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

The relationship of a full range of psychiatric symptoms to EE was examined in 40 men with BPRS and SANS diagnoses of schizophrenia or schizoaffective disorder. Patients from high-EE families had significantly higher ratings of positive symptoms, anxious depression, and overall psychopathology, but not negative symptoms, than did those from low-EE families. In predicting relapses of schizophrenia, account may need to be taken of an interaction between subtle differences in symptoms and relatives' attitudes.
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PMID:Patient psychopathology and expressed emotion in schizophrenia. 228 98

This study suggests that depressive symptoms are less common in severe, chronic, schizophrenic inpatients than would be predicted if these symptoms were manifestations of negative symptoms or drug-induced parkinsonism. The findings further suggest that depressive symptoms in such patients are independent phenomena which conform to a depressive syndrome. This depression does not represent a misidentification of the negative symptoms affective flattening and alogia, as measured by the SANS, or parkinsonism or akathisia. The study findings fail to support the view that long-term depot antipsychotic medication plays an important role in the genesis of depression and dysphoria in chronic schizophrenic patients. Depressive symptoms were found to occur as frequently, and dysphoria more frequently, in schizophrenic patients in the year after drug withdrawal compared with patients continuing on maintenance drug treatment for the same period.
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PMID:Dysphoric and depressive symptoms in chronic schizophrenia. 257 73

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

Clozapine has proven to be more effective than typical antipsychotics in treatment-refractory schizophrenic patients, and some evidence suggests that it may be particularly useful in treating the negative symptoms of schizophrenia. However, it is unclear whether this observation reflects improvement in "primary" or "secondary" negative symptoms. We hypothesized that a portion of clozapine's effect on negative symptoms would be related to an improvement in positive (psychotic and disorganization) symptoms, a decrease in extrapyramidal side effects (EPSE), and/or a decrease in depressive symptoms. The remainder of its effect would be related to a direct effect on the neural circuits or pathologic processes responsible for the negative symptoms. Twenty-nine treatment-refractory schizophrenics treated with clozapine for 6 weeks were studied. The core negative symptoms measured by the Scale for the Assessment of Negative Symptoms ([SANS] affective flattening, anhedonia/asociality, avolition/apathy, and alogia) all improved with clozapine treatment. Overall, there was a 31% improvement in negative symptoms, a 32% improvement in psychotic symptoms, and a 35% improvement in disorganization. The improvement in negative symptoms was correlated with improvement in disorganization, but not with improvement in psychotic symptoms, depression, or drug-induced EPSE. Although there was a correlation between improvement in negative symptoms and improvement in disorganization, there was a suggestion that the two are changing in parallel, but are independent of each other. It appears that at least a portion of clozapine's effect on core negative symptoms is mediated through a direct effect on the underlying pathophysiology of schizophrenia associated with negative symptoms.
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PMID:Clozapine's effect on negative symptoms in treatment-refractory schizophrenics. 814 34

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

This pilot study evaluated response of negative symptoms (NS) to methylphenidate in patients with dementia and relationships between NS, depression, and cognitive deficits in these patients. Consecutively admitted patients with NS and dementia--12 with dementia of Alzheimer's type and 15 with vascular dementia--were rated on severity of NS (SANS and PANSS-N scales), depressive symptoms (Ham-D), and cognitive impairment (MMSE) before and after treatment with methylphenidate. NS decreased significantly, and cognitive scores increased. A decrease in depression scores was nonsignificant after all variance attributable to NS was removed. NS, depression, and cognitive scores were not significantly intercorrelated. Results were similar for Alzheimer's and vascular dementia patients. Negative symptoms in dementia patients appear responsive to methylphenidate treatment. This effect may underlie putative changes in symptoms of depression observed by other researchers.
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PMID:Methylphenidate treatment of negative symptoms in patients with dementia. 914 2

The objective of this study was to compare the efficacy and reliability of sertraline versus imipramine in the treatment of postpsychotic depressive disorder of schizophrenia. The diagnosis was based on DSM-IV research criteria. The Sympson-Angus Scale and SANS were performed in order to discriminate between depressive symptoms, the extrapyramidal side-effects of neuroleptics and the negative symptoms of schizophrenia. A 10-day placebo treatment period was applied to eliminate the possible influence of the placebo effect. The degree of severity of depression was determined using the Hamilton Depression Scale and the Clinical Global Impression Scale. The patients were randomly divided into two subgroups, each consisting of 20 people, who were given either 50 mg/day sertraline or 150 mg/day imipramine, and their progress was followed for 5 weeks. The diagnosis and treatment results were evaluated using the double-blind method. In conclusion, although both drugs were found to be effective, sertraline was found to be more advantageous than imipramine in terms of rapid onset of action; frequency, severity and duration of side-effects, and relapse risk of schizophrenia.
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PMID:A comparative study of sertraline versus imipramine in postpsychotic depressive disorder of schizophrenia. 978 50

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


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