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

In a pilot study, a neuropsychological minibattery of tests consisting of Trail-Making Test A (TMA), Trail-Making Test B (TMB), and the Visual Reproduction subtest (VR) of the Wechsler Memory Scale was administered to patients with common psychiatric diagnoses in a psychiatric emergency room (ER). Patients with adjustment disorders were not distinguishable from normal controls, while patients with affective disorders and schizophrenia were more impaired than both of these samples. It is suggested that this or a similar minibattery of tests can be of use as an adjunct screening device for differential diagnosis of adjustment disorder versus more serious psychopathology in psychiatric ERs.
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PMID:Neuropsychological screening in the psychiatric emergency room. 139 48

A follow-up was made of ninety patients with a diagnosed psychogenic reaction (adjustment disorder) fourteen years after the index hospitalisation. Contrary to expectation, at the follow-up only half of the patients showed no symptoms of the illness. Approximately a quarter of the patients suffered from a more serious illness (drug dependence, schizophrenia or organic mental disorder) than the index diagnosis. The other quarter showed symptoms of a psychogenic disorder (neurotic disorder, personality disorder, adjustment disorder). A number of factors which describe the course of the illness leading to the index hospitalisation permit a prediction of the outcome of the disease.
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PMID:[Psychogenic reaction: course and prognostic factors]. 171 53

Concordance rates between clinical and DIS-generated diagnoses were compared using data sets from Fukuoka University in Japan and Neuropsychiatric Hospital at the UCLA. An overall concordance rate of 35% between standard clinical diagnosis and DIS-Lifetime diagnosis was discovered in both samples. Next, concordance rates were analyzed by diagnostic category, and differential concordance rates among major diagnostic categories were found in both samples. The highest concordance rates were found in anxiety disorders and major depression. The lowest concordance rates were found in dysthymic disorder and schizophrenia. The Fukuoka sample contained more patients with anxiety disorders and major depression, while the UCLA sample has more patients diagnosed as dysthymic disorder and adjustment disorder. Future directions in cross-cultural psychiatric research are also suggested.
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PMID:Concordance rate between clinical and DIS diagnoses: a cross-cultural comparison. 180 Aug 5

Instruments designed to assess psychiatric disorders in people with learning difficulties (mental handicap) were critically reviewed from a psychometric perspective. Major trends were found in the assessment of psychopathology related to DSM-III and depressive disorders although research in other areas was patchy. Although some psychometrically sophisticated measures were identified the area was characterized by an absence of important psychometric data for many measures. Future research should attend to developing assessments of schizophrenia, psycho-sexual disorders, adjustment disorders and the validation of screening procedures and instrument formats. Future studies should include more people with severe and profound learning difficulties.
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PMID:Psychometric assessment of psychiatric disorders in people with learning difficulties (mental handicap): a review of measures. 204 90

Over the last 20 years there has been a revival of interest in orthodox Judaism in Israel. In an area of Jerusalem with a large concentration of academies of study for 'baalei teshuva' (those who have undergone change to orthodox Judaism), it was noted that 12.6 per cent of referrals to the community mental health centre were newly religious. These referrals tended to have schizophrenia or severe personality disorders and were less likely than other referrals to have anxiety, depressive or adjustment disorders. Most of the newly religious referrals had psychiatric problems prior to becoming religious. Subsequent to religious change, many married and started a family before their psychiatric referral. The link between religious change and mental illness is explored.
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PMID:Mental illness and religious change. 233 50

Magnesium and calcium concentrations were measured in the cerebrospinal fluid (CSF) of 15 neurological controls and 41 psychiatric patients suffering from major depression (n = 16), schizophrenic disorder (n = 15), or adjustment disorder (n = 10). All subjects were women 19-67 years of age and free from drugs at the time of the study. CSF was evaluated for 5-hydroxyindoleacetic acid (5-HIAA), homovanillic acid (HVA), and cortisol (CS) levels, and all patients received a dexamethasone suppression test (DST) following lumbar puncture. CSF calcium levels did not differ among groups, although we found a trend toward higher mean levels in both depression and schizophrenia. By contrast, CSF magnesium was found to be significantly lower in both depression and adjustment disorder; if, however, patients who had made suicide attempts were excluded, the difference became insignificant. Patients who had made suicide attempts (by using either violent or nonviolent means) had significantly lower mean CSF magnesium level irrespective of the diagnosis. CSF calcium did not correlate with magnesium, 5-HIAA, HVA, CS, global severity, therapeutic response, or DST, but CSF magnesium correlated significantly with CSF 5-HIAA, especially after correcting for age and body height. Both variables seemed to be primarily related to recorded suicide attempts, but decreased magnesium was not limited to violent cases.
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PMID:Cerebrospinal fluid magnesium and calcium related to amine metabolites, diagnosis, and suicide attempts. 257 29

