Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0036341 (schizophrenia)
 60,220 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

The goal of this study is to understand how different admission statuses of varying degrees of restrictiveness (informal, voluntary, emergency admission, and involuntary admission on medical certification) are used in the psychiatric emergency room. The study included 656 consecutively admitted patients from a psychiatric emergency room over 28 months. Data were analyzed univariately and using two discriminant function models. Only six (0.9%) patients were informal admissions. Voluntary admissions (24.9%, n = 163) tended to be for patients with affective disorders, those who were self-referred, suicidal risks, those who had a marital or family problem, and those who were over age 60. Nonvoluntary admissions (74.2%) tended to be for patients with schizophreniform symptoms and those referred by police or court. Involuntary admission on medical certification (53.2%, n = 349) tended to be for patients who were family referred, younger than 20 years old, had social interpersonal nonfamily stressors, were suicidal risks, were or had been married, had organic psychotic disorder, history of violence, and manic episode or schizophrenia. Emergency admission patients (21%, n = 138) were characterized by being between 40 to 50 years old, having a diagnosis of psychoactive substance abuse, having previous outpatient treatment, and having been referred by emergency service. The major difference between involuntary admissions and voluntary was that the former were more often actively psychotic or referred by police or court. The major difference between emergency admission and involuntary admission on medical certification seemed to be that patients with a more available support system, whose primary diagnoses was not substance abuse and who were suicidal, were preferred for involuntary admission on medical certification.
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PMID:Differential use of admission status in a psychiatric emergency room. 863 87

1. There is an ongoing controversy, if increased binding of 3H-spiperone to lymphocytes might discriminate between schizophrenia and other psychiatric diseases or even be a genetic vulnerability marker for schizophrenia, or predict the response to neuroleptic treatment. 2. Some critical methodological details which might contribute to this controversy are described. 3. 3H-spiperone binding was evaluated in 31 patients with schizophrenia, 7 patients with schizoaffective disorder, bipolar type, 6 patients with a manic episode and 6 patients with a depressive episode of bipolar major affective disorder (DSM-III-R criteria), and in 19 healthy subjects. 4. There were no significant differences in characteristic binding parameters (KD, Bmax) between all groups of psychiatric in-patients and in comparison to healthy subjects. Moreover, there was no relation of binding parameters to any of the subtypes of schizopherenia or to the course of illness according to DSM-III-R-criteria. 5. Neuroleptic treatment or clinical response to treatment had no consistent effect on binding parameters intra-individually. 6. In summary, 3H-spiperone binding to lymphocytes failed to differentiate between the diagnostic subgroups (DSM-III-R) and between treatment responders and non-responders in our sample of patients.
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PMID:3H-spiperone binding to peripheral mononuclear cells in psychiatric in-patients. 877 1

To find the prevalence of 8 mental disorders and study knowledge, attitude, practice (KAP) upon mental health among people in Bangkok Metropolis a cross sectional, descriptive community survey was conducted. Two thousand, nine hundred and forty eight samples aged 15-60 years were selected by a multistage simple random sampling technique. Data collection was made by qualified interviewers who had experience in mental health care and had been trained to use the questionaires. The questionaires had been modified from DSM-IV and CIDI that had been tested for good validity and reliability. The survey methodology was divided into 2 stages, screening and diagnosis. The results showed that the life time prevalence of mental disorders were; schizophrenia (1.3%), mood disorders; manic episode (9.3%), major depressive episode (19.9%), dysthymia (1%), anxiety disorders (10.2%), mental retardation (1.8%), epilepsy (1.3%), suicidal idea (7.1%), drug and substances use disorders (11.2%), and alcohol use disorders (18.4%). Knowledge score was good, attitude was fairly good, practice was still weak in promotion and prevention aspects. As such, this study was used as a pattern to conduct a national survey in 14 provinces all over Thailand and the results are being summarized. The information is similar to the Global Burden of Diseases. We produced a national training program on "Detection and Management of Depression" for Primary Care Physicians that was, a 2 days' workshop. Other national programs promoting prevention and control have also been set up.
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PMID:Epidemiological survey of mental disorders and knowledge attitude practice upon mental health among people in Bangkok Metropolis. 1152 23

