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THE ARAB JOURNAL OF PSYCHIATRY Vol. 7, N° 1, May (1996) E.mail: takriti@nol.com.jo |
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CONTENTS / SOMMAIRE / فهرس
الموضوعات |
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Review
Article §
After Prescribing No Benzodiazepines / M.
Abdel-Hakam, M.A. Ibrahim, M. Fakhr El-Islam q
Obituary
q
Book Review
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SUMMARY / RESUMES /
ملخصات |
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q
Review Article
§
Serotonin Receptors- A Review Of their Function And Possible
Significance In Psychiatric
Disease. / B. E Leonard
ABSTRACT :
Thirty-three years ago
Gaddum and Picarelli classified the serotonin receptors in the guinea pig
ileum into D and M types based on the activity of dibenzyline (D) and
morphine (M) to block contractions of intestinal smooth muscle caused by
serotonin. The subsequent location of specific ligand binding sites for
serotonin in the brain has led to the identification of ten serotonin
receptor sub-types in art brain. While there is some controversy over the
functional importance of many of these receptor sub-types, there is evidence
that they fall into two major groups according to the nature of their
coupling to secondary messengers or ion channels. Thus the 5HT1 and 5HT2
receptors appear to occupy the G protein receptor subfamily which may be
coupled either to adenylate cyclase (most 5HT1 sub-types) or phosphatidyl
inositol (5HT2 sub-types). The central M receptors (now termed 5HT3) appear
to occupy a ligand gated ion channel super family. The cloning of these
receptor sub-types has been of importance in enabling them to be classified
as specific protein molecules encoded by specific genes. The problem now
arises with regard to the linking of the changes in the cellular activity of
the various receptor sub-types with the plethora of behavioural changes that
arise as a consequence of the actions of serotonin in the brain. The present
review summarizes the evidence
implicating the role of specific serotonin receptor sub-types in
thermoregulation, modulation of cardiovascular function, eating disorders,
sleep, sexual activity, anxiety states, aggression, schizophrenia and
depression. A summary of the relationship between these receptor sub-types
and their possible involvement in the etiology of these diseases is shown in
Table 2.
§
After Prescribing No Benzodiazepines / M. Abdel-Hakam, M.A. Ibrahim,
M. Fakhr El-Islam
ABSTRACT : A recent
review (Farlotta et al 1994) regretted the small number of controlled studies
on patients who discontinue Benzodiazepines (BZP).
METHOD :
Fifty three patients
treated with BZP continuously
> 3 months were studied as their own controls after discontinuation
of BZP at the only psychiatric clinic in Qatar. A simple clinic assessment of
patients outcome was made before and after BZP discontinuation as remitted
(=symptom-free), partially improved (=retaining some symptoms) and
unimproved.
RESULTS:
A significantly
better outcome was found after substituting BZP with tricyclic
antidepressants and/or small doses of neuroleptics especially in anxiety
disorders, younger patients and those receiving antidepressants.
DISCUSSION:
The better outcome
in younger patients and anxiolytic role of tricyclic antidepressants were
confirmed. No support could be found to the relevance of type, dosage and
duration of BZP therapy concerning the outcome of substitute therapies after
BZP discontinuation.
CONCLUSION:
Restrictive
use of BZP to a few weeks in acute cases should be the prophylactic dictum.
The use f antidepressants in the treatment of anxiety disorders should be
preferred to BZP.
§
Fertility in Schizophrenia: a comparative study / T. K. Daradkeh, M.T.Abou-Saleh, R. Ghoubash, 0. El
Rufaie A. Saad, Y. Younis,
F. Reda, Y. Amin
ABSTRACT : To test the
Hypothesis that fertility in schizophrenic patient is less than the
psychiatric population. This study has been conducts on an inpatient
population in psychiatric unit - Al Ain -U.A.E. Between 1st Oct. 1993 - 30th
of September 1995. The study showed no difference in fertility rate amongst
schizophrenic population.
