Harris Mj

Neuroleptic treatment of HIV-associated psychosis

The aim of this rater-blinded randomized study was to evaluate the efficacy and side effects of haloperidol and thioridazine in the treatment of new-onset psychosis in HIV-positive individuals. Participants were 13 men who had no history of psychosis prior to infection with HIV, and whose psychosis was not attributable to delirium or to non-HIV-related organic factors. Participants were evaluated at baseline after at least one month without neuroleptic treatment and then weekly for six weeks of the experimental treatment using several rating scales. The mean daily dose in chlorpromazine equivalents was 124 mg. Both neuroleptics produced modest but significant reduction in overall level of psychosis and in positive symptoms, but not in negative symptoms. All the haloperidol-treated patients developed extrapyramidal side effects and required treatment with anticholinergic medication, whereas three of the five thioridazine-treated patients had noticeable side effects. We make recommendations for the treatment of HIV-associated psychosis with neuroleptics.

Validating specific psychopathology scales in older outpatients with schizophrenia.

To our knowledge, there have been no published studies validating commonly used psychopathology rating scales in older outpatients with schizophrenia. We studied specific psychopathology rating scales (three subscales of the Brief Psychiatric; Rating Scale: positive symptoms, negative symptoms, and depression subscales; the Scale for the Assessment of Positive Symptoms; the Scale for the Assessment of Negative Symptoms; and the Hamilton Depression Rating Scale) in 101 older (age > 45 years) DSM- III-R-diagnosed schizophrenia outpatients. We found high interrater reliability (intra-class correlation coefficient >.77) on these scales. Using principal components analysis, we demonstrated satisfactory construct validity, suggesting three factors—positive symptoms, negative symptoms, and depressive symptoms.

Instrumental assessment of lingual motor instability in tardive dyskinesia

Instrumental measurement of fine tongue instability was carried out in 28 psychiatric patients (13 with and 15 without tardive dyskinesia [TD]) and 11 normal controls. All of the 13 TD patients and 4 of the 15 non-TD patients had instability of tongue greater than 2 standard deviations of the normal control mean. The tongue instability correlated with lingual (but not total body) dyskinesia rating and with age in the psychiatric patients. Our findings suggest that spectral analysis of fine tongue position is sensitive to overt as well as subclinical dyskinesia associated with neuroleptic usage.