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

Affective disorders in schizophrenia overlap with positive symptoms and are co-morbid with negative changes. At schizophrenia onset, depression may emerge in the form of psychogenic disorders (posttraumatic stress disorder, juvenile asthenic failure, etc.). Depression, developing during the disease, determines clinical picture of attacks provoked psychogenically (hysterical depression, anxious depression)--reactive schizophrenia. In post-attack stages of schizophrenia, two types may be singled out--post-psychotic depression and post-schizophrenic one. The post-psychotic depressions us includes neuroleptic depression with features of anesthetic melancholia, persevering depression, akinetic depression, neuroleptic dysphoria. Its induced by antipsychotics and combine with extrapyramidal disorders.
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PMID:[Depression and schizophrenia]. 1280 May 45

Studies show high comorbidity between post-traumatic stress disorder and psychotic symptoms. Despite this fact, there has been only one published study of the neurobiology of this enigmatic disorder. This preliminary study examines the relationship between psychotic symptoms in post-traumatic stress disorder (PTSD) and schizophrenia by measuring smooth pursuit eye movement (SPEM) in subjects with PTSD and secondary psychotic symptoms, schizophrenia, and healthy controls. The results show that PTSD with secondary psychotic symptoms is associated with a SPEM deficit that is different from the SPEM deficit associated with schizophrenia.
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PMID:Differences in smooth pursuit eye movement between posttraumatic stress disorder with secondary psychotic symptoms and schizophrenia. 1289 58

This study evaluated the hypothesis that trauma and posttraumatic stress disorder (PTSD) severity would be positively associated with schizophrenia symptoms. Forty-seven clients with schizophrenia were assessed for schizophrenia severity and for lifetime trauma history and PTSD symptoms in 2 independent symptom interviews; 35 (74%) participants reported at least 1 event in which there was threat of harm or life threat and subjective distress, and 6 (13%) had current PTSD. Trauma across the life span was associated with greater severity of PTSD. Within the total sample, PTSD symptoms were associated with greater emotional distress, but not with schizophrenia-specific symptoms. Distress among clients with schizophrenia and PTSD suggests the need for routine assessment of PTSD and development of PTSD interventions in this population.
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PMID:Trauma and posttraumatic stress disorder in people with schizophrenia. 1294 20

Empirical correlates of common Minnesota Multiphasic Personality Inventory-2 (MMPI-2) 2-point codes were identified for a sample of 1,213 inpatient men. A comprehensive standardized review of the hospital record was undertaken, and clinically relevant demographic, diagnostic, and behavioral information was extracted from intake summaries obtained prior to administration of the MMPI-2. Nonmutually exclusive psychiatric diagnoses found in the sample included substance abuse or dependence, schizophrenia, depression, bipolar affective disorder post-traumatic stress disorder, and other anxiety disorders as well as personality disorders. Subsamples consisting of the five most frequently obtained well-defined 2-point code types were selected, and empirical correlates of each code type were then identified and described. Remarkable consistency was found between the empirical correlates of the code types obtained in this study and the correlates of the same code types described by other investigators 40 years ago.
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PMID:Empirical correlates of common MMPI-2 two-point codes in male psychiatric inpatients. 1450 47

Several recent studies have provided direct evidence for the link between posttraumatic stress disorder (PTSD) and psychosis. Patients with psychotic disorders are known to be at a higher risk of traumatization and PTSD. Additionally, preclinical and clinical data suggest that the effects of trauma exposure on neural networks may provide a common diathesis for disorders like PTSD and schizophrenia. This article reviews evidence on a) the magnitude of association between PTSD and psychosis, b) the causal mechanisms implicated, and c) treatment considerations relevant to this association. A comprehensive MEDLINE search was conducted, and articles pertinent to epidemiological, clinical, and treatment aspects of comorbid PTSD and psychosis were identified. High rates of PTSD characterize patients with severe mental illness. Psychotic phenomena may also be a relatively common manifestation in patients with chronic PTSD. However, in clinical settings, the diagnosis is often missed, and few systematic guidelines exist for the identification and treatment of these comorbidities. Future neurobiological and treatment studies may be useful in better informing the clinical management of these subgroups.
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PMID:Linking posttraumatic stress disorder and psychosis: a look at epidemiology, phenomenology, and treatment. 1455 70

Despite speculation concerning the accuracy of self-reported information, particularly from certain patient populations, many neuropsychologists continue to estimate premorbid intellectual functioning on the basis of self-reported educational attainment. This study examined 116 individuals with diverse diagnoses [i.e., alcoholism, posttraumatic stress disorder (PTSD), schizophrenia or schizoaffective, and dementia] to determine the accuracy of their self-reported high school educational attainment. Results suggest that at least half of all participants were inaccurate as defined by discrepancies between actual and estimated GPA greater than.5 on a traditional 4-point grading scale. Most patients were inaccurate in the direction of overestimating their educational attainment. Patients diagnosed with alcoholism and PTSD were significantly less accurate in recalling their educational history when compared to a group of normal-control subjects. Several subjects, whose records could not be verified, were found to have not attended high school as they had claimed. These results underscore the potential inaccuracy that exists when estimating premorbid intelligence using self-reported information.
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PMID:Accuracy of self-reported educational attainment among diverse patient populations: a preliminary investigation. 1459 Jun 57

