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

This review provides a comprehensive overview of currently available treatments for psychogeriatric disorders, summarizing the efficacy of various treatment approaches based on research evidence. The severe mental illnesses in geriatric age-groups can be classified into the following groups: delirium, dementia, depression, mania, psychotic disorders, and anxiety disorders. There are specific disorders requiring specific treatments within each group. Effective treatments exist for most disorders. Effective treatment for delirium consists of identifying and treating an underlying cause, and the judicious use of medications for specific symptoms. Treatment for the dementias involves two considerations: (1) treatment of the cognitive symptoms; and (2) treatment of the behavioral symptoms. There are no currently FDA-approved, or generally acknowledged as effective, medications for the cognitive symptoms. Some medications marketed for other purposes may be used by some clinicians for treating cognitive symptoms. One medication, tacrine, is available under a treatment IND for patients with Alzheimer's disease (AD). Behavioral symptoms such as agitation, hallucinations, and delusions occur in a majority of patients some time during their illness. The treatment of behavioral symptoms involves behavioral management, environmental manipulations, and the use of medication for control of specific syndromes. The few medications assessed in randomized trials include neuroleptics and benzodiazepines. Neuroleptics such as haloperidol or thioridazine are modestly effective for some symptoms and are probably the treatments of choice for the acute, short-term. Benzodiazepines may be somewhat less effective, have cognitive-impairing side effects, are associated with increased falls, and, therefore, are less preferred. Many other medications have been suggested based largely on clinical experience. They include carbamazepine, trazodone, buspirone, and others. Treatment for depression involves consideration of acute and maintenance treatment, and of the type and severity of illness. For an acute depressive disorder of great severity, or with melancholia or psychosis either electroconvulsive therapy or the combination of antidepressant and neuroleptics may be required. Treatment requires adequate prescribing, patient education, and regular patient monitoring for compliance, symptom change, side effects, and intercurrent medical disorders which may complicate antidepressant therapy. Both antidepressant medications and brief structured psychotherapies, such as interpersonal or cognitive psychotherapies, have efficacy in the acute treatment of elderly depressed outpatients with major unipolar, nondelusional depression. Maintenance treatments are important, however, to prevent relapses or repeated episodes. Treatment recommendations are discussed. The mainstay of treatment for psychotic disorders such as late-onset schizophrenia and late-onset delusional disorder are neuroleptics. Clinical course is variable; maintenance treatments are required. Neuroleptic side effects occur with greater frequency than in younger patients.(ABSTRACT TRUNCATED AT 400 WORDS)
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PMID:Efficacy of treatment for geropsychiatric patients with severe mental illness. 808 81

The study was carried out in the Family Planning Center of Sir Salimullah Medical College, Mitford Hospital and Family Planning Center of Dhaka Medical College Hospital, Dhaka. 100 sterilized women were selected randomly within 6 months of sterilization during the period of July 1991 to December 1991. They were interviewed by a questionnaire collecting information on sociodemographic parameters, sterilization, and life events. Depressive disorder was assessed by applying the DSM III-R criteria for Major Depressive Episode (MDE). Then the Hamilton Rating Scale for Depression (HRSD) was applied. 19 were suffering from depressive disorder (MDE). Of these, 3 were severe, 8 were moderate, and 8 were mild. Their ages ranged from 21 to 38 years. 42.11% of the depressive cases were in the 26-30 age group. 84% of both groups were either illiterate or had primary education, and 86% were housewives. 78% were urban and 22% were rural residents, respectively. 52% were in the low and 41% were in the middle income category. 35.8% of the nondepressive group had 4 children at the time of operation, while 36.93% of the depressive group had 6 children (p 0.05). Abdominal pain occurred in 23 instances, while only 2% had pain, swelling, and fever. 46 (56.79%) of the nondepressive group had experienced no momentous life events 1 year prior to the interview. In contrast, only 2 (10.54%) of the depressive group had not experienced such life events. Relationship problems in both the nondepressive and depressive groups featured with 24 (29.63%) and 12 (63.16%) cases, respectively, (p 0.05). 3 (15.79%) of the depressive group had past history of anxiety disorder and 2 (10.5%) had previous history of depressive disorder. On the basis of DSM III-R, 18 (94.74%) of the depressive group had mood disorders as the main symptom. 16 each had insomnia and fatigability. 12 (63.16%) of the depressives were retarded and 10 subjects contemplated suicide. HRSD further revealed that all depressive patients had anxiety, and only 2 were receiving antidepressants. Among all patients there were 5 cases of family history of schizophrenia, 2 cases of depressive disorders, and 1 case of bipolar mood disorder in first degree relatives.
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PMID:Pattern of depressive disorder among the permanent sterilized women. 816 34

We have studied the prevalence of the psychiatry disorders in the young people of a Madrid's rural area. We have found a prevalence of 0.09% if we consider the population as a whole, and 0.9% referred only to young people. The most frequent diagnoses, we have found, are the affective disorders and the anxiety disorders, and in the second place the schizophrenia and personality disorders.
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PMID:[Psychiatric morbidity in young people in a rural area of Madrid]. 817 9

Plasma and platelet levels of excitatory amino acids were measured in 38 psychiatric out-patients and in 19 comparison subjects; the patients had DSM-III-R diagnoses of organic mental disorders (N = 3), mood disorders (N = 15), schizophrenia (N = 13), and anxiety disorders (N = 7). The glutamate plasma levels were significantly higher in the patients with mood disorders than in the comparison group.
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PMID:Plasma and platelet excitatory amino acids in psychiatric disorders. 821 85

