Effects of seizure duration on serum TSH concentration after ECT.

Serum thyroid stimulating hormone (TSH) concentrations were measured by a sensitive immunoradiometric assay in 14 patients immediately before and after the first treatment of a course of electroconvulsive therapy (ECT). There was a close correlation (r = +0.70, p less than 0.

Elevated plasma luteinizing hormone concentrations, cryptorchidism and mania.

A young man with acute mania and unilateral cryptorchidism had plasma luteinizing hormone (LH) concentrations that were much higher than the maximum LH concentrations we have found in normal subjects and patients with schizophrenia. Plasma concentrations of testosterone and sex hormone binding globulin were not abnormal, showing that the elevated plasma LH concentrations were probably due to increased secretion of LH-releasing hormone (LHRH). This case supports our previous results which suggest that an abnormally high secretion of LHRH, due presumably to an abnormality in central neurotransmission, may be a feature of acute mania in young men.

Oestrogen-stimulated neurophysin and outcome after electroconvulsive therapy.

Plasma concentrations of oestrogen-stimulated neurophysin (ESN), prolactin, and growth hormone were measured before and after the first treatment in a course of electroconvulsive therapy (ECT) given to 25 psychiatric patients and during induction of anaesthesia in 9 women undergoing elective cholecystectomy. Prolactin levels rose and growth hormone levels fell during both cholecystectomy and ECT, but ESN levels rose only after ECT. The peak ESN response to ECT was significantly greater (p less than 0.

Glucocorticoid receptors and depression.

The number of glucocorticoid receptor sites in lymphocytes was estimated and plasma cortisol concentrations measured in 17 depressed patients, 12 patients with chronic schizophrenia, and 31 healthy control subjects. The number of receptor sites was significantly lower in the depressed patients than in either the controls or the patients with chronic schizophrenia, but there were no differences between the groups in the dissociation constants of the glucocorticoid receptors or the plasma cortisol concentrations. When two control subjects were studied intensively over 28 hours a slight diurnal variation in the number of glucocorticoid receptors was detected.

Raised plasma cortisol concentrations a feature of drug-free psychotics and not specific for depression.

To determine whether high plasma cortisol concentrations are a distinctive feature of depression or whether plasma cortisol is also elevated in other forms of psychosis, cortisol concentrations were measured in 59 patients with acute functional psychoses, six non-psychotic depressed patients and 37 control subjects, all free of antidepressant and neuroleptic drugs for at least three months. Patients with schizo-affective disorder, manic type, had the highest concentrations throughout the day and those with major depressive disorder, psychotic sub-type had higher concentrations than controls in the afternoon and evening. Manic and schizophrenic patients had cortisol concentrations above controls in the afternoon only.

Ageing and affective disorders: the age at first onset of affective disorders in Scotland, 1969-1978.

First admission rates from 1969-78 for Scottish psychiatric units were calculated for discharge diagnoses of affective psychosis for each five-year age-group from 15 years to over 74 years. There were clear-cut linear increases in rates of depressive psychoses, mania, and all affective psychoses, consistent with a relatively steady increase in the rate of first-onset affective psychoses with increasing age. These findings are discussed in terms of social, psychological, and biological hypotheses of the causes of affective disorder.

Decline in the diagnosis of schizophrenia among first admissions to Scottish mental hospitals from 1969-78.

Annual age-standardised first admission rates from 1969-78 for Scottish mental hospitals were calculated for schizophrenia, paranoid states, reactive psychoses, all affective psychoses, mania, and depressive neuroses. Significant decreases were found in the diagnosis of schizophrenia (P less than 0.001) and, to a lesser extent, affective psychoses (P less than 0.

Selective increase in plasma luteinising hormone concentrations in drug free young men with mania.

The hypothalamic-pituitary-gonadal system was investigated in drug free young men with either mania or acute schizophrenia and in age matched controls by measuring, at frequent intervals during a 17 hour "neuroendocrine day," plasma concentrations of luteinising hormone (LH), follicle stimulating hormone, prolactin, testosterone, sex hormone binding globulin (SHBG), and cortisol. Plasma LH in mania was significantly increased compared with the control value at all time periods and increased in the morning and evening samples compared with values in the schizophrenic patients. Plasma prolactin and cortisol concentrations were significantly greater in mania and schizophrenia compared with control values at several times during the day, but there were no significant between group differences in plasma testosterone or SHBG.

Schneider's first-rank symptoms of schizophrenia. An association with increased growth hormone response to apomorphine.

Growth hormone and prolactin (PRL) responses to 0.75 mg of apomorphine hydrochloride were measured in 19 newly admitted psychotic patients who had been untreated by neuroleptic or antidepressant drugs for at least nine months. We compared hormonal responses between subgroups of patients who were distinguished using the diagnostic criteria of Feighner et al and Spitzer et al, and by the presence or absence of Schneider's first-rank symptoms of schizophrenia.

Genetics, ageing and dementia.

