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

Neuropsychological deficits in schizophrenia and affective illnesses have been a topic of increasing research interest for more than two decades. Currently, the cognitive dysfunctions are regarded as an essential element of these illnesses, occurring already in their prodromal phase, with an increment during the course of illness and with some deficits persisting also during the remission period. In schizophrenia, deficits in working memory and executive functions are most frequently demonstrated. In patients with affective illnesses, the initial research focused mainly on depression, where psychomotor slowness, deficits of attention, verbal and working memory and executive functions have been observed. It has been shown that during depression in the course of bipolar affective illness, the cognitive dysfunctions have been more marked as compared with recurrent depression. In this paper, the neuropsychological changes occurring during the period of mania and hypomania have been presented. The disturbances that have been shown most frequently include selective cognitive dysfunctions such as disturbances of attention and learning process, working memory and executive functions. During periods of mania/hypomania, the specific distortions of thinking occur ("anastrophic" thinking), as well as disturbances in the decision making process, connected with increased impulsivity. Another characteristic of the episode of elevated mood has been a change of information processing of affective type, mostly a lower ability for perception and recognition of negative emotions. Among persons with bipolar affective illness, especially during the hypomanic period, an increased level of creativity than in control persons has been observed, what may facilitate higher artistic activity. Recently, the evidence has been accumulated pointing to more severe cognitive dysfunctions in bipolar affective illness, type I (with manic states) compared with bipolar affective illness, type II (with hypomania).
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PMID:[Neuropsychological aspects of the manic syndrome in the course of bipolar affective illness]. 1972 21

Bipolar disorder (BD) is one of the most difficult to diagnose among all psychiatric disorders. BD is often misdiagnosed as recurrent depressive disorder, schizophrenia, anxiety or personality disorders. In 40% of patients BD is not detected at the first examination and in 2/3 of cases the proper diagnosis is made after about 10 years. The consequence of this condition is inadequate treatment leading to the worsening of the course of BD or increased risk of substance misuse and suicidal behavior. Those data reveal that the better detection of bipolar spectrum is strongly needed. It may be achieved by the application of the Mood Disorder Questionnaire (MDQ) in clinical practice. MDQ is a self rating questionnaire created by Hirschfeld et al. for screening of bipolar spectrum. According to previous data the usefulness of MDQ in populations of psychiatric patients (especially those with affective disorders) is unquestionable high. The significant limitation of MDQ is a relatively low sensitivity for BD type II. That's why the concomitant use of MDQ (as an excellent tool for detection of BD type I) and the other instrument characterized by the higher sensitivity for hypomania and BD type II (e.g. The Hypomania Symptom Checklist by Angst et al.) seems to be the best and recommended solution. This article describes the properties and structure of MDQ. The capabilities, advantages and limitations of MDQ were also presented. The authors discussed the results of validation studies of different language versions of MDQ and summarized--DEP-BI and TRES-DEP--Polish studies using MDQ.
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PMID:[Mood Disorder Questionnaire--characteristic and indications]. 1972 22

The diagnosis of bipolar disorder in depressed patients requires the ascertainment of prior episodes of mania and hypomania. Several research reports and commentaries have suggested that bipolar disorder is underrecognized and that many patients with nonbipolar major depressive disorder have, in fact, bipolar disorder. In a previous article from the Rhode Island Methods to Improve Diagnostic Assessment and Services (MIDAS) project, we reported the opposite phenomenon-that bipolar disorder is often overdiagnosed in psychiatric outpatients. An important question that has not been previously examined is whether there is a particular clinical or demographic profile associated with bipolar disorder overdiagnosis among depressed patients. Forty psychiatric outpatients with current major depressive disorder reported having been previously diagnosed with bipolar disorder, which was not confirmed when interviewed with the Structured Clinical Interview for Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (SCID). Psychiatric diagnoses, clinical and demographic variables were compared in these 40 patients and 233 depressed patients who were not diagnosed with bipolar disorder. Patients were interviewed by a highly trained diagnostic rater who administered the SCID for DSM-IV Axis I disorders, the Structured Interview for DSM-IV Personality for DSM-IV Axis II disorders, and the Schedule for Affective Disorders and Schizophrenia for clinical features of depression. The depressed patients who were overdiagnosed with bipolar disorder were diagnosed with a significantly higher number of Axis I disorders and were more likely to be diagnosed with specific phobia, posttraumatic stress disorder, and drug abuse/dependence. The patients overdiagnosed with bipolar disorder were also significantly more likely to be diagnosed with a current personality disorder and were more chronically ill with greater psychosocial impairment. Thus, the results suggest that depressed outpatients who had previously been overdiagnosed with bipolar disorder were more chronically and severely ill than depressed outpatients who had not been overdiagnosed.
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PMID:Clinical characteristics of depressed outpatients previously overdiagnosed with bipolar disorder. 2015 87

