Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0036341 (schizophrenia)
 60,220 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

This paper has examined the possibilities of applying significant pharmacologic help to a variety of psychiatric problems that may accompany narcotic addiction. It has been shown that many of the patients do have such difficulties, with affective disorders being most common. As far as the various psychotropic drugs are concerned, neuroleptics for schizophrenia and lithium for manic disorders are generally agreed upon. A more extensive trial of lithium in a variety of situations seems indicated. Minor tranquilizers for anxiety and MAO-inhibitors for depression are both seen as problematic in this population--the former because of the possibility of abuse, the latter because of the danger of drug interaction associated with the addict's careless lifestyle. Tricyclic antidepressants may clearly have a role in treating major depression in opiate addicts on or off methadone, but the lability of the syndrome over time with frequent spontaneous remission argues against their routine use until it is clear that depression has persisted 3-6 months into methadone. Disulfiram appears to be a useful adjunct for drug abusers with serious alcohol problems. Psychotropic agents are most helpful to opiate addicts when used to treat coexisting psychopathology. While there is no clear evidence that such agents will reduce or affect the addiction itself, they may help keep patients available for rehabilitation efforts. Failure to intervene may make treatment dropout and recidivism more likely. Given the relative frequency of potentially treatable psychiatric disorders in these patients and the consequences of undiagnosed and untreated conditions, it is important for clinicians to maintain a high index of suspicion for concomitant psychiatric illness and for programs to have a mechanism for routinely diagnosing either all patients or, at a minimum, all patients not doing well. If programs used a standard instrument such as the SADS, it would be possible to compare various programs on this factor; in addition, it would provide a rich source of data for outcome studies.
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PMID:Brief effective treatment strategies: pharmacological therapy for opiate addicts. 286 55

Psychotropic agents are most helpful to opiate addicts when used to treat co-existing psychopathology. While such agents may not impact directly on the addiction itself, they might help keep patients available for rehabilitation efforts since concomitant severe psychopathology has been associated with poorer outcome. Neuroleptics for schizophrenia and lithium for manic disorders are generally agreed upon. Minor tranquilizers for anxiety and MAO inhibitors for depression may be too risky for this population. Tricyclic antidepressants clearly have a role in treating major depression in addicts but the lability of the syndrome over time argues against their routine use until the depression has persisted at least 3 months.
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PMID:The use of psychotropic drugs in the treatment of compulsive opiate abusers: the rationale for their use. 287 Jun 23

All 77 residents aged under 65 in geriatric nursing homes and homes for the elderly in the Berlin (W) district of Charlottenburg were assessed in regard to mental illness and impairment. Additionally, data were collected covering psychopathology, clinical and personal data, medical and social care as well as the extent of contacts to nonresidents and institutional setting. 85% of these younger residents-8% of the total residential population-proved to be mentally ill. Primarily, they suffered from addiction, schizophrenia or mental retardation. Projecting our results to the total residential population of Berlin living in such homes, 728 younger mentally ill or retarded patients or 0,5%o of the population aged under 65 would live in such institutions. These residents had histories of unfavorable living conditions and a long psychiatric case history with frequent hospitalization. Distinct differences in regard to patient data as well as settings were found among public, welfare and private institutions. Results are discussed and arguments for improving care of this population are presented.
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PMID:[Younger psychiatric patients in homes for the aged and nursing homes]. 342 51

This article gives an overview of the biochemistry, physiology and pharmacology of endogenous opioid peptides. The role of endorphins in psychiatric pathology in the last ten years, has mainly been studied through two clinical research strategies: Pharmacological, administration of opiate agonists or antagonists, or substances altering endorphins metabolism. Biological, static or dynamic dosage of opioid activity in peripheral liquids, trying to correlate those measures either with a syndrome, or with a clinical trait. These methods applied to schizophrenia, affective disorders, anxiety, addiction, anorexia, and tardive dyskinesia are being reviewed. Results are very heterogeneous but support the involvement of the endogenous opioid system in some psychiatric pathology. Furthermore, this paper should help to underline some of the present day development of biological psychiatry.
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PMID:[Endorphins. Physiological and pharmacological aspects, and research in psychiatry]. 352 85

Two different methods for assessing psychopathology in opiate addicts were compared as predictors of long-term treatment outcome: (1) categorical psychiatric diagnosis using the Schedule for Affective Disorders and Schizophrenia--Lifetime Version and the Research Diagnostic Criteria and (2) global rating of psychiatric impairment using the Psychiatric Severity scale of the Addiction Severity Index (ASI). Follow-up interviews were completed 2.5 years after treatment seeking in 76% of a sample of 361 opiate addicts. Five dimensions of treatment outcome were assessed, including current functioning, psychosocial adjustment, substance use impairment, legal problems, and medical disability. Most lifetime psychiatric disorders with a prevalence of greater than 10% were significantly related to the outcome dimensions of current functioning and/or psychosocial adjustment and were unrelated to substance use impairment, legal problems, and medical disability. The ASI Psychiatric Severity rating more robustly predicted poorer functioning in the same two areas and less severe legal problems. While controlling for ASI Psychiatric Severity, the only Research Diagnostic Criteria diagnosis that remained significantly related to treatment outcome was major depression, suggesting that, as regards their prognostic characteristics, the other diagnoses are accounted for by a global underlying severity dimension.
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PMID:Prognostic significance of psychopathology in treated opiate addicts. A 2.5-year follow-up study. 372 68

