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

A survey of 46 randomly selected schizophrenic residents of six board-and-care homes in the Los Angeles area found that the schizophrenic who adjusts to the setting experiences a schizoid-compliant pattern of outcome on antipsychotic drugs that is characterized by blunted affect, passivity, and lack of initiative, interest, and spontaneity. The authors conclude that it is those negative symptoms of schizophrenia, mistakenly attributed to the presumed inadequacies of the board-and-care environment, that have given the board-and-care home a bad press both in the newspapers and in the psychiatric literature.
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PMID:The board-and-care home: does it deserve a bad press? 3 35

A cohort of schizophrenic patients consecutively admitted to a mental hospital for the first time in 1925 was investigated in search of symptoms and traits with prognostic meaning. Since Leonhard's diagnostic system was applied, cases with mixed symptoms and a favourable outcome were excluded as being neither schizophrenic nor manic-depressive. Owing to the admission policy then prevailing, cases with clinically less striking and socially less deleterious features were underrepresented. The sample (n = 70), so demarcated, was still considered fairly appropriate for the purpose of a differential study of outcome in nuclear schizophrenia with a life-long follow-up. The best outcome group consisted of 33% of the sample; 24% formed an intermediate group, and 43% profoundly deteriorated with continuous psychotic symptoms and a total loss of social function. Marriage before index admission was the only characteristic related to a favourable outcome. Nuclear schizophrenic symptoms, thought disturbance, blunted affect and all catatonic symptoms listed in DSM-III were related to an unfavourable outcome. When prognostic subgroups were compared pairwise, no favourable trait was detectable, and there were no decisive differences between the group with the best outcome and the intermediate group. When these 2 groups were compared with the group with worst outcome, however, significant differences arose with respect to unfavourable characteristics. Predictions using a discriminant analytic procedure yielded the same results. The hypothesis that affective and atypical signs would also have prognostic meaning in nuclear schizophrenia was disproved.
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PMID:Outcome in untreated schizophrenia: a search for symptoms and traits with prognostic meaning in patients admitted to a mental hospital in the preneuroleptic era. 135 Jun 98

The Positive and Negative Syndrome Scale (PANSS) was used to rate clinical symptoms in 42 inpatients with schizophrenia before they were examined by computed tomography. Significantly higher mean size of lateral and third ventricles, and higher mean cortical atrophy were found in schizophrenic patients compared with healthy control subjects. Ventricular enlargement and cortical atrophy were significantly related to low scores on the Composite subscale of the PANSS. Positive correlations were observed mainly with negative items such as blunted affect, emotional withdrawal, difficulties in abstract thinking, passive-apathetic social withdrawal, and lack of spontaneity of conversation. Additional positive correlations were observed with two items from the General Psychopathology subscale (mannerisms and disorientation). Inverse correlations were found with most positive items. These results suggest a relationship between brain structural abnormalities and the symptomatology of schizophrenia recorded with PANSS.
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PMID:Relationship between symptoms rated with the Positive and Negative Syndrome Scale and brain measures in schizophrenia. 146 47

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

Computerized tomography (CT-scan) studies in schizophrenia revealed that some patients have neuromorphological abnormalities. The structural changes consist mainly in lateral and third ventricle enlargement, and in cortical atrophy. The present study evaluates these three changes in 42 schizophrenics aged 18 to 50, compared to 24 healthy controls. Diagnosis were established from information gathered by personal interview with the SADS-LA. Clinical sub-types were evaluated according to the DSM III-R criteria. Moreover, detailed symptoms were rated according to the Positive And Negative Syndrome Scale (PANSS). CT scans were recorded in floppy disks and blindly analyzed. Schizophrenics shown significant higher mean size of lateral and third ventricles, and higher mean anterior cortical atrophy than healthy subjects. Significant differences were also found between subtypes, with more marked abnormalities in the disorganized group. The relationship between brain abnormalities and clinical symptoms recorded with the PANSS, were analysed using Pearson correlates. Positive correlations concerned mainly negative symptoms like blunted affect, emotional withdrawal, difficulties in abstract thinking, passive apathetic social withdrawal and lack of spontaneity of conversation. Positive correlations are also observed with some symptoms classified with the PANSS in the General Psychopathology scale such as mannerism and disorientation. Negative correlation concerned most of PANSS positive symptoms.
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PMID:[X-ray computed tomographic abnormalities in schizophrenia. Trial of relationship with clinical data]. 163

