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

While the impact of social learning programs upon social deficits in schizophrenia has been widely studied, less is understood about which patients have the poorest social skills, and among those which patients have deficits most refractory to rehabilitation. To explore these questions, this study compared the symptom levels and performance on neuropsychological testing of 91 subjects with impaired and unimpaired social skills enrolled in a vocational rehabilitation program. After 10 weeks of rehabilitation and a supportive group treatment, social skills among a subsample of 41 subjects with initially impaired social skills were reassessed. Results indicate that subjects with initially impaired social skills had significantly higher levels of negative symptoms. However, multiple regression analysis revealed that cognitive impairments at intake, rather than level of negative symptoms, predicted improvement among subjects with initially impoverished social skills (R2 = .35). Results suggest that level of cognitive impairment is associated with the persistence of social skills deficits in schizophrenia.
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PMID:Social skills at work. Deficits and predictors of improvement in schizophrenia. 759 30

Phencyclidine (PCP), in a dose of 15 mg/kg, produced delayed cognitive dysfunction (at 24 h) in rats subjected to water maze tasks. At 24 h after PCP administration, ataxia, hyperlocomotion and stereotyped behavior were not induced. NE-100, N,N-dipropyl-2-[4-methoxy-3-(2-phenylethoxy)phenyl]-enthylamine monohydrochloride, a selective and potent sigma receptor ligand, was administered orally 10 min after PCP administration or 15 min before the first trial (24 h after PCP administration). In both cases, NE-100 dose-dependently attenuated the delayed cognitive dysfunction induced by PCP. As these findings show that ingestion of PCP led to delayed cognitive dysfunction similar to the cognitive signs of psychosis seen in humans, NE-100 is being further studied for possible treatment of subjects with schizophrenia.
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PMID:Effect of NE-100, a novel sigma receptor ligand, on phencyclidine- induced delayed cognitive dysfunction in rats. 760 28

A fair appraisal of the public health significance of cannabis use has been hampered by the polarised opinions about its health effects expressed by partisans on both sides of the debate on its legal status. The findings of a recent review of the literature on the adverse health and psychological effects of cannabis are used to estimate the major probable public health risks of cannabis use in Australia. These appear to be, in order of approximate public health importance: adverse psychological effects; motor vehicle accidents; cannabis dependence; respiratory disease; precipitation and exacerbation of schizophrenia in vulnerable individuals; low-birthweight babies; and perhaps subtle cognitive impairment. On current patterns of use, cannabis use is a modest public health concern by comparison with alcohol and tobacco, although given the scale of public health damage caused by the latter drugs, and the currently low prevalence of regular cannabis use, this is not cause for complacency.
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PMID:The public health significance of cannabis use in Australia. 762 73

A 28-item behavioral rating scale, the Acute Psychiatric Rating Scale (APRS), was developed using factor-analytic methods for the assessment of functionally disturbed psychiatric inpatients. Fifty-eight staff rated 74 patients on the scale. Seven factorial dimensions were extracted comprising neuroticism, aggression, emotional withdrawal, cognitive impairment, schizophrenia, hypomania and self-injuriousness. The scale was evaluated in 4 different psychiatric inpatient units: two acute admission wards, an intensive care unit and a regional secure unit. Behavioral ratings on the scale were related to several patient demographic and treatment variables, including age, sex, marital status, legal status, length of admission and electroconvulsive therapy. The scale was found to possess a clear factorial structure, good interrater reliability and promising clinical validity for further research use in psychiatric inpatient settings.
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PMID:An acute psychiatric rating scale for the clinical assessment of functionally disturbed inpatients. 767 38

Cognitive symptoms of schizophrenia may represent a separate component of the disorder that is distinct from positive or negative syndromes. In a previous study, we reported a factor analysis of the Positive and Negative Syndrome Scale (PANSS) that revealed five components, one of which we labeled the Cognitive component. In the present study, we explored the validity of the PANSS Cognitive component by examining correlations between neuropsychological measures and the five factor-analytically derived PANSS scores for 147 subjects with diagnoses of schizophrenia or schizoaffective disorder. Higher scores on the PANSS Cognitive component were significantly correlated with poorer performance on all neuropsychological tests, including the Wisconsin Card Sorting Test (WCST), the Digit Symbol Substitution Task, the Slosson Intelligence Test, and the Gorham Proverbs Test. Multiple regression revealed that these test scores explained 37% of the variance in the Cognitive component score. Neuropsychological tests have very limited associations with the other PANSS components. These results suggest that the Cognitive component of the PANSS is a valid measure of cognitive deficits in schizophrenia, and they support the hypothesis that Cognitive impairment is a distinctive feature of schizophrenia independent of positive and negative syndromes.
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PMID:Concurrent validity of the cognitive component of schizophrenia: relationship of PANSS scores to neuropsychological assessments. 770 Oct 28

