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

This study is the first in a series investigating different aspects of living conditions and care utilization in a total population with long-term functional psychoses (LFP). The study cohort (n = 302) was defined as people that: were aged 18-64 years, were affected by a nonorganic psychosis continuously during at least 6 months, showed psychotic features or residual symptoms during 1984, and had their home address in the study area during 1984. The study area consists of one rural and one suburban municipality, and one urban parish (57,035 inhabitants aged 18-64 years). The LFP concept used shows a high interrater reliability (kappa = 0.93). The one-year prevalence in the rural, suburban and urban areas was 3.4, 5.6 and 6.6 per 1000 respectively, thus producing a gradient from the rural to the urban areas. The prevalence of schizophrenia (DSM-III) was 2.6, 3.8 and 5.0 per 1000 respectively. The other diagnoses covered by the LFP concept (paranoia, major affective disorder with psychotic features, and psychotic disorder not elsewhere classified) showed the same gradient, with the exception of paranoia, which showed a lower rate in the urban area. The prevalence of schizophrenia was higher among males, while for paranoia the prevalence was higher among females.
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PMID:Epidemiology of long-term functional psychosis in three different areas in Stockholm County. 278 54

This study asked, "What are the psychological characteristics of Vietnam combat veterans who claim Agent Orange exposure when compared with combat-experienced cohorts who do not report such contamination?" The question was researched among 153 heroin addicts, polydrug abusers, and chronic alcoholics who were seeking treatment: 58 reported moderate to high defoliant exposure while in combat; 95 reported minimal to no exposure while in Vietnam. The null hypothesis was accepted for measures of childhood and present family social climate, premilitary backgrounds, reasons for seeking treatment, patterns and types of illicit drug and alcohol use, interpersonal problems, intellectual functioning, and short-term memory. The null hypothesis was rejected for personality differences, however, those who self-reported high Agent Orange exposure scored significantly higher on MMPI scales F, Hypochondriasis, Depression, Paranoia, Psychasthenia, Schizophrenia, Mania, and Social interoversion. The results suggest that clinicians carefully assess attributional processing of those who report traumatic experience.
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PMID:Carcinogenicity and teratogenicity vs. psychogenicity: psychological characteristics associated with self-reported Agent Orange exposure among Vietnam combat veterans who seek treatment for substance abuse. 280 27

The study focuses on the frequency of inpatient care for patients with Posttraumatic Stress Disorder (PTSD). This factor, termed "chronicity," is, perhaps surprisingly, largely overlooked in many PTSD studies. The significance of chronicity was addressed through administration of Minnesota Multiphasic Personality Inventory (MMPI) to Vietnam Theater and Era veterans in an inpatient psychiatry service. MMPI scores were analyzed for two main effects: combat exposure and chronicity (i.e., number of inpatient psychiatry admissions). The results replicated research showing combat exposure is associated with greater maladjustment (i.e., higher MMPI scores). Moreover, chronicity also emerged as a significantly important variable: of all groups compared, Vietnam combat veterans higher in chronicity scored higher on MMPI clinical scales, particularly on scales Paranoia, Psychasthenia, and Schizophrenia, thereby (a) empirically establishing (a) the methodological point that number of admissions must be controlled and (b) the substantive point that chronicity is important in studies of PTSD.
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PMID:Chronicity. Adjustment differences of Vietnam combat veterans differing in rates of psychiatric hospitalization. 280 30

