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

The uptake of tryptophan and tyrosine by the brain has been studied in 6 manic-depressive patients and in 8 schizophrenics. In an attempt to saturate the blood-brain transport mechanisms, this uptake has been evaluated by measuring the arteriovenous differences (arterial plasma-internal jugular plasma) of these two amino acids before and after perfusion with L-dopa and L-5-HTP. Considering a positive difference as an uptake and a negative one as an outflow, results show (1) in melancholia an uptake of tryptophan and an outflow of tyrosine; (2) in mania an uptake of tyrosine and an outflow of tryptophan, and (3) in schizophrenia an outflow of tryptophan accompanied with either an uptake or an outflow of tyrosine. In addition, the kinetics of tryptophan binding to plasma proteins and the ratio of tryptophan/tyrosine uptake are different in manic-depressive illness and in schizophrenia. These results support the view that a disturbance in the blood-brain transport mechanisms of tryptophan and tyrosine could be involved in the physiopathology of manic-depressive illness and schizophrenia.
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PMID:[Uptake of tryptophan and tyrosine in some cases of manic depressive psychosis and schizophrenia (author's transl)]. 61 4

We review research literature on psychotic (delusional) depression, including demographic, illness pattern, clinical, biological marker and treatment issues. Secondly, we report a study of a consecutive sample of 137 patients meeting criteria for DSM-III melancholia, RDC definite endogenous depression and our "clinical" criteria for endogenous depression, of whom there were 35 "psychotic depressives" (PDs). The PDs were contrasted with the remaining 76 depressives (EDs) and with an age and sex-matched subset (MEDs). The PDs were distinctly older than the EDs at assessment and at initial onset of any affective disorder. Compared to the MEDs, they tended to have longer illnesses, were more likely to be hospitalised (and to have longer stays), to receive (in the past and for the current episode) combination antipsychotic/antidepressant medication and/or ECT, and to have a poorer course over the following year. They were no more likely to have a bipolar pattern, a family history of depressive disorder, schizophrenia or alcoholism, or vegetative depressive features. Developmental psychosocial stressors and antecedent life event stressors were not over-represented. Most of the PDs had delusions, one-fifth reported hallucinations and psychomotor disturbance was marked. Other differential clinical findings were sustained mood disturbance, constipation, and the absence of a diurnal variation in mood and energy.
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PMID:Psychotic depression: a review and clinical experience. 167 37

Puerperal psychoses are traditionally considered to be nosologically unspecific. They are defined exclusively by their occurrence close to delivery. Attempts to further diagnostically subdivide puerperal psychoses have been prevented to date by the influence of Kraepelin's dichotomy. New possibilities of nosological differentiation arose out of Kasanin's (1933) description of schizoaffective psychoses and out of Leonhard's differentiated nosology (1986). The objective of the present, retrospective study was to apply Leonhard's nosology to 42 postpartal psychoses. Five diagnostic groups could be identified: 6 cases of manic-depressive disorder, 7 cases of pure depression, 8 cases of pure melancholia, 2 cases of unsystematic schizophrenia, and 19 cases of cycloid psychoses. For this reason we consider that the concept of the cycloid psychoses is appropriate for the characterization of a large proportion of childbed psychoses.
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PMID:Puerperal and cycloid psychoses. Results of a retrospective study. 208 73

After a statement of the works of P. Janet, in a precedent article, the authors study the lived time in Minkowski. They expose then the notions of syntony and schizoidy inherited by Minkowski from Bleuler and the diagnosis by penetration. The notion of lived time is at last studied in schizophrenia, then in mania where there is a subduction of lived time, it is the contrary in melancholia where the lived time is slower and some times stopped.
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PMID:[Minkowski's concept of lived time]. 269 89

One hundred forty-eight psychiatric inpatients, 12 outpatients, and 17 normal controls were given the 1.0-mg overnight Dexamethasone Suppression Test (DST), with salivary cortisol concentrations being measured as the dependent variable. Based on the Structured Clinical Interview for DSM-III, the patients were diagnosed as having major depression with melancholia (n = 21), nonmelancholic major depression (n = 50), mania (n = 15), schizophrenia (n = 32), dementia (n = 6), substance dependence/abuse n = 18), and miscellaneous (n = 18). Neither the melancholic major depressives nor the entire group of major depressives had significantly higher salivary cortisol pre- or postdexamethasone as compared with all the other patients combined, nor did the melancholic patients have significantly higher cortisol than the nonmelancholic depressives. The inpatients as a group had significantly higher pre- and postdexamethasone cortisol values than the normal controls; cortisol values for the outpatients were intermediate between these two groups. Illness severity (in the depressives), length of time in hospital before the DST, and medication regimen were all unrelated to DST outcome. Thus, in this study, the salivary cortisol DST showed little clinical utility in discriminating major depressives with and without melancholia from other patients with a broad range of psychiatric diagnoses. The test did distinguish between hospitalized psychiatric patients and normal control subjects and between depressed inpatients and depressed outpatients, indicating that hospitalization-related variables contributed to DST outcome.
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PMID:Specificity of the salivary cortisol dexamethasone suppression test across psychiatric diagnoses. 272 3

