Images in psychiatry: Viktor Emil Frankl 1905-1997

Mat Gelman, Liesl Kosma, Christopher S.E. Wurm, Nicholas Kek

Suicide and schizophrenia : a review of literature for the decade (1990-1999) and implications for mental health nursing

This paper presents an overview of recent evidence on general and specific risk factors for suicide in patients with schizophrenia. The authors highlight the significant factors contributing to the likelihood of suicide in patients diagnosed with schizophrenia. This information will enhance the delivery of nursing care to these patients in all health care settings. A review of literature was conducted by two methods of investigation: Medicine and CINAHL search and a manual search through articles from 1990 to 1999. The lifetime risk of committing suicide is estimated at about 9-13% of persons with schizophrenia and it is 20 to 50 times higher than that in the general population. Young white males diagnosed with schizophrenia who are depressed, unmarried, unemployed, socially isolated, and functionally impaired and who lack external support are the most vulnerable in the early stages of schizophrenic illness. Findings can be instrumental in identifying and treating patients who are most vulnerable and in making psychiatric nurses aware of the scenarios and critical stages of the disease process when suicide is most likely to occur

No change in the density of the serotonin1A receptor, the serotonin4 receptor or the serotonin transporter in the dorsolateral prefrontal cortex from subjects with schizophrenia

Changes in serotonin receptors and the serotonin transporter have been reported in the dorsolateral prefrontal cortex from subjects with schizophrenia, an area of the brain thought to be important in the pathology of the illness. To further our understanding on how such changes could play a role in the pathology of the illness, in situ radioligand binding with autoradiography was used to measure the density of the serotonin1A receptor, the serotonin4 receptor and the serotonin transporter in the dorsolateral prefrontal cortex, obtained at autopsy, from 10 schizophrenic and 10 control subjects. The binding of [3H]8-OH-DPAT to serotonin1A receptor, [3H]GR113808 to the 5HT4 receptor and [3H]citalopram to serotonin transporter was not altered in subjects with schizophrenia. Significantly, only in tissue from the control subjects was there a relationship between age and the density of the serotonin4 receptor in Brodmann\u27s areas 8 (r = 0.71, P = 0.02) and 10 (r = -0.67, P = 0.03). Importantly, this confounding factor did not influence the comparison of the density of serotonin4 receptor in the tissue from the schizophrenic and control subjects. This study has failed to show a difference in the density of serotonin1A receptor, the serotonin4 receptor or the serotonin transporter in the dorsolateral prefrontal cortex (Brodmann\u27s areas 8, 9 and 10) from subjects with schizophrenia. These data suggest that not all serotonergic markers are altered in the dorsolateral prefrontal cortex from schizophrenic subjects