SSR abnormalities in chronic alcoholics.

We performed sympathetic skin response (SSR) studies on 29 male patients diagnosed as chronic alcoholics according to DSM-IV criteria. The average age was 43 years and the mean duration of alcohol abuse was 21 years, with all patients having a history of alcohol abuse for a minimum of 4 years. None of the patients had any symptoms and/nor signs related to autonomic nervous system dysfunction and all demonstrated normal nerve conduction velocities. Hand and foot latencies in alcoholics were prolonged relative to controls and the difference was statistically significant: reflected by p values of 0.02 and 0.004, respectively. Forty-four percent of patients demonstrated abnormal results. The unilateral prolongation of the lower extremity latency was the most commonly found abnormality (24%). Finding abnormal SSR in this patient population has made us aware that SSR has the potential to detect subclinical autonomic nervous system dysfunction even in patients who do not have autonomic complaints or neuropathy and to provide information about a part of the peripheral nervous system small unmyelinated C fibers that can not be assessed by currently performed techniques used in clinical EMG laboratories or by physical examination.

Event related potentials in children of alcoholics.

Assessment of ERPs (Event Related Potentials) is a special area of interest in research on vulnerability to alcoholism in human subjects. ERP not only provide information about potential neurofunctional anomalies in healthy individuals, but also relate those neurofunctional characteristics to the cognitive process involved. The aim of the present study is to evaluate the effects of chronic alcoholism and alcoholism risk on children of alcoholic fathers by using ERP parameters. 24 children of alcoholic fathers (9 boys, 15 girls) with a mean age of 18 +/- 3 (range: 15-25) and 17 control subjects (children of non-alcoholic fathers with out a family history of alcoholism) were included to the study. The age range was from 15 to 25 (mean: 21 +/- 3). N200 potential latency recorded from the parietal electrode position was significantly prolonged (p = 0.032) and amplitudes of P200 potential also recorded from the parietal region was significantly low (p = 0.043) relative to controls. However, the rest of the event-related potential parameters including P300 latency and amplitudes recorded from FZ, CZ, PZ electrode positions did not differ significantly from the children of non-alcoholic fathers. The difference in our results from the previous studies may be due to various factors. Genetic, gender, environmental, educational and social factors may have an overall effect on ERP and we believe these factors may be the cause of the differences seen in our study when compared to the previous ones. We believe the gender differences in our group may have had effected the overall results. Consecutive studies with more subject participation are needed to confirm and settle this issue.

Technetium-99m-HMPAO brain SPECT in anorexia nervosa.

Eating disorders have been redefined in recent years. Brain imaging techniques are useful in demonstrating the association between the morphologic and the functional cerebral changes in these cases. We report 99mTc-HMPAO brain SPECT findings in two patients with anorexia nervosa, before and after the treatment. While the detailed neurologic and laboratory examinations, including EEG and cranial CT, were within normal limits before therapy, SPECT study revealed diffuse bilateral hypoperfusion in frontal, parietal and frontotemporal areas which was more prominent in the left hemisphere. Post-treatment SPECT studies obtained after a clinical remission period of 3 mo showed normal brain perfusion in both patients. The pre- and post-treatment SPECT studies accurately reflect the functional state of the patients, and this technique may be used to follow-up the effect of treatment and predict the clinical response to therapy in patients with eating disorders.

Suicide attempts among Turkish psychiatric patients.

OBJECTIVES: The aim of this study was to investigate the sociodemographic characteristics of those who attempt suicide in an Islamic country, the effect of religion on suicide attempts, and the frequency of DSM-III-R diagnoses in suicide attempters referred to the Gazi Medical School Psychiatry Department. METHOD: Medical records of 185 cases of suicide attempts were reviewed. RESULTS: There was a predominance of single, female subjects. Students, housewives, and employees represented the 3 largest groups. Drug overdose was the most common method of suicide attempt, and the most common DSM-III-R diagnosis was depression. The rate of repetition of suicide attempt was 43.3%. CONCLUSION: Suicide is one of the major problems among Turkish psychiatric patients, although the Islamic religion strongly disapproves of it.

