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

Fifty physicians were evaluated and treated in a psychiatrically oriented, short-term addiction program. Psychopathology ranged from overt schizophrenia to no demonstrable psychiatric syndrome other than the addiction. Physicians experiencing addiction problems before age 40 years were more likely to exhibit serious psychopathology in the borderline range, while physicians older than 40 years were more likely to exhibit organic brain impairment and depression. Treatment outcome had some relation to psychiatric diagnosis but no relation to the addictive agent.
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PMID:Addicted physicians. A closer look. 745 50

The psycho-social problems of a group of 365 Italian emigrants to Switzerland, admitted to psychiatric hospitals, were studied. It was found that non professional subjects (housewives, unemployed, retired) and manual workers (builders, waiters, factory workers) were more likely to suffer from psycho-social disorders. Only 11.1% of those studied had received a secondary education, therefore it could be assumed that subjects having a low technical and cultural level were less prepared, psychologically, for their new situation and were thus more susceptible to psycho-social disorders. The most frequent diagnoses were found to be: affective disorders, alcohol addiction, opiate addiction and schizophrenia. The study revealed that emigrants ran a greater risk of first time admittance to psychiatric wards whereas the local population had a greater number of relapses. In conclusion it is stressed that assistance with an aim to improve work, social and relationship conditions and to integrate the emigrants into their host society can reduce some forms of psycho-social disorders.
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PMID:[The psychosocial problems in a population of emigrant Italian workers]. 761 70

Many forms of psychopathology in higher animals and humans include the production of maladaptive, repetitive behaviour. Behaviour which is both repetitive and excessive in amount can be described as stereotyped whereas behaviour which represents a restriction of behavioural possibilities without excessive production can be described as perseverative. Both types of repetition can result from pathology in the neural mechanisms which control either the production of motor output or the organisation of behaviour at a higher level. A number of forms of repetitive behaviour can be induced environmentally. Confinement in adulthood results in a functional disorder which rapidly dissipates when normal conditions are restored but confinement in infancy may have a permanent effect on the organism's ability to interact in a flexible and creative way with its environment. The permanence of these disorders suggests that the environment can affect the way in which the nervous system develops. Repetitive behaviour is also a feature of mental illness including schizophrenia, autism, OCD, addiction and some neurological disorders including frontal lobe lesions, Tourette's syndrome and PD. In experimental studies in animals, stereotyped behaviour seems to be related mainly to excess dopaminergic activity in the basal ganglia while perserverative behaviour can be produced by lesions of the frontal lobes. It is supposed that the level of dopamine activity in the basal ganglia affects the baseline level of behavioural activation such that excess activation results in the excessive execution of the most probable response to the environment to the exclusion of other possibilities (i.e. stereotypy) while deficient activation results in the production of only a few responses which can exceed the necessary activation level (i.e. perseveration). In either case behaviour is 'stimulus-bound', being driven by only the most salient feature of the environment. The symptoms of PD result from inadequate levels of dopamine in the basal ganglia while the stimulant psychoses result from excessive availability of dopamine. The frontal lobes have a modulating effect on (i) the activation of motor activity by the basal ganglia, (ii) in the generation of self-initiated behaviour, i.e. volition, and (iii) in the neural mechanisms which permit different modes of neural function (e.g. perceiving, remembering or thinking) to be identified. Failures in these three functions could result in excessive and repetitive motor activity, stimulus-bound behaviour, the paucity of volitional and creative behaviour, and the perceptual and experiential symptoms of psychosis.
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PMID:The psychology of perserverative and stereotyped behaviour. 783 78

Although schizophrenia usually emerges at mid to late-adolescence, it has been estimated that almost 20% of schizophrenic patients develop their first symptoms in mid to late life (late-onset schizophrenia). The biological characteristics that distinguish patients with early onset from those with late-onset schizophrenia have not been well delineated. A subgroup of neuroleptic-treated schizophrenic patients develops tardive dyskinesia (TD) and the majority of these patients are unaware of their movements. To investigate whether early and late-onset schizophrenic patients with TD could be differentiated on the basis of awareness of involuntary movements, we compared the prevalence of awareness of these abnormal movements in patients with early (N = 40) and late-onset (N = 15) schizophrenia. We found a significantly higher prevalence of awareness of involuntary movements in patients with late-onset schizophrenia as compared to those with an earlier age of onset (86.6% vs. 25.0%, p < .0001). In a second study, we investigated whether early and late-onset schizophrenia could be differentiated on the basis of dopamine functions in the mesolimbic system. Since tobacco addiction is mediated via limbic dopaminergic functions, we investigated the prevalence of tobacco addiction in patients with early (N = 51) and late-onset (N = 13) schizophrenia. We found a significantly lower prevalence of tobacco addiction in patients with late-onset schizophrenia as compared to those with an earlier age of onset (15.4% vs. 54.9%; X2 = 6.49; p < .01). Our findings support the notion that distinct pathophysiological mechanisms underlie the development of early and late-onset schizophrenia.
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PMID:Late-onset schizophrenia: relationship to awareness of abnormal involuntary movements and tobacco addiction. 840 59

