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

Clinical researchers have observed in relatives of schizophrenic individuals abnormal personality traits resembling the psychopathology of schizophrenia. Further similarities have been observed in correlations between measures of brain function, including attention and executive abilities, and these personality psychopathologies. However, two methodologic factors might account for the covariation of these 'schizophrenia spectrum' personality traits and measures of brain function. Clinical selection bias (Berkson's bias) might result in subjects with overlapping conditions being more likely to be studied, and normal personality attributes could affect performance on neurobehavioral tasks. This study investigated relationships between neurobehavioral correlates of schizophrenia, clinical schizophrenia spectrum personality traits, and normal personality dimensions in the five-factor model of personality. To avoid Berkson's bias, subjects expected to have a high probability of spectrum traits were recruited from the Baltimore Epidemiologic Catchment Area Survey community sample. About 40% of the sample were found to have DSM-IIIR Schizotypal, Schizoid, or Paranoid Personality Traits or Disorders. Schizophrenia Spectrum traits showed significant associations with personality dimensions of the five factor model, particularly Openness to Experience and Neuroticism. In ordinary linear regression models, after adjustment for a number of normal personality characteristics, Schizotypal Personality Traits were still strongly associated with perseverative responses on the Wisconsin Card Sorting Test (WCST). In logistic regression models, subjects with Schizotypal, Schizoid, or Paranoid Traits differed in terms of normal personality profiles and WCST performance.
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PMID:Covariance of personality, neurocognition, and schizophrenia spectrum traits in the community. 151 76

Oculomotor functioning of 26 probands with schizophrenia, 12 spectrum and 46 nonspectrum first-degree relatives, and 38 nonpsychiatric control subjects was evaluated. Spectrum relatives had more anticipatory saccades (ASs) and lower pursuit gain than nonspectrum relatives, who had more ASs and lower pursuit gain than control subjects. Probands also had lower pursuit gain than nonspectrum relatives and control subjects but did not differ from other groups on AS frequency. Control subjects had more globally accurate pursuit tracking (root mean square [RMS] error deviation) than both relative groups, whereas probands had the poorest RMS scores. Square wave jerk frequency did not differentiate the groups. Attention enhancement affected the frequency of ASs but did not affect either the other intrusive saccadic event or RMS scores. These results offer evidence that eye-movement dysfunction may serve as a biological marker for schizophrenia.
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PMID:Pursuit gain and saccadic intrusions in first-degree relatives of probands with schizophrenia. 226 5

We investigated the extent psychiatric illnesses can be differentiated by means of psychopathological symptoms. The present condition of 2269 patients was analyzed; they had been admitted to the psychiatric clinic of the Free University of Berlin during 1971-1976, as documented by the AMP (PAS) documentation system. The most frequent diagnosis in the sample was schizophrenia (32%), followed by neurosis (22%), affective psychosis (14%), addiction (6.7%), and organic psychosis (6.2%). We could demonstrate that even such diagnostic groups are usually discernible by symptoms, where the differential diagnosis is often difficult. Organic psychosis vs paranoid schizophrenia and depressive neurosis vs depressive psychosis can be determined, but manic syndromes in schizoaffective psychosis vs manic syndromes in affective psychosis are hardly discernible. The potential to differentiate, however, only pertains to diagnostic groups, since many individual patients cannot accurately be classified into diagnostic groups by psychopathological symptoms alone. Only a few symptoms are pathognomonic, and if there are pathogomonic symptoms characterizing a diagnostic group, only a few patients in this group show these symptoms. These results indicate, at least for the high number of patients without severe and typical symptomatology, that we must: 1. Achieve better differentiation on the diagnostic axis "psychopathology" by means of empirically derived syndromes instead of isolated symptoms. 2. Use other diagnostic axes (like etiology and course) for differential diagnostic purposes.
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PMID:[The potential of psychopathological symptoms to differentiate diagnostic groups (author's transl)]. 727 35

