Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0036341 (schizophrenia)
 60,220 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

A three-month prospective collection of primary care data from general surgery attendances in an inner London Health District was carried out to inform the setting of contracts for psychiatric services. This involved 21 general practitioners (GPs) selected from a total of 102 in the District. Information was collected on mental health disorders detected by GPs among the attenders, the resultant volume of care provided by the GPs, the referrals made to secondary care and other agencies, and the types of care identified by the practitioners as appropriate for a patient but which are currently not accessible or available. We found that 45.9 per cent of all patients (17,319/37,733) registered with the 21 GPs were seen in three months. There was an overrepresentation of White and Black Caribbean patients and an under-representation of Bangladeshi, Chinese, Black African and Black Other patients in the study population. Mental health disorders were detected in 13.3 per cent (2304) of all attenders. The commonest problems were depression (17.7 per cent), acute stress reaction (15.5 per cent), anxiety (15.1 per cent), drug abuse (7.2 per cent), schizophrenia (5.8 per cent) and alcohol abuse (5.3 per cent). It was found that 37.3 per cent (860) of all attenders received medication, 66.5 per cent (1532) were counselled by the GPs and only 4.4 per cent (102) were referred to a psychiatrist; 16.3 per cent (375) of those with mental health disorders were identified by the GPs as having a service need which the District's psychiatric service could not meet.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:The collection of general practice data for psychiatric service contracts. 803 58

While schizophrenia-like psychosis is known to occur with chronic alcoholism the nosological differentiation of schizophrenia-like psychosis in patients with drug abuse remains difficult. An increased risk for the development of such psychoses has been discussed for various substances, e.g. cannabis. On the one hand this is supported by clinical and epidemiological studies but a final agreement has not been reached. On the other hand high prevalence estimates for substance abuse in schizophrenics have been reported in the angloamerican literature. Prevalence estimates for drug abuse and dependence range between 7-65% and a comparatively distinct abuse pattern in schizophrenics has been discerned: Apart from alcohol schizophrenics tend to abuse cannabis and psychostimulants including cocaine and hallucinogenes, whereas narcotics are abused only infrequently. Whether these recent figures for substance abuse and dependence are due to a real increase (32) or to improved diagnostic instruments and differences in the classification of psychiatric disorders or to selected samples (3, 122) is still a matter of controversy. In comparison with other schizophrenics dual diagnosis schizophrenics show more positive (psychotic) and less negative symptoms. In this review some clinical and neuro-biological problems concerning the concept of drug-induced psychosis and basic principles of pharmacotherapy and psychotherapy in schizophrenic patients with substance abuse are discussed.
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PMID:[Addiction and schizophrenia. Nosological, clinical and therapeutic questions. 2. Substance dependence and schizophrenia]. 805 Jul 73

Recognition of maternal alcoholism as a risk factor for mental illness in adult offspring is important. Using the Diagnostic Interview Schedule (DIS), adult offspring of a clinical sample of alcoholic mothers were assessed for selected lifetime psychiatric disorders. Elevated adjusted odds ratio (OR) of alcohol abuse/dependence (OR 6.18, 95% confidence interval (CI) 2.0-19.02), and drug abuse/dependence (OR 3.75, 95% CI 1.13-12.34) were observed for daughters of alcoholic mothers compared with a group of women who reported no history of alcoholism in their parents. Prevalence rates of alcohol abuse/dependence, drug abuse/dependence, affective disorders, general anxiety disorder, panic disorder and schizophrenia were higher in sons of alcoholic mothers than in a male comparison sample who reported no history of parental alcoholism, however, these increases were not statistically significant.
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PMID:Prevalence of mental illnesses in adult offspring of alcoholic mothers. 805 39

A study on the prevalence of substance abuse in schizophrenics performed in 1989/1990 had shown high rates of alcohol and drug abuse in schizophrenia. An additional analysis of the data revealed that schizophrenics with substance abuse had been convicted more often than other schizophrenics. The possible role of substance abuse as a risk factor for delinquency or casualties in schizophrenia is discussed.
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PMID:[Alcohol and drug abuse as risk factors for violence and delinquency in schizophrenic patients]. 824 41

