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

We haven't to speak about "experienced-time", but about the "time-lived". The past is experienced the present time is lived in the moment, the future is anticipated. To the type of man, leaning to schizophrenia, to melancholia, to epilepsy, one of these kinds of time-realisation becomes always specifically overwhelming. For the schizophrenics the anxiety is typical, to be not able to realise his "self", because the anticipation of future is disturbed. The melancholics are anxious, not be able to remain in the orders of the past. The anxiety of the epileptics is, to lose the individual beeing in the "momentaniness" of the present. All kinds of psychoses are in an immediate context with the manner "how the self in his fundament is living and is opening the time".
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PMID:[Time and anxiety]. 403 37

The metyrapone test was applied to groups of patients suffering from major depressive illness with melancholia, mania or schizophrenia, before and after treatment. There were interesting individual correlations between post-metyrapone cortexolone values, cortexolone/cortisol ratios and clinical improvement in depressives. Two patients who had exhibited abnormal metyrapone responses displayed a normalization of post-metyrapone cortexolone values upon clinical improvement, whereas the opposite trend was observed in a patient who did not improve and in another who became manic. These preliminary results may indicate that abnormal metyrapone responses in depression are state dependent.
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PMID:The metyrapone test in affective disorders and schizophrenia II. Changes upon treatment. 615 57

The metyrapone test was applied to patients suffering from major depressive illness with melancholia, from mania, and from schizophrenia. Hypoactivity of the HPA axis as assessed by the test appears to occur infrequently in affective disorders and schizophrenia. High normal or exaggerated responses to metyrapone, as observed in Cushing's disease, appear to be correlated to DST non-suppression in melancholia.
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PMID:The metyrapone test in affective disorders and schizophrenia. 623 55

In a study of 20 inpatients who met DSM-III criteria for schizophrenia, there was a high incidence of depressed mood (N = 14), DSM-III melancholia (N = 6) and dexamethasone nonsuppression (N = 7). This incidence of positive DSTs (serum cortisol greater than 5 micrograms/dl at 3:30 or 10:00) was significantly higher than the expected rate based on a literature review (35% vs. 4%, p less than .001). A positive DST did not result in all cases in antidepressant pharmacotherapy, nor did a negative result preclude such treatment. Hence, clinicians in the study did not "treat the DST" in the absence of clinical evidence of depression. This study is consistent with others reporting a significant proportion of depressed schizophrenics. However, some studies have claimed no differences in response to dexamethasone between nondepressed and schizophrenic patients. These findings do not support a biological basis for the RDC differentiation of primary and secondary depression and challenge the DSM-III concept of schizophrenia as excluding the diagnosis of major depression. Viewed from a different perspective, the data may support recent reports casting doubt on the specificity of the DST.
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PMID:The dexamethasone suppression test in schizophrenia. 646 27

Catatonia, which until 1874 was called atonic melancholia, has remained a relative mystery despite many advances in the understanding of schizophrenia. Its typical symptoms are certainly distinctive: a motionless stupor, bizarre posturing, waxen flexibility, religious delusions, stereotyped movements, negativism, loss of will, confusion, and recurrent frenzy (Kahlbaum 1874). The processes which motivate this particular derailment of self and body have been sought in various organic etiologies, with little success. Arieti (1974) proposes several reasons for the paucity of case studies of the treatment of catatonic schizophrenia. First, catatonic schizophrenia has been declining in occurrence. Second, the symptoms themselves, such as mutism and excitement, make verbal therapy extremely difficult. Finally, catatonics often have no memory of their psychotic experiences. Psychotherapists have therefore had to rely on highly personal intuitions of their patients' crisis-in-being. Despite therapists' attention to nonverbal behavior, mutism and stupor are particularly effective hindrances to communication in psychotherapy. Psychotherapy is often not begun until the patient's symptoms ameliorate through chemotherapy and milieu support. The centrality of the verbal medium of communication in psychotherapy suggests that other approaches, using nonverbal media, may be indicated in the study of catatonia. This paper describes a treatment of a catatonic schizophrenic man which utilized movement and drama therapy. These methods were successful in evoking representations of the patient's inner life.
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PMID:Representation of the internal world in catatonic schizophrenia. 651 81

Cortex is not preprogrammed to recognise transthalamic sensory patterns or to prioritize them for motor reaction. Network subsets for these abilities are taught into neocortex in early life from the hippocampi where species-significant pattern-recognition and reaction-prioritizing ARE genetically preprogrammed. Thereafter whenever an indoctrinated subset of cortex is activated via thalamic sensory relay nuclei it axonally activates a specific subset of neurons within the thalamic pulvinar. Pulvinar analogically integrates this with concurrent specific inputs from the thalamic dorsomedial nucleus which itself is integrating inputs from the prefrontal cortex (goals) and the amygdaloid nuclei (moods). The pulvinar's specific integral is then axonally projected back to cortex UNDER NON-SPECIFIC BOOST from the thalamic centromedian nucleus. This ensures unitary attention focussing influenced by acquired priorities. Given that neocortex is genetically organized as a classifying mechanism, it also permits virtually limitless part-novel learning and best-match reality-testing of percepts (and concepts in humans). In schizophrenia the non-specific booster system is bilaterally blocked at the centromedian nucleus. In mania the non-specific thalamic system is shunted, at midbrain, into the non-specific direct cortical system. In melancholia both of these brainstem systems are subnormal in non-specific output. Figure 1 schematizes the main axonal circuitry. Analogical integration occurs within predominantly dendro-dendritic networks.
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PMID:Thalamic attention circuitry normal and psychotic. 652 73

