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

The author reports the results of five studies of panic disorder undertaken as part of the Epidemiologic Catchment Area Program of the National Institute of Mental Health (NIMH). This program involves community samples in New Haven, Conn. (N = 5,034), Baltimore (N = 3,481), St. Louis (N = 3,004), Durham, N.C. (N = 3,921), and Los Angeles (N = 3,132). Diagnoses were based on the NIMH Diagnostic Interview Schedule and DSM-III. Panic disorder led the list of disorders for which subjects in the five studies received ambulatory mental health services. Treatment rates for panic disorder were as high as or higher than those for somatization disorder, schizophrenia, and major affective disorders. Furthermore, panic attacks may have been the reason that many subjects with other disorders sought treatment.
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PMID:Use of mental health services for the treatment of panic disorder. 378 10

New uses are still being discovered for a number of psychotropic agents that have been available for some time. Among the more important recent discoveries are the efficacy of the tricyclic antidepressants for panic disorder and agoraphobia with panic attacks; the use of the monoamine oxidase inhibitors for the above disorders and for atypical depression and hysteroid dysphoria; the use of propranolol for anxiety disorders and for uncontrollable violent outbursts; the antianxiety and antipanic effects of clonidine; and the usefulness of lithium in treating schizophrenia and schizoaffective disorder and for emotionally unstable character disorders. In addition to strengthening the therapeutic armamentarium, the author says, the discovery of new drug response patterns helps generate or strengthen hypotheses about the pathophysiology of various psychiatric disorders.
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PMID:Newer uses for older psychotropic medications. 612 38

Anxiety is the second most common psychiatric condition that a nurse practitioner is likely to see clinically. It is first necessary to determine whether the anxiety is primary or secondary. Primary anxiety conditions include: acute and chronic anxiety reactions, panic attacks, simple or multiple phobias, post-traumatic stress disorders and obsessive-compulsive disorders. Secondary anxiety is seen in relationship to depression, schizophrenia, physical illness, organic mental disorders and substance abuse. This article focuses on the evaluation of panic attacks and generalized anxiety states.
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PMID:Panic attacks and generalized anxiety states. 647 42

Suicidal behaviours are multifactorial behaviours. While, historically, anxiety has not been regarded as an important risk factor in suicidal behaviours, recent epidemiological studies carried out on general population or panic patients have evidenced the possible links between suicidal behaviours and the occurrence of panic attacks. The aim of our study was to validate the hypothesis which stipulates that panic disorder may contribute to an actualization of suicidal behaviour in trying to establish the prevalence of panic disorder in a population of suicidal attempters. The diagnoses were reached after an interview using the Schedule for Affective Disorders and Schizophrenia-Lifetime Version modified for the study of Anxiety disorders (SADS-LA). The medical seriousness of the suicide attempts was assessed with the Risk Rescue Rating Scale (RRRS) of Weissman and Worden and the suicidal intent with the Suicidal Intent Scale of Beck (SIS). In the 62 suicide attempters hospitalized after minor or slightly more serious suicide attempts, we found high current and life-time prevalence of panic disorder (17.7% and 22.6% respectively). Comorbidity with major depressive episodes and addictive behaviours in suicide attempters with panic disorder was high. Current comorbidity rates were 72.8% and 27.3% respectively; life-time comorbidity rates were 71.4% and 21.4%. Patients who suffered from major depressive disorder with related panic disorder were given to more impulsive suicide attempts, even if the difference with depressed patients without panic disorder was statistically insignificant.
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PMID:[Suicide attempts and panic disorder: a study of 62 hospitalized suicidal patients]. 778 88

Twenty-four out-patients with globus were assessed for current and past psychiatric illness with the 'Schedule for Affective Disorders and Schizophrenia-Lifetime Anxiety' version. Patients then received amitriptyline or placebo in a double-blind fashion. Treatment outcome was assessed using an inventory of throat symptoms, Beck Depression Inventory, Spielberger State Anxiety Scale, Crown-Crisp Experimental Index and General Health Questionnaire. Nine patients met the DMS-III criteria for psychiatric disorder in the past; six had suffered from panic disorder. Two further patients had been troubled by classic panic attacks. Nine of the 12 patients treated with amitriptyline and two of the placebo group discontinued treatment. In conclusion, clinical and psychometric associations were found between pathological anxiety and globus, and it appears that the recommendation that globus be treated 'aggressively' with tricyclic antidepressants is likely to lead to a high proportion of treatment failures.
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PMID:Problems in treating globus pharyngis. 817 3

Until recently, Obsessive-Compulsive Disorder (OCD) was considered rare trouble with rather poor outcome. Currently progress in behavioral psychology, psychopharmacology and methodology of epidemiologic studies multiplying by 50 the traditional prevalence rates, give an impetus to the interest in this pathology. Recent clinical and epidemiologic data in OCD are reported in this paper. Multiple questions are evoked such as the issue of OCD homogeneity, the meaning of comorbidity with other psychological disorders: depression, panic attacks, schizophrenia, Gilles de la Tourette syndrome, the reality of OCD prevalence rate in general and psychiatric populations, the usefulness of classical demarcation between psychosis/neurosis in the treatment of OCD, and finally the search for a genetic diathesis and risk factors implicated in predisposition to OCD. A close relationship between clinical, epidemiologic and genetic approaches seems to be required in order to answer these questions and constitutes a first step prior to carrying on basic and applied research.
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PMID:[Obsessive compulsive disorder. Clinical and epidemiologic studies]. 864 Nov 57

