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

In the light of the heterogeneous literature on disturbances of body image in schizophrenic patients, we examined body schema, body concept and body cathexis, their changes during hospital treatment and their correlations with psychopathology in 38 patients with acute paranoid schizophrenia. The image-marking method according to Askevold, the Body Distortion Questionnaire, a visual-analogue scale on body cathexis and psychopathometric scales were applied. Body schema was also investigated in 27 healthy controls. On average, patients underestimated the size of their lower extremities, indicating a centralized body schema. They accurately assessed proximal fixed points. Underestimation was significantly correlated with anxiety, overestimation with grandiosity. Body schema and body concept were relatively independent from each other and from body hallucinations. Disturbances of body perception were reduced significantly, but not completely, during the time from admission to discharge. The results confirm and clarify some findings in the literature on a distorted perception of body size and support theories on body perception in schizophrenia.
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PMID:[Body image of patients with acute paranoid schizophrenia. A follow-up study]. 892

A 13-year-old boy with psychotic, depressive, and obsessive-compulsive symptoms initially presented with auditory and visual hallucinations and a lifetime of excessive worries about contamination. Family history was significant for schizophrenia and compulsive behavior. When treated with clomipramine 100 mg daily (plasma level 85 ng/mL), obsessive-compulsive symptoms but not the hallucinations improved significantly, and racing thoughts and grandiosity developed later. Haloperidol 0.5 mg daily reduced the psychotic symptoms but was poorly tolerated, and then trifluoperazine 3 mg daily was ineffective, so clomipramine was discontinued (without worsening of OCD symptoms). Trifluoperazine in combination with lithium 1500 mg daily (0.9 meq/L), and then with the addition of carbamazepine 250 mg daily (3.7 micrograms/mL), was only partially helpful. Dose reductions in any medication led to increased psychotic symptoms within days. Trifluoperazine was then replaced by risperidone 3 mg twice daily. Within 2 weeks of starting risperidone, psychotic symptoms ceased but the patient experienced an incapacitating exacerbation of obsessive-compulsive symptoms, experiencing the most severe symptoms in his illness. Sertraline 50 mg reduced the OCD symptoms only briefly. After 5 months on risperidone, risperidone and sertraline were discontinued, and the obsessive-compulsive symptoms significantly decreased within 2 weeks. These clinical observations suggest that even when risperidone has a therapeutic antipsychotic effect, it may exacerbate obsessive-compulsive symptoms in predisposed adolescents.
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PMID:Differential response of psychotic and obsessive symptoms to risperidone in an adolescent. 923 6

Single photon emission computed tomography with technetium-99m-d,l-hexamethylpropyleneamine oxime (99mTc-HMPAO) was used to assess regional cerebral blood flow (rCBF) during both florid and remitted stages of schizophrenia. Forty schizophrenic patients in an active phase of illness (diagnosis by DSM-III-R) were examined in two clinical states (ill vs. improved). At study entry, 24 patients were drug-naive, five were currently drug-free, and 11 were being treated with antipsychotic medication. Twenty medical patients who suffered from non-specific headaches but were free of neurological and psychiatric symptoms served as control subjects. At initial examination during the active phase of illness, cerebral perfusion patterns in the schizophrenic patients were characterized by both hypofrontality and hypotemporality. After remission, hypofrontality was no longer apparent in two of four frontal regions, and hypotemporality disappeared completely. As assessed with the Positive and Negative Syndrome Scale (PANSS), formal thought disorders, hallucinations, and ideas of grandiosity correlated with rCBF in the active phase of illness, but not after remission. In the remitted but not in the florid state, blunted affect, difficulties in abstract thinking, lack of spontaneity, and stereotyped thoughts correlated with rCBF. Correlations of five symptoms with rCBF changed significantly from first to second examination. The present study suggests that correlations between single psychotic symptoms and rCBF differ significantly in florid vs. remitted phases of schizophrenia.
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PMID:Active and remitted schizophrenia: psychopathological and regional cerebral blood flow findings. 1032 Feb 8