Geriatric health care practice strives to respond to the medical, psychologic and social needs of the elderly person through coordinating the services of the physician and the psychiatric social worker. In a geriatric clinic at the George Washington University Medical Center, the medical regimen for elderly ambulatory patients is supported and augmented by psychotherapy, counseling, behavioral therapy, and instruction of the family about the patient's need for environmental or residential changes. A review of the records of 40 elderly patients initially enrolled in the geriatric clinic program showed that 20 were in need of mental health support. Among these, 8 had a depressive disorder, 1 had paraphrenia, 2 had longstanding schizophrenia, and the rest showed mental decline secondary to organic brain syndrome. The geriatrician and the psychiatric social worker were able to provide sufficient mental health support for these elderly mental patients to permit them to remain in the community for worthwhile periods. Ambulatory geriatric patients, especially those with mental health impairment, can benefit greatly from services offered in a comprehensive fashion by a geriatrician and a psychiatric social worker.
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PMID:Management of the mental health of ambulatory elderly patients. 739 99

The Survey Psychiatric Assessment Schedule (SPAS) was used in a survey of elderly people living at home and in institutions to examine its reliability in determining mental state. A psychiatrist assessed the same subjects using the Geriatric Mental State Schedule (GMSS) and classified psychiatric disorder into three broad groups: organic disorders, schizophrenia and paranoid disorders, and affective disorders and psychoneuroses. The agreement between the psychiatrist's classification of mental state and the classification derived from SPAS was found to be satisfactory for organic disorders and less satisfactory for functional disorders. The limitations of this method of identifying psychiatric illness are examined.
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PMID:The reliability of a Survey Psychiatric Assessment Schedule for the elderly. 742 44

The first 13 consecutive referrals to a newly established Geriatric Psychiatry Research Division (GPRD) at a community mental health center (CMHC) in Baltimore, Maryland, were evaluated with the structured clinical interview (SCID) from the third edition of the Diagnostic and Statistical Manual, Revised (DSM-III-R). Although the referring primary diagnoses were confirmed in 54% of patients (7 of 13), an average of three new diagnoses were made for each patient that had not been considered. Of the remaining six patients, four (67%) patients with a diagnosis of schizophrenia were found to have a diagnosis of affective disorder based on the SCID interview (two patients with bipolar disorder, depressed and two patients with schizoaffective disorder, depressed). In the remaining two (33%) patients, one patient had a diagnosis of mixed dementia due to longstanding alcohol abuse with a superimposed primary degenerative dementia of the Alzheimer's type. The remaining patient's initial diagnosis of dementia associated with alcoholism was changed to bipolar disorder, depressed. These results provide support for the hypothesis that older persons with psychiatric illness may have been misdiagnosed at a time of less diagnostic rigor.
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PMID:Misdiagnosis among older psychiatric patients. 855 19

This study reports on a new rating scale, the short version (GIP-28) of the Dutch Behavioral Rating Scale for Geriatric Inpatients (GIP). Only a limited number of items was needed to adequately describe GIP variance in two patient samples (n = 2196 and n = 126). Based on previous results factor analysis produced three factors: 'apathy', 'cognitive' and 'affective' symptoms. This led to the construction of new subscales which showed significant differences between persons in different patient settings. Elderly patients with a cognitive disorder or schizophrenia/mood disorder according to DSM-IV criteria, were correctly classified in almost 80% of the cases. We conclude that the GIP-28 is equivalent to the GIP and describes aspects of apathy and cognitive and affective symptoms in elderly patients. A compact rating scale like this might best be used in (routine) screening of cognitive and noncognitive behavioral problems. It may also prove useful for outpatient purposes.
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PMID:[Short version of the Dutch Behavioral Rating Scale for Psychogeriatric Inpatients (GIP-28)]. 938 20

