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Query: UMLS:C0011570 (depression)
 172,036 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

The topic of foreign body ingestion has received extensive coverage in the areas of surgery, emergency medicine, and pediatrics. A subset of this topic, the intentional ingestion of foreign bodies, however, is much less common, and requires special evaluation and management. Here, we report a case of ingestion of a rolled, metal tuna can lid in a male prison inmate previously diagnosed with depression and paranoid schizophrenia. Following evaluation by the surgical team, the foreign body was removed by laparotomy and the patient was discharged back to the prison without complication. In many cases, ingestions of this type involve a command hallucination ordering the patient to swallow the foreign body. Interestingly, the patient in the present case reported auditory hallucinations commanding him not to swallow the can lid. On further investigation, we found that patient had a proclivity toward this swallowing behavior even prior to his incarceration. Early identification of inmates with this proclivity has important implications for treatment and prevention.
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PMID:An unusual foreign body ingestion in a schizophrenic patient: case report. 1648 Feb 46

The topic of foreign body ingestion has received extensive coverage in the areas of surgery, emergency medicine and pediatrics. A subset of this topic, the intentional ingestion of foreign bodies, however, is much less common, and involves subtleties in evaluation and management not usually seen in accidental ingestions. Here, we report a case of ingestion of a rolled, metal tuna can lid in a male prison inmate previously diagnosed with depression and paranoid schizophrenia. Following evaluation by the surgical team, the foreign body was removed by laparotomy and the patient was discharged back to the prison without complication. In many cases, ingestions ofthis type involve a command hallucination ordering the patient to swallow the foreign body. Interestingly, the patient in the present case reported auditory hallucinations commanding him not to swallow the can lid.
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PMID:Foreign body ingestions in a schizophrenic patient. 1719 27

Since depressive symptoms (SDS) are prevalent under-recognized and clinically important problems in patients with schizophrenia, the pattern of symptoms and associated features of depressive symptoms, as well, as inclusion of psychopathology and neurodynemic variations in personality structure of patients with chronic schizophrenia deserve more investigation. The aim of the research was to identify clinical and experimental-psychological features of post-schizophrenic depression. The longitudinal study has been designed to investigate patients with paranoid schizophrenia. As a result of the careful clinical and psychological analyses due to psychopathology we defined four types of depression. From which two types of depression--agitated and asthenic prevailed in active phase of schizophrenia and remained two hypochondriac and apathyc mainly occurred during stabilization. This finding would have prognostic value. The authors examined personality changes leaded by cognitive symptoms and specified psychopathological and neurodynamical input in alteration of personality structure with word association experiment by A.D. Zurabashvili. As the semantics of trigger words became more complex the qualitative impairment deepened. Lower pathological associations have overcome scanty logical thinking and fluctuation of latency time since thought blocking became prominent. SSRI (Fevarin, Rexetin) appeared especially effective in treatment of certain type of post-schizophrenic depression.
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PMID:[Clinical and experimental-psychological data of post-schizophrenic depression VG]. 1798 57

Delusional paranoia has been associated with severe mental illness for over a century. Kraepelin introduced a disorder called "paranoid depression," but "paranoid" became linked to schizophrenia, not to mood disorders. Paranoid remains the most common subtype of schizophrenia, but some of these cases, as Kraepelin initially implied, may be unrecognized psychotic mood disorders, so the relationship of paranoid schizophrenia to psychotic bipolar disorder warrants reevaluation. To address whether paranoia associates more with schizophrenia or mood disorders, a selected literature is reviewed and 11 cases are summarized. Comparative clinical and recent molecular genetic data find phenotypic and genotypic commonalities between patients diagnosed with schizophrenia and psychotic bipolar disorder lending support to the idea that paranoid schizophrenia could be the same disorder as psychotic bipolar disorder. A selected clinical literature finds no symptom, course, or characteristic traditionally considered diagnostic of schizophrenia that cannot be accounted for by psychotic bipolar disorder patients. For example, it is hypothesized here that 2 common mood-based symptoms, grandiosity and guilt, may underlie functional paranoia. Mania explains paranoia when there are grandiose delusions that one's possessions are so valuable that others will kill for them. Similarly, depression explains paranoia when delusional guilt convinces patients that they deserve punishment. In both cases, fear becomes the overwhelming emotion but patient and physician focus on the paranoia rather than on underlying mood symptoms can cause misdiagnoses. This study uses a clinical, case-based, hypothesis generation approach that warrants follow-up with a larger representative sample of psychotic patients followed prospectively to determine the degree to which the clinical course observed herein is typical of all such patients. Differential diagnoses, nomenclature, and treatment implications are discussed because bipolar patients misdiagnosed with schizophrenia are severely misserved.
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PMID:Hypothesis: grandiosity and guilt cause paranoia; paranoid schizophrenia is a psychotic mood disorder; a review. 1805 9

Compared to other antipsychotics quetiapine has been reported to be relatively safer in overdose. We report a case with paranoid schizophrenia who attempted suicide with 1400 mg of quetiapine and manifested drowsiness, supraventricular tachycardia (167/minute) and minimal ST depression in leads V1 to V6 on ECG; all other physiological parameters were normal. Gastric lavage, lorazepam 2mg i/v to control agitation, and 14-hour observation in emergency ended in she being sent home. Subsequently she was successfully managed with ECTs, and quetiapine 600mg and risperidone 6mg daily. This report tends to support the literature suggesting quetiapine as a relatively-safer-in-overdose antipsychotic, and preferable in medication-overdose-suicidal-risk cases.
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PMID:Quetiapine: Relatively safe in overdose? 1982 35

