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

The use of a structured diagnostic interview (The Schedule for Affective Disorders and Schizophrenia) with 58 consecutively admitted general adult psychiatric patients revealed that 62.1% of them abused alcohol and 58.6% had a substance use disorder. The drug abusers did not differ significantly from the nonabusers on mean psychoticism (Brief Psychiatric Rating Scale) scores. However, they received higher doses of antipsychotic agents (mean daily dose 1022 mg CPZ EQ (SD = 614) vs 609 mg CPZ EQ (SD = 481); z = 2.58, p < .01) to achieve stabilization. The clinical implications of this finding are discussed.
Am J Drug Alcohol Abuse 1995 May
PMID:Relationship between concurrent substance abuse in psychiatric patients and neuroleptic dosage. 763 11

Prevalence rates for delusional jealousy were found, respectively, to be 2.2 and 1.1% in two samples of 183 and 447 schizophrenic inpatients and therefore being lower than the prevalence rates reported in a recent sample studied by Tateyama and coworkers. Five of the 8 patients with delusional jealousy were found to have an additional alcohol abuse or dependence problem. Various other factors such as present age and age at onset of psychosis, gender, and transcultural factors might contribute to the development of the syndrome in schizophrenia.
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PMID:Prevalence of delusional jealousy in schizophrenia. 770 Oct 62

This report describes the clinical characteristics of psychotic patients who received a 6-month longitudinal research diagnosis of psychosis not otherwise specified (NOS) or for whom no consensus diagnosis was reached. The reasons why these subjects could not be classified into a specific DSM-III-R category, their classification under the proposed DSM-IV criteria, their reclassification at 24-month follow-up, and differences between these groups and patients with schizophrenia and affective disorders in demographic characteristics, initial clinical features, and short-term course are explored. Data were drawn from the first phase of the Suffolk County Mental Health Project. Longitudinal consensus procedures were used to derive 6- and 24-month DSM-III-R diagnoses based on information from a structured diagnostic interview, an interview with the patient's clinician, the medical record and discharge summary, and significant others. Thirteen subjects (4.7%) received a diagnosis of psychosis NOS, and 12 (4.3%) had no consensus diagnosis. Seven with psychosis NOS had an acute onset with rapid remission; this subgroup met DSM-IV criteria for brief psychosis without stressors. As a group, the psychosis NOS subjects were significantly older and had a lower rate of lifetime alcohol abuse/dependence than the schizophrenic and affective disorder groups. Their short-term course was significantly better than that of the schizophrenics and similar to that of patients with an affective disorder. Subjects with no consensus diagnosis were more likely to have lifetime drug abuse/dependence than the other two groups.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Psychotic patients with unclear diagnoses. A descriptive analysis. 771 9

Psychiatric comorbidity is common in psychotic disorders, but the chronology of comorbid and principal diagnoses has not been closely examined. Understanding chronology may be important for identifying risk factors, or alternatively, prodromal syndromes, for some patients with psychosis. To address this issue, we examined the rates of antecedent comorbid syndromes in patients with first-episode psychoses. Patients aged > or = 12 years presenting with psychosis were recruited from inpatient and outpatient treatment sites. Patients were excluded if they had been previously hospitalized or if symptoms resulted entirely from substance abuse or medical illness. All diagnoses were made using the Structural Clinical Interview for DSM-III-R-Patient Version (SCID-P). Comorbidity was defined as antecedent if the age of onset of the comorbidity predated the age of the onset of the psychotic disorder by more than 1 year. Seventy-one patients were recruited during a 1-year period and included 39 with bipolar disorder, 18 with schizophrenia spectrum disorders, and 14 with psychotic depression. Comorbidity was present in 69% of patients. This comorbidity was antecedent in over 80% of the patients with concurrent syndromes. Patients with psychotic depression had the highest rates of comorbidity, in particular alcohol abuse and antecedent posttraumatic stress disorder (PTSD). Comorbidity is common in first-episode psychosis and is often antecedent to the psychotic disorder. These antecedent comorbidities may represent risk factors or prodromal syndromes for the psychotic disorder.
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PMID:Chronology of comorbid and principal syndromes in first-episode psychosis. 775 95

In a sample of 412 patients with psychotic disorders, the authors examined whether comorbid substance use can be reliably diagnosed, is associated with increased rates of affective symptoms and syndromes and specific psychotic symptoms, and is associated with lowered reliability of the DSM-III-R principal diagnosis. Data from the DSM-IV Field Trial for Schizophrenia and Other Psychotic Disorders was analyzed. In this dataset, substance use was scored on a 4-point ordinal scale and reliability was determined using weighted kappa scores. The associations of significant substance use with affective syndromes and symptoms, and psychotic symptoms were analyzed. Kappa statistics were calculated for principal psychotic disorder diagnoses for patients with and without significant substance use. Weighted kappa scores for substance use ratings ranged from 0.27 to 0.96 (median = 0.85). Syndromal depression was significantly associated with current alcohol use in the entire sample and in the subgroup with schizophrenia alone. Grandiose delusions were also associated with substance use. Significant comorbid substance use was not associated with lowered reliability of diagnosing the principal psychotic disorder. These findings support the hypothesis that comorbid substance abuse can be reliably diagnosed and that alcohol abuse is associated with depressive syndromes in patients with psychotic disorders.
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PMID:Substance abuse in psychotic disorders: associations with affective syndromes. DSM-IV Field Trial Work Group. 789 24