There are gender-related differences in the prevalence, course and treatment response characteristics of schizophrenia and mood disorders. Gonadal steroids exert potent effects on mood, cognition and behavior, and there is little doubt that androgens are crucial for differentiating to each gender. Serum level of total testosterone, free testosterone, estradiol and sex hormone binding globulin was measured in 69 medication-free men with either schizophrenia (n=29) or bipolar I disorder, manic episode (n=18) or major depressive disorder (n=22). There was a statistically significant difference in free testosterone level between mania and schizophrenia groups (p<0.05). The higher free testosterone level in the mania group compared to the schizophrenia group found in this study supports further investigation of a potential difference in the hypothalamic-pituitary-gonadal axis between patients with schizophrenia and bipolar I disorder, manic.
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PMID:Gonadal hormones in schizophrenia and mood disorders. 1291 Mar 50

Olanzapine is currently marketed not only for the treatment of schizophrenia, but also for the treatment of acute mania and the prevention of relapse in patients successfully treated with this drug for a manic episode. A large body of good clinical trials supports these indications. In the mania trials, olanzapine was more efficacious than placebo, equal or more efficacious than valproate and more efficacious than lithium or valproate monotherapy when used in combination with either drug. A trial that compared olanzapine with haloperidol failed to show superiority of the atypical versus the conventional. Olanzapine showed a modest but statistically significant effect in the treatment of bipolar depression; this modest effect was substantially enhanced in combination with fluoxetine. The long-term trials showed that olanzapine was better than placebo in the prevention of manic and depressive relapse and not inferior to lithium or valproate. The combination of olanzapine with lithium or valproate was also more efficacious than lithium or valproate alone in the prevention of manic relapse in patients partially non-responding to monotherapy with lithium or valproate. All these trials suggest that olanzapine may be a valuable drug in the short- and long-term treatment of bipolar I disorder. However, there are some concerns about the safety and tolerability of olanzapine in this population, as far as weight gain and metabolic syndrome are concerned, which may be addressed in future pharmacovigilance studies.
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PMID:Olanzapine in bipolar disorder. 1521 11

For women at risk to develop schizophrenia, estradiol has been postulated to constitute a protective factor. Women suffering from psychotic disorders have accordingly been found to exhibit lower estradiol levels than controls. Our aim was to study gonadal function in psychotic men to determine the gender specificity of these observations, as available data in men are more scarce and conflicting and largely disregarded estradiol. Serum hormone levels were examined in 34 men admitted consecutively for an acute exacerbation or first onset of schizophrenia in a blinded prospective design. Subjects with current affective disorder including manic episode, concomitant substance abuse or severe medical illness were excluded. A control group of 34 healthy male blood donors was recruited. As compared to matched controls, acutely admitted men suffering from schizophrenia exhibited significantly lower serum levels of estradiol, oestrone, testosterone and free testosterone. Although results have to be regarded as preliminary, acute exacerbation of schizophrenia in men seems to be associated with low serum oestrogen and androgen levels. The oestrogen hypothesis postulating a protective action of estradiol concerning schizophrenia for women might well be valid for both genders. However, future research is needed before clinical applications are justified.
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PMID:Sex hormones in psychotic men. 1535 49

In the first meta-analysis of studies assessing insight in mania, we sought to determine whether insight in mania is state-dependent or a trait-like condition. In schizophrenia, insight is a trait-like condition. If state-dependent, insight in mania would differ from insight in schizophrenia, and different treatment and research implications would follow. Seven reports using standardized insight rating scales in mania were identified through a MEDLINE literature search. Four longitudinal studies were included in a meta-analysis. The meta-analysis found that insight appears to be state-dependent. Insight showed a 20% improvement (95% confidence intervals, 7% to 34%) after recovery from acute mania (p = .003). Insight improves in bipolar disorder with resolution of the acute manic episode, suggesting that insight is state-dependent in bipolar disorder. We suggest that impaired insight be considered as part of the diagnostic picture of acute mania.
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PMID:Is insight in mania state-dependent?: A meta-analysis. 1550 21

