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

The present investigation tested the hypothesis that childhood behavioral problems are differentially associated with clinical symptoms in adult-onset schizophrenia. Parents of 29 schizophrenic patients completed questionnaires concerning (1) the childhood behaviors of all their offspring from birth through 15 years of age, and (2) the symptomatology of their schizophrenic offspring. The childhood behavior scale was a modified version of Achenbach's Child Behavior Checklist (1991). Scores were derived for six childhood behavior problem factors: Withdrawal, Anxiety/Depression, Social Problems, Thought Problems, Attention Problems, and Aggression/Delinquency. Ratings of symptoms were based on parental versions of Andreasen's Scale for the Assessment of Positive Symptoms (SAPS; 1983) and Scale for the Assessment of Negative Symptoms (SANS; 1981). Symptomatology scores were computed from the SANS and SAPS following Malla et al.'s (1993) and Liddle's (1987b) tri-dimensional concept of schizophrenia: Reality Distortion, Psychomotor Poverty and Cognitive Disorganization. Regression analyses were conducted to examine the relation between childhood behavior and adult symptomatology in the schizophrenic patients. The results indicated that the Psychomotor Poverty and Cognitive Disorganization dimensions in adult patients are positively associated with Withdrawn behavior and inversely associated with Anxious/Depressed characteristics in childhood. The results are discussed in light of the distinction between primary and secondary negative symptoms, and the three dimension concept of schizophrenia.
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PMID:Childhood behavioral precursors of adult symptom dimensions in schizophrenia. 757 64

Although it is generally accepted that antipsychotic treatment improves the negative symptoms of schizophrenia in the context of improvement of positive symptoms, exactly how and to what extent they effect "primary" negative symptoms remains controversial. Antipsychotic treatment may reduce only those negative symptoms secondary to positive or depressive symptoms, and may have minimal, if any effect, on negative symptoms that represent a primary psychopathological trait manifestation of schizophrenia. In an effort to further examine this issue, we prospectively assessed negative, positive, depressive, and extrapyramidal symptoms following the discontinuation of antipsychotic medication. Fifty-nine DSM III-R schizophrenic patients underwent a three-week drug wash as part of our neuroimaging protocols. We assessed psychopathological status and adverse effects utilizing various rating instruments (i.e., Scale for Assessment of Positive Symptoms [SAPS], Scale for Assessment of Negative Symptoms [SANS], Hamilton Rating Scale for Depression, and Simpson-Angus Extrapyramidal) at baseline and weekly during this three-week period. Negative symptoms, as measured by the SANS, worsened significantly during the three-week drug wash. Positive symptoms showed a less consistent change with symptoms of disorganization worsening and with psychotic symptoms remaining the same. The changes in negative symptoms during the drug-free period were correlated with the changes in psychosis and disorganization, but not with changes in depression or extrapyramidal side effects. We were not able to substantiate if the worsening in negative symptoms was a direct result of the worsening of positive symptoms or if they were changing simultaneously, but independent of each other.
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PMID:Effect of antipsychotic withdrawal on negative symptoms in schizophrenia. 794 39

The aim of this study was to investigate the relationship between depressive and positive symptoms, two positive symptom using scales (PANSS and SAPS) in samples defined by three schizophrenic diagnostic systems (DSMIII-R, ICD9 and Langfeldt) at difference phases of the illness and in taking into account the negative and extrapyramidal symptoms and the doses of neuroleptics. With both scales, correlations between depressive and positive symptoms were significantly negative in two diagnostic subgroups (DSMIII-R and Langfeldt) in the acute phase. These correlations were also significant when negative symptoms, subjective extrapyramidal signs and the doses of neuroleptics were partialled out. Only the extrapyramidal physician's score was intercorrelated with positive and negative symptoms. Among the positive symptoms, 'conceptual disorganization' (or 'positive formal thought disorder') and 'suspiciousness/persecution' were especially correlated negatively with depression. At the post-acute phase or at the residual phase, no significant correlation between depressive and positive symptoms was found in any diagnostic subgroup. These results show the necessity of taking into account the phase of illness and the diagnostic criteria in order to study depression in schizophrenia.
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PMID:Relationship between depressive and positive symptoms in schizophrenia. 810 Aug 38

