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

Computerized tomography (CT-scan) studies in schizophrenia revealed that some patients have neuromorphological abnormalities. The structural changes consist mainly in lateral and third ventricle enlargement, and in cortical atrophy. The present study evaluates these three changes in 42 schizophrenics aged 18 to 50, compared to 24 healthy controls. Diagnosis were established from information gathered by personal interview with the SADS-LA. Clinical sub-types were evaluated according to the DSM III-R criteria. Moreover, detailed symptoms were rated according to the Positive And Negative Syndrome Scale (PANSS). CT scans were recorded in floppy disks and blindly analyzed. Schizophrenics shown significant higher mean size of lateral and third ventricles, and higher mean anterior cortical atrophy than healthy subjects. Significant differences were also found between subtypes, with more marked abnormalities in the disorganized group. The relationship between brain abnormalities and clinical symptoms recorded with the PANSS, were analysed using Pearson correlates. Positive correlations concerned mainly negative symptoms like blunted affect, emotional withdrawal, difficulties in abstract thinking, passive apathetic social withdrawal and lack of spontaneity of conversation. Positive correlations are also observed with some symptoms classified with the PANSS in the General Psychopathology scale such as mannerism and disorientation. Negative correlation concerned most of PANSS positive symptoms.
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PMID:[X-ray computed tomographic abnormalities in schizophrenia. Trial of relationship with clinical data]. 163

In a neuroendocrine challenge paradigm, the present study investigated responses of schizophrenic patients to m-chlorophenylpiperazine (MCPP), a serotonin (5-hydroxytryptamine, 5HT) agonist. In an oral dose of 0.25 mg/kg, MCPP was administered in a placebo-controlled double-blind design to male schizophrenic patients (n = 7) and normal male controls (n = 8). Behavioral (Positive and Negative Syndrome Scale; PANSS) and hormonal (cortisol, prolactin) variables were measured over the subsequent 210 min. The schizophrenic patients experienced an overall exacerbation of psychopathology on MCPP as compared with placebo (p less than 0.05), with specific worsening of PANSS-positive symptoms (p less than 0.025) and PANSS activation (p less than 0.001). In addition, the schizophrenic patients showed significantly lower cortisol (p less than 0.05) and prolactin (p less than 0.05) responses than the normal subjects. The schizophrenic patients had lower peak MCPP blood levels than the normal subjects, although this difference was not statistically significant. The findings are discussed in terms of 5HT receptor(s) sensitivity and the pharmacokinetics of MCPP in schizophrenia.
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PMID:The MCPP challenge test in schizophrenia: hormonal and behavioral responses. 175 20

The Kraepelinian subtypes, developed early in the century, recognize the heterogeneity of schizophrenia but do not reliably predict differences in response to classical neuroleptics. The newer distinction of positive and negative syndromes in schizophrenia carry promise as an approach to identifying meaningful clinical and neurobiological dimensions. The present review summarizes the supportive evidence from a series of investigations using the Positive and Negative Syndrome Scale (PANSS), and a hypothesis on the pathophysiology of negative and positive symptoms is advanced. Our data suggest that: (a) positive and negative syndromes in schizophrenia represent stable, independent dimensions and not co-exclusive subtypes; (b) both are unrelated to the progression of illness; (c) they are differentially related to fundamental aspects of schizophrenia, including premorbid adjustment, cognitive development, family psychiatric history, the cognitive and neuropsychiatric profiles, dopaminergic functions, drug response, and subsequent course; (d) together with depression and excitement, they comprise the fundamental symptomatic components of schizophrenia, which, in their interaction, can account for the specific Kraepelinian subtypes. We have proposed that negative symptoms represent the core pathology in schizophrenia and may be understood as a variant of parkinsonism, hence characterized by dopaminergic deficiency and increased cholinergic activity. This view is supported by the striking overlap with Parkinsonism in regard to clinical features, neurochemistry, pharmacology, neuropathology, and neuroradiology. Positive symptoms are thought to reflect increased dopaminergic activity, which may arise as a compensatory adaptive mechanism to overcome the progressive dopamine loss in the maturing brain. The early onset of schizophrenia by comparison to Parkinson's disease may explain why schizophrenia entails more pronounced positive symptoms, development deficits, and cognitive, social, and emotional impairments. We describe evidence that pineal calcification, which may reflect disturbance of melatonin functions, appears to be a nongenetic factor in schizophrenia associated with perinatal injury. This may in part underlie the negative syndrome and its response to antipsychotic compounds with serotonergic (5-HT) antagonism.
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PMID:Experimental models of schizophrenia. 193 75

