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

Research and treatment of schizophrenia have been impeded by its heterogeneity and the lack of well-standardized methods for a comprehensive assessment of symptoms, including positive and negative dimensions. To study symptom profiles, therefore, we standardized and administered a well-operationalized 30-item psychiatric symptom scale to 240 schizophrenic inpatients. Principal component analysis suggested a pyramidlike triangular model of uncorrelated but nonexclusive syndromes that encompassed the spectrum of psychopathology. Negative, positive, and depressive features constituted divergent points of a triangular base, and excitement made up a separate vertical axis. Paired syndromes could account for symptoms of the paranoid (positive-depressive), disorganized (positive-negative), and catatonic (negative-depressive) diagnostic subtypes. The transversal positions in this model suggested polarized dimensions in schizophrenia, including a prognostic axis (depression-cognitive dysfunction). The findings imply that (1) negative and positive syndromes show factorial validity and distinction from depression but, alone, are insufficient to accommodate the full diversity of symptoms; (2) schizophrenic subtypes derive from a hybrid between unrelated but co-occurring dimensions that may define the fundamental elements of psychopathology; and (3) the pyramidical model is of heuristic value. The results help to clarify the heterogeneity of schizophrenia and to illuminate the path toward syndrome-specific treatments.
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PMID:Pyramidical model of schizophrenia. 228 38

Two cases of electroconvulsive therapy (ECT) in adolescence are presented and the literature on the use of ECT in childhood and adolescence is reviewed. ECT was effective in children and adolescents with bipolar disorder and depression. Inadequate information exists to make a judgment regarding schizophrenia, delirium, and anorexia nervosa. ECT is not effective in autism and chronic organic brain syndromes. Complications cited include organicity and seizures in the period immediately after ECT, anxiety reactions, and disinhibition. Long-term memory deficit or cognitive impairment has not been found, although further research to rule out residual impairment is needed.
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PMID:A review of ECT for children and adolescents. 222 48

The distinction between bipolar disorder and schizophrenia customarily follows examination of the clinical symptomatology and course of illness. The presence of cognitive impairment has been held to be uncommon in bipolar disorder and more likely in schizophrenia. This study explored neuropsychological function in 30 ambulatory outpatients with a DSM-III-R diagnosis of bipolar affective disorder (all of whom had been psychotic during manic episodes), comparing their performance with that of controls. These bipolar patients proved to have significant levels of diffusely represented cognitive impairment when compared with controls. Further, the degree of impairment was significantly correlated with reduction in midsagittal areas of brain structures measured on magnetic resonance imaging scans. The implications of these findings in relation to bipolar disorder are discussed.
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PMID:Cognitive impairment and cerebral structure by MRI in bipolar disorder. 235 25

Ventricle-brain ratio was measured by CT scan in 24 bipolar patients, 27 unipolar patients with major depression, 108 schizophrenic patients, and 75 normal control subjects. The male bipolar patients had significantly larger ventricles, but the depressive patients did not. The findings suggest the possibility that ventricular enlargement in bipolar patients is independent of age, as it appears to be in schizophrenia, whereas in depressed patients it may be related to the aging process. Ventricular enlargement in bipolar patients was not related to relevant clinical correlates, such as response to treatment, history of substance abuse, history of ECT, or cognitive impairment.
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PMID:Ventricular abnormalities in affective disorder: clinical and demographic correlates. 235 74

We examined magnetic resonance (MR) scans of the heads of 8 patients with late onset psychosis and 8 aged controls. Although some patients had mild cognitive impairment, none had depression or a history or examination suggesting focal brain disease. Thus, all patients met DSM-III-R criteria for late-onset schizophrenia. All 8 patients showed significant leukoencephalopathy or vascular pathology on MR imaging, and temporoparietal and occipital lesions were especially prominent. Little such pathology was evident on control scans. We suggest that focal brain disease of vascular origin may be associated with late-onset psychosis, and that MR scanning of such cases may provide important clues to pathogenesis.
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PMID:Cerebral white matter disease in late-onset paranoid psychosis. 237 29

The two-syndrome concept of schizophrenia was investigated in a sample of 70 Nigerian schizophrenic patients. The positive and negative syndromes were studied in relation to demographic, historical, neurological and psychometric measures. The negative syndrome was associated with cognitive impairment, behavioural deterioration and left eye dominance, and also with poor pre-morbid educational achievement and longer length of current stay in hospital. The positive syndrome was unrelated to any of the independent variables. The two syndromes were not significantly related, supporting the view that they represent relatively independent dimensions of pathology. This provides further support for the validity of the Type I-Type II subtyping of schizophrenia in populations of patients from different cultural backgrounds, and suggests that the negative syndrome is related to the presence of neurodevelopmental deficits that possibly antedate the schizophrenic illness.
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PMID:Correlates of positive and negative schizophrenic syndromes in Nigerian patients. 257 23

