine on the rates of 5-HT synthesis and turnover appeared to have been reduced by repeated exposure to the drug. Acute caffeine increased the blood levels of nonesterified fatty acids (NEFA), glucose and insulin, and reduced the levels of tyrosine (Tyr). Except for Tyr, chronic caffeine substantially reduced the NEFA and glucose responses in magnitude and duration; moreover, daily caffeine significantly lowered serum insulin levels. Chronically caffeinated rats, however, were able to display positive insulin and glucose responses when challenged with an oral glucose load and epinephrine, s.c., respectively. Those events possibly mediating the acute and chronic effects of caffeine on brain Trp and thus 5-HT levels may include, on the one hand, enhanced insulin secretion and increases in the serum Trp ratio, and, on the other hand, lipolysis and the release of plasma Trp from protein binding.

Effects of a psychiatrists' strike on emergency psychiatric referral and admissions.

This is a report on the effects of a psychiatrists' strike in Israel on emergency psychiatric referrals and admissions from two catchment areas. One had comprehensive psychiatric services, the other did not. Three periods were compared - before, during and after the strike. During the strike period, overall referrals to the emergency room decreased by 3.9%. A significant 15.8% decrease in referrals was registered in the comprehensive psychiatric service area, and an 11.4% increase in referrals in the other catchment area. Although no increase was seen in total emergency admissions during the strike, involuntary admissions increased by 21.6%, within the catchment area which did not have a comprehensive service, whereas within the area with the comprehensive service there was a significant decrease of 33% in involuntary admissions. The impact of these services on emergency referrals and admissions, especially during the strike, is discussed.

Behavioral correlates of serotonin depletion.

Depletion of telencephalic serotonin (5-HT) content by medical forebrain bundle lesions, which interrupt the ascending serotonergic pathways or by DL-p-chlorophenylalanine produces an increased sensitivity to pain as measured by the flinch-jump, stabilimetric, or hot-plate methods. Examination of the effects of a number of other lesions and drugs indicated that dopamine, norepinephrine and acetylcholine are not involved in pain sensitivity. Dosages of 75 mg/kg DL-5-hydroxytryptophan(5-HTP), 37.5 mg/kg L-5-HTP or 50 mg/kg Ro 4-4602 (NI-(DL-seryl)-N2-(2,3,4-trihydroxybenzyl)hydrazine) plus 37.5 mg/kg L-5-HTP administered to medical forebrain bundle lesioned rats returned both the telencephalic content of 5-HT and the pain threshold to normal values. Injection of 37.5 mg/kg of D-5-HTP or an equimolar dose of L-dopa had no effect on pain threshold. Normal animals display increased sensitivity to pain and decreased 5-HT contents in frontal pole, hippocampus, and amygdala during dark as compared to light hours. All three of these telencephalic areas are innervated by the ascending serotonergic pathways, and cells in these areas show inhibition of firing following the iontophoretic application of 5-HT. Taken together these data suggest that the serotonergic system normally acts to inhibit the effects of painful stimuli. A review of a variety of behavioral effects of 5-HT depletion including an enhanced response to lysergic acid diethylamide and amphetamine suggests that the ascending serotonergic system may have a general role in the inhibition of arousal, rather than a specific role with respect to various categories of behavior.