A controlled study of sensory tics in Gilles de 1a Tourette syndrome and obsessive-compulsive disorder using a structured interview.

Objective: To determine the prevalence and characteristics of sensory tics in the Gilles de la Tourette syndrome (GTS), and a matched population of patients with obsessive-compulsive disorder (OCD) using a structured assessment.

Methods: 50 subjects each of GTS, OCD, and healthy controls were studied to determine the prevalence and phenomenology of sensory tics, and diagnose tic disorders, OCD, and affective disorders according to DSM-III-R criteria. The severity of tics and obsessive-compulsive symptoms were quantified using the Tourette syndrome global scale (TSGS) and Yale-Brown obsessive-compulsive scale (Y-BOCS) respectively.

Sustainability of a successful malaria surveillance and treatment program in a Runggus community in Sabah, east Malaysia.

The district of Kudat has one of the highest and most persistent malaria transmission levels in Sabah, Malaysia, with annual parasite incidence of 102 per 1,000 inhabitants per year. Due to this situation and the failure of DDT spraying to control malaria, a community participation health program (Sukarelawan Penjagaan Kesihatan Primer or SPKP) was developed as an adjunct to current anti-malarial measures during 1987-1991. SPKP is made up of unpaid community workers known as village health volunteers (VHVs).

Tics status.

Objectives: To describe two patients with tics status, propose a definition of this syndrome and draw attention to its clinical significance.

Method: Two patients suffering from Tourette's Syndrome who had developed episodes of continual motor tics that lasted from minutes to hours, were non-suppressible and intruded into normal functioning, were treated with an increase in the dose of haloperidol, in one case with the addition of clonazepam.

Results: The offset of the episodes was gradual and the tic disorder was worse after the episodes.

Management of panic disorder.

Symptoms of panic attack can be found in both medical disease and mental disorder. At least 4 of 13 diagnostic symptoms need to be present to constitute an attack which onset is sudden and unpredictable. The duration of attack usually lasts minutes but sometimes longer.

Survey on developmental-behavioural training experiences of Australian paediatric advanced trainees.

In order to monitor whether paediatric education has adapted to meet modern practice 91 paediatric advanced trainees were surveyed to elicit their satisfaction with developmental-behavioural (DB) training. A response of 69% was obtained to a postal questionnaire. The traditional imbalance persists, with trainees considering themselves significantly better informed in the medical disciplines (P < 0.

De Clerambault syndrome and medical practitioners: medico legal implications.

De Clerambault's syndrome or erotomania is a condition in which a patient, usually a woman, develops a delusional belief that a man, usually older and of higher social status, is in love with her. This paper describes such cases where medical practitioners were involved. In a case where a doctor was brought to court, the judge stressed that because of the nature of the allegation, it was vital that there be corroborative evidence.

Oculogyric spasm in Asian psychiatric in-patients on maintenance medication.

Background: The objective was to investigate the occurrence and characteristics of oculogyric spasm (OGS) in an Asian country.

Method: All 2035 Asian (88% Chinese, 7% Malays and 5% Indonesians) psychiatric in-patients in the state psychiatric hospital in Singapore were surveyed for occurrence of oculogyric spasm (OGS) over a two-month period.

Results: Thirty-four patients (1.

A postmarketing surveillance study of zopiclone in insomnia.

Zopiclone, a novel cyclopyrrolone compound has recently become available for the treatment of insomnia in Singapore. Pharmacodynamic and pharmacokinetic studies have shown it to be an effective hypnotic with a good safety profile and minimal side-effects. The efficacy of Zopiclone was studied in a group of patients with insomnia (n = 40).

The clinical features of Tourette's disorder: an Australian study using a structured interview schedule.

The clinical features of an Australian series of patients fulfilling DSM-III-R criteria for Tourette's Syndrome (TS) were examined. Fifty patients, recruited from a hospital-based outpatient clinic and a self-help group, were interviewed using a structured schedule. TS is a complex disorder with wide ranging manifestations.

A simple collection method for saliva in children: potential for home monitoring of carbamazepine therapy.

