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

1. Preclinical studies reveal that long-term treatment with antidepressant drugs induces significant changes in serotonergic (5-HT) receptor sensitivity. Similarly, clinical studies suggest that brain 5-HT function is abnormal in depression. Of the available methodologies for conducting such clinical studies, the pharmacological challenge strategy has proven particularly useful. 2. I.v. L-TRP has emerged as the most frequently used challenge agent in diagnostic and neuropsychopharmacological studies of 5-HT function. I.v. L-TRP increases serum prolactin (PRL) in humans, probably via 5-HT mechanisms. Under carefully standardized conditions, this PRL response to L-TRP appears to be a reasonably sensitive and valid measure of net 5-HT function. 3. The PRL response to L-TRP is blunted in depressed patients compared with healthy controls. Blunting has not been observed in panic disorder, obsessive compulsive disorder, or schizophrenia, although preliminary findings suggest it may occur in bulimia. 4. The PRL response to L-TRP is enhanced by certain classes of thymoleptic drugs (TCAs, MAOIs, 5-HT reuptake inhibitors, lithium) in a differentially time-dependent fashion. So-called "atypical" antidepressants (trazodone, mianserin) and benzodiazepines have no effect. Such findings are generally consistent with preclinical electrophysiological findings. 5. These clinical studies of the PRL response to L-TRP, in conjunction with emerging evidence that experimentally reduced plasma TRP can reverse the therapeutic effects of some antidepressants, suggest that antidepressant drug action may be more accurately conceptualized as 5-HT dependent rather than 5-HT enhancing. The availability of more selective 5-HT-active drugs promises to further clarify 5-HT mechanisms of neuropsychiatric disease and drug action at the clinical level.
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PMID:Clinical studies of 5-HT function using i.v. L-tryptophan. 223 80

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

Until the early 1980s, the only estimate of the prevalence of obsessive compulsive disorder (OCD) in the general population was 0.05%. Data collected from the Epidemiology Catchment Area (ECA) survey have suggested that OCD is 50 to 100 times more common than previously believed and twice as common as schizophrenia or panic disorder in the general population. These results have been corroborated in a second, more carefully designed epidemiologic study. Several reasons account for the previous underestimation of the prevalence of the disorder: (1) reluctance of patients to divulge their symptoms; (2) lack of recognition of the diversity of presenting symptoms in OCD by professionals; (3) misdiagnosis; (4) failure to ask OCD screening questions in the routine mental status examination. Demographic and clinical characteristics of the disorder have been consistent across studies and time, supporting the validity of current nosologic criteria and the disorder's relative homogeneity. OCD appears to be familial, suggesting that genetic factors play a prominent role in the phenotypic expression of illness.
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PMID:Epidemiology of obsessive compulsive disorder. 240 65

A structured interview, the Dissociative Disorders Interview Schedule, was administered to 20 patients with multiple personality disorder, 20 with panic disorder, 20 with eating disorders, and 20 with schizophrenia. The frequencies of somatization disorder and of individual somatic symptoms in the four groups were compared. The multiple-personality patients reported more somatic symptoms than the other groups. Of the 20 multiple-personality patients, seven met the criteria for somatization disorder. The average number of somatic symptoms per multiple-personality patient was 13.5.
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PMID:Somatic symptoms in multiple personality disorder. 271 Sep 14

The Dissociative Disorders Interview Schedule was administered to 20 subjects with multiple personality disorder, 20 with schizophrenia, 20 with panic disorder, and 20 with eating disorders. The findings showed that multiple personality can be differentiated from the other groups on variables such as history of physical abuse, sexual abuse, substance abuse, sleepwalking, childhood imaginary playmates, secondary features of multiple personality and extrasensory and supernatural experiences. Those with multiple personality also differ from the other groups on DSM-III criteria for multiple personality, psychogenic amnesia, and psychogenic fugue. The groups did not differ on the number of subjects who had had a major depressive episode.
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PMID:Differences between multiple personality disorder and other diagnostic groups on structured interview. 276 Jun

