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

The authors present a new rating scale for the psychotic symptoms of schizophrenia and related psychoses. The scale links specific symptoms of psychopathology to dysfunction and overactivity of dopaminergic mechanisms underlying the processes of reward and selective attention. The Rating Scale for Psychotic Symptoms (RSPS) is a 44-item rating instrument with a seven-point severity scale for each item. Psychotic symptoms are classified into three groups: Pathological amplification of mental images (perception symptoms) (subscale 1), Distraction symptoms (including catatonia and passivity experiences) (subscale 2), and Delusions (subscale 3). A dimensional, rather than a categorical, conceptualization of psychosis is assumed. Rating is accomplished through a manual and a semi-structured interview (SSCI-RSPS). In this first of two papers, general issues about the construction of the scale and the derivation of symptom groups are discussed. Dopamine-mediated modification of cortico-striatal synapses is seen as being of critical importance in all three groups of symptoms. In this first paper, we present subscale I (perception symptoms), which includes both amplified perceptual images (illusions) and hallucinations. A total of seven illusions and 11 hallucinations are rated as individual items.
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PMID:A rating scale for psychotic symptoms (RSPS) part I: theoretical principles and subscale 1: perception symptoms (illusions and hallucinations). 1046 58

To determine whether patients with catatonic schizophrenia have specific alterations in brain morphology, internal (ventricles) and external (frontal, temporal, parieto-occipital) components of the cerebrospinal fluid (CSF) spaces were examined morphometrically. Planimetric measurements of computed tomographic (CT) scans from 37 patients with catatonic schizophrenia, 28 patients with hebephrenic schizophrenia, and 39 patients with paranoid schizophrenia, all diagnosed according to DSM-III-R criteria, were compared with separate age- and sex-matched non-psychiatric control groups, respectively. The areas of the frontal sulci, the parieto-occipital sulci, the inter-hemispheric fissure, and the lateral and third ventricles were measured separately for the right and left hemispheres. Catatonic patients showed significant enlargements in almost all CSF spaces, especially in the left fronto-temporal area which, in addition, correlated significantly with illness duration. Hebephrenic patients showed selective enlargements in left temporal and left/right lower frontal cortical sulci, whereas paranoid schizophrenic patients showed no enlargements but significant correlations between left temporal cortical sulcal volume and illness duration. Alterations in temporal cortical areas were present in all three sub-types of schizophrenia. In addition to temporal alterations, hebephrenic schizophrenia was characterised by lower frontal (i.e. orbitofrontal) enlargement. Catatonic schizophrenia, the most severe sub-type with regard to clinical symptomatology and brain pathology, showed fronto-parietal cortical alterations.
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PMID:Cortical sulcal enlargement in catatonic schizophrenia: a planimetric CT study. 1049 91

Catatonia is commonly encountered in psychiatric and medical practice but is under-recognized. It occurs in association with a wide range of disorders and drugs. Psychiatric education and textbooks mistakenly only consider catatonia as a subtype of schizophrenia. This article, the first of two, reviews the development of the concept of catatonia, its epidemiology, clinical features and pathophysiology.
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PMID:Catatonia. 1: History and clinical features. 1065 68

To investigate the differences between schizophrenic subjects with and without obsessive-compulsive disorder (OCD), the authors systematically assessed 76 schizophrenic subjects for OCD. Subjects with and without OCD were then compared with regard to motor symptoms, including catatonia, and several measures of psychopathology. Treatment strategies were evaluated retrospectively. The 12 subjects with OCD (15.8%) had more motor symptoms, including catatonia, than non-OCD schizophrenic subjects. Some differences were found with regard to psychopathological symptoms. Treatment strategies also differed in the two groups. The high prevalence of motor symptoms in these subjects supports the hypothesis of a basal ganglia-frontal lobe connection linking OCD with schizophrenia.
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PMID:Prevalence of obsessive-compulsive disorder in schizophrenia and significance of motor symptoms. 1067 7

