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)

Identification of alcohol abuse in psychiatric patients is essential, since it can confuse the clinical picture and complicate treatment. The utility and reproducibility of the Self-Administered Alcoholism Screening Test (SAAST) was assessed in 236 acutely ill psychiatric patients. Both an initial SAAST given at admission, and a second SAAST given shortly before discharge, were completed by 173 (73%) patients; significant correlation (r = 0.85) was found between scores on SAAST 1 and SAAST 2. Only 41 (17%) patients were unable or refused to complete the initial SAAST and the majority of these received a schizophrenia diagnosis. SAAST scores were also significantly correlated with the clinical assessments and histories. Most (76%) patients with a current or past history of alcohol abuse scored in the "alcoholic" (> or = 8) range on one or both SAASTs. Men were almost twice as likely as women to have a history of alcohol abuse, and significantly more likely to score > or = 8 on the SAAST. The SAAST could be completed by the majority of acutely ill psychiatric patients even at admission, and was clinically useful in the diagnosis of alcohol abuse, especially when used in conjunction with the clinical interview.
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PMID:Reliability of the Self-Administered Alcoholism Screening Test (SAAST) in psychiatric inpatients. 829 41

The prevalence of cocaine abuse by patients with schizophrenia has led researchers to investigate features of the disorder correlated with abuse. Although abuse has been found to be more common among patients with a diagnosis of paranoid subtype and a history of earlier and more frequent hospitalizations, it is unclear if it is related to any particular pattern of negative or positive symptoms. This study examines the severity of positive and negative symptoms for patients with and without histories of cocaine abuse. Subjects with a history of at least 2 months of cocaine abuse (N = 25), no lifetime substance abuse (N = 20), and 2 months of alcohol abuse with no other substance abuse (N = 23) are compared on five-factor analytically and three rationally derived scores from the Positive and Negative Syndrome Scale (PANSS). Following a multivariate analyses of variance (p < .01), univariate analyses indicated significant differences on the negative syndrome scales, with cocaine-abusing subjects exhibiting less severe negative symptoms than subjects with no substance-abuse history. Cocaine-abusing subjects were also found to have been younger at time of first psychiatric hospitalization and more likely to qualify for a diagnosis of the paranoid subtype.
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PMID:Relationship of positive and negative symptoms to cocaine abuse in schizophrenia. 830 28

We investigated whether Scale 2 (Depression [D]) and the Wiggins Content Scale of Depression (DEP) of the Minnesota Multiphasic Personality Inventory (MMPI) have different clinical correlates when only one of these two scales is elevated. According, a group of patients who elevated DEP higher than Scale 2 (DEP > 2) were compared with a group of patients who elevated Scale 2 higher than DEP (2 > DEP). The patients with DEP > 2 were rated as being less severe than the patients with 2 > DEP on the following Brief Psychiatric Rating Scales: Somatic Concern (SOM), Emotional Withdrawal (WDRA), Depressive Mood (DEP), and Blunted Affect (AFF). The patients with DEP > 2 were rated as more severe on Excitement (EXC). The patients with DEP > 2 were more likely to receive the Axis I diagnoses of: bipolar disorder, manic, and alcohol abuse. Schizophrenia was equally probable for patients in the two groups. It appears that these two MMPI scales of depression have different clinical correlates when either one scale or the other is elevated.
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PMID:Clinical correlates of MMPI depression scales. 847 72

The first 13 consecutive referrals to a newly established Geriatric Psychiatry Research Division (GPRD) at a community mental health center (CMHC) in Baltimore, Maryland, were evaluated with the structured clinical interview (SCID) from the third edition of the Diagnostic and Statistical Manual, Revised (DSM-III-R). Although the referring primary diagnoses were confirmed in 54% of patients (7 of 13), an average of three new diagnoses were made for each patient that had not been considered. Of the remaining six patients, four (67%) patients with a diagnosis of schizophrenia were found to have a diagnosis of affective disorder based on the SCID interview (two patients with bipolar disorder, depressed and two patients with schizoaffective disorder, depressed). In the remaining two (33%) patients, one patient had a diagnosis of mixed dementia due to longstanding alcohol abuse with a superimposed primary degenerative dementia of the Alzheimer's type. The remaining patient's initial diagnosis of dementia associated with alcoholism was changed to bipolar disorder, depressed. These results provide support for the hypothesis that older persons with psychiatric illness may have been misdiagnosed at a time of less diagnostic rigor.
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PMID:Misdiagnosis among older psychiatric patients. 855 19

The high comorbidity of schizophrenia and substance abuse raises the question of a causal relationship between the two disorders. Clarifying the temporal sequence of their onsets can shed light on this issue. For this purpose, onset and course of schizophrenic symptoms and of alcohol and drug abuse were retrospectively investigated within the ABC Schizophrenia Study in a representative first-episode sample of 232 schizophrenic patients. The rates of alcohol abuse (24%) and of drug abuse (14%) were twice the rates compared to the general population but schizophrenic patients seemed to have started substance abuse later than the control group. Male sex and early symptom onset were major risk factors. At all important landmarks during the early course of schizophrenia, drug-abusers were younger than alcohol-abusers who were younger than non-abusers. Alcohol abuse usually started during the prodromal phase, i.e., after the first sign of schizophrenia but before the first positive symptom. Drug abuse emerged before the first symptom in one third, simultaneously with it in another third, and during the prodromal phase in the last third of patients. Drug abuse significantly preceded the psychotic phase. The hypothesis that substance abuse causes schizophrenia thus is not generally supported. Findings on symptomatology illustrate the problems substance-abusing schizophrenics pose from early on with dissocial behaviors and preoccupation with magical ideas but without a specific positive or negative subsyndrome.
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PMID:[Do alcohol or drug abuse induce schizophrenia?]. 867 87