Risk of relapse and recidivism makes the failure to take antipsychotic medication as prescribed a significant issue in forensic psychiatry. This question may arise in such contexts as the setting of bail, plea bargaining, the insanity defense, and sentencing. We have reviewed the literature on medication noncompliance in schizophrenia and present here the results, organized by topics relevant for the work of forensic mental health experts. Reported rates of noncompliance vary widely, reflecting major differences in the populations studied and the methods used as well as the complexities involved in defining noncompliant behavior. A noncompliance rate of 50 percent has been attributed globally to chronic patients, both medical and psychiatric. The tendency of significant factors to interact precludes a simple typology of noncompliance. However, environmental security and supportiveness correlate positively with adherence; whereas anxiety, paranoia, grandiosity, depression, and side effects correlate negatively. Clinicians' assessments of whether medication is being taken have proven to be unreliable. Although monitoring by chemical measurement, particularly a radioreceptor assay for urine samples, can be useful, depot injection ensures that prescribed medication is being taken. Less invasive means of promoting compliance are described; psychodynamic and ethical issues to be considered in the monitoring and promotion of compliance over extended time periods are presented. We also probe the link between medication noncompliance and behavioral relapse. The time between default and relapse is most often measured in weeks. Whether due to medication withdrawal or not, the relapse pattern of each individual tends to repeat, allowing its recognition before recidivism occurs. Restarting medication at this stage, especially with a dosage increase, is usually effective. In sum, the forensic mental health expert can now readily use a large and diverse literature to assist with a variety of significant issues.
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PMID:Medication noncompliance in schizophrenia: codification and update. 287 51

Central dopaminergic activation is hypothesized to underly schizophrenia and, paradoxically, stimulant euphoria. Four cocaine abusers with histories of stimulant-induced paranoid psychoses reported selective reduction in psychotic symptoms but not euphoria when treated with dopamine blockers. This provides preliminary evidence against efficacy of neuroleptics in cocaine abuse prevention, and suggests euphoria and paranoia may have discriminable neurophysiological substrates.
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PMID:Neuroleptic reduction of cocaine-induced paranoia but not euphoria? 287 52

Ninety-one patients who were treated for lumbar disc herniation with chymopapain chemonucleolysis were evaluated preoperatively by means of the Health Attribution Test (HAT) and the Minnesota Multiphasic Personality Inventory (MMPI). There were 54 good, 10 fair, and 27 poor results after chemo-nucleolysis. Nineteen patients subsequently underwent lumbar laminectomy and discectomy and the ultimate outcome for the entire series including these laminectomy patients was 66 good, 10 fair, and 15 poor results. The fair/poor chemonucleolysis outcome patients scored significantly lower than did the good outcome patients on the HAT Powerful Others and significantly higher on the Chance scale. Patients with fair or poor outcomes after chemonucleolysis only scored significantly higher on the Hypochondriasis, Hysteria, Psychopathic Deviate, Paranoia, and Hypomania scales in preoperative MMPI testing. Good versus fair/poor ultimate outcome patients differed significantly on preoperative MMPI Hypochondriasis, Hysteria, Psychopathic Deviate, Paranoia, Psychasthenia, Schizophrenia, Hypomania, and Social Introversion scales. These groups also differed significantly on preoperative HAT Internal and Chance scales. Further analyses found the MMPI to be a slightly better predictor of chemonucleolysis outcome and much better predictor of ultimate outcome than the HAT.
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PMID:Lumbar disc herniations: the predictive value of the Health Attribution Test (HAT) and the Minnesota Multiphasic Personality Inventory (MMPI). 298 60

The present study investigates the frequency, gender distribution, mode of appearance, and prognostic value of affective symptoms in a group of 90 patients with paranoid disorders of various etiologies (with the exception of marked organicity) who underwent a follow-up control. It appears that affective symptoms manifest more frequently than the brunt of delusional and hallucinatory ones, whereby the pronounced differences in gender (preponderance of females) that appear in acute states disappear in the course of the illnesses. Altogether, the frequency of affective symptoms diminishes just as that of delusions and hallucinations. Paranoic syndromes (simple delusional syndrome with a logically organized structure corresponding to the classical concept of paranoia) are characterized by a particularly frequent occurrence of dysphoric (irritable) mood, systematic and unsystematic paraphrenias by a depressive mood. Delusion subsided in all three delusional entities in about 50% of the cases; however, defect develops in unsystematic paraphrenias more often to a statistically highly significant degree than in the other two forms. Despite the expected low stability of affective symptoms over longer periods of time, the presence of affective syndromes has a high prognostic value, even in a population characterized primarily by the presence of a mood-incongruent delusion. The results of this investigation suggest that Jaspers' hierarchical principle, still important for many diagnostic systems, according to which the presence of delusions and hallucinations is considered to be pathognomonic for schizophrenia and takes priority over any affective ones, be abandoned. The consequence this would have for the theoretical basis of the diagnosis of endogenous psychoses is that apart from affective syndromes only schizophrenic nuclear symptoms would form the basis of nosological diagnosis, and so-called productive symptoms (delusions and hallucinations) would be construed as a superstructure.
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PMID:Position of affective symptomatology in the course of delusional psychoses. 322 25