§
Zuclopenthixol Versus Haloperidol In The Initial
Treatment Of Schizophrenic
psychoses, Affective Psychoses And Paranoid States; A Controlled
Clinical Trial / M. AI-Haddad, C.Kamel, R.P. Sequeria, M.A. Mawgood
ABSTRACT : An open-ended controlled
clinical trial was carried out on forty-nine patients with mania, acute psychoses
or exacerbation of a chronic psychosis to compare zuclopenthixol acetate with
haloperidol to determine the
efficacy and adverse effects during a six day trial period. Both
zuclopenthixol acetate and haloperidol were equally effective in patients with
acute psychosis, exacerbation of chronic psychosis and in mania.
Zuclopenthixol acetate produced a greater degree of sedation in the initial
phase of treatment and caused fewer extrapyramidal side effects than
haloperidol and the patients treated with zuclopenthixol acetate needed less
anti-parkinsonian treatment. §
Psychosocial aspects of limb amputation: The Impact of age
differences / T. E. Ahmad,
A.Al-Worikat, W.M. Said, W. Al-Thunaibat and R. Suleiman
ABSTRACT :
This study was designed to
identify the psychological and social adjustment aspects in amputees of
various ages. Fifty-one amputee patients participated in this study,
twenty-six patients above fifty years of age and twenty-five patients below
this age. All patients were assessed by using the Arabic version of a
personality test, Minnesota Multiphasic Personality Inventory (MMPI) and
Psychosocial Adjustment Scale. Results showed that the main reason for
amputations was due to accidents. Results of comparing the older and younger
amputees on the MMPI and psychosocial Adjustment Scale revealed that younger
amputee patients have a significantly higher score regarding depression and
anxiety disorders and are less able to adjust than older amputee patients. §
Case Report:-
Psychiatric Presentations and Social Consequences of Hypothyroidism.
Case Report / T. A. AI-Habeeb,
A. AI-Ruhaily
ABSTRACT :
The
aim of this case report is to show the wide range of different psychiatric
presentations and social consequences of hypothyroidism. Here a 46 year old
female with hypothyroidism was misdiagnosed as having psychotic depression
for 12 years. The role of the physician in patient education and the consequences
of misdiagnosis have been discussed. Also, the relationship between
hypothyroidism and hyperprolactenemia, quick response to replacement therapy
and the importance of considering hypothyroidism in the differential
diagnosis, especially of atypical psychiatric disorders, were evaluated. §
Forensic Psychiatry 1
The Role of Current Legislation In the Treatment and Rehabilitation of Substance- Abuse Programs in the UAE. / Zain Omara
SUMMARY : This paper
describes a five year follow-up study (1987-1991) for substance-abusers
admitted compulsory or voluntary for treatment into the drug dependency units
in the UAE. It describes the existing legislation governing the treatment
programs in the drug-dependency units in the UAE. It discusses the role of
these regulations in the promotion of more practical systems of follow-ups,
community surveillance and aftercare. It emphasizes the need for reevaluation
of the existing legislation and revision of certain legal provisions in the
current law, No "6" (1986) (Control of Narcotic substances and the
like-substances). It highlights the need for regional collaboration with GCC
Council of Health Ministers, the General Secretarial of Arab Ministers of
Interior and W.H.O. policies, legislation and programs on dependence and the
harmful use of drugs and alcohol. q
Obituary
q
Book Review
§
Forensic Psychiatry Il
A proposed unified Mental Health Act for the Arab countries. / K. Chaleby,. Y. Rakhawi,. S. Abdel Azim
ABSTRACT :
Most the Arab countries have either
no written canonized Mental Health Act, or still struggling with an old law that does not reflect the spirit
of our age and the contemporary advances in Psychiatry.
During the
last meeting of the Pan Arab Federation of Psychiatrist in dec. 1994, an ad
hoc committee was formed to write a draft for a proposed Mental Health Act
that can be either suitable to be used by most of the Arab countries or can
form a framework for the law makers in a particular country to make its own law depending on its need the unique
characteristic of that country. Now the bulk of the work has been completed,
we are inviting all Arab Psychiatrists, and who ever is interested in this
matter to write his or her suggestion or correction to be published in this journal. It will be studied and
discussed to be implemented in the final version of the Pan Arab Mental
Health Act. |
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