This is a retrospective study that aimed at studying the diagnostic stability of psychiatric diagnoses over a 4-year period. Three-hundred and twelve patients (n = 312) admitted more than once to Al Ain in-patient unit from January 1, 1990 to December 31, 1993, were the subjects for this study. The sample included patients with the following index diagnoses: acute psychoses (n = 37), alcohol abuse (n = 15), bipolar disorder (n = 27), depressive disorders (n = 63), drug abuse (n = 21), hysteria (n = 23), neurotic disorders (n = 50) and schizophrenia (n = 76). Diagnoses on discharge for first admissions were considered the index diagnoses. The shift from index diagnoses to subsequent diagnoses was counted. Diagnostic stability was calculated as the percentages of index diagnoses that did not change over time. In nearly half of the patients the index diagnoses changed over the 4-year period. Highest diagnostic stability was found in patients with index diagnoses of alcohol abuse, schizophrenia and drug abuse (92%, 74% and 71% respectively), while the lowest stability was found in patients with neurotic, hysterical, depressive disorders, acute psychoses and bipolar disorders (38%, 48% and 45%, 42%, 52% respectively). Two distinct patterns of shifts were noted. First shift occurred between functional psychoses and second shift between depressive and neurotic disorders. This study provides further support to the notion that diagnostic stability in clinical practice is still far from being satisfactory.
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PMID:Stability of psychiatric diagnoses in clinical practice. 888 44

Up to 60% of chronic schizophrenic patients are reported to abuse alcohol or drugs. This comorbidity raises the question whether one disorder is a consequence of the other. With the structured interview "IRAOS," the onset and course of schizophrenia and substance abuse were retrospectively assessed in a representative first-episode sample of 232 schizophrenic patients. Information by relatives validated the patients' reports. Alcohol abuse prior to first admission was found in 24%, drug abuse in 14%-twice the rates in the general population. Alcohol abuse more often followed than preceded the first symptom of schizophrenia. Drug abuse preceded the first symptom in 27.5%, followed it in 37.9%, and emerged within the same month in 34.6% of the cases. The study demonstrates a remarkable association between first-episode schizophrenia and substance abuse, but a unidirectional causality is not supported, nor is a specific psychotic disorder in comorbid cases.
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PMID:Substance abuse and the onset of schizophrenia. 893 19

A comprehensive report mandated by the U.S. Congress on the state of the science of prevention recommends a stricter definition of the term prevention; summarizes specific preventive intervention research programs across the life span; and specifies funding, personnel, and coordination priorities to build a national prevention research infrastructure. A major conceptual recommendation is a focus on reducing risk for mental disorders, which has been a fruitful strategy in the prevention of physical illness. The report argues that the prevention field should also draw from advances in mental disorder treatment research and from the major contributions to the knowledge base occurring in the behavioral and biological core sciences. Relevant advances in neuroscience, genetics, epidemiology, and developmental psychopathology are examined in detail. Five major disorders are chosen to illustrate possible approaches to prevention: conduct disorder, depressive disorders, alcohol abuse and dependence, schizophrenia, and Alzheimer's disease.
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PMID:Institute of Medicine report on prevention of mental disorders. Summary and commentary. 893 62

We have recently characterized a functional polymorphism in the catechol-O-methyltransferase (COMT) gene that is responsible for substantial variability in COMT enzymatic activity found in humans. A common low-activity variant of the enzyme contains a methionine residue at amino acid 158 of membrane-bound COMT whereas the common high activity variant has a valine at this site. Considering the role of COMT in dopamine metabolism and the involvement of dopaminergic pathways in the pathogenesis of schizophrenia and violence, we screened 37 patients with schizophrenia to determine whether or not a behavioral association with the COMT polymorphism exists. Patients were assessed for dangerousness on the basis of a history of violent and threatening behavior, crime, cocaine and alcohol abuse, and other antisocial behaviors. We found that schizophrenic patients who were homozygous for the low activity allele were judged by their psychiatrists to be at higher risk for aggressive and dangerous behavior than those who were homozygous for the high activity allele (Kruskal-Wallis statistic = 10.43; P = 0.003).
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PMID:Analysis of a functional catechol-O-methyltransferase gene polymorphism in schizophrenia: evidence for association with aggressive and antisocial behavior. 910 74

This case-control study investigated the extent to which aberrant behaviors, in contrast to more traditional clinical factors (such as symptoms and alcohol abuse), place individuals with schizophrenia at increased risk for rehospitalization. One hundred and one recidivists (cases) were matched to 101 non-recidivists (controls) on gender, race, and time since index hospitalization. Key informants, usually family members, were interviewed to assess behaviors during a 2-week period. After controlling for possible confounding variables, we found that each aberrant behavior increased the risk for rehospitalization, but highly disruptive or dangerous behaviors (such as threatening others, acting very bizarrely, or attempting suicide) conveyed a markedly high degree of risk (adjusted odds ratio = 83.9). It is possible that service providers may be able to avert the fiscal and emotional cost of hospitalization by collaborating more closely with family members to identify these behaviors and intervene before hospitalization becomes unavoidable.
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PMID:Behaviors as risk factors for rehospitalization: implications for predicting and preventing admissions among the seriously mentally ill. 918 63


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