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)

The effect of 1 mg dexamethasone on CSF levels of 5-hydroxyindoleacetic acid (5 HIAA), homovanillic acid (HVA) and cortisol (CS) was investigated in 100 psychiatric inpatients: 45 subjects had their lumbar punctures 1-4 days following dexamethasone administration, and the results were compared with those from 55 other patients investigated before drug ingestion. All patients were women, and none had received psychotropic medication for at least two weeks before the study. Seven subjects consented to two LPs both before and after dexamethasone. As expected, cortisol in the CSF significantly decreased after dexamethasone: the decrease was greatest 10 hours following the drug. HVA showed a weak and transient elevation after 10 hours only. CSF 5 HIAA was found to be significantly increased in postdexamethasone samples and high levels were still found even after 82 hours. Diagnostic differences (major or minor depression, schizophrenia, alcohol abuse or dependence) did not account for the observed differences. Repeated CSF examinations in seven subjects corroborated these findings: all cortisol values were decreased and all 5 HIAA values were increased after dexamethasone while HVA values showed random changes. The data may suggest that serotonergic mechanisms may be involved in dexamethasone action in the CNS. In addition, dexamethasone administration can alter CSF 5 HIAA level, a possible factor which should be taken into consideration in CSF studies.
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PMID:The effect of dexamethasone on cerebrospinal fluid monoamine metabolites and cortisol in psychiatric patients. 619 44

Nearly 10% of a sample of men charged with a variety of offences claimed amnesia for their offence. The amnesia occurred only among those who had committed violence and was most frequent following homicide. All the amnesics had a psychiatric disorder, four having a primary depressive illness and the remainder being almost equally divided between schizophrenia and alcohol abuse. None of the amnesias had any legal implications. The circumstances of the offences suggested a variety of mechanisms to account for the amnesia, including repression, dissociation and alcoholic black-outs. Psychological defence mechanisms were probably of some importance, even when alcohol was an important factor.
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PMID:Amnesia for criminal offences. 649 66

The concentrations of Co, Fe, Rb, Se and Zn were analysed, by means of neutron activation analysis, in the brains of three patients with alcohol abuse, of one patient with endogeneous psychosis and of one patient with schizophrenia. The patients with alcohol abuse suffered from the Wernicke-Korsakoff syndrome. The data were compared with results from brains which were not diseased ("normals"). Patients with alcohol abuse had diminished values of rubidium in nearly all analysed samples of cerebral nuclei (greater than 30% compared to normals), whereas the Rb values were normal or diminished in cortical regions. The cobalt values were reduced (greater than 20%) in eight out of 14 nuclei and in five out of nine cortical regions. Differences in the Fe and Se values were mainly located in the cerebral nuclei. In the caudate nucleus the patient with endogeneous psychosis had highly significant elevated values of all analysed elements. The element concentrations of the patient with schizophrenia did not significantly differ from those of normal controls. The loss of nearly all elements was conspicuous in those regions which show neuro-pathological cell degeneration or atrophy in the case of Wernicke-Korsakoff syndrome. This loss of element concentrations in patients with alcohol abuse is interpreted as a loss of cellular vitality.
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PMID:Trace elements in brains of patients with alcohol abuse, endogeneous psychosis and schizophrenia. 652 26

Primary alcoholics may display symptoms of affective or psychotic disorders, while mentally ill patients may develop persistent alcohol-related problems. The author discusses the importance of distinguishing alcoholic psychosis from schizophrenia and alcohol-induced confusion from organic brain syndrome. He then outlines the diagnosis and treatment of other alcohol-induced conditions such as alcoholic dementia, antisocial behavior, and drug abuse. After stressing that primary alcoholism can mimic almost any psychiatric disorder, and secondary alcohol abuse can exacerbate any psychiatric symptoms, the author asserts that physicians should routinely include substance abuse as part of the differential diagnosis of psychiatric patients.
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PMID:Alcoholism and other psychiatric disorders. 664 46

All 533 patients in the acute and subacute psychiatric wards of a VA psychiatric facility were evaluated by nursing staff for substance abuse history and for illicit drug use. Eighteen percent had a history of either drug or combined drug and alcohol problems, 40% had a history of alcohol abuse, and only 42% had no substance abuse problems. Fifty-six of the patients with a history of drug problems (58%) were illicitly using drugs in the hospital. They were compared with a group of 64 randomly chosen patients with no substance abuse history. Drug users were much younger and tended to be black; they had more re-admissions, even though their original hospital admission was much more recent. Eighty-three percent of both groups had a primary diagnosis of schizophrenia, but drug users were more likely to be diagnosed paranoid schizophrenic. The groups did not differ significantly in treatment status and progress, except that drug users were more likely to exhibit marked mood changes. Half of the drug users were taking drugs three or more times weekly. Marijuana use was by far the most common substance observed. Ten consequences of drug use occurred in at least one-third of the users on a regular basis, the most common effects being negative attitudes toward treatment, cliquishness, secretiveness, and a need for greater supervision. The treatment problems and effects of drug use were much more serious for about half of the drug users than for the others.
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PMID:Effects of illicit drug use in an inpatient psychiatric population. 718 Jun 17