Over a 12-month period in 1985-1986, 325 cases of deliberate self-poisoning were admitted to the Princess Alexandra Hospital in Brisbane. This survey confirms that deliberate self-poisoning remains common, accounting for 19.6% of all admissions to the intensive-care unit, and 5.4% of all medical-ward admissions. In 232 (71.4%) cases formal psychiatric consultation occurred, and some form of follow-up was organized in 227 (69.8%) cases. In the total group, the female-to-male ratio was 1.5 to one. In the 325 cases, a total of 489 substances was consumed. Benzodiazepine agents were consumed the most often (39.5% of all substances), followed by antidepressant drugs (11.7% of substances) and paracetamol (7.2% of substances). Barbiturate drugs, which previously have been shown to be prominent in deliberate self-poisoning, accounted for only 1.6% of the substances that were used in this survey. Alcohol was consumed in almost one-third (31.1%) of cases. The diagnosis of adjustment disorder with depressed mood was the most-frequent primary diagnosis (64.8% of diagnosed cases), followed by personality disorder (16.7% of diagnosed cases), schizophrenia (5.5% of diagnosed cases) and major depression (3.7% of diagnosed cases). Nearly one-half (46.8%) of all cases involved a past history of deliberate self-poisoning. Comparison of the results of this survey with those of past surveys shows that the profile of deliberate self-poisoning is changing. Barbiturate usage has declined markedly with a reciprocal increase in benzodiazepine usage. A review of the prescribing pattern of antidepressant agents in groups of individuals who are at high risk of deliberate self-poisoning is suggested in the light of the frequency of this phenomenon.
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PMID:A survey of deliberate self-poisoning. 271 41

A 3-year urban material of suicides in adolescents and young adults (age 15-29 years) was studied retrospectively by means of interviews with survivors (n = 58). Classification of mental disorders according to DSM-III-R showed that major depression was important as background to suicides in 41%, primary (22%) or secondary (19%) to other disorders. Adding major depression, depressive disorder, not otherwise specified, dysthymia and adjustment disorder with depressed mood gave a total of 64% depressive syndromes. Schizophrenia (14%) and borderline personality disorder (28%) constituted other relevant groups. Coexisting substance use disorder occurred in 47%. A majority of the subjects (72%) were known by psychiatric caregivers and 16% committed suicide during inpatient care.
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PMID:Mental disorder in youth suicide. DSM-III-R Axes I and II. 275 May 50

The authors gave DSM-III diagnoses to 116 Chinese psychiatric outpatients in Shanghai and compared them with the diagnoses of the same patients made by a Chinese psychiatrist according to Chinese criteria. Affective disorders were the most common DSM-III diagnoses, accounting for 26.7% of the sample. A full range of psychopathology, including schizophrenia, organic mental disorders, adjustment disorders, anxiety disorders, and paranoid disorders, was seen. Some consistent differences in diagnosis by Chinese and Western standards, especially in the area of major depression, were found. The authors discuss the implications for interpreting psychiatric studies from China and for future cross-cultural research comparing U.S. and Chinese diagnoses.
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PMID:Who seeks mental health care in China? Diagnoses of Chinese outpatients according to DSM-III criteria and the Chinese classification system. 275 Sep 88

Psychiatric disorders are common in medical inpatient and outpatient populations. As a result, internists commonly are the first to see psychiatric emergencies. As with all medical problems, a good history, including a collateral history from relatives and friends, physical and mental status examination, and appropriate laboratory tests help establish a preliminary diagnosis and treatment plan. Patients with suicidal ideation usually have multiple stressors in the environment and/or a psychiatric disorder (i.e., a major affective disorder, dysthymic disorder, anxiety or panic disorder, psychotic disorder, alcohol or drug abuse, a personality disorder, and/or an adjustment disorder). Of all patients who commit suicide, 70% have a major depressive disorder, schizophrenia, psychotic organic mental disorder, alcoholism, drug abuse, and borderline personality disorder. Patients who are at great risk have minimal supports, a history of previous suicide attempts, a plan with high lethality, hopelessness, psychosis, paranoia, and/or command self-destructive hallucinations. Treatment is directed toward placing the patient in a protected environment and providing psychotropic medication and/or psychotherapy for the underlying psychiatric problem. Other psychiatric emergencies include psychotic and violent patients. Psychotic disorders fall into two categories etiologically: those that have an identifiable organic factor causing the psychosis and those that have an underlying psychiatric disorder. Initially, it is essential to rule out organic pathology that is life-threatening or could cause irreversible brain damage. After such organic causes are ruled out, neuroleptic medication is indicated. If the patient is not agitated or combative, he or she may be placed on oral divided doses of neuroleptics in the antipsychotic range. Patients who are agitated or psychotic need rapid tranquilization with an intramuscular neuroleptic every half hour to 1 hour until the agitation and combativeness are under control. Haloperidol (Haldol) is the safest neuroleptic. Chlorpromazine (Thorazine), perphenazine (Trilafon), and, in the elderly, thiothixene (Navane) can also be useful if haloperidol (Haldol) is not effective and more sedation is needed; these drugs, however, produce more side effects. Violent patients need to be physically restrained and then given antipsychotic medication or, in the case of drug abuse or alcohol withdrawal, the appropriate drug management.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Psychiatric emergencies. 373 71


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