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

"Functional psychosis is conventionally subdivided into schizophrenia and manic depressive psychosis. Response to treatment is assumed to be a validating criterion for these diagnoses. The efficacy of pimozide (a dopamine antagonist neuroleptic), lithium, and a combination of the two was compared with that of placebo in a 4-week trial in 120 functionally psychotic patients, each of whom was assessed for psychotic symptoms, manic symptoms, and depressive symptoms. The sample was subdivided into patients with predominantly elevated mood, predominantly depressed mood, and no consistent mood change. Pimozide reduced psychotic symptoms in all groups of patients. The only significant effect of lithium was to reduce elevated mood. Thus dopamine blockade seems relevant to the resolution of psychotic symptoms in all types of 'functional' psychosis, but the mode of action of lithium in psychotic patients concerns only mood. Application of standardised classifications of functional psychosis to these data did not change this conclusion."
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PMID:Comments on the Northwick Park 'Functional' Psychosis Study. 268 81

Organic delusional disorders and secondary mania are clinical syndromes produced by neurologic diseases and toxic-metabolic disorders. Delusional disorders are associated primarily with limbic system lesions and basal ganglia dysfunction. These two groups of structures are united into a single system involved in the assessment of ongoing perception and experience, and dysfunction in these structures may explain the presence of psychosis. Lesions producing delusional disorders involve dopaminergic projections considered important in idiopathic schizophrenia, and involvement of similar anatomic and biochemical systems may explain the identity of symptoms noted in both disorders. Secondary mania is associated with deep midline lesions and with pharmacologic agents affecting monoaminergic function. Midline lesions may involve reward-system nuclei and euphoriant enkephalins to produce an elevated mood and hypothalamic nuclei to produce alterations in sleep, appetite, and libido. Mania appears to be more common with right-sided than with left-sided lesions. Lesions, metabolic disturbances, and drugs causing mania may disturb serotonergic and noradrenergic transmitters implicated in idiopathic bipolar disease. Study of the organic psychoses is providing insight into the neurophysiologic basis of idiopathic psychotic disorders. Clinically, greater awareness of the organic psychoses may lead to the discovery of additional cases of secondary mania and organic delusional disorders with potentially treatable neuromedical causes.
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PMID:Organic psychoses. Delusional disorders and secondary mania. 287 60

Functional psychosis is conventionally subdivided into schizophrenia and manic depressive psychosis. Response to treatment is assumed to be a validating criterion for these diagnoses. The efficacy of pimozide (a dopamine antagonist neuroleptic), lithium, and a combination of the two was compared with that of placebo in a 4 week trial in 120 functionally psychotic patients each of whom was assessed for psychotic symptoms, manic symptoms, and depressive symptoms. The sample was subdivided into patients with predominantly elevated mood, predominantly depressed mood, and no consistent mood change. Pimozide reduced psychotic symptoms in all groups of patients. The only significant effect of lithium was to reduce elevated mood. Thus dopamine blockade seems relevant to the resolution of psychotic symptoms in all types of "functional" psychosis but the mode of action of lithium in psychotic patients concerns only mood. Application of standardised classifications of functional psychosis to these data did not change this conclusion.
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PMID:The Northwick Park "functional" psychosis study: diagnosis and treatment response. 289 86

Four patients with treatment-resistant euphoric mania characterized by elevated mood, hyperactivity, and rapid speech, refractory to standard treatments and anticonvulsants, showed dramatic improvement in symptoms when treated with clozapine. All developed enhanced functioning and new insight into previous psychopathology. This degree of improvement suggests that clozapine can be considered in the treatment of not only schizophrenia, schizoaffective disorder, and dysphoric mania but also classic euphoric mania unresponsive to traditional treatments.
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PMID:Clozapine treatment of euphoric mania. 872 94

Previous four- and five-factor solutions of the 18-item Brief Psychiatric Rating Scale (BPRS) suggested the possibility of an affective dimension in psychosis. A principal components analysis was used to analyze psychiatric symptom data rated on an expanded 24-item version of the BPRS. BPRS data were collected during a period of acute psychotic and affective illness with 114 young adult, recent-onset schizophrenia and schizoaffective patients and 27 bipolar manic patients. Principal components analyses of the 18-item and 24-item BPRS indicated a four-factor solution was the most interpretable. Principal components analysis of the 24-item BPRS produced a clear mania factor characterized by high loadings from items added to the 18-item BPRS, which included elevated mood, motor hyperactivity, and distractibility. This factor solution suggests that the 24-item BPRS allows for an expanded assessment of affective symptoms relating to a manic dimension. Potentially important symptoms that were added to the traditional 18-item version, namely suicidality, bizarre behavior, and self-neglect, also make clear contributions to other factors.
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PMID:Symptom dimensions in recent-onset schizophrenia and mania: a principal components analysis of the 24-item Brief Psychiatric Rating Scale. 1116 85

