Affective psychosis

Kupfer DJ, Broudy D, Coble PA, et al EEG sleep and affective psychosis. J Affect Disord 2 17-25, 1980... 

Two studies have directly addressed the question of lithium s specificity for mania or affective psychosis, as it is sometimes called. In one of these studies a group of 78 patients admitted with an acute psychotic episode diagnosed as mania, schizophrenia or schizoaffective disorder were randomised to receive lithium or chlorpromazine. The authors hypothesised that patients diagnosed as manic would respond better to lithium and those diagnosed with schizophrenia would respond better to chlorpromazine. In contrast they found that there was no difference in the effects of the different drugs on people with different diagnostic labels and that the only discernible effect was the inferiority of lithium in severely disturbed patients (Braden et al. 1982). A similar study published in 1988 claimed to show that lithium had specificity for... 

The specificity of HG volume changes to schizophrenia is supported by parallel measurements in patients with affective psychosis or mania, where decreased HG volume was not found (Hirayasu et al., 2000 Kasai et al., 2003b McCarley et al., 2002 Salisbury et al., 2007). It is undetermined whether the volume change in schizophrenia precedes the onset of psychosis. Although some studies found a decreased volume at early onset of schizophrenia (Hirayasu et al., 2000 McCarley et al., 2002 Salisbury et al., 2007 Sumich et al., 2005), there is evidence that the volume deficit worsens with disease progression and drug treatment (Crespo-Facorro et al., 2004 Kasai et al., 2003b Salisbury et al., 2007). 

Q7 Other conditions which may present similar symptoms include drug-induced psychosis such as one brought on by lysergic acid diethylamide, or LSD, or amphetamine, personality disorder or affective psychosis. In older patients dementia may present with schizophrenia-like symptoms, but these patients usually have significant memory deficits, which do not occur in schizophrenia. 

Bredkjaer SR, Mortensen PB, Parnas J. Epilepsy and non-organic non-affective psychosis. National epidemiologic study. Br J Psychiatry 1998 172 235-8. 

Barak YAC, Wohl YBC, Greenberg YA, Dayan YBB, Friedman TB, Shoval GA, Knobler HAD. Affective psychosis following Accutane (isotretinoin) treatment. Int Clin Psychopharmacol 2005 20 39-41. 

Muller N, Hofschuster E, Ackenheil M, Mempel W, Eckstein R (1993) hivesdgations of the cellular immunity during depression and the free interval E vidence for an immune activation in affective psychosis. Prog Neuropsychophaimacol Biol Psychiady 17 713—730. 

Beri-beri or clinically manifest thiamin deficiency exists in several subforms infantile beri-beri and adult beri-beri. Infantile beri-beri occurs in exclusively breastfed infants of thiamin-deficient mothers. Adults can develop different forms of the disease, depending on their constitution, environmental conditions, the relative contribution of other nutrients to the diet as well as the duration and severity of deficiency. First of all, there is a so called dry or atrophic (paralytic or nervous) form, including peripheral degenerative polyneuropathy, muscle weakness and paralysis. Second, a wet or exudative (cardiac) form exists. In this form, typical symptoms are lung and peripheral oedema as well as ascites. Finally, there is a cerebral form, that can occur as Wernicke encephalopathy or Korsakoff psychosis. Tli is latter form mostly affects chronic alcoholics with severe thiamin deficiency. 

Affects mood and possibly causes neuronal or brain excitability, causing euphoria, anxiety, depression, psychosis, and an increase in motor activity in some individuals... 

In clinical psychiatric terms, the affective disorders can be subdivided into unipolar and bipolar disorders. Unipolar depression is also known as psychotic depression, endogenous depression, idiopathic depression and major depressive disorder. Bipolar disorder is now recognised as being heterogeneous bipolar disorder I is equivalent to classical manic depressive psychosis, or manic depression, while bipolar disorder II is depression with hypomania (Dean, 2002). Unipolar mania is where periods of mania alternate with periods of more normal moods. Seasonal affective disorder (SAD) refers to depression with its onset most commonly in winter, followed by a gradual remission in spring. Some milder forms of severe depression, often those with an identifiable cause, may be referred to as reactive or neurotic depression. Secondary depression is associated with other illnesses, such as neuro-degenerative or cardiovascular diseases, and is relatively common. 

Bipolar disorder A group of affective disorders characterised by alternating periods of pathologically elevated moods, followed by severely reduced moods. Previously known as manic depression, or manic depressive psychosis. 

The answer is b. (Hardmanr p 1158.) Isoniazid inhibits cell-wall synthesis in mycobacteria. Increasing vitamin B6 levels prevents complications associated with this inhibition, including peripheral neuritis, insomnia, restlessness, muscle twitching, urinary retention, convulsions, and psychosis, without affecting the antimycobacterial activity of INH. 

The typical antipsychotic drugs, which for 50 years have been the mainstay of treatment of schizophrenia, as well as of psychosis that occurs secondary to bipolar disorder and major depressive disorder, affect primarily the positive symptoms[10]. The behavioral symptoms, such as agitation or profound withdrawal, that accompany psychosis, respond to the antipsychotic drugs within a period of hours to days after the initiation of treatment. The cognitive aspects of psychosis, such as the delusions and hallucinations, however, tend to resolve more slowly. In fact, for many patients the hallucinations and delusions may persist but lose their emotional salience and intrusiveness. The positive symptoms tend to wax and wane over time, are exacerbated by stress, and generally become less prominent as the patient becomes older. 

Psychotic Disorders. Patient descriptions of flashback experiences occasionally resemble those of auditory or visual hallucinations. In addition, the numbing and affective restriction of PTSD can resemble the affective flattening of schizophrenia. Finally, some evidence indicates that those with chronic psychotic disorders such as schizophrenia are more vulnerable to trauma, creating the possibility of comorbid PTSD and psychosis. Flashbacks can be distinguished from hallucinations in that the sounds and visions described by a patient with PTSD during a flashback represent a reexperiencing of an earlier traumatic event. The content of the flashback, therefore, is either directly or indirectly tied to the trauma. 

Toxicology. Tetraethyl lead (TEL) affects the nervous system and causes mental aberrations, including psychosis and mania, convulsions, and death. 

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