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Alzheimer’s disease (AD) is characterized by effortful retrieval memory impairments, loss of hippocampal neurons and elevated plasma cortisol (CORT) concentrations. The latter could induce further memory decline. AD is also characterized by increased central and peripheral noradrenergic activity. Since noradrenergic function is involved in memory formation, this upregulated function could counteract memory decline. The aim of the present study was to test these hypotheses using plasma norepinephrine (NE) as a noradrenergic parameter, and recall of the prerecency part of neutral valence word lists as a measure of effortful retrieval.
Area under the curve (AUC) of morning, midday and afternoon plasma CORT and plasma NE concentrations was related to two measures of recall performance, ie summated recall scores of the prerecency and recency parts of three word lists, and to the stage of the Clinical Dementia Rating (CDR).
Partial correlation between each hormone AUC value and prerecency recall performance, controlling for the effect of the other hormone, showed opposite relations between recall and either plasma CORT or NE. Similar stronger correlations were found with the CDR score.
Plasma CORT and NE are oppositely related with effortful retrieval and the stage of progression in AD.
Psychometric research in the field of alcohol dependence has concentrated on identifying certain (personality) characteristics (i.e. typologies). This paper is aimed to identify such typologies and studies the relation of the Minnesota Multiphasic Personality Inventory-2 (MMPI-2) and Cloninger’s temperament-character inventory (TCI).
To find MMPI-2 scales associated with maximization of group differences between 222 DSM-IV alcohol dependent inpatients and a control group of 222 normal subjects, discriminant analysis was used. In addition, a cluster analysis was performed with these scales, and the MMPI-2 mean scale values of the resulting patient clusters were examined for their TCI-correlates.
The discriminant analyses showed several MMPI-2 scales that could clearly distinguish between alcohol-dependent patients and the normal controls. Cluster analysis resulted in semantically different MMPI-2 profiles implying qualitatively different groups of patients. When related to TCI scales, these differences revealed harm avoidance, self-directedness, and persistence, amongst others, as important elements in the description of the clusters.
Evidence for the validity of MMPI-2 constructs as well as those of the TCI in the assessment of alcohol-dependent patients was provided.
In both Prader-Willi syndrome (PWS) and 22q11 deletion syndrome [velo-cardio-facial syndrome (VCFS)], an increased risk for psychotic disorders is reported, which are as a rule not included in the behavioural phenotype of these two syndromes. For the description of a behavioural phenotype, the complete spectrum of physical, developmental, neuropsychological and psychiatric aspects is generally not taken into account. Moreover, psychiatric signs and symptoms often do not meet the criteria for a categorical diagnosis.
In this study, a further specification of psychotic symptoms in PWS and VCFS is shown as well as a proposal for a new model to ascertain predictors, including behavioural, for a genetic syndrome.
Over the past years, 27 patients with PWS and 19 with VCFS were referred for neuropsychiatric evaluation because of psychotic symptoms. In all the patients, a standardised psychiatric examination was performed; seven of the patients with VCFS were evaluated by means of an extensive neuropsychological battery.
In both patient groups, a rather specific psychopathological profile seemed to be present, which in the case of patients with PWS showed some resemblance with bipolar affective disorder. In patients with VCFS, no formal psychiatric diagnosis could be established. Because the psychopathological profiles were rather aspecific, they are not sufficient to predict membership of a certain syndrome.
A quantitative probabilistic approach toward the description of a (behavioural) phenotype is suggested. For such a procedure, large data sets and international collaboration are required.
Neurosyphilis remains a differential diagnosis for a wide variety of psychiatric syndromes, including dementia, mood disorders and psychosis. However, the incidence of neurosyphilis presenting initially with psychiatric symptomalogy is unclear. In this article, a clinical case is reported so as to illustrate some of the issues involved.
A 33-year-old married man was admitted because of a depressive episode associated with somatic preoccupations and a gradual loss of ability to function a year prior to his admission. The symptoms described above raised the question of an organic brain syndrome associated with the psychotic depression. Some laboratory and additional examinations were performed. Serological tests for syphilis were positive for both the hemagglutination test, Treponema pallidum hemaglutination (TPHA), and the immunofluorescent antibody test, fluorescent treponemal antibody-absorption (FTA-ABS). Based on these findings, the diagnosis of neurosyphilis was made. The patient was treated with benzathine penicillin (2 400 000 units i.m. once a week) for 3 weeks and venlafaxine (150 mg daily) and olanzapine (5 mg daily). His depression disappeared gradually, and he was discharged in partial remission.
High-risk groups such as patients with neuropsychiatric diseases should be screened with serological tests so as to prevent morbidity and help eliminate syphilis.