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

From a population of long-stay patients with a diagnosis of schizophrenia according to the St Louis criteria, a group of 21 patients with 'age disorientation' was selected, and compared on a series of tests of intellect and learning capacity with a matched control group of 21 schizophrenic patients without this feature. The age-disorientated patients demonstrated substantial impairments on tests of orientation and general knowledge, associational learning, the 'famous personality' test, tests of vocabulary and aphasia, Raven's matrices, the digit-symbol substitution test and the mental test score. We conclude that profound 'organic-type' psychological deficits (global impairment of intellectual function associated with temporal disorientation) undoubtedly occur in chronic schizophrenia. The findings on the 'famous personality' test and the Peabody vocabulary test did not exclude the possibility that such impairment arises early in life, at a time preceding the onset of the illness which leads to hospital admission.
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PMID:Age disorientation in chronic schizophrenia is associated with global intellectual impairment. 670 7

Studies in Great-Britain and the USA have established the prevalence of 'age disorientation', defined as a discrepancy between true and subjective age of five years or more, as approximately 25% in the population of long-stay patients with a diagnosis of schizophrenia. We examined all schizophrenic patients in long-stay wards of three mental hospitals and found a prevalence of 6% (95% CI: 0.9-10.6%). We have no definitive explanation for this finding. 'Age disorientation' may be the result of an interaction between a serious form of the illness and poor psychosocial treatment.
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PMID:Low prevalence of age disorientation in Dutch long-stay patients. 771 Sep 94

Many schizophrenic patients exhibit significant neuropsychological impairment, and age disorientation is considered to be one of the more extreme manifestations. To evaluate clinical correlates of age disorientation with reference to the course of schizophrenic illness, we compared 39 deteriorated chronic Kraepelinian schizophrenic patients and 39 nondeteriorated schizophrenic patients early in the course of illness. Age disorientation was observed in 36% of patients in the Kraepelinian group, but in no patient in the non-Kraepelinian group. In the Kraepelinian group, age disorientation was unrelated to positive/negative symptoms or illness duration. Our data suggest that age disorientation may be a function of aging in schizophrenia, but is not merely a function of chronicity.
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PMID:Age disorientation in Kraepelinian schizophrenia: frequency and clinical correlates. 823 39

Clozapine, used in the treatment of patients with schizophrenia resistant to other neuroleptic medication, is metabolized by the hepatic microsomal system to demethyl-clozapine and clozapine-N-oxide. Changes in clozapine serum concentrations have been documented after initiation of therapy with medications known to induce or inhibit liver microsomal enzymes. These interactions are of clinical importance when diminished efficacy or increased toxic effects of clozapine therapy occur. A 34-year-old schizophrenic man had increased clozapine serum concentrations, leukocytosis, and adverse effects as a result of concomitant erythromycin therapy given for suspected lower respiratory tract infection. Symptoms included somnolence, difficulty in coordination and ambulation, slurred speech, disorientation, and incontinence. The symptoms resolved after treatment with clozapine and erythromycin were discontinued, and treatment with clozapine was gradually resumed.
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PMID:Erythromycin-induced clozapine toxic reaction. 862 81

Age disorientation was studied in 45 geriatric patients with chronic mood disorders. In a yearly assessment of cognitive functions, subjects were questioned about their age, year of birth, and the current year. Patients who misstated their age by > or = 5 years were considered age disoriented. Among the 45 patients, age-disorientation data were available for 32 patients, with the remainder either stating that they did not know their age or providing age-delusional responses. Six of the 32 patients were characterized as age disoriented at baseline and again at 12- to 18-month follow-up assessment. Age-disoriented patients performed worse overall on the Mini-Mental State Examination compared with patients who did not show age disorientation. Future studies of brain function and structure should include poor-outcome patients with mood disorders as well as patients with schizophrenia in attempts to identify the possible neurological dysfunctions that may underlie the phenomenon of age disorientation.
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PMID:Age disorientation in chronically hospitalized patients with mood disorders. 885 70

Some psychiatric patients diagnosed with schizophrenia have a secondary diagnosis of polydipsia which is manifested by consuming excessive quantities of fluids, marked confusion, and disorientation. In most instances, these persons are less amenable to treatment and rehabilitative interventions due to the changes in cognitive and physical processes. A review of our own current practice found that we had a small group of polydipsia patients requiring a large amount of one-to-one staff time for little or no long-term benefit. Further, there was no uniform approach to identify, treat, and monitor outcomes for patients with polydipsia. A TQM team was assembled with the goal of identifying a protocol for assessing the presence of polydipsia and a care map for the treatment of confirmed cases. The outcome was the development of a care map using diagnostic procedures and interventions found in the professional literature and empirical data collected on site. A short pilot study revealed that a number of polydipsia patients on Clozaril along with other interventions were successfully discharged from the hospital.
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PMID:Developing a best practice model for care of patients with polydipsia. 930 17