Depressed inpatients with psychotic features were compared to those without them in terms of demographic features, depressive symptoms at intake and family history. These variables were then used to compare patients with mood-congruent psychotic features to those with mood-incongruent psychotic features. Patterns of familial psychopathology were similar for psychotic and non-psychotic patients. In accord with other studies, the families of mood-incongruent patients had slightly more schizophrenia and significantly less depression than did the families of mood-congruent patients. Depressive symptoms, particularly those used to define major depression and melancholia, were more severe in psychotic patients. Moreover, these particular depressive symptoms were more likely to distinguish mood-congruent from mood-incongruent patients than were other depressive symptoms. Thus mood-congruent psychotic features accompanied a more typical depressive syndrome than did mood-incongruent psychotic features.
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PMID:Phenomenology and family history in DSM-III psychotic depression. 316 Jul 43

The purpose of this study was to evaluate the specificity of the dexamethasone suppression test (DST) for endogenous depression. Between July 1983 and June 1985 we collected 51 cases of endogenous depression (including 16 bipolar disorder, depressed, and 35 major depression with melancholia), 36 cases of schizophrenia (including 14 with depression and 22 without depression), 19 cases of borderline disorder with depression, 16 cases of dysthymic disorder, and 20 normal volunteers. The sensitivity of the DST in the endogenous depression group was 62.7%, which was significantly higher than that of the schizophrenic group (36.1%), the borderline disorder with depression group (31.6%), and the control group (11.1%) (including dysthymic disorder patients and normal volunteers) (X2 = 24.48, df = 3, p less than 0.001). However, the specificity of the DST was 63.9%, 68.4%, and 88.9% when the endogenous depression group was compared with the other three groups, respectively. To differentiate endogenous depression from other mental disorders (e.g., schizophrenia, borderline disorder), such critical variables as patient history and clinical symptoms may be more valuable. Many factors that were reported to be related with DST were discussed.
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PMID:The specificity of the dexamethasone suppression test in endogenous depressive patients. 325 96

Sixty-seven patients with melancholia and 42 normal controls were tested with a battery of neuropsychological tasks selected to assess regional cortical functioning in both hemispheres. Compared with controls, melancholics exhibited a pattern of bifrontal and right parietal impairment, which was independent of age, sex, handedness and drug administration. These findings confirm and extend prior studies and contrast with those we and others have reported in patients with schizophrenia.
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PMID:Cognitive dysfunction in melancholia. 360 28

The rate of abnormal dexamethasone suppression test (AbDST, post-dexamethasone cortisol greater than 5.0 micrograms/dl) was analyzed in different psychiatric samples, diagnostic categories and different time points of blood sampling. Differences in the AbDST rate in different samples were largely due to different composition of diagnostic categories and time points of samplings. By standard DST protocol (using 4 PM and 11 PM as sampling time points), melancholics had the highest AbDST rate (58.5%) among all diagnostic groups. DST was not a practical technique for differential diagnosis in psychiatric practice because of low prevalence of melancholia in the total patient population. However, it could be a promising variable for psychopathological study. The rate of AbDST was higher at the sampling time of 4 PM than any others. For one time point sampling, the 4 PM one was suggested. 8 AM and 4 PM sampling times were suggested as a practical 2-time-point sampling for DST. The rate of AbDST in different diagnostic groups had a positive relation with the severity of depressive psychopathology in a global sense. There was not any single item or any cluster of depressive symptomatology consistently related to AbDST among all diagnostic categories. Each diagnostic category had its own specific depressive symptoms in relation to AbDST, either positively or negatively. The severity of hypothalamic-pituitary-adrenal axis dysfunction, as shown in persistent AbDST and a high level of post-dexamethasone cortisol level, showed heterogeneous relation with depressive psychopathology. The relation was positive in schizophrenia and mania, was nill in melancholia, and probably reversed U relation in other psychotics and neurotics. Multiple psychopathological and pathophysiological mechanisms responsible for AbDST were suggested.
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PMID:Dexamethasone suppression test in psychiatric diagnosis and psychopathology for Chinese patients. 361 70

Investigators continue to debate whether the Dexamethasone Suppression Test (DST) reflects clinical severity or degree of melancholia ("endogeneity"). To evaluate this question, we studied 73 drug-free inpatients diagnosed with Schedule for Affective Disorders and Schizophrenia/Research Diagnostic Criteria (SADS/RDC) as having major depressive disorder (MDD). We compared absolute and dichotomous DST values (DST suppression versus nonsuppression) with absolute and dichotomous measures of endogeneity (as measured by operationally defined RDC items) and with Hamilton Rating Scale for Depression (HRSD) scores that were collected immediately prior to treatment. We found that degree of endogeneity correlated moderately (r = 0.27) but significantly (p = 0.02) with absolute DST values; DST nonsuppression increased proportionately with changes in categorical endogenous subtype (0% of the nonendogenous patients were nonsuppressives, 52% of probable endogenous, and 61% of subjects definitely endogenous); mean values for maximum DST concentrations increased steadily with categorical endogeneity (nonendogenous, 1.44 microgram/dl; probable endogenous, 7.65 micrograms/dl; definite, 10.93 micrograms/dl; p = 0.01); HRSD scores correlated more strongly (r = 0.45, p = 0.000) with maximum DST levels than did the degree of endogeneity. Age and weight changes did not account for the relationship of endogeneity to DST values. These data suggest that maximum postdexamethasone plasma cortisol levels reflect overall severity of depression and endogeneity and that endogeneity per se is highly confounded with severity.
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PMID:Relationships of the dexamethasone suppression test to clinical severity and degree of melancholia. 369 34


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