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

Suicidal behaviours are multifactorial behaviours. While, historically, anxiety has not been regarded as an important risk factor in suicidal behaviours, recent epidemiological studies carried out on general population or panic patients have evidenced the possible links between suicidal behaviours and the occurrence of panic attacks. The aim of our study was to validate the hypothesis which stipulates that panic disorder may contribute to an actualization of suicidal behaviour in trying to establish the prevalence of panic disorder in a population of suicidal attempters. The diagnoses were reached after an interview using the Schedule for Affective Disorders and Schizophrenia-Lifetime Version modified for the study of Anxiety disorders (SADS-LA). The medical seriousness of the suicide attempts was assessed with the Risk Rescue Rating Scale (RRRS) of Weissman and Worden and the suicidal intent with the Suicidal Intent Scale of Beck (SIS). In the 62 suicide attempters hospitalized after minor or slightly more serious suicide attempts, we found high current and life-time prevalence of panic disorder (17.7% and 22.6% respectively). Comorbidity with major depressive episodes and addictive behaviours in suicide attempters with panic disorder was high. Current comorbidity rates were 72.8% and 27.3% respectively; life-time comorbidity rates were 71.4% and 21.4%. Patients who suffered from major depressive disorder with related panic disorder were given to more impulsive suicide attempts, even if the difference with depressed patients without panic disorder was statistically insignificant.
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PMID:[Suicide attempts and panic disorder: a study of 62 hospitalized suicidal patients]. 778 88

We examined for risk factors for suicide among psychiatric in-patients by comparing 37 in-patients from an Ontario Provincial Psychiatric Hospital who had committed suicide with 37 age and sex matched in-patient controls. Significantly more of the suicide victims had made a previous suicide attempt (62.2 v. 35.1%), suffered from schizophrenia (75.7 v. 35.1%), were involuntary at their last admission (70.3 v. 43.2%) and lived alone (70.3 v. 43.2%). Only six patients committed suicide on the ward. Almost a third of the patients, the majority schizophrenic, committed suicide after having been in the hospital for more than a year. These results suggest that in the psychiatric hospital setting the in-patient at risk for suicide has previously exhibited suicidal behaviour, suffers from schizophrenia, was admitted involuntarily, lives alone and that the risk of suicide may remain high among long-stay schizophrenics.
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PMID:Suicide among psychiatric hospital in-patients. 779 56

Suicide provocates 0.5 to 1% of the deaths in France. Every year, more than 12,000 people die by suicide. In France, the annual incidence rate of suicide is 21/100,000. Among young people (15 to 24) suicide rate is 13.9/100,000 in men and 4.2/100,000 in women. Methods of suicide are hanging (38%), firegun (23%), overdose (13%) and drowning (10%). Among the suicides, most subjects are unmarried, live alone and more often in Paris. Suicide is more frequent during the day than during the night, in the beginning of the week, in summer and in spring. Suicide rates in France are comparable to those observed in United States and Great Britain. Suicide appears to be closely related to psychiatric morbidity. Most frequent psychiatric diagnosis in patients who commit suicide are depression (64%), alcoholism (15%), schizophrenia (3%) and anxiety (3%). History of depression is associated with a 30 fold increase in suicide risk. Globally, the annual incidence of suicide among depressives is 1% and 15% of the depressives die by suicide. When depressive symptoms are retrospectively assessed, it appears that 45 to 70% of patients who committed suicide presented depression. Depressives older than 50 and patients with history of attempted suicide have a greater risk of suicide. Among schizophrenics, frequency of suicide is 10 to 13%. Suicide are more frequent during the first ten years of the illness. In patients presenting panic disorder, frequency of suicide is variable according to the authors, between 30% and 3%. Attempted suicide are much more frequent than suicide. The annual rate is 162/100,000 in men and 265/100,000 in women.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:[Prevalence and risk factors of suicide and attempted suicide]. 782 12

