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

The historical antecedents of the current diagnostic criteria for mania involve the German phenomenologic descriptions of the late 1800s, the introduction of lithium for treatment and prevention of mania (which broadened the definition of mania in this country), the attempts to subclassify bipolar disorder into at least two subtypes, and the differentiation of patients with mania and hypomania from those with depression alone. Current diagnostic criteria for bipolar disorder are delineated in DSM-III-R. The differential diagnosis of bipolar disorder includes other conditions that may have manic-like symptoms, including organic mood disorders such as endocrine or metabolic conditions, drug intoxications, and tumors. Mania occurring in the context of substance abuse would be called a secondary mania. In addition, schizoaffective disorder can be diagnosed if there is a manic syndrome superimposed in the context of schizophrenia. Because of the absence of duration criteria for mania in DSM-III-R, the differential diagnosis within the bipolar disorders is largely based on severity and duration of depression. A problem in studying mania at present is that the prototypic cases have largely disappeared from treatment centers because of the success of lithium maintenance treatment. Patients available for study at psychiatric treatment facilities are largely treatment resistant, atypical, and likely to have experienced considerable amounts of substance abuse in their histories. Among the changes being considered for DSM-IV are to include duration criteria for mania, to separate bipolar II patients (depression and hypomania) from bipolar not otherwise specified, to refine the criteria for hypomania, and to add rapid cycling to the list of parenthetical modifiers for bipolar disorder with mania and bipolar disorder with hypomania.
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PMID:Differential diagnosis of bipolar disorder. 154 21

A total of 18 outpatients (17 male, 1 female) ranging in age from 36-66 years old were on a constant dosage of haloperidol in equally divided doses at 9:00 a.m. and 9:00 p.m. for at least 1 month. DSM-III-R diagnoses included schizophrenia (N = 9), schizoaffective disorder (N = 3), bipolar disorder (N = 4), organic mental disorder (N = 1), and delusional disorder (N = 1). Blood samples for steady-state concentrations of plasma and red blood cell haloperidol (H) and reduced haloperidol (RH) were drawn at 9:00 a.m. (12 hr trough). The haloperidol dosage was held at 9:00 a.m. until samples of whole saliva and parotid saliva could be collected for flow rates and concentrations of H and RH. Haloperidol dosages ranged from 1 mg/day to 60 mg/day (mean 11 +/- 15). Correlation coefficients were calculated for saliva concentrations versus blood levels and for saliva secretion rates versus blood levels. The correlations between whole saliva measures and blood concentrations were all higher than the correlations between parotid saliva measures and blood concentrations. In one case the higher correlation reached statistical significance. There was only one case in which substitution of saliva secretion rate improved the correlation between measures with saliva concentration. Our findings suggest that saliva measures of H and RH are useful alternatives to plasma concentrations in monitoring maintenance haloperidol treatment.
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PMID:Haloperidol and reduced haloperidol in saliva and blood. 162 85

One piece of genetic evidence for the biological distinctness of schizophrenia and bipolar illness is the rarity of monozygotic twin pairs in which one twin suffers from schizophrenia and the other from bipolar disorder. The authors describe a pair of monozygotic mirror-image twins with discordant diagnoses, schizophrenia in one twin and bipolar or schizoaffective disorder in the other.
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PMID:A monozygotic mirror-image twin pair with discordant psychiatric illnesses: a neuropsychiatric and neurodevelopmental evaluation. 163 8

This paper reviews recent literature on schizoaffective disorder. Research studies of diagnosis, clinical course and outcome and family history are evaluated. It is concluded that schizoaffective disorder is a heterogeneous category which includes patients with bipolar disorder, schizophrenia, a genetically distinct psychosis and a genetic disposition to both schizophrenia and bipolar disorder.
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PMID:A review of schizoaffective disorder: I. Current concepts. 163 57

Of a large sample of patients with paranoid psychoses consecutively admitted to the Psychiatric Department, University of Oslo, during a period after World War II, 10 patients (6.3%, 9 women and 1 man) became ill through accusations of unpatriotic conduct during the war. The psychosis seemed precipitated in connection with legal procedures against the patient in 3 cases, and against close relatives in 2 patients. In 2 cases mixed precipitating events were present, while the psychosis in 3 cases had a connection with the woman being intimate with occupation soldiers. Discharge diagnosis according to DSM-III was schizophrenia (n = 2), schizophreniform disorder (n = 4), schizoaffective disorder (n = 1), major depressive disorder (n = 1), mania (n = 1), and atypical psychosis (n = 1). The patients have been followed up twice, with a mean 31 years of observation. Course and outcome varied, mostly according to the diagnosis. Most patients had a favorable global outcome, although they had a tendency to keep up their social isolation. None of the patients felt they had done anything wrong or regretted their behavior during the war.
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PMID:Delusional psychoses associated with unpatriotic conduct during World War II: a long-term follow-up study. 175 52

