Clinical subtypes and age at onset in schizophrenic siblings.

This study examines the concordance of clinical subtypes and age at onset of schizophrenia in 42 sibships of multiply affected schizophrenic patients. Subtypes were defined by four major diagnostic systems (DSM-III, DSM-III-R, ICD-10, and Tsuang-Winokur criteria) and rated both for the first hospitalization and long-term diagnosis. When a sibship method was used, no concordance for subtypes was found in siblings.

[Familial forms of schizophrenia. Cytogenetic study].

As a preliminary step in the search for chromosomal location of a susceptibility gene predisposing to schizophrenia, cytogenetic screening of patients might be useful. Search for chromosomal aberrations has successfully directed and accelerated the identification of several disease genes, such as the Duchenne muscular dystrophy gene, retinoblastoma, Burkitt's lymphoma and chronic myeloïd leukemia. Although karyotypes abnormalities do not account for a large portion of cases of Schizophrenia, the two candidate regions predisposing to this disease resulted from observation of chromosomal abnormalities.

[Clonidine versus a placebo trial in manic disorder].

Clonidine efficacy was evaluated in 24 manic inpatients, hospitalised in a locked ward. This is a double blind and randomized study. The duration of the trial was 14 days, and the daily dose of clonidine was 0.

[Obsessive-compulsive neurosis explored using positron emission tomography. Apropos of a case].

Regional cerebral glucose metabolic rates were studied during three sessions of positron emission tomography in an obsessive-compulsive patient. Changes in whole cortex metabolism, apparently related to the clinical relapses, were found. These preliminary findings are discussed in the light of the available literature.

[Depressions resistant to tricyclic antidepressive treatment and hypothyroidism].

The relationship between thyroid disorders and depression is well known. This type of endocrine disease is mainly observed in patients with depression resistant to appropriate antidepressor therapy. Three clinical forms of this association may be distinguished: hypothyroidism in a patient with depression but without a previous psychiatric history; a relapse of depression in a manico depressive patient who has developed hypothyroidism; the finding of slight thyroid dysfunction (increased TSH response after injection of TRH) in a patient with depression.

[Renal clearance technic for individualizing lithium dosage in routine hospital care].

Lithium has a narrow therapeutic index and exhibits a wide pharmacokinetic variability. Individual dosage regimen adjustment is necessary to warrant the efficacy and safety of long-term treatment. We propose the "renal clearance method" for rapid determination of the lithium carbonate daily dose for chronic therapy.

[Plasma levels of desmethylclomipramine and clomipramine at steady-state in the morning. Correlative analysis and prediction of theoretical blood clomipramine].

Clomipramine (CMI) was administered to eight patients, either as an antidepressive drug or, in two patients, as an antalgic drug (average age: 54 y.; average body surface area: 1,71 m2). These patients were treated with 20 to 150 mg, every day, for various lengths of time: min.

[Psychiatric emergencies and family crisis. A possible systemic approach at a general hospital].

Psychiatric emergencies concern not only sectorized psychiatric organizations but general hospitals as well, especially in large cities. No set-ups for long-term management are available in general hospitals and means for short-term intermittent action should be evolved. Family crisis may be responsible for psychiatric emergencies as they may lead to decompensation due to the breaking-up of familial relationships.

[Drug combinations in the treatment of depression].

Four types of combination therapy may be used in the treatment of depression: anxiolytics and antidepressants, neuroleptics and antidepressants, co-administration of two or more antidepressants, association of antidepressants with drugs correcting antidepressant-induced side-effects. First, the pros and cons of these combinations are described as they appear in daily practice. In the second part, the theoretical reasons for supporting or contraindicating such combinations are discussed in the light of pharmacological data.

[Lithium and diabetes insipidus. Theoretical and practical aspects. Therapeutic value of thiazide diuretics (author's transl)].

Lithium is increasingly prescribed by psychiatrists for manic-depressive psychosis and other affective disorders. Therefore, psychiatrists should be familiar with lithium-induced nephrogenic diabetes insipidus. Management of this condition is discussed.