We have developed a method of monitoring plasma concentrations of antiepileptic drugs which uses salivary samples, and is suitable for home monitoring in children. To validate the method, paired plasma and saliva samples from 39 children aged between 2 and 15 years were assayed for carbamazepine and its active metabolite, carbamazepine-10,11-epoxide by h.p.

Medico-legal implications of electro-convulsive therapy--a Singapore viewpoint.

The clinical characteristics of 100 consecutive cases of ECT in a state mental hospital were surveyed. The medico-legal implications with regards to indications for and consent to ECT were looked into. The findings showed that ECT was given mostly for management reasons rather than based on diagnosis.

Pharmacological characterization of tardive akathisia.

A patient with tardive neuroleptic-induced akathisia was investigated with multiple pharmacological challenges. It was noted that the patient responded positively to benztropine, bromocriptine, and propranolol, and negatively to physostigmine, and showed little or no response to discontinuation of neuroleptics and challenges with metoclopramide, metoprolol, atenolol, and clonidine. The implications of this pharmacological characterization for the understanding of the pathophysiology of tardive akathisia in relation to acute akathisia and tardive dyskinesia are discussed.

Fatty acid content of marine oil capsules.

The use of dietary omega 3 fatty acid capsules has been associated with a decrease in plasma triglyceride levels. In addition, populations consuming diets rich in fish appear to have a decreased incidence of cardiovascular disease. Eicosapentaenoic acid (EPA, 20:5 omega 3) and docosahexaenoic acid (DHA, 22:6 omega 3) are major fatty acids in fish oils.

Depersonalization syndrome--a report of 9 cases.

Depersonalization is defined and the clinical characteristics of 9 patients presenting with Depersonalization Syndrome are discussed. The cases comprise 5 males and 4 females with an age range of 15-47 years, of which two-thirds presented with an acute onset of symptoms. The diagnosis is made on the patients' own descriptions of their symptoms.

Diminished responsibility--a psychiatric viewpoint.

Diminished responsibility is based on the notion that mental disorder may make a person only partially accountable for his act in the killing of another person. For this plea to succeed it has to be shown that an accused has to be suffering from such an abnormality of mind that his responsibility for the action is substantially diminished. As these concepts of abnormality of mind and criminal responsibility do not fit easily into psychiatric classification of mental disorders, nine senior psychiatrists who regularly attend court as expert witnesses were surveyed and their viewpoints about mental abnormality and diminished responsibility were elected.

Criteria for essential fatty acid deficiency in plasma as assessed by capillary column gas-liquid chromatography.

To develop criteria for deficiency of essential fatty acids (EFA), we used capillary-column gas-liquid chromatography to determine fatty acids (percentage of total fatty acids) in plasma obtained in the fasting state from 56 reference subjects and from 10 patients with intestinal fat malabsorption and suspected EFA deficiency. Fatty acid evaluations (percentage of total fatty acids) that allowed for a clear distinction (P less than 0.01) between reference subjects and patients, based on values two standard deviations below or above the reference mean, included values for linoleic acid (18:2w6) below 27%, and values for palmitic acid (16:0), palmitoleic acid (16:1w7), oleic acid (18:1w9), vaccenic acid (18:1w7), and Mead acid (20:3w9) exceeding 21%, 2.

A cross-cultural study of the possession-trance in Singapore.

Possession-trance is a common culture-bound syndrome in Singapore. The characteristic features as seen in 36 young men of the three different ethnic communities are described. At follow-up four to five years later, none of the 26 who could be contacted showed any evidence of mental illness.

Protein intake regulation in adult obese (ob/ob) and lean mice: effects of nonprotein energy source and of supplemental tryptophan.

Adult obese (ob/ob) and lean mice were allowed to self-select between diets varying in level of protein and carbohydrate, or protein and fat. Obese and lean mice self-selected 29% and 26% of their energy, respectively, from protein when fed diets varying in protein and carbohydrate. Intake of protein decreased 45% in obese mice and 32% in lean mice when diets varying in level of protein and fat were fed.