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

While one of the original underpinnings of the dopamine theory of schizophrenia was the paranoid psychosis which often develops during the binges or speed runs of chronic amphetamine addicts (and, more recently, in cocaine addicts), neurochemical studies of such drug abusers or from animals given continuous stimulants in an effort to model stimulant psychoses have not played a major role in the further evolution of this theory. One clear persisting alteration produced by continuous amphetamine is a neurotoxicity to dopaminergic innervations in caudate. Yet continuous cocaine administration apparently does not induce a similar neurotoxicity and this makes this effect a poor candidate for an underpinning of stimulant psychoses. However, it has recently been found that both continuous amphetamine and cocaine induce a strong pattern of degeneration which is highly confined to the lateral habenula and its principal output pathway, fasciculus retroflexus. This finding has led to a reconsideration of the role of these structures in psychoses. The habenula, as the chief relay nucleus of the descending dorsal diencephalic system (consisting of stria medullaris, habenula and fasciculus retroflexus), is an important link between limbic and striatal forebrain and lower diencephalic and mesencephalic centers. Studies of glucose utilization have consistently shown the habenula to be highly sensitive to dopamine agonists and antagonists. Lesions of habenula produce a wide variety of behavioral alterations. The dorsal diencephalic system has major and predominantly inhibitory connections onto dopamine-containing cells and it mediates part of the negative feedback from dopamine receptors onto dopamine cell bodies. It represents one of the major inputs in brain to the raphe nuclei and has anatomical and functional connections to modulate important functions such as sensory gating through thalamus, pain gating through central gray and raphe and motor stereotypies and reward mechanisms through substantia nigra and the ventral tegmental area. It is argued that alterations in these pathways are ideal candidates for producing the behaviors which occur during psychosis and that future considerations of the circuitry underlying psychoses need to include this highly important but relatively neglected system.
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PMID:Stimulant-induced psychosis, the dopamine theory of schizophrenia, and the habenula. 791 93

Aberrations of pain experience occur frequently in psychiatric disorders and hence pathological alterations in the basic mechanisms underlying pain experience can be expected. Nevertheless, pain perception, as one of the most important basic mechanisms of pain experience, has rarely been assessed experimentally in psychiatric disorders. The authors review the relevant experimental studies on pain perception in patients with anxiety disorders, schizophrenia, depression, eating disorders and personality disorders and suggest lines for future research. Finally, they point out that the experimental study of pain perception is useful not only in understanding aberrant pain experiences in psychiatric disorders but also in elucidating pathophysiological mechanisms because pain perception is controlled by neurochemical and neurohormonal functions known to be affected by psychiatric disease processes.
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PMID:Pain perception in psychiatric disorders: a review of the literature. 793 74

The psychiatrist might be called upon for states of pain on two occasions. The first is when the pain is mainly functioned, with or without a previous history of organic pain. It is most frequently met, with various diagnostic difficulties, in hypochondriac neurosis, complaining delirium, schizophrenia, multiple somatizations, isolated psychogenic pain and masked depression. The second is when the pain is organic, always progressive, with associated psychiatric disturbances which interact with it. We shall consider these various problems from both a clinical and a therapeutic point of view aiming at their practical rather than their theoretical aspects.
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PMID:[The psychiatrist and pain]. 793 86

Categories of self-injurious behaviour are briefly reviewed. Serious and bizarre self injurious behaviour is usually psychotic in origin. The literature concerning self-inflicted enucleation of the eyes is reviewed and two additional patients, both with a diagnosis of schizophrenia, are reported. The lack of pain and the lack of concern shown by the patients and their management are discussed.
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PMID:Self-inflicted enucleation of both eyes. 799 93

The literature on insensitivity to pain in schizophrenia is reviewed. Numerous reports indicate that, relative to normals, individuals with schizophrenia are insensitive to physical pain associated with illness and injury. In addition, insensitivity to pain of various sorts administered in experimental studies has been reported frequently in this population. This extensive and diverse literature of clinical and experimental reports suggests that many individuals with schizophrenia are less sensitive to pain than normal individuals. However, because the experimental studies--almost all of which were conducted before 1980--suffer from a variety of methodological limitations, this research provides neither a satisfactory characterization nor an adequate explanation of pain insensitivity in schizophrenia. It is argued that this widely reported but currently neglected phenomenon has important implications for physical health, self-mutilation, homelessness, premorbid development, and affective flattening in individuals with schizophrenia.
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PMID:Pain insensitivity in schizophrenia: a neglected phenomenon and some implications. 808 27

There has been tremendous interest in 5-HT3 receptor antagonists since their discovery and the subsequent identification of 5-HT3 receptors in the CNS. Based on the results of early behavioural tests with these compounds, there has been substantial interest in their potential use for the treatment of various CNS disorders. In this review, Andrew Greenshaw attempts to clarify the status of the therapeutic potential of these drugs, discussing inconsistencies in preclinical findings and identifying areas in need of clarification through future research. 5-HT3 receptor antagonists are claimed to be potentially useful in the treatment of nausea, inflammatory pain (migraine and irritable bowel syndrome), anxiety, depression, schizophrenia, dementia and drug abuse!
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PMID:Behavioural pharmacology of 5-HT3 receptor antagonists: a critical update on therapeutic potential. 810 96

