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

The prognostic significance of signs and symptoms taken individually rather than in diagnostic clusters was investigated in 61 schizophrenic patients seen at 5-year follow-up in the Washington Center of the International Pilot Study of Schizophrenia. Best and worst outcome patients (Ns = 20) were selected on the basis of total outcome score from a reliable 9-item schedule; 21 middle-outcome patients were excluded. Data from these two groups were analyzed to determine which signs and symptoms assessed 5 years previously were associated with outcome. Only restricted affect predicted poor outcome: depression, anxiety, and nuclear symptoms of schizophrenia were not significant predictors. The findings are discussed within the conceptual framework of productive and defect symptoms.
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PMID:Signs and symptoms as predictors of outcome: a report from the International Pilot Study of Schizophrenia. 66 38

The relationship between DSM-III-R schizophreniform disorder, delusional disorder (DD) and psychotic disorder not otherwise specified (PD-NOS) and schizophrenia and affective illness (AI) remains uncertain. We explore this question in the Roscommon Family Study by examining symptoms, outcome and patterns of psychopathology in relatives. Probands were selected from a population-based case registry in the west of Ireland with an ICD-9 diagnosis of schizophrenia or AI. Personal interviews were conducted with 88% of traceable, living probands, a mean of 16 years after onset, and 86% of traceable, living first-degree relatives. Best-estimate diagnoses were made at follow-up. Schizophreniform disorder, DD and PD-NOS constituted 6.4%, 2.8% and 7.5%, respectively, of all probands with a registry diagnosis of schizophrenia. Probands with schizophreniform disorder had prominent positive psychotic symptoms, negligible negative symptoms and a good outcome, comparable to that seen in AI probands. Their relatives had an excess risk of schizophrenia spectrum illness but not AI. Probands with DD had prominent delusions but no other psychotic symptoms, few negative symptoms, fair to good outcome and an increased risk in relatives for alcoholism. Probands with PD-NOS had both moderate positive and negative psychotic symptoms, a poor to fair outcome and a substantially elevated risk in relatives of schizophrenia and schizophrenia spectrum disorders but not AI.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Schizophreniform disorder, delusional disorder and psychotic disorder not otherwise specified: clinical features, outcome and familial psychopathology. 767 34

A number of schizophrenia patients live untreated in the community in the developing countries. There is little recorded experience of how such patients would respond to treatment after years of untreated illness. A cohort of 72 never-treated chronic schizophrenia patents in Chennai, India were directed to attend a health facility. A substantial proportion of them (68%) came for treatment. Unemployed status of male patients, living in a joint family setting and families initially unaware of the psychiatric nature of the problem were the factors that related to failure to seek treatment. Patient's sex, age, education, marital status, economic status, age at onset and duration of illness, degree of disability and clinical symptoms (except self-neglect) were not related to taking treatment. Those who attended were treated with typical antipsychotic drugs and followed up for one year. Evaluation was done using the Present State Examination and Psychiatric History and Sociodemographic Schedule and Disability Assessment Schedule. The clinical outcome was good (Best Remission) in 29%. There was no impairment in social functioning in 35% and 51% has no impairment in occupational functioning at the end of one year.
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PMID:Initiating care for untreated schizophrenia patients and results of one year follow-up. 1143 13

At first, this article comprises the innovative programme of the international "Early Detection and Intervention" research and then shows results of the "Cologne/Bonn Early Recognition - CER" project on schizophrenia, the first longterm prospective study on patients in potentially initial prodromal stages prior to the first psychotic manifestation. At re-examination at an average of 9.6 years later, 79 of 160 patients had subsequently developed a schizophrenic psychosis according to DSM-IV criteria. Prediction values for the complete range of prodromal symptoms, for 5 subsyndromes and for individual symptoms were assessed. Best prediction values with a high positive predictive power (71 - 91 %) and a low rate of false-positive predictions (7.5 - 1.9 %) were achieved for 10 symptoms and symptom complexes mainly out of the group of thought, speech and perception disturbances. As only unsatisfactory prediction values for other prodromal symptom definitions were reported, e.g. the commonly used DSM-III-R definition, empirical evidence for the possibility of diagnosing schizophrenia as early as in the initial prodromal stage, has been found for the first time. In the following, this article considers essential initiatives for the development, performance and evaluation of a promising early intervention programme based on the results found. In Germany, within the project unit "Early Recognition and Intervention" of the competence network "Schizophrenia", such a programme has been initiated. Late prodromal stages are defined by attenuated or transient psychotic symptoms and early prodromal stages by the presence of at least one of the highly predictive prodromal symptoms from the CER-study or decline in psychic functions in combination with other risk factors. Intervention strategies are a multimodal psychological programme for the intervention in early prodromal stages and a combination of psychotherapy with atypical neuroleptic drugs in the late prodromal stages. If such strategies were able to suppress the progress to first psychotic episodes, this prevention could be classified as a primary prevention, not with regard to the prodromal symptoms but to frank/manifest schizophrenia.
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PMID:[Is there a primary prevention of schizophrenic psychiasis?]. 1153 60

