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

There is evidence that the psychiatric importance of hypochondriacal or cenestopathic symptoms in schizophrenia is prone to be neglected, in so far as these symptoms are expressed through the discourse of somatic medicine. Psychopathological studies of these symptoms are few as compared to studies of other schizophrenic symptoms such as delusion or verbal acoustic hallucination. However, it could be said that such study is indispensable in developing both an understanding of schizophrenics and therapeutic strategies for the treatment of them, in so far as hypochondriaco-cenestopathic symptoms directly indicate a pathology of body-consciousness in schizophrenia. Motivated by these practical as well as theoretical demands, the author presents first of all statistical characteristics of hypochondriaco-cenestopathic symptoms based on a longitudinal study of 183 schizophrenic patients, who were observed for at least 5 years. All the patients satisfied the DSM-III-R criteria for schizophrenia. Taking into consideration these statistical characteristics, as well as certain detailed representative cases, the author proposes a new psychopathological perspective of the hypochondriaco-cenestopathic symptoms in schizophrenia. The essential result of this statistical investigation is summarized as follows. 81 schizophrenic patients exhibited the hypochondriaco-cenestopathic symptoms, accounting for 44.3% of the sample. If we exclude the cases which presented physical experience of being influenced (physikalische Beeinflussungserlebnis), appearance frequency of hypochondriaco-cenestopathic symptoms accounted for 27.9% of the sample. Among the manifestations of these symptoms, uncharacteristic somatic complaint was the most frequent. Here, the most common was pain of body (especially headaches). The second most common was complaint of easy fatigability. Concerning the appearance pattern of the symptom, we found no significant difference between the acute and chronic types, nor between the early and tardive types, while the complex type was significantly more frequent in comparison with the simple type. Among the other symptoms that co-occurred with the hypochondriaco-cenestopathic symptom, the most common was acoustic hallucination, whose frequency was highly statistically significant when compared to the non hypochondriaco-cenestopathic group. Regarding the relationship of the hypochondriaco-cenestopathic symptom with the subtypes of schizophrenia, the proportion of the paranoid type was significantly high in the non hypochondriaco-cenestopathic group.
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PMID:[Psychopathological study of hypochondriaco-cenestopathic symptoms in schizophrenia]. 819 Aug 14

Diminished gating of the auditory evoked response to repeated stimuli is a psychophysiological defect associated with schizophrenia and several other psychiatric illnesses. The P50 wave of the auditory evoked response to the second of paired stimuli is decreased in most normal subjects, whereas many psychotic subjects show significantly less decrement. The aim of this experiment was to test whether the cold-pressor test, which causes transient distress and pain accompanied by increased sympathetic activity, also causes a transient impairment in P50 auditory sensory gating in normal control subjects. Ten normal control subjects with normal gating of the P50 response immersed their hands in an ice water bath for 2 min. This cold-pressor test diminished P50 auditory gating in nine of these subjects, although the degree of impairment was highly variable among subjects. The impairment in gating was transient, with partial resolution by 30 min. The cold-pressor test was subjectively viewed as painful and also caused blood pressure to increase. Thus, a transient stressor can impair P50 auditory gating in some subjects.
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PMID:Transient impairment in P50 auditory sensory gating induced by a cold-pressor test. 838 6

Over a 3-year period 17 people were admitted for intentionally self-inflicted burns. The mean total body surface area burn was 29.5%, and 59% of the patients sustained an inhalation injury. Two patients died from their injuries (one male and one female). The method most often used (59%) was a flammable liquid ignited by a flame. Of those patients, 50% used gasoline. Fifty-nine percent of the patients were current substance abusers, with alcohol (80%) being the favored drug. Aside from substance abuse, psychiatric abnormalities were present in 53% of the patients. Schizophrenia/schizoaffective disorders was the primary psychiatric diagnosis (44%), with most patients having undergone previous psychiatric treatment. All had diagnosed disorders (using the Diagnostic and Statistical Manual III--Revised) including substance abuse and/or other psychiatric disorders. Actual stated suicidal intent was present in 41% of the cases, and another 41% were irrational attempts to escape from or control emotional pain.
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PMID:Self-inflicted burns. 840 79

A case report is given of a patient who came to the oral surgery office apparently in pain, but was referred by her general practitioner dentist for an evaluation of a root fragment. The periapical radiograph revealed a "filament" type opacity in the upper right canine area. It was explained to the patient, who opted for its removal. Although, the removed material appeared to be dental amalgam fragments, the patient insisted that it was a transmitter implanted by her gynecologist. The patient was referred for psychiatric therapy but only went for one visit. The tentative diagnosis was schizophrenia.
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PMID:Implanted transmitter in maxilla: real or imaginary? 858 14

The problem of pain is felt more and more by people at various levels of privacy and social life. It is important to examine the possibility of pain as "communicative metalanguage", or language of languages. This language is deeply analogic, metaphoric, symbolic, experienced. The authors, in this paper, try to consider the problem of pain from a psychopathologic point of view and outline some lines of phenomenological analysis, from depression to schizophrenia.
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PMID:[Pain in psychopathology. Brief phenomenological analysis]. 872 Dec 1

