Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0036341 (schizophrenia)
 60,220 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

During a 13-month period, 9 patients with phencyclidine-induced psychosis were admitted to Darnall Army Hospital. They exhibited hostility agitation, and tangentiality and had delusions of influence and religious grandiosity. Six subjects reported auditory hallucinations, and 4 were disoriented in at least 1 sphere. Despite treatment with antipsychotic medication, the psychotic episodes often persisted for more than 30 days. Our clinical finding of prolonged psychotic reactions, together with previous reports of the effects of phencyclidine, suggests that phenycyclidine provides an intriguing drug model for schizophrenia.
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PMID:Phencyclidine-induced psychosis. 69 30

Plasma levels of 3-methoxy-4-hydroxyphenylglycol (MHPG) were found to be significantly higher in manic patients than in age- and sex-matched normal controls (n = 22). In 18 manic patients plasma MHPG correlated with manic symptoms but not with anxiety, depression, motor behaviour, acute psychosis, schizophrenia and severity of illness. A positive correlation between MHPG and grandiosity items on rating scales suggests a link with cognitive contents and therefore a relationship with central factors.
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PMID:Plasma 3-methoxy-4-hydroxyphenylglycol in manic patients: relationships with clinical variables. 233 Aug 23

Risk of relapse and recidivism makes the failure to take antipsychotic medication as prescribed a significant issue in forensic psychiatry. This question may arise in such contexts as the setting of bail, plea bargaining, the insanity defense, and sentencing. We have reviewed the literature on medication noncompliance in schizophrenia and present here the results, organized by topics relevant for the work of forensic mental health experts. Reported rates of noncompliance vary widely, reflecting major differences in the populations studied and the methods used as well as the complexities involved in defining noncompliant behavior. A noncompliance rate of 50 percent has been attributed globally to chronic patients, both medical and psychiatric. The tendency of significant factors to interact precludes a simple typology of noncompliance. However, environmental security and supportiveness correlate positively with adherence; whereas anxiety, paranoia, grandiosity, depression, and side effects correlate negatively. Clinicians' assessments of whether medication is being taken have proven to be unreliable. Although monitoring by chemical measurement, particularly a radioreceptor assay for urine samples, can be useful, depot injection ensures that prescribed medication is being taken. Less invasive means of promoting compliance are described; psychodynamic and ethical issues to be considered in the monitoring and promotion of compliance over extended time periods are presented. We also probe the link between medication noncompliance and behavioral relapse. The time between default and relapse is most often measured in weeks. Whether due to medication withdrawal or not, the relapse pattern of each individual tends to repeat, allowing its recognition before recidivism occurs. Restarting medication at this stage, especially with a dosage increase, is usually effective. In sum, the forensic mental health expert can now readily use a large and diverse literature to assist with a variety of significant issues.
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PMID:Medication noncompliance in schizophrenia: codification and update. 287 51

In the Amish Study of affective disorders, 79% of the 28 active bipolar I patients, diagnosed according to Research DIagnostic Criteria, previously had received hospital record diagnoses of schizophrenia. Both cultural and clinical factors hindered correct diagnosis, and cultural influences particularly complicated the interpretation of the manic symptoms of grandiosity and excessive involvement in activities. Other factors central to misdiagnosis were form of thought (flight of ideas), content of thought (grandiose and religious delusions), paranoid features, and the failure to recognize the presence of a manic syndrome.
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PMID:Amish Study, III: the impact of cultural factors on diagnosis of bipolar illness. 684 88

Forty-eight undrugged hospital admissions with a present state examination (PSE) diagnosis of schizophrenia were subdivided by the direction of lateral differences in electrodermal response amplitudes to tones. The 29 with larger right-hand responses and the 19 with larger left-hand responses were compared on CATEGO syndromes and brief psychiatric rating scale (BPRS). The larger group had symptoms like those of classical Bleulerian schizophrenia--blunted affect, emotional withdrawal, impaired social functioning, disorganized thought and retarded motility. The other group manifested florid symptoms including hypomanic affect, pressure of speech, ideas of reference, depressive hallucinations and delusions, hypochondriasis, grandiosity and situational anxiety. The psychophysiological measures may provide an objective aid to diagnosis and implications for altered cerebral organization in psychotic patients.
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PMID:The syndrome of schizophrenia: relations between electrodermal response, lateral asymmetries and clinical ratings. 715 Aug 86