Stability has been considered an important aspect of vulnerability to schizophrenia. The temporal stability of the scales in the Minnesota Multiphasic Personality Inventory (MMPI) was examined, using adoptees from the Finnish Adoptive Family Study of Schizophrenia. Adoptees who were high-risk (HR) offspring of biological mothers having a schizophrenia spectrum disorder (n=28) and low-risk (LR) controls (n=46) were evaluated using 15 MMPI scales at the initial assessment (HR, mean age 24 years; LR, mean age 23 years) and at the follow-up assessment after a mean interval of 11 years. Stability of the MMPI scales was also assessed in the groups of adoptees, assigned according to the adoptive parents'(n=44) communication style using Communication Deviance (CD) scale as an environmental factor. Initial Lie, Frequency, Correction, Psychopathic Deviate, Schizophrenia, Manifest Hostility, Hypomania, Phobias, Psychoticism, Religious Fundamentalism, Social Maladjustment, Paranoid Schizophrenia, Golden-Meehl Indicators, Schizophrenia Proneness and 8-6 scale scores significantly predicted the MMPI scores at the follow-up assessment indicating stability in the characteristics of thinking, affective expression, social relatedness and volition. Low CD in the family had an effect on the stabilization of personality traits such as social withdrawal and restricted affectivity assessed by Correction and Hostility.
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PMID:Stability in MMPI among adoptees with high and low genetic risk for schizophrenia and with low Communication Deviance of their adoptive parents. 2376 94

Frontal meningiomas may present only with psychological symptoms that resemble depression, anxiety states, hypomania and schizophrenia. Herein, we present the case of a 55-year-old man who was initially thought to have depression and bipolar disorder, but was eventually diagnosed with frontal lobe syndrome caused by a giant frontal meningioma.
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PMID:Frontal lobe syndrome caused by a giant meningioma presenting as depression and bipolar disorder. 2400 63

A third of patients suffering from major depression cannot be helped by conventional treatment methods. These patients face reduced quality of life, high risk of suicide, and little hope of recovery. Deep brain stimulation (DBS) is under scientific evaluation as a new treatment option for these treatment-resistant patients. First clinical studies with small samples have been stimulated at the subgenual cingulate gyrus (Cg25/24), the anterior limb of the capsula interna (ALIC), and the nucleus accumbens (NAcc). Long-term antidepressant effects, augmentation of social functioning, and normalization of brain metabolism have been shown in about 50% of patients. Cognitive safety regarding attention, learning, and memory has been reported. Adverse events were wound infection, suicide, and hypomania, amongst others. Larger studies are under way to confirm these preliminary encouraging results. New hypothesis-guided targets (e.g., medial forebrain bundle, habenula) are about to be assessed in clinical trials. The application of DBS for other psychiatric diseases (e.g., bipolar disorder, alcohol dependency, opioid addiction, schizophrenia) is debated and single case studies are under way. Standards are needed for study registration, target selection, patient inclusion and monitoring, and publication of results to guarantee safety for the patients and scientific exchange.
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PMID:Deep brain stimulation for major depression. 2411 97