This postauthorization safety study evaluated the long-term safety, tolerability, and efficacy of risperidone long-acting injectable (RLAI) in routine clinical practice. In this 6-month, multicenter, European, naturalistic study, patients were included if, during routine clinical practice, long-term antipsychotic therapy with RLAI was deemed necessary by the treating physician. Efficacy measures included Clinical Global Impression-Severity and Global Assessment of Functioning. Safety was evaluated by recording treatment-emergent adverse events (AE). RLAI was initiated in 5134 patients (aged 14-94 years); predominantly male (58.6%) with paranoid schizophrenia (69.8%). RLAI initial doses were 25 mg every 2 weeks (37.0% patients), 37.5 mg (18.0%), and 50 mg (44.4%). Treatment was completed by 4314 patients (84.0%). RLAI was discontinued on account of loss to follow-up (n=346; 6.7%), insufficient response (n=116; 2.3%), and AEs (n=106; 2.1%). Clinical Global Impression-Severity significantly improved from baseline to endpoint (P<0.001). Patient functioning on the Global Assessment of Functioning scale also significantly improved from baseline to endpoint (45.4 + or - 16.0 vs. 62.4 + or - 17.7, respectively, P<0.001). Treatment-emergent AEs were recorded by 1018 (20%) of patients. AEs occurring in > or = 5% of patients were akathisia, extrapyramidal disorders, depression, psychotic disorder, anxiety, and weight gain. Serious AEs were reported by 384 (8%) patients. This study confirms good safety, tolerability, and efficacy with RLAI in routine clinical practice.
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PMID:Safety and efficacy of long-acting injectable risperidone in daily practice: an open-label, noninterventional, prospective study in schizophrenia and related disorders. 2030 67

This study investigated the possible association between three functional polymorphisms in the promoter region of the dopamine D4 receptor (DRD4) gene and schizophrenia, depression, and heroin addiction. Genomic DNA was isolated from the venous blood leukocytes of 322 unrelated patients with schizophrenia, 156 patients with depression, 300 patients with heroin addiction, and 300 healthy unrelated individuals. Polymorphisms in the promoter region of DRD4 (-120 bp duplication, -616C/G, and -521C/T) were genotyped using allele-specific polymerase chain reaction analysis. Genotype and allele were analyzed using SPSS 11.5 software. Results of this analysis indicated that there is a strong finding of -120 bp duplication allele frequencies with schizophrenia (p=0.008) and weak finding with -1240 L/S and for paranoid schizophrenia (p=0.022). Interestingly, there is a stronger finding with -521 C/T allele frequencies with heroin dependence (p=0.0002). These observations strongly suggest that the -120-bp duplication polymorphism of DRD4 is associated with schizophrenia and that the -521 C/T polymorphism is associated with heroin addiction.
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PMID:Association study of polymorphisms in the promoter region of DRD4 with schizophrenia, depression, and heroin addiction. 2080 Nov 4

The present study compares the occurrence of depressive symptoms evaluated by the Calgary Depression Scale for Schizophrenia (CDSS) in patients of Multiplex (MS) and Simplex Schizophrenia families (SS). The Positive and Negative Syndrome Scale (PANSS) was used to evaluate psychopathology. A total of 206 paranoid schizophrenia patients were studied according DSM-IV criteria. The Family Interview for Genetic Studies (FIGS) was used to study the families. A result in the FIGS for a positive family history of schizophrenia was referred as MS (patients); its lack as SS (patients). CDSS scores were compared among MS and SS patients and possible sex differences intra- and inter-groups were explored. In the analysis of our sample (30) 19% of the total persons with schizophrenia group was depressed. The depressive symptoms measured by the CDSS were higher in females and the MS males group. Males from MS group showed more depressive symptoms than males from SS group. No differences with females from both groups were found. Findings in this study underscore the importance of gender and family history in understanding the heterogeneity of schizophrenia. This study suggests that sex and familiar history are important to consider in studying depressive symptoms.
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PMID:Depressive symptoms evaluated by the Calgary Depression Scale for Schizophrenia (CDSS): genetic vulnerability and sex effects. 2119 52

One hundred and fifty patients of epileptic psychosis, registered over a period of five years in neuropsychiatry clinics at NIMHANS were studied. Patients with organic causes which may produce both epilepsy and psychosis were excluded. The epileptic psychosis ratio to epilepsy was 1:23 and the epileptic psychosis ratio to psychosis was 1:75. The mean age at the onset of epilepsy was 19.4 years, while the mean age at the onset of psychosis was 29 years and thus the mean duration of epilepsy at the onset of psychosis was 9.4 years. With regard to type of seizures, 93 (62%) had grandmal, 50 (33.3%) had temporal lobe epilepsy and 7 (4.7%) had partial motor or sensory epilepsy with generalization. With regard to type of psychosis, 64 (42.7 %) had post-ictal and/or inter-ictal psychosis, 15(10%) paranoid schizophrenia, 9 (6%) mania, 2 (1.3%) depression and 60 (40%) unspecified psychoses. The mean duration of epilepsy was significantly less (p < 0.05) at the onset of acute psychosis than chronic psychosis. Family history of epilepsy and mental illness, premorbid personality and frequencies of seizures were not significantly associated with pathogenesis of epileptic psychosis.
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PMID:A study of epileptic psychoses - 150 cases. 2192 81

Multiple sclerosis (MS) has both neurological and psychiatric manifestations. Though depression, bipolar disorder and la belle indifference are commonly described, schizophrenia-like-psychosis is not widely reported with MS. Drug interactions and side effects make treatment, in such scenario, challenging. We, for the first time, report a patient with MS and paranoid schizophrenia successfully treated with concurrent use of clozapine and risperidone with interferon-beta-1a.
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PMID:Successful treatment of co-morbid schizophrenia and multiple sclerosis. 2305 Aug 95


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