Significant advances in our understanding the phenomenology of cocaine addiction have occurred in the past 12 years such that we now recognize addiction to cocaine as a major public health problem. We now can diagnose cocaine addiction more accurately. Furthermore, cocaine addiction has stimulated creation and testing of novel treatment efforts because standard addiction treatment, although efficacious, is not as effective for cocaine addiction as compared with other addictions. Much remains to be learned. We need to clarify symptoms and syndromes associated with cocaine addiction to more precisely delineate true "comorbidity." Special attention is needed to understand the course and response to treatment in women addicted to cocaine. Also, work is needed to clarify the interaction of HIV, cocaine, and pharmacotherapy used to treat HIV. Regarding treatment, effort is needed to better understand the interactions among educational, group, cognitive-behavioral, and pharmacologic interventions. Specific attention is needed regarding use of 12-step recovery programs adapted for cocaine addicts with comorbid psychiatric disorders, such as schizophrenia, mood, and anxiety disorders. Finally, we need to better understand ways of attracting and holding cocaine addicts in treatment earlier in the course of their disorder. To that end, "nontraditional" interventions, such as acupuncture, deserve systematic examination as alternative methods of recruitment and intervention for certain populations of cocaine addicts.
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PMID:Cocaine. Diagnosis and treatment. 845 49

The proceedings of the inaugural scientific meeting of the Society for Research on Nicotine and Tobacco (SRNT) are summarized. The primary objective of the meeting was to foster the exchange of information on the effects of nicotine and tobacco use, as well as factors which influence their use, drawing from biological, behavioral and social sciences. Much of this research can be viewed as a tale of "two" drugs--nicotine as a key to an important public health problem, and nicotine as a classical tool of physiological and pharmacological research. A historical overview of research on "both" drugs is provided first. Public policy alternatives for reducing the prevalence of tobacco use have been derived in part from basic and clinical research results and are briefly outlined. Evidence for genetic determinants on nicotine use and effects is presented using data from twin studies and from molecular genetic research with humans and animals. Consistent with this research, there is evidence of individual differences in pharmacokinetics and effects of nicotine, which could account for differences in smoking behavior and nicotine dependence. Finally, recent developments in the therapeutic uses of nicotine and novel nicotinic agonists with schizophrenia, Alzheimer's disease, Parkinson's disease, Tourette's syndrome and ulcerative colitis are presented. Overall, the research presented at the meeting demonstrated the vast diversity of areas of study involving nicotine and tobacco, as well as the rich opportunities for cross-communication among researchers from different disciplines.
Addiction 1996 Jan
PMID:Society for Research on Nicotine and Tobacco. 882 21

This article briefly reviews the history of psychiatric emergency services (PES) in the United States and concludes that the dominant model, the triage model, unnecessarily limits modern PES. Trends in the mental health system and the corresponding development of compensatory PES structures are described. These include observation units, outreach, and crisis residential treatment and other innovations. These new structures have had the effect of increasing the length of stay in emergency services, increasing the number and complexity of services provided in the PES and professionalizing emergency service personnel. A new model, the treatment model, is proposed for this type of PES. Strategies for the rapid initiation of definitive treatment of bipolar disorder, schizophrenia, major depression and opiate addiction are outlined for services with this capability.
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PMID:Definitive treatment in the psychiatric emergency service. 893 26