The author report a case of Capgras' syndrome in a 12-years-old girl, who had been hospitalized for attacks of abdominal pain. These symptoms had gone on for two years and led twice to surgical interventions which did not find any organic etiology. Interviews with the girl showed that the abdominal pains were related to symptoms of typical panic attacks which lasted about 20 minutes. In some on them, she experienced multiple autoscopy and the "illusion des sosies", described by Capgras. Long-term evolution showed that Capgras' syndrome disappeared with improvement of the panic attacks, but ten years later the patient is still suffering from generalized anxiety. To our knowledge, no case, even in adult patients, was previously described in the context of panic attacks. Furthermore, Capgras' syndrome is particularly rare at adolescence. Our review of literature exhibits only 19 cases under 18. Diagnosis was available in 16 cases, and consisted of schizophrenia or schizophreniform psychosis in 62.5% of the cases. The others involved acute psychosis (2 cases), post-partum psychosis (1 case), drug-induced-psychosis (1 case), psychotic major depression (1 case), and post-varicella encephalitis (1 case). The doubles (out of the 15 cases where relevant detail is available) included at least a parent in 92.9% of patients, a brother or sister in 35.7%, a member of the medical team in 21.4% and a grand-parent in 14.3%.
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PMID:[Capgras syndrome in adolescence: a review apropos of one case]. 867 74

The goal of this paper is to draw conclusions about the usefulness of the standard EEG in psychiatry. In general, two thirds of psychiatric referrals for an EEG are expected to provide useful information. The emphasis in schizophrenia is placed on left-sided abnormalities, especially on the left temporal area. In mood disorders the emphasis is on right-sided foci, in addition to the controversial 6/sec spike and wave complexes, small sharp spikes and positive spikes. In the acute stage of alcoholism, a relationship is seen between the degree of intoxication and the amount of slow activity, while in the chronic stage an increase in slow activity is seen, but another change is fast activity on the temporal areas. During withdrawal a low seizure threshold can be seen as irregular bilateral spike and wave complexes. During abstinence 2-4 yr may be required before slow wave sleep is normal in all regards. Among the organic mental syndromes, delirium shows slow activity, except in delirium tremens, which often is associated with a normal record with fast activity. In dementia the prevalence of EEG abnormalities is related to the degree of impairment. After five sessions of ECT diffuse slow waves are often seen. In other conditions, among developmental disorders about one half of autistic children show abnormalities and epileptiform activity is not uncommon. Mild nonspecific abnormalities are seen in about 40% of dyslexics and also in behavior disorders. Anxiety disorders include anorexia nervosa, showing abnormal background activity related to the effect of starvation on cerebral metabolism. In panic attacks paroxysmal activity can be seen. In borderline personality positive spikes have been (again) associated with impulsivity and 6/sec spike and wave complexes with interpersonal problems. Of the drugs of abuse psilocybin and phencyclidine are often associated with generalized epileptiform patterns and with marijuana the alpha shows a decreased frequency with increased amplitude. Typically, an increase in slow activity is seen with psychotropic drugs if there is a change in the level of awareness. Finally, distinctive personality traits are, at times, seen in temporal lobe epilepsy and the phenomenon of "forced normalization" may appear when seizures stop and psychotic symptoms appear.
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PMID:A review of the usefulness of the standard EEG in psychiatry. 871

It has been suggested that cholecystokinin (CCK), a gut-brain peptide found in high concentrations in the mammalian brain, might be implicated in the neurobiology of anxiety and panic disorder. The administration of CCK tetrapeptide induced panic attacks analogous to spontaneous ones in patients suffering from panic disorder and to a lesser degree in healthy volunteers. In animal models of anxiety, the pretreatment with CCK agonists and antagonists produced, respectively, anxiogenic- and anxiolytic-like action on the exploratory paradigms. On the other hand, CCK could also play a role in the pathophysiology of schizophrenia. The administration of CCK agonists (caerulein, CCK-8s) to rodents results in behavioural effects analogous to those of antipsychotic drugs. However, CCK agonists lack any activity in rodent behavioural models to reveal antipsychotic drugs. A significant reduction of CCK concentration and CCK receptors has been shown in cortical and limbic structures of patients suffering from schizophrenia. Nevertheless, administration of CCK agonists to these patients does not effect their symptoms. Two major conclusions should be drawn: first, CCK is involved in the neurobiology of anxiety; second, changes in the CCK system in schizophrenia could be linked to a cortical neurodegeneration related to this disease.
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PMID:Two faces of cholecystokinin: anxiety and schizophrenia. 873 54

Although panic attacks have been described as relatively common in schizophrenia, few studies have examined treatments for this problem. Because cognitive-behavioral therapy (CBT) has demonstrated efficacy for panic disorder without schizophrenia, the authors conducted an open clinical trial of CBT for the treatment of panic attacks in schizophrenic patients. Eight patients meeting DSM-III-R criteria for schizophrenia and panic disorder were given a 16-week clinical trial of CBT. Ratings after treatment demonstrated both a statistically significant reduction in panic symptoms and a diminution in the number of panic attacks compared with baseline ratings. These results suggest use of CBT in the integrated treatment of patients with a diagnosis of schizophrenia and panic disorder is a promising approach that merits further investigation.
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PMID:Cognitive-behavioral treatment of panic attacks in chronic schizophrenia. 907 65


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