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

This paper discusses the concept of anhedonia defined as the inability to experience pleasure. Many authors have noted the presence of anhedonia as a personality feature in patients with schizophrenia and other disorders. Anhedonia apparently begins early in life in relation to pathological reactions within the core family. Many authors feel that anhedonia is closely associated with poor premorbid adjustment, interpersonal incompetence and chronicity, and mediates towards poor prognosis. The authors feel that interpretive forms of psychotherapy and psychoactive medication are not particularly effective in the treatment of anhedonic patients. They propose a selection of intellectual, physical and social activities as a more direct attack on this problem of anhedonia. Through these activities the patients are able to gain a tangible experience of pleasure while developing more effective interpersonal skills. The response of patients to activities also provides material for structured forms of psychotherapy and the combination and interaction of activity therapy and traditional psychotherapy is considered to be effective in many anhedonic patients.
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PMID:Notes on the treatment of anhedonia. 70 97

Earlier researchers have suggested that the ability of process-reactive measures to predict future adjustment may result from their relationships to the anhedonia dimension. In the present study the abilities of process-reactive and anhedonia measures, independent of one another, to predict rehospitalization data were compared. After anhedonia scores had been partialed out, schizophrenics' process-reactive scores were correlated modestly with length of the patients' next hospitalization and reclassification as nonschizophrenic. No such significant correlations appeared between anhedonia and adjustment measures after process-reactive scores had been partialed out. Among nonschizophrenics, a sizeable correlation between anhedonia and the probability of later diagnosis of schizophrenia appeared, which suggests that anhedonia may be a useful prodromal marker for schizophrenia.
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PMID:The prediction of outcome from anhedonia and process-reactive scales. 71 79

The authors administered semi-structured interviews to 187 psychiatric inpatients to determine the role of anhedonia in schizophrenia. The interviews were taperecorded and then given blind ratings for anhedonia on a 7-point scale. Schizophrenic patients had significantly more anhedonia than nonschizophrenics, although many of the latter group had anhedonic tendencies. Most of the difference between the groups resulted from high anhedonia scores for chronic schizophrenics; less anhedonia was found in the acute schizophrenic patients. The data indicate that anhedonia is not necessary or unique to schizophrenia but is a prominent factor in chronic schizophrenia.
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PMID:Anhedonia and schizophrenia. 86 58

The affective disorder in schizophrenia is an important manifestation of the schizophrenic illness. Such clinical features of joylessness, interpersonal aversion, and affective blunting have been considered by Rado and Meehl to represent a neurophysiological deficit in pleasure capacity which they termed anhedonia, but is more aptly characterized by the term hypohedonia. A free-recall task employing 24 affectively laden words presented in random order over nine trials was given to a carefully selected group of nonpsychotic hospitalized schizophrenics, hospitalized nonschizophrenics, and normals. The results of the study demonstrate that normals remember pleasant words to a significantly greater extent than upleasant words. This Pollyanna tendency or the tendency to utilize pleasant words over upleasant words has been described by Osgood as a stable cross-cultural phenomenon. By contrast, the schizophrenics show a significantly lower recall of pleasant words when compared with normals, although they remember unpleasant words to a comparable degree as normals. These findings provide experimental support for the hypohedonia hypothesis in schizophrenia. The nonshcizophrenic patients recall pleasant and unpleasant words to a significantly greater degree than neutral words. They are thus affectively governed in the free-recall task and seem equally sensitized to both pleasant and unpleasant affect in their mnemonic processing.
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PMID:Hypohedonia in schizophrenia. 119 10

A distinct hypokinetic syndrome appears to exist across several different neuropsychiatric diagnoses, involving (1) slowed motor activity with difficulty initiating and sustaining behaviors, (2) anhedonia with depressed mood and reduced affective range, and (3) cognitive impairment. Specifically, three well-recognized states--parkinsonism, retarded depression, and the negative symptoms of schizophrenia--prominently feature the components of this syndrome, and reduced dopamine turnover in the brain has been hypothesized to play a part in the pathophysiology of each. While aspects of this conceptualization remain controversial, it generates testable hypotheses that could have implications for the understanding and treatment of these states.
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PMID:Akinesia: a syndrome common to parkinsonism, retarded depression, and negative symptoms of schizophrenia. 135 15