According to the Danish Civil Commitment Law, very dangerous psychotic patients can be transferred from a general psychiatric department to the only psychiatric maximum security institution in Denmark. Denmark passed a new Mental Health Act in 1989, and according to this "decrees of dangerousness" are issued by the Ministry of Justice, followed by a court hearing. The Ministry of Justice asks the Danish Medico-Legal Council for a statement in all such cases. The number of patients who are transferred to the Maximum Security Institution according to these rules has increased greatly, the average number per year in the seventies being two to three patients, while in 1990, 11 patients were transferred. In the period 1985 to 1990, 39 cases concerning "decrees of dangerousness" were submitted to the Medico Legal Council. The Council did not find the conditions fulfilled in five cases, one case was invalidated by the court, and in two cases the requests were withdrawn. The increase in the number of "decrees of dangerousness" was equally divided between younger patients, i.e. up to 29 years old, the average duration of illness being about three years and elderly patients, i.e. 30 years or older the average duration of illness in this group being about 13 years. The majority of the patients suffered from schizophrenia. Among the younger patients, 11 of 18 had alcohol and/or drug abuse, which was only seen among three of the 21 elderly patients. Drug abuse increases the risk of dangerous behaviour among schizophrenics, and drug abuse among younger schizophrenics might be part of the explanation for the increasing number of "decrees of dangerousness".(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:[Decrees of dangerousness]. 847 83

The high comorbidity of schizophrenia and substance abuse raises the question of a causal relationship between the two disorders. Clarifying the temporal sequence of their onsets can shed light on this issue. For this purpose, onset and course of schizophrenic symptoms and of alcohol and drug abuse were retrospectively investigated within the ABC Schizophrenia Study in a representative first-episode sample of 232 schizophrenic patients. The rates of alcohol abuse (24%) and of drug abuse (14%) were twice the rates compared to the general population but schizophrenic patients seemed to have started substance abuse later than the control group. Male sex and early symptom onset were major risk factors. At all important landmarks during the early course of schizophrenia, drug-abusers were younger than alcohol-abusers who were younger than non-abusers. Alcohol abuse usually started during the prodromal phase, i.e., after the first sign of schizophrenia but before the first positive symptom. Drug abuse emerged before the first symptom in one third, simultaneously with it in another third, and during the prodromal phase in the last third of patients. Drug abuse significantly preceded the psychotic phase. The hypothesis that substance abuse causes schizophrenia thus is not generally supported. Findings on symptomatology illustrate the problems substance-abusing schizophrenics pose from early on with dissocial behaviors and preoccupation with magical ideas but without a specific positive or negative subsyndrome.
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PMID:[Do alcohol or drug abuse induce schizophrenia?]. 867 87

Explanations for the high prevalence of alcohol and drug abuse in schizophrenia purport that substance use is related to social-affiliative needs or to symptom regulation. Neither explanation was adequate in describing substance-use episodes in the present longitudinal study. The study involved repeated interviews of 10 individuals with schizophrenia about their internal and external environment during substance use. Qualitative analyses of interview responses showed variability in multiple versus single episodes in a day and categories labeled Activities Prior to Use and Social Context of Use. Individual subject's responses each had a unique pattern that characterized their substance-use episodes.
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PMID:Internal and external environment of individuals with schizophrenia during alcohol and drug use. 868 49

There is clear evidence of illicit drug abuse in psychiatric hospitals (Deahl, 1991), and illicit drug use has been associated with relapse in people with serious mental health problems. Cannabis abuse in the general population is common and has both desirable and undesirable effects on users. However, when cannabis is used by people with serious mental health problems, a more pronounced effect may be seen. There is little evidence to suggest that cannabis 'causes' schizophrenia, but its abuse may prove to be a trigger in vulnerable individuals. Studies have demonstrated that cannabis abuse can exacerbate the symptoms of schizophrenia and may reduce the effectiveness of antipsychotic drugs. Mental health nurses need to develop interventions in order to manage illicit drug abuse effectively in both the hospital and community settings.
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PMID:Effects of cannabis abuse on people with serious mental health problems. 870 51