The opportunity to assess prevalence, incidence, and outcome of schizophrenia and delusional disorder was provided by an age- and sex-stratified random sample of 5,222 persons age 65 years and over. This sample was chosen from general practitioner lists, and interviewed by psychiatric nurses trained to use the Geriatric Mental State (GMS)-AGECAT computerized diagnostic system. GMS-AGECAT ensured the reliability of the selection of cases between the two waves of the study. A subsample was interviewed by a research psychiatrist. The sample was followed up 2 years later using the same method by interviewers blind to the initial findings. The protocols of all nominated cases and subcases of schizophrenia/paranoid disorder diagnosed by AGECAT were reviewed by a clinician and DSM-III-R diagnoses were made. Refusal rate was 13 percent for initial interviews (wave 1) and 15 percent for reinterview 2 years later (wave 2). The prevalence of DSM-III-R schizophrenia was 0.12 percent (95% confidence interval [CI] 0.04-0.25) and delusional disorder 0.04 percent (95% CI 0.00-0.14). The minimum incidence of schizophrenia for new cases was 3.0 (95% CI 0.00 to 110.70); for new and relapsed cases, 45.0 (95% CI 3.54-186.20); and for delusional disorder, 15.6 (95% CI 0.02-135.10) per 100,000 per year. Two of the five cases with schizophrenia were known to have been first diagnosed before age 65. After 2 years, none of the cases of schizophrenia had recovered fully, but none was deluded at followup. Two had developed dementia. The outcome was bad because they remained cases of some type of psychiatric illness but good because of the improvement in their schizophrenia/delusion disorder symptoms.
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PMID:Schizophrenia and delusional disorder in older age: community prevalence, incidence, comorbidity, and outcome. 950 53

This paper presents results from the UCLA Follow-Up Study of Childhood-Onset Schizophrenia Spectrum Disorders. Eighteen children with schizophrenia (SZ) were assessed 1 to 7 years following initial project intake. Results demonstrated significant continuity between SZ spectrum disorders in childhood and adolescence. Although not all children who presented initially with SZ continued to meet criteria for SZ spectrum disorder as they progressed through the follow-up period, rates of SZ spectrum disorders ranged from 78-89% across the first three follow-up years. Rates of continuing SZ ranged from 67% to 78% across the three follow-up years and rates of schizoaffective disorder ranged from 11% to 13% across the three follow-up years. Variability in levels of functioning were observed with 45% of the sample showing deteriorating course or minimal improvement and 55% of the sample showing moderate improvement or good outcomes. This variability in outcome is comparable to that seen in adults with SZ, suggesting that with current treatments childhood-onset does not ensure a more severe disorder.
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PMID:Childhood-onset schizophrenia: a follow-up study. 1054 78

Neuropsychological deficits are found in both schizophrenic patients and their relatives, and some studies have shown similar, but less severe, deficits in affective psychotic patients and their relatives. We set out to establish: (a) whether schizophrenia spectrum personality traits are more common in the relatives of schizophrenic patients than, in the relatives of affective psychotic patients; and (b) what the relation is between spectrum personality traits and neuropsychological deficits in these relatives. Relatives were interviewed using the International Personality Disorder Examination (IPDE), and also completed the National Adult Reading Test (NART), the Trail Making Test (TMT; Parts A and B) and Thurstone's Verbal Fluency Test (TVFT). Spectrum personality traits were equally common in 129 relatives of schizophrenic patients and 106 relatives of affective psychotic patients, but the performance of the former group was inferior to that of the latter on the NART and the TVFT. Relatives with high paranoid traits had lower NART scores than relatives without such personality traits; similarly, those with high schizoid traits took longer to complete the TMT, part B, than those without such traits; and relatives with high schizotypal traits generated significantly fewer words on the TVFT than those without such traits. We conclude that relatives of schizophrenic and affective psychotic patients share a propensity to schizophrenia spectrum traits, but relatives of the former have poorer neuropsychological performance. Furthermore, there exists an association between neuropsychological deficits and spectrum traits in both groups of relatives; in particular those with high paranoid traits have lower IQ scores than their less paranoid counterparts.
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PMID:Neuropsychological performance and spectrum personality traits in the relatives of patients with schizophrenia and affective psychosis. 1128 13


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