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

The phenomenon of child abuse and neglect is universal and involves all population groups or classes. It is more the expression of a socio-affective deficiency than of economic poverty. Cultural factors are more important in its pathogenesis than traditional alienating factors such as schizophrenia and alcoholism. The victims are pre-school children and infants. The most common lesions are multiple hematomas, sometimes associated with fractures and epiphyseal wrenching. Subdural hematomas and bursting of abdominal viscera represent acute threats to the child's life. Risk factors are now better known and alarm signals of predictive value can be identified, which allow preventive steps to be taken. These alarm signals are to be observed during pregnancy, during delivery and in the neonatal period. They emanate from the mother but also from the married couple as a functional unit. After the fact, intervention in the form of control is only effective by the fear it produces. It is not therapeutic, because denial and lack of motivation for psychotherapy are prevalent. Effective therapy can only be prophylactic; hence the importance of identifying the risk. Primary prevention in the authors' opinion, must begin with adolescents, who must be informed and educated while still at school and before they are faced with the problems leading to this interpersonal disorder.
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PMID:[Child as a victim of abuse and negligence. Plea for a pluridisciplinary approach and for public education]. 56 93

This study assesses the frequency of childhood abuse and adult traumatization and the presence of symptomatology of post-traumatic stress and dissociation across different DSM-III diagnostic categories including affective disorder, schizophrenia, eating disorders, PTSD, borderline personality disorder, and multiple personality disorder. Findings revealed high levels of child abuse among patients with dissociative disorder and borderline personality disorder. The patients with dissociative disorders were found to have an increased incidence of rape and wife battery in adulthood. Patients with dissociative and post-traumatic stress disorders were found to experience similar symptomatology. The findings from this study highlight the need to assess all psychiatric patients for a history of physical and sexual trauma. Major treatment issues in patients who suffer from either type of trauma include the development of trust and the abreaction and working through of traumatic memories. Conjoint sessions with concerned others may be beneficial.
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PMID:Post-traumatic aspects of the treatment of victims of sexual abuse and incest. 274 40

A total of 160 babies taken statutorily into care at or soon after birth in Britain have so far been traced, mostly since 1973. Both this and the figure of 47 such actions between April 1978 and March 1979 are almost certainly underestimates. In 144 instances child abuse or neglect or both had occurred in most (76%), but statutory action was also reported in 16 first-born babies. Schizophrenia and severe mental handicap in the parents accounted for 13%, major psychiatric factors being reported in half the cases. The practice is more widespread than was generally imagined, with doctors and nurses always concerned. More detailed surveillance of statutory care actions at birth and in the first three months of life is recommended.
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PMID:Babies removed from their parents at birth: 160 statutory care actions. 741 74

The purpose of the study was to study the influence of life events on adolescent patients suffering from anorexia nervosa. Twenty one hospitalized adolescent inpatients with severe anorexia nervosa were compared with 79 adolescent nonanorectic psychiatric inpatients and 40 healthy adolescents for stressful life events throughout their lives. The nonanorectic patients suffered from schizophrenia, affective disorders, anxiety disorders, borderline personality disorder or conduct disorder. The assessment of the contribution of life events to the development of anorexia and the control mental disorders was based on semistructured interviewing of the patients, their parents and the patients' therapists. The instrument used was that developed by Pfeffer. The anorectic patients showed significantly higher negative life event scores than healthy controls in all the areas of life events examined. In addition, they showed significantly more negative life events concerning parents than patients in the other psychiatric diagnostic categories. These findings have relevance for the growing literature on the association between eating disorders and certain forms of child abuse.
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PMID:Life events and severe anorexia nervosa in adolescence. 775 87

