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

A survey was made of all female admissions to the State Hospital, Carstairs, between the time of the first female admission in 1959, and 31 December 1973. There were 66 female admissions, constituting 7-1 per cent of the total admissions over the same period. The females fall into two separate sub-groups. The first consists of persistently violent patients transferred from other hospitals, suffering from mental subnormality or personality disorder; they have a poorer prognosis than the second group, who are sent from Courts or prison because of single serious acts of violence often directed at a member of the family, and who suffer from a personality disorder or from schizophrenia. Some features of the two groups are compared and contrasted. There may be an increase in the proportion of pateints in the first group being admitted to the State Hospital, and some implications of this trend are discussed.
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PMID:A fifteen-year review of female admissions to Carstairs State Hospital. 120 34

This review of the literature does seem to reveal an association between schizophrenia and a variety of antisocial behaviors that include violent crime, and even homicide, especially in North America. The literature consistently shows that since the 1950s, schizophrenics have been involved in crime and arrested more frequently than the general population, they are overrepresented in correctional settings, and they represent the majority of those found not guilty by reason of insanity. Many authors cite changes in mental health policies, particularly de-institutionalization, as one of the major causes of these phenomena. It is important to note that a history of prior arrests and of being male, poor, unskilled, uneducated, and unmarried are perhaps the best predictors of antisocial behaviors in the mentally ill and in the general population alike. Schizophrenic drift and increased family pathology in schizophrenic families, however, may predispose people suffering from schizophrenia to these demographic variables. Interestingly, these variables do not seem as relevant in the emergency room or inpatient wards where violence seems to be mainly affected by the severity of psychopathology, substance abuse, neurologic signs, and the environment within the mental health setting. The implications for the practice of psychiatry are diverse. Clearly clinicians in both hospitals and community mental health settings must have experience, training, and an awareness of the literature relating to the prevention, causes, and management of violence. It behooves us in the mental health field, having vociferously supported the community mental health movement, to assist police in the management of the mentally ill who are now in the community, perhaps by the use of mobile crisis intervention teams and by a considerably increased amount of effort and cooperation. Correctional services require urging to develop resources for identifying and tracking the mentally ill so as to be able to provide programs and continuity of care. Community mental health and criminal justice systems need to cooperate in planning the transition of mentally abnormal offenders from prisons into the community and then providing support and after-care for them. One exemplary program that has developed and benefited from the coordination and planning at the interministerial level is the Inter-ministerial Project (IMP) program in Vancouver. This program identified the people whose histories revealed repeated admissions to both correctional and mental health facilities, bouncing between one and the other. Using a case management approach with a limited caseload, clinicians were able to reduce the number of admissions to both types of facilities. This program should serve as a model for other jurisdictions.(ABSTRACT TRUNCATED AT 400 WORDS)
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PMID:The forensic psychiatric aspects of schizophrenia. 140 22

Ticehurst House, a private asylum, flourished during the nineteenth century as the most expensive of such establishments, being owned and run by the Drs Newington over five successive generations. The discovery of the full set of patient casebooks begun in 1845-6 made it possible to review in detail the clinical features of a complete cohort of patients admitted to the asylum between 1845 and 1890. Six-hundred-and-one patients were thus analysed in terms of their age, sex, length of stay, symptoms, treatment and outcome. Modern operational diagnoses were used, and 80% of the cohort were found to conform to Research Diagnostic Criteria, in particular to the categories for schizophrenia and manic-depressive disorder. An additional finding was the high prevalence of movement and postural disorder among the schizophrenic group, as well as a significant trend towards the selection of a treatable, good-outcome group of patients with manic-depressive illness. These results are discussed by comparison with other modern studies of the asylum period, and in the contemporary context of Victorian psychological medicine. It is suggested that the violence, physicality and chronicity of psychotic illness must be seen as central to the debate about the rise of the asylum in nineteenth-century Britain. Furthermore, the similarity in core symptoms found in such patients and those seen in the 1980s indicates that the categories 'schizophrenia' and 'manic-depressive disorder' have a robust validity that is not confined to the social parameters of a particular time period.
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PMID:A diagnostic analysis of the Casebooks of Ticehurst House Asylum, 1845-1890. 162 Jul 51

The majority of psychiatric patients are not violent during hospitalisation. A minority behave violently during hospitalisation on repeated occasions but violent episodes are mainly concerned and these do not result in corporeal injuries. Gross violence rarely occurs. Violence involves the caring staff most frequently and, more rarely, fellow patients. The patients who are most frequently violent are the most severely ill and untreated psychotic patients. The commonest diagnosis among the violent patients is schizophrenia. Younger patients are often violent. No sex differences exist for violent behaviour. Manic patients are rarely violent and depressive illness is negatively correlated with violence. Approximately 1/5 of the demented patients show violent behaviour. The review demonstrates many methodological deficiencies in the investigations mentioned and presents recommendations concerning the design of investigations in future investigations.
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PMID:[Violent behavior among hospitalized psychiatric patients. 1. Occurrence and psychopathology]. 188 69