The contribution of genetic differences to variation in ageing and the relationship of ageing to certain types of dementia are discussed. Neuropathological changes commonly found in the ageing brain are present in more severe form in Alzheimer-type dementia, Down's syndrome, multi-infarct dementia, and a substantial number of patients with Parkinson's disease. An increased frequency of ageing-associated changes outside the brain have been reported in Alzheimer-type dementia, Down's syndrome, and multi-infarct dementia, although the evidence is generally meagre and in many cases requires further corroboration.

ADP and arachidonic acid induced platelet aggregation in schizophrenia and atypical psychoses.

Platelet aggregatory responses to adenosine diphosphate (ADP) and arachidonic acid were examined in 6 drug-free schizophrenics, 5 other drug-free psychotics, 8 'acute-on-chronic' schizophrenics (on long-term neuroleptic therapy) and 38 healthy controls. Platelet aggregation and disaggregation following ADP was significantly lower in 'acute-on-chronic' schizophrenics (on drugs) compared with healthy controls, and disaggregation following 1 microM ADP was significantly less in drug-free schizophrenics. The difference between maximum aggregation induced by ADP and that induced by arachidonic acid was significantly greater in schizophrenics (both on drugs and drug-free) than in controls.

Hypertension, multi-infarct dementia and Alzheimer's disease.

Retrospective review of 89 patients with pre-senile dementia followed by necropsy indicated significant differences between sub types of dementia. Patients with multi-infarct dementia (MID, 27 subjects) more often had cardiovascular abnormalities than patients with Alzheimer's disease (46 subjects). No patients with MID alone had a systolic blood pressure below 140 mm Hg, whereas 23 of 46 Alzheimer subjects and three of 16 patients with mixed features had such a systolic pressure.

7. Corticosteroid secretion--clinical aspects. Plasma cortisol concentrations in the functional psychoses and Alzheimer type dementia: a neuroendocrine day approach in drug-free patients.

We have investigated the plasma concentration of cortisol in psychotic patients classified according to Feighner's criteria as either depressed, manic, schizophrenic or unclassified, and in 8 patients with Alzheimer's Type Dementia. The patients had been free of either neuroleptic or antidepressant drugs for at least 3 months before the study. Blood sampling was carried out by way of a "neuroendrocrine day" approach in which venous samples were taken at 07:00, 07:30 and 08:00 h; 15:00, 15:30 and 16:00 h; and 23:00, 23:30 and 24:00 h.

Chromosome changes in Alzheimer's presenile dementia.

Lymphocyte chromosomes were examined in 36 patients with Alzheimer's presenile dementia, 36 healthy, age and sex matched controls, and 36 sex matched, non-demented, elderly controls, approximately 20 years older than the Alzheimer patients. Increased chromosome aneuploidy was found in females with Alzheimer's disease but not in male subjects. Chromosome abnormalities observed in female patients were similar to those observed in elderly controls, though in this latter group there was an increase in the frequency of cells that had lost an X chromosome.

Immediate increases in plasma prolactin and neurophysin but not other hormones after electroconvulsive therapy.

Plasma prolactin, growth hormone, cortisol, luteinising-hormone-releasing hormone (LHRH), thyrotropin-releasing hormone (TRH), and nicotine and oestrogen stimulated neurophysin (NSN and ESN) were measured before and for 6 min after electroconvulsive therapy (ECT) in eight women with severe electroconvulsive therapy (ECT) in eight women with severe depression. Plasma concentrations of NSN and ESN had increased significantly (as much as 10-fold for NSN) within 1 min of the seizure, and concentrations of prolactin had increased within 2-4 min after the seizure. Whereas plasma prolactin and ESN either continued to increase or remained raised throughout the 6 min after seizure, the concentrations of NSN fell to reach a value at 6 min that was approximately 50% of the maximum.

Effect of ECT on the neuroendocrine response to apomorphine in severely depressed patients.

Animal studies have suggested that the mechanism of the antidepressant action of ECT may be to increase monoaminergic post-synaptic receptor sensitivity. We have tested this hypothesis in 12 drug-free patients suffering from severe depression, 11 of whom had depressive delusions. The responses of growth hormone, prolactin and cortisol to 0.

A study of familial factors in Alzheimer's disease.

Data on the families of 74 probands with autopsy-proven Alzheimer's disease did not support the hypothesis, advanced by Heston and co-workers, of a familial association between Alzheimer's disease, Down's syndrome and immunoproliferative disorders. However, there are difficulties of interpreting negative conclusions in this type of study, particularly those resulting from small sample size and the impossibility of tracing all relatives; only the data for immunoproliferative disorders are incompatible with the hypothesis, those for Down's syndrome being too few to be informative. The incidence of presenile dementia among the first-degree relatives of probands was raised, as in many previous studies, and was consistent with a simple polygenic model.

Chromosome aneuploidy in Alzheimer's disease.

Lymphocyte chromosomes were examined in 20 women with Alzheimer's pre-senile dementia, 42 non-demented women of similar age and 31 women 15-20 years older than the Alzheimer patients and who were not demented, living independently in the community. Increased chromosome aneuploidy was found in Alzheimer's disease compared to age-matched controls, and this aneuploidy was of a similar nature and degree as that observed in controls 15-20 years older than the Alzheimer patients, though in this latter group there was an increased loss of chromosomes. No single chromosome was preferentially affected in Alzheimer's disease.