This study has used neuropsychological tasks--Wisconsin Card Sort (WCST), Trail Making (TMT) A and B, Verbal Fluency, Digit Span--to compare acute and currently off-medication schizophrenics, patients with unipolar nonpsychotic major depression and healthy controls. Both patient groups differed significantly from healthy controls in their neuropsychological performance. Furthermore there was only little (quantitative) difference between schizophrenics and depressed patients in the frontal lobe associated tasks: WCST, TMT and Verbal Fluency. Depressed patients tended to perform worse than schizophrenics on Digit Span, a task hypothesized to involve other than frontal areas of the brain. Although the group of depressed patients was older than the schizophrenic sample, the effect of age may not totally explain the findings. The results indicate that there do exist disturbances in frontal lobe cognitive functioning in schizophrenia and depression. Symptomatology (SANS/SAPS) and cognitive functioning in the schizophrenic group revealed only a trend for negative symptoms to be associated with worse performance in the WCST, but were significantly correlated with negative as well as positive symptoms on the TMT.
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PMID:Assessment of frontal lobe functioning in schizophrenia and unipolar major depression. 832 96

Forty-eight schizophrenic outpatients treated with flexible doses of haloperidol decanoate were followed up in a naturalistic fashion for 3 years with periodic monitoring of clinical symptoms, side effects and haloperidol plasma concentrations. There was no relationship between plasma level and clinical response, however categorical data analysis showed that patients with plasma levels over 4 ng/ml had a significantly reduced relapse rate compared with patients with plasma levels below this plasma 'threshold' level. This effect could be observed during the first, second as well as third year of treatment. The relapse rate did not change significantly in relation to time (during years 1, 2, 3), when patients with haloperidol plasma levels below and equal to or over 4 ng/ml were considered separately. In patients with haloperidol equal to or over 4 ng/ml, the variability (measured as coefficient of variation %) in the total scores of SAPS and SANS was lower, indicating a better clinical stability. These data are in fairly good agreement with other literature findings showing that an indiscriminate dose reduction strategy during long-term treatment of schizophrenic disorders with haloperidol decanoate should be discouraged, since it leads to an increase in the relapse rate. Before deciding about a dose reduction, clinicians should take into careful consideration some clinically relevant variables (i.e. frequency of previous relapses, severity of symptoms, iatrogenic depression, risk for development of extrapyramidal side effects) for each patient. A better clinical stability during treatment with haloperidol decanoate can be obtained when plasma 'threshold' levels for response are reached.
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PMID:Haloperidol plasma 'threshold' levels for relapse prevention in schizophrenia: a study with haloperidol decanoate. 877 59

Type and extent of objectively tested cognitive impairments (attention, verbal fluency, nonverbal reasoning) and their association with self-ratings (Paranoia Depression Scale; Frankfurt Complaint Questionnaire) and clinical assessments (Brief Psychiatric Rating Scale, Scales for the Assessment of Positive Symptoms and Negative Symptoms) of psychopathological symptoms were studied in a sample of 74 adolescents primarily suffering from chronic schizophrenia (DSM-III-R; mean duration of illness = 3.4 years), including 15 patients with a very early onset (< 14 years). Special consideration was given to the differentiation between positive and negative symptoms. In cross-sectional analyses, the schizophrenic adolescents were remarkably impaired in both cognitive functions (attention, reasoning) and psychopathological measures (BPRS, SANS, SAPS). However, factor analysis yielded orthogonal factors for cognitive and psychopathological parameters, and canonical correlation analyses did not find a significant correlation between these two areas. As the degree of objectively measured cognitive impairment in chronic schizophrenic adolescents cannot be predicted by the severity of individual psychopathological symptoms, a multidimensional evaluation of the symptomatology seems to be appropriate. Moreover, premorbid disturbances (motor and/or language developmental disorders) and onset characteristics (age, pattern, subdiagnosis), and their relationship to cognitive impairments were investigated. Premorbid disturbances were confirmed as risk factors for the subsequent occurrence of cognitive impairments.
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PMID:Cognitive functions and psychopathological symptoms in early-onset schizophrenia. 1079 51

We aimed to investigate the reliability and the clinical sensitivity of the World Health Organization Quality of Life (WHOQOL-100) scale for patients diagnosed with schizophrenia because of its multilingual, multidimensional, and cross-cultural properties. Fifty-four stabilized outpatients with schizophrenia and 49 age-, sex-, and occupation-matched healthy control subjects were recruited. The scale showed high internal consistency (Cronbach alpha = 0.94). While there was no correlation between total scores of psychopathology measures (Brief Psychiatric Rating Scale [BPRS], Scale for the assessment of Negative Symptoms [SANS], Scale for the Assessment of Positive Symptoms [SAPS], and Clinical Global Impression [CGI]), significant negative correlations were obtained especially between subscales of the BPRS, SANS, SAPS, and QOL domains. Stepwise multiple regression analysis also revealed that the BPRS anxiety/depression and SANS anhedonia subcales were the predictor variables in five of six QOL domains in the schizophrenia group. The better quality-of-life scores of the mild group on physical and psychological domains indicate that the WHOQOL-100 could be used as an outcome measure in clinical studies. Thus, the WHOQOL-100 scale is a reliable, subjective quality-of-life scale for patients diagnosed with schizophrenia. The clinical sensitivity should also be assessed in large follow-up studies.
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PMID:The sensitivity of quality-of-life scale WHOQOL-100 to psychopathological measures in schizophrenia. 1467 38