Blink reflex abnormalities in chronic alcoholics.

PURPOSE: The aim of the present study was to evaluate the efficacy of blink reflex as a method for obtaining early diagnosis of cranial nerve involvement in alcoholic patients. MATERIALS AND METHODS: The study was conducted on 30 male alcoholics with a mean age of 43 years. They had histories of alcohol abuse for at least 6 years (mean: 25). At the time of recording, they had undergone detoxification treatment for a mean of 27 days. RESULTS: R1 (early response), R2Y (second ipsilateral response), and R2C (second contralateral response) latencies in alcoholics were prolonged relative to controls and the differences were statistically significant (p < 0.02, p < 0.001, p < 0.001, respectively). According to the defined criteria, 40% of the patients had abnormal responses, and the most common abnormality was the unilateral prolongation of R1 (13%). CONCLUSION: Finding abnormal blink reflex responses in alcoholic patients has suggested that blink reflex testing is a useful method for the evaluation of subclinical cranial nerve involvement in alcoholic patients. Blink reflex testing may be useful in detecting early changes and in the follow-up of alcoholic disorder.

Bulimia in a male alcoholic: a symptom substitution in alcoholism.

In recent years, evidence points to a relation between bulimia nervosa and alcoholism. A significant number of bulimics have been reported to abuse alcohol and drugs. Additionally, there is a high prevalence of alcoholism in the families of bulimic patients. In the light of the proposed hypothesis concerning symptom substitution between the dyscontrol syndromes, we present an alcoholic patient who developed bulimic symptoms in the abstinence period. In this patient bulimic manifestations disappeared as he restarted drinking again, suggesting that these two symptoms serve as a substitute for each other.

Single photon emission computerised tomography in chronic alcoholism. Antisocial personality disorder may be associated with decreased frontal perfusion.

BACKGROUND: We examined the functional and structural cerebral changes in chronic alcoholics, analysing their association with personality features and alcohol drinking habits. METHOD: Forty patients with alcohol dependency, including 15 with antisocial personality disorder (ASP) as defined in DSM-III-R and 10 age and sex matched healthy controls were studied after termination of withdrawal symptoms, using high resolution single photon emission tomography (SPECT), cranial computerised tomography (CT) and brainstem auditory evoked potentials (BAEP). RESULTS: We found significant reductions in regional cerebral blood flow (rCBF) measurements of alcoholic patients. Low flow in frontal regions encountered in 67.5% of the patients was associated with the duration of alcohol consumption, while no such relation existed with the amount of daily intake. Patients with ASP exhibited more marked frontal hypoperfusion. Significant brain atrophy detected by CT was present in 40% of the patients and did not correlate with frontal hypoperfusion. CONCLUSIONS: Patients with ASP are more sensitive to toxic effects of alcohol. Alternatively chronic alcoholism leads to frontal lobe dysfunction recognised as ASP in the clinical setting.

Multidisciplinary evaluation of diabetic impotence.

Patients referring to the Urology and/or Endocrinology Departments of Ankara Medical School with complaints of diabetes mellitus (DM) and related complications were evaluated during the last year. A detailed history was obtained and all of the patients were questioned especially about sexual function problems. Following this evaluation, all patients were divided into two main groups, i.e. patients with sexual disorders, and those with normal sexual function. Factors such as BPH, cerebrosclerosis and other important vascular-neurologic pathologies which may play a role in the etiology of impotence were excluded from the study and 38 patients with sexual dysfunction and 15 with normal sexual activities have undergone further evaluation. Following routine blood and urine analyses, serum hormone levels (testosterone, FSH, LH, prolactin) were determined. Penile color-flow doppler analysis, cavernosometry, cavernosography, bulbocavernous reflex latency time and evaluation of somatosensory evoked potentials were performed. Additionally, all patients were evaluated from the psychiatric aspect using the Hamilton depression scale and MMPI questionnaire. The presence of vascular or neurologic pathology in 89.4% of our patients and of both pathologies in 39.4% of the patients, indicated the importance of multifactorial evaluation of diabetic impotence in order to plan a complete and efficient therapy program.