We examined the association between scales measuring physical anhedonia, social anhedonia, and perceptual aberration and premorbid functioning, clinical state, and current level of adjustment in 91 psychotic subjects. The patients were examined at the onset of their first psychotic episode and again 18 months later. For patients with schizophrenia, anhedonia was significantly related to premorbid functioning. No association was found between the scales and clinical state or level of adjustment at intake or follow-up. In affective disorder patients, no correlation was found between premorbid functioning (a stable characteristic) and scale scores, but moderately large correlations emerged between the scales and clinical state and level of adjustment at both assessment times. These results suggest that schizophrenic and affective disorder patients endorse items on these scales for different reasons. We hypothesize that for patients with schizophrenia, the scales assess enduring personality characteristics, whereas for the affective disorder patients, they assess clinical condition at the time of testing.
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PMID:Clinical correlates of anhedonia and perceptual aberration in first-episode patients with schizophrenia and affective disorder. 153 65

Regional cerebral blood flow was evaluated using Tc99m-HMPAO SPECT in 10 medicated patients with schizophrenia and 9 healthy volunteers. There were no prefrontal regions in the patient group with lower regional indices than in the control group. However, in the left hippocampal region, relative blood flow was significantly increased in the patient group compared with the control group. Furthermore, there was a relative increase in blood flow in the left basal ganglia of the patient group. A negative correlation coefficient was calculated between the relative blood flow in the left middle prefrontal cortex and the severity of the blunted affect, as well as between the relative blood flow in the left basal ganglia and the severity of the anhedonia-asociality. These findings indicate that prefrontal hypoactivity is not invariably present in all schizophrenics and that left basal ganglial hyperactivity may be associated with the effects of antipsychotic treatment and clinical improvement. Moreover, the left hippocampal hyperactivity may correspond to left limbic dysfunction in schizophrenia.
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PMID:Regional cerebral blood flow in patients with schizophrenia. A preliminary report. 157 74

The present study examined modification of the startle reflex in psychosis-prone and normal control subjects, using a continuous pure tone prestimulus (S1) and an intense white noise startle stimulus (S2). Reflex modification conditions consisted of stimulus pairs with onset asynchronies of 60, 120, and 2000 ms with a startle-alone condition as control. Startle was indexed by the eyeblink, which was measured by vertical electro-oculography. Subjects were identified as psychosis-prone by their high scores on the Perceptual Aberration or the Physical Anhedonia scales. Group differences in blink magnitude inhibition were observed between perceptual aberration and control subjects during short stimulus onset asynchronies, with perceptual aberrators showing significantly less inhibition than controls at 120 ms. No differences were evident between anhedonic and control subjects at the two short onset asynchronies nor were there any significant between-group differences when the interval between stimuli was long (2000 ms). These results suggest that subjects with perceptual aberrations may share with schizophrenics and other schizophrenia-spectrum subjects an underdeveloped mechanism which in normal subjects is presumed to operate during preattentive processing and functions to protect sensory information from the interfering effects of subsequent stimuli.
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PMID:Reflex modification in psychosis-prone young adults. 160 30

The natural history and long-term course of schizophrenia divided by pervasiveness of positive and negative symptoms was explored among 187 schizophrenic patients from the Chestnut Lodge follow-up study. Schizophrenia with many negative symptoms was associated with poor premorbid functioning, insidious onset, partial or no remissions during the first several years of illness, and in most cases a progressive course leading to permanent disability. Schizophrenia with few negative symptoms was associated with good premorbid functioning, acute onset, intermittent early course, and a better prognosis. Positive symptoms predicted future hospitalizations but were less powerful and specific as indicators of differential illness history, course, and long-term functional incapacity. As predictors of long-term outcome, negative symptoms were of greater value measured at index admission several years after illness onset than at first hospital admission. Multivariate analyses indicated that two negative symptoms (anhedonia and affective flattening) contribute significantly to outcome variance independent of their association with premorbid functioning or positive symptoms. Patients with the poorest long-term outcome tended to show an increase in negative symptoms during the early years of their illness. Progressive negative symptoms early in the course of schizophrenia may thus reflect or signal a process leading to long-term functional disability.
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PMID:Natural history of schizophrenia subtypes. II. Positive and negative symptoms and long-term course. 174 21

We administered scales of Perceptual Aberration (PERAB) and Physical Anhedonia (PHYSAN), traits that may be related to risk for schizophrenia, to 54 schizophrenics, 146 of their first-degree relatives (evaluated for schizophrenia-related disorders), and 178 normal subjects (screened for psychotic disorders in them or their relatives). For both scales, there was a significant effect of group membership. For the PERAB scale, the schizophrenics had higher scores than the normal subjects, who had higher scores than the relatives. For the PHYSAN scale, schizophrenics had higher scores than their relatives, who had higher scores than the normal subjects. Patterns of familial correlations also suggested that physical anhedonia, but not perceptual aberration, may be familial among schizophrenics and their relatives. The PHYSAN scale, but not the PERAB one, may be a useful indicator of liability for schizophrenia among the relatives of affected probands.
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PMID:Psychometric detection of schizotypy: perceptual aberration and physical anhedonia in relatives of schizophrenics. 175 76


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