Social phobia was studied in a North Carolina community, using DSM-III criteria. Two kinds of comparison were made: social phobia v. non-social phobia, and comorbid social phobia v. non-comorbid social phobia. Six-month and lifetime prevalence rates were 2.7 and 3.8% respectively. Social phobia had an early onset, lasted a long time and rarely recovered. Predictors of good outcome recovery in a logistic regression analysis were onset of phobia after age 11, absence of psychiatric comorbidity and greater education. The disorder was often missed in medical consultation. Increased rates of psychiatric comorbidity existed, especially for other anxiety disorders and for schizophrenia/schizophreniform disorder. There was increased risk of neurological disorder. Social phobia was also associated with an increased rate of suicide attempts, antisocial behaviour and impaired school performance during adolescence, impaired medical health, increased health-seeking behaviour, poor employment performance, reduced social interaction and impaired social support. Comorbidity accounted for some, but not all observed differences.
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PMID:The epidemiology of social phobia: findings from the Duke Epidemiological Catchment Area Study. 823 77

Both epidemiological and clinical studies have demonstrated a high prevalence of panic disorder among alcoholic patients. In contrast, little attention has been given to studying alcohol abuse and/or dependence in patients suffering from panic disorder. One hundred and fifty-five consecutive referrals for treatment for panic disorder were interviewed using a modified version of the Schedule for Affective Disorders and Schizophrenia--Lifetime Version, modified for the study of anxiety disorders. Thirty-two patients (20.7%) had a lifetime history of alcohol abuse and/or dependence. Although the lifetime comorbidity rate of either agoraphobia and/or social phobia seems without any influence on the risk of alcohol-related disorder, alcoholic patients suffering from panic disorder appear to be more likely to have a history of depression and other addictive disorders. The majority of patients with primary alcoholism were male, and those who became alcoholics after they developed panic disorder were more likely to be female. The comparison between patients with primary and secondary alcoholism did not indicate any difference in the comorbidity rate with other psychiatric disorders nor the severity of panic disorder.
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PMID:[Panic disorder and alcoholism: effects of comorbidity]. 824 21

Magnetic resonance imaging (MRI) has become an important tool in the investigation of cerebral abnormalities associated with psychiatric illnesses. There are a number of benefits of investigating psychiatric illness with MRI, which is superior to computed tomography scanning. MRI has been used to study neurologic deficits seen in schizophrenia, affective disorders, dementia, and more recently, anxiety disorders. Magnetic resonance spectroscopy offers a new investigational technique that adds functional information to the structural changes seen with standard MRI scanning. This review highlights the current data in living human subjects that demonstrate structural changes in psychiatric disorders using MRI, including recent studies of the anxiety disorders.
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PMID:The role of nuclear magnetic resonance imaging in psychiatric research. 827 45

The Personality Assessment Inventory (PAI; Morey, 1991) represents an important development in the assessment of psychopathology. We examined the usefulness of the Negative Impression (NIM) scale to detect naive (undergraduates with minimal preparation) and sophisticated (psychology graduate students with 1 week preparation) subjects simulating specific disorders. We found that the NIM cutting score (> 8) was highly effective with feigned schizophrenia, marginally effective with feigned depression, and ineffective with feigned generalized anxiety disorder. Sophistication did not appear to be relevant to successful feigning, although it did allow graduate students to achieve higher clinical elevations in simulating depression.
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PMID:Feigning specific disorders: a study of the Personality Assessment Inventory (PAI). 833 69

Data were collected on the point and lifetime prevalences, 1-year incidence, and comorbidity of depression with other disorders (Diagnostic and Statistical Manual of Mental Disorders [3rd ed., rev.]) in a randomly selected sample (n = 1,710) of high school students at point of entry and at 1-year follow-up (n = 1,508). The Schedule for Affective Disorders and Schizophrenia for School-Age Children was used to collect diagnostic information; 9.6% met criteria for a current disorder, more than 33% had experienced a disorder over their lifetimes, and 31.7% of the latter had experienced a second disorder. High relapse rates were found for all disorders, especially for unipolar depression (18.4%) and substance use (15.0%). Female subjects had significantly higher rates at all age levels for unipolar depression, anxiety disorders, eating disorders, and adjustment disorders; male subjects had higher rates of disruptive behavior disorders.
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PMID:Adolescent psychopathology: I. Prevalence and incidence of depression and other DSM-III-R disorders in high school students. 843 89

Significant advances in our understanding the phenomenology of cocaine addiction have occurred in the past 12 years such that we now recognize addiction to cocaine as a major public health problem. We now can diagnose cocaine addiction more accurately. Furthermore, cocaine addiction has stimulated creation and testing of novel treatment efforts because standard addiction treatment, although efficacious, is not as effective for cocaine addiction as compared with other addictions. Much remains to be learned. We need to clarify symptoms and syndromes associated with cocaine addiction to more precisely delineate true "comorbidity." Special attention is needed to understand the course and response to treatment in women addicted to cocaine. Also, work is needed to clarify the interaction of HIV, cocaine, and pharmacotherapy used to treat HIV. Regarding treatment, effort is needed to better understand the interactions among educational, group, cognitive-behavioral, and pharmacologic interventions. Specific attention is needed regarding use of 12-step recovery programs adapted for cocaine addicts with comorbid psychiatric disorders, such as schizophrenia, mood, and anxiety disorders. Finally, we need to better understand ways of attracting and holding cocaine addicts in treatment earlier in the course of their disorder. To that end, "nontraditional" interventions, such as acupuncture, deserve systematic examination as alternative methods of recruitment and intervention for certain populations of cocaine addicts.
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PMID:Cocaine. Diagnosis and treatment. 845 49


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