Patients in the early phases of schizophrenia and schizoaffective disorders effectively treated with risperidone long-acting injectable.

The efficacy and safety of risperidone long-acting injectable (RLAI) was investigated in patients in the early phases of schizophrenia and schizoaffective disorders (< or = 3 years). Patients who required a treatment change received RLAI (2-weekly gluteal injections of 25, 37.5 or 50 mg, per clinical judgement), without an oral risperidone run-in phase.A total of 382 patients were included in this 6-month open-label study; 73% of patients completed the study. A total of 84% had schizophrenia with a median duration of 1.0 year since diagnosis. Previous medications were mainly atypical antipsychotics (70%) and depot neuroleptics (24%). The main reasons for treatment change were non-compliance (42%) and insufficient efficacy (31%) of previous medication. The total Positive and Negative Syndrome Scale (PANSS) and all its subscale scores improved significantly (p < or = 0.0001), with 40% of patients showing a 20% improvement on total PANSS. Global Assessment of Functioning, quality of life, patient satisfaction and movement disorders also improved significantly. Tolerability of RLAI was generally good and no unexpected adverse events were reported. The ensured delivery of medication with RLAI resulted in significant symptom improvement in this patient population. Direct initiation of RLAI is well accepted by patients. RLAI might represent a novel option for patients in the early phases of psychosis.

Sustained improvement of clinical outcome with risperidone long-acting injectable in psychotic patients previously treated with olanzapine.

The efficacy and tolerability of risperidone long-acting injectable were investigated in patients with schizophrenia or other psychotic disorders who had previously been symptomatically stable on olanzapine treatment. Patients received risperidone long-acting injectable, 25 mg, by intramuscular injection every 2 weeks; the dose could be increased to 37.5 or 50 mg if necessary. Patients were transferred directly from their previous medication to risperidone long-acting injectable without a run-in period of oral risperidone treatment. Of 192 patients recruited, 134 patients (70%) completed the study. The principal reasons for discontinuation were withdrawal of consent (8%), adverse events (6%), insufficient response (5%) and non-compliance (4%). Risperidone long-acting injectable produced a significant improvement (p = 0.0001) in Positive and Negative Syndrome Scale (PANSS) total scores, from 74.2+/-21.3 at baseline to 65.8+/-21.4 at endpoint. There were also significant reductions in PANSS subscales (positive symptoms, negative symptoms, general psycho-pharmacology) and Marder factor scores. The Clinical Global Impression increased significantly from baseline to endpoint (p = 0.0001), as reflected by the increase in the proportion of patients rated as 'not ill' or 'borderline ill' from 10% at baseline to 21% at endpoint. Risperidone long-acting injectable was also associated with significant improvements in Global Assessment of Function, patient satisfaction with treatment, and quality of life, measured on the SF-36 scale. Movement disorders, measured on the Extrapyramidal Symptom Rating Scale, were significantly reduced following the change to risperidone long-acting injectable. Treatment with risperidone long-acting injectable was well tolerated, and no significant weight gain occurred during the study. This open study suggests that risperidone long-acting injectable produces symptomatic improvement in schizophrenia patients previously considered symptomatically stable with olanzapine, along with improvement in movement disorders. The combination of improved efficacy and good tolerability may have important implications for patient adherence to therapy and subsequent long-term outcomes.

Neural correlates of emotions in psychiatric patients in the light of functional neuroimaging findings.

The question whether there exists "the emotional brain" still remains open. The greatest scientific challenge at the threshold of 2000 is to make "a map of brain emotions" with a detailed topography for each "basic emotion". The investigations, with the use of the most advanced neuroimaging techniques: positron emission tomography(PET), functional magnetic resonance (fMRI) and SPECT (single photon emission computed tomography), aimed at obtaining more precise location data on the system regulating the effect in normal and in pathology. In recent years, with the use of neuroimaging techniques, an important role of posterior temporal cortex, orbital-frontal cortex, amygdaloid nucleus and insula in the regulation of emotional behaviour has been indicated. The present study is an attempt at: 1) systemizing the research experiments serving the investigation of emotions with the use of neuroimaging techniques, 2) systemizing the latest results of investigations aimed at either search of the "emotional brain", or neural correlates of emotions responsible for the regulation of emotional behaviour in anxiety and affective disorders as well as in schizophrenic disorders.

