Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0036341 (schizophrenia)
 60,220 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Different drugs have been used as adjuvant to neuroleptics in chronic schizophrenia. Bromocriptine, carbamazepine and cyproheptadine have shown an efficacy added to neuroleptics in schizophrenia. In our study, 24 chronic schizophrenic inpatients considered to be resistant to neuroleptics were treated double blind with the associations haloperidol (40 mg a day)--carbamazepine (400 mg a day), haloperidol (40 mg a day)--bromocriptine (2.5 mg a day), haloperidol (40 mg a day)--cyproheptadine (24 mg a day) and haloperidol (40 mg a day)--placebo. The drugs were given successively, in a randomized succession using a latin square procedure, for four 5-weeks periods. A psychiatric assessment using the Brief Psychiatric Rating Scale (BPRS), the SANS (Scale for Assessment of Negative Symptoms) and the SAPS (Scale for Assessment of Positive Symptoms) occurred every two weeks. Extrapyramidal symptomatology and abnormal movements were assessed using the AIMS (Abnormal Involuntary Movement Scale) and the Simpson-Angus scale. Using an ANOVA, we cannot show any clinical efficacy of any of those three drugs as an adjuvant to haloperidol. The discrepancy between our results and the data of the literature can be linked to the high specificity of our sample (resistance to neuroleptics). We cannot show any specific efficacy of those drugs on positive and negative symptoms, using the sub-factors of the SAPS and SANS.
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PMID:[Comparative efficacy of bromocriptine, carbamazepine and cyproheptadine with neuroleptics in 24 refractory chronic schizophrenic patients]. 830 25

Clinical interest in the so-called atypical antipsychotics currently focuses on the possibility of improving the negative symptoms of schizophrenia and the cognitive dysfunction associated with the disease. While clozapine has been shown to be effective in this respect, no data are available on zotepine. We report on a double-blind randomized study designed to evaluate the impact of zotepine and clozapine on cognitive dysfunction in schizophrenia. Cognitive function was operationalized by a maze test in which patients traversed computer-displayed mazes of increasing complexity. Passage time, route, and motor errors were evaluated. 25 schizophrenic (DSM-IIIR) patients were included in each group. After washout, they were randomized on zotepine or clozapine and given up to 450 mg of substance each. Patients were followed for six weeks and evaluated weekly. We report on a subsample of 26 patients matched for baseline BPRS, SANS, and age. 13 matched healthy persons were recruited as controls. ANOVA with group and course over time as factors was used for analysis. Both clozapine and zotepine achieved a highly significant decrease in overall symptoms (BPRS) and negative symptoms (SANS). Zotepine and clozapine were equally effective. In the maze tests, motor errors in simple mazes were stable over time and differentiated schizophrenics from controls as a "trait" marker. In passage time and maze route, schizophrenics performed worse than controls. An improvement by medication was evident in both medication groups, but was more pronounced in the zotepine-treated group. The study confirms previous results on the efficacy of clozapine and zotepine in treating negative symptoms of schizophrenia. The data presented show for the first time that zotepine is efficacious in improving cognitive dysfunction, confirming this substance's value as an atypical antipsychotic.
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PMID:Improvement of cognitive function in schizophrenic patients receiving clozapine or zotepine: results from a double-blind study. 913 23

Tardive dyskinesia (TD) affects between 10 and 50 percent of all patients on long-term antipsychotic therapy, depending on the population studied. Various risk factors for TD have been reported; a correlation between TD and substance abuse has been suggested in some reports and not found in others. This study analyzes the association of substance abuse with the incidence of tardive dyskinesia in a schizophrenic population. All patients at the West Side Veterans Affairs Medical Center are evaluated prior to the initiation of neuroleptic therapy with the Dyskinesia identification System: Condensed User Scale (DISCUS); those with a diagnosis of schizophrenia, schizoaffective disorder, or schizophreniform disorder during the years 1986 through 1993 were included in this analysis. History of substance abuse was considered positive if there was clinician report or diagnosis of substance abuse. These data were collected and analyzed using ANOVA. In a sample of 1,027 subjects (97% male), 83.2 percent had a neuroleptic exposure of 10 or more years, and slightly more than half (50.8 percent) had a positive history of substance abuse. Using research diagnostic criteria, 28.9 percent of the sample had tardive dyskinesia. Analysis of variance showed history of substance abuse (p < .000) and years on neuroleptics (p < .000) to be strongly correlated to a diagnosis of TD. Age was less strongly correlated to the DISCUS score (p < .01), and there was no association of TD with diagnosis (p = .237). This study therefore demonstrates a robust correlation between TD and substance abuse. A mechanism of action involving N-methyl-D-aspartate (NMDA)-mediated excitotoxicity is proposed.
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PMID:Substance abuse as a risk factor for tardive dyskinesia: a retrospective analysis of 1,027 patients. 913 72