The dopamine D4 receptor (DRD4) may play a role in the pathogenesis of neuropsychiatric disease and in the action of dopaminergic drugs. The 48-bp repeat polymorphism (48-bp VNTR) coding for a 16-amino acid segment in the third cytoplasmatic loop of the DRD4 was studied as a predictor of the therapeutic response to antipsychotics and as susceptibility factor for schizophrenia. We included 638 in-patients with acute schizophrenic, schizoaffective (mainly schizophrenic), and other nonaffective psychoses, as well as two reference groups: one with 278 in-patients with non-psychiatric diseases, and one with 474 healthy volunteers. Catatonic patients (DSM-IV 295.2) more frequently carried the DRD4 D4.2 and D4.3 allele than did all other schizophrenic cases (P < 0.001; OR: 2.7; CI: 1.5-4.9) and controls (P < 0.004; OR: 2.3; CI: 1.3-4.2). We found no significant difference in the DRD4 allele or in genotype frequencies in our comparison of all schizophrenic patients and controls. The subgroups with affected family members, and the subgroups with early or late onset of disease, also did not differ from the controls in DRD4 allele frequencies. The 48-bp VNTR was not a predictor for therapeutic outcome measured by the positive and negative symptoms scale. A total of 1390 subjects showed between 1 and 10 repeats (D4. 1 and D4.10), with 25 different genotypes. These data exclude a major role of DRD4 48-bp VNTR in response to antipsychotic therapy and as susceptibility factor for schizophrenia, but catatonic schizophrenia may be associated with the D4.2 and D4.3 alleles.
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PMID:Dopamine D4 receptor 48-bp repeat polymorphism: no association with response to antipsychotic treatment, but association with catatonic schizophrenia. 1088 53

The human synapsin III gene (synapsin III) is a member of a neuron-specific phosphoprotein gene family involved in short-term neurotransmitter release. We mapped synapsin III to chromosomal region 22q13 (13.1-13.31) by fluorescence in situ hybridization, a region that has been identified as a potential schizophrenia susceptibility locus. The dinucleotide repeat marker D22S280 located in intron 5 of synapsin III was genotyped in a linkage and family-based association study to assess the role of the synapsin III locus in the etiology of schizophrenia. In 12 pedigrees with periodic catatonia comprising 135 individuals, we found exclusion of linkage of marker D22S280 using lod score analysis with autosomal dominant/recessive models as well as affected only LOD score methods with dominant/recessive models. In a family-based association study of 61 unrelated parent-offspring trios with schizophrenia (according to the the Diagnostic and Statistical Manual of Mental Disorders, fourth edition [DSM-IV, American Psychiatric Association, 1994]), we found no association of individual D22S280 alleles to disease. Results of a multiallelic transmission/disequilibrium test (TDT(max) = 3.00; P = 0.55) challenged the possibility that D22S280 alleles appear with DSM-IV schizophrenia more frequently than expected. In addition, no evidence for gender differences or parent-of-origin effects were found. Thus, the synapsin III locus at chromosome 22q13 is not likely to contain a schizophrenia susceptibility gene.
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PMID:Linkage and family-based association study of schizophrenia and the synapsin III locus that maps to chromosome 22q13. 1089 20

This study was performed to establish the incidence of catatonia in a psychiatric intensive care unit, to test the Bush-Francis Catatonia Screening Instrument (BFCSI) and to assess the response of catatonic signs to benzodiazepines. During a 12-month period all patients admitted to a psychiatric intensive care unit were screened for catatonic signs using the BFCSI. Patients with catatonia were further assessed with the Bush-Francis Catatonia Rating Scale (BFCRS), the Modified Rogers Scale (MRS), and scales for associated psychotic and parkinsonian symptoms. They were treated with oral lorazepam or parenteral clonazepam and their responses evaluated daily. Neuroleptics were stopped for at least 3 days. Twenty four patients met the DSM IV criteria for catatonia, giving an incidence of 15% with a significantly higher proportion of non-Europeans. The most common associated diagnosis was schizophrenia (54%). Twenty two patients completed the benzodiazepine trial. All showed significant responses after 3 days of treatment. Sixteen (16/22, 73%) had full remission within 6 days, most within 2 to 4 days. Partial responders (n = 6) all had schizophrenia and were more likely to have longer pre-trial catatonic episodes. We find the BFCSI a simple and reliable tool to screen for catatonia, and our data attest to the efficacy of benzodiazepines in the treatment of catatonia.
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PMID:Catatonia in a psychiatric intensive care facility: incidence and response to benzodiazepines. 1090