This study extends our prior research by examining the lifetime comorbidity, history of psychosis and suicide attempts, and current symptoms of an unusual group of patients with major affective disorders who have not only been symptomatic for prolonged periods but have also been so functionally impaired that they required years of care in psychiatric facilities or by family members. Twenty-seven of these deteriorated affective patients and 29 patients with deteriorated schizophrenia were recruited from a large state hospital; 27 patients with non-deteriorated affective disorder were recruited from an affiliated outpatient facility. Patients with deteriorated affective disorder, as compared to those with non-deteriorated affective disorder, were far more likely to have a history of psychotic symptoms with suicidal themes and a history of life-threatening suicide attempts and completed suicide. Deteriorated affective patients were also more likely to meet criteria for melancholia and to have attentional deficits, thought disorder and negative symptoms. The deteriorated and non-deteriorated affective groups had similar lifetime rates of psychotic symptoms (bizarre and non-bizarre) and lifetime psychiatric comorbidity. Functional deterioration in schizophrenia, as compared to functional deterioration in affective disorders, was distinguished by a virtual absence of psychotic symptoms with suicidal themes, lower lifetime rates of life-threatening suicide attempts, greater variety and severity of psychotic symptoms, and greater severity of current affective flattening, anhedonia-asociality and disorientation to time. The results of this study extend our previous research by demonstrating that patients with major mood disorders who have experienced extreme functional deterioration evidence a distinct constellation of symptoms that differentiates them from their better outcome peers with mood disorders, and from similarly functionally deteriorated patients with schizophrenia.
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PMID:Lifetime comorbidity, lifetime history of psychosis and suicide attempts, and current symptoms of patients with deteriorated affective disorder. 946 37

Schizophrenia is clinically and neuropsychologically characterized by severe cognitive and functional impairment suggesting the presence of a neurodegenerative process in the brains of affected individuals. A variety of neuroanatomical changes have been described such as loss and disorientation of neurons in grey and white matter and cortical atrophy. However, the neuropathological basis for schizophrenia is still unclear. In the present study we monitored the density of GFAP-positive astrocytes in brains of 33 schizophrenic patients and 26 healthy controls. Both grey matter (entorhinal cortex and subiculum) and white matter (premotor cortex, subventricular zone of the third ventricle and next to inferior horn) structures were measured bilaterally. The overall finding was that there is no evidence for increased astrogliosis in brains of schizophrenic patients vs healthy controls. Therefore, degeneration is unlikely to be the main neuropathological mechanism in schizophrenic brains.
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PMID:No evidence for astrogliosis in brains of schizophrenic patients. A post-mortem study. 1019 75

A 26-year-old Japanese woman slowly developed a change of character such as hypospontaneity and blunted affect, followed by obvious mental deterioration. She was diagnosed as having a disorganized type of schizophrenia at the first examination. Brain magnetic resonance imaging demonstrated diffuse high intensity in the cerebral white matter, particularly in the frontal lobes. The single photon emission computed tomography images using 123I-IMP disclosed diffuse cerebral hypofusion, especially in the frontal lobes. Electroencephalogram showed a moderate amount of 5-6Hz theta waves on the background of alpha activity. Nerve conduction velocities in the extremities were delayed. The level of leucocyte arylsulphatase was low. In the arylsulphatase A gene analysis, a compound heterozygote having the 99Gly-->Asp and 409Thr-->Ile mutations was confirmed. The patient was diagnosed as having metachromatic leukodystrophy. She gradually showed obvious dementing symptoms such as memory disturbance and disorientation. The characteristics of the psychiatric symptoms in the leukodystrophy are discussed.
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PMID:Adult-type metachromatic leukodystrophy with a compound heterozygote mutation showing character change and dementia. 1045 47

Thirty patients (24 inpatients and 6 outpatients) with a clinical diagnosis of SLE were examined between September 1, 1998 and August 1, 1999 in the rheumatology clinic of Jichi Medical School Hospital. All of these patients fulfilled the 1982 revised criteria of the American Rheumatism Association for the classification of SLE and had some psychiatric manifestations (psychiatric SLE; P-SLE group). Mean patient age was 38.6 +/- 13.0, and there were 5 males and 25 females. When classified into 5 subgroups according to the most prominent symptoms, the distribution was as follows: consciousness disturbance group: 6 (20%), schizophrenia-like group: 5 (16.7%), mood disorder group: 7 (23.3%), neurosis-like group: 10 (33.3%), and convulsive disorder group: 2 (6.7%). Among all 37 psychiatric episodes, symptoms appeared in 37.8% of cases during the acute phase of SLE (during onset or recurrence) and in 62.9% during the chronic phase (during remission). The profile of the P-SLE group showed that the psychiatric symptoms of the SLE patients were milder and more chronic than those described in previous reports. To begin to comprehend the psychopathology of SLE, we put forward the concept of "Psychiatric basal state" and "psychiatric conjugated state". The former is considered a direct reflection of the acute-phase SLE process on mental condition. It is defined clinically as psychiatric symptoms that parallel the activity of SLE and respond well to steroid therapy. The latter include all other psychiatric problems in which one cannot rule out the effects of pharmacological, somatic, personality, and environmental effects on psychiatric symptoms. Only 3 patients in the P-SLE group fulfilled the criteria for the "psychiatric basal state". All three patients belonged to the consciousness disturbance group, whose clinical features were defined as slight clouding of consciousness, so-called "Amentia" in the sense of the German terminology. The clinical profile of this state is: 1. the patients are young (about 16 years old), 2. the onset of psychiatric symptoms is within 5 years after the onset of SLE, 3. confusion and disorientation are the most characteristic features, and 4. the clinical course of this state is almost 2 months. The experience structure of the "psychiatric basal state" consists of: 1. difficulty in selecting and holding a topic in cognition, 2. confusion and emotional instability as the basal mood, and 3. primitive and floating forms of delusions and hallucinations. Using this concept of the "psychiatric basal state" as a clue, we can hypothesize the continuity of diverse psychiatric symptoms in SLE. The "proper process of SLE (Harada)" has a disintegrating effect on the "ego" and it allows various psychopathological phenomena to emerge in the experience field. Against this background, additional factors, such as secondary organ damage, personality structure, and social environment, induce organization of the "psychiatric conjugated state".
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PMID:[A clinical study of psychopathology in systemic lupus erythematosus]. 1102 78


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