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

This study reports that there are schizophrenics who do relatively well long term without the routine or continuous use of antipsychotic medication. Specially selected young males undergoing an acute schizophrenic episode were followed, after hospitalization, for up to three years. While hospitalized they were assigned randomly to either placebo or chlorpromazine treatment. Many unmedicated-while-in-hospital patients showed greater long-term improvement, less pathology at follow-up, fewer rehospitalizations and better overall function in the community than patients who were given chlorpromazine while in the hospital. Factors related to post-hospital outcome were good premorbid history and short-lived paranoid characteristics. Considerations which may have an effect on the successful management of acute schizophrenic patients not on medication are mentioned. The findings underline the need for further study of how to utilize antipsychotic medication more selectively in the treatment of schizophrenia.
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PMID:Are there schizophrenics for whom drugs may be unnecessary or contraindicated? 35 76

Cross-national studies have indicated that American psychiatrists diagnose schizophrenia more often than others. Clinical, genetic, and follow-up studies suggest that many patients diagnosed as having acute schizophrenia might be more appropriately diagnosed as having affective disorder. Forty probands diagnosed in Aarhus, Denmark, as having reactive psychoses are compared with 28 probands diagnosed in St Louis as having schizophrenia with good prognosis. Clinical differences largely reflect diagnostic criteria, with the patients from the St Louis group frequently having diagnosable affective disorder. A smaller proportion, 39% of the patients from St Louis, could be considered for the diagnosis of reactive psychosis. This is additional evidence supporting the use of the diagnostic category, reactive psychoses. Patients ordinarily given the diagnoses acute schizophrenic episode and/or schizo-affective schizophrenia may be more appropriately diagnosed as having (1) affective disorder and (2) reactive psychoses.
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PMID:Reactive psychoses and schizophrenia with good prognosis. 126 73

The effects of phencyclidine (PCP) on regional cerebral glucose utilization was determined by using quantitative autoradiography with [14C]-2-deoxyglucose. PCP increased brain metabolism in selected areas of cortex, particularly limbic, and in the basal ganglia and thalamus, whereas the drug decreased metabolism in areas related to audition. These results are consistent with the known physiology of central PCP neurons and may help to suggest brain areas involved in PCP-mediated actions. Moreover, based on the behavioral similarities between PCP psychosis and an acute schizophrenic episode, these data may be relevant to the understanding of schizophrenia. The PCP-receptor-acylating agent, metaphit, blocked most of these PCP actions. In addition, metaphit by itself was found to diminish glucose utilization rather uniformly throughout brain. These results indicate an antagonist effect of metaphit on the PCP system and suggest a widespread action of metaphit, putatively at a PCP-related site, possibly in connection with the N-methyl-D-aspartate (NMDA) receptor.
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PMID:PCP-induced alterations in cerebral glucose utilization in rat brain: blockade by metaphit, a PCP-receptor-acylating agent. 285 Jun 26

New experimental findings show that schizophrenics, as well as some of their non-schizophrenic relatives, manifest basic cognitive disorders defined in terms of variables from the field of experimental psychology. These basic disorders can be regarded as markers--if not, indeed, as psychological manifestations--of vulnerability to schizophrenia. They can be associated with subjectively experienced forms of non-clinically manifest impairments in psychological functioning. It was therefore hypothesised that schizophrenics, as well as non-schizophrenic subjects vulnerable to schizophrenia, will, in the course of learning processes, develop compensatory efforts which may be more or less effective. It is assumed that effective efforts of this kind will take on special significance in stress situations which would tend to elicit the occurrence of a schizophrenic episode. Effective efforts at compensation for basic disorders should be able to act as a 'buffer' against negative stressor effects (moderator function), thus reducing the danger of a psychotic breakdown. These compensation efforts were studied in 40 inpatients in remission after an acute schizophrenic episode. It was found that significant correlations exist between the extent of subjectively experienced basic disorders and the number and kind of conscious compensation attempts. Although the findings to date are of a preliminary and purely descriptive nature they would seem to justify further research.
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PMID:Self-healing strategies among schizophrenics: attempts at compensation for basic disorders. 673 Sep 92

