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Query: UMLS:C0036341 (schizophrenia)
 60,220 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

The author reviews a study by Kety and associates that reported a significantly greater prevalence of schizophrenic spectrum disorders among the biological relatives of schizophrenic adoptees than among those of nonschizophrenic adoptees. The principal statistical analysis of the Kety study used an incorrect sample size (306 rather than 66) and failed to weight each index and control case (family) equally. This violation of the independence assumption would allow a few families to disproportionately influence the outcome. The author argues that proper statistical analysis applied separately to available categories indicates that significant differences between the index and control groups occurred mainly in the half-sibling category; this result violates the principle that genetic effects increase with greater consanguinity. She concludes that Kety and associates' study raises more questions than it answers regarding the role of genetic factors in schizophrenia.
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PMID:A reconsideration of the Kety and associates study of genetic factors in the transmission of schizophrenia. 97 Apr 83

In the 1970s, David Rosenhan and seven other persons were hospitalized in twelve different psychiatric hospitals, pretending having heard voices uttering such words as void, hollow, thud. They were immediately hospitalized with a diagnosis of schizophrenia and, for one of them, of bipolar condition. Right after entering hospital, they reversed to normal behavior. None of them had a psychiatric history. Nevertheless, they were released after a time lapse of 7 to 52 days with a mean of 19 days. Release diagnosis was the same as the admission with the adjunct "in remission". D. Rosenhan points out the contextual and incertain aspect of the diagnosis and underlines the fact that it is apparently impossible to consider as being normal a person who has been admitted to a psychiatric hospital. Psychiatric labels stick to the skin. D. Rosenhan describes the pervasive boredom in a psychiatric hospital and the general set which leads to de-personalization. C. Chiland gives some precisions on what lead D. Rosenhan to undertake such an "experiment". She analyzes the reactions of the American psychiatric community which felt attacked in it's knowledge to the point of entirely rejecting the message. Indeed the criticism concerned the contextual aspect of diagnosis in the framework of the Gestaltpsychology and called to a necessary awareness of what is experienced by a hospitalized patient. Instead of seeking solutions to ward off the negative effects of the psychiatric hospital, effects that are inherent to any total institution, the community has rejected Rosenhan's experiment as being based on faking. Should a child psychiatrist feel securely innocent? The danger of labelling does exist for the children and their parents. Although a one-way choice in the dynamic contradiction between segregation and integration is not possible, one nevertheless has to remain vigilant regarding the institutions, even in day-care ones, so as to avoid imprisoning the child in rejection or stagnation attitudes.
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PMID:[Reflections of a child psychiatrist on the diagnosis and hospitalization in psychiatry of adults: an experience of David Rosenhan]. 149

A 63 year old female, who was admitted to a psychiatric hospital for schizophrenia, was referred to our emergency room because of sudden loss of consciousness and convulsions. On arrival, she was drowsy and hypoxemic. Her chest X-ray showed cardiomegaly with pulmonary edema. ECG showed marked ST depression in precordial leads and serum chemistry revealed marked elevation of CPK, GOT and LDH along with hyponatremia and hypochloremia. She was immediately admitted to CCU on suspicion of acute non-transmural myocardial infarction complicated with congestive heart failure. After fluid restriction and intravenous infusion of dopamine she passed large amount of urine, and her consciousness level, electrolyte imbalance and ECG change, improved gradually. Although serum CPK level increased as high as 32,307 IU/ml, there were no signs of left ventricular asynergy on UCG and CPK isozyme analysis performed later revealed more than 99% of serum cCPK was MM-type. We concluded that water intoxication was the cause of the ECG change and the elevated serum CPK, GOT and LDH levels. There are few reports on elevated CPK level in association with water intoxication, in which rhabdomyolysis is speculated as the cause of CPK elevation. But there is no report on ECG change complicated with water intoxication. In our case, electrolyte imbalance caused by water intoxication seemed to play a major role in ST depression and QT prolongation. Although water intoxication is a rare disorder in the general population, it is not infrequent among patients with psychiatric diseases. Care must be taken when such patients present ECG change and serum enzyme elevation mimicking ischemic heart disease.
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PMID:[A water intoxication patient who showed remarkable ST depression and suspected ischemic heart disease]. 152 80

Research on schizophrenia has suggested an association between relapse of patients and high expressed emotion (EE), defined as criticism, hostility, or emotional overinvolvement of at least one family member. In international studies, however, the majority of families of persons with schizophrenia demonstrate low expressed emotion. These families are described as empathic, calm, and respectful by EE researchers, who also reject the idea of family schizophrenogenesis. The author discusses expressed emotion as a construct, its validity and stability over time, and the direction of the relationship between relatives' expressed emotion and patients' symptoms and behavior. She reviews studies indicating significant differences in levels of expressed emotion across cultures, examines the social policy implications of programming based on the construct, and suggests research on EE analogues in clinical and rehabilitative environments.
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PMID:Expressed emotion: conceptual, clinical, and social policy issues. 160 1

