Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0011551 (depersonalization)
1,117 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Fenazepam, a potent anxiolytic tranquillizer (7-brom-5/o-chlorphenyl/1,2-dihydro-3H-1,4-benzodiazepin-2-on) was used in the treatment of 173 psychotic patients ( schizophrenia, endogenous depressions, involutional and organic psychoses). In all cases the clinical picture was characterized by anxiety. In 37% of the patients the psychopathological symptomatology disappeared altogether, in 27% there was a significant improvement. The best results were attained in the treatment of anxious-depressive, depersonalization and affective-delusional states. Anxious-depressive conditions in endogenous depressions gave worse results during fenazepam treatment, than in schizophrenia and organic brain disorders. Affective-delusional attacks were arrested by fenazepam in the initial phases. A good effect was also seen in depersonalization.
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PMID:[Experience in using fenazepam to treat psychotic patients]. 610 40

Do patients with borderline personality disorder (BPD) display psychotic symptoms as part of their syndrome? This question has important theoretical significance, since it bears on the question of whether BPD lies 'on the border' of psychotic functioning, or whether it is unrelated to psychotic disorders. A review of available evidence suggests that 'narrowly defined' psychotic symptoms, such as those included under the DSM-III definition of psychosis, are rare in BPD. Furthermore, when such symptoms have been reported in BPD, they may have been attributable to a concomitant, possibly independent, disorder suffered by the patient, such as substance abuse or major affective disorder. Broadly defined psychotic symptoms, such as depersonalization, are much more often reported in BPD, but many of these symptoms have also been reported frequently in patients with non-psychotic disorders and in normals. Finally, the prevalence of factitious psychotic symptoms in BPD has not been systematically investigated. Thus, the evidence for psychotic symptoms in BPD remains equivocal.
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PMID:Psychosis in borderline personality disorder. 639 40

The theme of death highlighted the depersonalization phenomena of four patients with complex partial seizures. These patients became preoccupied with death in association with psychomotor seizures, visual hallucinations, and altered perception of time and reality. The episodic sense of being dead or of having an appointment with death is a clue to the diagnosis of recurrent complex partial seizures even without overt motor stigmata of seizures. The syndrome differs from fear of death, steroid psychosis, the "near death syndrome," and Cotard's syndrome. Adjustment of antiseizure medication is an important therapeutic maneuver.
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PMID:The theme of death in complex partial seizures. 650 64

Autoscopy is thought to be a rare phenomenon in which a person visualizes or experiences a veritable hallucinatory image of his double. It may be more common than has hitherto been thought, however. It has no general pathological significance compared with its counterpart, the Capgras syndrome, where there is the experience of the object as a double, but it can occur in psychotic and borderline states and in afflictions of the central nervous system. Autoscopy has been known since ancient times but came into prominence only in the nineteenth century, both in the romantic literature of the double and in neuropsychiatric research. This paper details its history in literature as well as in psychiatry and neurology and also offers clinical examples from the author's caseload. It is the contention of the author that the phenomenon is far more common as an intrapsychic (nonhallucinatory) experience and that it is especially common in dreams. Autoscopy can ultimately be considered the quintessence of a "Cartesian artifice" in which one mind-body ("I") is caught in the act of regarding its compatriot self as a mind-body with sufficient distance as to register the ultimate meaning of self-recognition. A theory is offered that autoscopy is a special form of depersonalization which may be related to the "split-brain" phenomenon neurophysiologically and which is due to special forms of splitting and projective identification psychically.
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PMID:Autoscopy: the experience of oneself as a double. 667 45

During a four-week open study, amoxapine (AX), a new antidepressant agent, was administered to seven patients with pseudoneurotic schizophrenia, seven with neurosis and another seven with schizophrenia, all having similar symptoms. The improvement ratio was 71.4% in the pseudoneurotic schizophrenia group, 57.1% in the neurosis group and 42.8% in the schizophrenia group. Through the application of rating instruments, improvements were observed in the pseudoneurotic schizophrenia group in such items as psychotic and psychoneurotic symptoms in the assessment through the Springfield Outpatient Symptom and Adjustment Index, somatic concern and blunted affect through the Brief Psychiatric Rating Scale, and depression and depersonalization through the Clinical Rating Scale. On the other hand, overall improvements were less seen in the items of the neurosis group and the schizophrenia group. Effective doses of AX were 30 to 75 mg/day in the three groups. Side effects were observed in four cases which included insomnia, tachycardia, palpitation and hypomanic state. There were no cases in which AX was discontinued because of the side effects as these symptoms were slight. AX is remarkable and characteristically efficacious in the pseudoneurotic schizophrenia, and this effectiveness is presumed due to its antidepressant and antipsychotic actions.
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PMID:Effects of amoxapine, a new antidepressant, on pseudoneurotic schizophrenia. 702 96

The therapeutic efficacy, utility and safety of bifemelane hydrochloride were studied in 52 elderly depressive patients. The drug was administered as a tablet containing 50 mg orally three times daily for 8 consecutive weeks. The final global improvement rating and global utility rating were respectively 80.8 and 73.1 percent for all patients. The improvement rates on the Hamilton depression rating scale (HAM-D) were more than 60% for depressed mood, guilt, suicide, middle insomnia, delayed insomnia, psychotic anxiety, gastro-intestinal symptom, hypochondriasis, depersonalization and derealization. The rates regarding global symptoms evaluated by the Psychoneurotic rating scale for doctor's use were more than 60% for tension, agitation, irritability and excitement, phobia, depression, hypochondria and nocturnal delirium in psychotic symptoms, and insomnia in addition to palpitation in somatic symptoms. A significant decrease was also observed in the symptoms covered by the Self-rating depression scale of Zung after treatment with this drug. There were no instances of side-effects, nor any abnormalities in laboratory tests, encountered throughout the trial. Therefore, bifemelane hydrochloride is of value for the treatment of geriatric depression.
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PMID:The effects of bifemelane hydrochloride on depressive illness of the elderly. 749 Jan 69

