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

The growing old of patients levels and reduces the affective impact of the mental diseases in the way of leucotomia (Muller). The author considers this problem of these patient's destiny. The fact of sending them to retreat-home may recreate new-focus of segregation. The chimiotherapy becomes illusory when treating old people (iatrogene pseudo-dementia. Irreversible tertiary effect of the medical treatments). The old psychotic dies more peacefully than the old person who has become psychotical late in life with a kind of serenity which evokes a bonze's wisdom, identification pattern for the young people. Is schizophrenia a chronic disease or is it made chronic by our society? Is there an analogy between the residual mental automatism and the Far-Eastern extasis?
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PMID:[The aging of the mentally ill]. 122 18

In a recent article, Andreasen and Flaum (Schizophrenia Bulletin, Vol. 17, No. 1, 1991) argued that greater emphasis should be placed on negative symptoms in the diagnosis of schizophrenia, leading to a less important role for positive symptoms. This article presents a counter-argument to this view. Positive symptoms are common and reliable and therefore highly useful diagnostically. First-rank symptoms, although not specific to schizophrenia, show good discriminability. No other type of symptom or investigative method can make such claims to usefulness. Although positive symptoms do not predict outcome, this is not a necessary function of diagnostic criteria. The predictive power of negative symptoms is, in any case, based largely on studies of patients with chronic disorder. Premorbidly impaired social development may interact with schizophrenia, worsening the prognosis. We believe positive symptoms have always been the essence of psychiatric disorder and should remain so. Increasing the diagnostic weight given to negative symptoms risks restricting the definition of schizophrenia excessively.
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PMID:Diagnostic criteria in schizophrenia: accentuate the positive. 204 88

North American outcome studies of schizophrenia conducted within the past quarter century are reviewed if their minimum average followup is 10 years and they meet at least some modern design criteria. Ten such investigations are described and summarized. Taken as a whole, they demonstrate that schizophrenia can be a chronic disease whose outcome on the average is worse than that of other major mental illnesses. It is associated with an increased risk for suicide, physical illness, and mortality. The schizophrenic process, however, is not relentlessly progressive, as originally described, but appears to plateau after 5-10 years of manifest illness. Overall, outcome is heterogeneous, but much of the variance can be linked to sample characteristics, including expressions of psychopathology (broad vs. narrow diagnostic criteria, subtypes, and comorbidity), dimensions of chronicity (length of manifest illness, treatment resistance, age of onset, and institutionalization), and other predictor variables (gender, marital status, socioeconomic status, physical setting, and premorbid health). Long-term followup studies have yet to demonstrate clearly any effect of treatment on the natural history of schizophrenia. Finally, these studies support a broad definition of schizophrenia.
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PMID:A selective review of recent North American long-term followup studies of schizophrenia. 306 80

Structural brain abnormalities in schizophrenia have been reported by several computertomographic (CT) studies. However the prevalence and the localization of the abnormalities vary widely among studies. These differences might stem from samples heterogeneity, from the choice of the CT parameter to be investigated and from the use of different criteria for defining abnormalities. In spite of some contradictory findings, it seems established that at least one subgroup of schizophrenic patients shows mild or moderate brain atrophy; this subgroup might be characterized by a chronic course of the disease, poor response to neuroleptic therapy, and the presence of other neurodiagnostic signs of a diffuse brain dysfunction such as neuropsychological impairment, EEG abnormalities and neurological "soft signs". Atrophic findings have been observed in young schizophrenic patients at the first onset of the disease, indicating that the development of the structural abnormalities are not a consequence of a chronic disease and treatment. Schizophrenics with atrophy are unlikely to have a genetic loading (family history) with schizophrenia and they present more frequently pregnancy and birth complications as well as brain trauma in the first years of development. Because schizophrenics with brain atrophy might represent a more homogeneous subgroup with regard to clinical and aetiopathological variables, it is still an important task to identify more precisely these patients on the basis of CT data and then to study the features that could characterize this subgroup.
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PMID:[Cerebral computed tomography and schizophrenia: a critical review of the literature]. 306 11

In present-day African psychiatry, there is a sharp differentiation between serious mental illness, which requires medically orientated treatment and chemotherapy, and the more superficial disturbances of personality for which psychological, sociological and educational measures are indicated. With the severe shortage of Western psychiatrists who are prepared to undertake this work, it is providential that black traditional healers address themselves to the latter group of mental abnormalities with a measure of success comparable to psychotherapy in First-World practice. In the back wards of a mental hospital (run on First-World lines) and in outpatient clinics in periurban Durban townships, one meets a large number of patients with severe and chronic disease. All those conditions (mental retardation, organic brain syndromes, schizophrenia and affective disorders) with positive symptomatology (excitement, restlessness and aggression) are found to respond to neuroleptic drugs. Possible reasons why patients with negative symptoms (emotional withdrawal, poverty of ideas and speech), especially in schizophrenia, do not react, are discussed, and administrative and socio-economic implications are reviewed.
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PMID:Severe invalidism--the dominant feature of Third-World psychiatry in southern Africa. 335 19

