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

The frequency of affective symptoms in most descriptions of premenstrual syndromes (PMS) suggests a potential etiologic link between menstrually-related mood changes and specific psychiatric disorders. The purpose of this study is to assess women presenting with "PMS" for lifetime psychiatric illness and PMS, according to rigorous diagnostic criteria comparable to those for "late luteal phase disorder," a proposed DSM-III-R diagnosis requiring further study. The women were interviewed with the Schedule for Affective Disorders and Schizophrenia Lifetime Version (SADS-L) and they kept prospective records of menstrual symptoms with the Moos Menstrual Distress Questionnaire - Form T (Moos MDQ-T). Of the 20 women evaluated, 85% had lifetime psychiatric illness and 30% had PMS. Careful psychiatric assessment is recommended in patients presenting with "PMS" as their chief complaint.
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PMID:Lifetime psychiatric illness and premenstrual syndromes. 179 Jul 5

This paper, on the use of antianxiety drugs to relieve certain neurotic symptoms, involves decision making at the level of the individual organism. The words "anxiety," "fear," and "stress" are often used interchangeably in everyday English. In medical usage "anxiety" denotes a state caused by an internal danger, while "fear" is a response to an external danger. "Stress" is the sum total of the bodily responses which occur when the organism has to adapt to a change. The antianxiety tranquilizers relieve anxiety and certain other neurotic symptoms, but do not counteract stress, fear, or anxiety caused by schizophrenia and other psychiatric disorders. The antianxiety drugs are now being most frequently prescribed for the relief and prevention of emotional distress that might accompany a physical disorder. Somatic illness can cause stress and fear, but does not usually induce neurotic anxiety. In patients suffering from physical disorders, treatment with antianxiety drugs appears justified only in the presence of an underlying psychoneurotic condition.
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PMID:Effect of antianxiety drugs on fear and stress. 610 71

The question has been raised whether it is useful or meaningful to dichotomize the homeless population by mental illness - i.e., to consider the mentally ill homeless as distinct from other homeless people. The current article presents evidence from a single data set to address this question empirically. Data from a randomly sampled population of 900 homeless men and women systemically interviewed using the Diagnostic Interview Schedule were examined to determine associations of mental illness with the problems of homelessness, controlling for the presence of substance abuse in the analyses. Although a few clinically meaningful associations with mental illness were found that might suggest directions for appropriate interventions, mental illness did not differentiate individuals in many important demographic and biographic respects. Individual diagnoses did not perform much better in differentiating the homeless by mental illness. Schizophrenia and bipolar mania showed a few significant associations not identified by the "major mental illness" construct. Major depression, constituting the majority of nonsubstance Axis I disorder in the homeless, provided no association beyond that obtained with the "major mental illness" category. The data provide little support for conceptualizing homeless subgroups or homelessness in general on the basis of mental illness alone. To do so also risks neglecting the emotional distress of the majority without major mental illness and the other problems that homeless persons share regardless of psychiatric illness. While serious mental illness is overrepresented among the homeless, it represents just one of many important vulnerability factors for homelessness. Substance abuse is far more prevalent than other Axis I disorders. Media images equating homelessness with major mental illness unnecessarily stigmatize homeless people and encourage oversimplified and narrowly conceived psychiatric interventions. While continuing attention is needed on improving identification and management of serious mental illness among the homeless, this must be accomplished within the broader context of social and economic aspects of homelessness.
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PMID:Are the mentally ill homeless a distinct homeless subgroup? 889 30

A qualitative study using the interpretive interactionism method was conducted to investigate the inner experiences of individuals with schizophrenia that surround, mobilize, and shape their awareness of, and responses to, the symptoms of their illness. Biographical data were collected from a purposive sample of 15 respondents suffering from this illness. Their narratives indicated that psychic pain dominated their lives; this theme was intertwined with the themes of lack of control, failure, and loss. Psychic pain was the key factor in informants' developing recognition of fluctuations in the course of their illness. The findings suggest that nurses may facilitate symptom monitoring in individuals who have schizophrenia, by attending to the emotional distress permeating every facet of their existence and by helping them look inward, to heighten their consciousness of specific components of psychic distress.
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PMID:Subjective experience of symptoms in schizophrenia. 892 Mar 20

It is argued that a child with schizophrenia represents an ongoing source of loss and grief for parents. The study aimed to (a) validate the presence of grief in mothers and fathers of children with schizophrenia, and (b)explore whether the hours of parental contact with the child influences the strength of grief reactions. The mean age (62 years) of the 16 mother-father dyads constituted an investigation of older parents, for 43% of whom the duration of diagnosed schizophrenia was over 10 years. Grief was conceptualised as a cognitive, behavioural, and emotional reaction to loss, and was operationalized by measuring current intrusive thoughts and avoidance behaviours, as well as emotional distress over reminders of time of diagnosis. As hypothesised, mothers and fathers were grieving in relation to their child's psychiatric illness. No differences between mothers and fathers in intrusive thinking, avoidance behaviours, and distress related to recall of diagnosis were detected. With the exception of intrusive thoughts, number of contact hours with the child was not an intervening variable of mothers' and fathers' grieving.
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PMID:Grief, parenting, and schizophrenia. 946 Aug 18

