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

An act of suicide is understood as a sort of decompensation inside a schizophrenia, a cyclic psychosis as described by Leonhard, or a reactive depression, but is in particular the expression of a depressive reaction and the end result of a depressive neurotic development. 107 patients (55 men and 52 women) were under constant treatment because of suicide attempts: 37 cases of depressive neurosis, 23 cases of depressive reaction, 7 cases of reactive depression, 10 cases of hysterical reaction, 8 alcoholics, and 22 endogenous psychotics. In 1974 there were still 50 patients under examination. 22 patients were no longer alive, 15 of which had committed suicide. Check-ups showed that the depressive neurotics and reactive depressives had an emotive personality stress, whilst the cases of depressive reaction appeared mostly beyond help.
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PMID:[Catamnestic studies of 107 patients receiving inpatient treatment 1966-1969 because of attempted suicide]. 12 54

The granting of abortions according to the psychiatric indication (PI) in West Germany is discussed. The PI is sharply differentiated from the emergency indication, which is of a social nature. These 2 indications merge in the case of psycho-social considerations. Possible psychological complications of the abortion operation itself should be considered in deciding whether an abortion should be granted, and a waiting period of at least a day should be allowed for both patient and physician before a definite decision is made. The indication for sterilization in conjunction with the abortion operation and the possibility of continuing therapy for those whose abortions are not granted are additional considerations or the decision on the suitability of the PI for a particular patient. The evaluation of suicidal tendencies is important for the psychological evaluation of abortion seekers. In general, cases of endogenous depression do not constitute a indication for abortion, while reactive depression may lead to depressive decompensation in a patient who has an unwanted pregnancy. The prognosis in such cases is especially hard to determine in younger patients. Character neuroses and alcoholism or similar diseases complicate the psychiatrical determination. In cases of schizophrenia and oligophrenia with good prognoses, abortion is not usually indicated. Most applications for abortion which are denied under the PI are of social character and belong under the emergency indication, e.g. serious physical illness of the mother, other handicapped family members, young, unwed mothers. These principles are illustrated with sample cases.
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PMID:[Psychiatric indications for pregnancy interruption]. 35 Aug 3

The authors studied 26 patients with slowly progressive schizophrenia, where prior to distinct symptoms of a schizophrenic process there was a reactive depression in the framework of the dynamics of psychopathy and in patients with an eventual development of the schizophrenic process. The report contains arguments indicating to the possibility of assessing the period of reactive lability, prior to the manifestation of schizophrenia, as a latent phase in the development of an endogenous process.
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PMID:[Psychogenic onsets of slowly progressive schizophrenia]. 67 15

The change in paragraph 218 of the criminal code regarding abortion was responsible for new guidelines for the psychiatric evaluation regarding a therapeutic abortion is reported. The commonest indications were medical reasons such as exhaustion, and reactive depression. There was one case of schizophrenia, one case of affective psychosis, two attempted suicides, twenty reactive depressions, one character disorder, and one case of cerebral seizures. Five applications were approved. The follow-up evaluation of the women with the approved and dismissed applications for therapeutic abortions showed no physical or psychic abnormalities. A comparison with 88 German applicants showed similar results. The stringent evaluation of applications for therapeutic abortion is still necessary even after the change of the law.
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PMID:[Desire for therapeutic abortion in the dependents of foreign workers. Outpatients psychiatric evaluation (author's transl)]. 70 Mar 47

During the fiscal year 1 April 1972 to 31 March 1973, 22,210 ECT treatments in 3,438 series were given in Denmark (6-46 treatments per series). Indications for treatment were: endogenous depression, acute delirium, mania, hysterical psychosis, reactive depression and schizophrenia. Unilateral ECT was used in more than half of the departments concerned. Two treatments were given weekly. The types of apparatus and anaesthesia techniques used are described. One death, which had questionable relation to the ECT, was reported, and other complications were few and mild. The advantages of ECT compared to tricyclic antidepressants are described, including the higher percentage of remissions or improvements in the treatment of endogenous depressions (about 80 per cent for ECT compared to about 60 per cent for tricyclic antidepressants). Little risk was found in out-patient administration of ECT. With present techniques and unilateral placement of electrodes out-patient ECT may be recommended for wider use than before.
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PMID:Electroconvulsive therapy in Denmark. 125 87

