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

Substance abuse among schizophrenic patients is an increasingly recognized clinical phenomenon. The authors review experimental and observed clinical effects of drug abuse and patients' subjective experiences of acute intoxication. Though drug abuse may exacerbate psychotic symptoms, abused drugs may also lead to transient symptom reduction in subgroups of schizophrenic patients. Some patients report feeling less dysphoric, less anxious, and more energetic while intoxicated. Models of the relationship of drug abuse and schizophrenia, particularly the self-medication hypothesis, are discussed in reference to these data.
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PMID:Acute effects of drug abuse in schizophrenic patients: clinical observations and patients' self-reports. 218 36

Numerous pharmacological agents have been shown to have powerful effects on cognitive behavior. Schizophrenia-like reactions have been reported in some instances. There have also been persistent reports of drug abuse among psychiatric patients before and during hospitalization. These phenomena have led to speculation that psychoactive substances are affecting the course and outcome of psychiatric illnesses, and in particular, schizophrenia. This report first reviews the evidence for psychotomimetic effects of various drugs, and then focuses on reports of the effect that substance abuse has on the course of schizophrenia and long-term outcome. The evidence to date indicates that there is a need for a large epidemiological analysis of the interplay between drug abuse and schizophrenia as well as more intensive case studies of afflicted individuals. This discussion concludes with suggestions for improved research methods and two designs for future investigations.
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PMID:Impact of substance abuse on the course and outcome of schizophrenia. 218 37

The review presents evidence that 5-HT3 receptors within the brain may contribute to the control of behavior. 5-HT3 receptor antagonists GR38032F, zacopride, ICS 205-930 and other agents are very potent in reducing mesolimbic dopamine hyperactivity caused by the injection of amphetamine or infusion of dopamine into the rat nucleus accumbens and amygdala, and the ventral striatum of the marmoset. Such actions are distinguished from those of neuroleptic agents by a failure to reduce normal levels of activity or to induce a rebound hyperactivity after discontinuation of treatment. Indeed, the 5-HT3 receptor antagonists can prevent the neuroleptic-induced rebound hyperactivity. Further evidence that 5-HT3 receptors moderate limbic dopamine function is shown by their ability to reduce both the behavioral hyperactivity and changes in limbic dopamine metabolism caused by DiMe-C7 injection into the ventral tegmental area. The 5-HT3 receptor antagonists also have an anxiolytic profile in the social interaction test in the rat, the light/dark exploration test in the mouse, the marmoset human threat test and behavioral observations in the cynomolgus monkey. They differ from the benzodiazepines by an absence of effect in the rat water lick conflict test and a withdrawal syndrome. Importantly, the 5-HT3 receptor antagonists are highly effective to prevent the behavioral syndrome following withdrawal from treatment with diazepam, nicotine, cocaine and alcohol. Intracerebral injection techniques in the mouse indicate that the dorsal raphe nucleus and amygdala may be important sites of 5-HT3 receptor antagonist action to inhibit aversive behavior. Studies with GR38032F indicate an additional effect in reducing alcohol consumption in the marmoset. The identification and distribution of 5-HT3 receptors in the brain using a number of 5-HT3 receptor ligands, [3H]65630, [3H]zacopride and [3H]ICS 205-930 correlates between studies, and the 5-HT3 recognition sites in cortical, limbic and other areas meet the criteria for 5-HT3 receptors to mediate the above behavioral effects. Thus the use of 5-HT3 receptor antagonists reveals an important role for 5-hydroxytryptamine in the control of disturbed behavior in the absence of effect on normal behavior. The profile of action of the 5-HT3 receptor antagonists has generated a major clinical interest in their potential use for schizophrenia, anxiety and in the control of drug abuse.
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PMID:The psychopharmacology of 5-HT3 receptors. 220 69

It is becoming increasingly recognized that one third to one half of children diagnosed as having attention deficit/hyperactivity disorder (ADHD) continue to exhibit symptoms of the disorder into adulthood. The nature of the clinical picture is not well understood by a substantial number of clinicians. The purpose of this study is to report on the demographic and clinical profile of 56 adults, age 19 to 65 years (48 men, eight women) who present with adult ADHD and meet DSM-III-R criteria for the disorder. Patients underwent a diagnostic work-up consisting of medical and psychiatric evaluation, a structured interview Schedule for Affective Disorders and Schizophrenia-Lifetime Version [SADS-L]), the Symptoms Checklist Revised (SCL-9OR), Conners Attention Deficit Disorder With Hyperactivity (ADDH) scale, structured interview of ADDH, the Global Assessment of Functioning Scale (GAF), and, when available, information from parents was obtained. Ninety-one percent of our sample met the Utah Criteria for adult ADHD. The majority of the sample had additional DSM-III-R diagnoses and only seven had ADHD diagnosis alone. Fifty-three percent of the sample met the criteria for generalized anxiety disorder, 34% alcohol abuse or dependence, 30% drug abuse, 25% dysthymic disorder, and 25% cyclothymic disorder. These findings were similar to those reported in the literature.
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PMID:A clinical and demographic profile of a sample of adults with attention deficit hyperactivity disorder, residual state. 222

