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 21,692 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

The prevalence of neurological soft signs in schizophrenics was compared with that in patients with major affective disorder and in normal subjects. The two patient groups did not differ from one another, but both differed from normal controls in the occurrence of right-left confusion. The paranoid and nonparanoid subtypes of schizophrenia did not differ in the prevalence of neurological soft signs. Schizophrenic patients with or without one sign had similar demographic, clinical and treatment attributes. It is concluded that neurological soft signs are not specific to schizophrenia, but may, in general, reflect the level of obstetric care in a community. However, certain soft signs may be more strongly indicative of neurodysfunction associated with the psychotic state.
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PMID:Neurological soft signs in Nigerian schizophrenics: a controlled study. 322 71

Many psychiatric patients have polydipsia and polyuria without identifiable underlying medical causes. Hyponatremia develops in some polydipsic patients and can progress to water intoxication with such symptoms as confusion, lethargy, psychosis, and seizures or death. This syndrome is sometimes called "compulsive water drinking," "psychogenic polydipsia," and "self-induced water intoxication." Although the underlying pathophysiology of the syndrome is unclear, several factors have been implicated in producing polydipsia and symptomatic hyponatremia. These include a possible hypothalamic defect, the syndrome of inappropriate secretion of ADH (SIADH), and neuroleptic medication. Evaluation of psychiatric patients with polydipsia includes a search for other medical causes of polydipsia, polyuria, hyponatremia, and SIADH. Treatment modalities currently available include fluid restriction and medications.
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PMID:Polydipsia and hyponatremia in psychiatric patients. 328 1

Perinatal death entails bereavement for the family and confusion for the care-givers. In the light of a brief theoretical study of grief, the present article reviews the difficulties and complications of parental grief and the propositions for support and counselling. The most recent works in the subject as well as topics for future research are emphasized. Perinatal bereavement is followed by severe complications: depression, psychosis for mothers, mainly following the next live birth; family disagreement; disturbances, running away, drug, suicide among already born or future children, especially for the replacement child. Professional behaviour: listening, letting see the dead baby, offering possibilities for the expression of the emotions, is followed by gratitude from the parents instead of annoyance due to the usual conspiracy of silence. Bereavement outcome is furthered by the new management. More research is needed about maternal risk factors and prevention of parental grief repercussions on their children.
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PMID:[Perinatal bereavement. Psychopathology and counseling]. 329 78

The toxicities of antimalarial drugs vary because of the differences in the chemical structures of these compounds. Quinine, the oldest antimalarial, has been used for 300 years. Of the 200 to 300 compounds synthesised since the first synthetic antimalarial, primaquine in 1926, 15 to 20 are currently used for malaria treatment, most of which are quinoline derivatives. Quinoline derivatives, particularly quinine and chloroquine, are highly toxic in overdose. The toxic effects are related to their quinidine-like actions on the heart and include circulatory arrest, cardiogenic shock, conduction disturbances and ventricular arrhythmias. Additional clinical features are obnubilation, coma, convulsions, respiratory depression. Blindness is a frequent complication in quinine overdose. Hypokalaemia is consistently present, although apparently self-correcting, in severe chloroquine poisoning and is a good index of severity. Recent toxicokinetic studies of quinine and chloroquine showed good correlations between dose ingested, serum concentrations and clinical features, and confirmed the inefficacy of haemodialysis, haemoperfusion and peritoneal dialysis for enhancing drug removal. The other quinoline derivatives appear to be less toxic. Amodiaquine may induce side effects such as gastrointestinal symptoms, agranulocytosis and hepatitis. The main feature of primaquine overdose is methaemoglobinaemia. No cases of mefloquine and piperaquine overdose have been reported. Overdose with quinacrine, an acridine derivative, may result in nausea, vomiting, confusion, convulsion and acute psychosis. The dehydrofolate reductase inhibitors used in malaria treatment are sulfadoxine, dapsone, proguanil (chloroguanide), trimethoprim and pyrimethamine. Most of these drugs are given in combination. Proguanil is one of the safest antimalarials. Convulsion, coma and blindness have been reported in pyrimethamine overdose. Sulfadoxine can induce Lyell and Stevens-Johnson syndromes. The main feature of dapsone poisoning is severe methaemoglobinaemia which is related to dapsone and to its metabolites. Recent toxicokinetic studies confirmed the efficacy of oral activated charcoal, haemodialysis and haemoperfusion in enhancing removal of dapsone and its metabolites. No overdose has been reported with artemesinine, a new antimalarial tested in the People's Republic of China. The general management of antimalarial overdose include gastric lavage and symptomatic treatment.(ABSTRACT TRUNCATED AT 400 WORDS)
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PMID:Clinical features and management of poisoning due to antimalarial drugs. 330 66

It has been argued that there is an important group of conditions, seen for the first time in late infancy and early childhood, which are both remarkably persistent and pervasive in their influence on cognitive and social development. They combine features of childhood autism, mental retardation and cognitive deterioration and the term 'disintegrative' most precisely characterizes their impact on development. The term 'psychosis' is only usually appropriate in describing the severity of the psychiatric symptoms. In order to avoid confusion with the psychoses or dementia of adult life, the term 'disintegrative disorder of development' may be preferred. While specific pathology is being identified in an increasing number of cases, the combined use of psychiatric and physical diagnostic categories perhaps best serves to draw attention to this important group of disorders. It is likely that, with increasing knowledge, the need for such an interim diagnostic category may become unnecessary.
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PMID:Development, disintegration and dementia. 332 49