The clinical utility of the Oklahoma Premorbid Intelligence Estimate--3 (OPIE-3; Schoenberg, Scott, Duff, & Adams, 2002) in estimating premorbid FSIQ was investigated with the WAIS-III standardization sample. The OPIE-3 algorithms combine Vocabulary, Information, Matrix Reasoning, and Picture Completion subtest raw scores with demographic variables to predict FSIQ. Estimated WAIS-III FSIQ scores are presented for patients' diagnosed with dementia, traumatic brain injury, Huntington's disease, Korsakoff's disease, chronic alcohol use, temporal lobectomy, and schizophrenia. A group of patients with depression was employed as a clinical control group. The OPIE-3V and OPIE-3MR algorithms performed well, with the average predicted FSIQ of the combined clinical sample approximating the mean FSIQ of healthy adults. The OPIE-3(Best), which is a procedure that employs either the OPIE-3V, OPIE-3MR, or OPIE-3(2ST) algorithms in a best performance method, is presented. Recommendations in the application of the OPIE-3 are made and future research is proposed.
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PMID:An evaluation of the clinical utility of the OPIE-3 as an estimate of premorbid WAIS-III FSIQ. 1470 82

Recent research has suggested that the DiGeorge syndrome critical region gene 14 (DGCR14) exhibits activity differences of more than 1.5 fold between the haplotypes of the variants in the promoter region. DGCR14 is located at 22q11.21, an acknowledged region for susceptibility to schizophrenia. To test the hypothesis that DGCR14 may be involved in the etiology of the disease, we carried out a family-based association study between the reported functional markers and schizophrenia in 235 Chinese Han trios. We found significant evidence of preferential transmission of the promoter variants of DGCR14 across all the trios (Best p-value = 0.00038, Global p-value = 0.0008). The positive results have suggested that DGCR14 is likely to play an important role in the etiology of schizophrenia in the Chinese Han population.
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PMID:Transmission disequilibrium test provides evidence of association between promoter polymorphisms in 22q11 gene DGCR14 and schizophrenia. 1643 32

Cognitive rehabilitation (CR) approaches seek to enhance cognitive processes or to circumvent cognitive impairments in schizophrenia in an effort to improve functional outcome. In this review we examine the research findings on the 8 evidence-based approaches to cognitive remediation listed in the 2005 Training Grid Outlining Best Practices for Recovery and Improved Outcomes for People With Serious Mental Illness, developed by the American Psychological Association Committee for the Advancement of Professional Practice. Though the approaches vary widely in theoretical orientation and methods of intervention, the results are, for the most part, encouraging. Improvements in attention, memory, and executive functioning have been reported. However, many persons with schizophrenia are more impaired in real-world functioning than one would expect given the magnitude of their cognitive deficits. We may need to look beyond cognition to other targets such as motivation to identify the reasons that many persons with schizophrenia demonstrate such marked levels of disability. Although a number of current CR approaches address motivation to varying degrees, treating motivation as a primary target may be needed to maximize CR outcomes.
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PMID:Cognitive rehabilitation for schizophrenia and the putative role of motivation and expectancies. 1664 24

This article traces the connections between the public career and private life of Constance Pascal (1877-1937), the first woman psychiatrist in France, in the social context of the Belle Epoque. Pascal, of Romanian origin, attained professional success at the cost of suppressing her personal life. Best known for her work on dementia praecox, she researched the social as well as the biological causes of mental illness. She founded one of the first 'medical-pedagogic' institutes in France. Her monograph, Chagrins d'amour et psychoses (1935) reflects her wide cultural interests. Until recently, Pascal has been neglected by historians of psychiatry and of French women's history. Her life exemplified many of the conflicts experienced by women entering hitherto all-male professions.
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PMID:French psychiatry and the new woman: the case of Dr Constance Pascal, 1877-1937. 1714 88

Diabetes mellitus (DM) is more common among individuals with schizophrenia/schizoaffective disorders than among the general population. Eleven mental health consumers diagnosed with comorbid schizophrenia/schizoaffective disorder and DM participated in a grounded theory study that examined their approaches to diabetic self-care. The resulting model, Evolving Self-Care, describes the process by which respondents developed health beliefs about the self-care of dual illnesses. One subcategory of the model, Doing My Best, was further analyzed to examine the social context of respondents' diabetic self-care. Limited financial resources and material deprivation interfered with access to the resources necessary for adequate diabetic self-care. Mental health providers are encouraged to provide treatment and patient education that are consistent with the real world living situations of individuals with schizophrenia. Policymakers at the federal and state levels need to address the impact of financing of mental health services on the overall health of vulnerable individuals with serious mental illnesses.
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PMID:Doing my best: poverty and self-care among individuals with schizophrenia and diabetes mellitus. 1767 17

Rheumatoid arthritis (RA) is a complex disease that affects approximately 0.5% of the adult population worldwide, and occurs in 20-50 cases per 100 000 annually, mainly in women after their 40s. The onset of the disease has important diagnostic, prognostic and therapeutic implications and is yet to be defined. The distribution of the disease, in terms of both occurrence and clinical expression, has unclear geographical borders that may reflect differences in genetic admixture, environmental factors and socio-demographic determinants. Some diseases co-occur more frequently than expected with RA, as it is the case of cardiovascular disease, infections or lymphoma, but others in lower frequency than expected, such as cancer or schizophrenia. RA is associated with increased mortality rates compared with the general population in the majority of cohorts published, and the expected survival of RA patients is likely to decrease 3-10 years. As in the general population, the leading cause of death among patients with RA is cardiovascular disease, and deaths due to malignancy occur at a comparable incidence; however, patients with RA are at greater risk of mortality due to infection. Many genes have been implicated in the susceptibility of RA, all of which with a modest effect on isolation. Gene-environment interactions appear as the most plausible underlying cause of RA. Age, sex, smoking, shared epitope and others correlate with its RA. The most important determinants of prognosis in RA are the severity at presentation and the management of the disease, both of which are subject to inequalities.
Best Pract Res Clin Rheumatol 2010 Dec
PMID:Rheumatoid arthritis. 2166 22


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