The course of schizophrenia before a patient's first admission is important theoretically, prognostically, and from a preventive psychiatric perspective. However, there is little systematically collected information on this topic. In this evaluation of a representative sample of first-admission schizophrenic patients, there was a wide variation in chronicity of psychotic symptoms before admission, with 20% of the patients having been symptomatic for more than 2 years and 28% for less than 1 week. Delusions of grandeur, delusions of reference, and suspiciousness were more common in the more chronic patients than in the most acute patients; symptoms of withdrawal and retardation showed the opposite pattern. The authors discuss the implications of these findings for prognosis, prevention, and theory.
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PMID:Established chronicity of psychotic symptoms in first-admission schizophrenic patients. 724 8

The author briefly outlines important classifications of schizophrenia from this century, with emphasis on the current interest in the distinction between psychotic symptoms categorized as positive (for instance delusions, hallucinatory behaviour and grandiosity) or negative (for instance flat affect, and emotional or social withdrawal). Knowledge about the practical meaning and clinical consequences of this positive-negative distinction can be useful for staff at outpatient clinics and for general practitioners involved in community care and treatment of schizophrenia. The Positive And Negative Syndrome Scale (PANSS) for schizophrenia is briefly presented and recommended.
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PMID:[Positive and negative psychotic symptoms in schizophrenia. Clinical significance and benefits in the light of the history of classification]. 767 15

In a sample of 412 patients with psychotic disorders, the authors examined whether comorbid substance use can be reliably diagnosed, is associated with increased rates of affective symptoms and syndromes and specific psychotic symptoms, and is associated with lowered reliability of the DSM-III-R principal diagnosis. Data from the DSM-IV Field Trial for Schizophrenia and Other Psychotic Disorders was analyzed. In this dataset, substance use was scored on a 4-point ordinal scale and reliability was determined using weighted kappa scores. The associations of significant substance use with affective syndromes and symptoms, and psychotic symptoms were analyzed. Kappa statistics were calculated for principal psychotic disorder diagnoses for patients with and without significant substance use. Weighted kappa scores for substance use ratings ranged from 0.27 to 0.96 (median = 0.85). Syndromal depression was significantly associated with current alcohol use in the entire sample and in the subgroup with schizophrenia alone. Grandiose delusions were also associated with substance use. Significant comorbid substance use was not associated with lowered reliability of diagnosing the principal psychotic disorder. These findings support the hypothesis that comorbid substance abuse can be reliably diagnosed and that alcohol abuse is associated with depressive syndromes in patients with psychotic disorders.
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PMID:Substance abuse in psychotic disorders: associations with affective syndromes. DSM-IV Field Trial Work Group. 789 24

The presence or absence of 22 schizophrenic symptoms was recorded with the age at onset of illness in 470 patients with non-affective, non-organic psychoses. Positive and negative formal thought disorder, affective symptoms, inappropriate affect, delusions of grandiosity or passivity, primary delusions other than delusional perception, and thought insertion and withdrawal were all more common in early-onset cases (age at onset 44 years or less; n = 336). Persecutory delusions with and without hallucinations, organised delusions, and third-person, running commentary and accusatory or abusive auditory hallucinations were all more common in late-onset cases (age at onset 45 years or more; n = 134). There was no difference between cases of early and late onset in the prevalence of delusions of reference, bizarre delusions, delusional perception, or lack of insight. We conclude that although there are clinical similarities between cases of schizophrenia with early and late onset, there are sufficient differences between them to suggest that they are not phenotypically homogeneous.
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PMID:A comparative study of 470 cases of early-onset and late-onset schizophrenia. 813 98

Metachromatic leukodystrophy (MLD) is a degenerative disease caused by the deficiency of aryl sulfatase (ASA). It can course with psychiatric symptoms. We determined the prevalence of ASA deficiency in a group of 23 patients with presumable schizophrenia. The median serum ASA was 53.2 nmol/mL/h (range 3.3-152.5). Six patients (26%) showed low ASA activity (< 27.5 nmol/mL/h which is the lowest value observed in 29 normal controls); five of them had clinical history of delusions of grandeur, auditive hallucinations, multiple hospitalizations, low response to neuroleptics, and abnormal evoked potentials. It is probable that the schizophrenic symptoms in these patients may be due to the enzyme deficiency. We conclude that the assay is useful in clinical practice as it may help to identify cases of MLD in patients with suspected schizophrenia.
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PMID:[Activity of aryl sulfatase A enzyme in patients with schizophrenic disorders]. 858 9


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