The paper deals with the methodology and methods for the assessment of negative (or minus) symptoms of schizophrenia. Two approaches are distinguished: Rating scales and objective methods. Statistical analysis of symptom-ratings with comprehensive psychiatric assessment systems (eg Brief Psychiatric Rating Scale, Present State Examination) have supported the distinction between positive and negative symptoms. Therefore special scales have been constructed for the purpose of differentially assessing these symptoms, eg the Scale for the Assessment of Negative/Positive Symptoms (SANS, SAPS) or the Positive and Negative Syndrome Scale (PANSS). Relations to self-rating scales for subjectively experienced deficits and basic symptoms in schizophrenic patients are pointed out, eg Frankfurt Complaint Inventory (FBFB) or Scale for Emotional Blunting (SEB). Psychometric properties of the rating scales for negative symptoms have to be improved, especially their validity often is not shown. Objective--rater-independent--assessment methods for negative symptoms are rare and being experimentally developed. Some symptoms may be assessed by psychological tests as deficiencies in psychological functioning, other by laboratory based (automated) analysis of behaviour, eg speech or facial actions. These investigations increase the reliability of the symptom-assessments. The validation of the methods involves etiological, prognostic and treatment implications of the negative symptoms. Current results suggest, that the negative syndrome of schizophrenia is a heterogenous construct, which has further to be differentiated.
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PMID:[Negative schizophrenic symptoms and their detection]. 202 79

The positive-negative distinction has emerged as a meaningful basis for understanding the heterogeneity of schizophrenia and treatment alternatives, but its delineation requires carefully devised, well validated techniques. This article considers the psychometric requisites for such an instrument and describes 30 criteria associated with operationalization, scale construction, and standardization. Six prominent positive-negative scales are compared on these criteria, and most are found deficient in terms of: a formalized interview procedure; detailed definitions for levels of symptom severity; exclusion of "secondary" negative symptoms; comparative scales to assess positive symptoms, depression, and global severity of illness; broad sampling of negative symptoms; large scale standardization studies; and determination of multiple facets of reliability and validity. The Positive and Negative Syndrome Scale (PANSS) is described as an effort to approach these principles of test standardization, and its clinical and research applications are discussed.
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PMID:Positive-negative symptom assessment in schizophrenia: psychometric issues and scale comparison. 207 20

The systematic assessment of subjective experience independently from its impact on schizophrenic's behavior is neglected in most structured interviews and symptoms rating scales. However, subjective complaints may predict outcome functioning, medication compliance, and future psychotic episodes and better reflects patients' well-being than does behavioral assessment. We demonstrate the reliability of the Subjective Deficit Syndrome Scale and the considerable prevalence of subjective complaints in 166 acute and chronic inpatients and outpatients. Complaints were correlated with global measures of psychopathology in acute but not chronic patients. They were not correlated with negative symptoms or neurological side effects. Some overlap was observed with measures of depression, although most patients denied depressed mood. We conclude that subjective deficits are prevalent in schizophrenia, that they can be reliably assessed, and that they constitute an independent, clinically important dimension of the disease.
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PMID:The measurement of subjective experience in schizophrenia: the Subjective Deficit Syndrome Scale. 234 Jul 16

