This in turn may regu late the do pa min ergic func tion. This lat ter study found that cas tra tion de creased the 5-HT2 A -r eceptor bind ing sites, the con tent of 5-HT2 A mes sen ger ri bo nu cleic acid (mRNA), and the serotonin-transporter bind ing sites in the brain, thus de creas ing the sero to ner gic trans mis sion. Con versely, admini stra tion of tes tos ter one had the op po site ef fect. When viewed in light of the well-chronicled in hibi tory role of the se ro to ner gic sys tem over the do pa min ergic sys tem, es pe cially in the fron tal areas, this in di cates that fal ling tes tos ter one lev els con se quent to cas tration cause a hy per do pa min er gic state. These ob ser va tions thus in di rectly support the hy pothe sis that tes tos ter one protects against schizo phre nia by modu lat ing the neu ro trans mit ters im plicated in the dis or der. A simi lar role for es tra diol is more ac cepted in the lit erature; whether tes tos ter one ex erts its protec tive ac tion via con ver sion to es tra diol (7) is a ques tion that opens new ave nues for elu ci dat ing its im pact on the psy chopa thol ogy of schizo phre nia. The psy cho logi cal im pact of the World Trade Cen ter dis as ter was more sig nificant than simi lar pre vi ous in ci dents, partly be cause of the live tele vi sion cover age. I re port 3 cases of pa tients af fected by this trauma. Ref er ences Case Report 1On Sep tem ber 20, 2001, a 36-year-old man who is an as sem bly worker at a lo cal fac tory was ad mit ted through the emergency de part ment of our gen eral hos pital. He was in a psy chotic state, suf fer ing from con fu sion and para noia. Ap parently, around Sep tem ber 11, a fel low worker of East In dian ori gin left the factory abruptly, and from that point on the pa tient was con stantly wor ry ing, as suming the worker to be in some way connected to the dis as ter. Al though that par ticu lar worker re turned to work af ter a few days, the pa tient con tin ued to worry. He did not sleep ade quately and ul ti mately be came con fused and needed hos pi tali za tion.The pa tient had a his tory of 2 psy chotic epi sodes, both pre cipi tated by stress, that re solved com pletely within a week of treat ment. There was no his tory of al cohol or drug abuse or any sig nifi cant family his tory of men tal ill ness. He has a sta ble mar riage and has been func tion ing quite well at his work place for the last 15 years. He sta bi lized within 24 hours of ad mis sion and was dis charged af ter 3 days, with a pre scrip tion of queti apine 100 mg, to be taken at bed time. Case Report 2A 52-year-old fe male out pa tient suf fering from dysthymic dis or der and chronic anxi ety, with a his tory of sex ual abuse, was men tally sta ble prior to the dis as ter. Sub se quently, she be came in creas ingly de pressed, anx ious, and agi tated. She suf fered from in som nia and com plained of night mares in which her abu sive exhusband was the pi lot of one of the planes in volved in the dis as ter. This patient sta bi lized quick...
CORRESPONDENCEby burning (just as many others) are carried to Britain and maintained. This factor, together with those described above, provides a better explanation ofburning as a method ofsuicide than suttee. RAMAMOHAN VELURI
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