Neuropsychiatric Diagnosis Research Articles

An Analysis of Synapsin II, a Neuronal Phosphoprotein, in Postmortem Brain Tissue From Alcoholic and Neuropsychiatrically Ill Adults and Medically Ill Children and Young Adults

Synapsin II (formerly known as protein III) is a synaptic vesicle-associated neuronal phosphoprotein that may be involved in the regulation of neurotransmitter release. Synapsin II was studied in postmortem brain samples from 132 individuals with various neuropsychiatric and medical diagnoses. Molecular weight variants of synapsin II were present in 73% of samples from alcoholic individuals but in only 31% of samples from non-diseased individuals, thus confirming our two previous reports of an association between synapsin II variants and alcoholism. The presence of synapsin II variants was not correlated with age or nutritional state. Synapsin II variants were also present in 56% of samples from individuals with schizophrenia and 41% of samples from individuals with Huntington's disease. Synapsin II variants were present in samples from children and young adults, consistent with the possibility that synapsin II variants may reflect a genetically inherited trait. Synapsin II variants were not found in any of 18 rodent models of alcoholism, aging, or vitamin B deficiency, suggesting that synapsin II variants may be a uniquely human trait.

Pharmacotherapy for self-injurious behavior: Preliminary tests of the D1 hypothesis

Gualtieri C. Thomas and Stephen R. Schroeder: Pharmacotherapy for Self-Injurious Behavior: Preliminary Tests of the D1 Hypothesis. Prog. Neuro-Psychopharmacol. & Biol. Psychiat. 1990, 14 (Supple.): S81–S107. 1. 1. The D1 dopamine hypersensitivlty model of self-injurious behavior leads to a testable clinical hypothesis: that the mixed D1/D2 dopamine antagonist fluphenazine may improve the symptoms of self-injurious patients. 2. 2. The hypothesis was tested in an open pilot trial in six patients and a partially controlled trial in nine patients. 3. 3. Some degree of clinical improvement was observed in eleven of the fifteen. 4. 4. The trials represent a partial affirmation of the D1 hypothesis. However, it is also clear that conventional methodology for psychopharmacologic research is inappropriate for the proper clinical evaluation of self-injurious patients. The proper method should include the following elements: i) An epidemiologically representative sample 4.1. ii) A naturalistic study environment 4.2. iii) A longitudinal design with long-term follow-up 4.3. iv) Concurrent behavioral ratings using direct observations and a reliable, treatment-sensitive rating scale. 5. 5. Before subjects enter a clinical trial of an experimental medication, a neuropsychiatric differential diagnosis should be applied to limit the diversity of the sample.

A Nested Case-Control Study of Disability Pension among Seamen, with Special Reference to Neuropsychiatric Disorders and Exposure to Solvents

A cohort of 1,687 captains and mates from different types of ships were followed for recording of disability pension from 1970 to 1986. 199 cases were found. At date of diagnosis each case was age-matched to 4 randomly selected seamen within the rest of the cohort at risk. A strong relationship between disability pension due to neuropsychiatric diagnoses and work on tankers was found, especially when restricted to work as a mate on the tankers. These mates experience the highest exposure to organic solvents within the investigated group. The findings indicate an occurrence of chronic nervous system disorders due to long-term exposure to organic solvents.

The prevalence of neuropsychiatric disorders in a nursing home population.

The prevalence of neuropsychiatric disorders and other medical illnesses was investigated in 65 nursing home residents. The authors found neuropsychiatric disorders to be present in 94% of the sample. The neuropathologic causes of these syndromes were found to be more diverse than in previous studies. The most frequent causes were degenerative, vascular, and toxic. The most common psychiatric syndromes that resulted from these neuropathologic disorders were dementia syndrome (72%), organic personality syndrome (14%), and organic psychotic disorders (12%). The most common behavioral problems, agitation and aggression, most likely reflected the high prevalence of frontal lobe damage and affected 48% of the sample. Other non-neuropsychiatric medical problems were significantly less common. While only 4% of the sample had no neuropsychiatric diagnosis, 39% had no other non-neuropsychiatric diagnosis. These results suggest that the nursing home is not used as a referral source for chronic medical conditions in general but almost exclusively for the care of chronic neuropsychiatric disorders.