To assess the role of alcohol and drug abuse among schizophrenics with assaultive behaviour, we analysed case records of 38 patients who were responsible for a total of 71 violent offences between 1972 and 1986. They were identified from a population-based cohort of 644 individuals with schizophrenia hospitalized in Stockholm County during 1971. Fourteen of the 38 offenders abused alcohol and/or drugs and another 7 were probable abusers. These figures are higher than previously reported as regards abuse among schizophrenics. Most of the offences were performed by nonhospitalized patients who had been ill for many years. The nature of most of the violent incidents resembled that of offences committed by non-psychotic individuals. Our findings give further evidence for the role of abuse and social disintegration in assaultive behaviour among persons with schizophrenia.
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PMID:Schizophrenia and assaultive behaviour: the role of alcohol and drug abuse. 224 43

Lifetime prevalence rates were calculated for comorbid psychiatric disorders in 119 patients who were referred from primary care physicians for unexplained somatic complaints and who met DSM III-R criteria for somatization disorder. Comparisons were made with general population norms from the ECA study. Prevalence of nine comorbid conditions was significantly higher than in the general populations. The most prevalent comorbid diagnoses were major depression (54.6%), generalized anxiety disorder (33.6%), and phobic disorders (31.1%). The least common comorbid disorders were mania (4.2%) and drug abuse (4.9%); drug abuse prevalence rates did not significantly exceed general population estimates. Risk ratios were highest for panic disorder (16.25), major depression (9.41), schizophrenia (7.77), and obsessive-compulsive disorder (7.04).
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PMID:Psychiatric comorbidity in primary care somatization disorder. 239 95

The sociodemographic and clinical characteristics of 84 adolescents admitted to the psychiatric unit of a teaching hospital in Nigeria were studied. Their ages ranged from 12-20 years (mean 17). The pattern of psychiatric disorders in this population reflected the pattern in the adult population. Major psychoses comprising schizophrenia (44%), organic brain syndrome (23%), and affective disorders (16%) predominated. Infections and drug abuse are preventable causes of organic brain syndrome. Male adolescents were as likely to be hospitalized for a major psychiatric disorder as female adolescents. The peak period for psychopathology is late adolescence. The contributions of such factors as rural-urban migration, birth order, family size, polygamy and genetics to the etiology of major mental disorders in this population require further investigations. Understanding the prevalence and pattern of presentation of mental disorders in all age groups is essential for effective mental health planning.
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PMID:Inpatient adolescent psychiatry in a teaching hospital in Nigeria. 261 86

One hundred and seventeen biological mothers and 63 biological fathers of depressed and nondepressed, psychiatrically disturbed children and adolescents were interviewed with the Schedule for Affective Disorders and Schizophrenia-Lifetime Version. Diagnostic information was also obtained on 54 biological fathers who were unavailable for interview. Histories of depressive disorders and other forms of psychopathology were reported at high rates in the parents. Major depression was the most commonly reported disorder in interviewed parents of both sexes, but it was reported more often in mothers. Substance abuse and antisocial pathology was more prevalent in fathers. Depression in parents did not distinguish depressed from nondepressed probands, but maternal history of anxiety disorders, alcoholism and/or drug abuse, and suicidality did. Depressed probands were more likely than their nondepressed peers to have two parents with histories of depression. Mothers of younger patients had more substance abuse and suicidality in their histories than mothers of adolescents. They also reported earlier age of onset of depression and earlier age of entry into treatment.
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PMID:Psychopathology in parents of depressed children and adolescents. 273

A 32-year-old paranoid schizophrenic man repeatedly stabbed both his eyes with a sharpened wire coat hanger. The patient underwent vitrectomy on each eye approximately 2 1/2 weeks after injury, with multiple retinal defects noted OU. None of the posterior wounds involved the macula or optic disc, and final vision was 20/70 OD and 20/50 OS. Ocular self-mutilation, deliberate and severe self-injury which threatens visual function, is a rare occurrence most often described in acutely psychotic patients. Psychosis may be due to schizophrenia, drug abuse, manic phases of bipolar mood disorders, and depression. A striking number of these patients have delusions with religious and sexual content. They are prone to repeated attempts during the acute psychotic phase and must be monitored closely at this time.
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PMID:Ocular self-mutilation. 277 33

Physicians may have the opportunity to prevent suicide. An awareness of suicide risk factors, such as depression, alcoholism, drug abuse, schizophrenia, and chronic pain or disease, may facilitate suicide prevention. Recognition of acute and chronic suicidal vulnerability occurs through direct questioning. Psychiatric consultation is indicated for patients exhibiting clear self-injury risk, as exemplified by expressed suicide intent, an overt plan for death, or a "gesture." Hospitalization is usually recommended for socially isolated patients presenting with overt suicidal ideation, complicated by injurious self-harm, encephalopathy, or substance abuse. Family involvement and a "no-suicide" contract with the patient, coupled with close outpatient follow-up appointments, should suffice for those exhibiting milder or transient thoughts of suicide without manifest intent to die.
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PMID:A preventive approach to the suicidal patient. 327 11


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