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

After John Warnock Hinckley jr. had fired shots at President Reagan and had severely injured three others, he was considered not guilty by reason of insanity and brought to a psychiatric hospital. The case caused an unprecedented public interest because the psychiatric testimonies were contradictory (schizophrenia vs. personality disorder). According to the known facts it is very unlikely that a German psychiatrist would have diagnosed Hinckley as schizophrenic. One of the sequels of the sentence was a lowering of the reputation of psychiatrists for their inability to arrive at clear diagnosis. Another sequel was to increase the funds for research in biological psychiatry. Still another sequel was an insanity defense reform bill. The scientific debate and public discussions continue.
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PMID:[The Hinckley case and some sequelae for psychiatry]. 226 96

The present study involves a retrospective chart review of all patients who visited the Emergency Mental Health Service during the period of July 1, 1985 to June, 30, 1986 (total visits = 2,772). It compares those 'suicidal' patients seen only once during the index year with those seen multiple times (comparison of first visit only for both 'one-timers' and 'repeaters'). The 'repeaters' were generally found to be older and were more likely to have a diagnosis of schizophrenia and personality disorder. Unlike previous studies, substance abuse and affective disorder did not significantly differentiate the two groups. The 'repeaters' were also more likely to be taking antipsychotic and antiparkinson medications, have histories of past psychiatric hospitalizations in the public sector, be living alone, and most importantly, to have made a previous suicide attempt.
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PMID:Repetitive suicidal crises: characteristics of repeating versus nonrepeating suicidal visitors to a psychiatric emergency service. 227 20

This article is a short review of associations between depression and suicide, and formed part of a symposium held in Munich in August 1988 to discuss toxicity in antidepressive therapy. The association between depressive disorders and suicide is well documented. The detailed characteristics of this association, however, are still under discussion. Phenomenological aspects of depression seem to be more important than nosological ones, especially associations between personality traits, aggression and depression. Differentiation of depressions into primary and secondary depressive disorders (the latter as consequences of somatic or especially other mental disorders, such as schizophrenia, personality disorder, or alcoholism) can be a fruitful approach to elucidating differences in the suicide pattern of these different disorders. Recurrent depressive episodes, although they may be short, may have as severe mental symptoms as more longstanding episodes and thus partly explain suicide in nonpsychiatric as well as psychiatric populations. Ways of preventing suicide are discussed from biological and clinical perspectives.
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PMID:Depression and suicide. 240 88

Admissions for mania have risen significantly in Edinburgh since 1970. Differencing was used to remove time trends; this showed that the rise was not accounted for by diagnosis change (from schizophrenia or personality disorder) or by lithium prescription. The contribution of non-specific factors such as admission policy and the experience of trainee psychiatrists deserves evaluation. If this rise continues there will be significant resource implications for the future.
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PMID:Diagnosis change, lithium use and admissions for mania in Edinburgh. 259 40

A survey was conducted of 47 suicides, 16 failed suicides, and 24 attempted suicides that occurred from Brisbane river bridges over 15 years. Compared with findings from other suicide surveys, subjects of bridge suicides and failed suicides had a much higher rate of schizophrenia (46%), with hallucinations often precipitating the jump. They also had extensive histories of previous self-harm. Those who attempted suicide by jumping had a higher rate of personality disorder (58%) compared with findings from other attempted suicide surveys, and had very extensive histories of previous self-harm which tended to continue beyond the bridge incident. Both groups had histories of extensive previous psychiatric care.
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PMID:Suicide and related behaviour from river bridges. A clinical perspective. 262 Feb 10

The aggregation of disorder in families identified by a schizophrenic disorder proband (index case) has provided indirect clues to the question of diagnostic boundaries of schizophrenic spectrum categories. The Danish Adoption Studies provided quasi-experimental evidence for the range of expression of a putative schizophrenic spectrum disorder which was subsequently denoted schizotypal personality disorder (STPD) in DSM-III-R. It has been hypothesized that such schizophrenic spectrum categories bear a genetic relationship to schizophrenic disorder and thus are continuous with schizophrenia in terms of etiology and pathogenesis. For meaningful use of such spectrum categories in genetic analyses, i.e., linkage analysis, it is important that rates of spectrum traits and disorder in normal control and in psychiatric control populations are known. The rate of DSM-III-R schizotypal traits and disorder was assessed in three offspring groups (ages 18-29) defined by parental diagnoses, including schizophrenic disorder (N = 90), affective disorder (N = 79), and no parental disorder (N = 161). The assessment was conducted by trained social workers and psychologists by means of a direct interview (Personality Disorder Examination). The interviewers were blind to the parental status and to previous psychiatric assessments of these offspring. The rates of three, four and five schizotypal features were elevated in the offspring with parental psychiatric disorder in contrast to the offspring with no parental psychiatric disorder. However, the rates between the offspring of the schizophrenic disorder parental group and the offspring of the affective disorder parental group did not differ significantly, thus failing to support the assumption of diagnostic specificity.
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PMID:DSM-III-R schizotypal personality traits in offspring of schizophrenic disorder, affective disorder, and normal control parents. 263 20

