L-tryptophan and the eosinophilia-myalgia syndrome: a clinical and laboratory study.

Case notes of 202 patients who were prescribed a single brand of L-tryptophan (Optimax, manufactured by Merck) between January 1987 and December 1991 were examined. Fourteen patients' notes indicated that they had clinical or laboratory findings suggestive of a diagnosis of eosinophilia-myalgia syndrome (EMS). However, results of clinical examination and measurement of serum aldolase, total eosinophil count and antinuclear antibodies did not support the diagnosis of EMS in any of the 14 patients.

Women and agricultural work.

Women farm workers are exposed to a multitude of biologic, chemical, physical, and mechanical hazards. High rates of machinery-related accidents and respiratory occupational illnesses are seen among agricultural workers. Many occupational diseases in women go undiagnosed if the "farmer's wife" is not asked what she does on the farm or if the physician is unfamiliar with occupational disease.

Palliative care and taboos within motor neurone disease.

Taboos, whether held by professional carers, patients or families have the capacity to influence a whole range of choices that must be made during the course of any illness. In the case of motor neurone disease, decisions regarding if, when and how to break bad news, the place of care (home, hospital or hospice), the introduction of aids and devices, and, ultimately, choices regarding the place of death, will all be influenced by a range of taboos. If professional carers have major unresolved issues concerning their own mortality, it is unlikely that they will be able to truly stand alongside those who are facing their own imminent death.

A triaxial classification of health problems presenting in primary health care. A World Health Organization multi-centre study.

Over the past two decades, research in a variety of countries and settings has revealed the extent to which psychological morbidity and social problems constitute an important proportion of primary health care contacts, either in their own right or in association with physical ill-health. The development of appropriate responses, medical and non-medical, to such problems is, in part, hindered by the relatively low level of awareness concerning the significance of such problems and by currently inappropriate methods of describing and classifying health care problems in the primary care setting. There is a pressing need for an appropriate, relatively simple and flexible classification or list of problems presenting in primary care.

The reduction of claustrophobia--I.

The purpose of this study was to investigate the process of change during three interventions for claustrophobia, with particular reference to cognitive changes. Forty-eight participants, recruited from the community through the local media, were randomly assigned to one of four groups: pure exposure, exposure to the sensations of anxiety (interoceptive exposure), modification of negative cognitions, or a control group. All interventions were given over three sessions.

Blood pressure effects of tranylcypromine when prescribed singly and in combination with amitriptyline.

Data on blood pressure was extracted from the findings of a 6-week double-blind study that was carried out to evaluate the efficacy and safety of prescribing tranylcypromine (TCP) singly and in combination with amitriptyline (AMI). The effect of TCP on blood pressure was one of the methods used to evaluate its safety. Target daily doses of medication for the final 2 weeks of the study were: TCP 30 mg, AMI 150 mg, or the two in combination.

Bipolar disorder and cerebral sarcoidosis.

A 40-year-old man suffered both a short-term memory defect and bipolar mood disorder. It is postulated that both conditions are due to progressive cerebral sarcoidosis affecting the limbic system. The need for early detection and treatment is emphasised.

Serum and red cell folate and affective morbidity in lithium prophylaxis.

Serum and red cell folate concentrations were estimated in 68 affective disorder patients taking lithium prophylactically, 65 of whom had bipolar disorder. The number of hospital admissions, the frequency of use of additional mood altering treatments and the Affective Morbidity Index were calculated for the 2 years of the study. Contrary to other findings, there were no differences between the folate concentrations for different severities of affective morbidity.

Serum thyrotropin responses to thyrotropin-releasing hormone in alcohol-dependent patients with and without depression.

Forty-one patients with DSM-III alcohol dependence syndrome were studied, as were 30 patients with major depression and 20 healthy controls. Nineteen of the alcohol-dependent patients had depressive symptoms. All subjects underwent a TRH/TSH stimulation test.

A follow-up study on alcoholics with and without co-existing affective disorder.

Three-hundred male alcoholics were selected from consecutive admissions to hospital. They were divided into three diagnostic sub-groups: primary alcoholics; alcoholics with unipolar affective disorder; and alcoholics with bipolar affective disorder. After three follow-up interviews over a 2-year period after hospital discharge, the three sub-groups reported differences in frequency of mood change, amount of treatment received, and hospital attendance, although there were no clear-cut differences in items associated with their alcoholism.

Familial aspects of obsessive-compulsive neurosis.

The first-degree relatives of 50 obsessive-compulsive patients and those of matched controls completed the General Health Questionnaire (GHQ) and the Leyton Obsessional Inventory (LOI). Relatives who were identified as possible 'cases' by their high GHQ scores, or by their own or informant relatives' reports, were interviewed using the Schedule for Affective Disorders and Schizophrenia. Index relatives had a significantly higher lifetime prevalence of mental illness (36%) than had those of controls (17%), due mainly to an excess of depressive and neurotic disorders.

Development of person description over adolescence.

Free-written descriptions of self and various others were obtained from 190 adolescent boys and girls. Descriptions of persons became longer, more "psychological," and more organized over adolescence. Modes of construing persons were positively correlated across different stimulus persons.

Effects of reserpine, chlorpromazine, imipramine and amitriptyline on urinary excretion of adenosine 3' 5' cyclic monophosphate in rats.

RATS were treated with reserpine, chlorpromazine, imipramine and amitriptyline to assess the effect of these drugs on the urinary excretion of adenosine 3' 5'-cyclic monophosphate (cAMP).Reserpine led to a decrease in the urinary excretion of cAMP. The tricyclic antidepressants, imipramine and amitriptyline, led to an increase in the urinary excretion of cAMP.

Clinical experience with Ro 5-3350 (bromazepam).

A pilot study using Ro 5-3350 was followed by a double-blind trial comparing Ro 5-3350 and chlordiazepoxide in a total of 25 patients who were either hospital in-patients or previous in-patients attending an out-patients follow-up clinic. The patients all had a long history of obsessive-compulsive or phobic symptoms. The visual analogue scale, the Taylor Manifest Anxiety Scale and clinical ratings were used to measure the response to treatment.