Marcel Assael

SERUM-PROLACTIN IN WOMEN WITI PREMENSTRUAL SYNDROME

Abstract Serum-prolactin was measured by radioimmunoassay during the menstrual cycle in 28 women who had the premenstrual syndrome (P.M.S.) and in a control group who did not have P.M.S. symptoms. Throughout the menstrual cycle mean serum-prolactin was significantly higher in women with P.M.S. than in the controls. The average individual increase in serum-prolactin during the premenstrual period compared with the first 3 weeks of the cycle was also significantly higher in women with P.M.S. It is not clear whether the increase in serum-prolactin was merely an indicator of stress or was actually involved in producing some of the symptoms which constitute P.M.S.

Antimuscarinic properties of antidepressants: Dibenzepin (Noveril®)

The antimuscarinic potency of dibenzepin (Noveril®) was estimated by measuring (a) central in vivo effects in mice (antihypothermia and antitremor, both induced by oxotremorine), (b) peripheral in vivo activity (mydriasis caused by systemic administration of the drug), (c) the effects of dibenzepin on isolated smooth muscle from guinea pig ileum, and (d) in vitro determination of the affinity constant of dibenzepin toward the muscarinic binding sites in whole mouse-brain homogenate.The data allowed the construction of a normalized antimuscarinic potency scale for some of the common tricyclic antidepressants. With a value of 1 for scopolamine, the following relative anticholinergic potencies were calculated: dibenzepin-1/600, nortriptyline-1/300, imipramine-1/200, and amitriptyline-1/75. These values suggest an explanation for the absence of clinically detectable anticholinergic side effects during treatment of depression with high doses of dibenzepin.Structural and spatial interrelations among various tricyclic antidepressants and scopolamine are discussed.

Prolactin secretion during and after Noveril infusions to depressive patients

Dibenzapine (720 mg, Noveril) was infused intravenously to 16 depressed patients during a period of 3 h. Serum prolactin levels were determined by radioimmunoassay and changes in clinical condition were evaluated according to the Hamilton Equation. The two variables were correlated to each other. In most of the patients Noveril caused a dramatic but short-lived improvement in depressive symptoms. There was much variability in the prolactin response to the drug. Serum prolactin levels showed a great elevation in 9 patients. In all patients the hormonal levels returned to their former normal levels after termination of the infusions. The treatment was then continued with Noveril per os. There was no significant correlation between serum prolactin levels and clinical condition or its change. The elevation of serum prolactin levels as a reaction to Noveril treatment may be explained by the prominent serotonergic action of Noveril. A time lag between serotonergic and dopaminergic actions of the drug when given in higher doses may be an additional explanation. Other possible hypotheses are discussed.

Electroencephalogram with Sphenoidal Needles in Sleepwalkers

The etiology of sleepwalking is controversial, the theory that sleepwalking is an epilepsy-like symptom is mostly discounted. Electroencephalogram records, obtained by using sphenoidal needles, are presented as a useful technique and aid to etiological and topical diagnosis. A temporal focus of waves of 4-6 cps was recorded which was not found in the routine EEG procedures. The question is thus raised as to whether sleepwalking may be a result of a paroxysmal disorder in the temporal lobe.

Psychogenic Retention of Urine

Psychogenic retention of urine (PRU) may manifest itself in different clinical forms which mimic a genuine organic disturbance. Three clinical examples are presented in which PRU appears as: (1) malingering; (2) an upper motor lesion inducing spastic closure of the bladder neck, and (3) an alteration of the sensory input, closely resembling sensory neuron damage. The urologist becomes involved in the treatment of these patients by the natural expression of the symptoms. The underlying psychogenic factor does not become evident until urodynamic investigations and often specific therapeutic steps have been undertaken. The urologic treatment sometimes appears helpful because the patients do not realise or refuse to accept the idea of a psychogenic cause and expect relief from the urologist. The latter should withdraw his involvement as soon as an organic cause has been excluded.

Rheumatic brain disease: a disease in its own right.

In many cases of patients who had rheumatic fever—at times undiagnosed—there is a chronic involvement of the brain as a result of disseminated recurrent obliterating arteritis or emboli in the small blood vessels, especially in the brain membranes or the cortex. As a result, disseminated, unstable, and transient neurological and psychiatric symptoms appear. The nature of these symptoms depends upon the age of the patient and the time of onset of the disease. It is suggested that the term “rheumatic brain disease” or “rheumatic encephalopathy” be used, and introduced into the nomenclature of the American Rheumatic Association.

Drawings of cephalopodes by schizophrenic patients, and their meaning

Abstract Cephalopodes are formed by condensation of head and body. As a special form of mask, such drawings contribute to the understanding and representation of some important processes found in schizophrenia, namely: the disturbance in the “I-Now-Here” experience, the magic power of the image, the ambivalent-contradictory feelings, the perception of inevitable change and lack of control, and the emphasis on the internal-fantasy world. The drawings of cephalopodes serve as an adaptational reaction to the above-mentioned processes, by mechanisms of condensation, symbolization and identification.

Incomplete Testicular Feminization Syndrome

A rare case of psychosis with testicular feminization of the incomplete type is described from the clinical, hormonal, genetic and psychiatric aspects. She had a definite beard, well-developed breasts