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This study developed a method for measuring subjective costs and benefits of psychiatric treatments. Forty-one patients rated the relative bothersomeness of symptoms of schizophrenia and side effects of neuroleptics. Thirty-four psychiatrists made parallel ratings from the perspective of the average patient (individual utility) and of the patient's family and society (institutional utility). Psychiatrists predicted patients' ratings moderately well, but misjudged the bothersomeness to patients of 24% of side effects and 20% of symptoms. When considering the patient's perspective, both schizophrenic patients and psychiatrists rated symptoms as no more bothersome than side effects. However, psychiatrists saw side effects as significantly less bothersome than symptoms when considering costs to society. The subjective utility of neuroleptic medications for schizophrenia is most justifiable from an institutional perspective.
Micellar calcium phosphate has the chemical composition and physicochemical properties that are consistent with it being a complex of the phosphate centres of casein with an acidic amorphous calcium phosphate. Similar acidic amorphous calcium phosphates have been prepared in the laboratory and for these, as well as for micellar calcium phosphate, the most appropriate crystalline model compound from which the short-range structure may be derived is brushite, CaHPO4.2H2O. The predicted secondary structures around sites of phosphorylation in the Ca2+-sensitive caseins often comprise an α-hclix-loop-α-helix motif with the sites of phosphorylation in the loop region. This motif may be important in linking the colloidal calcium phosphate with casein in native casein micelles.
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