During the period 23.11.1987-22.11.1989, a total of 7,906 patients attended the psychiatric outpatient department and observation section on 12,469 occasions. Sixty patients (0.8%) behaved violently on 85 occasions. None of these episodes of violence resulted in injuries to persons requiring medical attention. 90% of the violent patients were men and 70% were in the age group 20-39 years. Approximately 1/5 were psychotic and, of these, approximately half suffered from schizophrenia. Comparison with the non-violent patient revealed that the probability of violence was greater if the patient was a man under the influence of alcohol and who had the diagnoses of narcomania, drug abuse or personality disorders. Significantly fewer violent patients were admitted than non-violent patients. Over 80% of the violent patients had previously been admitted to psychiatric departments. Approximately 60% had behaved violently on previous consultations with the psychiatric outpatient department.
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PMID:[Violent patients in a psychiatric outpatient department]. 192 14

This article addresses itself to the apparent conflict between those reports indicating that caffeine affects schizophrenic behavior and the present study which failed to show substantial behavior or medication changes with caffeine. It is suggested that there are important subgroups of schizophrenic patients who are unusually sensitive to caffeine's apparent psychotogenic actions as reported in case reports and data on violence and destruction. It is also suggested that there are subgroups of schizophrenia which seem to require increased medication doses to "cover" caffeine effects.
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PMID:Response to "Effects of caffeine on behavior of schizophrenic inpatients". 274 92

The ventral tegmental area (VTA) is the major dopaminergic (DA) center responsible for the innervation of the prefrontal cortex, nucleus accumbens, and entorhinal region. These areas have been causally implicated in schizophrenia. Thus, the existence of brainstem pathology could explain many of the previously reported findings in schizophrenic (SC) patients. The authors focus on uncovering brainstem abnormalities in schizophrenia by studying the autopsied material of a patient having an early onset of symptomatology. The patient was evaluated at the age of 10 years for manneristic behavior, a speech disorder, and violence. Prominent auditory hallucinations became apparent years later. His mental status and ability for self-care steadily deteriorated until he succumbed to pneumonia at age 22. Microscopic examination of the brain showed central chromatolysis of neurons and mild gliosis in a restricted distribution of the brainstem and thalamus. Cell loss and cytoarchitectural disruption were evident in the frontal lobes, prepyriform cortex, and entorhinal region. The neuropathological changes were interpreted as a chronic derangement in the function of neurons of the rostral brainstem tegmental area and medial thalamus with secondary involvement of their terminal projection sites.
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PMID:Neuropathological findings in a suspected case of childhood schizophrenia. 213 91

Data from the Epidemiologic Catchment Area survey were used to examine the relationship between violence and psychiatric disorders among adults living in the community. Psychiatric assessment of survey respondents was based on the Diagnostic Interview Schedule, which also provided self-report information about violent behavior. Those who reported violent behavior within the preceding year tended to be young, male, and of low socioeconomic status, and more than half met DSM-III criteria for one or more psychiatric disorders. Subjects with alcohol or drug use disorders were more than twice as likely as those with schizophrenia to report violent behavior. In a multivariate model of the predictors of violence, a significant interaction effect was found between major mental illness and substance abuse. The risk of violent behavior increased with the number of psychiatric diagnoses for which respondents met DSM-III criteria.
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PMID:Violence and psychiatric disorder in the community: evidence from the Epidemiologic Catchment Area surveys. 214 18

In an effort to improve the prediction of violence among psychiatric inpatients, the authors retrospectively studied 25 patients who were violent and 34 who were not violent after admission to a psychiatric emergency ward in Norway. The only demographic variable that discriminated between the two groups was violence in the family of origin; the violent group had experienced significantly more. The best single predictor of violence was a history of previous violence by the patient, which correctly classified 80 percent of the patients. The combined information about patients' level of aggression rated at referral and level of anxiety rated at admission correctly classified 78 percent. In a subgrouping of violent patients who inflicted injuries and did not inflict injuries, a higher percentage of the injury-inflicting patients were found to have a diagnosis of schizophrenia. These patients also had a higher level of aggression at referral.
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PMID:Can prediction of violence among psychiatric inpatients be improved? 236 10

Research on the relationship of diagnosis, genetics, violence, and psychological factors to suicide has changed dramatically during the past 20 years. Within this changing framework the author reviews current research, which focuses on understanding why some patients within one diagnostic category such as depression or schizophrenia commit suicide while others do not; separating genetic factors responsible for suicide from those responsible for depression; clarifying the biological correlates of suicide and aggression; and examining the psychosocial and demographic factors affecting suicide among the young and old, men and women, and various cultures and subcultures.
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PMID:Suicide: a review of new directions in research. 241 33


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