Ketamine is an N-methyl-D-aspartate (NMDA) receptor antagonist with psychotogenic and dissociative effects in healthy humans. These cognitive and perceptual effects in humans are reportedly reduced by benzodiazepine premedication. This study assessed the interactive effects of a ketamine (i.v. bolus of 0.26 mg/kg followed by an infusion of 0.65 mg/kg per hour) and lorazepam 2 mg., PO, in humans. Twenty-three healthy subjects completed 4 test days involving the oral administration of lorazepam or matched placebo 2 h prior to the i.v. infusion of ketamine or placebo. Ketamine: 1) produced behaviors similar to the positive and negative symptoms of schizophrenia as assessed by the Brief Psychiatric Rating Scale (BPRS); 2) evoked perceptual alterations as measured by the Clinician-Administered Dissociative States Scale (CADSS); 3) impaired performance on the Wisconsin Card Sorting Test (WCST) and other tests sensitive to frontal cortical impairment; and 4) had amnestic effects. Lorazepam produced attention impairments, concrete proverb interpretations, and recall impairments. Lorazepam reduced ketamine-associated emotional distress and there was a non-significant trend for it to decrease perceptual alterations produced by ketamine. However, it failed to reduce many cognitive and behavioral effects of ketamine, including psychosis. Further, lorazepam exacerbated the sedative, attention-impairing, and amnestic effects of ketamine. There was no evidence of pharmacokinetic interaction between these medications. These data suggest that subhypnotic lorazepam and ketamine show a spectrum of interactive effects, ranging from antagonism to potentiation.
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PMID:Interactive effects of subanesthetic ketamine and subhypnotic lorazepam in humans. 949 24

The purpose of the study was to examine (1) to which negative symptoms schizophrenia patients attribute distress and (2) whether clinical variables can predict the levels of reported distress. With the help of a research assistant, 86 hospitalized patients completed a self-rating scale for negative symptoms. The 21 items of the self-rating scale were taken from the Scale for the Assessment of Negative Symptoms (SANS). A psychiatrist rated the patients on a number of scales, including the SANS. When patients reported particular symptoms, they were asked whether those symptoms bothered or distressed them. Answers to this question were highly dependent on the type of symptom involved. Distress was most often attributed to symptoms in the subscale avolition-apathy. Patients were also asked how much they were bothered or distressed. Again, high levels of distress were most often attributed to items in the subscale avolition-apathy. A summary score was developed for the level of reported distress: the distress score. Regression analysis showed that distress scores were not associated with the observed severity of negative symptoms or with the level of psychiatric disability. High distress scores were best predicted by the combination of high scores for depression and high scores for insight into positive symptomatology. However, this model explained only a quarter of the variance in distress scores.
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PMID:Distress attributed to negative symptoms in schizophrenia. 1099 10

Based on the analysis of 42 in-depth interviews, this article highlights different aspects of the subjective burden experienced by parents and spouses of patients suffering from schizophrenia. The onset of a schizophrenic disorder and acute episodes during the later course of the disease lead to considerable emotional distress for the patients' caregivers. In everyday life with the patient, parents and spouses experience a comparatively less dramatic chronic burden, which nevertheless can severely affect their living situation and well-being. Caregivers often feel disappointed and dissatisfied with the information and cooperation offered by psychiatric institutions. Parents and spouses perceive the caregiver burden differently, although there are some apparent similarities. The study reveals that the symptoms of a schizophrenic disorder as well as different family roles contribute to the subjective burden of parents and spouses. Supportive assistance for schizophrenic patients' caregivers should address their particular needs more adequately.
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PMID:Living with a schizophrenic patient: a comparative study of burden as it affects parents and spouses. 1210 36

The author sought to determine domain-specific quality of life (QOL) changes over time and to identify predictors of change in life satisfaction among schizophrenia patients. He assessed 148 schizophrenia inpatients at admission and 16 months later. Multiple regression analysis identified predictors of domain-specific changes in QOL from changes in psychopathology, emotional distress, side effects, insight, and stress process-related factors ratings. On the group level, satisfaction with subjective feelings and leisure activities improved significantly during the follow-up period. Individual changes in specific QOL domains are influenced by different patterns of predictors that accounted for 12% to 36% of variance. Emotional distress, paranoid symptoms, side effects, and insight inversely associated with variability of scores in domain-specific QOL. Changes in self-efficacy, self-esteem, and support from others were positively correlated to improvement in QOL domain ratings. Schizophrenia patients may experience improvement in specific QOL domains. Changes in stress process-related factors are stronger predictors of fluctuations in QOL domains than changes in illness symptoms and should be considered when evaluating life satisfaction.
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PMID:Predicting changes in domain-specific quality of life of schizophrenia patients. 1281 47

Over the last two decades, day care (DC) treatment for mentally ill patients has come into wide use in Japan, following the precedents get in Western countries providing evidence of effectiveness. Several studies to examine the efficacy of DC treatment have already been performed in Japan. However, they were limited to chronic schizophrenic patients as subjects, and therefore the findings showed only improvement of the negative symptoms of schizophrenia. In contrast, Western studies have included heterogeneous mental disorders, and some showed DC was effective not only for treatment of global mental dysfunction but also for that of antisocial or violent behavior, drug dependence, emotional distress, and other characteristic disorders. Several Japanese and Western studies have shown DC treatment to be superior to outpatient treatment for relieving psychiatric symptoms. Regarding reduction of readmission rate, the Western studies were not supportive, but some Japanese studies showed that DC treatment was preventive against readmission as long as the follow up period was brief (within two or two and a half years). These findings suggested that the effectiveness of DC treatment may be limited. However, recently, medication against negative symptoms of schizophrenia has been revolutionary changing, offering the possibility that the combination of DC treatment and appropriate drug therapy may overcome the great obstacle of rehabilitating mentally ill patients in society. It is also very important that an evidence-based, standardized methodology of DC treatment should be immediately established in Japan.
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PMID:[Comparison of the effectiveness of psychiatric day care treatment between Japan and western countries: a review]. 1287 39


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