Evidence of hemispheric asymmetries in schizophrenia has been reported from different research areas. Asymmetries in evoked potential P300 topography are still controversial because of inconsistent findings. In the present study, previous results of abnormal lateralization of P300 were replicated in stabilized residual schizophrenic patients. Auditory P300 was recorded during an oddball task in which subjects detected rare target stimuli. Schizophrenic patients had the P300 peak shifted to the right hemisphere and differed significantly from age- and sex-matched normal control subjects who had left-lateralized P300 peaks. A comparison of different methods of assessment and analysis of the topographical features of the P300 electric fields showed that the extraction of reference-independent descriptors of P300 topography is a reliable and sensitive method for statistical handling of the maps. The results suggest left hemispheric dysfunction during cognitive tasks in a subgroup of schizophrenic patients. Inconsistencies between previous studies are likely to be due to heterogeneous patient groups, which may have included patients in an acute schizophrenic episode or patients in clinical remission. Investigation of the clinical meaning of P300 alterations requires careful psychopathological definition of the patient groups.
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PMID:P300 asymmetries in schizophrenia revisited with reference-independent methods. 787 Aug 55

This study examined depressive symptoms in acute schizophrenic episodes and their relationship to neuroleptic treatment. Sixty-three depressed and 62 non-depressed acutely exacerbated schizophrenic patients were evaluated with the Brief Psychiatric Rating Scale, the Scale for the Assessment of Positive Symptoms, the Simpson-Angus Extrapyramidal Scale, and the Hamilton Rating Scale for Depression. Subjects were then randomly assigned to different haloperidol plasma levels and followed for 3 weeks. Overall, depression improved with treatment of the acute psychosis, but a positive association between extrapyramidal side effects and depressive symptoms emerged over time. Depressive symptoms tended to be positively related to haloperidol plasma levels. The results suggest that depressive symptoms in schizophrenia are heterogeneous in origin; while neuroleptics can ameliorate depressive symptoms inherent in the acute schizophrenic episode, they can also contribute to depression.
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PMID:Effect of neuroleptic treatment on depressive symptoms in acute schizophrenic episodes. 924 78

As part of a World Health Organization collaborative study in 12 centres in developing and developed countries within defined urban and rural catchment areas with populations of 348,786 and 103,865, respectively, a total of 155 and 54 cases of first-onset schizophrenia, respectively, were identified over a 24-month period by a comprehensive and active recruitment of all cases. Approximately 50% of the subjects in both cohorts were in the age range of 15-24 years. There was a preponderance of males in the younger age group and of females in the older age group. The majority of cases had no family history and had shown good adjustment in childhood and adolescence. The onset was much more frequently acute and much less often insidious in our samples and (more so in the rural cohort), compared to the figure for all developed countries' sites. With regard to early manifestations of the disorder, there was a much higher incidence of loss of interest in appearance and cleanliness, being irritable and angry without reason, and loss of appetite, sleep or interest in sex in both of our samples, and of being excited or overactive for days or weeks in our rural cohort than in the developed countries' centres as a whole. On the other hand, claiming impossible things, behaving as if hearing voices and feeling persecuted, harmed or bewitched were much less frequent in our rural cohort than in the urban cohort or the developed countries' centres as a whole. With regard to the clinical diagnosis of schizophrenia, paranoid, hebephrenic/disorganized and residual types were under-represented in our samples (more so in the rural sample), and catatonic type and acute schizophrenic episode were over-represented compared to the developed countries' centres. Moreover, the proportion of subjects of CATEGO class S+ was lower in our samples. With regard to onset, early manifestations and clinical subtypes of schizophrenia, our rural cohort deviated most from developed countries' centres as a whole, with our urban sample falling in between, thus indicating the role of socio-cultural factors in general, and urbanization in particular, in these variables in schizophrenia.
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PMID:First-onset schizophrenia in the community: relationship of urbanization with onset, early manifestations and typology. 942 39