The frontal lobes can be subdivided into major functional neuroanatomical domains, which, when injured, surgically destroyed, or reduced in activity or volume, give rise to signature pathological and psychiatric symptomology. A review of case reports and over 50 years of research, including magnetic resonance imaging, positron emission tomography, and single photon emission computed tomography scans, indicates that apathy, "blunted" schizophrenia, major depression, and aphasic-perseverative disturbance of speech and thought are associated with left lateral as well as bilateral frontal (and striatal) abnormalities. Impulsiveness, confabulatory verbosity, grandiosity, increased sexuality, and mania are associated with right frontal (as well as bilateral) disturbances. Gegenhalten, catatonia, and disturbances of "will" are indicative of medial frontal injuries. Disinhibitory states and obsessive-compulsive perseverative abnormalities are more frequently observed with orbital frontal lobe dysfunction, including frontal-striatal disturbances. These associations, however, are not always clear-cut as patients with the same diagnosis may demonstrate different symptoms that may be due to an additional abnormality in a different region of the brain. Moreover, as the frontal subdivisions are richly interconnected, and as frontal lobe abnormalities are not always discrete or well localized, a wide array of seemingly divergent waxing and waning symptoms may be manifest, sometimes simultaneously, including manic depression and what has been referred to as the "frontal lobe personality."
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PMID:Frontal lobe psychopathology: mania, depression, confabulation, catatonia, perseveration, obsessive compulsions, and schizophrenia. 1042 Apr 28

One of the central purposes of cross-cultural psychiatry is to scrutinize the sociocultural influences on the phenomenology of psychiatric diseases. On the other hand it is possible to lay bare a nucleus of symptoms, common to all cultures, which, independently of all influences, occupies a central position for an understanding of the disease considered. In this study an attempt was made to approach this problem by means of investigating the contents of delusion of schizophrenic patients in Austria and Pakistan. The contents of delusion among 126 Austrian and 108 Pakistani patients diagnosed as having schizophrenia according to DSM-III-R (art. 295) were compared following the classification of Huber and Gross. Additionally the kind of persecution and the type of the persecutor were registered. However it appeared that only a few contents of delusion are frequent in both countries. In both countries persecution was the most frequently mentioned content of delusion. The comparison of the contents of delusion revealed significantly higher frequencies of delusions of grandeur, guilt and religious delusions in Austrian patients. Significant differences could also be found with the kind of persecution and the persecutor's type. Cultural factors seem to have a decisive influence on shaping the contents of delusion.
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PMID:Comparison of delusions among schizophrenics in Austria and in Pakistan. 1049 61

Administration of the N-methyl-D-aspartate (NMDA) antagonist S-ketamine in normals produces a psychosis-like syndrome including several positive and negative symptoms of schizophrenic disorders (Abi-Saab WM, D'Souza DC, Moghaddam B, Krystal JH. The NMDA antagonist model for schizophrenia: promise and pitfalls. Pharmacopsychiatry 1998;31:104-109). Given the clinical efficacy of dopamine (DA) D2 receptor antagonists in the treatment of positive symptoms, it is conceivable that S-ketamine-induced psychotic symptoms are partially due to a secondary activation of dopaminergic systems. To date, animal and human studies of the effects of NMDA antagonists on striatal DA levels have been inconsistent. The present study used positron emission tomography (PET) to determine whether a psychotomimetic dose of S-ketamine decreases the in vivo binding of [11C]raclopride to striatal DA D2 receptors in humans (n = 8). S-ketamine elicited a psychosis-like syndrome, including alterations in mood, cognitive disturbances, hallucinations and ego-disorders. S-ketamine decreased [11C]raclopride binding potential (BP) significantly in the ventral striatum (-17.5%) followed by the caudate nucleus (-14.3%) and putamen (-13.6%), indicating an increase in striatal DA concentration. The change in raclopride BP in the ventral striatum correlated with heightened mood ranging from euphoria to grandiosity. These results provide evidence that the glutamatergic NMDA receptor may contribute to psychotic symptom formation via modulation of the DA system.
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PMID:Effects of (S)-ketamine on striatal dopamine: a [11C]raclopride PET study of a model psychosis in humans. 1069 31

There is growing evidence for a relationship between the duration of untreated psychosis (DUP) and the prognosis. However, determinants of the DUP have been minimally explored, as is the detailed initial temporal unfolding of untreated psychosis. In this study, in-depth interviews with 19 first-episode DSM-IV schizophrenia patients and their relatives revealed detailed phenomenology of the initial prodrome and untreated psychosis. The findings suggest that a later prodrome onset (mean age in this sample, 20.5 years), a prodrome shorter than 2 years, acute initial psychosis development, the initial presence of grandiosity and/or disorganization, and a mild level of withdrawal all may reduce treatment delay. This set of characteristics might therefore represent built-in components of psychotic illnesses related to a shortened DUP, irrespective of early intervention efforts. In other words, the DUP could partly reflect these built-in aspects of psychosis. The rate of initial (untreated) psychosis development could contribute to broaden the prevailing mode of onset concept (presently defined as the duration of the initial prodrome) to comprise both the duration and content of the initial prodrome, as well as untreated psychosis, tentatively designated as the mode of initial psychosis development.
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PMID:First-episode schizophrenia: do grandiosity, disorganization, and acute initial development reduce duration of untreated psychosis? An exploratory naturalistic case study. 1083 27