Over a 12-month period in 1985-1986, 325 cases of deliberate self-poisoning were admitted to the Princess Alexandra Hospital in Brisbane. This survey confirms that deliberate self-poisoning remains common, accounting for 19.6% of all admissions to the intensive-care unit, and 5.4% of all medical-ward admissions. In 232 (71.4%) cases formal psychiatric consultation occurred, and some form of follow-up was organized in 227 (69.8%) cases. In the total group, the female-to-male ratio was 1.5 to one. In the 325 cases, a total of 489 substances was consumed. Benzodiazepine agents were consumed the most often (39.5% of all substances), followed by antidepressant drugs (11.7% of substances) and paracetamol (7.2% of substances). Barbiturate drugs, which previously have been shown to be prominent in deliberate self-poisoning, accounted for only 1.6% of the substances that were used in this survey. Alcohol was consumed in almost one-third (31.1%) of cases. The diagnosis of adjustment disorder with depressed mood was the most-frequent primary diagnosis (64.8% of diagnosed cases), followed by personality disorder (16.7% of diagnosed cases), schizophrenia (5.5% of diagnosed cases) and major depression (3.7% of diagnosed cases). Nearly one-half (46.8%) of all cases involved a past history of deliberate self-poisoning. Comparison of the results of this survey with those of past surveys shows that the profile of deliberate self-poisoning is changing. Barbiturate usage has declined markedly with a reciprocal increase in benzodiazepine usage. A review of the prescribing pattern of antidepressant agents in groups of individuals who are at high risk of deliberate self-poisoning is suggested in the light of the frequency of this phenomenon.
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PMID:A survey of deliberate self-poisoning. 271 41

Using a semi-structured interview, 18 DSM-III borderline personality disorder (BPD) patients and 17 other (nonborderline) personality disorder (OPD) patients were compared blind 4 1/2 years after their index discharge. Although significantly younger and mostly single, BPD patients did not differ from OPD patients in the degree of overall psychopathology or in the level of psychosocial functioning and adjustment. They do not seem to represent a particularly severe personality disorder group. Those characteristics differentiating BPD patients from affective disorders and schizophrenia may be nonspecific regarding other personality disorder types. As such, more attention should be paid to cases of OPD in the future.
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PMID:Follow-up study on borderline versus nonborderline personality disorders. 273 22

Inpatients from the Chestnut Lodge follow-up study diagnosed with character disorder were studied to predict future schizophrenic decompensation. Individually, three DSM-III criteria for schizotypal personality disorder predicted schizophrenia at long-term follow-up: magical thinking, suspiciousness or paranoid ideation, and social isolation. Additionally, lower IQ, poorer premorbid quality of work, and transient delusional experiences were predictive. No borderline personality disorder criterion was predictive. This suggests that schizotypal but not borderline personality disorder belongs in the schizophrenic spectrum. Within schizotypal personality disorder, criteria from both familial and clinical traditions appear to be dimensions of vulnerability to psychosis.
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PMID:Risk of schizophrenia in character disordered patients. 278 71

Between 10 and 30% of depressed patients, mostly bipolar, develop a therapy-resistant illness. The known causes of such chronic evolutions are discussed: misdiagnosis (underlying schizophrenia, personality disorder or dementia), drug-induced depression (neuroleptics), systemic disease (hypothyroidism, multiple sclerosis, cardiovascular or neoplastic disease etc.), or lack of efficacy (drug compliance, insufficient dosage). Remedies are suggested: adequate dosage, drug combination (Newcastle cocktail. tricyclic antidepressant + MAOI, imipramine + T3), carbamazepine in lithium-resistant cases, alprazolam, reduction in vanadium intake, sleep deprivation, psychosurgery.
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PMID:The management of resistant depression. 308 16


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