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

The independent status of schizoaffective psychosis is reviewed in relation to 6 hypotheses, using pattern of inheritance, treatment response, course and outcome, and platelet 5-HT uptake as discriminating variables. The 'coincidence of 2 diseases' hypothesis would predict an annual frequency of some 2 per 10(8), compared with the observed 2 per 10(5). The 'variant of schizophrenia' hypothesis has been supported from patient groupings weighted in favour of chronicity, but little else. The 'variant of affective psychosis' hypothesis has been supported in the manic sub-group by evidence of lithium response, and outcome better than schizophrenia (but worse than mania). However in the depressed sub-group, despite responsiveness to ECT, a tendency towards chronicity is observed in a substantial proportion. The 'provisional diagnosis' hypothesis is supported by heterogeneity of outcome, and the presence of both schizophrenia and affective disorder in families of schizoaffective patients, prompting a distinction between 'mainly schizophrenic' and 'mainly affective' groupings. Evidence for the 'third psychosis' hypothesis is mainly genetic, suggesting a small aetiologically distinct subgroup which breeds true. The authors conclude with an 'interacting process' hypothesis where distinct diseases can cause, or interact to cause, the same symptoms via some final common pathway of psychological dysfunction.
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PMID:The nosology of schizoaffective psychosis. 614 98

A survey of the records of 1241 men remanded in prison on criminal charges over four months yielded a high prevalence of psychiatric disorder. Of the total prison intake of 2743 men over the same period, 246 (9.0%) showed major symptoms of psychiatric illness and a further 237 (8.6%) symptoms of withdrawal from drugs or alcohol. Symptoms of neurotic disorders were underrecorded, so in terms of diagnosis 237 men (8.7%) were considered to be psychotic. Of these, 166 (70%) were schizophrenic. The influence of affective psychosis was small. The risk of violence among men with schizophrenia was high. Twenty five (9%) non-fatal personal assaults and 24 (21%) offences of damage to property were committed by men with schizophrenia. The presence of mental illness probably influences the decision to remand in custody for some of these offences, but this is unlikely to explain the substantially higher prevalence of schizophrenia among men convicted of homicide (five (11%) ) and arson (six (30%) ) than would be expected in the general population of Greater London (0.1-0.4%). The prevalence of schizophrenia among men convicted of homicide may even be an underestimate, as may the prevalence of affective psychosis and possibly of other psychiatric abnormalities, given the substantial incidence of concurrent suicide in such men.
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PMID:Violence and psychosis. I. Risk of violence among psychotic men. 642 16

Quantitative and qualitative measures of brain morphology were derived through CT scans using computer-assisted methodology in patients with schizophrenia or schizo-affective psychosis and headache controls. Schizophrenics had significantly higher density of white matter, together with greater right vs. left asymmetry in density of white matter than controls. Schizophrenics tended to have larger widths of cortical sulci than headache patients. In our sample of schizophrenics, however, no significant differences were found on measures of lateral ventricle (LV) width, LV area, VBR, or other measures of ventricular size compared to headache controls. There were no differences between CT scan measures taken in patients with schizophrenia vs. schizo-affective psychosis.
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PMID:Abnormalities of brain structure and density in schizophrenia. 647

A group of 57 women, who had been hospitalised for puerperal psychiatric disorders from 1958 to 1977, were reexamined in 1982. The aim of the study was to determine the proportion of patients who had suffered from nonpuerperal psychotic relapses or other subsequent psychopathology, to define the sample diagnostically, taking into account progress in classification, to characterize the so far relatively neglected later course of illness, and to establish criteria related to relapse and global clinical outcome. Of these patients 65% had at least one nonpuerperal relapse, only 25% remained free of later psychopathology, but the global outcome was favorable or relatively favorable in many cases. Of the patients who had had nonpuerperal relapses 43% were classified as suffering from affective psychosis, as many as 38% from schizoaffective psychosis, and only 19% from schizophrenia. Schizoaffective psychosis seems to be particularly liable to be provoked by childbirth. No major evidence was found that endogenous psychoses with puerperal onset and nonpuerperal relapses have a course of illness different from that of the corresponding diagnostic category in general. Cases with exclusively puerperal decompensations seem to be nosologically independent from the traditionally recognized endogenous psychoses. Characteristics strongly related to nonpuerperal relapses were a family history of psychosis and the occurrence of psychotic episodes before the index episode. Puerperal relapses occurred at a much higher rate in patients who also had nonpuerperal relapses than in patients without.
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PMID:On the nosology of severe psychiatric post-partum disorders. Results of a catamnestic investigation. 648 97

A 1-year sample of consecutively admitted patients between 18 and 40 years of age is studied. Psychopathology has been elicited by the Schedule for Affective Disorders and Schizophrenia (SADS), and diagnoses have been set according to Research Diagnostic Criteria (RDC). The sample consists of 57 cases with schizophrenia, 8 cases with schizo-affective psychosis and 23 cases with affective psychoses. Bellak's Ego Function Assessment Test was given to all these patients. The test does not show any significant differences between the schizo-affective and the schizophrenic groups. Some significant differences are found between the schizo-affective group and the group of affective psychosis. The findings do not validate schizo-affective psychosis as a diagnostic category.
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PMID:Ego function assessment of schizo-affective patients as compared to schizophrenic and affective psychotic patients. 662 34