Three cases of hallucinatory delirium preceded by prodromal symptoms of several months duration are described. The prodromes were reoccurring visual and tactile hallucinations which were misdiagnosed and ascribed to nonalcohol-related illness such as schizophrenia and disorders of mood.
Am J Drug Alcohol Abuse
PMID:Prodromal syndromes in delirium tremens. 718 3

The DRD4 dopamine receptor is thus far unique among neurotransmitter receptors in having a highly polymorphic gene structure that has been reported to produce altered receptor functioning. These allelic variations are caused by a 48-bp segment in exon III of the coding region which may be repeated from 2-10 times. Varying the numbers of repeated segments changes the length, structure, and, possibly, the functional efficiency of the receptor, which makes this gene an intriguing candidate for variations in dopamine-related behaviors, such as alcoholism and drug abuse. Thus far, these DRD4 alleles have been investigated for association with schizophrenia, bipolar disorder, Parkinson's disease, and chronic alcoholism, and all have been largely negative for a direct association. We evaluated the DRD4 genotype in 226 Finish adult males, 113 of whom were alcoholics, many of the early onset type with features of impulsivity and antisocial traits. Genotype frequencies were compared to 113 Finnish controls who were free of alcohol abuse, substance abuse, and major mental illness. In 70 alcoholics and 20 controls, we measured CSF homovanillic acid (HVA), the major metabolite of dopamine, and 5-hydroxyindoleacetic acid (5-HIAA). No association was found between a particular DRD4 dopamine receptor allele and alcoholism. CSF concentrations of the monoamine metabolites showed no significant difference among the DRD4 genotypes. This study of the DRD4 dopamine receptor in alcoholics is the first to be conducted in a clinically and ethnically homogeneous population and to relate the DRD4 genotype to CSF monoamine concentrations. The results indicate that there is no association of the DRD4 receptor with alcoholism.
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PMID:DRD4 dopamine receptor genotype and CSF monoamine metabolites in Finnish alcoholics and controls. 757 71

Compliance is adherence to a prescribed and appropriate treatment, not necessarily pharmacological. Non-compliance may occur in up to 50% of patients with schizophrenia who are prescribed neuroleptics. It may be commoner in young people, particularly if male or from certain ethnic minority groups, but demographic factors are relatively unimportant. Clinical features such as positive symptoms are associated with non-compliance but the strongest clinical relationship is with a "dual diagnosis", usually with an associated alcohol abuse. Patients' and relatives' beliefs about schizophrenia and about medication are of considerable importance in determining compliance, and can be understood in terms of the "health belief model". However, a full understanding of non-compliance must take into account the relationship between patients and doctors in the context of the sick role. Several techniques for increasing compliance have been described, but they contain common elements--the provision of information within the context of a warm and equitable therapeutic relationship, preferably maintained over some time, and the use of the relationship to encourage and prompt compliance and to establish more productive views of the illness and medication. The costs of poor compliance to sufferers and to society alike are considerable, and effective ways of improving it are a crucial part of good management.
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PMID:The content and context of compliance. 762 33

A study of risk factors for homelessness among the severely mentally ill was extended to include women, and a case-control study of 100 indigent women with schizophrenia meeting criteria for literal homelessness and 100 such women with no history of homelessness was conducted. Subjects were recruited from shelters, clinics, and inpatient psychiatric programs in New York City. Clinical interviewers used standardized research instruments to probe three domains of risk factors: severity of mental illness, family background, and prior mental health service use. Findings adjusted for ethnicity revealed that homeless women had higher rates of a concurrent diagnosis of alcohol abuse, drug abuse, and antisocial personality disorder. Homeless women also had less adequate family support.
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PMID:Risk factors for homelessness among women with schizophrenia. 762 18

County Roscommon, a rural area in the western part of Ireland, was the site of a family study of schizophrenia. As part of this study, we have assessed several elements of attention, identified by principal components analysis in previous investigations, in a group of subjects with schizophrenia, first-degree relatives of subjects with schizophrenia and age- and education-matched controls. The schizophrenic subjects performed significantly more poorly than the controls; the performance of the relatives fell somewhere between the other two groups. Those relatives with a DSM-III-R diagnosis (most frequently, alcohol abuse or an affective disorder) tended to perform more poorly on some of the attention elements than relatives without a diagnosis; in contrast, control subjects with diagnoses were not distinguishable from other controls. The attention elements appeared to differ in their capacity to differentiate the groups and each seemed to have a distinctive profile. The effects of alcohol abuse were also considered. The results obtained with this cohort may provide clues concerning the pathophysiological basis of schizophrenia and the heterogeneity of its expression.
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PMID:Analysis of the attention deficit in schizophrenia: a study of patients and their relatives in Ireland. 762 53


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