Prior research on the MMPI has cautioned against misdiagnosing schizophrenia in patients with dissociative identity disorder. The present study examined the full spectrum of the dissociative experience in relation to MMPI-2 profiles. Ninety-eight women in treatment for trauma-related disorders completed the Dissociative Experiences Scale and the MMPI-2 in routine inpatient diagnostic evaluations. Consistent with prior research, severe dissociation was associated with high elevations on MMPI-2 scales typically associated with psychotic symptoms. Contrary to hypotheses, the ostensibly most benign form of dissociation, absorption and imaginative involvement, was somewhat more strongly related to MMPI-2 scores than the more pathognomonic forms of dissociation, depersonalization and amnesia. Although it should not be misdiagnosed, severe impairment on the MMPI in conjunction with dissociation should be taken seriously as suggesting vulnerability to psychotic experience. The dissociative retreat from the stressors of outer reality opens the door to the inner world of traumatic images and affects, along with compromised reality testing and disorganized thinking.
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PMID:Dissociation and vulnerability to psychotic experience. The Dissociative Experiences Scale and the MMPI-2. 756 6

Phencyclidine (PCP) and ketamine can induce a model psychosis in drug addicts and exacerbate the symptoms of chronic schizophrenics. The model psychoses these drugs induce mimic a variety of schizophrenic symptoms, including flattened affect, dissociative thought disorder, depersonalization and catatonic states. These symptoms can persist for prolonged periods and chronic PCP and ketamine addicts have persisting memory deficits. Dizocilpine (MK-801) is a simpler drug than PCP or ketamine in its actions, but it shares with both the property of blocking in a non-competitive manner the N-methyl-D-aspartate (NMDA) ion-channel. Behavioral observations and drug-discrimination studies in animals indicate that PCP and dizocilpine are similar in their effects and they both have a neurotoxic effect on neurons in posterior cingulate cortex. Recent studies have indicated that both of these drugs, when given continuously for several days, further induce neuronal degeneration in other limbic structures. These include brain regions of rats related to olfaction, associated limbic structures such as piriform cortex and posterior regions of entorhinal cortex and in it's projections, through the perforant pathway, to dentate gyrus and other cells in ventral hippocampus. These degenerative consequences may be excitatory neurotoxic effects, for these compounds also induce an elevation in glucose metabolism maximal in just those structures where degeneration is observed and the degeneration involves entire cells, with all of their processes. It has been suggested these non-competitive NMDA antagonists induce an increase in firing rate in a limbic circuit which includes the perforant pathway. At least some competitive NMDA antagonists induce the same pattern of degeneration and altered glucose utilization. There is anatomical and functional evidence that alterations in these same limbic structures are present in the dementia syndrome manifested by some schizophrenics and most Alzheimer's patients. This suggests that these non-competitive NMDA antagonists may provide a more complete model of psychoses and memory disturbances than previously recognized, in that they can mimic both persisting symptomatology and neuroanatomical abnormalities. While the neurochemical underpinnings of this effect remain elusive, it appears to be both age and sex dependent. Further studies of the mechanisms by which NMDA antagonists induce increased glucose utilization and neurotoxicity in these limbic structures may clarify these alterations in this simplified Papez-like circuit.
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PMID:The N-methyl-D-aspartate antagonists phencyclidine, ketamine and dizocilpine as both behavioral and anatomical models of the dementias. 779 58

The authors investigated the prevalence of psychotic symptoms in depression and borderline personality disorder employing the Diagnostic Interview for Borderlines. Clear-cut delusions and hallucinations were rare among the borderlines. However, derealization and depersonalization symptoms were common and were found to be prevalent as among depressives. The prevalence of these symptoms among patients with both borderline personality disorder and depression was similar to that among patients with only borderline personality disorder or depression. The relationship between depression and borderline personality disorder and the significance of psychotic symptoms in these disorders is discussed.
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PMID:Psychotic symptoms in depression and borderline personality disorder. 822 64

In this article, the authors report two observations of short delusion that occurred after taking Guronsan--a psychostimulant commercialized in France--for a few days, with the intention of maintaining a total deprivation of sleep for three days in both cases. The ensuing clinical picture included a state of depersonalization, a loss of the sense of reality, illusions and even visual hallucinations as well as a delirious feeling of persecution. These disorders altered with the state of vigilance and the patients remembered them clearly. The authors discussed the etiopathogenic role of this psychotrope, as its components--acid ascorbic, glucuronamide and caffein--are not mentioned in literature as causing factors of a psychotic state. Then they compared this psychotrope with other molecules: amphetamines in particular may start a delirium of persecution, but normally they just reveal an underlying psychotic structure, which doesn't seem to be the case here, where the two young adults were only found a little immature. Chloroquine has sometimes been incriminated for disorders similar to those mentioned above, with a difference lying in a greater stability in the duration of these disorders that would persist several days after the end of the treatment. The clinical picture of the two cases was more labile and sedation was complete as soon as the absorption of the psychotrope was interrupted and sleep was restored at the same time. That is why the authors emphasize the importance of the deprivation of sleep as a causing factor of those delusion disorders which have particularly been observed in the case of solitary navigators. The psychiatrist dealing with emergencies shouldn't overlook this clinical and etiological possibility, all the less so as the treatment is simple and the resort to neuroleptics unnecessary.
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PMID:[Delusion and sleep deprivation]. 876 52


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