Because of the continued controversy about the nature of the schizoaffective disorders and their relationships to schizophrenia and the affective disorders, a thorough review of the concept, genetics, treatment, outcome, and biological aspects of the schizoaffective disorders in relationship to schizophrenia and the affective disorders appears timely. The use of explicit criteria for schizoaffective disorders, such as those provided by the Research Diagnostic Criteria, permits clinical investigators to continue the inquiry into these disorders. Current evidence appears most consistent with the idea that schizoaffective disorder is usually a variant of affective psychosis and sometimes a variant of schizophrenia. However, the possibility that an interacting group of biological vulnerabilities, environmental insults, and ensuing psychological reactions produces the spectrum of clinical states from "pure" schizophrenia to "pure" affective psychosis with schizoaffective disorder as a genuine mixed state needs further investigation. Dimensional diagnostic systems rather than categorical ones may be of value for many clinical and research purposes.
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PMID:Schizoaffective disorder: is the news of its nonexistence premature? Editor's introduction. 670 76

Different diagnostic groups were compared in order to find out how constant individual patterns of illness remained over different hospital admissions. First, each of the syndrome scales in the Inpatient Multidimensional Psychiatric Scale and the Clinical Self-Rating Scales was examined to see how stable the patients' scores remained over two different admissions. Low correlations between scores on the two admissions were seen in the scales for mania and depression, reflecting changes in the clinical symptom patterns of patients with affective disorders. Many other scales, however, were fairly stable and were more closely connected with the given diagnosis. Secondly, each patient's pattern of illness on the first admission was compared with his or her pattern on the second admission. It was observed that patients with diagnoses of schizophrenia or schizo-affective psychosis tended to have less stable patterns of illness.
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PMID:Changes in patterns of mental illness over different hospital admissions. 672 5

The pharmacological properties and the equivocal antipsychotic effects of diazepam reported in the literature suggested the use of high doses of this drug on schizophrenic patients to re-evaluate its usefulness. Treatment of 15 schizophrenic patients with doses of up to 400 mg/day showed a specific effect on hallucinations and certain forms of delusion. One group (nine patients with paranoid-hallucinatory and one with schizo-affective psychosis) showed a significant reduction in psychopathology as documented in the Brief Psychiatric Rating Scale (BPRS) and the Global Clinical Impressions (GCI), whereas five other patients (all of the schizo-affective type with symptoms of depression, euphoria, and/or psychotic anxiety) did not respond and had to be withdrawn from the study. Under the treatment an absence of sedative effects and a development of the feeling of well-being and euphoria were noticed. In three patients with doses of over 260 mg/day a marked loss of inhibitions in sexual and social behaviour was observed. It is concluded that high doses of diazepam may be useful in certain types of schizophrenia.
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PMID:High dose diazepam in schizophrenia. 677 28

Recent data from a 2-year follow-up of functional non-affective psychosis, and particularly schizophrenia, favoured social selection rather than social causation theory. Data concerning the cohort were compared with inter- and intra-generational mobility in a random Dutch sample. The results indicate that the educational and occupational mobility of patients, relative to their fathers, was greater than expected. Although patients were better educated than the random sample, they fared less well occupationally. An analysis of patterns of occupational mobility before and after the onset of psychosis also showed that social selection played a major role in achieving social status. The outcome of patients' occupational career at follow-up was poor, and only a minority succeeded in obtaining or keeping a regular job.
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PMID:Social class and schizophrenia in a Dutch cohort. 684 59

Thirty patients with cycloid psychosis were found among 244 general psychotic and schizo-affective patients studied in London. The main clues to the diagnosis were the presence of "confusion', a pleomorphic clinical picture or an acute onset. Most of the patients were classified as schizophrenic by British psychiatrists and the Catego system, and as schizo-affective or mood-incongruent affective psychotics by the American Research Diagnostic Criteria and DSM-III. There was little overlap between the cycloids and any Anglo-American category, and cycloid psychosis is not synonymous with schizo-affective psychosis. The outcome of the cycloids was better than that of psychotic patients as a whole, and much better than schizophrenia as defined by Catego, Schneider's, Langfeldt's or Carpenter's rules, or by the guidelines set by the International Classification of Diseases. Compared with manic-depressive patients (defined by the presence of mania at some stage), cycloids had more schizophrenic and fewer depressive and manic symptoms. There was a negligible concordance between the diagnosis of cycloid psychosis and the final diagnosis of manic-depressive disease. It is concluded that these patients should not be diagnosed as schizophrenic, but that the relation of cycloid psychosis to manic-depressive disease is not yet resolved.
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PMID:The course and outcome of cycloid psychosis. 707 34


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