The current diathesis-stress model of schizophrenia proposes that a genetic deficit creates a predisposing vulnerability in the form of oversenstivity to stress. This model positions all psychosocial events on the stress side of the diathesis-stress equation. As an example of hypotheses that emerge when consideration is given to repositioning adverse life events as potential contributors to the diathesis, this article examines one possible explanation for the high prevalence of child abuse found in adults diagnosed schizophrenic. A traumagenic neurodevelopmental (TN) model of schizophrenia is presented, documenting the similarities between the effects of traumatic events on the developing brain and the biological abnormalities found in persons diagnosed with schizophrenia, including overreactivity of the hypothalamic-pituitary-adrenal (HPA) axis; dopamine, norepinephrine, and serotonin abnormalities; and structural changes to the brain such as hippocampal damage, cerebral atrophy, ventricular enlargement, and reversed cerebral asymmetry. The TN model offers potential explanations for other findings in schizophrenia research beyond oversensitivity to stress, including cognitive impairment, pathways to positive and negative symptoms, and the relationship between psychotic and dissociative symptomatology. It is recommended that clinicians and researchers explore the presence of early adverse life events in adults with psychotic symptoms in order to ensure comprehensive formulations and appropriate treatment plans, and to further investigate the hypotheses generated by the TN model.
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PMID:The contribution of early traumatic events to schizophrenia in some patients: a traumagenic neurodevelopmental model. 1182 10

In light of recent studies indicating a relationship between child abuse and the positive symptoms of schizophrenia, this study investigated the hypotheses that childhood sexual and physical abuse are related to hallucinations, delusions, and thought disorder in adults, and that those relationships are greater in those who have suffered abuse during adulthood as well as childhood. In 200 community mental-health-centre clients, the clinically evaluated symptomatology of the 92 clients whose files documented sexual or physical abuse at some point in their lives was compared with that of the 108 for whom no abuse was documented. In the 60 patients for whom child abuse was documented, hallucinations (including all six subtypes), but not delusions, thought disorder or negative symptoms, were significantly more common than in the non-abused group. Adult sexual assault was related to hallucinations, delusions, and thought disorder. In linear regression analysis, a combination of child abuse and adult abuse predicted hallucinations, delusions, and thought disorder. However, child abuse was a significant predictor of auditory and tactile hallucinations, even in the absence of adult abuse. Possible psychological and neurobiological pathways from abuse to symptoms are discussed, along with research and clinical implications.
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PMID:Sexual and physical abuse during childhood and adulthood as predictors of hallucinations, delusions and thought disorder. 1268 31

The first objective was to identify the provoking events of suicide in patients with schizophrenia or schizoid-type disorder, and to assess the humiliation component of these events. The second objective was to verify if quality of care during childhood is a vulnerability factor for suicide in patients with schizophrenia or schizoid-type psychosis. Thirty-three cases of suicide with a diagnosis of schizophrenia or schizoid-type psychosis were compared with 34 living patients with a similar diagnosis. The psychological autopsy method was used. The assessments were made with the Structured Clinical Interview for the Diagnostic and Statistical Manual for Axis I mental disorders, the Life Events and Difficulties Schedule, and the Child Experiences and Child Abuse Interview. The suicide group (SG) experienced more often a recent severe event, usually of a humiliation nature, than the control group (CG). It also experienced more severe events associated with aggressive behavior or with psychiatric impairment. Contrary to expectations, the CG had worse scores than the SG for quality of care during childhood. In conclusion, suicide in schizophrenia is related both to environmental stress and to psychiatric impairment.
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PMID:Suicide, schizophrenia, and schizoid-type psychosis: role of life events and childhood factors. 2130 25

A high prevalence of childhood abuse has been reported in patients with severe mental illness. We conducted a cross-sectional study of 102 patients with schizophrenia, bipolar disorder, or schizoaffective disorder. Social, demographic, and clinical data were obtained. Patients were evaluated using Brief Psychotic Relative Scale, and Traumatic Life Events and Distressing Event questionnaires. Almost half (47.5%) of these patients had suffered some kind of child abuse, and our results confirmed a relationship between a history of childhood abuse and more severe psychosis. Diagnosis of schizophrenia was determined 4.1 years earlier in victims of childhood abuse. Hospital admissions were twice as high in victims of psychological abuse. Patients with a history of sexual abuse were more than twice as likely to attempt suicide (68% vs. 28.9%).
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PMID:Prevalence and clinical impact of childhood trauma in patients with severe mental disorders. 2134 85