Longitudinal evaluation of psychiatric patients often yields information that cross-sectional study does not. We previously examined 31 older (age greater than 55) chronic schizophrenics for prevalence of extrapyramidal side effects, severity of psychiatric symptoms, and ventricular brain ratio (VBR). We reexamined 22 of these patients after 2-4 years. Tardive dyskinesia (TD) and drug-induced parkinsonism (DIP) were common (mean prevalences were 52% and 62%, respectively) and often occurred together (38%). The overall prevalences of the disorders did not change significantly with time, although there was some individual fluctuation in diagnosis. Severity of TD was constant, but severity of DIP decreased, probably because neuroleptic doses were significantly decreased. Magnitude of DIP was positively correlated with VBR and severity of negative symptoms of schizophrenia. The correlation of DIP and negative symptoms occurred primarily because of the similarity between masked facies and blunted affect. VBR did not change over the follow-up period. Negative symptoms of schizophrenia were prevalent, moderately severe, and quite stable over time in this cohort. Positive symptoms were less severe but highly variable between examinations.
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PMID:Three-year follow-up of older schizophrenics: extrapyramidal syndromes, psychiatric symptoms, and ventricular brain ratio. 168 18

Eighty newly admitted or readmitted men with DSM-III schizophrenia were assigned to receive 5, 10, or 20 mg/d of haloperidol for 4 weeks. Staff were not "blind" to dose. By Clinical Global Impression Scale ratings, the 20-mg dose appeared to be superior to both the 5- and 10-mg doses for the first 2 weeks of treatment but not thereafter. On the Brief Psychiatric Rating Scale Schizophrenia factor, the 20-mg dose was superior to the 5-mg dose throughout the trial and tended to be marginally superior to the 10-mg dose after the first 2 weeks of treatment. By the second week of treatment, however, the group receiving the 20-mg dose deteriorated significantly with regard to Brief Psychiatric Rating Scale ratings of Withdrawal-Retardation (blunted affect, motor retardation, and emotional withdrawal) as well as akinesia and akathisia ratings. Furthermore, 35% of patients given 20 mg/d of haloperidol insisted on leaving the hospital against medical advice vs only 4% of those given 5 or 10 mg/d of haloperidol. A 20-mg/d dose of haloperidol, therefore, may have substantial "psychotoxic" effects by the second week of treatment.
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PMID:A controlled dose comparison of haloperidol in newly admitted schizophrenic patients. 134 92

The therapeutic efficacy and target symptoms of maprotiline were tested by administering it in addition to conventional neuroleptic treatment for 10 weeks to a total of 32 chronic schizophrenic patients who showed no, or only partial, response to the neuroleptic medication. The final global improvement rating was 68.8% for all patients. Average therapeutic doses administered were 150 mg per day. Changes in psychotic symptoms were assessed by the Brief Psychiatric Rating Scale (BPRS), Psychiatric Evaluating scale (PES), and the Scale for the Assessment of Negative Symptoms (SANS). All mean improvement rates of these rating scales were observed at the 2nd week after the start of treatment, and maprotiline produced a marked amelioration in negative symptoms such as decreased spontaneity, blunted affect, emotional withdrawal, impaired work or recreation, etc. The incidence of side-effects was 37.5%. Constipation was the most frequently occurring side-effect. Neither side-effects nor laboratory test results were serious enough to discontinue the trial, except in the case of one chronic patient who showed acute exacerbation of symptoms due to maprotiline-induced insomnia, elation and hallucination. These results suggest that maprotiline improves the negative symptoms of schizophrenia by a noradrenaline potentiating action not demonstrated by dopaminergic or serotonergic reward systems.
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PMID:Effect of maprotiline combined with conventional neuroleptics against negative symptoms of chronic schizophrenia. 257 Jun 87

Changes in regional cerebral blood flow and behavioral and physiological indices were monitored after intravenous administration of d-amphetamine sulfate and placebo in groups of patients with schizophrenia and normal volunteers. Amphetamine administration was associated with decreased anxiety, emotional withdrawal, depressed mood, blunted affect and increased excitement in the patients. Subjects who received amphetamine showed significant increases in systolic and diastolic blood pressure and reduction in end-tidal carbon dioxide. Post-amphetamine cerebral blood flow was decreased equally in both patients and controls. The blood flow change, however, did not show any regional variations.
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PMID:Changes in cerebral blood flow and mental state after amphetamine challenge in schizophrenic patients. 261 28

Recent attempts at subgrouping schizophrenia have emphasized negative symptoms (e.g., blunted affect, emotional withdrawal), and several works have suggested that patients with negative symptoms show greater cognitive deficits and structural brain abnormalities. However, many of these studies have relied on screening devices or single measures of neuropsychological performance. Accordingly, the present study used the Luria-Nebraska Neuropsychological Battery (LNNB) in assessing 38 unmedicated inpatients with a diagnosis of schizophrenia. The results found no relationship between LNNB performance and symptom ratings derived from clinical interviews using the Brief Psychiatric Rating Scale. The findings show that cognitive performance may be unrelated to symptomatology when a complex battery type test is used.
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PMID:Luria-Nebraska performance and symptomatology in unmedicated schizophrenic patients. 323 4


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