Posttraumatic Stress Disorder From Pentaborane Intoxication

Fourteen individuals briefly exposed to a toxic industrial compound, pentaborane, were evaluated for neuropsychiatric abnormalities four to 12 weeks after exposure. Results of physical, neurological, and routine laboratory evaluations were normal. Initial and persistent psychiatric symptoms, neuropsychological deficits, electroencephalographic changes, elevated central nervous system neurotransmitter levels, and ventricular brain ratios (computed tomographic scan) provide evidence of central nervous system damage. Seven patients met diagnostic criteria of the Diagnostic and Statistical Manual of Mental Disorders, ed 3, for posttraumatic stress disorder, and seven patients had neuropsychological test evidence of mild brain dysfunction. No statistically significant relationship was found between neuropsychiatric test results and psychiatric diagnoses. These results contradict previous literature that reports most symptom resolution within the first week after exposure to pentaborane. Results suggest that patients suffered a combination of organic brain insult and psychological trauma.

NEUROPSYCHIATRIC DISORDERS

Eighty-five patients with childhood-onset pervasive neuropsychiatric disorders (infantile autism, pervasive developmental disorders, developmental language disorders, severe attentional deficit disorders with learning difficulties, and Tourette's syndrome of chronic multiple tics) underwent computed tomographic scanning of the brain. Clinical assessments of each image of the patients' scans by a diagnostic radiologist, who was "blind" to the neuropsychiatric diagnosis, were used in the first phase of the study, which is reported here. Twenty-four percent of the scan series revealed clear abnormalities and 13% showed mild asymmetries in ventricular and/or hemispheric size. Of the children with pervasive developmental disorders, 59% had abnormal scans, as did 44% of those who were language impaired and 38% of those with Tourette's syndrome. No distinct abnormality was isolated by which diagnostic categories could be separated, nor was an increased prevalence of scan abnormalities associated with overall severity of symptoms. Mild asymmetries, involving increased size of the left hemisphere and/or left ventricular system, were found in all diagnostic groups, and may be associated with one or more behavioral or cognitive disturbances found in the five syndromes. No systematic relationship was found between computed tomography (CT) scan abnormalities and EEG abnormalities. Critical methodologic issues involving diagnostic formulation and assessment of brain status through computed tomographic scanning are discussed.

Computed Tomographic Brain Scanning in Children with Developmental Neuropsychiatric Disorders

Eighty-five patients with childhood-onset pervasive neuropsychiatric disorders (infantile autism, pervasive developmental disorders, developmental language disorders, severe attentional deficit disorders with learning difficulties, and Tourette's syndrome of chronic multiple tics) underwent computed tomographic scanning of the brain. Clinical assessments of each image of the patients' scans by a diagnostic radiologist, who was “blind” to the neuropsychiatric diagnosis, were used in the first phase of the study, which is reported here. Twenty-four percent of the scan series revealed clear abnormalities and 13% showed mild asymmetrics in ventricular and/or hemispheric size. Of the children with pervasive developmental disorder, 59% had abnormal scans, as did 44% of the language impaired and 38% of the Tourette's syndrome groups. No distinct abnormality was isolated by which diagnostic categories could be separated, nor was an increased prevalence of scan abnormalities associated with overall severity of symptoms. Mild asymmetries, involving increased size of the left hemisphere and/or the left ventricular system, were found in all diagnostic groups.

Neuropsychiatric diagnosis on a short-term treatment service.

The evaluation of suspected neuropsychiatric disorder in a series of 17 patients is described. The heuristic value of DSM-III's multiaxial approach is noted. The use of routine and neuropsychological tests, EEGs, CAT scans, T-3 and T-4 tests, and lumbar puncture, in conjunction with prolonged behavioral observation in a stable, therapeutic milieu, provided the means for clarification of neuropsychiatric illness in this series of complex cases. The value of CAT scans, neuropsychological tests and of prolonged behavioral observation in selected cases is discussed.