About 10-15 per cent of schizophrenic patients are 5-15 years after onset still hospitalized, and more than 50 per cent will show some psychopathology and therefore be unable to work. The possibility of a permanent recovery from the schizophrenic illness is probably greater today than it was half a century ago when 50-60 per cent were chronically hospitalized. The diagnostic criteria, at least in the USA, are today, however, broader than they were half a century ago in Europe and therefore comparisons are difficult to make. Schizophrenia in some patients a chronic disease, and the risk of being permanently incapacitated is some way (unable to work) is still 50 per cent or more.
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PMID:Schizophrenia, a chronic disease. 694 31

Schizophrenia is a chronic disease which begins during early adulthood and persists throughout life. It may appear in two main clinical patterns: chronic progressive and relapsing-remitting. The diagnosis is based entirely on clinical data, as no auxiliary laboratory tests are available. Schizophrenia has a heterogeneous clinical expression which may reflect different etiological factors, such as genetic susceptibility, dysfunction of different neurotransmitter systems or environmental, stressogenic and interfamilial influences. Recently, an autoimmune hypothesis has gained acceptance, which proposes that schizophrenia is one of a spectrum of neuropsychiatric diseases in which an autoimmune attack on the brain occurs. It is also possible, however, that the immunological changes seen in schizophrenic patients are secondary to the disease itself. The main evidence supporting an autoimmune hypothesis is the presence of immunological alterations in schizophrenia that also occur in other autoimmune diseases, e.g. an elevation in serum immunoglobulin levels, a decrease in mitogen responses, morphologically abnormal lymphocytes, an increase in antibrain antibodies, an increase in antibodies to nuclear factor, and a decrease in CD4+ T cells. An autoimmune etiology, if proven correct in the pathogenesis of schizophrenia, would have potential implications for the direction of future psychopharmacological therapies.
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PMID:Schizophrenia and autoimmunity--a possible etiological mechanism? 786 63

Two approaches can be used to estimate the cost of schizophrenia. Prevalence-based cost provides an estimate of the direct and indirect economic burden incurred in a period of time as a result of the prevalence of schizophrenia during the same base period, most often a year. Incidence-based cost represents the lifetime cost resulting from the illness. Different examples of studies applying the 2 methods are illustrated, by stressing the advantages and the pitfalls of both. The incidence-based approach is the most appropriate for the purpose of making decisions about which treatment to implement. Cost analysis of lifetime schizophrenia requires reliable data on service use and treatments and particular methodological instruments. In particular, since schizophrenia is in many cases a chronic disease, pharmaco-economic evaluation should also be applied using an incidence-based approach rather than a short period of treatment.
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PMID:Methods for evaluation of the direct and indirect costs of long-term schizophrenia. 809 3

Schizophrenia is a chronic disease, with phase course. Most of patients (about 78%) experience more than one episode of the disease in the course of life. Pharmacotherapy is the standard method of troating schizophrenia. Since the middle of the 70 a new orientation of therapy of schizophrenia has been developing. Its main goal is prophylaxis, which combines pharmacotherapy and psychosocial treatment. In the paper we discuss the term "relapse of schizophrenia" and researches concerning the index of relapses and dynamics of the disease. We present theoretical presumptions which are the base of psychoeducational programs, that is, stress-vulnerability model. The main purposes of psychoeducation in schizophrenia are also discussed. The article contains current review of the researches relative to effectiveness of psychoeducational programs in relapse of schizophrenia prevention.
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PMID:[Psychoeducation in schizophrenia relapse prevention]. 954 85

According to the ICD 10 only acute psychotic disorders and transitory acute disorders are specified, whereas DSM IV index, in the same class, schizophreniform disorder, schizoaffectif disorder and atypical psychosis. State biological markers of these disorders are present during the acute episode and disappear with it. A few studies concerns trait predispositional markers of these acute psychotic disorders. In addition, several studies of acute psychotic states are indexed as a partition of usual schizophrenic disorder, as a simple occurrence of that chronic disease. From the biological point of view, dysfunctions of norepinephrine and dopaminergic metabolisms are reported within these acute schizophrenic disorganisation, especially hyperdopaminergia, causality, consequence or evidence of the state syndrome. Those kinds of data are also reported in mood disorder with delusional symptoms. A hypothetic dysregulation of the balance between oxydation and antioxydation system has been searched in these acute states of schizophrenia. From the electrophysiologic perspective, no abnormalities are found for ocular movement functions during these acute psychotic disorders. Besides the clouding of consciousness of confusional states, neuropsychological abnormalities are reported: attention disorders, lack of inhibition of non relevant informations, abnormalities of working memory. Brain imaging can substantiate a diminution of the caudate nucleus size and a possible increase of D2 receptors number. Also, in these acute psychotic states abnormalities of humoral and cellular immunologic system have been found. Lastly, street drugs can originate confusional states and depersonalization, through their serotoninergic, dopaminergic and anticholinergic properties. Ethical drugs can also create an acute psychosis disorder: individual vulnerability and somatic disease cooccurrence act as risk-factors.
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PMID:[Biological approaches to acute psychoses]. 1059 92


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