We report a prospective study of 65 burned inpatients referred for psychiatric consultation. All of the subjects in the sample were evaluated by a structured questionnaire and clinical interview. Reasons for referral were: suicide attempt by burning (n = 7), substance dependence (n = 8) and behaviour disturbed by coping difficulties (n = 50). The diagnoses were adjustment disorder (n = 40), alcohol dependence (n = 7), opiate dependence (n = 2), dementia (n = 3), depressive disorder (n = 5), schizophrenia (n = 1), delirium (n = 1) and post-traumatic stress disorder (n = 5). Patients with post-traumatic stress disorder (PTSD) were specifically and carefully evaluated. There were no significant differences between patients with PTSD and adjustment disorder for severity and type of burn injuries. We conclude that PTSD is apt to be missed by the medical staff of burn units.
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PMID:Psychiatric consultation and post-traumatic stress disorder in burned patients. 788 Apr 20

This publication presents a case of 38-year old woman suffering from schizophrenia, whose body temperature reached 41 degrees C after she had taken 1250 mg of levomepromazine during a suicide attempt. Initially, the dominant symptoms were quantitative and qualitative disturbances of consciousness and periodically increased psychomotor activity, negativism, hallucinations, delusions, schizophrenic disturbances of affect became prominent. When the patient was hospitalized on the internal diseases ward, only symptomatic treatment was conducted, while the cause of the patient's high temperature was still investigated. Only when acute lethal catatonia was diagnosed and ECT was used, did the patient recover. In the event of rapid onset of high temperature in a patient with a mental disorder, a possibility of acute lethal catatonia must be always considered. A differential diagnosis of this disorder with neuroleptic malignant syndrome is very important, as the treatment is quite different. Many M.D.s aren't aware that high body temperature may be a symptom of a mental disease.
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PMID:[Diagnostic difficulties and efficacy of electroconvulsive therapy in the treatment of lethal catatonia]. 790 92

The purpose of this study was to observe the treatment of patients suffering from schizophrenic disorders and to assess the cost of this treatment in medical and social terms. The survey based on a questionnaire was sent to 6,000 French psychiatrists practising both in the hospital sector and in the ambulatory sector, whether acting through the national health service or privately. The psychiatrists who accepted to answer (N = 494) described all the treatment and assistance undergone by the last patient suffering from schizophrenia, as defined by the DSM III-R, seen either during a consultation or when hospitalized during the previous year. The clinical, epidemiological and therapeutic information collected for 356 patients treated as out-patients (72%) and 138 hospitalized patients (28%) in the public (49%) or private (51%) sectors underwent medical and economic modelling. The most frequent forms of schizophrenia encountered were paranoid type (48.6%) and those which developed chronically without severe exacerbation (32%). The average length of time between the date of the survey and the first symptoms is on average 11 +/- 8 years and the average length of time between the date of the survey and the first symptoms is on average 11 +/- 8 years and the average length of time between the first hospitalization is 9.5 +/- 8 years. This means that the time between the first symptoms and the first hospitalization is 25 +/- 4 months on average. The average number of previous full-time hospitalizations is 4 and the patients spent 22 months (+/- 48) in hospital on a full-time basis and 26 months (+/- 39) as day patients in hospital, from the start of their disorders. 27% of patients had at least one previous suicide attempt and 28% had already committed a medico-legal act.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:[Therapeutic management of schizophrenic patients and its cost]. 808 33

Social phobia was studied in a North Carolina community, using DSM-III criteria. Two kinds of comparison were made: social phobia v. non-social phobia, and comorbid social phobia v. non-comorbid social phobia. Six-month and lifetime prevalence rates were 2.7 and 3.8% respectively. Social phobia had an early onset, lasted a long time and rarely recovered. Predictors of good outcome recovery in a logistic regression analysis were onset of phobia after age 11, absence of psychiatric comorbidity and greater education. The disorder was often missed in medical consultation. Increased rates of psychiatric comorbidity existed, especially for other anxiety disorders and for schizophrenia/schizophreniform disorder. There was increased risk of neurological disorder. Social phobia was also associated with an increased rate of suicide attempts, antisocial behaviour and impaired school performance during adolescence, impaired medical health, increased health-seeking behaviour, poor employment performance, reduced social interaction and impaired social support. Comorbidity accounted for some, but not all observed differences.
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PMID:The epidemiology of social phobia: findings from the Duke Epidemiological Catchment Area Study. 823 77

