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The article presents a comparative review of British phenomenological and psychopathological concepts. Concepts from British researchers such as the Present State Examination (PSE) and the Hamilton Rating Scale have provided significant contributions in the field of psychopathology. The use of various inexact concepts and symptom description in the PSE have been noted due to the scope of the meanings that they convey. The exposure of various psychopathological theories extracted from British and German principles suggests convergence in the study of psychopathology. Concepts used in discussing affective disorder and schizophrenia as well as psychopathological consideration on nosology are discussed.

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Abstract We investigated the degree of striatal dopamine-2 (D[sub 2]) receptor occupancy in six schizophrenic patients receiving clinically effective antipsychotic treatment with olanzapine 10-25 mg/day in comparison to patients treated with clozapine 300-600 mg/day (n = 6) or haloperidol 5-20 mg/day (n = 10).[sup 123]I Iodobenzamide (IBZM) and single photon emission computerized tomography (SPECT) were used for the visualization of striatal D[sub 2] receptors. For the quantification of striatal D[sub 2] receptor occupancy, striatal IBZM binding in patients treated with antipsychotics was compared to that in untreated healthy controls (n: 8) reported earlier. Olanzapine led to a mean striatal D[sub 2] receptor occupancy rate of 75% (range 63-85). Haloperidol-treated patients showed dose-dependently (Pearson r: 0.64; P < 0.05) a significantly higher (P < 0.05) mean occupancy rate of 84% (range 67-94). During clozapine treatment, the mean D[sub 2] receptor occupancy of 33% (range<20-49) was significantly lower than with olanzapine (P < 0.005). The higher striatal D[sub 2] receptor occupancy of haloperidol was correlated with the incidence and severity of extrapyramidal motor side-effects (EPS). No clinical relevant EPS occurred during treatment with olanzapine or clozapine. There was no correlation between the degree of striatal D[sub 2] receptor occupancy and clinical improvement. [ABSTRACT FROM AUTHOR]

Abstract The striatal D[sub 2] dopamine binding was studied in schizophrenic patients treated with the novel atypical antipsychotic drug sertindole (n = 10). Comparisons were obtained with haloperidol (n = 8), clozapine (n = 6), risperidone (n = 11) and untreated healthy controls (n = 8) of a dataset which has partly been reported previously. [sup 123]I-Iodobenzamide (IBZM) single photon emission computerized tomography (SPECT) was used for estimation of striatal dopamine D[sub 2] receptor binding. Sertindole-treated patients exhibited significantly (P < 0.001) lower levels of striatal D[sub 2] binding (BG/FC ratio:l.28) compared with those treated with haloperidol (BG/FC ratio:l.09) and risperidone (8 mg:l.18) but significantly (P < 0.005) higher levels compared with clozapine (BG/FC ratio: 1.49). However, if patients were pretreated with a depot neuroleptic, significantly (P < 0.05) higher striatal D[sub 2] binding (BG/FC ratio: 1.12) has been obtained. Since sertindole has been shown to exert distinct clinical efficacy for treatment of positive and negative symptoms, our data are indicative that antipsychotic efficacy is not associated with a high degree of striatal D[sub 2] receptor occupancy in schizophrenic patients. [ABSTRACT FROM AUTHOR]

Abstract We investigated the striatal dopamine-2 (D[sub 2]) receptor occupancy caused by different antipsychotic substances in 18 psychotic patients (16 with schizophrenic and two with schizoaffective disorder according to DSM-IV) with single photon emission computed tomography (SPECT) using [sup 123]I-iodobenzamide (IBZM) as tracer substance. Four patients were treated with the novel antipsychotic compound quetiapine (300-700 mg/day), six with clozapine (300-600 mg/ day) and eight with haloperidol (10-20 mg/day). They were compared with eight healthy controls. Measurement of S/F ratios and consecutive calculation of D[sub 2] receptor occupancy revealed a significantly lower striatal D[sub 2] occupancy rate with quetiapine and clozapine in comparison to haloperidol. In correspondence with the low striatal D[sub 2] receptor occupancy rates and again in contrast to the haloperidol treatment group, there were no extrapyramidal motor side-effects (EPS) in the quetiapine and clozapine treatment groups. Therefore, the reported data support the position that quetiapine can be considered to be an atypical antipsychotic substance due to its relatively weak striatal D[sub 2] receptor blocking property and therefore its low propensity to induce EPS. [ABSTRACT FROM AUTHOR]

Abstract Considerable progress has been achieved over the past 15 years in uncovering the biological basis of major psychiatric disorders. Since psychopharmacological treatment is thought to act on the underlying biological basis of the disease, brain imaging techniques enable us to understand the mechanism of action of such compounds. Positron emission tomography (PET) as well as single photon emission computerized tomography (SPECT) are important tools used to determine patterns of brain dysfunction and to uncover the mechanism of action for antipsychotic compounds. These techniques allow us to determine striatal D[sub 2] receptor as well as cortical 5-HT[sub 2A] receptor occupancy rates which are linked, at least partly, to clinical efficacy as well as side effect rates. In general it has been shown that atypical antipsychotics have a lower striatal D[sub 2] receptor occupancy rate than typical antipsychotics, parallelling the more favorable extrapyramidal side effects of atypical antipsychotics, and as a group effect they have a high 5-HT[sub 2A] occupancy compared to low rates for typical agents. However, there is no association between striatal D[sub 2] receptor occupancy rates and antipsychotic efficacy but 5-HT[sub 2A] occupancy rates are associated with favorable treatment for depressive symptoms within schizophrenia and improvement of cognitive function. The availability of ligands for measurement of extrastriatal D[sub 2] receptors or different 5-HT receptors (e.g. 5-HT[sub 1A]) will further shed light on the pathophysiology of schizophrenia as well as possible psychopharmacological treatment perspectives. [ABSTRACT FROM AUTHOR]