A case is presented of Torsade de Pointes (TDP) with T wave alternans in a 31-year-old female receiving a moderate dose of chlorpromazine. She was treated in an another hospital for schizophrenia with chlorpromazine (100 mg daily) for several years and admitted to Fujisawa city hospital for numerous episodes of syncope. The electrocardiogram immediately after admission revealed a marked QTc prolongation to 0.81 seconds, T wave alternation without any obvious change in morphology of the QRS complex, and recurrent ventricular tachycardia called TDP. The T wave alternans and TDP were easily abolished by intravenous administration of a bolus of 50 mg lidocaine infusion. The QT interval however, remained prolonged. Physical examination, including cardiac examination, was normal. Serum potassium was 3.6/mEq. Chlorpromazine was discontinued immediately after admission and no further episodes of TDP were seen after the first day. After the QT interval returned to almost normal, chlorpromazine (50 mg daily) was re-administered. Two days after the re-administration, the electrocardiogram revealed marked QT interval prolongation with prominent T waves. Psychotropic drugs, such as chlorpromazine, prolong the QT interval and cause TDP. Chlorpromazine appears to have been responsible for TDP and the T wave alternans in this case. TDP caused by a moderate dose of chlorpromazine has not been previously reported. Lone T wave alternans unaccompanied by changes in the QRS complex is a rare phenomenon and the mechanism underlying T wave alternans remains unknown.
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PMID:[Torsade de Pointes with T wave alternans in a patient receiving moderate dose of chlorpromazine: report of a case]. 221 93

A 39-year-old female with several past psychiatric hospitalization for schizophrenia was admitted to our hospital because of severe pain and swelling of her legs. A few days before onset, she had often sat down upon her heels in water closet, agitated and talking to herself for many hours. Two days before the admission, she had suffered from severe pain and swelling of her bilateral calf-muscles, and her urine became brownish. On admission, neurological findings revealed delirious state, moderate rigidity of limbs, hyporeflexia of legs, marked swelling and severe spontaneous pain in bilateral legs. She was afebrile with body temperature of 36.4 degrees C. Laboratory data showed marked increase of levels of serum CK to 163,000 U/1, myoglobin to 9,860 ng/ml and aldolase to 42.8 IU/1, and the diagnosis of rhabdomyolysis was made. Although she fell into acute renal failure, the renal function recovered after repeated hemodialysis. Several days after admission, swelling and pain of calf-muscles began to improve, and serum CK, myoglobin and aldolase decreased rapidly. One month later, she was able to walk on her own legs. In the literature, rhabdomyolysis associated with immobile posture caused by schizophrenia is extremely rare, and this is the first case reported in Japan. The relationship between rhabdomyolysis and schizophrenia was discussed.
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PMID:[A case of rhabdomyolysis following long time immobile posture caused by schizophrenia]. 259 45

We pay tribute to Lew Robbins and Hillside Hospital for the opportunity given me to develop work in the psychopharmacological treatment of mental disorders. A historical review is given of early experience with antipsychotics and antidepressants and the failed attempts to relate therapeutic effect of psychoanalytic formulations. Work done at Hillside demonstrated the importance of developmental history for schizophrenic prognosis and drug responsivity. Surprising findings such as the positive antidepressant benefits of chlorpromazine are detailed and discussed. The resemblances between bipolar affective disorder and schizophrenia are detailed and related to the peculiar finding that all anti-schizophrenic drugs are also anti-manic. The converse of this is also discussed. The psychopharmacological resemblances between bipolar disorder and schizophrenia, as well as the relationship to genetic findings, lead to a two factor theory of schizophrenia and hypotheses concerning the nature of delusional and deteriorative processes.
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PMID:Schizophrenia and bipolar affective disorders: likenesses and differences. 261 86

Miss Jane Cole was 26 years old when admitted to Chestnut Lodge with a diagnosis of schizophrenia in 1949. She remained an inpatient and day patient for 18 years, and engaged in treatments that were primarily psychotherapeutically oriented, with three different therapists. She ultimately recovered sufficiently to live on her own while remaining in private treatment with her last Chestnut Lodge therapist. Her extended psychotherapeutic encounters at this institution are richly documented, with about 400 pages of transcribed annual treatment case conferences, allowing us to reconstruct her course in some detail. We offer her narrative as uniquely instructive about the utility of different psychotherapeutic models and styles in the treatment of people with long-term, severe, psychotic disorders.
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PMID:Psychotherapeutic models and the treatment of schizophrenia: the records of three successive psychotherapists with one patient at Chestnut Lodge for 18 years. 323 97

A 19-year-old woman, recently discharged from the hospital and being treated for schizophrenia, presented with an unusual reaction to trifluoperazine. She complained of nausea and vomiting and experienced bilateral swelling of the tongue. Symptoms subsided when the medication was discontinued. Although dystonic reactions to high doses of phenothiazines are not uncommon, we postulate that this case represented an unusual allergic reaction to the medication.
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PMID:Unusual reaction to trifluoperazine. 339 73

The author chronicles her 20-year battle with schizophrenia and her growing acceptance of her illness. She has committed herself to leading the fullest life her disease will allow and to educating others about mental illness. While she does not deny that hospitals have their place in the treatment and stabilization of acute psychiatric problems, she believes community-based residential treatment programs are most successful in promoting long-term gains because they provide a protected yet flexible environment in which to build confidence and social skills. She believes mentally ill individuals need to be educated about their illnesses and require appropriate supportive psychotherapy, pharmacotherapy, access to support groups, and structured activities, such as working, attending school, and training for a job. She describes her own strategies for preventing relapse.
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PMID:The treatment of schizophrenia: a patient's perspective. 359 83


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