A study was made of burns patients who were referred for psychiatric problems. There were a total of 69 subjects, divided into three groups. The first group comprised thirty-four cases who attempted suicide by burning themselves--there were more women than men, the majority were less than forty years, and Indians were overrepresented. The majority of these were suffering from schizophrenia or a major depressive disorder. The second group of twenty-three patients were those who had a non-psychotic psychological reaction to their burns. The majority were also less than 40 years of age, and the main reactions were anxiety neurosis or reactive depression. The third group of twelve patients were suffering from delirium. All were pyrexic and in eleven, infective agents were cultured. Some of them also had electrolyte abnormalities and two had respiratory burns.
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PMID:Psychiatric disorders associated with burns. 129 99

To test a clinical impression that lower-class Black narcotic addicts from a ghetto "welfare" setting primarily manifest reactive schizophrenia when they become mentally ill, whereas White lower-middle- or working-class addicts primarily manifest reactive depression when they become neurotic or psychotic, a series of 20 consecutive mentally ill addicts from each group were compared with respect to diagnosis. The two groups were matched for age and sex. The findings overwhelmingly supported the hypothesis and are interpreted as confirming it insofar as the nature of our two populations permitted. It was impossible, for example, to separate the effects of racial membership from those of social class or from an interaction between the two variables.
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PMID:The role of race and social class in the psychiatric disorders of treated narcotic addicts. 739 62

Depressive syndromes in schizophrenia are reported in the prodromal stage of the early course, during the first or later psychotic episodes, but also after the fading out of an acute episode and as a precursor of relapse. According to these multiple conditions several explanations also exist as to how to understand depression in schizophrenia. Some authors interpret it as an elementary part of the schizophrenic symptomatology, which is only masked by positive symptoms (revealed depression). However, it can also be understood as a reactive depression or as caused by neuroleptic treatment, as part of the negative syndrome or as co-morbidity. In the ABC-Schizophrenia-Study, depression in the early course was analysed for patients in their first psychotic episode at index admission and an ICD-9 diagnosis of schizophrenia (ICD 295). In 81% of this sample depression was observed, beginning on average 4.3 years prior to index admission. In 42% of the patients depression began in the prepsychotic phase. In 18% the positive and the depressive syndrome developed within one month, and in 21% depression started after the first positive symptom occurred. We could only observe a clear sequence of depressive, negative and positive symptoms in the subgroup characterised by prepsychotic depression. A clear order of negative and positive symptoms was not observed in the other groups. Patients without depression in the early course have lower symptom levels at index admission. They present less positive symptoms (CATEGO-subscore DAH), fewer behavioural disturbances (subscore BSO) and also lower scores of non-specific symptoms (subscores SNR and NSN). More than 80% of the patients with depression in the early course also had a simple depression (as defined by the CATEGO-syndrome SD). Contrary to this, only 20% of the patient group without depression in the early course have positive SD values. Comparable percentages of males and females have depression in the early course, but in females depression begins more frequently in the prepsychotic phase, whereas in the male subgroup it more often starts postpsychotically, i.e. after the onset of the first psychotic symptom.
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PMID:[Depression in the early course of schizophrenia]. 795 15

In order to improve our understanding of depression in chronic schizophrenia, depressive symptoms were assessed in institutionalized, so called Kraepelinian, patients with schizophrenia (N = 43). The patients had been ill and dependent on others for at least 5 years. Depressive symptoms as measured by the Hamilton Depression (HAM-D) scale were less prevalent in this population compared to published data on non-Kraepelinian patients. Only 5% of our Kraepelinian patients had a HAM-D score >/= 16. There was also a low prevalence of core depressive symptoms (depressed mood, suicidal ideation, and guilt). The relationship of depression to other dimensions of schizophrenia was explored. Depression had a modest positive correlation (r = 0.44) with general psychopathology as measured by the Brief Psychiatric Rating Scale (BPRS), but not with positive symptoms as measured by BPRS positive subscale or negative symptoms as measured by the Scale for the Assessment of Negative Symptoms (SANS). Depression also showed a modest positive correlation (r =.48) using the Simpson-Angus Rating Scale (SAS) for extrapyramidal symptoms (EPS). These results indicate that in Kraepelinian schizophrenia, depression is not prevalent, even though patients are severely ill both in symptom and functioning domains. The results of our analysis support that Kraepelinian schizophrenia is a distinct subtype, and raise questions regarding the boundary between schizoaffective disorder and non-Kraepelinian schizophrenia. Finally, the low rate of depression observed revives the notion that preservation of core functional abilities is important for a depressive reaction to evolve in schizophrenia.
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PMID:Depression in Kraepelinian schizophrenia. 1252 29