The effects of risperidone on affective symptoms were determined by an analysis of pooled data from six double-blind trials of risperidone versus haloperidol in 1254 patients with chronic schizophrenia. Symptoms indicating mania were assessed by the Positive and Negative Syndrome Scale (PANSS) excitement and grandiosity items and by the excited cluster (excitement, hostility, uncooperativeness, and poor impulse control); anxious / depressive symptoms were assessed by the PANSS anxious / depressive cluster (somatic concern, anxiety, guilt feelings, and depression). Mean change scores from baseline to endpoint were compared in patients receiving risperidone, haloperidol or placebo by analysis of variance with factors for trial and baseline score included in the model. In all patients, change scores on excitement and grandiosity items and excited and anxious / depressive clusters were significantly greater for risperidone than for haloperidol or placebo. Dropouts due to inefficacy were less frequent with risperidone (5 of 59; 8%) than with haloperidol (7 of 38; 18%) or placebo (8 of 10; 80%). In patients with anxious / depressive symptoms at baseline (anxiety / depression cluster score > or = the median), anxiety / depression scores decreased significantly more with risperidone than with haloperidol, and symptom reduction occurred faster with risperidone. These results are consistent with previous reports and suggest that risperidone is more efficacious than haloperidol for affective symptoms in patients with schizophrenia.
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PMID:Effects of risperidone on affective symptoms in patients with schizophrenia. 1111 10

Whether there is a specific link between certain delusional symptoms and particular etiologies has not yet been completely clarified. In this study, 639 first ever admitted deluded patients were investigated in order to find out whether age and gender are associated with certain delusional contents, whether age at first admission may be linked to certain etiologies and whether it is possible to detect indicators particularly related to basic dysfunctions. At first admission, delusional female patients were older than men with a significant predomination of delusions of persecution, while men presented significantly more frequently delusions of jealousy and grandiosity. Within delusions of persecution, of religious or metaphysical content and of grandiosity, women were even significantly older than men. Religious or metaphysical and grandiosity contents occurred significantly more frequently in ICD-8 schizophrenia, indicating that these themes seem to be particularly linked to ICD-8 schizophrenia. Additionally, some target symptoms not included in the delusional symptomatology were investigated to test the relationship between delusions and schizophrenia. Overall, the results of the present investigation indicate that delusions are not specific for schizophrenia, and therefore, other symptomatological criteria should be applied for the nosographic attribution.
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PMID:Delusions in first-admitted patients: gender, themes and diagnoses. 1115 Sep 24

Schizophrenia is one of the most researched, yet still one of the least understood, of the mental disorders. One key area that remains comparatively neglected is the fact that schizophrenia typically develops at late adolescence. In common with people with psychotic disorders, around 25% of normal teenagers also report finding adolescence very distressing, and a substantial empirical literature shows that certain characteristics typical of adolescence such as conflicted family relationships, grandiosity, egocentrism, and magical ideation bear a distinct resemblance to phenomena seen in psychotic disorders. Indeed, such phenomena, as might be judged prodromal or symptomatic in first-onset schizophrenia, have been shown to be remarkably common in normal adolescents, generally in about 50% of samples. Furthermore, prodromal-like signs in normal adolescents appear to be functionally linked to psychological development. For most adolescents, such phenomena pass with successful psychological development. It is proposed that psychosis in late adolescence is a consequence of severe disruption in this normally difficult psychological maturational process in vulnerable individuals, and explanations are offered as to why and how this comes about. It is suggested that problems either in reaching psychological maturity with regard to parents or in bonding to peers or both, may lead to crucial self-construction difficulties, and that psychosis emerges out of such "blocked adolescence." This approach proposes therapeutic interventions that enable professional services to side with both parents and clients simultaneously, and is normalizing and stigma-free.
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PMID:Why does schizophrenia develop at late adolescence? 1129 67


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