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

New uses are still being discovered for a number of psychotropic agents that have been available for some time. Among the more important recent discoveries are the efficacy of the tricyclic antidepressants for panic disorder and agoraphobia with panic attacks; the use of the monoamine oxidase inhibitors for the above disorders and for atypical depression and hysteroid dysphoria; the use of propranolol for anxiety disorders and for uncontrollable violent outbursts; the antianxiety and antipanic effects of clonidine; and the usefulness of lithium in treating schizophrenia and schizoaffective disorder and for emotionally unstable character disorders. In addition to strengthening the therapeutic armamentarium, the author says, the discovery of new drug response patterns helps generate or strengthen hypotheses about the pathophysiology of various psychiatric disorders.
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PMID:Newer uses for older psychotropic medications. 612 38

In the 1960s, several studies reported that propranolol and other beta-blocking drugs appeared especially useful in patients with physical symptoms of anxiety. However, subsequent reports produced conflicting findings, and at this time the efficacy of propranolol in anxiety disorders is not clearly established. Propranolol's utility in anxiety states may be entirely restricted to those anxiety patients whose physical symptoms have not adequately responded to benzodiazepine therapy. This places the beta-blockers among the least useful drugs in treating anxiety disorders. A major problem in assessing propranolol's antianxiety properties has been a virtual lack of well-designed studies addressing the issue; the studies reviewed here contained a surprising number of study design problems. Several guidelines regarding study design are included to assist the reader in evaluating studies of antianxiety agents. High dose (e.g., 2,000 mg) propranolol may have a role as an alternative to traditional antipsychotic therapy in neuroleptic-resistant patients. During the last decade a number of studies have demonstrated symptomatic improvement in schizophrenic patients using propranolol alone or combined with neuroleptics. However, four recent double-blind reports have failed to replicate this finding. Future research should focus on possible identification of propranolol-responsive patients and their characteristics. The use of propranolol and other beta-blockers in schizophrenia should remain in the research or medical center setting.
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PMID:The use of beta-adrenergic blocking agents in anxiety disorders and schizophrenia. 613 73

A group of 48 inpatient alcoholics were studied using the Schedule for Affective Disorders and Schizophrenia--Life-time Version (SADS-L) and the Brief Standard Self-rating for Phobic Patients. Approximately one-quarter of the patients were diagnosed as suffering from agoraphobia and social and mixed phobias. Approximately 44% were diagnosed as suffering from anxiety disorders and 46% had suffered from an episode of major depression. Data from the self-rating questionnaire were consistent with the diagnostic data. The alcoholics with phobias had experienced more severe dysphoric feelings than nonphobic alcoholics with other psychiatric disorders.
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PMID:Alcoholism, anxiety disorders, and agoraphobia. 637 23

Three relatively clear-cut diagnostic groups, namely primary major depressive disorder-endogenous subtype (PRI MDD-E), primary anxiety disorder with no depression (PRI ANX), and normal controls as well as two additional patient groups with mixed or coexisting anxious/depressive diagnoses were studied. Clinical assessment was made by routine psychiatric interview, Schedule of Affective Disorder and Schizophrenia (SADS) research interview, and obtaining family history of MDD. Subjects underwent both routine 'baseline' sleep EEG polygraphic arecoline, a muscarinic, cholinergic agonist infused during sleep. Cholinergic sensitivity was assessed by measuring the time to induction of REM sleep after arecoline infusion. In addition, a subgroup of MDD patients underwent pupillographic testing. Peripheral alpha-adrenergic responsivity was measured by the magnitude of pupillary mydriatic response after local ocular instillation of phenylephrine. Successful separation (83% correct classification) of the 'pure' groups (PRI MDD-E, PRI ANX, and normal) was achieved by discriminant function analysis of sleep EEG variables. Compared to PRI ANX and normal groups, patients with PRI MDD-E had supersensitive cholinergic REM-induction response, shorter REM latency, increased first REM density and REM percent. Separation of the PRI ANX and normal groups was by intermittent awake time, delta sleep percent, and total REM density. Classification of the mixed anxious/depressive groups was next attempted using the discriminant coefficients derived from the above analysis of 'pure' groups. We found that the presence of absence of family history of MDD in patients with mixed diagnosis offered the best prediction of classification into PRI MDD-E and PRI ANX groups, respectively. MDD patients with coexisting panic disorder were significantly subsensitive to phenylephrine-induced mydriasis compared to MDD patients without anxiety.
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PMID:Acetylcholine and alpha 1-adrenergic sensitivity in the separation of depression and anxiety. 650 19