Using proton magnetic resonance spectroscopic imaging (1H-MRSI) we found in a previous study a specific pattern of neuronal pathology in patients with schizophrenia as determined by relative loss of signal from N-acetyl-containing compounds (NAA). The purpose of the present study was to assess the reproducibility of the results of 1H-MRSI both in patients with schizophrenia and in normal controls. We studied twice 10 patients and 10 controls on 2 days separated by, on average, 3 months. Reproducibility was assessed with several statistical procedures including ANOVA, coefficients of variation (CVs) and intra-class correlation coefficients (ICC). Patients showed significant reductions of NAA/creatine-phosphocreatine (CRE) and NAA/choline-containing compounds (CHO) selectively in the hippocampal region (HIPPO) and in the dorsolateral prefrontal cortex (DLPFC) on both experimental days. A repeated measures ANOVA showed no effect of time on metabolite ratios in all subjects. CVs were fairly low (especially for NAA/CRE and CHO/CRE) and did not differ significantly between patients and controls. The ICCs of the ROIs reached statistical significance only in a few instances. The present multislice 1H-MRSI study shows that: (1) patients with schizophrenia, when compared as a group to normal controls, show a consistent 1H-MRSI pattern of group differences, i.e., bilateral reductions of NAA/CRE and NAA/CHO in HIPPO and DLPFC; (2)1H-MRSI data in both patients and controls do not show significant changes over this 90-day period; however, absolute metabolite ratios in individuals show low predictability over this time interval; (3) 1H-MRSI data show relatively low variability (as measured by the CVs) both in patients and normal controls, especially for NAA/CRE and CHO/CRE.
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PMID:Reproducibility of proton magnetic resonance spectroscopic imaging in patients with schizophrenia. 940 13

This study had three aims: to compare a schizophrenia sample (n = 50) with a substance abuse (n = 25) and normal sample (n = 81) on affect recognition; to compare differences in their performance between positive and negative affect recognition; and to introduce a new videotape method of stimulus presentation. Subjects were asked to identify the predominant affect depicted in 21 5-10-s vignettes containing three trials of seven affect states. Results demonstrate significant group differences: normal subjects scored in the normal or mild range, substance abuse (s/a) subjects scored in the mild and moderate ranges, and the schizophrenia sample scored predominantly in the moderate to severe ranges. Accuracies were 92.3% for the normal sample, 77.2 for the s/a sample and 64.8 for the schizophrenia sample. Response dispersions were 97.6% for the schizophrenia group, 69% for the s/a sample and 38% in the normal sample. A repeated measures ANOVA revealed a group by type of affect interaction with schizophrenia subjects showing far greater differential impairment on negative affect recognition. Difficulty of item did not contribute to this difference. Test-retest reliability at 5 months for this new method was r = 0.76, and stability of categorization was very high over 5 months (weighted kappa = 0.93). These affect recognition deficits in schizophrenia are discussed as they relate to lateralization of brain function, high EE families, social skills impairment and implications for rehabilitation services.
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PMID:Positive and negative affect recognition in schizophrenia: a comparison with substance abuse and normal control subjects. 946 40

Forty-four first-admission patients with childhood-onset schizophrenia (age at onset < or = 14 years) were examined retrospectively for 30 clinical symptoms using the Positive and Negative Syndrome Scale (PANSS; 15). A principal component analysis with varimax rotation was applied to the full item set of this scale and revealed five orthogonal independent symptom groups: cognition affect, social withdrawal, anti-social behavior, excitement, and reality distortion. In order to validate these psychopathological dimensions we analyzed the relation between the five factor scores and outcome variables (Disability Assessment Schedule, DAS-M; 13) several years after onset: Social withdrawal was correlated with poor outcome; reality distortion was related to good outcome (P < 0.01). A multivariate ANOVA identified group differences in the anti-social behavior factor between acute and insidious onset of illness and between boys and girls; patients with an acute onset scored significantly higher on the excitement factor than those with an insidious onset (P < 0.05). According to our results more than two dimensions are necessary to describe the psychopathology of childhood-onset schizophrenia, similar to adolescent- and adult-onset schizophrenia.
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PMID:[The 5 factor model of childhood schizophrenia]. 956 78

Although gender differences in schizophrenic symptom expression have been widely established, no systematic studies have documented if these differences extend to the perception of quality of life. This survey gathered international data on the perception of quality of life among 102 outpatient men and women with schizophrenia from Canada, Cuba, and the United States. Using portions of Lehman's Quality of Life Interview, quality of life was assessed on the domains of social relationships, health, living situation, leisure, finances and general quality of life. Gender differences were tested with ANOVA where site was treated as a nested variable and separate t-tests comparing men and women within each country. Although no differences were found for the combined sample, differences were observed between men and women in Canada and Cuba on the social relationship domain. In Canada, women with schizophrenia reported a higher quality of life for social relationships. In contrast, Cuban men with schizophrenia reported higher quality of life for social relationships than Cuban women. Findings from the three sites show no differences for the other domains. With the possible exception of social relationships, these findings suggest no discernable differences in the perception of quality of life for men and women with schizophrenia. Overall, men and women with schizophrenia were only somewhat satisfied with some aspects of life. These findings have implications for developing comprehensive community care that includes quality of life promotion.
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PMID:Quality of life, gender and schizophrenia: a cross-national survey in Canada, Cuba, and U.S.A. 979 40

