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

We compared the general distribution of diagnoses in 20,895 patients at the Maudsley Hospital with that of 504 patients born twins, including 117 twins where the co-twin had died before the age of 15. Significant differences in diagnostic distribution were found in the co-twin-dead compared with the co-twin-alive group; the former received diagnoses of schizophrenia, personality disorder, or substance abuse more often than the latter. While there were no overall differences between twins and non-twins, there were relatively more twins in the above three diagnostic groups. We suggest that the factors leading to the death of one twin are implicated in the later psychiatric morbidity of the survivor.
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PMID:Twin birth and adult psychiatric disorder. An examination of the case records of the Maudsley Hospital. 316 76

Multiple studies have reported about substance abuse in Blacks and Hispanics. However, little is known about substance-abusing psychiatric patients of these ethnic groups. This study reports the prevalence and patterns of substance abuse among 171 consecutive patients (90 Blacks and 81 Hispanics) admitted to the acute psychiatric unit of an inner-city general hospital. The lifetime prevalence was 63%. Within the month prior to admission, 48% had used the following substances: cannabis, 40%; alcohol, 37%; amphetamines, 20%; cocaine, 12%; phencyclidine (PCP), 12%; barbiturates and/or sedative-hypnotics, 10%; opioids, 9%; inhalants, 1%; hallucinogens, 1%. Those who abused alcohol were more likely to abuse barbiturates and/or sedative-hypnotics, and opioids. Logistic regression analysis showed that major depression, ethnicity, and schizophrenia each were significant predictors of particular types of abuse. Patients with major depression were less likely to use PCP, Blacks were more likely than Hispanics to use hallucinogens, and schizophrenics were less likely to use opioids. In all cases in which sex, age, and personality disorder were significant, males, the young adult group, and those with personality disorder were more likely to be abusers. These three variables were all strong predictors of both multiple and extensive substance abuse. Overall, our findings suggest that in the inner-city, a substantial number of young adult psychiatric inpatients are a high risk group for multiple substance abuse. The coexistence of substance abuse and other psychiatric disorders has clinical and treatment implications, and calls attention for changes within the conventional psychiatric milieu.
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PMID:Inner-city substance abuse patterns: a study of psychiatric inpatients. 326 29

In this issue, Coryell and Zimmerman report no significant increase in the risk of schizophrenia or "schizophrenia spectrum" personality disorders in relatives of schizophrenics vs never-ill controls. This article attempts to evaluate critically and interpret their findings. Given the modest number of relatives studied, their negative findings regarding schizophrenia could easily be the result of sampling variation. Relatives were assessed using a general personality disorder instrument, and over two thirds were interviewed by telephone; this method may have a low sensitivity to detect key features of the schizophrenia spectrum such as inadequate rapport and suspiciousness. True population differences may, however, exist in the pattern of familial aggregation for schizophrenia and related disorders. The convincing demonstration of this would be of considerable interest and should lead to a constructive search for the source of the interpopulation differences.
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PMID:Familial aggregation of schizophrenia and schizophrenia spectrum disorders. Evaluation of conflicting results. 328 28

The authors review the literature on the diagnosis of borderline personality disorder and describe the core dynamic features that account for its unstable phenomenology and explain in part the complexity of and the controversies associated with the diagnosis. A review of differential diagnosis suggests that the boundary with schizophrenia is well established, that the boundary with affective disorder is becoming clearer, and that the most subtle boundary distinctions lie with other forms of personality disorder. A growing body of evidence about antecedents to and longitudinal aspects of borderline personality disorder confirms its diagnostic validity.
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PMID:Current overview of the borderline diagnosis. 330 24

The relationship between epilepsy and psychiatry is reviewed. It is concluded that patients with epilepsy display more psychopathology than control populations and that patients with temporal lobe epilepsy are especially susceptible to more severe psychiatric illness. Psychosis, particularly with a schizophrenia-like presentation seems associated with dominant hemisphere pathology especially with altered function. The relationship between personality disorder and epilepsy is less clear. Affective disorder is a common clinical problem, although earlier reports of a link with the non-dominant hemisphere have not been replicated in some recent studies. The problem of cognitive decline is examined and it is concluded that many patients with epilepsy show either selective or more generalized impairments of abilities. This may be related to the effects of anticonvulsant drugs, and the possibility that carbamazepine may possess psychotropic properties is noted.
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PMID:Psychiatric aspects of epilepsy. 332 98

Although adolescent norms have been developed for the MMPI (e.g., Marks, Seeman, & Haller, 1974) and Rorschach (e.g., Exner, 1986a), little is known regarding the discriminate diagnostic validity of these measures with adolescents. This study investigated the usefulness of these measures in the detection of depression and schizophrenia among adolescent inpatients. Subjects (mean age = 15.3) consisted of 134 adolescents who received Rorschach and MMPI administrations at hospital admission. Clinical diagnoses resulted in the following groupings for this sample: schizophrenia = 15, dysthymic disorder = 41, major depression = 26, conduct disorder = 28, personality disorder = 18. MMPI scale Sc elevation was found to be the most effective single predictor of schizophrenic diagnoses, with a hit rate of .76, sensitivity of .62, and specificity of .78. Neither MMPI scale D scores nor Rorschach DEPI scores were found to be significantly related to patients' diagnoses. Results were interpreted in terms of prior findings in adult psychiatric populations and in relation to implications for the clinical assessment of adolescents.
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PMID:MMPI and Rorschach indices of schizophrenic and depressive diagnoses among adolescent inpatients. 340 90