Sleep is a sensitive indicator of well-being and a helpful early-warning symptom in many psychiatric disorders. Healthy sleep and a balanced sleep-wake rhythm are desirable goals of a salutary conduct of life. Preventive and psychoeducational measures should take up this point. Non-organic sleep disorders are commonly associated with psychiatric diseases such as major depressive disorder, hypomania, mania, schizophrenia, anxiety disorders, alcoholism and other substance related disorders as well as dementias. Sleep disturbances are often the first symptoms of a psychiatric disorder and thus important early warning signs. Polysomnography is a useful tool to show the characteristic patterns of sleep disturbances in different psychiatric disorders.
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PMID:[Sleep disorders associated with psychiatric diseases]. 2424 59

Glutamate is the main excitatory neurotransmitter in the central nervous system. Dysfunction of the glutamatergic system plays an important role in the pathogenesis of schizophrenia. Therefore, glutamatergic agents such as N-methyl-D-aspartate receptor co-agonists (ie, glycine, D-cycloserine) and glycine transporter type 1 inhibitors (eg, sarcosine) are studied for their efficacy in ameliorating negative and cognitive symptomatology in patients with schizophrenia. We report the case of a 23-year-old schizophrenic patient treated with quetiapine and citalopram, who was offered concomitant sarcosine treatment. After obtaining an informed consent, we started administration of 2 g of sarcosine per day to treat persistent negative and cognitive symptoms. The patient's activity and mood improved within 2 weeks, but in the following 2 weeks the patient reported increased drive, activity, libido, unpleasant inner tension, and irritability. We ruled out hypomania and decided to decrease the daily dose of sarcosine to 1 g, which resulted in reduction of drive and irritability. Activity and mood improved compared with his state before adding sarcosine. We suggest a sarcosine dose between 1 g and 2 g per day with an initial dose of 2 g, but if side effects occur, the dose should be decreased to 1 g per day. We would like to emphasize the clinically important glutamate-serotonin interaction during concomitant use of sarcosine, citalopram, and quetiapine in our patient, which may lead to serious discomfort.
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PMID:Two grams of sarcosine in schizophrenia - is it too much? A potential role of glutamate-serotonin interaction. 2452 91

Presently, the use of atypical antipsychotics is getting increasingly widespread. There are several mania/hypomania cases that have been associated with atypical antipsychotic treatment that also display antimanic, antidepressive and anxiolytic effects in addition to their antipsychotic effects. In this study, a case of schizophrenia in which manic symptoms developed after increasing the dosage of quetiapine to 300 mg/day, and subsequently disappeared after cessation of treatment is presented. Although the blockage of 5HT2 receptors and the disinhibition of frontal dopamine secretion seemed to be the reasons for the development of the mania/hypomania related to atypical antipsychotics, the mechanism is not clear. During the use of atypical antipsychotics, clinicians should be cautious to patients' mood fluctuations.
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PMID:[Mania associated with quetiapine treatment]. 2459 Aug 52

Psychiatric diagnosis is not considered a risk factor for offending following discharge. However, treatment interventions and aftercare are strongly influenced by clinical primary diagnosis. We compared differential risks of reoffending of patients falling into six primary diagnostic categories following discharge from Medium Secure Units in the UK: schizophrenia/schizoaffective disorder; delusional disorder; mania/hypomania; depressive disorder; organic brain syndrome; personality disorder. We followed up 1344 patients, on average 6.2 years (SD=2.1) at risk, discharged from 7 of 14 Regional Medium Secure services in England and Wales. Outcomes were period prevalence, incidence, and cumulative probability of criminal conviction. Established demographic and criminal history predictors of reoffending were observed across different diagnostic categories. Risks of all offending were increased for personality disorder, violence/acquisitive offending for delusional disorder, sexual offending for mania/hypomania and violence/acquisitive offending for organic brain syndrome. Patterns of risk over time differed markedly between categories of mental disorder. Most patients with personality disorder who offended violently did so within 4 years of discharge. A subgroup with delusional disorder demonstrated increased risk of violent offending 5 years after discharge. Differential risks of reoffending are observed between different diagnostic groups. Clinical diagnosis should be included together with established risk measures in risk management following discharge. Close supervision of patients with personality disorder should begin immediately after discharge when risks of reoffending are greatest. For delusional disorder further investigation is needed into the marked increase in risk of violence after 5 years.
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PMID:Psychiatric diagnosis and differential risks of offending following discharge. 2566 Mar 50


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