Previous studies have suggested that qualitatively distinct aspects of dysphoria (anxiety and depression) are related to specific dimension of schizophrenia symptomatology. Most of these studies used simple dimensions and dysphoria models, although finer distinctions could help defining specific relationships. This study examined the relationships of distinctive aspects of depression and anxiety (both state and trait) with symptom dimensions. Forty patients with a DSM-IV diagnosis of schizophrenia were assessed for symptoms (SAPS-SANS), trait and state anxiety (STAI) and depression (CDS). Symptoms ratings were summarized as dimensional scores according to a two-, three- or five-dimensional models proposed in the literature. The correlation analysis replicates previous observations that distinct aspects of dysphoria are associated with specific dimensions of schizophrenia, with the exception of disorganization. Moreover, controlling for intercorrelated variables revealed that schizophrenia and dysphoric symptoms might act in combination and/or through indirect links to contribute to illness expression. Our data further suggested that these associations may be best understood in terms of interactions between various processing biases alluded in the most recent cognitive accounts of schizophrenia symptoms.
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PMID:The relationships between symptom dimensions and dysphoria in schizophrenia. 1582 Mar 27

A 44 base pair insertion ("l")/deletion ("s") polymorphism (called 5-HTTLPR) in the 5' promoter region of the human serotonin transporter gene (SLC6A4) modulates expression and has been associated to anxiety and depressive traits in otherwise healthy individuals. In individuals with psychiatric diagnoses, including schizophrenia, it seems to modulate symptom severity. Thus, it may be a disease modifying gene. In this study, 92 patients with psychosis (including schizophrenia, schizoaffective disorder, bipolar psychosis, and major depression) were assessed at their first hospital admission. Symptom ratings, including SANS negative symptoms, SAPS positive symptoms, and SCID depressive symptoms, were obtained. Stress was also assessed. Bi-allelic genotyping at the 5-HTTLPR locus was done. Using multiple regression models, we found that 5-HTTLPR genotype (especially in dominant models) accounted for a significant portion of the variance in SCID Depression and SANS (about 5%). In particular we found that the l allele was associated with greater psychopathology. This is consistent with our review of the literature and is at variance with findings in healthy controls that the s allele is associated with greater anxiety and depression levels. We believe that this set of findings argues for principled reversal of directionality in associations at the 5-HTTLPR locus and raises the possibility that allelic variation may have very different consequences for personality traits or psychiatric symptoms depending on epistasis or epigenetic context. Furthermore, these results also imply that categorical diagnostic distinctions may still be relevant in understanding some genetic effects.
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PMID:The serotonin transporter gene and disease modification in psychosis: evidence for systematic differences in allelic directionality at the 5-HTTLPR locus. 1936 59

Whether studies agree or disagree on the positive-negative dichotomy in schizophrenia, the relevance of a third component, disorganization, remains a point of debate. Disorganization, as expressed by the scale for the assessment of negative symptoms and positive symptoms (SANS-SAPS) and the positive and negative syndrome scale (PANSS) principal-component analyses, could be considered as permanent and determinant a dimension as the positive and negative components. The aim of this study therefore was to determine whether this disorganization, with the negative and positive components, is stable and has the same composition in the acute and postacute phases of illness. This study was carried out in 57 patients, broadly defined by at least one of four diagnostic criteria (American Psychiatric Association, Langfeldt, Carpenter and Schneider), established with a computerized checklist, and evaluated with SANS-SAPS and PANSS. Principal component analyses (PCA) of these scales were performed at admission and discharge from hospital. The PCA of SANS-SAPS displayed a 3-factor solution, regardless of the phase of illness (acute or postacute), showing that the negative, positive and disorganization components were stable. The PCA of PANSS yielded negative and positive components perfectly stable over time and a disorganization component whose composition varied between admission and discharge. At admission, this component included the conceptual disorganization item negatively correlated with one of depression. At discharge, this disorganization component included two additional items, autistic preoccupation and mannerisms and one depression component appeared. The instability of the PCA of PANSS could express the role played by the phase of illness; in an acute phase, this disorganization component was constituted by more "positive" items such as grandiosity, unusual thought content and active social avoidance whereas in the postacute phase, it included items that reflected more the chronicity of the illness, such as mannerisms and autistic preoccupation. Moreover, the depressive item appeared, in the postacute phase, in a specific depressive component. This result could be due to the fact that depressive symptoms cannot be expressed when positive symptoms are very severe, which explains why no depressive components were shown during the acute phase.
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PMID:Principal-component analyses of PANSS and SANS-SAPS in schizophrenia: their stability in an acute phase. 1969 21


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