Morphological evidence for brainstem involvement in infantile autism.

Previous neurophysiological and neuroanatomic studies suggest brainstem dysfunction in infantile autism. Therefore, we investigated the brainstem structure of autistic patients by planimetric analysis of midsagittal magnetic resonance imaging scans. We found the entire brainstem and one component--the pons--to be statistically significantly smaller in the autistic group when compared with medical controls. We also noted no correlation between brainstem size and age in the autistic group--a correlation that was found in the control group. These data present morphological evidence of brainstem involvement in the infantile autism syndrome.

Family history and psychiatric comorbidity in persons with compulsive buying: preliminary findings.

OBJECTIVE: The authors explored the family history and psychiatric comorbidity of a group of compulsive buyers who volunteered for medication studies. Compulsive buying is characterized by inappropriate shopping and spending behavior that leads to impairment. METHOD: Thirty-three subjects who met the criteria of McElroy and colleagues for compulsive buying, and who scored more than two standard deviations above the mean on the Compulsive Buying Scale, were recruited. Twenty-two comparison subjects were recruited in the course of another study, and the presence of obsessive-compulsive disorder was the only reason for exclusion. Both groups were administered the Structured Clinical Interview for DSM-III-R disorders. The Family History Research Diagnostic Criteria were used to collect information about psychiatric disorders in first-degree relatives. RESULTS: Compulsive buyers had a mean age of 40 years; two (6%) were men. Comparison subjects had a mean age of 39 years; six (27%) were men. The two groups differed in gender distribution but not in age, marital status, or educational achievement. Compulsive buyers were more likely than comparison subjects to have lifetime mood disorders (especially major depression) and to have more than one psychiatric disorder. First-degree relatives of compulsive buyers were more likely than comparison relatives to suffer from depression, alcoholism, and a drug use disorder and to suffer more psychiatric disorders in general. CONCLUSIONS: These results indicate that persons who report compulsive buying behavior, and their first-degree relatives, are more likely to have a higher prevalence of psychiatric disorder than are comparison subjects.

Serum neuroleptic levels and extrapyramidal side effects in patients treated with amoxapine.

Serum neuroleptic levels were measured by radioreceptor assay in patients treated with the antidepressant amoxapine. When compared to standard neuroleptics, amoxapine produced relatively weak neuroleptic activity. Amoxapine dose correlated significantly with serum neuroleptic level. Three of eight patients developed significant extrapyramidal side effects. Neither dose of amoxapine nor neuroleptic level correlated with the presence or severity of EPS.

Forebrain structure in infantile autism.

Researchers implicate central nervous system dysfunction in infantile autism, but postmortem examinations and in vivo brain imaging studies have produced conflicting results concerning the neuronal systems involved. Magnetic resonance imaging--a new modality of in vivo brain imaging--was used to investigate the cerebral and thalamic structure of 105 autistic patients. Compared with the control group, there was an overall difference in the forebrain morphology of the autistic subjects due to subtle but statistically significant differences in the anterior ventricular horns, lateral ventricles, and the right lenticular nucleus. These results, when considered with previous studies of cerebral structure, suggest that there are subtle alterations in the forebrain of autistic patients.

Neuroimaging in child and adolescent psychiatry.

Although less well studied in child and adolescent psychiatry than in adult psychiatry, brain imaging has significantly altered psychiatric research and practice. This review focuses on the modalities that are used to image the brain. These include structural imaging techniques of computer tomography (CT) and magnetic resonance imaging (MRI), as well as functional imaging techniques of computed electroencephalography (CEEG), positron emission tomography (PET), and single photon emission computed tomography (SPECT). The technologies are reviewed, strengths and weaknesses of modalities discussed, and research progress reported.

Lymphocyte subsets and interleukin-2 receptors in autistic children.

Blood samples were obtained from 10 male autistic children ages 7-15 years and 10 age-matched, male, healthy controls. Lymphocyte subsets (helper-inducer, suppressor-cytotoxic, total T, and total B cells) were enumerated using monoclonal antibodies and flow cytometry. Bound and soluble interleukin-2 receptors were assayed in unstimulated blood samples and in cell cultures following 72-hour stimulation with phytohemagglutinin. The children with autism had a lower percentage of helper-inducer cells and a lower helper:suppressor ratio, with both measures inversely related to the severity of autistic symptoms (r = - .56 and - .68, respectively). A lower percentage of lymphocytes expressing bound interleukin-2 receptors following mitogenic stimulation was also noted, and this too was inversely related to the severity of autistic symptoms.

Renal actions of oxyphenbutazone.

Oxyphenbutazone decreased the renal excretion of sodium and water in anesthetized dogs. As these excretions decreased, the drug also produced a decrease in renal blood flow and in the glomerular filtration rate. Blood pressure increased slightly. These changes are consistent with an inhibition of renal prostaglandin synthesis and could explain why oxyphenbutazone is reported to produce weight gain and edema when used clinically.

SPECT brain imaging abnormalities in attention deficit hyperactivity disorder.

SPECT using N-Isopropyl I-123 IMP was performed, as part of a neuropsychiatric evaluation, on 10 patients with the DSM III-R diagnosis of Attention Deficit Hyperactivity Disorder (ADHD) and 6 patients from a non-ADHD mixed psychiatric group used as controls for comparison. Mean regional I-123 IMP SPECT region of interest (ROI) count ratios (left to right) demonstrated that the ADHD patients had greater overall hemispheric I-123 IMP uptake asymmetry with less activity in the left frontal and left parietal regions in comparison to control patients. Both groups demonstrated similar I-123 IMP uptake asymmetry in the temporal regions. These findings are consistent with previous studies of brain physiology in ADHD implicating regional cortical perfusion and metabolism abnormalities in areas which are involved in the control of attentional processes.