Dexamethasone suppression tests were given to 69 consecutively admitted psychiatric patients. Nonsuppression rates for depression with or without melancholia and for schizophrenia were similar to those previously reported, but for mania and other psychoses the frequencies were higher than expected.
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PMID:The dexamethasone suppression test in psychotic disorders. 662 7

Measures of neuroendocrine function--plasma cortisol and its response to dexamethasone, and plasma thyroid-stimulating hormone (TSH) and its response to thyrotropin-releasing hormone (TRH)--were employed in 50 hospitalized male veteran psychiatric patients with diagnoses of unipolar or bipolar melancholia, secondary depression, or schizophrenia. Of 20 cases of unipolar melancholia, 17 (85%) exhibited hypercortisolism; 14 (70%) failed to suppress plasma cortisol after dexamethasone; and 4 (31%) of 13 tested had an abnormal TSH response to intravenous TRH. Two patients with secondary depression also exhibited hypercortisolism; no other patients evinced abnormal neuroendocrine test results. These measures were repeated in 14 unipolar depressed patients after a course of electroconvulsive therapy (ECT). Improvement in psychopathology was directly related to normalization of measures of hypothalamic-pituitary-adrenal (HPA) function. The TSH response to TRH was not systematically altered. After a followup period of 1 to 9 months, there was a good correlation between the measures of HPA function and the clinical outcome. These findings encourage further study of HPA function measures as outcome criteria for depressed patients receiving ECT.
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PMID:Neuroendocrine measures in psychiatric patients: course and outcome with ECT. 678 39

DSM-III and its revisions have provided little in the way of explicit historical or philosophical foundations. The logical empiricism embedded in its operational criteria and its external approach to validation are inadequate to account for the presumption of nosological regularities or the specific categories endorsed by the taxonomy. The nosologic operation that Jaspers referred to as the "synthesis of disease entities" is explored in connection with the central distinction in DSM-IV between mood disorders and schizophrenic disorders. This synthetic operation is analyzed in terms of the paradigmatic shift from the mania-melancholia matrix of pre-modern psychiatry to the manic-depression/dementia praecox model defined by the work of Kraepelin. In the context of this analysis the self-evidence of these regularities is questioned.
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PMID:Foundations of the new nosology. 796 9

This review provides a comprehensive overview of currently available treatments for psychogeriatric disorders, summarizing the efficacy of various treatment approaches based on research evidence. The severe mental illnesses in geriatric age-groups can be classified into the following groups: delirium, dementia, depression, mania, psychotic disorders, and anxiety disorders. There are specific disorders requiring specific treatments within each group. Effective treatments exist for most disorders. Effective treatment for delirium consists of identifying and treating an underlying cause, and the judicious use of medications for specific symptoms. Treatment for the dementias involves two considerations: (1) treatment of the cognitive symptoms; and (2) treatment of the behavioral symptoms. There are no currently FDA-approved, or generally acknowledged as effective, medications for the cognitive symptoms. Some medications marketed for other purposes may be used by some clinicians for treating cognitive symptoms. One medication, tacrine, is available under a treatment IND for patients with Alzheimer's disease (AD). Behavioral symptoms such as agitation, hallucinations, and delusions occur in a majority of patients some time during their illness. The treatment of behavioral symptoms involves behavioral management, environmental manipulations, and the use of medication for control of specific syndromes. The few medications assessed in randomized trials include neuroleptics and benzodiazepines. Neuroleptics such as haloperidol or thioridazine are modestly effective for some symptoms and are probably the treatments of choice for the acute, short-term. Benzodiazepines may be somewhat less effective, have cognitive-impairing side effects, are associated with increased falls, and, therefore, are less preferred. Many other medications have been suggested based largely on clinical experience. They include carbamazepine, trazodone, buspirone, and others. Treatment for depression involves consideration of acute and maintenance treatment, and of the type and severity of illness. For an acute depressive disorder of great severity, or with melancholia or psychosis either electroconvulsive therapy or the combination of antidepressant and neuroleptics may be required. Treatment requires adequate prescribing, patient education, and regular patient monitoring for compliance, symptom change, side effects, and intercurrent medical disorders which may complicate antidepressant therapy. Both antidepressant medications and brief structured psychotherapies, such as interpersonal or cognitive psychotherapies, have efficacy in the acute treatment of elderly depressed outpatients with major unipolar, nondelusional depression. Maintenance treatments are important, however, to prevent relapses or repeated episodes. Treatment recommendations are discussed. The mainstay of treatment for psychotic disorders such as late-onset schizophrenia and late-onset delusional disorder are neuroleptics. Clinical course is variable; maintenance treatments are required. Neuroleptic side effects occur with greater frequency than in younger patients.(ABSTRACT TRUNCATED AT 400 WORDS)
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PMID:Efficacy of treatment for geropsychiatric patients with severe mental illness. 808 81


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