Recent studies indicate that the pregnancy rates of mothers with schizophrenia do not differ significantly from those of the general population. Mothers' severe mental illness, combined with poor social support and comorbidity, may significantly affect her parenting capacity. However, the poor quality of parenting by psychotic mothers should not be taken for granted, in advance. Some of them may become excellent parents while other may abuse their children and finally lose custody because of this. The parenting capacity is significantly influenced by the existing insight of patient-parent's disease. Assessing the parenting capacity comprises the measurement of insight and of the risk of child abuse as well. Factors associated with increased risk for child abuse are: (a) active psychiatric symptomatology, (b) history of violent behavior in the past, (c) maternal history of abuse during childhood, (d) dangerous domestic environment, (e) stressful events and poor social support to the mother and (f) unrealistic parental expectations. These factors should be assessed both clinically and by using the appropriate psychometric tools. Tools which have been widely used for this purpose are: (a) "Schedule for Assessment of Insight-SAI", (b) "Childhood Trauma Interview", (c) "Home Observation for the Measurement of the Environment Inventory-HOME" and "Home Screening Questionnaire -HSQ", (d) "Parental Stress Inventory-PSI", "Swedish Parenthood Stress Questionnaire-SPSQ", "Arizona Social Support Inventory" (e) "Parent Opinion Questionnaire-POQ". Interventions to ensure a more adequate parenting capacity should be focused on family planning: mothers with severe mental illness have poor knowledge about reproductive and contraception issues. Their pregnancies are mostly not planned. It is important for the family planning to be tailored according to the specific needs of schizophrenic mothers and to take into account the following issues: (a) the severity and the duration/chronicity of the disease, (b) the onset of the disease in relation to the gestational period, (c) the education of mothers with schizophrenia considering their double patient/mother role. An educational program should train the mother to recognize early signs of the disease, comply with medication, increase her empathy towards the baby and reduce any distorted perceptions about it. The treating, assessing, educating and preventing programs and interventions of mental health services should be continuous and supportive.
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PMID:[Parenting capacity of mothers with schizophrenia]. 2339 53

The aims of this study were to examine the mediating effect of bullying involvement on the relationships between body mass index (BMI) and mental health problems, including social phobia, depression, suicidality, and low self-esteem among adolescents in Taiwan. The moderation effect of sex on the mediating role of bullying involvement was also examined. Five thousand two hundred and fifty-two students of high schools completed the questionnaires. Victimization and perpetration of passive and active bullying were assessed using the Chinese version of the School Bullying Experience Questionnaire. BMI was calculated from self-reported weight and height measurements. The Social Phobia Inventory, the Mandarin Chinese version of the Center for Epidemiological Studies-Depression Scale, the suicidality-related questionnaire from the epidemiological version of the Kiddie-Schedule for Affective Disorders and Schizophrenia, and the Rosenberg Self-Esteem Scale were applied to assess social phobia, depression, suicidality, and low self-esteem, respectively. The mediating effect of bullying involvement on the associations between increased BMI and mental health problems was examined by the Sobel test. The moderation effect of sex on the mediating role of bullying involvement was tested by the multiple-group structural equation model. Victimization of passive and active bullying and perpetration of passive bullying, but not perpetration of active bullying, had a mediating effect on the relationships between increased BMI and all four mental health problems. Sex did not have a significant moderation effect on the mediating role of bullying involvement. Bullying involvement should be a target of prevention and intervention in developing a strategy to improve mental health among adolescents with increased BMI.
Child Abuse Negl 2014 Mar
PMID:Mediating effects of bullying involvement on the relationship of body mass index with social phobia, depression, suicidality, and self-esteem and sex differences in adolescents in Taiwan. 2401 67


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