Detection of lysergic acid in ruminal fluid, urine, and in endophyte-infected tall fescue using high-performance liquid chromatography.

Ergot alkaloids present in endophyte-infected tall fescue induce fescue toxicosis in livestock consuming the plant. The lysergic acid (LA) ring structure is a common moiety among the ergot alkaloids. Little is known about the bioavailability of LA because of limitations in available analytical protocols. Thus, a high-performance liquid chromatography procedure was developed to analyze biological matrices for LA. The biological matrices of interest were tall fescue straw and seed, and ruminant feces, urine, and ruminal fluid. Lysergic acid was added to each matrix at a high (150 ng/ml) or low (30 ng/ml) level. Using the high-level addition, the greatest recovery of LA was obtained from ruminal fluid, feces, and urine (P < 0.05), with an average 85.1% recovered. At the low level, a greater recovery of added LA was observed in the ruminal fluid, urine, and feces (82.1%; P < 0.05) than that in the other 2 matrices (62.6%). The limit of quantitation (LOQ) in ruminal fluid and urine was 5.5 and 18.4 ng/ml, respectively. Seed, straw, and feces had higher LOQ (24.2, 14.5, and 36.0 ng/g, respectively). Limit of detection (LOD) was 1.64, 10.80, 4.35, 5.52, and 7.26 ng/g for ruminal fluid, feces, urine, seed, and straw, respectively. To test the assay in vivo, samples of ruminal fluid and urine were collected from steers consuming a diet containing 400 ng of ergovaline/g and 30 ng of LA/g. All matrices sampled resulted in levels above the LOD and LOQ for the assay, indicating that this assay is sufficiently sensitive for use in assessing the bioavailability of LA.

The relationship between parental communication deviance and relapse in schizophrenic patients in the 1-year period after hospital discharge. A pilot study.

The present pilot study examined the ability of parental communication deviance (CD) to predict relapse in schizophrenic patients in the 1-year period after hospital discharge. Measures of CD were obtained from verbatim transcripts of family problem-solving discussions for 20 schizophrenic patients and their parents at an initial assessment and before the patients' hospital discharge. Relapse was assessed using the Brief Psychiatric Rating Scale at 3-month intervals after discharge. Findings indicated that parental CD measured at an assessment immediately before the patient's release from the hospital was moderately correlated (r = .49, p < .05) with relapse in the 1-year follow-up period. Results are discussed with respect to the possible role of parental CD as an environmental stressor in the period after discharge. Potential contributors to parental CD, including genetically transmitted cognitive deficits and stress resulting from resuming the care-giver role, are also discussed.

A comparison of instrument sensitivity to negative symptom change.

Accurate assessment of negative symptom changes in schizophrenic patients is crucial to determining the efficacy of new treatments. The present study examined the sensitivity to change over the course of hospitalization in negative symptomatology assessed by the Scale for the Assessment of Negative Symptoms (SANS), the Negative Symptom Assessment (NSA), and an expanded version of the Brief Psychiatric Rating Scale (BPRS) in a sample of 60 schizophrenic patients. Symptoms were assessed when the patients were acutely ill and again when they were stabilized. Effect sizes were compared across all three rating scales. The retardation factor of the BPRS had a relatively small effect size (0.32). Effect size for the total NSA was 0.78 and ranged from 0.38 to 0.87 for the SANS. Individual factors had moderate to large effect sizes that ranged from 0.18 to 0.91 for both scales. Separate analyses were performed to calculate effect sizes for a five-factor version of the NSA and to examine only those symptoms specified in DSM-IV (alogia, affective flattening, and avolition). Effect sizes relatively comparable to those found for the entire SANS and NSA scales were found for the separate calculations. Results indicate that the addition of a negative symptom assessment instrument to research protocols increases the ability to detect changes in negative symptoms with substantially fewer subjects than would be required with the BPRS retardation factor alone.

Preliminary evaluation of cognitive adaptation training to compensate for cognitive deficits in schizophrenia.

Cognitive adaptation training is a treatment approach designed to alter the physical environment of patients with schizophrenia to compensate for cognitive deficits and improve adaptive function. A wide range of environmental manipulations such as labels, signs, schedules, and rearrangement of objects are employed. In a preliminary study at a state hospital, outcomes for cognitive adaptation training were compared with outcomes for standard psychosocial treatment for two groups of patients with schizophrenia, matched on levels of functional impairment and symptoms. Both groups showed improvement in symptoms and adaptive function, but patients receiving the specialized training showed greater improvement in adaptive function than did the standard-treatment group.

Serotonin-mediated increase in cytosolic [Ca++] in platelets of risperidone-treated schizophrenia patients.