The existence of a genetic background is now a well admitted notion in schizophrenia, but some individuals at genetic risk for that disease could never manifest it at a clinical level. However, several vulnerability models could help us to identify such individuals. According to them, when similar perturbations at a given test are observed both in clinically stable schizophrenics and their nonschizophrenic first degree relatives, this test could be qualify as an indicator of the vulnerability to schizophrenia. In literature, that seems the case for several neuropsychological tasks, exploring attentional abilities (degraded version of the Continuous Performance Task [DS-CPT], and Span Of Apprehension task [SOA]) and executive functions (Wisconsin Card Sorting Test [WCST]). Our study was undertaken to replicate literature data and to further explore the relationship between these three neuropsychological markers. For that purpose, performances at DS-CPT, SOA and WCST were assessed among 18 clinically stable schizophrenics, 18 of their biological full siblings and 15 unrelated control subjects matched with the two others groups for several socio-demographic factors. Comparisons were performed by non parametric analysis (Kruskal-Wallis one way ANOVA, and Mann-Whitney). Compared to controls, the siblings group performances were significantly impaired on the three tasks, while they did not statistically differ from the schizophrenic ones. No relationship was observed between the markers, except for the "d'" index at DS-CPT and the number of successfully performed categories at the WCST. Results from the sibling group suggested that the observed impaired neuropsychological performances may actually represent indicators of the genetic vulnerability to schizophrenia. Moreover, the generally admitted relationship between WCST poor performances and an impairment of the prefrontal cortex, lead us to hypothesize some role of this brain area in schizophrenia vulnerability.
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PMID:[Vulnerability to schizophrenia. I: Familial nature of of neuropsychologic indicators]. 985 Aug 18

During a 2-year period, 34 patients of catatonic features in Chinese ethnic background Taiwanese were brought to the emergency unit of Chang Gung Memorial Hospital at Linkou. The ratios of the causes of catatonic features by schizophrenic disorders, mood disorders, neuroleptic-induced disorders, and general medical conditions were 26, 9, 24 and 41%, respectively. After the treatments of antipsychotics, benzodiazepam, or electroconvulsive therapy (ECT), 24 patients (70.6%) showed complete remission, seven patients (20.6%) showed partial remission, and three patients (8.8%) showed no response (two died). Additionally, a suggestive period is proposed in order to distinguish acute and insidious onset catatonic conditions to help clinicians in deciding on probability immediately. The patients were grouped into four diagnostic categories; namely, schizophrenic disorders, mood disorders, neuroleptic-induced disorders, and general medical conditions for comparison. One-way ANOVA and Duncan's multiple-range test were used for continuous variables, and the Chi-squared test was used for categorical variables. The mean duration of 'insidious onset catatonic condition' (including schizophrenic disorders and general medical conditions) before seeking medical help was longer than 3.33 weeks, while the mean duration of 'acute catatonic condition' (including mood disorders and neuroleptic-induced disorders) was shorter than 1.83 weeks. These findings suggest that 2-3 weeks would be a cut-off point for acute or insidious onsets of catatonic conditions.
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PMID:Catatonic features: differential diagnosis and treatments at an emergency unit. 1020 Dec 86

The major purposes of this paper are to explore the phenomena of family structure, illness symptoms, family coping and adaptation for patients with schizophrenia or manic-depression psychosis. This paper tries to provide a good reference instrument for application by nurses in home care, in order to understand and evaluate family needs. Subjects are schizophrenic or manic-depression outpatients from 3 hospitals located in northern Taiwan. Data were collected through home interview with primary caregivers and observations. There were fifty subjects from each of the 3 hospitals, and 151 subjects in total. Descriptive statistics, t-test, one way ANOVA, Pearson correlation and multiple stepwise correlation were used to analyze data. Research indicates that most patients are aged between 31 to 40, with over 10 years elapsed since onset, and are not married. Most primary caregivers are parents over 60 years old. Most family development was at the stage with young adult offspring. The manic-depressive patients have more working opportunities than schizophrenic patients. For schizophrenic patients, paranoia was the most serious in active symptoms; lack of interpersonal interaction was the most serious in negative symptoms; the other major problem was sleep disturbance in emotion-behavior assessment. Patient's disposition was the most concerning issue for families and the worst coping efficiency occurred with lazy behavior and sleep disturbance. For manic-depressive patients, aggressive behavior was the most serious active symptom, lack of energy was the most serious in negative symptom, and sleep disturbance was the most concerning problem in emotion-behavior assessment. The patient's symptom was the most concerning issue for families and the worst coping efficiency was found in drug side effect. The result also indicates that active and negative symptoms are both related to coping efficiency.
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PMID:[The study of family structure, illness symptom, and stress adaptation of psychotic patients]. 1044 43


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