[Comparative research on some clinical and psychopharmacological parameters of reactive paranoid psychoses]. / Badania porównawcze niektórych parametrów klinicznych i psychofarmakologicznych psychoz paranoidalnych reaktywnych.

10 patients suffering from reactive psychoses were treated in a standardized manner with pernazine. The dynamic of the clinical picture as well as the behaviour of prolactin levels and the activity of DBH in blood plasma were assessed.

[Placental lactogen level and activity of oxytocinase, beta-glucuronidase and thermostable alkaline phosphatase isoenzyme in blood serum of women with ectopic pregnancy]. / Poziom laktogenu lozyskowego oraz aktywnosc oksytocynazy, beta-glukuronidazy i termostabilnego izoenzymu fosfatazy alkalicznej w surowicy krwi kobiet z ciaza ektopowa.

The lack of literature data dealing with placental lactogen concentration as well as with the other biochemical parameters in blood serum in women with ectopic pregnancy was the reason we turned to that problem. In eight patients with ectopic pregnancy there was determined placental lactogen level and oxytocinase activity as well as the activity of beta-glucuronidase and thermostable alkali phosphatase isoenzyme in blood serum. The results obtained were compared to the concentration of those parameters in blood serum in women with ectopic pregnancy and to those of not pregnant women. It was stated that in women with ectopic pregnancy there was produced placental lactogen and its concentration in blood serum was lower (about 30 percent) than that in women with ectopic pregnancy. Similarly, mean value of oxytocinase activity in women with ectopic pregnancy was twice lower in comparison to that of ectopic pregnancy, while beta-glucuronidase activity was twice higher when compared to that of ectopic pregnancy values. Placental alkali phosphatase isoenzyme activity was similar in both groups of pregnant women.

The usefulness of serum angiotensin-converting enzyme test in the diagnosis of sarcoidosis.

Angiotensin-converting enzyme (ACE) was determined in blood serum of 110 patients with sarcoidosis and 80 healthy persons. Taking into account the advancement of pulmonary changes as well as disease activity the behaviour of this enzyme was estimated. It was found that ACE activity is significantly higher in patients with sarcoidosis than in control group. The rise of ACE activity took place in 90% of patients with active sarcoidosis and almost in 50% with inactive sarcoidosis.

[Prognostic value of measuring serum angiotensin I-converting enzyme (ACE) in patients with sarcoidosis]. / Prognostyczna wartosc oznaczania enzymu konwertujacego angiotensyne I (ACE) w surowicy chorych na sarkoidoze.

Serum ACE (s-ACE) activity were determined in 112 sarcoid patients and 60 healthy volunteers. The mean s-ACE activity in sarcoid patients were 39.5 +/- 14.1 U. and in healthy volunteers 22.1 +/- 3.6, U. Significant increase of s-ACE was seen in active sarcoidosis 51.2 +/- 13.7 U. Serum ACE activity increased twice or more in comparison with control values imply activity of the process. Serum-ACE determination may be of use as a prognostic factor in sarcoidosis.

[Comparative studies of various clinical and psychopharmacological parameters of schizoaffective psychosis and paranoid schizophrenia]. / Badania porównawcze niektórych parametrów klinicznych i psychofarmakologicznych psychozy schizoafektwnej i schizofrenii paranoidalnej.

Two groups of male patients were investigated: 19 subjects with diagnosis of paranoid schizophrenia and 13 with schizoaffective psychosis (8 with both depressive and paranoid symptoms, 5 with manic and paranoid). All patients were treated with perazine in this same manner. During the consecutive stages of therapy the following parameters were examined and compared: clinical symptoms, DBH activity, plasma prolactin concentration and the simple reaction time task to auditory and visual stimuli. The noticeable changes, similarities and differences were described.

Clinical and pharmacological approach to the diagnosis of paranoid schizophrenia.