Through a review of the literature, the average mortality in schizophrenia is twice higher than among the population. This over mortality is highest among the 20-40 years range of age and added risk tends to disappear after 60 years. All studies stress the unnatural causes of death, suicide or accidental deaths. However several studies found an over mortality caused by natural death. The pathologies most often involved are: infections, lung, gastrointestinal, urogenital and cardiovascular diseases. Cancer mortality in schizophrenic patients is still debated. Some studies point out a reduced mortality compared to the general population whereas other studies find similar or over mortality. Nevertheless mortality ratio is found to be near 1 in the majority of studies. So it can be admitted that schizophrenic patient do really not differ from the general population in regard to cancer mortality. Premature death is highly linked to suicide. The epidemiological indicators that enable us to estimate the importance of suicide mortality are: the rate of suicide per 105 patients per year varies between 150 and 500, the percentage of death by suicide range between 10 and 15 percent. Suicide risk factors are numerous. Some of them are accepted as valid and others are still discussed. The former are: male gender, young and medium age ten first years of the illness course, associated depressive symptoms, past history of suicide attempts, iterative relapses and post hospital discharge period. The latter are: social isolation, celibacy, unemployment, high level of instruction, delusional and hallucinatory activity and familiar rejection.
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PMID:[Mortality and cause of death in schizophrenia. Review of the literature]. 827 90

506 patients with schizophrenia, diagnosed according to Diagnostic and Statistical Manual of Mental Disorders (DSM-III) criteria, were included in a long term treatment programme with remoxipride, a selective dopamine (D2)-receptor antagonist. This overview includes pooled data from all patients who have been treated long term with remoxipride in clinical trials, focusing on patients treated for more than 6 months (n = 283). Remoxipride was administered in daily doses of 75 to 600mg. The assessment tools were Brief Psychiatric Rating Scale (BPRS), Clinical Global Impression (CGI), Simpson and Angus scale, Abnormal Involuntary Movements Scale (AIMS) for abnormal involuntary movements, adverse events/symptoms using a 26-item checklist, clinical chemistry, and haematology and cardiovascular investigations. The majority of patients had a long duration of illness (median 11 years). 67% of patients (340/506) withdrew from treatment before 12 months and 44% (223/506) stopped treatment before 6 months. The median BPRS total score decreased during the first 3 months from 23 to 12, and this level of improvement was maintained throughout the 12-month period. Treatment-emergent adverse events reported by more than 5% of the patients were insomnia, tiredness, drowsiness and tremor in the group treated for 6 to 12 months. No symptoms, including checklist extrapyramidal symptoms (EPS), were reported by more than 5% of patients treated for 12 months. Low frequencies of EPS according to the Simpson and Angus scale were seen in patients treated for more than 6 months (n = 147). A small but statistically significant reduction of the mean total AIMS score from baseline to last rating was observed. There were infrequent changes in heart rate, resting diastolic blood pressure and electrocardiogram (ECG). Clinical chemistry and haematology data showed no evidence of clinically significant changes over time during the 12 months of treatment. Among 506 patients, 7 suicides and 7 suicide attempts occurred during the study period. Other serious adverse events were abnormal liver function test (2 cases), gastrointestinal, urinary retention, status epilepticus (psychotic polydipsia), granulocytopenia (1 each) and myocardial infarction (5 cases). Remoxipride is of potential value as a drug which is both effective and well tolerated in the long term management of patients with schizophrenia.
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PMID:Tolerability of remoxipride in the long term treatment of schizophrenia. An overview. 832 49

Platelet serotonin2 (5-HT2) binding was determined in 47 neuroleptic-free schizophrenic patients and 42 normal control subjects. Although the maximum number of 5-HT2 binding sites (Bmax) was significantly higher in the blood platelets of schizophrenic patients than in those of the normal control subjects, the difference disappeared after correction for age and sex effects. However, the Bmax of schizophrenic patients who had made suicide attempts was significantly greater than that of schizophrenic patients who had not, as well as that of normal controls. There was no difference in Kd between the schizophrenic patients and control subjects, and no relation between Kd and suicide attempts. The importance of serotonin in schizophrenia and suicide attempts is discussed.
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PMID:Serotonin2 receptor binding in blood platelets of schizophrenic patients. 834 64


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