Phencyclidine (PCP) induces stereotyped behaviour and social isolation in rats; comparisons with clinical observations have suggested that these behaviours may mimic certain aspects of the positive and the negative symptoms, respectively, of an acute schizophrenic episode. Novel antipsychotics are effective in treating the positive symptoms in schizophrenic patients and have also shown some promise in treating the negative symptoms. In the present study the effects of the novel antipsychotics remoxipride (2.5-20 mg/kg), risperidone (0.02-0.63 mg/kg), sertindole (0.01-2.5 mg/kg), olanzapine (0.16-2.5 mg/kg) and quetiapine (0.16-10 mg/kg) on PCP-induced behaviours were determined. The drugs were administered daily for 3 or 21 days in combination with vehicle or 2.0 mg/kg of PCP for the last 3 days of the administration regime, and the rats were tested using the social interaction test. The antipsychotic drugs all reliably reduced the level of PCP-induced stereotyped behaviour and had distinct effects on PCP-induced social isolation. Comparison with clinical findings suggests that the PCP-induced behaviours respond to treatment with antipsychotic drugs in a manner that correlates well with clinical observations, and that this animal model of schizophrenia may be useful for evaluating novel drug candidates. However, the study also showed that additional experiments are required to determine the specificity by which antipsychotic drugs alleviate PCP-induced behaviours because most of the drugs also affected considerably the behaviour of the control animals.
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PMID:Effect of novel antipsychotic drugs on phencyclidine-induced stereotyped behaviour and social isolation in the rat social interaction test. 983 15

Twenty cases of cannabis psychosis were compared with a control group of 20 patients with 'acute schizophrenic episode' on a number of demographic, clinical, illness-related and outcome variables in a case-control study design using a retrospective chart review. The two groups were comparable on demographic, past and family histories of mental illness, premorbid personality, psychomotor activity, Schneiderian first-rank symptoms and mild cognitive deficits. The cases, in contrast to the control group, had a psychosis of shorter duration characterized by reactive and congruent affect, relative absence of schizophrenic formal thought disorder and a predominantly polymorphic clinical picture. Relapse was always preceded by cannabis use. This study suggests that, in spite of certain overlaps, 'cannabis psychosis' may still be considered nosologically distinct from schizophrenia in India. The implication of the study is that the role of cannabis in any acute psychosis should be investigated carefully so as to prevent an overdiagnosis of schizophrenia.
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PMID:Cannabis psychosis and acute schizophrenia. a case-control study from India. 1039 36

Clozapine is a dibenzodiazepine derivative with established antipsychotic efficacy in adult patients with schizophrenic psychoses. There are more than 15 studies that have also demonstrated the antipsychotic efficacy of clozapine in childhood and adolescent schizophrenia. The main advantages of clozapine treatment in this age group in comparison with typical antipsychotics are: (i) high antipsychotic efficacy during an acute schizophrenic episode; (ii) better improvement in chronic cases with a high load of negative symptoms; and (iii) markedly fewer extrapyramidal adverse effects and, therefore, fairly good tolerability. However, because of its possible adverse effects on the haemopoetic system (granulocytopenia, agranulocytosis), clozapine should not be used as first-line antipsychotic medication. Other adverse effects are related to the cardiovascular system (hypotonia, tachycardia or arrhythmia), the central nervous system (epileptic seizures, fever) and liver function (transient increases in levels of hepatic transaminases). Two other frequent adverse effects are hypersalivation and body-weight gain, which may present a particular problem in adolescents and young adults. Careful monitoring of haematological parameters and other adverse effects are preconditions for a successful treatment programme.
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PMID:Management of schizophrenia in children and adolescents. The role of clozapine. 1094 14


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