The study examined the ethnic ratio of 16 DSM-III mental disorders among White, Black, Hispanic, and Asian Americans. A total of 18,126 residents from 5 sites and 2,939 residents from the Epidemiological Catchment Area's Los Angeles site were studied separately. Logistic regression analysis was performed. Results showed that Blacks were significantly less likely than Whites to have major depressive episode, major depression, dysthymia, obsessive-compulsive disorder, drug and alcohol abuse or dependence, antisocial personality, and anorexia nervosa, but they were significantly more likely than Whites to have phobia and somatization. Lifetime prevalence rates of schizophrenia, obsessive-compulsive disorder, panic, and drug abuse or dependence were significantly lower among Hispanics than among Whites. Asians also had significantly lower rates than Whites of schizophreniform, manic episode, bipolar disorder, panic, somatization, drug and alcohol abuse or dependence, and antisocial personality. Compared with the overall findings, ethnic differences at the Los Angeles site were lessened between Blacks and Whites, enhanced between Hispanics and Whites, and basically unchanged between Asians and Whites.
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PMID:Ethnic characteristics of mental disorders in five U.S. communities. 1560 83

In a new approach to the interpretation of data from flexible-dose studies, we examined the safety and efficacy measurements that preceded and followed dose changes, to identify clinical factors that predict dose change as well as subsequent outcome of clinical status with dose change. This was a post hoc analysis of 3 flexible-dosed olanzapine studies: acutely ill bipolar I patients with an index manic episode (N = 452) who received olanzapine (5-20 mg/d) or haloperidol (3-15 mg/d); acutely ill patients with schizophrenia (N = 339) who received olanzapine (10-20 mg/d) or risperidone (4-12 mg/d) for 28 weeks; and remitted bipolar I patients (N = 361) who received olanzapine (5-20 mg/d) or placebo for 48 weeks. The major findings of this analysis were: an increase in dose was predicted by baseline illness severity in the acute studies, and a decrease in dose was predicted by illness symptom improvement or worsening of adverse events. Dose decrease was followed by significantly decreased efficacy for patients with acute mania treated with olanzapine or haloperidol, and olanzapine dose increases were followed by improved efficacy. Treatment-emergent extrapyramidal symptom adverse events and akathisia typically predicted dose decreases. Techniques used in this analysis may prove to be useful in assessing the relationship between dose change and safety and efficacy measures.
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PMID:Flexible-dose clinical trials: predictors and outcomes of antipsychotic dose adjustments. 1601 84

Aripiprazole exhibits high affinity for dopamine D2 and D3, serotonin 5-HT1A and 5-HT2A receptors, moderate affinity for dopamine D4, serotonin 5-HT2C and 5-HT7, alpha1-adrenergic and histamine H1 receptors. The mean elimination half-lives are about 75 hours and 94 hours for aripiprazole and dehydroaripiprazole, respectively. Steady-state concentrations are attained within 14 days of dosing for both active moieties. At least 1 to 2 weeks, and sometimes up to 4 weeks, may pass before aripiprazole reaches its full effect. The efficacy of aripiprazole was investigated in the treatment of schizophrenia, in the treatment of acute manic episode associated with Bipolar I Disorder, and in the treatment of psychosis associated with Alzheimer's dementia. Aripiprazole has demonstrated superiority to placebo in clinical studies of the treatment of both schizophrenia and acute bipolar mania. Aripiprazole has been evaluated for safety in 5592 patients who participated in multiple dose, premarketing trials in schizophrenia, bipolar mania, and dementia of the Alzheimer's type. The recommended starting and target dose for aripiprazole is 10 or 15 mg/day administered on a once-a-day schedule without regard to meals. Aripiprazole has been systematically evaluated and shown to be effective in a dose range of 10 to 30 mg/day. Dosage increases should not be made before 2 weeks of continuous therapy, the time needed to achieve steady state. At least 1 to 2 weeks, and sometimes up to 4 weeks, may pass before aripiprazole reaches its full effect. In this presentation was given an overview of novel antipsychotic aripiprazole.
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PMID:Aripiprazole: an overview of a novel antipsychotic. 1639 46


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