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)

Of 113 patients in long-stay wards of a psychiatric hospital, 43 had TD. Twenty-six of the 39 patients who consented to take part in the study were unaware of abnormal involuntary movements. These patients scored significantly lower on a short test of cognitive function than patients who were aware of such movements. The diagnosis of schizophrenia, particularly the 'defect' state with cognitive deficit and negative symptoms, was found to be associated with lack of awareness of TD.
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PMID:Tardive dyskinesia. Patients' lack of awareness of movement disorder. 134 79

The ventricle-brain ratio (VBR) of 42 chronic schizophrenic patients was compared with that of 42 age-matched medical controls. For the schizophrenics, the relationship of various clinical parameters to the VBR was assessed, and the outcome of 12 weeks of double-blind treatment with either risperidone or haloperidol. The results confirm that schizophrenic patients have slightly enlarged lateral ventricles compared with medical controls. Only for schizophrenics, an effect of age, but not of duration of illness, was noticed. This study does not support the validity of a clinical subdivision of chronic schizophrenic patients on the basis of the VBR. Neither negative, positive nor general psychopathological symptoms, as measured by the Positive and Negative Syndrome Scale for Schizophrenia (PANSS), were related to the VBR, nor were abnormal involuntary movements or extrapyramidal symptoms. No association between season of birth or a family history of major mental disorder and VBR could be demonstrated. Treatment response was predicted by the total PANSS score and the PANSS general psychopathology subscale score at baseline. There was a trend for patients with higher VBR to have a more or haloperidol). or haloperidol).
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PMID:Ventricular enlargement, clinical correlates and treatment outcome in chronic schizophrenic inpatients. 137 2

Computed tomographic (CT) studies have demonstrated structural brain abnormalities including cortical atrophy and enlarged lateral ventricles in a subset of schizophrenic patients including those with abnormal involuntary movements. In the following series of studies, we present our findings pertaining to neuroradiological covariates of drug-induced Parkinsonism and Tardive dyskinesia in schizophrenic patients. In these studies we have explored the relationship of Parkinsonism and Tardive dyskinesia to pineal and choroid plexus calcification. In addition, we also investigated the relationship of pineal calcification to schizophrenia, and specifically to the paranoid and nonparanoid subgroups. In a further series of studies, we investigated the neuroradiological covariates of disorders of gait and posture as well as tremor in schizophrenic patients with drug-induced Parkinsonism. In addition, we explored the relationship of Tardive dyskinesia and its subsyndromes to CT scan measurements of cortical and subcortical atrophy in schizophrenia. Our findings highlight the significance of the pineal gland in the pathophysiology of schizophrenia and drug-induced movement disorders. Furthermore, these studies underscore the heterogeneity of Parkinsonism and Tardive dyskinesia.
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PMID:Neuroradiological covariates of drug-induced parkinsonism and tardive dyskinesia in schizophrenia. 193 76

The two-syndrome concept postulates two "dimensions of pathology" underlying schizophrenia--a reversible (and potentially neuroleptic-responsive) component and a sometimes progressive and relatively irreversible component associated with the deficit state and poor long-term outcome. Negative symptoms (narrowly defined) appear to be more closely associated with the latter component (the type II syndrome), as also are cognitive impairments, abnormal involuntary movements, and behavioral deterioration. This syndrome is assumed to be more closely related than the type I syndrome of positive symptoms to the structural brain changes inferred from pneumoencephalograms, computed tomography scans, and recent post-mortem studies. However, since both syndromes often occur in the same patient--sometimes at the same point in time--they presumably have the same etiology.
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PMID:The two-syndrome concept: origins and current status. 286 73

Intellectual impairment, negative symptoms, and medication history were assessed in chronic schizophrenic patients with and without abnormal involuntary movements (tardive dyskinesia). Patients with involuntary movements had received neither longer nor more intensive treatment with neuroleptics or anticholinergics. However, the presence or absence of involuntary movements was prominently associated with the presence or absence of intellectual impairment/negative symptoms; these features are characteristic of the defect state/type II syndrome of schizophrenia, in which structural abnormalities of the brain may be over-represented. The role of subtle organic changes in conferring vulnerability to the emergence of such involuntary movements should be re-evaluated.
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PMID:Late onset involuntary movements in chronic schizophrenia: relationship of 'tardive' dyskinesia to intellectual impairment and negative symptoms. 288 Jun 30