The history of psychosurgery in Russia can be divided into 3 periods: The first period starts at the turn of the century under the initiative of Bekhterev. His pupil and one of the fathers of Russian neurosurgery Puusepp performed leucotomy-like cuttings of frontal association fibers in manic-depressive cases and psychic equivalents of epileptics as early as 1906-1910. The second period includes the time from the late 1930ies till the late 1940ies. The classical leucotomy of Moniz and Lima, with some modifications, was used for treatment of schizophrenia and severe pain. In 1950 psychosurgery was prohibited by the special order of the Minister of Health of the USSR for ideological reasons. The third period starts in the early 1980ies with the acceptance of modern stereotactic techniques for treatment of intractable pain and obsessive-compulsive disorders.
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PMID:On the history of psychosurgery in Russia. 812 32

The study was carried out in the Family Planning Center of Sir Salimullah Medical College, Mitford Hospital and Family Planning Center of Dhaka Medical College Hospital, Dhaka. 100 sterilized women were selected randomly within 6 months of sterilization during the period of July 1991 to December 1991. They were interviewed by a questionnaire collecting information on sociodemographic parameters, sterilization, and life events. Depressive disorder was assessed by applying the DSM III-R criteria for Major Depressive Episode (MDE). Then the Hamilton Rating Scale for Depression (HRSD) was applied. 19 were suffering from depressive disorder (MDE). Of these, 3 were severe, 8 were moderate, and 8 were mild. Their ages ranged from 21 to 38 years. 42.11% of the depressive cases were in the 26-30 age group. 84% of both groups were either illiterate or had primary education, and 86% were housewives. 78% were urban and 22% were rural residents, respectively. 52% were in the low and 41% were in the middle income category. 35.8% of the nondepressive group had 4 children at the time of operation, while 36.93% of the depressive group had 6 children (p 0.05). Abdominal pain occurred in 23 instances, while only 2% had pain, swelling, and fever. 46 (56.79%) of the nondepressive group had experienced no momentous life events 1 year prior to the interview. In contrast, only 2 (10.54%) of the depressive group had not experienced such life events. Relationship problems in both the nondepressive and depressive groups featured with 24 (29.63%) and 12 (63.16%) cases, respectively, (p 0.05). 3 (15.79%) of the depressive group had past history of anxiety disorder and 2 (10.5%) had previous history of depressive disorder. On the basis of DSM III-R, 18 (94.74%) of the depressive group had mood disorders as the main symptom. 16 each had insomnia and fatigability. 12 (63.16%) of the depressives were retarded and 10 subjects contemplated suicide. HRSD further revealed that all depressive patients had anxiety, and only 2 were receiving antidepressants. Among all patients there were 5 cases of family history of schizophrenia, 2 cases of depressive disorders, and 1 case of bipolar mood disorder in first degree relatives.
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PMID:Pattern of depressive disorder among the permanent sterilized women. 816 34

The pain thresholds of patients with schizophrenia often seem to differ from those of healthy subjects. In the present study we assessed the pain thresholds of ten patients with schizophrenia, and of ten controls, by measuring the leg flexion nociceptive reflex threshold: the stimulation threshold at which this reflex is triggered, is known to be correlated with the pain threshold. Our conclusion is that, in most cases, the increase in pain threshold is the result of 'attitude' and not of alterations in brain function.
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PMID:Objective evaluation of pain perception in patients with schizophrenia. 817 31

Prostaglandin E1 (PGE1) is a naturally occurring substance that is present in a variety of mammalian tissues, including the semen of fertile men. Its use in the diagnosis and treatment of erectile dysfunction has been extensively studied. In doses of 10-20 micrograms, PGE1 produces full erections in 70-80% of patients with erectile dysfunction. In diagnostic use PGE1 is employed as a simple office test and in conjunction with various hemodynamic tests. Self-injection of PGE1, either with the patient or his partner administering the injection, is a minimally invasive and effective treatment for erectile dysfunction in patients with organic or psychogenic erectile dysfunction. Its use is contraindicated in patients with sickle cell anemia, severe coagulopathy, schizophrenia or severe psychiatric disorder, poor manual dexterity, severe venous incompetence, or severe systemic disease. As calculated from data in the published literature, the most frequent side effects are pain at the injection site or during erection (occurring in 16.8% of patients), hematoma/ecchymosis (1.5% of patients), and prolonged erection/priapism (1.3% of patients). The potential for prolonged erection/priapism, the most serious side effect, can be minimized by careful titration of the dose and through patient education. Systemic side effects occur rarely during PGE1 use. During extended use, patients should be monitored for potential long-term side effects, such as fibrosis and angulation.
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PMID:Intracavernous prostaglandin E1 in erectile dysfunction. 818 62


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