This study provides preliminary psychometric support for a version of the Clinician-Administered Posttraumatic Stress Disorder (PTSD) Scale (CAPS; D. D. Blake et al., 1990) adapted for use with patients with schizophrenia (CAPS-S; J. S. Gearon. S. Thomas-Lohrman, & A. S. Bellack, 2001). Nineteen women with schizophrenia and co-occurring illicit drug use disorders were administered the CAPS-S, the Structured Clinical Interview for DSM-IV diagnoses (SCID). and scales measuring trauma-related psychopathology. The results indicate that the CAPS-S can distinguish between those with and without PTSD and that the symptom clusters measure unified constructs. Interrater and test-retest reliability were high for PTSD diagnosis and symptom clusters. Solid convergent validity was demonstrated between the CAPS-S and SCID-based PTSD diagnoses and the Impact of Event Scale. There is also preliminary evidence of discriminant validity. These results support the use of the CAPS-S in women with schizophrenia.
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PMID:Preliminary reliability and validity of the Clinician-Administered PTSD Scale for schizophrenia. 1475 21

Previous studies on sensory gating process in post-traumatic stress disorder (PTSD) have yielded conflicting results. To investigate sensory gating function in PTSD we performed a case-control study in a sample of 12 patients with PTSD related to urban violence, compared to 24 normal subjects and 12 schizophrenic subjects evaluating auditory mid-latency evoked potential P50 in a double-click paradigm as a measure of sensory gating. PTSD subjects showed poorer sensory gating as evidenced by higher P50 ratios as compared to normal subjects (85.6% vs. 44.4%, P=0.002). Test and conditioning amplitudes did not differ with statistical significance alone, suggesting a combined effect. Schizophrenic subjects had higher conditioning and marginally smaller test amplitudes when compared to healthy controls, but were not statistically different from PTSD subjects. The present study replicated previous findings of sensory gating dysfunction in PTSD. The pattern of this dysfunction resembles that found in schizophrenia, with both test and conditioning amplitudes possibly implicated. Further studies are still necessary to better understand the pathophysiology of this neurophysiological dysfunction and its nature as a trait or state marker. The P50 paradigm may also become an objective parameter to assess the effects of new treatments for PTSD.
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PMID:Impaired P50 sensory gating in post-traumatic stress disorder secondary to urban violence. 1496 72

BACKGROUND: Recent reports have shown that risperidone, which has established antipsychotic efficacy, is effective and safe in a once-daily dosing regimen. METHOD: The efficacy and safety of once-daily risperidone were assessed in a retrospective study of 27 patients with a variety of psychiatric disorders who were attending a community day treatment program. Their DSM-IV diagnoses included schizophrenia, schizoaffective disorder, bipolar disorder, major depression with psychosis, and posttraumatic stress disorder. They had received once-daily risperidone for a mean of more than 18 months. RESULTS: Disorders of most patients were controlled with once-daily dosages of 1 to 6 mg/day of risperidone. The nighttime once-daily risperidone dosage was well tolerated by patients. In addition, there was no increase in antipsychotic-related side effects, and compliance was enhanced. CONCLUSION: Risperidone was well tolerated, and no patient needed antiparkinsonian medications even at high dosages of risperidone once daily.
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PMID:Real-World Outcomes of Once-Daily Risperidone Dosing. 1501 84

Knowledge about the biological basis of psychological trauma is changing at an exponential rate. A PsychlNFO search on the search terms "locus coeruleus" and "PTSD" revealed one peer-reviewed journal article between 1982 and 1992 and 51 in the subsequent decade. A similar search revealed zero articles on "hippocampus" and "PTSD" between 1982 and 1992 and 170 in the past decade. As clinicians, it is important to become increasingly familiar with this growing literature to use that knowledge to treat and educate patients. Imagine the relief that can be provided to survivors of trauma if clinicians can tell them that they have a good idea about what causes their symptoms and even clearer ideas about how to treat them.One ancillary but invaluable outcome to this work is the fact that understanding the neurological underpinnings of PTSD will go a long way to establishing a necessary equilibrium in nature and nurture's role in the etiology and maintenance of the disorder. In its early conceptualization, PTSD was thought by many to be an ordinary reaction to an extraordinary event, thus placing responsibility for the disorder firmly in the hands of environmental factors. A subsequent emphasis on vulnerability and resiliency factors in the disorder, however, gave the impression that genetic and potentially hard-wired neurological factors were dominant in the expression of the disorder. Appreciating the balance between nature and nurture in the development of stress disorders like PTSD will allow clinicians and patients alike to appreciate the role of personal responsibility in the process of recovery. A parallel, albeit more mature process, has occurred in the area of schizophrenia in the past four decades. Early conceptualizations of schizophrenia placed a heavy burden on parenting and behavioral factors, leaving the patients angry at their parents and parents with unnecessary guilt. The later dominance of genetic and biological theories in the disorder allayed parents of their guilt, but left both parents and patients wondering what might be done in the face of such an affliction. Modern theories of schizophrenia seem to have achieved an appropriate balance that recognizes biological vulnerabilities, but also emphasizes familial and patient responsibilities in recovery and care. In PTSD, a similar equilibrium needs to be found, and understanding the neurobiology of the disorder will go far in achieving that goal. When it is understood how trauma affects the brain and how treatment produces neurobiological changes that may remediate trauma-related effects, the patient will be in a better position to make choices about what can and cannot be done in the process of recovery. Giving patients this critical internal locus of control will provide therapeutic benefits such as confidence,self-esteem, and hope that are likely to enhance changes that occur with intervention.
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PMID:Clinical correlates of neurological change in posttraumatic stress disorder: an overview of critical systems. 1506 30


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