Suicide seems to be increasing in young people in various countries and causes the greatest loss of years of life under the age of 65 in the Swedish population. Data from a national survey of 50,465 conscripts in Sweden were used in a prospective follow up study to assess personality and behavioural predictors of suicide in young men. Altogether 247 completed suicides occurred in the cohort during 13 years' follow up. Baseline data on social conditions, psychological assessments, and psychiatric diagnoses of the conscripts were entered into a Cox regression model with suicide as the outcome variable. Several early indicators of antisocial personality (poor emotional control, contact with a child welfare authority or the police, and lack of friends) were strongly predictive of suicide. None of the few conscripts who had a diagnosis of schizophrenia or affective psychosis committed suicide. A diagnosis of neurosis was associated with a twofold increase in the suicide rate and personality disorder with a threefold increase. Although the risk of suicide is difficult to assess in an unselected population owing to the low base rate of suicide, the predictors identified in the study may help to identify those at high risk in units where people with deviant behaviour and personality disorders cluster.
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PMID:Predictors of completed suicide in a cohort of 50,465 young men: role of personality and deviant behaviour. 340 55

A nation-wide cohort of all first admitted patients to all Danish psychiatric institutions over a 1 year period and aged 15 years or more was followed for 10 years in the Danish psychiatric register. Revolving door patients were defined as patients with a minimum of four admissions and 1) no admission or discharge period lasting for more than 1/4 of the observation period or 2) at least four admissions over the first 1/4 of the observation period. The revolving door population comprised 1,397 patients with an incidence rate of 0.42 males and 0.32 females per 1,000. Forty-three point five percent belonged to the same diagnostic group at first and last diagnostic assessment ranging from 28.3% in "organic psychosis" to 57.6% in "neurosis". A multiple contingency analysis showed a number of variables at first admission significantly associated with the outcome "revolving door". Many were conditioned by others and the independent variables were "age group", "main diagnosis" and "sex". Patients aged 15-24 years constituted a high risk group among schizophrenics. The 15-24 age group was further at high risk among females with personality disorder or abuse and males with manic depressive and psychogenic psychosis. Living close to a psychiatric institution was in males associated with the outcome independently of age and diagnosis, in females it was restricted to personality disorder. Revolving door patients were significantly younger than others and more likely to suffer from schizophrenia or alcohol/substance abuse.
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PMID:The use of a psychiatric register in predicting the outcome "revolving door patient". A nation-wide cohort of first time admitted psychiatric patients. 343 27

Acetylcholinesterase (AChE) from erythrocytes was solubilized by Triton X-100. Size and charge heterogeneity of AChE was investigated by polyacrylamide gel electrophoresis (PAGE) and isoelectric focusing (IEF) in polyacrylamide gels in the presence of 0.5% (v/v) Triton X-100. There were no interindividual differences in these parameters in 46 psychiatric patients (schizophrenia, major affective disorder, personality disorder, dependency, dementia) and controls. The specific activity of solubilized AChE did not discriminate between controls and patients or between the diagnostic subgroups.
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PMID:Erythrocyte acetylcholinesterase in psychiatric disorders and controls. 365 30

A total of 261 regional cerebral blood flow (rCBF) studies were carried out on 34 medication-free patients with chronic schizophrenia and 50 normal subjects. rCBF, an indicator of local cortical metabolism and activity, was measured during the resting state and also during four cognitive activation tasks or "cortical stress tests." The latter included the Wisconsin Card Sort (WCS), a test of prefrontal lobe function; a simple numbers matching task, and two versions of a visual Continuous Performance Task (CPT). Multivariate comparisons of the two subject groups were performed for each of the five testing conditions, and discriminant function analyses for each condition were carried out to define mathematical models that differentiated normal subjects from medication-free patients. The best such model was determined and was then applied to another group of patients who had diagnoses other than schizophrenia or for whom the diagnosis was unclear. This group included two patients with clinical "frontal lobe syndrome" and radiological evidence of frontal lobe damage. The most robust differences between the groups were seen in frontal rCBF during the WCS. In the discriminant function analysis, rCBF during the WCS was the best discriminator between the two groups, retrospectively classifying 85% of the subjects correctly. rCBF during the resting state and one of the CPTs correctly classified subjects at a rate only marginally better than chance. When the model derived from WCS rCBF was applied to a second group of patients, the two patients with known frontal lobe disease were classified as "schizophrenic" with 100% certainty. Three other patients with psychotic illnesses were also assigned to this group with greater than 80% certainty, whereas a patient with character disorder (rule-out affective disorder) was classified as "normal" with a high level of confidence. These data suggest (1) that schizophrenia is characterized by a deficit in prefrontal function that is revealed when regionally specific demand exceeds the physiological capacity, and (2) that functional brain imaging studies, such as rCBF, can best identify brain abnormalities during "cortical stress tests."
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PMID:Cortical "stress tests" in schizophrenia: regional cerebral blood flow studies. 366 84


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