Catatonic syndromes in patients under 18 appear sporadically in literature. It is probable that its frequency in the clinic is greater than is recognised. On the basis of study and treatment of an adolescent in the acute Unit in our service, an exhaustive revision of literature was realized. The most relevant conclusions that we can gather are the following: 1) the catatonic syndromes in adolescence obey a multitude of psychiatric and organic causes which make a minicule study which rules out somatic associated pathology obligatory; 2) among the psychiatric forms of catatonic syndrome in adolescence unusual pictures of unspecific psychosis may predominate although schizophrenia or affective pathologies are not infrequent together with unspecific psychoses; somatic ethiology (medical diseases or induced substances) is the most frequent; 3) benzodiazepines and ECT appear to be efficient and safe treatment for catatony in adolescents although, they require more investigation; 4) it is especially important to distinguish catatonic syndromes provoked by neuroleptics from those forms of malignant catatony associated with psychotic clinical pictures; 5) the studies realized among these populations are very scarce. It is necessary to look deeper into the psychotic psychopathology of infancy and adolescence and specifically in the infant-juvenile catatonic syndromes. The lack of clinical studies implied difficulties in recognising and adequate treatment of juvenile catatonic syndromes.
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PMID:[Catatonic syndrome in adolescence]. 1100 Jul 1

The nature of subtypes in schizophrenia and the meaning of heterogeneity in schizophrenia have been considered a principal controversy in psychiatric research. We addressed these issues in periodic catatonia, a clinical entity derived from Leonhard's classification of schizophrenias, in a genomewide linkage scan. Periodic catatonia is characterized by qualitative psychomotor disturbances during acute psychotic outbursts and by long-term outcome. On the basis of our previous findings of a lifetime morbidity risk of 26.9% of periodic catatonia in first-degree relatives, we conducted a genome scan in 12 multiplex pedigrees with 135 individuals, using 356 markers with an average spacing of 11 cM. In nonparametric multipoint linkage analyses (by GENEHUNTER-PLUS), significant evidence for linkage was obtained on chromosome 15q15 (P = 2.6 x 10(-5); nonparametric LOD score [LOD*] 3.57). A further locus on chromosome 22q13 with suggestive evidence for linkage (P = 1.8 x 10(-3); LOD* 1.85) was detected, which indicated genetic heterogeneity. Parametric linkage analysis under an autosomal dominant model (affecteds-only analysis) provided independent confirmation of nonparametric linkage results, with maximum LOD scores 2.75 (recombination fraction [theta].04; two-point analysis) and 2.89 (theta =.029; four-point analysis), at the chromosome 15q candidate region. Splitting the complex group of schizophrenias on the basis of clinical observation and genetic analysis, we identified periodic catatonia as a valid nosological entity. Our findings provide evidence that periodic catatonia is associated with a major disease locus, which maps to chromosome 15q15.
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PMID:Splitting schizophrenia: periodic catatonia-susceptibility locus on chromosome 15q15. 1100 82

The human calcium-activated potassium channel gene (hKCNN3, hSKCa3) contains two tandemly arranged, multiallelic CAG repeats located in exon 1 which result in short to moderate polyglutamine stretches of unknown functional significance. Case-control and family-based association studies suggested an association of hKCNN3 repeats with susceptibility for schizophrenia. Twelve multiplex pedigrees with periodic catatonia, a schizophrenia subtype with major gene effect and patterns of anticipation, were genotyped using the multiallelic hKCNN3 repeat polymorphism. Using a dominant model of inheritance with sex- and age-dependent penetrance classes, cumulative results showed exclusion of linkage of hKCNN3 to periodic catatonia under the assumption of genetic homogeneity with lod score of -48.01 at zero recombination fraction. Our results provide evidence that hKCNN3 is not the causative gene in the familial schizophrenia subtype of periodic catatonia. By fluorescent in situ hybridization we confirmed the assignment of hKCNN3 to chromosome 1q21 near the heterochromatin region. Linkage mapping showed segregation with marker D1S498 (theta = 0.05) and placed hKCNN3 in the genetic linkage map in a cluster of genes near the centromeric region of chromosome 1.
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PMID:hKCNN3 which maps to chromosome 1q21 is not the causative gene in periodic catatonia, a familial subtype of schizophrenia. 1100 68


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