Romney and Saccuzzo et al. (J Nerv Ment Dis 176:364-367; 368-371, 1988) disagreed concerning the need for further studies investigating the presence of thought disorder and associative cognitive dysfunction in relatives of schizophrenics. Saccuzzo et al. were concerned at the variations in the results of previous studies. Methodological issues relevant to such variation are discussed. It is pointed out that the study (McConaghy J Neurol Neurosurg Psychiatry 22:243-246, 1959) initiating psychometric investigation of cognitive processes of relatives of schizophrenics was based on the belief that what was familially transmitted was not thought disorder, but a nonpathological looseness of associations, shown also by a percentage of normal subjects. This looseness was later termed allusive thinking. It was considered that allusive thinking acted as an inherited predisposition to schizophrenia. It required the addition of impairment of abstract thinking to constitute the characteristic thought disorder originally described by Bleuler. To account for the significant degree of thought disorder found in 6% to 12% of normal subjects, some researchers now accept that thought disorder exists in normal subjects on a continuum with schizophrenic thought disorder. It is suggested that replication of a later study demonstrating familial transmission of allusive thinking in university students and their parents could aid in clarifying the significance of the findings of increased incidence of looseness of associations in the families of schizophrenics.
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PMID:Thought disorder or allusive thinking in the relatives of schizophrenics? A response to Callahan, Madsen, Saccuzzo, and Romney. 259 62

The demography, course of illness, cognitive dysfunction and neurological consequences of long term treatment of 11 family pairs with long history of chronic schizophrenic illness were studied. There was concordance for the presence of tardive dyskinesia in 6 pairs; each of 2 brother-brother pairs; 3 brother-sister pairs and one of mother-daughter pair. There was concordance for the absence of tardive dyskinesia in 5 pairs, each of 3 father-son pairs and 2 brother-sister pairs. In schizophrenic patients the presence or absence of tardive dyskinesia in one member of the family is a risk factor for the development of the syndrome in another member with the same psychotic illness. Those pairs with tardive dyskinesia were characterized by negative symptoms of schizophrenia and evidence of intellectual deterioration.
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PMID:Familial psychosis and vulnerability to tardive dyskinesia. 260 29

This study tested the hypothesis that psychosis-prone individuals show patterns of visual search that suggest a lateralized cerebral hemispheric abnormality, similar to one hypothesized by Venables (1980) to underlie cognitive dysfunction in schizophrenia. Self-report measures of psychiatric vulnerability were completed by 881 college students. Experimental subjects (n = 73) were those with high scores on one of four psychosis-proneness scales. Control subjects (n = 33) scored within 0.5 SD of the mean on all scales. Subjects were tested using verbal and nonverbal visual search tasks designed to detect abnormalities in the spatial distribution of attention. When searching random arrays of nonverbal stimuli, 53% of the experimental subjects used an erratic search strategy similar to that typically observed in right-brain-damaged patients, compared with 23% of controls. The most deviant search patterns were shown by subjects who scored high on Physical Anhedonia and Perceptual Aberration-Magical Ideation. The results suggest that early development of schizophrenic disorder might be associated with dysfunction of right-hemispheric mechanisms of attentional control.
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PMID:Spatial attention in hypothetically psychosis-prone college students. 271 Aug 66

Seventy-seven patients with diagnosis of schizophrenia (62) or schizoaffective disorder (15) were studied 2-20 years since onset of illness, when in a stable condition. The investigation included clinical assessment, measurement of plasma concentrations of neuroleptics and prolactin, computed tomography brain scan, neuropsychological and neurological examination. Outcome of illness was classified according to the presence of chronic psychiatric symptoms and social impairment, and response to neuroleptics according to the effect of treatment in the most recent psychotic episode. Neither outcome nor response to neuroleptics was related to duration of illness. The groups with good and poor outcome differed in premorbid adjustment, age at onset and symptoms of the initial episode, but not in drug bio-availability or prolactin response. Large cerebral ventricles and cognitive impairment, but not neurological 'soft' signs, were associated with unfavourable outcome. The three measures of organicity were not inter-related. No clinical differences were found between chronic patients with and without signs of organic dysfunction. The findings suggest that schizophrenia with good and unfavourable outcome may be separate sub-types. However, the role of organic factors in the latter group remains unclear.
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PMID:Schizophrenia with good and poor outcome. I: Early clinical features, response to neuroleptics and signs of organic dysfunction. 285 67


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