In 1961, Tellenbach published the concept of "Typus melancholicus" (melancholic type) to illustrate the complementary relationship between premelancholic (predepressive) situations and a premorbid personality. The melancholic type is often considered to be a non-universal type that is localized in Germany and Japan; however, this belief is increasingly considered to be incorrect. When referring to papers written in the United States around the time that Tellenbach's monograph was published, it is now possible to identify some personalities corresponding to the melancholic type. In the early 20th century in Germany, the precipitating events and premorbid personalities of manic-depressive illness were frequently reported by Kraepelin and other researchers. They identified a conscientious, punctual, and orderly character that is analogous to the melancholic type. However, they ignored the relationships between events and personality. For them, the etiologies of endogenous psychoses, such as schizophrenia and manic-depressive illness, should not be sought from exogenous factors, such as precipitating events and environmental factors, but from endogenous and constitutional factors. After the end of the Second World War, the traditional view of a reactive (exogenous)-endogenous dichotomy of depression increasingly began to be deemed no longer valid. Consequently, it gradually became clear that many patients develop endogenous and autonomous depression after a psychological precipitating event. Tellenbach tried to resolve the impasse in the reactive-endogenous dichotomy of depression through creation of the concept of the "endon" in place of the "endogenous" concept. Tellenbach considered the endon not as cryptogenic but as transcending the dichotomy between the somatogenic and psychogenic. The endon is represented phenomenologically as transformations of arising rhythms, transformations of form of movement, the globalism of transformations, binding to a maturing process, and reversibility. According to Goethe's morphology. Tellenbach placed the endon in the ideal and phenomenological (empirical) realms simultaneously. The essential feature of the melancholic type is orderliness, which manifests in the following three areas: work, behavior, and conscientiousness. The interpersonal relationships of people with the melancholic type are described as "Being-for-others", which is analogous to altruism. People with the melancholic type think highly of common sense and duty. Furthermore, they cannot lower their level of aspiration even if the quality and quantity of their work is beyond their abilities or their capacities are weakened. In these premelancholic situations, pre-melancholic persons are forced to choose either quality or quantity and are plunged into the depths of despair, which means a hiatus or onset of melancholia. Thus, Tellenbach analyzed the complementary relationship between premelancholic situations and a premorbid personality at the beginning of melancholia. However, Tellenbach failed to explain why people with the melancholic type do not develop any illnesses other than melancholia or contradict the possibility that people with non-melancholic type personalities could have melancholia. In Japan, the melancholic type originated from Hirasawa's viewpoint that he had shifted the essential feature of Shimoda's Immodithymie (Shuuchaku Seikaku) from enthusiasm to orderliness. Subsequently, Kasahara developed the Japanese concept of the melancholic type, which remains in the empirical and descriptive realm and its essential feature is "orderliness underlying the altruism." In the United States, although the melancholic type probably existed, the concept was infrequently discussed because there were few psychiatrists who knew the concept of endogenous depression very well. Moreover, in DSM-III, the difference between endogenous and reactive depression was eliminated according to the "atheoretical" policy. Consequently, Tellenbach's theory of melancholia lost significance. The value of the theory of endon, which constitutes Tellenbach's theory of melancholia in empirical medicine, is considered to be restrictive. However, the discovery of the melancholic type concurrently in Germany, the United States, and Japan is of marked significance. It is now possible to reappraise the importance of the melancholic type and premelancholic situations.
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PMID:[Rethinking the theory of melancholia (Tellenbach): its construction process and theoretical significance]. 2405 14


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