The aim of the study was finding out the correlations between some clinical and biological variables in paranoid schizophrenia. The group of 16 patients with paranoid schizophrenia, chosen in careful diagnostic procedure was treated with perazine during 4 weeks time. Before and during the treatment, the following parameters: psychopathology, serum perazine and prolactin concentration, dopamine-beta-hydroxylase activity and simple reaction time were measured. We found changes of those parameters caused by the treatment. The simple reaction time retardation was side-dependent before the treatment and not side-dependent after the treatment.

Insulin coma therapy in the treatment of early schizophrenia.

The results of the insulin therapy of early schizophrenia patients in the Department of Psychiatry at the Medical Academy of Lublin are summarized in the article. The clinical data of 236 patients hospitalized in 1950-1983 was analysed with the use of standardized methods. The analysis showed that insulin therapy, is a relatively safe method of treatment. The antipsychotic effects of insulin therapy were substantial and comparable with the antipsychotic effectiveness of contemporary agents.

[Personality disorders in adolescents]. / Zaburzenia w rozwoju osobowosci u mlodziezy.

The aim of the study was the investigation of symptoms and origin of the disturbances in personality development of adolescents. The group of 50 patients (22 girls and 28 boys aged from 14 to 20 years) of the Young People's Unit and Outpatient Clinic of the Department of Child and Youth Psychiatry of the Institute of Mother and Child in Warsaw were examined. The study consists of the psychiatric, psychological and sociological types of investigation. The following methods were used in the study: the standard methods of the clinical investigation, Wechsler-Bellevue Intelligence Scale, R. B. Cattell, M. Choynowski and M. Nowakowska 's 16 PF; A. Roe and M. Siegelman 's "My Father" and "My Mother" questionnaires; E. S. Schaefer and R. Q. Bell's Parental Attitude Research Instrument and E. Kobia lka's Family Environmental Questionnaire. The control group was formed in the method of pairs and was investigated in the same way as patients. After the detailed analysis of the data, the final conclusions were formed. They are as follows: In the clinical picture of disturbances of the development of patients personality, the conduct disorders prevailed. The suicidal and parasuicidal behaviour occurred in 1/3 of the patients. Also the depressive and other neurotic symptoms took place. The intelligence level was average and dull normal. The following personality features were established: emotional instability, guilt proness , low self- sentiment , high ergic tension (both sexes); protension ( suspection jealous ), shrewdness (girls) and threat sensitive (boys). Patients attitudes toward both parents were disturbed and unfavourable for normal personality development. The declared mothers attitudes toward patients were also unfavourable for development of mature personality. The general family environment (also living standard) was significantly worse in the criterion group. It should be stressed in conclusion, that the results of the study showed among others that the disturbed family hinder the development of adjustment mechanisms, mainly of the adjustment to the small group, which are essential for the normal personality functioning.

Serum levels of certain trace elements (Ag, Co, Cr) in healthy subjects (part II).

In 95 healthy subjects including 55 women and 40 men the serum levels of Ag, Co and Cr were determined by means of neutron activation analysis using the method of gamma spectrometry without separation of different elements from the sample. It was found that people aged over 60 years had higher serum silver levels than younger subjects. In women a statistically significantly higher serum cobalt level was demonstrated in relation to men. Men and women aged over 60 years had serum chromium levels very similar while women aged below 60 years had lower serum chromium levels.

Serum levels of certain trace elements (Fe, Rb, Se, Zn) in healthy humans (part III).

In 95 healthy subjects serum concentrations of Fe, Rb, Se and Zn were determined by means of neutron activation analysis using the method of gamma spectrometry without isolation of different elements from the sample. The studied subjects were divided into 4 groups according to sex and age. In the serum of women rubidium concentration decreased with age. On the other hand, the serum levels of Fe, Zn and Se were similar in the studied groups.

Serum levels of certain trace elements (Cu, Au, Mn) in healthy subjects (Part I).

In 95 healthy subjects of either sex the serum concentrations of Cu, Au, and Mn were determined by means of neutron activation analysis (NAA). It was found that copper concentration in the serum of healthy subjects increased with age up to 70 years of life. In subjects aged below 60 years a higher gold level was demonstrated in the serum than in the subjects aged above 60 years. Serum manganese level was higher in men than in women.