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Major and exciting advances in psychiatric genetics were discussed
at a 3-day international workshop. The internationally renowned
editors assembledan impressive list of specialists, all of whom are
leading in their subject. Reviews and short articles which stress
special problems or new research results have been brought together
in this book, also including intensive discussions of the different
topics. Much of the material covers the application of molecular
genetics in major psychoses, Alzheimer's dementia or preclinical
research. However, the problems of diagnostic features or
phenotypical characterization broaden further the content of this
volume, making it truly a collection of the art information.
This volume contains the proceedings of the symposium Pathochemical
Markers in Major Psychoses, held in Vienna in July 1983. The
development of biological markers in psychiatric diseases, par
ticularly in the field of neurochemistry, has made substantial
progress during recent years although the multiple mechanisms of
mental illness are still not fully understood. The greatest
contribution has come through the development of new therapeutic
agents that not only pro vide invaluable help for psychiatric
patients but also serve as chemical tools for the investigation of
the biological mechanisms underlying the disease. The catecholamine
and serotonin hypotheses for major psy choses have been of
particular heuristic value and have stimulated im portant research.
However, the scope of our scientific endeavours has to be broadened
to include other putative biological causes of psychoses, e. g.,
pathomorphological changes, aberrations in the metabolism of other
amino acids and oflipids, or the formation of endogenous toxins.
This book presents new selected studies of the pathochemical bases
of schizophrenia and affective psychoses. Although several topics
were inevitably not included in this symposium, we nevertheless
hope that it represents an integration of basic pathomorphological
research with current clinical findings in the area of
pathochemical markers in psy chiatry. October 1984 HELMUT BECKMANN
PETER RIEDERER Contents Neuromorphological Background of
Pathochemical Studies in Major Psychoses K. JELLINGER (With I
Figure) . . . . . . . . . . of Psychopathological Classification
The Significance in Interpreting Biochemical Findings E. GABRIEL .
. . . . . . . . . . . . . . . ."
The volumes on "psychotropic substances" in the Handbook of
Experimental Phar macology series clearly show that the classical
concept of this discipline has become too narrow in recent years.
For instance, what substances are psychotropic is determined not by
the criteria of the animal trial, i.e. by experimental
pharmacology, but by their action on the psy che, which in the
final analysis is only accessible to us in man. Psychotropic
substances force experimental pharmacology (and thus also this
Handbook) outside its tradition allimits, which have essentially
depended on animal studies. The antipsychotics and antidepressants
were not discovered in animal ex periments, but by chance (or more
precisely, by clinical empiricism). Experienced psy chiatrists
trained in the observation of patients recognised the efficacy of
drugs, the beneficial effect of which nobody had dreamed of before:
DELAY and DENICKER in the case of chlorpormazine, KLINE in the case
of the monoamine oxidase inhibitors and KUHN in the case of
imipramine. It was only after these discoveries that the pharma
cologists developed experimental models of the psychoses in animal
experiments. However, even today we still do not know with
certainty which of the effects shown in animals is relevant for the
clinical effect despite the vast abundance of individual
investigations. For many years, this uncertainty led to the testing
of antipsychotics (e.g. of the neuroleptic type) in models which
actually produced the undesired effects."
The discovery of chlorpromazine for the specific treatment of
schizophrenic symp toms and, later on, of imipramine for the
specific treatment of depressive symptoms marked a new milestone in
clinical psychiatry and basic neuroscience 40 years ago. The
exploration of biochemical mechanisms of action of these
psychotropic drugs created new theories on the pathophysiology of
psychiatric disorders, such as the dopamine hypothesis of
schizophrenia and the catecholamine and serotonin hypotheses of
depression. Thus the discovery of these biological treatments had a
major impact on natural science-oriented research. Biological
psychiatry as we know it today has its origin in these
psychopharmacological drugs and influences many disciplines in
psychiatry. It was a fortunate coincidence that Hans Hippius, whose
70th birthday we celebrated this year with an international
symposium, started his professional career during this time in the
1950S. He was one of the early pioneers in clinical psycho
pharmacological research and enthusiastic about both the scientific
and the thera peutic prospects of the new psychotropic drugs. He
has worked in this field for more than three decades and has made
many lasting contributions to biological psychiatry. Among the many
activities, his contributions in the development of the new
atypical antipsychotic drug clozapine should be mentioned."
Mehr als die Halfte aller Patienten weisen Krankheiten mit
seelischen Stoerungen oder mit einer psychosomatischen AEtiologie
auf. Dementsprechend wichtig ist es, sowohl fur Studierende als
auch fur AErzte aller Fachdisziplinen, die Grundlagen der
psychosomatischen Medizin zu beherrschen. Im "Klussmann" werden die
wichtigsten Krankheitsbilder aller klinischen Fachgebiete aus
psychosomatischer Sicht behandelt. Dabei erleichtern Einleitungen
und Definitionen den Einstieg in die Materie, zahlreiche
Fallbeispiele sorgen fur Anschaulichkeit und stellen den Bezug zur
Praxis her. Umfangreiche Hinweise zu weiterfuhrender Literatur, ein
Glossar und ein Verzeichnis psychotherapeutischer Einrichtungen
erhoehen den Wert dieses Lehrbuchs als Nachschlagewerk.
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