Dopamine plays a pivotal role in the regulation and control of movement, motivation and cognition. It also is closely linked to reward, reinforcement and addiction. Abnormalities in brain dopamine are associated with many neurological and psychiatric disorders including Parkinson's disease, schizophrenia and substance abuse. This close association between dopamine and neurological and psychiatric diseases and with substance abuse make it an important topic in research in the neurosciences and an important molecular target in drug development. PET enables the direct measurement of components of the dopamine system in the living human brain. It relies on radiotracers which label dopamine receptors, dopamine transporters, precursors of dopamine or compounds which have specificity for the enzymes which degrade dopamine. Additionally, by using tracers that provide information on regional brain metabolism or blood flow as well as neurochemically specific pharmacological interventions, PET can be used to assess the functional consequences of changes in brain dopamine activity. PET dopamine measurements have been used to investigate the normal human brain and its involvement in psychiatric and neurological diseases. It has also been used in psychopharmacological research to investigate dopamine drugs used in the treatment of Parkinson's disease and of schizophrenia as well as to investigate the effects of drugs of abuse on the dopamine system. Since various functional and neurological parameters can be studied in the same subject, PET enables investigation of the functional integrity of the dopamine system in the human brain and investigation of the interactions of dopamine with other neurotransmitters. Through the parallel development of new radiotracers, kinetic models and better instruments, PET technology is enabling investigation of increasingly more complex aspects of the human brain dopamine system. This paper summarizes the different tracers and experimental strategies developed to evaluate the various elements of the dopamine system in the human brain with PET and their applications to clinical research.
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PMID:PET evaluation of the dopamine system of the human brain. 896 6

For the first time it was possible to study psychiatric inpatient treatment over a period of 7 years in a major German city (Hamburg) using data of 77% of all psychiatric inpatient cases collected by health insurance agencies. Among the most prominent results is the fact that 4 out of 8 illnesses with the highest sum of inpatient days of all treatment cases are psychiatric cases. These are schizophrenia, neurotic disorders, affective psychoses and alcohol abuse. Schizophrenia is the diagnosis which adds up to the highest amount of inpatient days in Hamburg hospitals. Of all psychiatric diagnoses, 35% show up in somatic departments, mainly internal medicine. This is especially true for alcohol and drug abuse, neurotic and personality disorders and organic psychoses. The greatest part of these cases were hospitalised for 0 to 3 days only, which points to the importance of crisis intervention provided by somatic departments. By introducing new offers of low threshold detoxification for drug abuse in psychiatry it was possible to increase the percentage of cases treated in psychiatry departments in the years 1993/94 as compared to 1988/89. During the same period the share of cases suffering from all kinds of psychoses decreased in psychiatry whereas the percentage of cases with drug abuse, neurotic and personality disorders rose. In nonpsychiatric departments, diseases seen in the context of alcoholism as well as neuroses and functional disorders prevail among the group of mental disorders. In internal medicine 6% of all cases are related with all kinds of addiction including its respective somatic consequences and 2-3% with neurotic and psychosomatic disorders. Looking at the amount of inpatient days 11.2% are spent for treating alcohol abuse, alcohol psychoses and diseases of liver and pancreas by patients of 15 to 65 years of age. In the light of these results it is suggested to set up psychiatric liaison-services in somatic departments, especially in internal medicine, to deal with psychosomatic and neurotic disorders and of course, alcoholism. This would help to lower hospitalisation costs. The introduction of motivational approach to the treatment of alcoholism in internal medicine departments appears warranted. Such changes of approach would result in new points of emphasis also in psychiatry.
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PMID:[Analysis of psychiatric hospital cases in Hamburg 1988-1994--developmental trends, health care deficiencies and prospects]. 933 82

In particular studies conducted in the U.S. display a tendency for schizophrenics to combine hallucinogens and amphetamines, whereas other studies report on a combination of psychotropic substances with a similar range of action. Influencing negative symptoms is reported to be the motivation for consumption. A total of 222 patients with a schizophrenic disorder (F2) and addiction (F1) were examined. The main substance was alcohol (F10.1 or F10.2; 52.2%), followed by cannabis (F12; 25%), opiates (F11; 4.1%), sedatives or hypnotics (F13; 2.7%) and cocaine (F16; 0.5%). A multiple drug use (F19) is reported by 14% of them. The most frequent combination was alcohol and cannabis, whereas hallucinogens and amphetamines were only rarely combined. Actual multiple consumption was reported by 55% of the patients, while lifetime multiple consumption applied to 72%. The motivation seems to be an unspecified sedation of unpleasant affective symptoms of schizophrenia. The most frequently seen combinations do not correlate with the reports published in the literature. The great variations in motivation seem to mainly reflect the importance of the availability of the substance.
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PMID:[Consumption patterns and motivation for use of addictive drugs in schizophrenic patients]. 934 Jun 58


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