Psychiatry and clinical neurosciences
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Psychiatry Clin. Neurosci. · Apr 1999
Randomized Controlled Trial Clinical TrialThe hypnotic effects of melatonin treatment on diurnal sleep in humans.
This study investigated the hypnotic effects of 10 mg melatonin and placebo, which were administered at 10.00 h, according to a single-blind crossover design, on an 8-h diurnal sleep from 11.00 to 19.00 h, following a full night of sleep. The subjects were six healthy male students, each of whom underwent polysomnography and rectal temperature monitoring. ⋯ As to changes in rectal temperature during diurnal sleep, however, there were no significant differences between the melatonin and placebo conditions. Thus, these results indicated that melatonin administered at 10.00 h had direct hypnotic effects on diurnal sleep.
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Psychiatry Clin. Neurosci. · Apr 1999
Comparative StudyClinical efficacy and indication of acetazolamide treatment on sleep apnea syndrome.
The efficacy and indication of acetazolamide treatment on patients with sleep apnea syndrome (SAS) were discussed from assessing the changes of polysomnographic findings with the treatment in 75 SAS patients. For the patients as a whole, respiratory disorder variables improved significantly during the treatment. ⋯ The lower values of body mass index and AHI in the responder group indicated that monotherapy with acetazolamide is the treatment choice only for mild SAS cases without obesity. However, combined treatment with acetazolamide and uvulopalatopharyngoplasty was thought to be beneficial for severe cases.
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Psychiatry Clin. Neurosci. · Dec 1998
Child psychiatry training for pediatricians: Japanese perspectives in infant psychiatry.
Since August 1993, child psychiatry training by a full-time child psychiatrist has become an essential component of the postgraduate training programme at the Department of Paediatrics, Keio University Hospital, Japan. Thirty trainees, 15 first-years and 15 second-years, had first-hand experience in residential child psychiatric treatment concurrently with pediatric training. ⋯ After the 2 years of training the first group of trainees showed competency in handling children's emotional problems on their own in distant affiliated hospitals. The flexible multidisciplinary style of training that has evolved over the past 2 years has proved to have enormous relevance in the changing contexts of the pediatric practice in Japan.
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Using an actigraph, the activity patterns in 13 demented patients with delirium were examined. We analyzed the data of the eight patients, wearing the actigraphs for more than 10 days. They were classified into four types: type A, nocturnal delirium type; type B, wandering type; type C, hypobulia type; and type D, lying down type. ⋯ The dominant period of activity rhythm was nearly 24 h in all cases. Additional 12-h period was observed in type C. Actigraphs might become useful in making therapeutic decisions regarding demented patients with delirium.
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We tried melatonin treatment in two patients with non-24 h sleep-wake syndrome, who did not respond to treatments by vitamin B12, bright light therapy, or hypnotics. In one patient, melatonin 5-10 mg improved difficulty in falling asleep and in waking, although it failed to improve the sleep-wake rhythm. ⋯ However, melatonin re-administration after a 4-month drug-free interval failed to improve his free-running sleep-wake rhythm. These results suggest that melatonin acted as a sleep inducer in one patient and as a phase setter in the other, although the effect on the latter patient was transient.