Does catatonia belong to schizophrenia or manic-depression? There's no answer to this question as far as each concept doesn't represent an entity but a type. It seems the particular problem, but it is related to the general one -Does any clinical entity exist within endogenous psychoses? The dichotomy of endogenous psychoses has not been established yet. It remains to be a hypothesis. Here a typical case of late catatonia is presented and its symptomatol-ogy is discussed. Then I refer to a genus and a type of a disease and look at the difference between them. In my opinion, as for endogenous psychoses, clinical psychiatry should be more involved in using clinical types efficiently than trying to achieve clinical entities (genera). Late catatonia is one of the few life-threatening types of metal disor-ders. From the point of view, it's not proposed as a clinical entity, but a very useful type and must be remembered in clinical settings.

View full abstract

Pathphysiological and biochemical discussion about catatonia has developed, having been focused on the similarity with neuroleptic malignant syndrome, which was recognized with 20 years delay after the induction of antipsychotics. With respect to treatment, benzodiazepines and electroconvulsive therapy are the first line recommendation, while antipsychotics believe to be contraindication. To call these in question, consecutive fifty cases with catatonic features were analyzed.

View full abstract

As the description of “catatonic features” in the operational criteria shows, recent psychiatry focuses on catatonic looks or appearances. However, Kahlbaum described catatonia as a type (Typus) containing a definite clinical pic-ture and a definite course. Certainly many psychiatric disorders show catatonic “appearances.” It is appropriate that catatonia is a nonspecific cross-diagnostic syndrome. Kretschmer pointed out that catatonia resembles primitive reflex. Catatonia may reveal an archaic layer of the human mind. From a clinical standpoint, catatonia is located in the hinge of schizophrenia and manic-depressive psychosis. On the other hand, the fact that Kraepelin's concept of dementia praecox was formed from Hecker's hebephrenia and Kahlbaum's catatonia, indicate that intension of cata-tonia may lead the essence of schizophrenia: the pathology of temporarity.

View full abstract

Kahlbaum assumed that catatonia would be developed from organic disease. Endogenous psychosis is one of the causes of catatonia, however it seems that not a few patients with catatonic symptoms can be developed by the effects of physical disease. We investigated 3 patients who were difficult to diagnose. Notably, the patient in case 1 could not be diagnosed from her state when we considered the possibility of 3 causes: catatonia, neuroleptic malig-nant syndrome, and encephalitis. The patient was treated with intensive therapy and achieved a good recovery, then, was finally diagnosed with non-herpetic limbic encephalitis. Herein, we discuss the relationship between catato-nia and encephalitis including non-herpetic limbic encephalitis, anti-NMDAR encephalitis and smilar disease.

View full abstract

Drug abuse and addiction are influenced by multiple genes and environmental risk factors half and half, which can be a complicated process. There are two hypotheses to explain the genetic influences on drug abuse, CDCV and CDRV. Based on CDCV, GWAS is performed. It is necessary to prepare a large size of case-control samples and absolutely-healthy controls in the tests, with a careful consideration of a gene-environmental interaction, to evaluate susceptibility genes for the disease. Also in near future, based on CDRV, whole genome sequencing would be performed in every drug abuse patient, to find rare variants, such as CNVs. While those rare variants could have some roles in drug abuse, it is not easy to be proven.

View full abstract

The prevalence of drug dependence is a serious social problem in many countries as well as Japan. This problem involves many background factors including medical science, socio-economics and politics. In the present paper, the epidemiology of drug dependence in Japan is briefly described. Then, I account for the neurobiological basis of drug dependence, but it has not been clear. First, the reward system in the brain is explained, and the stage of addiction on the development of drug dependence is followed. The biological pathogenesis of schizophrenic disorders also has been still unknown. Symptoms of MAP or PCP psychosis are very similar to those of schizophrenic disorders, involving hallucination or delusion. PCP causes not only positive symptoms, but negative symptoms. Therefore, it has been considered as a more comprehensive model of schizophrenia than the other drugs. Understanding the neurobiological basis of drug dependence using the molecular biological approach will provide an important cue to reveal the mechanisms of schizophrenia, endogenous psychiatric disorders.

View full abstract

Alcohol dependence is a chronic relapsing disorder with an enormous economic loss worldwide. Alcohol-related issues should be elucidated based on the broad area including the health sciences, education, socioeconomics, and political measures. In this review, the neurobiological mechanisms underpinning alcohol dependence were outlined by previous findings. A phenotype of alcohol abuse/dependence may be a form of dysfunctional, maladaptive learning that is difficult to reverse after once established. The development of alcohol dependence is involved in the interaction between dopamine-based reward systems and mechanism of neural plasticity, learning and memory that are mediated by the glutamatergic neurotransmission.

View full abstract

Methamphetamine (METH) is an addictive stimulant drug used all over the world, and METH has long been the most popular substance of abuse in Japan. Several investigations reported that some genes were associated with METH use disorders including methamphetamine dependence and METH-induced psychosis. Also, the symptoms of METH-induced psychosis are similar to those of paranoid type schizophrenia. Therefore, it may indicate that METH-induced psychosis and schizophrenia have common susceptibility genes. In this review, we give an outline about the genetic research using Japanese Genetics Initiative for Drug Abuse (JGIDA) samples.

View full abstract