Three interviewers (second raters) blindly rated 15 audiotapes each of the Structured Clinical Interview for DSM-III-R, Axis II (SCID-II) administered to the first degree relatives of probands with either DSM-III-R schizophrenia, schizoaffective disorder, or bipolar disorder, for a total of 45 second ratings. Interrater reliability was determined using the intraclass correlation coefficient and ranged from 0.60 to 0.84. The previous studies of the reliability of structured interviews for diagnosing personality disorders are summarized and compared to the present findings. We conclude that the SCID-II can be reliably used to diagnose schizophrenia-spectrum and affective spectrum disorders in the first degree family members of probands with schizophrenic or bipolar affective disorders.
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PMID:Interrater reliability of the Structured Clinical Interview for DSM-III-R, Axis II: schizophrenia spectrum and affective spectrum disorders. 177 Dec 9

The authors interviewed 32 patients (25 with an RDC diagnosis of schizophrenia and seven with schizoaffective disorder) consecutively admitted to a psychiatric outpatient clinic. Ten patients had a history of photophilic behaviour with sun-gazing, while 20 patients showed no unusual behaviour related to light. Two patients who had depressive symptoms at the time of interview had a history of photophobic behaviour. Sixteen patients and 12 controls were tested for their threshold for discomfort of high intensity light; the thresholds were significantly higher in the patients with schizophrenia (especially in those with history of sun gazing). The implications of these findings for clinical practice and research are discussed.
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PMID:Photophilic and photophobic behaviour in patients with schizophrenia and depression. 177 4

The authors used a randomized, placebo-controlled design to assess the therapeutic efficacy of adjunctive imipramine, added to fluphenazine decanoate and benztropine, among well-stabilized, negative-symptom schizophrenia and schizoaffective disorder patients who additionally met operationalized criteria for postpsychotic depression. The outcome of the imipramine-treated group was superior in both global ratings and a specific negative-symptom scale. Exacerbation of psychotic symptomatology was not found to be problematic. The implications of this study are discussed in terms of a potential strategy for pharmacotherapy among certain negative-symptom patients and in terms of its relevance to a possible pathophysiological basis for the negative-symptom state.
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PMID:The use of antidepressants for negative symptoms in a subset of schizophrenic patients. 177 7

200 first admissions with functional psychoses were interviewed with PSE and rated simultaneously according to different diagnostic criteria (ICD-9, RDC, DSM-III, St. Louis, Taylor, Vienna Research Criteria). At follow-up 7 years later 186 patients could be traced and a course diagnosis was applied to each patient. Temporal stability of diagnostic criteria was calculated for ICD-9, RDC and DSM-III by stability coefficient and kappa values and was used as a criterion for validity. Schizophrenia and affective disorder display considerable stability over time, no matter whether one uses ICD-9, RDC or DSM-III. The data for schizoaffective disorder are less impressive, the stability coefficient is much higher for schizoaffective bipolar than for schizoaffective depressive patients.
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PMID:Temporal stability of diagnostic criteria for functional psychoses. Results from the Vienna follow-up study. 178 9

The expression of schizotypal personality traits was assessed in mid-adolescence and again in young adulthood for three groups of offspring defined by the psychiatric diagnosis of their parents. Parental diagnoses included schizophrenic disorder (47 offspring), affective disorder (39 offspring), and 'no psychiatric disorder', or normal controls (82 offspring). Initially, schizotypal traits were assessed from video-taped semi-structured psychiatric interviews, subsequently rated by trained psychiatrists blind to the parental psychiatric status of the subjects, and/or direct clinical interviews (Schedule for Affective Disorders-Lifetime Version (SADS-L)). The second assessment was conducted by trained social workers and psychologists by means of a semi-structured interview specifically for DSM-III-R personality disorders (Personality Disorder Examination) and sections of the SDS-L where indicated. These interviewers were blind to the parental status and to previous psychiatric assessments of the offspring. The rates of stability of features or the rates of progression to axis I psychotic disorders (Schizophrenia, Schizoaffective Disorder, and Unspecified Functional Psychosis) were evaluated. Concordance of assessments over time is reported as a function of threshold for expression of traits at initial evaluation, i.e., two or more, three or more, or four or more features present. Concordance increases as the threshold for expression increases, as expected. The effect of comorbid clinical status, e.g., the coexistence of schizotypal traits and anxiety and/or depressive features on the concordance pattern, is also examined by parental diagnostic group status. The offspring of affective disorder parents exhibited higher rates of anxiety and/or depressive features at both points in time, exhibited higher concordance for anxiety and/or depressive features, and exhibited higher rates of 'transformation' of initial schizotypal features to anxiety and/or depressive features at the second assessment.
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PMID:The assessment of schizotypal features over two points in time. 178 36


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