We administered the National Institute of Mental Health Diagnostic Interview Schedule to 41 patients with a lifetime history of anorexia nervosa (25 with and 16 without bulimia) and to 49 patients with bulimia alone. Results showed that 77% of the patients with eating disorders had a lifetime diagnosis of DSM-III major affective disorder, a rate significantly higher than that found in comparison groups composed of the first-degree relatives of probands with schizophrenia and bipolar disorder. High lifetime rates of anxiety disorders, substance use disorders, and kleptomania were also observed. By contrast, few cases of personality disorders and no cases of schizophrenia were found. These findings combine with the results of studies of family history, long-term outcome, response to biological tests, and treatment response to suggest that anorexia nervosa and bulimia may be closely related to major affective disorder.
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PMID:Phenomenologic relationship of eating disorders to major affective disorder. 658 Jun 63

Psychiatry becomes everyday more scientific: inter-rater reliability improves constantly, thanks to the development of more rigorous methods. Diagnostic classifications make real headways: the gap between ICD-9 and DSM-III will certainly be reduced in the next few years. For instance, the introduction of sub-categories of anxiety states (or anxiety neuroses), such as panic disorder and generalized anxiety disorder, implies different treatment choice, and clarification in therapeutic indications. The same will happen probably soon for schizophrenic disorders and major affective disorders. Conflicting theories of organogenesis versus psychogenesis may not be so conflicting when we understand better how environmental signals and subjective experiences alter transmitter levels, receptors, and synaptic regulations.
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PMID:[Clinical research in psychiatry. Future prospects]. 662 5

A survey evaluated current and lifetime rates of psychiatric disorders in 533 opiate addicts in treatment at a multimodality program. Information was gathered using a structured interview format, the Schedule for Affective Disorders and Schizophrenia-Lifetime version, and the criteria were the Research Diagnostic Criteria. Most were give the diagnosis of at least one psychiatric disorder in addition to opiate addiction. The most common diagnoses were major depressive disorder, alcoholism, and antisocial personality, and rates of chronic minor mood disorders and anxiety disorders also were found to be elevated in comparison with those found in a community population. In contrast, rates of schizophrenia and mania were very low and did not exceed those reported for the general population. The findings are interpreted as suggesting the importance of detecting and attending to psychopathology associated with opiate addiction.
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PMID:Heterogeneity of psychiatric diagnosis in treated opiate addicts. 706 30

Standardization of diagnosis is an essential preliminary in the clinical research in biological psychiatry. Between the different systems of nosographical selection, Research Diagnostic Criteria (RDC) are the most internationally diffused. After having recalled the spirit of RDC, we have looked for seven major illnesses (major and minor depressive disorders, endogenomorphic major depressive disorder, schizophrenia, manic disorder, panic disorder and generalized anxiety disorder) equivalents of RDC criteria in psychopathological and somatical items of AMDP system. With a minimum of modifications (adjonction of some reserve items for each illness), AMDP scales could become compatible. The verification of this theorical equivalence secondly makes it a duty to use jointly RDC and AMDP scales and to analyse both of them separately. After this methodological control, patients who meet RDC criteria could be automatically selected from AMDP scales.
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PMID:[The necessity for standardized diagnosis in research in biological psychiatry. Attempted integration of "Research Diagnostic Criteria" into the AMDP system]. 716 64

Familial factors have been shown to be important in the transmission of both anxiety disorder and schizophrenia. The familial relationship between these two disorders, however, has received little attention. This study examines the relationship between anxiety disorder and schizophrenia by a blind independent analysis of the interviews from the Danish Adoption Study of Schizophrenia using DSM-III criteria. The results show neither a genetic nor a familial-environmental link between the two disorders. These results are not consistent with the unitary hypothesis of mental illness. From a genetic and familial-environmental perspective, anxiety disorder and schizophrenia appear to be distinct, unrelated psychiatric illnesses.
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PMID:An independent analysis of the copenhagen sample of the Danish adoption study of schizophrenia. I. The relationship between anxiety disorder and schizophrenia. 728 68

Concentrations of cerebrospinal fluid (CSF) 5-hydroxyindoleacetic acid (5-HIAA) were similar in patients with major depressive disorder and in those with non-depressive psychiatric problems, although concentrations were significantly lower in suicidal patients (particularly in those attempters who used violent methods) than in non-suicidal patients. In contrast, post mortem CSF 5-HIAA concentrations in suicide victims were significantly higher than in controls. In addition, there appear to be fewer imipramine binding sites in the left frontal cortex of the brain than the right in suicide victims, the converse being true for controls. The serotonergic dysfunction associated with suicidal behaviour is likely to be involved in other conditions such as depression, schizophrenia and anxiety disorder. Thus selective serotonin reuptake inhibitors may be useful in the treatment of various types of psychiatric disease. Fluvoxamine, in particular, is associated with a very low incidence of suicidality compared with other antidepressants.
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PMID:Prophylactic potential of selective reuptake inhibitors in suicidal patients. 754 77


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