Reply to Weingold, Dawson, and Kael

After submitting for publication the report on Brain lesions and five MMPI ( 1964), I checked two new groups of male veterans with neuropsychiatric diagnoses, each of whom had taken the MMPI. Members of one group had records of abnormal electroencephalograms, the other of normal ones. The results were consistent with those obtained by Weingold, Dawson, and Kael ( 1965 ) . In other words, the five MMPI items failed to discriminate significantly in my samples as well, between psychiatric Ss having abnormal (organic) EEGs and those with normal EEGs. So, we may conclude that these Ss collectively reacted differently from the nonpsychiatric cases referred for neurological evaluations co the five special items as well as to the instrument as a whole. However, it should be noted that there could be a number of reasons for the differences in results obtained with the five MMPI items. For instance, our Ss took the test before diagnoses were made of brain damage or some other conditions. Also, they were all under special hospital observation for diagnostic evaluation at time of psychological testing. Persons can view themselves differently after they have been informed of the presence, or most probable absence, of brain dysfunction.

Leisure activities in relation to neuropsychiatric diagnosis and treatment.

Journal of Clinical PsychologyVolume 13, Issue 1 p. 56-58 Diagnostic Procsses: General Leisure activities in relation to neuropsychiatric diagnosis and treatment† J. P. S. Robertson, J. P. S. Robertson Netherne Hospital, Coulsdon, EnglandSearch for more papers by this author J. P. S. Robertson, J. P. S. Robertson Netherne Hospital, Coulsdon, EnglandSearch for more papers by this author First published: January 1957 https://doi.org/10.1002/1097-4679(195701)13:1<56::AID-JCLP2270130113>3.0.CO;2-5 † The author's thanks are due to Dr. R. K. Freudenberg, physician superintendent, Netherne Hospital, for his encouragement of this investigation. AboutPDF ToolsRequest permissionExport citationAdd to favoritesTrack citation ShareShare Give accessShare full text accessShare full-text accessPlease review our Terms and Conditions of Use and check box below to share full-text version of article.I have read and accept the Wiley Online Library Terms and Conditions of UseShareable LinkUse the link below to share a full-text version of this article with your friends and colleagues. Learn more.Copy URL Share a linkShare onFacebookTwitterLinked InRedditWechat No abstract is available for this article. Volume13, Issue1January 1957Pages 56-58 RelatedInformation

Duration of hospitalization, readmission rate and stability of diagnoses in veterans hospitalized with neuropsychiatric diagnoses.

Duration of hospitalization, readmission rate and stability of diagnoses in veterans hospitalized with neuropsychiatric diagnoses.

INCIDENCE OF NEUROPSYCHIATRIC DISEASE IN THE DEMOBILIZED VETERAN

1. The neuropsychiatric study of 10,000 separatees demobilized under the regulations existing during December 1945 and January 1946 showed that only 257 men (2.57%) had sufficient complaints to warrant a neuropsychiatric diagnosis. Of these, 51, or 0.51%, had a disorder sufficient in severity to cause them some degree of incapacity. 2. The lay press has overestimated the psychological problem of the veteran upon returning home. 3. Those cases whose neuropsychiatric disorders were precipitated by combat show a better response to reconditioning and had fewer complaints upon separation then those whose disorder was precipitated by factors other than combat. 4. The disorders discussed in this paper present a group for which hospital care is neither necessary nor desirable. The veteran has learned to accept the psychiatrist while in the Army and will expect skilled professional assistance within easy availability when out of the Army.

THE ELECTROENCEPHALOGRAM IN SOME MILITARY AND SELECTIVE SERVICE CONVULSIVE AND NON-CONVULSIVE PROBLEMS

Electroencephalography was performed in 92 military and selective service convulsive and non-convulsive problems. Of 20 subjects with a history of convulsion during military service observed by other than medical personnel, the EEG was abnormal in 10 (50%), doubtful in 2 (10%) and normal in 8 (40%). Of 41 subjects with a self-claimed history of rare convulsions months to years ago, the EEG was abnormal in 18 (43.9%), doubtful in 1 (2.4%) and normal in 22 (53.4%). Of 9 subjects with a history of "fainting attack" in the military service, the EEG was abnormal in 5 (55.6%) and normal in 4 (44.4%) Of 12 subjects with episodes of faintness with retention of consciousness, the EEG was abnormal in 1 (8.3%), doubtful in 1 (8.3%) and normal in 10 (83.4%). Of 10 subjects considered malingerers with vague "nervousness" or vague fainting spells, the EEG was abnormal in none, doubtful in 1 (10%) and normal in 9 (90%). From this study it was concluded that the electroencephalogram was of assisting value in the neuropsychiatric diagnosis of non-convulsive and convulsive problems.