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

Fifty-three psychiatric hospital inpatients with a dual diagnosis of substance abuse and schizophrenia were given the Brief Symptom Inventory and the Schizophrenia/Substance Abuse Interview Schedule. Mean age was 29; 49 were men. Only 11% were employed. Forty percent abused mainly alcohol, 40% cannabis and 8% amphetamines; 20% abused more than one substance. Mean onset age of drug abuse was 16 years; schizophrenia was diagnosed a mean of 5 years later, and subjects had been admitted to hospital an average of 7 times since then. Most believed that drug abuse initiated or exacerbated their schizophrenia; 80% took drugs primarily to relieve dysphoria and anxiety. Amphetamines improved subjective well-being significantly more than alcohol, but choice of drugs was determined mainly by price and availability. Only cannabis increased positive symptoms of schizophrenia and only amphetamines reduced negative ones. Effectively treating this population requires an integration of psychiatric and drug treatment services, ideally in a community context.
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PMID:Self reports of the interaction between substance abuse and schizophrenia. 762 79

This study explored the symptoms of self-injurious behaviour (SIB) in a consecutive sample of 54 mostly female psychiatric inpatients. The phenomenological analysis presented SIB as quite a uniform syndrome that starts latest in early adulthood, is often committed impulsively, is used in the function of releasing tension and occurs in patients with eating and psychoactive substance use but also schizophrenic disorders. The quality of mood preceding SIB was best characterized as dysphoria and was qualitatively not different from patients' longstanding affective traits. Two subgroups were differentiated, those with borderline personality disorder and those without; there was some evidence that patients with borderline personality disorder present a quite homogeneous core group of SIB, whereas others show a higher variety of psychopathological features. The hypothesis is proposed that poor affect regulation is the underlying psychopathological dimension.
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PMID:Self-injurious behaviour. Psychopathological and nosological characteristics in subtypes of self-injurers. 775 89

Weekly assessments of depression, anxiety, and positive and negative symptoms were performed on 80 subjects with schizophrenia or schizoaffective disorder. Using procedures previously reported in another study, the frequency of significant correlations between the sum of anxiety and depression ratings and positive symptoms was compared with the frequency of significant correlations between the sum of anxiety and depression ratings and negative symptoms. Results confirm that dysphoria in schizophrenia tends to be more frequently associated with positive versus negative symptoms, regardless of diagnostic subtype or symptom type. This provides further evidence of the independence of negative symptoms from dysphoria and suggests that the level of positive symptoms and level of dysphoria may mutually influence one another.
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PMID:The frequency of associations between positive and negative symptoms and dysphoria in schizophrenia. 775 96

In a sample of 120 long-stay in-patients who fulfilled DSM-III-R criteria for schizophrenia, chronic akathisia and pseudoakathisia were relatively common, with prevalence figures of 24% and 18%, respectively. Compared with patients without evidence of chronic akathisia, those patients with the condition were significantly younger, were receiving significantly higher doses of antipsychotic medication, and were more likely to be receiving a depot antipsychotic. Patients who experienced the characteristic inner restlessness and compulsion to move of akathisia also reported marked symptoms of dysphoria, namely tension, panic, irritability and impatience. The findings support the suggestion that dysphoric mood is an important feature of akathisia. Male patients appeared to be at an increased risk of pseudoakathisia. No significant relation was found between chronic akathisia and tardive dyskinesia, although there was a trend for trunk and limb dyskinesia to be commonest in patients with chronic akathisia while orofacial dyskinesia was most frequently observed in those with pseudoakathisia. Akathisia may mask the movements of tardive dyskinesia in the lower limb. There was no evidence that akathisia was associated with positive or negative symptoms of schizophrenia nor with depression.
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PMID:Akathisia: prevalence and associated dysphoria in an in-patient population with chronic schizophrenia. 790 11

Noncompliance with neuroleptic treatment is a major barrier to delivery of effective treatment for schizophrenia outpatients. This article describes the development of a standardized measure for the assessment of attitudinal and behavioral factors influencing patient compliance with neuroleptic treatment. The Rating of Medication Influences (ROMI) scale was developed as part of a longitudinal study of neuroleptic noncompliance in schizophrenia and administered to 115 discharged schizophrenia outpatients. Analyses of the following were conducted to assess the scale's psychometric properties: (1) interrater reliability, (2) internal consistency, (3) principal components, (4) correlation with other subjective measures, and (5) correlation with independent family reports. Most (95%) of the ROMI patient-report items were reliable, whereas rater-judgment items were not reliable. The rater section was dropped. A principal components analysis of the reliable patient-report items yielded three subscales related to compliance (Prevention, Influence of Others, and Medication Affinity) and five subscales related to noncompliance (Denial/Dysphoria, Logistical Problems, Rejection of Label, Family Influence, and Negative Therapeutic Alliance). There were significant correlations between these subscales, and independently obtained family-report ROMI items were significant. The Denial/Dysphoria subscale correlated strongly with two other published measures of dysphoric response to neuroleptics, whereas the other noncompliance subscales did not. The ROMI is a reliable and valid instrument that can be used to assess the patient's subjective reasons for medication compliance and non-compliance. The subscale findings suggest that the ROMI provides a more comprehensive data base for patient-reported compliance attitudes than the other available subjective measures. Indications for use of the ROMI and other subjective measures of neuroleptic response are reviewed.
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PMID:Rating of medication influences (ROMI) scale in schizophrenia. 791 62