Some literature on the significance of culture on psychiatric phenomenology and also literature on psychiatric phenomenology in immigrants, particularly in Great Britain, are reviewed. It is pointed out that paranoid and religious phenomenology is particularly common in some immigrant groups and that this can be understood to some extent as a reflection of cultural factors. In order to elucidate more the role of culture in psychiatric phenomenology in immigrants to Great Britain the socio-cultural backgrounds of the immigrants and in particular the Africans, the West Indians and the Asians are discussed in some details. The phenomenology of psychiatric illness as recorded in a hospital based population of diverse cultural backgrounds in a London hospital was studied to see if any variations across the various cultural groups could be understood in terms of cultural factors. It was found that paranoid and religious phenomenology was more associated with African and West Indian groups for cultural reasons rather than their socio-environmental and racial status in Britain. Paranoia was directed to fellow immigrants rather than to the host population. It is concluded that paranoia and religious phenomenology do not necessarily have the same clinical significance in various cultural groups. It is also pointed out that hallucinations, and in particular auditory hallucinations and First Rank Symptoms of schizophrenia, which have assumed diagnostic significance in some cultures, may not necessarily have the same significance in other cultures.
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PMID:Psychiatric phenomenology across countries: constitutional, cultural, or environmental? 322 85

Systematic screening of death certificates referable to residents of two health districts covered by a psychiatric case register allows the study of excess mortality in unselected psychiatric patients from a defined area of known population. Deaths among the case register patients exceeded those expected by 80%; the relative risk was maximal during the first year after registration and was significantly raised in both sexes and in patients of all age-groups. Patients may be selected by service use and by diagnostic group: the excess mortality of "inpatients" both in relative and absolute terms exceeded that of "outpatients". For dementia patients both the relative risk and more notably the absolute risk was high, and the excess mortality was significantly raised in both sexes and all age-groups. It was again greatest during the first year after registration. Deaths of patients with schizophrenia and paranoid psychosis exceeded those expected by 40 per cent and the excess was limited to the first year after registration and occurred predominantly among men.
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PMID:A preliminary study of excess mortality using a psychiatric case register. 325 Oct 10

Alprazolam was added, under double-blind conditions, to stable fluphenazine hydrochloride regimens in 12 symptomatic, chronically ill inpatients with schizophrenia. The addition of alprazolam was associated with significant, albeit modest, reductions in global psychosis, thought disorder, and paranoia ratings, with a return to pretreatment levels on discontinuation of alprazolam treatment. Improvement in "negative symptoms" such as emotional withdrawal paralleled the changes in "positive symptoms" but did not, in itself, reach statistical significance. There were no significant changes in group mean plasma levels of homovanillic acid or 3-methoxy-4-hydroxyphenylglycol during alprazolam treatment, although group mean serum cortisol levels were significantly decreased by alprazolam treatment. Patients who responded favorably to alprazolam treatment were significantly more psychotic or anxious before treatment, were older, showed significant alprazolam-associated reductions in plasma levels of homovanillic acid, and had significantly more prominent prefrontal cortex atrophy on computed tomographic scans than patients in whom alprazolam was without therapeutic effect. These preliminary data, based on a small sample, suggest that some patients with schizophrenia who are only partially responsive to standard neuroleptic treatment may benefit from the addition of triazolobenzodiazepines, such as alprazolam.
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PMID:Alprazolam augmentation of the antipsychotic effects of fluphenazine in schizophrenic patients. Preliminary results. 281 41


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