Fear is an adaptive response of the organism to external threat and the physiologic and behavioral responses to stimuli that induce fear involves activation of the sympathetic nervous system. Drugs that alter the function of two of the major brain monoamine neurotransmitter systems involved in sympathetic nervous system regulation (NE and 5-HT) have been shown to alter levels of "fear and anxiety" in laboratory animals, healthy humans, and patients. The relative clinical efficacy in the treatment of anxiety disorders with many of these drugs also emphasizes the importance of these two systems in anxiety. Recent advances in neuropharmacology have led to an improved understanding of how drugs that interact at specific NE and 5-HT receptors alter the function of these two neurotransmitter systems, and a few of the drugs that selectively interact at NE and 5-HT receptors have been used in studies of patients with anxiety disorders. Stimulation of the 5-HT system does not produce marked abnormalities in patients, but stimulation of the NE system does produce abnormal changes in measures of anxiety, somatic symptoms, blood pressure, and a plasma NE metabolite and cortisol levels in patients with panic disorder but not in patients with generalized anxiety disorder, obsessive-compulsive disorder, depression, or schizophrenia. This indicates that some patients with panic disorder have an abnormality in the regulation of the NE system that could explain many of the clinical features of this syndrome. Progress in assessing neurochemistry in the brains of living patients through brain imaging and new advances in the molecular biology of neurotransmitter receptor proteins will offer important new methods to be used in the study of these possible abnormalities.
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PMID:Monoamine receptor systems and anxiety disorders. 284 38

This article reviews electroencephalographic sleep studies in schizophrenia, obsessive-compulsive disorder, eating disorders, panic disorder, borderline personality disorder, Alzheimer's disease, and certain instances of substance abuse.
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PMID:Sleep disturbances in various nonaffective psychiatric disorders. 290 3

This article reviews the interrelationship between panic disorder and vestibular function. There is a possibility of both somatopsychic and psychosomatic interactions between panic and the vestibular system. Another possibility is that vestibular dysfunction could be associated with certain mental disorders, including panic disorder, as a nonspecific marker. Somatopsychic interactions are suggested by findings of high prevalence of vestibular dysfunction in selected patients with panic disorder, by the occurrence of "space and motion phobia" in patients with panic disorder, and by the report of anxiety and pseudoagoraphobia in some patients with a primary complaint of vertigo. Psychosomatic influences include symptoms of dizziness and increased sensitivity of the vestibular system due to anxiety or hyperventilation. Vestibular dysfunction as a nonspecific marker is discussed in the context of a review of studies of the vestibular system in schizophrenia. Before more definite conclusions can be drawn whether panic disorder is related to vestibular dysfunction in some cases, further research is needed to establish the specificity of vestibular dysfunction for panic disorder.
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PMID:Panic disorder and the vestibular system. 304 5

The reliability of psychiatric diagnosis using the Schedule of Affective Disorders and Schizophrenia-Lifetime Version in personal and telephone interviews with 39 subjects was assessed using a 12- to 19-month test-retest design. Interrater reliability was high (kappa, .69 to .84) for the diagnosis of panic disorder, agoraphobia with panic attacks, probable panic disorder, major depression, and alcohol abuse. We conclude that it is possible to reliably make these lifetime diagnoses in a family study using the telephone interview.
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PMID:Reliability of the telephone interview in diagnosing anxiety disorders. 333 10

Twenty persons with schizophrenia were identified in a community sample of 2144 adult household residents interviewed by trained lay interviewers using the Diagnostic Interview Schedule. The hierarchy-free lifetime prevalence for a variety of psychiatric disorders is compared in those with and without schizophrenia. Those with schizophrenia were found to have increased chances of having other disorders, all except one having had at least one other disorder. Major depressive episodes, obsessive compulsive disorder, phobia, alcohol abuse/dependence and drug abuse/dependence, each occurred in over half of the schizophrenics, and panic disorder, antisocial personality, and mania were each found in one sixth to one quarter of the schizophrenics. Although current diagnostic systems generally lack an empirical basis for hierarchies, the practical significance of co-morbidity must be determined from outcome studies, familial morbid risk data and possible differential effects of treatments.
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PMID:Schizophrenia: lifetime co-morbidity in a community sample. 349 58


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