Epidemiological studies such as the Epidemiological Catchment Area survey have shown that bipolar or schizophrenic patients are especially prone to display a comorbid substance use disorder. These studies have demonstrated that this comorbidity condition constitutes a major mental health problem owing to its high frequency. The aim of the present study was to assess the prevalence of a comorbid substance use disorder in a sample of psychotic patients, and to compare the pattern of street drug use in schizophrenic, schizoaffective and bipolar patients. Comorbidity of illicit substance use disorders was assessed with the Composite International Diagnostic Interview in 92 consecutive patients fulfilling the DSM III-R criteria for bipolar disorder (BP, n = 40), schizophrenia (S, n = 38) and schizoaffective disorder (SA, n = 14). The lifetime prevalence for any substance use was 25% in the total sample, and did not differ significantly between the three groups, although a higher prevalence was found in SA (BP: 20%, S: 23.7%, SA: 42.9%, NS). The current prevalence (previous six months) was 14.1%, in the total sample (BP: 17.5%, S: 7.9%, SA: 21.4%, NS). In the three diagnostic groups, the most commonly used drug was cannabis, followed by opiates and cocaine. These results do not confirm that schizophrenics might preferentially display abuse or dependence on psychostimulants, and highlight the possible role for the drug choice of the availability of the various illicit drugs in the geographical environment of the subject. Nearly half patients (47.8%) have a lifetime history of abuse or dependence on at least two different drugs. Age at onset of substance use disorder was earlier than or concomitant to that of schizophrenic and/or mood symptoms in most patients. This chronological pattern was the same in the three diagnostic groups. Clinical variables (age at onset, age at first hospitalization, number of hospitalizations) and sociodemographic variables (age, sex, educational level, marital and occupational status) did not significantly differ between patients with a lifetime history of drug abuse or dependence and those without. Patients presenting with a current abuse or dependence were younger than those without. These results confirm in a French sample of schizophrenic and/or mood disordered patients the high frequency of the comorbidity with substance use disorders.
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PMID:[Comparative study of substance dependence comorbidity in bipolar, schizophrenic and schizoaffective disorders]. 870 27

There are different opinions about the cause of chronic psychiatric symptoms observed in drug abusers between Japanese and foreign psychiatrists. The Japanese seem to recognize the chronic psychosis as the result of drug abuse. In the other hand, foreigners diagnose these cases as dual diagnosis of drug abuse and psychosis. Authors studied the problem in this research. One of the authors has examined 120 inhalant abusers of all, in- and out-patients in Kanagawa Prefectural Center of Psychiatry, Serigaya Hospital from 1991 to 1995. These patients were classified into three groups: psychosis group (23 patients), dependence group (51 patients) and abuse group (46 patients) according to their clinical courses and psychiatric symptoms. The psychosis group consists of patients who showed psychiatric symptoms such as hallucination, delusion and thought disturbance for long time after detoxification. The dependence group contains patients whose inhalant dependence was severe and met DSM-4 Diagnostic Criteria for Substance Dependence, but manifested no chronic psychiatric symptoms after detoxification. The patients belonging to abuse group were at the earlier stages of inhalant abuse and had no chronic psychiatric symptoms. The average age of the first inhalant abuse was 14.7 years old in the psychosis group, 14.8 years in the dependence group and 14.7 years in the abuse group. The average years of abuse was 9.0 years in the psychosis group, and 8.5 years in the dependence group. There was little difference between these two groups. The psychosis patients manifested chronic symptoms 5.7 years on average after the first abuse of inhalants. About one forth (26.1%) of the psychosis patients and only 5.9% of the dependence patients had family history of schizophrenia. The difference was statistically significant. These results suggest that chronic psychiatric symptoms are caused not only by inhalant abuse, but also by the genetic factors of psychosis of each patient. There have been several reports that many patients with dual diagnosis of substance dependence and other mental disorders are poly-drug abusers. In our study, 43.4% of the psychosis group patients and 19.6% of the dependence group patients had the past history of abuse of other drugs including methamphetamine and marijuana. The difference was, however, not statistically significant.
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PMID:[Inhalant abusers and psychiatric symptoms]. 871 Sep 94


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