Psychopath antipsychotics

INTRODUCTION: Antisocial personality disorder (AsPD) is a pervasive pattern of violation of others' rights, related to the concept of psychopathy. AsPD is stable over time from adolescence, with evidence of conduct disorder (CD) before 15 years. DSM-5 included a specifier 'with limited prosocial emotions' (LPE), which characterizes adolescents with higher developmental vulnerability to develop AsPD. Despite being relatively frequent with considerable societal impact, AsPD is a difficult-to-treat condition with high comorbidity rates and poor evidence for effective pharmacological interventions...

Aggressive behavior is one of the most disturbing symptoms of Alzheimer disease and other progressive neurodegenerative dementias. Development of strategies for management of aggressive behaviors in people with dementia is hindered by a lack of recognition that aggression is not a uniform behavioral construct. It is possible to distinguish 2 types of aggression: reactive or impulsive aggression and proactive or premeditated aggression. Research concerning aggressive behaviors in people with dementia is hindered by scales describing behavioral symptoms of dementia which do not distinguish between reactive and proactive aggressions because they do not consider the factors leading to these behaviors...

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On the basis of the observation of 62 patients with heroin addiction there was described the post-withdrawal syndrome. It was characterised by a lability of psychopathologic symptomatology and by undulate course (with exacerbation and desactualization of the drive to narcotic). Clinically there were determined 3 types of post-withdrawal syndrome's course. The 1-st type was characterised by irresistible drive to narcotic, followed by psychopathic-like behaviour. For the 2-nd type a prevalence of the depressive symptomatology with different intensity of the disorders of the affect was more typical...

Gabbard (1994) divided the pathology of therapists, both male and female, who commit sexual boundary violations into those who are psychotic, those who are predatory psychopaths, those engaging in masochistic surrender, and those called "the lovesick therapist." Lovesick therapists are the most common type and manifest crucial narcissistic themes of "a desperate need for validation by their patients, a hunger to be loved and idealized, and a tendency to use patients to regulate their own self-esteem" (p. 127)...

All Afro-Caribbean patients admitted to the Mental Illness Division of Rampton Hospital (a Special Hospital) between 1977 and 1986 and a randomly selected control cohort of Non Afro-Caribbean patients admitted in the same period, were compared on a variety of sociodemographic, psychiatric, criminological, treatment and outcome variables. Significantly, fewer of the Afro-Caribbean patients attracted the legal classification of Psychopathic Disorder. Detailed analysis was thus restricted to mentally ill patients in the two ethnic groupings...

Out of five injectable long-acting neuroleptics (LANs) in general use in France, two are french derivatives. LANs in France have been introduced at high dosages, because of the administration of high doses of oral activating neuroleptics at that time. Despite the apparent lack of relationship between dosage and adverse effects, the clinical use of LANs has nowadays moved to lower doses, probably because of the treatment of a greater proportion of less severely-ill outpatients and of patients at an early stage...

The short term activity of neuroleptics allows the possibility to distinguish between: 1 - their instictive-affective effects which can, according to the case, either diminish agitation, vigilance, aggressivity, anxiety and mood, or the disinhibitors in case of anti-autistic action; 2 - their effects reducing hallucinations and delusions. After 6 months, and more, in the case of schizophrenia or other psychotic evolution, the preventive effect on psychotic relapses appears as unquestionable to many psychiatrists even though there do exist discrepancies in controlled studies...

After a short review of the German literature dealing with basal schizophrenic disturbances, the authors present the results of their own studies involving 135 schizophrenics. A large inventory of statistical methods is used to present the findings gained during differential neuroleptic therapy by means of the Frankfurt complaints questionnaire and the structured psychopathic assessment system (SPES-A). The studies indicate that basal schizophrenic disturbances are accessible to (differential) neuroleptic influence...

The presence of tardive dyskinesia in a sample of 43 patients with schizophrenia and 37 psychopaths who had been hospitalised for many years and exposed to large amounts of medication was assessed while testing their cognitive function. Subjects who showed no evidence of abnormal movements performed significantly better on the test of delayed recall, but there were no differences in performance on any of the other tests of cognitive function used. Multiple regression analysis revealed that age and the total lifetime dose of neuroleptic medication received (in chlorpromazine equivalents) were the only variables to predict the Abnormal Involuntary Movement Scale score, although a large amount of variance in this variable was unaccounted for...

A clinico-statistical study of therapy and rehabilitation of 37 patients with psychopath-like schizophrenia selected by the method of blanket sampling using a criterion of the loss of the working ability within 12 months and more showed high efficiency of comprehensive medicated and intensive socio-rehabilitative action (industrial therapy). The role of the stimulating component in the spectrum of psychotropic activities of neuroleptics in the treatment of psychopath-like schizophrenia was ascertained. The result of the work was the employment of 20 of the 37 patients studied...

Some aspects of drug management of acute behavioural disorder are discussed. Drug management aims at the amelioration of the patient's ineraction with his environment; it is used as a diagnostic procedure, and to facilitate further definitive diagnosis and investigation, as a form of psychotherapeutic contact, to facilitate further psychotherapy, and to initiate a treatment programme aimed at returning the patient to being a useful and health member of society. Some methods of rapid tranquillisation are described and the drug management of the following specific behavioural disturbances are discussed: schizophrenic distrubance, acute mania, depressive behavioural disturbance, acute anxiety states, acting-out psychopathic behaviour, toxic states, epileptic furore and dyscontrol syndrome, behavioural disturbances of the elderly, and behavioural disturbances in organic conditions...