Schizophrenic patients have been observed to manifest a variety of abnormal neurological signs, but the nature of their association with differing clinical presentations is less well established. To address this issue, we administered a newly compiled neurological inventory to 28 well-characterized chronic schizophrenic inpatients and separately assessed them on the Positive and Negative Syndrome Scale and on control variables that included measures of global pathology, chronicity of illness, neuropsychological and intellectual integrity, and extrapyramidal dysfunction. We found, first, that our neurological battery provided statistically independent measures of apraxia, fine motor function, and prefrontal, parietal, and nonlocalizing signs. A significant association emerged between negative symptomatology and neurological signs of prefrontal impairment (p less than 0.01), which could not be accounted for by any of the control variables. Positive symptoms were associated with an absence of parietal and nonlocalizing signs; however, these correlations were mediated by higher neuroleptic doses in these patients. There was no association between any neurological sign and age, extrapyramidal symptoms, general neuropsychological integrity, education, IQ, or severity or chronicity of illness. We concluded that the negative syndrome in schizophrenia represents a distinct dimension of psychopathology that is related specifically to prefrontal deficit.
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PMID:Neurological signs and the positive-negative dimension in schizophrenia. 237 25

The Positive and Negative Syndrome Scale (PANSS) consists of a formalized clinical interview and 30 operationally defined items for psychopathology assessment. We report here on the psychometric equivalence of a Spanish language adaptation (PANSS-S), developed to facilitate minority group, multinational, and cross-cultural studies on schizophrenia. Two bilingual psychiatrists simultaneously rated 57 psychiatric inpatients using the PANSS (N = 20), PANSS-S (N = 20), or both methods (N = 17). The PANSS-S demonstrated sound interrater reliabilities (r = .93 for positive and .74 for negative syndrome, p less than .001), which were similar to those from the current PANSS assessment and original standardization studies. In support of criterion-related validity, the means and variance of the two instruments were comparable, and significant cross-correlations were obtained for the principal scales (r = .92 for positive and .83 for negative syndrome, p less than .0001), component symptoms, and five additional psychopathology clusters. The results suggest that the PANSS-S has psychometric properties resembling those of the PANSS and may be used interchangeably in a Spanish-speaking population.
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PMID:The Positive and Negative Syndrome Scale--Spanish adaptation. 238 Jun 97

The present paper gives a review of German studies concerning the AMP and AMDP system that have been published since 1983. The test manual to the AMDP-system, published 1983, is complemented herewith. The following topics are discussed: Syndromes/scales on the basis of psychological and somatic outcomes, studies on reliability (especially interrater reliability); capability to differentiate diagnoses; comparison with other assessment instruments, especially biological parameters; results of several diagnoses (schizophrenia, affective disorders, depression etc.); range of application (psychopharmacological studies, diagnostic questions, etc.). The review points out that the AMDP system covers a very wide and elaborate range. Some topics are pointed out that would merit additional study.
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PMID:[Evaluation of the system of the Study Group of Methodology and Documentation in Psychiatry based on recent literature (1983 to 1987)--a review]. 267 9

Reports over the last 20 years suggest that pimozide, a neuroleptic of the diphenylbutylpiperidine (DPBP) group, might be helpful in the treatment of negative symptoms of schizophrenia, which are considered less responsive to standard neuroleptics than are positive symptoms. Research suggests that neuroleptic drugs of the DPBP group possess a unique property--potent calcium channel antagonism--which could explain their ability to relieve negative symptoms. Earlier reports, however, used measures not specifically designed to assess the negative syndrome. The Positive and Negative Syndrome Scale (PANSS) was developed and standardized to measure the negative syndrome in schizophrenia. The authors used the PANSS to study the effects of pimozide in a 6-week, open clinical trial with 10 neuroleptic-resistant schizophrenic inpatients who had prominent deficit features. Negative but not positive symptoms improved significantly, suggesting that the drug might target the negative profile. The authors discuss possible pharmacologic mechanisms for pimozide's potentially distinct clinical properties.
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PMID:Pimozide treatment of the negative schizophrenic syndrome: an open trial. 328 15


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