Antagonists of the N-methyl-D-aspartate (NMDA) subtype of glutamate (Glu) receptor have become the focus of considerable attention as potential neurotherapeutic agents in view of mounting evidence implicating NMDA receptors in acute central nervous system (CNS) injury syndromes such as stroke, trauma, and status epilepticus. In addition, NMDA receptor antagonists are of potential interest for the clinical management of neuropathic pain and preventing the development of tolerance to opiate analgesics. A potentially serious obstacle to the development of NMDA antagonists as neurotherapeutic drugs is the paradoxical fact that whereas these agents do have significant neurotherapeutic potential, they also have psychotogenic and neurotoxic properties. We have been intensively investigating the mechanisms underlying these adverse properties and have discovered several methods of suppressing or preventing their expression. In addition, we have been exploring the possibility that a common mechanism may underlie the psychotogenic and neurotoxic actions of these agents and that this mechanism may have relevance to the pathogenesis of idiopathic psychotic processes such as schizophrenia. In this chapter, we will review our findings pertaining to NMDA antagonists in the dual context of their value as tools for exploring mechanisms underlying neuropsychiatric disturbances, particularly schizophrenia, and their potential promise as therapeutic agents. For additional references and a more complete elaboration of our hypothesis pertaining to NMDA receptor dysfunction and schizophrenia, please see a recent review (Olney and Farber 1995).
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PMID:NMDA antagonists as neurotherapeutic drugs, psychotogens, neurotoxins, and research tools for studying schizophrenia. 874 58

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

In contrast to the well known chlorpromazine-induced cholestatic hepatitis, we report the case of a schizophrenic patient who presents a cytolytic hepatitis, without any prior hepatic disease. Mr G. was first hospitalized for depressive symptomatology. A pseudo-nevrotic schizophrenia was diagnosed. Pretherapeutic clinical and biological data were normal. A treatment with chlorpromazine 400 mg/day was given. At day 8, the patient was still anxious and began to be agitated. An increase to 500 mg/day of chlorpromazine posology and an addition of haloperidol 200 mg/day was implemented. At day 10, the following clinical symptoms appeared: 38.6 degrees C fever; headache; myalgia; epigastralgia and hypocondrium pain. Biological hepatitis disturbances (ALAT, 984 U/L; ASAT, 414 U/L) and hypereosinophilia with normal white cell count were found. Clinical and biological investigations were normal. Blood-culture, A, B, C hepatitis, HIV and CMV serologies were negative. Neuroleptic treatment was discontinued. Evolution to normality of the disturbances and biological data suggested a cytolytic hepatitis. Mr G... remained treated with flupentixol without side-effects. Phenothiazine-induced cholestatis is frequent, mild, and recovers spontaneously. The biological mechanism is supposed to be immunologic. Prevalence of biological hepatic disturbances is 10 to 20% with chlorpromazine in long-term treatment. More often, symptomatology is the same; jaundice, pruritus, abdominal pain, fever. Although pharmacological data suggest for a cytotoxic activity of phenothiazines, cytolytic hepatitis is poorly described. Maximum range of transaminase blood level reported in previous studies is about 400 U/l. This level is not clearly correlated with hepatic cell lysis. Few cases of hepatic necrosis have been reported. In all cases, preexistent hepatic injuries were observed. Chlorpromazine-induced cytolytic hepatitis is uncommon and cholestatic hepatitis mild. Biological hepatic parameters investigations remain necessary during neuroleptic treatment.
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PMID:[Cytolytic hepatitis during treatment with phenothiazines: apropos of a case]. 903 96

Schizophrenia is an expensive illness, with hospitalization representing a major cost of treatment. To evaluate new drugs and management strategies for schizophrenia, we must have reliable measures of outcomes and costs. Cost-outcome evaluations are particularly important because they allow comparisons of the potential costs and consequences of various strategies. The best estimates of outcome use batteries of instruments to score the well-being of patients and their caregivers. Dimensions of well-being include clinical status, functional status, access to resources and opportunities, subjective quality of life, family well-being, and patient satisfaction with services. The best overall outcome may involve trade-offs between different dimensions (eg, moving a patient from hospital-based care to community-based care may improve the patient's quality of life but increase family burden). Although measuring direct costs of schizophrenia is reasonably straightforward, indirect costs are more difficult to measure. The cost of pain and suffering (intangible costs) caused by schizophrenia for an individual patient or family is seldom assessed, although quality-of-life measures may provide some information. Increased costs of treatments in one area (eg, medication) may well be offset by reduced expenditures in another (eg, hospitalization), Trade-offs between different dimensions and different schizophrenia management agencies are only possible once the boundaries between these have been made clear by proper economic evaluations.
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PMID:Economic outcomes and costs in the treatment of schizophrenia. 908 15

Disturbances of body experience in schizophrenia patients occur frequently. They vary phenomenologically and lack exact and distinct definitions. Their theoretical and clinical relevance remains widely unclear. This review summarises the literature on clinically relevant symptoms such as coenaesthesis and body hallucinations, disturbances of pain perception, out-of-body-experiences, dysmorphophobia and self-injuries or self-mutilation. Empirical studies on the concepts of body schema, body concept and body cathexis are reported. Many of these studies have serious methodological shortcomings. The correlation of disturbances of body experience with other psychopathology is considered. Standardised methods for assessing these disturbances are listed. Effects of body-oriented psychotherapy have been suggested, but not empirically tested. Finally, the possible relevance of further research in this field is discussed.
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PMID:[Disturbances of body experience in schizophrenic patients]. 934 Mar 15


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