Noncompliance is a major contributing factor to therapeutic failure. Many complex variables hae been reported to interfere with patient compliance. Though there are exceptions, educational techniques have been shown to be of value. Patients with diagnoses of schizophrenia, and bipolar and unipolar affective disorders were separated into control and experimental groups and studied to determine the factors associated with poor compliance and the potential value of educational techniques. Following a course of lectures and data sheets, the "educated" patients tended to be more compliant on outpatient follow-up. They were also less fearful of side effects and addiction. Factors associated with poor compliance were related to severity of illness, social isolation, fear of dependency and side effects (extra-pyramidal).
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PMID:Effect of patient education on medication compliance. 611 Apr 71

In Huntington's disease, there is a decrease of the neuropeptides, substance P, enkephalins, and cholecystokinin in the striatonigral system, whereas in Parkinson's disease an increase of substance P is found in the substantia nigra. Several neuropeptides should be involved in Alzheimer's disease: substance P, endorphins, vasopressin, ACTH, somatostatin, vasoactive intestinal peptide, cholecystokinin, neurotensin, delta sleep-inducing peptide. Alterations of substance P, vasoactive intestinal peptide, cholecystokinin, somatostatin, and endorphins may be related to the pathophysiology of schizophrenia. Delta sleep-inducing peptide may interfere in addiction pathology.
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PMID:Putative peptide neurotransmitters in human neuropathology: a review of topography and clinical implications. 618 57

There are several diseases, including schizophrenia, alcoholism, and opiate addiction, for which the long-term prognosis is subject to disagreement between clinicians and researchers and also among researchers. Part of this disagreement may be attributable to a difference in the populations they sample. The clinician samples the population currently suffering from the disease (a "prevalence" or census sample), while research samples tend to more nearly represent the population ever contracting the disease (an "incidence" sample). The clinician's sample is biased toward cases of long duration, since the probability that a case will appear in a prevalence sample is proportional to its duration, hence "the clinician's illusion." The statistical mechanism of this bias is illustrated and its consequences detailed. Other sources of sampling bias in clinical and research samples are briefly described and partial remedies are suggested.
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PMID:The clinician's illusion. 633 3

A survey evaluated current and lifetime rates of psychiatric disorders in 533 opiate addicts in treatment at a multimodality program. Information was gathered using a structured interview format, the Schedule for Affective Disorders and Schizophrenia-Lifetime version, and the criteria were the Research Diagnostic Criteria. Most were give the diagnosis of at least one psychiatric disorder in addition to opiate addiction. The most common diagnoses were major depressive disorder, alcoholism, and antisocial personality, and rates of chronic minor mood disorders and anxiety disorders also were found to be elevated in comparison with those found in a community population. In contrast, rates of schizophrenia and mania were very low and did not exceed those reported for the general population. The findings are interpreted as suggesting the importance of detecting and attending to psychopathology associated with opiate addiction.
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PMID:Heterogeneity of psychiatric diagnosis in treated opiate addicts. 706 30

We investigated the extent psychiatric illnesses can be differentiated by means of psychopathological symptoms. The present condition of 2269 patients was analyzed; they had been admitted to the psychiatric clinic of the Free University of Berlin during 1971-1976, as documented by the AMP (PAS) documentation system. The most frequent diagnosis in the sample was schizophrenia (32%), followed by neurosis (22%), affective psychosis (14%), addiction (6.7%), and organic psychosis (6.2%). We could demonstrate that even such diagnostic groups are usually discernible by symptoms, where the differential diagnosis is often difficult. Organic psychosis vs paranoid schizophrenia and depressive neurosis vs depressive psychosis can be determined, but manic syndromes in schizoaffective psychosis vs manic syndromes in affective psychosis are hardly discernible. The potential to differentiate, however, only pertains to diagnostic groups, since many individual patients cannot accurately be classified into diagnostic groups by psychopathological symptoms alone. Only a few symptoms are pathognomonic, and if there are pathogomonic symptoms characterizing a diagnostic group, only a few patients in this group show these symptoms. These results indicate, at least for the high number of patients without severe and typical symptomatology, that we must: 1. Achieve better differentiation on the diagnostic axis "psychopathology" by means of empirically derived syndromes instead of isolated symptoms. 2. Use other diagnostic axes (like etiology and course) for differential diagnostic purposes.
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PMID:[The potential of psychopathological symptoms to differentiate diagnostic groups (author's transl)]. 727 35


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