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

Sixty-nine patients, each with a combined diagnosis of epilepsy and psychosis, were compared with 53 patients with a diagnosis of functional psychosis. The epileptic affective patients often lacked convincing psychotic features; ECT and lithium were rarely prescribed; only three showed evidence of bipolarity. The epileptic schizophrenic patients were judged to have the better premorbid personality; experienced more paranoid delusions and delusions of reference, and showed less catatonic features than the functional schizophrenic patients. The course of the epileptics' illness was more variable. The concept that the schizophrenia-like psychosis associated with epilepsy is a distinct nosological entity is supported, but not the suggestion of a relationship between affective psychosis and epilepsy.
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PMID:The psychoses of epilepsy and the functional psychoses: a clinical and phenomenological comparison. 713 7

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 psychopathological traits of paranoial delusions were studied in 65 patients with paranoial schizophrenia. Of these patients, 16 had hypochondriacal delusions, 13 delusions of jealousy and 36 delusions of reference and persecution. All cases were studied from the standpoint of structural-dynamic aspects of the development of systematized interpretative delusions. Two variants of the development of such delusions were distinguished: paranoic and mixed. The paranoic variant by its nature appeared to be catathymic (4 cases), in a mixed variant separate elements of sensorial and imaginative delusions were interspersed with a catathymic development of delusions. Such states were mainly expressed in the form of delusions of significance and special significance. An assumption is made that there is a reciprocal transition of catathymic delusions, delusions of significance and special significance in compliance to the development of the morbid process.
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PMID:[Delusional psychopathology of the paranoid stage of paranoid schizophrenia]. 740 66

We tested the hypothesis that the expression of schizophrenic psychopathology is dependent on the stage of adolescent development. The study had a retrospective design, using high-quality case-note material of cases of schizophrenia at first admission. Patients with onset of illness between the age of 11 and 21 years were included. Sexual delusions were more apparent in females (OR = 3.6;95% CI 1.6-8.0), but otherwise no gender differences in the frequency of a range of positive symptoms were apparent. There was evidence that the age at which positive symptoms first appeared differed between males and females. The frequency of typical, 'first rank' schizophrenic symptoms such as auditory hallucinations, passivity phenomena and though interference, increased linearly with age in male patients, but did not vary with age in their female counterparts. The likelihood of displaying delusional beliefs such as persecutory delusions, explanatory delusions, delusions of reference and grandiose delusions increased with age in both sexes, but the association was stronger in males. The observation that typical schizophrenic symptoms in male patients are relatively uncommon during early adolescence, but increase as they grow older, could be explained by the later manifestation of puberty and associated maturational processes in boys.
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PMID:Gender, psychopathology, and development: from puberty to early adulthood. 771 Sep 90

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

Previous research has suggested that schizophrenics exposed to influenza in the second trimester have more delusions of jealousy, delusions of reference and suspiciousness. We therefore hypothesised that the risk-increasing effect of in utero exposure to influenza would be particularly demonstrable in paranoid schizophrenia. We studied patients with an ICD diagnosis of schizophrenia in England and Wales who were born each month between 1923 and 1965 (N = 17,247. Chi-square test for trend showed that an increase in influenza exposure level during the fifth month of gestation was accompanied by an increase in the proportion of patients with paranoid schizophrenia. However, logistic regression analysis including sex, seasonality and birth period in the model resulted in the loss of any significant association between in utero exposure to influenza and the development of paranoid schizophrenia, the loss of this significance being mainly accounted for by birth period. Therefore, the association in utero exposure to influenza and subsequent development of paranoid schizophrenia we hypothesised was not supported by our data.
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PMID:Maternal exposure to influenza and paranoid schizophrenia. 932 42

We describe the first reported case of symptomatic psychosis with the 'hallucination of soliloquy.' A 48[correction of 40]-year-old woman with Hashimoto disease exhibited of compulsive checking, mysophobia, and excessive hand washing. When these obsessive-compulsive symptoms diminished, she began to suffer from the 'hallucination of soliloquy', the automatic flow of meaningless words inside her mind. As the 'soliloquy' increased, her mood became unstable and she attempted suicide by analgesic ingestion. After this, she was admitted to the psychiatric ward of a general hospital. The administration of clomipramine (150 mg daily) decreased the 'soliloquy' symptoms, but they did not resolve. When hypothyroidism became available, thyroid hormone treatment (levothyroxine at 50 mg daily) was started. Four weeks later, her 'soliloquy' symptoms had almost resolved and after three months in a stable state, thyroid hormone treatment was stopped and her 'soliloquy' symptoms soon reappeared. After thyroid hormone treatment was resumed, her 'soliloquy' symptoms disappeared immediately. Typical auditory hallucinations and delusions of reference were not observed throughout the clinical course. We speculate that the symptoms were symptomatic psychosis induced by hypothyroidism secondary to Hashimoto disease, because the changes of her hallucinations were related to free T3 values and the symptoms disappeared soon after starting thyroid hormone treatment. The main features of this case were 'soliloquy' alternating with obsessive-compulsive symptoms, but her 'soliloquy' symptoms were thought to be autochthonous ideas rather than obsessive thoughts. Furthermore, the symptoms in this case were different from schizophrenia, since there was no disturbance of communication, and she had the sensation of both speaking and hearing her own voice. The psychopathology of this 'hallucination of soliloquy' may be related to the theory of 'vocalization of background thinking' (N. Nakayasu). Detailed observation of patients with symptomatic psychosis and a psychopathological description of their symptoms may help to contribute to the etiologic elucidation and treatment of psychosis.
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PMID:[A case of 'hallucination of soliloquy' with hypothyroidism induced Hashimoto disease. Meaning of psychopathological research about symptomatic psychosis]. 1132 41