Stimulating the platelet 5HT2 receptor generates the second messenger IP3, and results in an increase in cytosolic [Ca++] ([Ca++]cyt). Platelets from risperidone-treated patients would be expected to respond less effectively, as measured by decreased [Ca++]cyt, after 5HT2 receptor stimulation. We report the data on 6 risperidone-treated patients and 6 normal controls evaluated at our site using the Fura-2 method for determining platelet [Ca++]. Data analysis was performed by unpaired two-tailed Student's t-test. No significant differences between groups were found for ED50 5HT-stimulated [Ca++]cyt (ED50 5HT delta [Ca++]cyt). Significant differences were found for maximal change [Ca++]cyt (Max delta [Ca+2]cyt) between risperidone-treated patients and normal controls (p = .03). These preliminary data suggest that measurement of 5HT-stimulated changes in platelet cytosolic [Ca+2] might be a useful marker for in vivo risperidone inhibition of 5HT2 function.

Validity of the Allen Cognitive Levels Assessment: a tri-ethnic comparison.

Schizophrenia is a mental illness which is characterized by severe cognitive deficits and impairments in adaptive functioning. The Allen Cognitive Levels (ACL) Assessment is a screening instrument designed to assess cognitive functioning and to aid clinicians in making judgments about how a patient will be able to perform basic activities of daily living. While the ACL has been widely used, the validity of ACL scores for predicting concurrent adaptive functioning has not been established empirically. The present study examined ACL scores in 110 schizophrenic patients. Scores on the ACL were found to be highly related to scores on the Functional Needs Assessment (r = 0.66), which measures a patient's ability to perform basic activities of daily living. Findings provided some of the first strong evidence that ACL scores reflect adaptive functioning. Correlations between the ACL and the Functional Needs Assessment were equally strong in non-Hispanic whites (n = 31, r = 0.67), Mexican-Americans (n = 58, r = 0.60), and African-Americans (n = 21, r = 0.46). Mean scores did not differ between patients from different ethnic groups. In addition, there was no relationship between ACL scores and level of acculturation within the Mexican-American group. Our data strongly support the hypothesis that the ACL provides a valid and culturally unbiased measure of cognitive functioning that can be helpful in determining how a patient is likely to perform activities of daily living.

Executive impairment among the functionally dependent: comparisons between schizophrenic and elderly subjects.

OBJECTIVE: Executive deficits have traditionally been associated with frontal lobe brain damage. They are relevant to a variety of disabling mental conditions, including schizophrenia and Alzheimer's disease. To measure these deficits, the authors developed the Executive Interview, a 25-item, 15-minute interview. It has been validated among elderly subjects across a wide range of functional impairment. METHODS: Forty young, chronically ill schizophrenic residents of a state mental health facility and 104 elderly residents, representing three levels of care, of a comprehensive retirement community were tested with the Executive Interview and the Mini-Mental State. RESULTS: When age, gender, education, and number of prescribed medications were controlled, cognitive impairment on the Executive Interview and Mini-Mental State rose with level of care. The Executive Interview alone discriminated between subjects at each level of care, and it was more sensitive to cognitive impairment than the Mini-Mental State. Executive Interview scores correlated the strongest with level of care. Mini-Mental State scores, number of prescribed medications, and age also correlated significantly. Schizophrenic patients showed as much executive impairment on the Executive Interview as elderly subjects at the same level of care despite significant differences in age, sex, and neuroleptic use. Executive Interview and Mini-Mental State scores were highly correlated among the elderly but less so among the schizophrenic patients. Cross-group differences were also found in the pattern of failure on selected Executive Interview items despite similar total Executive Interview scores. CONCLUSIONS: Increasing executive dyscontrol is associated with the need for increasing levels of care and supervision. This finding is neither age nor disease specific. Cross-group differences on selected Executive Interview items suggest the existence of disease-specific patterns of failure. Their recognition could prove useful in the identification of anatomically or pathophysiologically distinct subgroups among patients with executive dyscontrol.

Acute effects of neuroleptics on unmedicated schizophrenic patients and controls.

Acute administration of haloperidol (0.2 mg/kg) produced many more side effects in normal controls than in unmedicated schizophrenic patients. Prior to the neuroleptic challenge, both groups were on the peripheral monoamine oxidase inhibitor, debrisoquin, for at least 1 week, in order to enhance the relative contribution of CNS catecholamine metabolites to those measured in both plasma and urine. The patient group had higher plasma levels of methoxyhydroxyphenylglycol (MHPG) and homovanillic acid (HVA) and higher urinary MHPG output than controls, but there were no effects of haloperidol challenge, compared to placebo challenge. In both groups there were significant declines in plasma HVA levels from 8:30 AM to 12 NOON. These declines were unaffected by the haloperidol challenge. Explanations for the marked differences in behavioral effects of haloperidol on patients and controls include the possibility that dopamine receptor numbers were increased in the brains of the schizophrenic patients.

A national study of associate degree mental health and human services workers.

A random sample of 140 graduates of associate degree mental health/human services programs were studied to determine their work activities, adequacy of work performance, and job satisfaction. Seventy-seven percent were employed in relevant human services jobs. On site interviews with these workers and their supervisors revealed that they were performing virtually the entire range of traditional mental health service functions and performing them well. A majority were satisfied with their work, although low salary levels and restricted opportunities for future advancement were recognized as problems. Many were receiving little supervision and the user agencies had, for the most part, not developed appropriate in-service training programs. The findings appear very supportive to the notion that the mental health associate is a valuable new source of manpower for the mental health/human services field.