In the context of a prevalence survey of schizophrenia in South Westminster, a questionnaire was administered to 271 patients to assess alcohol-related morbidity. In this epidemiologically based sample, the lifetime prevalence of alcohol abuse was 22.1%. Compared with control patients matched for age and sex, these index cases had a significantly shorter duration of illness. A possible explanation is that drinking may mask the onset of schizophrenia, leading to a delay in diagnosis. The index cases also had significantly higher ratings for hallucinations and for hostility, anxiety and depression, and a greater number of disturbed types of behaviour. The highest levels of alcohol consumption were associated with more severe orofacial dyskinesia, suggesting that alcohol use may be an added risk factor for the development of tardive dyskinesia in some patients. The severity of akathisia was also related to alcohol use, and there were significant relationships between the subjective distress related to akathisia and the level of abuse. A possible interpretation is that alcohol had been used by patients with akathisia to alleviate the associated agitation and dysphoria.
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PMID:South Westminster schizophrenia survey. Alcohol use and its relationship to symptoms, tardive dyskinesia and illness onset. 799 24

A three-month prospective collection of primary care data from general surgery attendances in an inner London Health District was carried out to inform the setting of contracts for psychiatric services. This involved 21 general practitioners (GPs) selected from a total of 102 in the District. Information was collected on mental health disorders detected by GPs among the attenders, the resultant volume of care provided by the GPs, the referrals made to secondary care and other agencies, and the types of care identified by the practitioners as appropriate for a patient but which are currently not accessible or available. We found that 45.9 per cent of all patients (17,319/37,733) registered with the 21 GPs were seen in three months. There was an overrepresentation of White and Black Caribbean patients and an under-representation of Bangladeshi, Chinese, Black African and Black Other patients in the study population. Mental health disorders were detected in 13.3 per cent (2304) of all attenders. The commonest problems were depression (17.7 per cent), acute stress reaction (15.5 per cent), anxiety (15.1 per cent), drug abuse (7.2 per cent), schizophrenia (5.8 per cent) and alcohol abuse (5.3 per cent). It was found that 37.3 per cent (860) of all attenders received medication, 66.5 per cent (1532) were counselled by the GPs and only 4.4 per cent (102) were referred to a psychiatrist; 16.3 per cent (375) of those with mental health disorders were identified by the GPs as having a service need which the District's psychiatric service could not meet.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:The collection of general practice data for psychiatric service contracts. 803 58

Recognition of maternal alcoholism as a risk factor for mental illness in adult offspring is important. Using the Diagnostic Interview Schedule (DIS), adult offspring of a clinical sample of alcoholic mothers were assessed for selected lifetime psychiatric disorders. Elevated adjusted odds ratio (OR) of alcohol abuse/dependence (OR 6.18, 95% confidence interval (CI) 2.0-19.02), and drug abuse/dependence (OR 3.75, 95% CI 1.13-12.34) were observed for daughters of alcoholic mothers compared with a group of women who reported no history of alcoholism in their parents. Prevalence rates of alcohol abuse/dependence, drug abuse/dependence, affective disorders, general anxiety disorder, panic disorder and schizophrenia were higher in sons of alcoholic mothers than in a male comparison sample who reported no history of parental alcoholism, however, these increases were not statistically significant.
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PMID:Prevalence of mental illnesses in adult offspring of alcoholic mothers. 805 39

Wernicke's encephalopathy producing an altered mental state may occur in malnourished psychiatric patients even in the absence of alcohol abuse. A case is reported of a woman, aged 61 years, with schizophrenia who refused her medication for four months, had the delusion she was dying from a tumour, and withdrew to her bed with a neglect of her nutrition. She was committed to hospital in a mute unresponsive state and after taking some food and fluids for four days lapsed into coma. She responded within three hours to the administration of thiamine. Clinicians need to remain vigilant to the possibility that an altered mental state in malnourished patients may be due to thiamine deficiency rather than to the primary psychiatric disorder. If doubt exists as to the presence of Wernicke's encephalopathy, then parenteral thiamine should be administered.
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PMID:Wernicke's encephalopathy complicating schizophrenia. 813 89

Both epidemiological and clinical studies have demonstrated a high prevalence of panic disorder among alcoholic patients. In contrast, little attention has been given to studying alcohol abuse and/or dependence in patients suffering from panic disorder. One hundred and fifty-five consecutive referrals for treatment for panic disorder were interviewed using a modified version of the Schedule for Affective Disorders and Schizophrenia--Lifetime Version, modified for the study of anxiety disorders. Thirty-two patients (20.7%) had a lifetime history of alcohol abuse and/or dependence. Although the lifetime comorbidity rate of either agoraphobia and/or social phobia seems without any influence on the risk of alcohol-related disorder, alcoholic patients suffering from panic disorder appear to be more likely to have a history of depression and other addictive disorders. The majority of patients with primary alcoholism were male, and those who became alcoholics after they developed panic disorder were more likely to be female. The comparison between patients with primary and secondary alcoholism did not indicate any difference in the comorbidity rate with other psychiatric disorders nor the severity of panic disorder.
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PMID:[Panic disorder and alcoholism: effects of comorbidity]. 824 21


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