In the context of a prevalence survey of schizophrenia in South Westminster, a questionnaire was administered to 271 patients to assess alcohol-related morbidity. In this epidemiologically based sample, the lifetime prevalence of alcohol abuse was 22.1%. Compared with control patients matched for age and sex, these index cases had a significantly shorter duration of illness. A possible explanation is that drinking may mask the onset of schizophrenia, leading to a delay in diagnosis. The index cases also had significantly higher ratings for hallucinations and for hostility, anxiety and depression, and a greater number of disturbed types of behaviour. The highest levels of alcohol consumption were associated with more severe orofacial dyskinesia, suggesting that alcohol use may be an added risk factor for the development of tardive dyskinesia in some patients. The severity of akathisia was also related to alcohol use, and there were significant relationships between the subjective distress related to akathisia and the level of abuse. A possible interpretation is that alcohol had been used by patients with akathisia to alleviate the associated agitation and dysphoria.
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PMID:South Westminster schizophrenia survey. Alcohol use and its relationship to symptoms, tardive dyskinesia and illness onset. 799 24

Monthly assessments of depression, anxiety, and positive and negative symptoms of schizophrenia were performed on 52 schizophrenic patients over periods ranging from 12 to 29 months. Data were analyzed to assess the extent to which symptoms of dysphoria (anxiety and depression) were more strongly related to negative or positive symptoms of schizophrenia. Consistent with past research using comparisons across subjects, the current longitudinal data show that there is a more consistent relationship between dysphoria and positive rather than negative symptoms.
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PMID:Correlations over time between dysphoric mood and symptomatology in schizophrenia. 814 27

Latent class analysis on an epidemiologically based series of 447 first contact patients with a broad diagnosis of schizophrenia revealed evidence for two subtypes: a 'neurodevelopmental' type characterized by early onset, poor pre-morbid social adjustment, restricted affect and a male:female ratio of 7:3; and a 'paranoid' type characterized by later onset, persecutory delusions and an almost equal sex ratio. A third 'schizoaffective' subtype, whose existence was less clear cut, was almost entirely confined to females and characterized by dysphoria and persecutory delusions, and had negligible familial risk of schizophrenia. The aetiological, biological and clinical significance of this typology remains to be tested.
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PMID:The subtyping of schizophrenia in men and women: a latent class analysis. 820 93

This article delineates the conceptual models used when medications are prescribed for patients with personality disorders and reviews the data on the efficacy of these medications. Studies before 1980 are difficult to interpret because of changes in diagnostic criteria. Nonetheless, early studies on non-DSM-III disorders such as pseudoneurotic schizophrenia, emotionally unstable character disorder, hysteroid dysphoria, and subaffective disorders indicated the potential utility of pharmacotherapy for treating personality disorders. Models to consider in evaluating the possible use of medications for treating personality disorders are: (1) treating the disorder itself; (2) treating symptom clusters within and across disorders; and (3) treating associated axis I disorders. Among the current personality disorders, borderline personality disorder has been the most extensively studied, with antipsychotic agents being the most well-documented treatment. Monoamine oxidase inhibitors, fluoxetine, and carbamazepine show promise. Schizotypal disorders may respond to low-dose antipsychotic drugs. Although heuristically valuable, the symptom cluster approach to treatment has not yet been validated. Axis I disorders, especially depression, are frequently associated with all personality disorders. Dependent personality disorder is linked to panic disorder with agoraphobia, whereas avoidant personality disorder is associated with social phobia and panic. In general, pharmacotherapy for axis I disorders is less effective in the presence of a comorbid personality disorder. Despite the modest benefits seen in many studies, pharmacotherapy can add significantly to the overall treatment of those with personality disorders. Future research must carefully assess the effect of comorbid axis I disorders on responses. The symptom cluster/psychobiologic dimension approach should be investigated in clinical studies.
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PMID:Pharmacotherapy of personality disorders: conceptual framework and clinical strategies. 822 92

Tardive psychopathology (TP) corresponds to mental changes from chronic neuroleptic exposure, as tardive dyskinesia corresponds to induced movement disorders. TP was prospectively identified in 4 inpatients. Each took neuroleptics more than 3 years, showed good premorbid adjustment or initiative, and met criteria for chronic schizophrenia. Each also had obsessions or compulsions, and apathetic dysphoria, symptoms not previously attributed to TP. Following neuroleptic termination with introduction of lithium and sertraline, each showed atypically rapid disappearance of this psychopathology. The incidence of these features is over 47% (p < 0.05). Some cases of apparent neuroleptic-resistant schizophrenia may be TP.
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PMID:Tardive psychopathology. 854 66


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