Effect of furosemide on canine splenic arterial blood flow.

Furosemide has been reported to cause pathological changes in the intestines as a consequence of the decrease in splanchnic blood flow that it produces. In view of the pancreatic toxicities of this diuretic, it was of interest to examine the effect of the agent on blood flow to this organ. An electromagnetic flow probe, was placed around the splenic artery, a vessel which supplies a major fraction of pancreatic blood flow. Within 60 min after furosemide (1 mg/kg, iv) administration, splenic blood flow (SBF) decreased by 20% and the decrease paralleled the drug-induced diuresis. When the diuresis was prevented, the agent failed to affect SBF. Thus, furosemide causes a reduction in SBF, which appears to involve a mechanism dependent upon the volume reduction produced by the drug-induced diuresis.

Effect of indomethacin and meclofenamate on canine mesenteric and celiac blood flow.

Two nonsteriodal antiinflammatory agents, indomethacin and meclofenamate, were found to produce a marked decrease in mesenteric blood flow, an increase in blood presure and no significant change in celiac blood flow. The initial effect of indomethacin on mesenteric blood flow differed from that seen with meclofenamate. Whereas meclofenamate induced a fall in mesenteric blood flow that was gradual in onset, indomethacin induced a marked vasoconstriction of the mesenteric bed that was immediate in onset and of short duration, which was followed by a decrease of slower onset similar to that seen with meclofenamate.

Is there hypothalamic-pituitary-gonadal dysfunction in paedophilia? A pilot study.

The hypothalamic - pituitary - gonadal axis was evaluated in men with paedophilia and non-paedophilic paraphilia, and in normal male controls, by infusion of 100 mcg. of synthetic luteinising hormone-releasing hormone (LHRH). There were no significant differences among groups in age, height, weight, testosterone, baseline luteinising hormone (LH) and follicle stimulating hormone (FSH), and FSH response to LHRH. However, there was a significant difference between the paedophilic group and the other two groups in the LH response to LHRH. The paedophiles responded with a marked elevation of LH, when compared with the non-paedophilic paraphiliacs and controls. These data indicate a hypothalamic - pituitary - gonadal dysfunction in paedophiles.

Somatic complaints in childhood tic disorders.

Twenty-six children diagnosed with chronic tic disorders (18 with Gilles de la Tourette syndrome and 8 with chronic motor tic disorder) were studied for unexplained physical complaints. Compared to normal controls, an excess of somatic complaints was found in the tic disorders group; this was similar to an excess of somatic complaints in a mixed psychiatric clinic group. Medication produced no significant effect on somatic complaints for patients in the tic and psychiatric clinic groups. Within the tic disorders group, no significant correlation was found between the increased somatic complaints and the severity of anxiety, dysphoria, or movement disorder.

Is there familial transmission of pedophilia?

A naturalistic, double-blind, family history comparison of sexual deviancy in the first degree relatives of inpatients with pedophilia and nonpedophilic paraphilia was done. Both proband groups were similar in demographic characteristics, except that pedophiles had a later onset of illness and were older during hospitalization. All patients were men. Sexual deviancy was found in 18.5 per cent of the families of paraphiliacs; only 3 per cent of a psychiatric control group had a family member with sexual deviancy. The preponderance of affected relatives were men. The types of sexual deviancy found in the families of the groups differed. Sexual deviancy among the pedophiles' families consisted of pedophilia. In families of nonpedophilic paraphiliacs, sexual deviancy was predominantly a paraphilia not involving children. These data suggest that pedophilia is familial; however, further studies are needed to delineate the manner of transmission. Nonetheless, pedophilia is found more frequently in families of pedophiles than in families of nonpedophilic paraphiliacs. This indicates specificity in the familial transmission. Thus pedophilia may be independent of the other paraphilias.

Effect of furosemide on mesenteric blood flow in the dog.

Diuretic therapy has been implicated as a possible inciting factor in nonocclusive mesenteric infarction. In view of this possibility, the effect of furosemide on superior mesenteric arterial blood flow (MBF) was investigated using electromagnetic flow probes in pentobarbital anesthetized dogs. After administration of furosemide, 1 mg/kg iv, MBF decreased by 44%. To assess the role of extracellular volume depletion induced by the diuresis in reducing MBF, volume depletion was prevented by infusing isotonic saline at a rate matching urine flow. In these experiments, MBF was not decreased by furosemide. Thus furosemide induces a marked decrease in mesenteric blood flow and this hemodynamic action involves a mechanism that is dependent upon the volume depletion induced by the drug.

Children of parents with obsessive-compulsive disorder -- a 2-year follow-up study.

OBJECTIVE: To examine the association between parental obsessive-compulsive disorder (OCD) and emotional and behavioural disorders in offspring. METHOD: Demographic, clinical, and diagnostic data were collected from parents with OCD, control subjects, and their respective offspring. Offspring were reassessed at a 2-year follow-up. RESULTS: Probands with OCD and controls were relatively well matched for age, gender, race, educational rating, and marital status. Offspring of OCD probands were at greater risk than offspring of controls for dimensionally measured anxiety, depression, somatization, and social problems. OCD offspring were significantly more likely than control offspring to have lifetime overanxious disorder, separation anxiety disorder, OCD, or 'any anxiety disorder'. Female gender in the parent with OCD, evidence of family dysfunction, and high symptom levels in offspring were predictive of broadly defined OCD at follow-up. CONCLUSION: Children having a parent with OCD are more likely than control offspring to have social, emotional, and behavioural disorders.