Tardive dyskinesia (TD); abnormal involuntary movements appearing late in neuroleptic treatment) was described shortly after introduction of chlorpromazine and other antipsychotic agents in the 1950s. Consideration of this disorder as a common, progressive, and relentless problem of major public-health and medicolegal concern in the 1970s now appears to have been somewhat exaggerated. Several symptom patterns associated with neuroleptic treatment may or may not appropriately be lumped with the concept of TD (acute and withdrawal-emergent dyskinesias, dystonias, and akathisia, in particular); parkinsonism (with bradykinesia, rigidity, and tremor, including perioral tremor of the "rabbit syndrome") should be differentiated from TD, even though elements of both may occur together. Dyskinesias, more or less similar to TD, can occur in chronically ill neuropsychiatric patients not exposed to neuroleptics. Some may represent stereotyped behaviors of schizophrenia or undiagnosed neurological disorders, but a risk of spontaneous dyskinesias indistinguishable from TD averages about 5% (probably less in young patients). Mean prevalence rates for TD, corrected for spontaneous dyskinesias, average about 15-20% with higher risks at advancing ages. Incidence rates are less certain, but estimates average about 5% a year for at least several years in young patients, with higher rates within the first two years of treatment of elderly patients. Risk factors most clearly defined are advancing age, use of neuroleptic agents at relatively high daily doses for more than six months, and perhaps the diagnosis of a major affective disorder. Female gender and relatively high plasma levels of neuroleptic agents are less significant risk factors and other metabolic or neuroradiological indicators of risk remain unproved. The etiology of TD remains obscure.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:A summary of current knowledge of tardive dyskinesia. 290 54

226 patients in a Nigerian chronic psychiatric patients' unit were examined for the evidence of abnormal involuntary movements. 21 (9.3%) of the patients had the disorder. The prevalence rate was higher among the females (14.5%) than among the males (7%). All the 21 patients had the diagnosis of schizophrenia. Also, they were found to be of an older age group than the total population. In comparison with a control group, the development of persistent abnormal involuntary movement was found not to be related to the daily dose of neuroleptic drugs administered or to the duration of the illness. The disorder was thought to be an idiosyncratic reaction.
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PMID:Prevalence of persistent abnormal involuntary movements among patients in a Nigerian long-stay psychiatric unit. 611 35

Two hundred and twenty-six patients in a Nigerian chronic psychiatric patients' unit were examined for evidence of abnormal involuntary movements. Twenty-one (9.3%) of the patients had the disorder. The prevalence rate was higher among the females (14.5%) than among the males (7%). All the twenty-one patients had the diagnosis of schizophrenia. Also, they were found to be of an older age group than the total population. In comparison with a control group, the development of persistent abnormal involuntary movement was found not to be related to the daily dose of neuroleptic drugs administered or to the duration of the illness. The disorder was thought to be an idiosynchatic reaction.
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PMID:The prevalence of persistent abnormal involuntary movements among patients in a Nigerian long stay psychiatric unit. 612 10

Several short-term trials of baclofen for tardive dyskinesia have yielded conflicting results. We evaluated 33 patients maintained on a constant dose of neuroleptic during a randomized 6-week double-blind placebo-controlled trial, followed by a 6-week open-label trial. During the double-blind part, 67% of baclofen-treated patients and 47% of placebo-treated patients showed a reduction of 25% or more in their original dyskinesia score on the abnormal involuntary movement scale. In the open-labeled part, we further evaluated seven of nine baclofen responders and nine of nine placebo nonresponders. We found a 77% baclofen response rate for the original placebo nonresponders, a loss of efficacy in 23% of the original baclofen responders, and an attenuation of response in others. Patients with major depressive disorders were poorer responders to baclofen than those with schizophrenia. Side effects were infrequent and reversible, but dose limiting in several instances. Although baclofen may help some cases of mild tardive dyskinesia, its efficacy may attenuate with long-term administration.
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PMID:Baclofen in tardive dyskinesia patients maintained on neuroleptics. 613 Aug 38

Research on strategies using low doses of neuroleptics in the long-term maintenance and/or prophylactic treatment of schizophrenia is reviewed. The evidence available from prospective controlled trials suggests that substantial dosage reduction is feasible for a subgroup of outpatient schizophrenics and that the incidence of abnormal involuntary movements might be reduced by such a strategy. In addition, lowering dosages may bring about some improvement in psychosocial adjustment. Further work is clearly needed to explore fully the benefit to risk ratio of this strategy and to identify those patients for whom it is most appropriate.
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PMID:Low dose medication strategies in the maintenance treatment of schizophrenia. 614 Jul 51


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