Although, emotions play a crucial role in schizophrenia, the changes in emotional dimension in relation to brain asymmetry still remain controversial. The aim of our work was: 1) to compare the emotional behaviour between the examined groups: S--non-chronic schizophrenic patients (n = 50), CS--chronic schizophrenic patients (n = 50), N--healthy controls (n = 50), R--right brain-damaged patients (n = 30), and L--left brain-damaged patients (n = 30), 2) to assess the changes in attitude processes and in types of emotional reactions, its relation to lateralised hemisphere damage and chronicity of the schizophrenic process. All psychiatric subjects were diagnosed as paranoid schizophrenics according to DSM-IV criteria and were scored on the PANSS scale after four weeks of neuroleptic treatment. Brain-damaged patients were included if they experienced single-episode cerebrovascular accidents causing right or left hemisphere damage (confirmed in CT scan reports). The neurological patients were examined at least 3 weeks after the onset of the episode. Emotional behaviour was assessed using Observational Scale of Emotional Behaviour aimed at the evaluation of: A) attitude processes B) the emotional reactions. Our results revealed differentiated type of emotional behaviour in the examined population. Right brain-damaged patients significantly often revealed elevated mood, lack of adequacy of self-evaluation and active or negative attitude towards the environment. Left brain-damaged patients showed depressed mood, resignation, positive or seldom passive attitude to others and adequate self-evaluation. Schizophrenic patients mostly revealed indifferent mood and passive attitude to environment, their self-evaluation was rather adequate. Based on our data, the changes in emotional behaviour in schizophrenic patients might reflect frontal lobes dysfunction rather than dysfunction localised in one of cerebral hemispheres.
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PMID:[Emotional behavior in schizophrenia and one-sided brain damage. Cerebral hemispheric asymmetry. Part I]. 1214 18

Disordered communication of emotions belongs to the primary schizophrenia symptoms. The aim of this study was our attempt of the localisation of the deficits in emotional communication (its decoding and expression) in dimensional models of schizophrenia. The evaluation of emotionality in schizophrenia might be performed indirectly via negative dimension (for instance: apathy, diminished verbal fluency, flat or inappropriate emotional reactions), via excitement (elevated mood) and depression (decreased mood) or via cognitive dimension. Interpretation of emotional phenomena within the cognitive dimension remains an oversimplification. Brain emotional and cognitive systems act independently although they also reveal mutual interactions enabling the control of emotional behaviour via social learning of emotions. To conclude, to date emotional dimension in schizophrenia has not yet received satisfactory explanation which is in line with the complex nature of emotions. Thus the question regarding the location of emotions in dimensional models of schizophrenia still remains open.
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PMID:[The location of the deficits of emotional communication in dimensional models of schizophrenia]. 1552 28

In this paper, a concept has been presented stating that the process of creativity may be connected with psychopathological features such as mood disorders, mainly bipolar, and psychosis-like thought abnormalities. Biographic studies point to a more frequent occurrence of affective disorders in creative subjects and members of their families. There is also data concerning the occurrence of schizophrenia in the families of prominent persons. A number of studies have demonstrated a similarity of patients with bipolar affective illness and members of their families to creative persons, as to increased indexes of creativity as well as such temperamental features as cyclothymia, neuroticism and openness. An association has been also found between the dimension of"psychoticism", schizotypal features and the measures of creativity. A reduction of the so called "latent inhibition" mechanism, resulting in perception of seemingly irrelevant external stimuli is connected with a predisposition to both increased creativity and schizophrenia-like disturbances. A neurobiological model of generating ideas and creative drive assumes a dominant role of three brain structures: frontal lobes, temporal lobes and the mesolimbic system. The neurotransmission system mostly connected with elevated mood and psychotic thinking is the dopaminergic system, especially its mesolimbic and cortical pathways. Both neurobiological and pharmacological evidence has been accumulated for an association of these pathways with motivational, emotional and cognitive processes, and indirectly, with the processes of creativity. In recent years, a number of interesting results has also been obtained from molecular-genetic studies about genetic determinants of creativity processes in association with bipolar mood changes and psychotic conditions.
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PMID:[Psychopathology and creativity]. 1744 85

Neuropsychological deficits in schizophrenia and affective illnesses have been a topic of increasing research interest for more than two decades. Currently, the cognitive dysfunctions are regarded as an essential element of these illnesses, occurring already in their prodromal phase, with an increment during the course of illness and with some deficits persisting also during the remission period. In schizophrenia, deficits in working memory and executive functions are most frequently demonstrated. In patients with affective illnesses, the initial research focused mainly on depression, where psychomotor slowness, deficits of attention, verbal and working memory and executive functions have been observed. It has been shown that during depression in the course of bipolar affective illness, the cognitive dysfunctions have been more marked as compared with recurrent depression. In this paper, the neuropsychological changes occurring during the period of mania and hypomania have been presented. The disturbances that have been shown most frequently include selective cognitive dysfunctions such as disturbances of attention and learning process, working memory and executive functions. During periods of mania/hypomania, the specific distortions of thinking occur ("anastrophic" thinking), as well as disturbances in the decision making process, connected with increased impulsivity. Another characteristic of the episode of elevated mood has been a change of information processing of affective type, mostly a lower ability for perception and recognition of negative emotions. Among persons with bipolar affective illness, especially during the hypomanic period, an increased level of creativity than in control persons has been observed, what may facilitate higher artistic activity. Recently, the evidence has been accumulated pointing to more severe cognitive dysfunctions in bipolar affective illness, type I (with manic states) compared with bipolar affective illness, type II (with hypomania).
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PMID:[Neuropsychological aspects of the manic syndrome in the course of bipolar affective illness]. 1972 21

The occurrence of manic/hypomanic switch in patients being treated with risperidone has been reported by various authors, and they have described a variety of strategies for their management. In this report, we describe two cases of induction of elevated mood symptoms in patients treated with risperidone. We propose that the emergence of these symptoms may be a complication of treatment with this drug in susceptible individuals, of which the clinicians should be aware, mainly in those diagnosed with schizophrenia and bipolar disorder. We then discuss a few findings that might be useful in the management of such cases. We thereby also propose a mechanism for such an induction.
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PMID:Risperidone-induced mania: An emergent complication of treatment. 2542 70


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