The present paper proposes a new psychophysiological approach to the genesis of positive and negative schizophrenic symptoms. According to this approach, the initial factor in schizophrenic disorders is a functional insufficiency of the right hemisphere which can be determined by early emotional experience in combination with subtle brain damage. This functional insufficiency causes (a) the inability to grasp and select information before its realization; and (b) the inability to produce a polysemantic context which is crucial for creativity, psychological defense, and the restoration of search activity, all of which determine psychophysiological adaptation to the environment. Right hemisphere insufficiency causes left hemisphere hyperactivity as an ineffective attempt to compensate for this functional deficiency. As a result, normal search activity is replaced by artificial search activity which is represented by "positive" symptoms, and which uses the predisposition of the left hemisphere's catecholamine system for its increased activity. The suggestion is made that cognitive impairment in schizophrenia (the inability to use appropriate previous information in relation to current perceptual input) is related to the competition between information processing which requires left hemisphere activity, and the formation of positive symptoms, also based on left hemisphere activity.
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PMID:An integrative psychophysiological approach to brain hemisphere functions in schizophrenia. 770 62

While recent studies have found that most patients with schizophrenia who participate in work rehabilitation experience symptom improvement, there appears to be a subgroup of patients whose symptoms remain stable or even worsen. The present study explores the hypothesis that cognitive impairment is one factor which reduces the clinical effectiveness of rehabilitation and accounts for a lack of improvement in some patients. To explore this question, performance on two neuropsychological tests was used to predict improvement on six symptom dimensions for 59 subjects who completed 5 months of work in a rehabilitation program. Discriminant function analyses indicated that quadratic combinations of standardized scores on the Wisconsin Card Sorting Test and thought disorder scores from the Gorham Proverbs Test could correctly classify 83% of subjects as improved or unimproved on a total symptom measure, and between 84% and 100% of subjects as improved or unimproved on various symptom dimensions, with greater levels of cognitive impairments at intake predicting no symptom improvement. Implications for the potential role of cognitive remediation in rehabilitation are discussed.
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PMID:Cognitive deficits in schizophrenia. Prediction of symptom change for participators in work rehabilitation. 774 89

Research has suggested that impaired insight in patients with schizophrenia is associated with poorer treatment compliance and outcome. Little is known about what forms of treatment can lead to improvements in insight. Research has found that impairments in insight remain stable despite participation in standard treatments. This study examined changes in insight in a sample of 44 subjects with impaired insight who were enrolled in a vocational rehabilitation program. Significant improvements in insight rating were observed for the sample, with a total of 61% of subjects (N = 27) improving. Multiple regression analysis revealed that measures of cognitive impairment (Digit Symbol Subtest Test, Slosson IQ Test, Wisconsin Card Sorting Test) predicted improvement in insight (R2 = .33), with greater levels of cognitive impairments predicting lesser improvement. Psychosocial variables, including concurrent measurements of positive and negative symptoms, were not significant predictors of improvement. These results suggest that vocational rehabilitation can favorably affect insight, particularly for subjects with less severe cognitive deficits.
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PMID:Work rehabilitation and improvements in insight in schizophrenia. 784 71

We compared global and regional cerebral blood flow in 11 schizophrenic patients and 11 normal comparison subjects, all over the age of 45 years. The schizophrenic patients had lower global cortical uptake than the control subjects. Among the individual regions of interest, the schizophrenic patients had significant decrements in the left posterior frontal region and in the bilateral inferior temporal regions. The uptake did not correlate with age of onset or duration of schizophrenia, current daily neuroleptic dose, severity of psychopathology, or global cognitive impairment.
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PMID:Preliminary report: cerebral blood flow abnormalities in older schizophrenic patients. 787 Aug 52

Literature of the past ten years is reviewed to examine psychosocial, psychiatric, organic, and general medical causes of psychotic symptoms in persons over age 65. Being bedfast with poor caretaker relationships and being socially isolated are risk factors for psychosis among elderly persons. A thorough history is essential to differential diagnosis. Psychiatric causes to be ruled out include schizophrenia; depression, including mania; dementia and delirium; paranoid state; and late-life delusional disorder. Perhaps the most common etiology is cognitive impairment, generally attributable to Alzheimer's disease or multi-infarct dementia. Organic or toxic etiologies need to be ruled out, especially in persons with visual hallucinations. Drug toxicity, a structural brain lesion, or a subtle seizure disorder should be considered. If symptoms are not alleviated when psychosocial triggers or underlying toxic, organic, or medical causes are addressed, patients may respond to supportive therapy and low doses of high-potency neuroleptics. The clinician should keep in mind that older adults are highly sensitive to the side effects of these agents.
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PMID:The older patient with psychotic symptoms. 789 23


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