A 34-year-old woman experienced three episodes of an atypical psychosis, characterized by confusion, agitation, delusional thinking, paranoid ideation, and auditory hallucinations, during the 14 months prior to her death. Findings of gross examination of the brain and spinal cord were unremarkable. Histologic examination revealed scattered subpial foci of demyelination throughout the brain stem, with involvement of the hippocampal formation bilaterally. Although occasional active lesions at early stages of development were noted, most lesions were gliotic and therefore quiescent. This case and one similar example of disseminated subpial demyelination found in the literature probably represent an unusual variant of multiple sclerosis.
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PMID:Atypical psychosis with disseminated subpial demyelination. 336 70

Fifteen cases of presumed cocaine intoxication were evaluated in the emergency room (ER) at a city hospital over a four-day period. This series is unique in that many of these patients were from a similar area of the city, in some cases had the same street address, were regular abusers of cocaine, and presented to the ER with similar symptoms of tachycardia, dilated pupils, marked confusion, bizarre and sometimes violent behavior, psychosis, and hallucinations. Many of these symptoms were present several hours after drug use. Samples of a white powder presumed by the patients to be cocaine were obtained from two patients and analyzed by gas-liquid chromatography. Neither sample contained cocaine, but rather revealed atropine, benzocaine, and procaine. The signs and symptoms of cocaine, amphetamine, and atropine intoxication are reviewed and the problems of drug analysis and differential diagnosis of drug intoxication are discussed.
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PMID:Differentiation of cocaine toxicity: role of the toxicology drug screen. 341 45

The assessment of competency to stand trial is frequently fraught with conceptual confusion resulting from a failure to properly apply the data of the clinical examination to the relevant legal criteria. A basic question scheme that encompasses (1) the defendant's psychiatric status, (2) the effects of that status on his functioning, and (3) his apparent ability to participate in legal proceedings, is introduced to clarify the evaluation of fitness to stand trial. The way in which combinations of answers to three "basic questions" generate a scheme that clarifies the difficulties encountered in most competency evaluations is shown. Eight paradigm cases are generated. Five of these (competence, incompetence, mentally ill but competent, malingering, and impaired but competent) are frequently straightforward. However, the three possibilities in which a defendant meets criteria entailed by two of the three questions are inherently subject to controversy. These situations (circumscribed psychosis related to the charges, malingering in the context of mental illness, and functional deficits in the context of minor mental illness) are discussed in detail and illustrated with case material.
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PMID:Competency to stand trial: a conceptual model for its proper assessment. 342 33

Psychiatric disorders induced by drugs are of most concern when they occur in the context of therapeutic use of a drug. Such iatrogenic psychiatric disturbances may interfere considerably with the treatment of the primary illness and may cause concern to patients, their relatives and the medical staff. Because many drugs are often used simultaneously in seriously ill patients, it may be difficult to be sure which drug may have been responsible. The best procedure is to remove those drugs which are most probable causes of the psychiatric disturbances as well as any drugs that are not truly essential for the treatment of the patient. Problems involved in evaluating the relationship between use of drugs and psychiatric disorders are considerable. Many reports are isolated cases and the denominators which might provide some idea of the potential risk are unknown. Many relationships are still controversial, such as the association of depression with sedatives, antihypertensives and oral contraceptives. Areas of uncertainty are great. Psychomotor impairment may be caused by a drug that can alter consciousness, or any drugs that can produce more delineated psychiatric syndromes. Sedative drugs are those most commonly associated with psychomotor impairment, and may include psychotherapeutic drugs, sedative antihistamines, narcotic analgesics and, of course, the widely used social drug, alcohol. Delirious states are most often associated with drugs that possess central anticholinergic actions. These include not only drugs clearly identified as anticholinergics, but also tricyclic antidepressants and anti-Parkinson drugs. Cimetidine, which is often used parenterally in seriously ill patients, is also a prominent cause. Delirium is most often seen in elderly patients and in those who have received rather large doses of drugs. The association of schizophrenic-like psychoses with dopaminomimetic drugs tends to support the prevailing dopamine hypothesis of schizophrenia. Levodopa, the dopamine precursor, and bromocriptine, a direct dopamine agonist, are examples of such relationships. Abuse of social drugs has also been thought to provide a useful model of schizophrenia. Hallucinogens are probably a rather poor model, abuse of amphetamines may provide a better model, and possibly the best is the psychotic state elicited by phencyclidine. Manic reactions are clinically difficult to differentiate from schizophrenic-like psychoses and are often produced by similar drugs. Corticosteroids may produce either manic or schizophrenic-like disorders, as well as occasionally confusion and depression.(ABSTRACT TRUNCATED AT 400 WORDS)
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PMID:Drug-induced psychiatric disorders and their management. 354 May 20

The term fear of flying (FOF) has been applied to many sets of symptoms. Confusion has resulted from the use of the term FOF to describe problems arising from anxiety disorders, traumatic stress, exhaustion, psychosis, and motivational changes. This literature review describes the history and development of the term FOF, and suggests an approach to its evaluation by clinicians and administrators. Representative works from the last 65 years are reviewed in their historical contexts.
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PMID:A historical review of the fear of flying among aircrewmen. 355 51


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