Although delusions of reference are one of the most common psychotic symptoms, they have been the focus of little research. The aims of the present research were, first, to determine whether it is possible to identify different kinds of referential delusions reliably and, if so, to investigate associations among them and between these delusions and other positive psychotic symptoms. Participants with a diagnosis of schizophrenia (n=57) were recruited from a volunteer register (n=26) and from inpatient psychiatric wards (n=31). They were interviewed with the Scale for the Assessment of Positive Symptoms (SAPS) except that the questions about ideas and delusions of reference were replaced with questions targeted at seven particular delusions and three content areas. Ratings were made independently by two assessors. Agreement between the assessors was high for all of the delusions of reference and other psychotic symptoms. A factor analysis of these ratings revealed two factors that represent delusions of communication and delusions of observation. Only delusions of observation were associated with hallucinations and persecutory ideation. Delusions of communication showed few significant correlations with other symptoms and therefore appear to require different explanations.
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PMID:On two kinds of delusion of reference. 1622 16

Gestures are an important aspect of non-verbal communication, but people with schizophrenia have poor comprehension of them. However, the tests of gesture comprehension that have been used present only scenes in which interpersonal meaning is communicated, though there is evidence that people with psychotic disorders tend to perceive communications where none were intended. Such mistakes about non-verbal behaviour are the hallmark of a subtype of delusions of reference identified as delusions of communication. Thus we hypothesised that patients with delusions of communication would tend to misinterpret incidental movements as gestures and, since delusions are often derogatory to the self, they would also tend to misinterpret gestures as insulting. Patients with acute psychotic symptoms (n=64) were recruited according to a 2 x 2 design (presence vs. absence of delusions of communication by presence vs. absence of auditory hallucinations). They, and 57 healthy controls, were presented with 20 brief video clips in which an actor either made a well-known gesture or an incidental movement. After each clip, they selected one of four interpretations: a correct interpretation if a gesture had been presented; the interpretation of a different gesture; an insulting interpretation; no gesture intended (correct for incidental movements). The patients made significantly more errors of all kinds than the controls, perceived significantly more of the incidental movements as gestures, and selected significantly more insulting interpretations of the clips. These differences between patients and controls were almost wholly due to patients with delusions of communication. These results suggest that the difficulties that people with delusions of communication experience in understanding gestures can be explained, at least in part, by the misattribution of self-generated internal events to external sources.
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PMID:Referential delusions of communication and interpretations of gestures. 1806 85

In the field of clinical psychiatry, cases of late-onset schizophrenia are often observed in the population of 40 years or older. Female patients seem to significantly predominate those diagnosed with late-onset schizophrenia. Generally, paranoid delusions of reference with family members, neighbors, and friends are observed as clinical features of such late-onset schizophrenia conditions. Medical treatment for such a condition is often effective and considered to improve the prognosis. The authors conducted clinical research at Jichi Medical University Hospital psychiatric ward involving 38 late-onset schizophrenia patients (7 males; 31 females) diagnosed over the age of 40 using DSM-IV-TR diagnostic criteria. Subjects were selected from 316 schizophrenia patients (164 males; 152 females) admitted to the hospital for schizophrenia treatment at some time during the 13 years from April 1, 1993 to March 31, 2006. Also, another 14 late-onset schizophrenia patients diagnosed over the age of 40 (1 male; 13 females), with additional investigation, were selected from 130 cases (50 males; 80 females) treated in related facilities at some time during the 2 years from April 1, 2004 to March 31, 2006. The investigation revealed the following results: (1) Cases showing an onset after the age of 40 comprised 12% of the total population. Female cases comprised 20.4%, being significantly higher than that of male cases (4.3%). Within the psychiatric ward, cases showing an onset after 40 made up 10.8% of the total population. Female cases comprised 16.3%, being significantly higher than that of male cases (2.0%). (2) The paranoid type comprised 55.3% of the total population of late-onset cases, being significantly higher than in early-onset cases younger than 40 years old. A total of 55.3% of late-onset cases also showed depressive symptoms, being significantly higher than in early-onset cases. (3) For late-onset, 55.3% of patients showed an introverted premorbid character, while 15.8% of patients exhibited an extroverted premorbid character. Regarding late-onset cases, the number of introverted premorbid character cases significantly lower than in early-onset cases diagnosed at 40 years or younger; however, no significant difference was observed for the extroverted premorbid character. (4) A total of 65.8% of the population of late-onset cases were diagnosed as having psychosocial stresses as their cause. In addition, 36 % of subjects with psychosocial stress recognition had experienced a sense of loss. Of these, 66.6% of the loss experience involved separation from their family members. (5) Cases showing a successful recovery from schizophrenia comprised 55.3 % of the total population. On the other hand, cases with an unsuccessful outcome were observed in 34.2% of the total population, accounting for a relatively large portion. A total of 30.8% of subjects with an unsuccessful outcome were unmarried at the time of onset, and made up 57.1% of the late-onset population. According to the results of this investigation, late-onset schizophrenia represents about 10% of the total cases, and female cases are significantly more common than male cases. For late-onset patients, subjects' self-functions were more developed compared to those of early-onset patients, so they did not seem to clearly show early-onset symptoms during a younger period. The late-onset type has a tendency to show a better rate of successful recovery; however, there are situations where the condition reverts toward the "disorganized type", moving closer toward Kraepelin's early-onset disorganized schizophrenia.
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PMID:[Clinical psychopathological research on late-onset schizophrenia--mainly patients with schizophrenia from a hospital psychiatric ward]. 1942 90


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