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

Present clinical and research methods of differential diagnosis of schizophrenia and affective psychoses rely very heavily on presenting symptoms and signs, especially in acute psychosis. We have reviewed studies bearing on this issue, including studies of the phenomenology of psychotic illness, outcome, family history, response to treatment with lithium carbonate, and cross-national and historical diagnostic comparisons. We conclude that most so-called schizophrenic symptoms, taken alone and in cross section, have remarkably little, if any, demonstrated validity in determining diagnosis, prognosis, or treatment response in psychosis. In the United States, particularly, overreliance on such symptoms alone results in overdiagnosis of schizophrenia and underdiagnosis of affective illnesses, particularly mania. This compromises both clinical treatment and research.
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PMID:Diagnosis in schizophrenia and manic-depressive illness: a reassessment of the specificity of 'schizophrenic' symptoms in the light of current research. 35 52

The success of lithium carbonate in the treatment of manic-depressive illness has led to its use in many other psychiatric disorders. Within this group, schizophrenia and schizo-affective disorder have come under the closest scrutiny. The literature, however, is difficult to reconcile. Conclusions are often contradictory, methodologies confusing, and well-designed studies few in number. In this paper, the authors have attempted to extract common denominators that may prove of value in delineating those symptoms which predict therapeutic response to lithium carbonate.
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PMID:Lithium carbonate in the treatment of schizophrenia and schizo-affective disorder: review and hypothesis. 48 21

Ten patients in a Veterans Administration hospital who had been diagnosed and treated as schizophrenic were rediagnosed as having bipolar affective illness and were shown to be responsive to lithium. The authors feel that the diagnosis of schizophrenia is made too frequently and often is made with inadequate information. A further complicating factor in diagnosis is that some patients exhibit schizophrenia-like symptoms during the acute manic phase. The authors found that valuable aids to rediagnosis of such patients include a good premorbid and interepisodic adjustment, a history of depressive episodes, a family history of affective disorder, and a favorable response to a therapeutic trial on lithium carbonate.
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PMID:Rediagnosis of schizophrenia as bipolar affective illness. 62 Sep 97

One hundred ninety cases of lithium carbonate use in children and adolescents are reviewed and divided by the authors according to DSM-II criteria into major affective disorders, behavior disorders of childhood and adolescence, and schizophrenia, childhood type. Of these 190 cases, only 46 cases were described in detail. In this group of 25 males and 21 females, aged 3 to 19, there were 30 positive responses to lithium carbonate. A family history of diagnosed manic-depressive illness was reported in only eight cases, while 19 had a family history of other psychiatric disorders. We were impressed by the affective component, irrespective of diagnosis, in youngsters responding to lithium carbonate and by the use of the drug despite multiple neurological problems. Thirty cases had positive neurological findings. Nevertheless, the many incompletely reported cases prevent conclusive generalization and demonstrate the need for well-documented studies correlating clinical, familial, and biochemical indices.
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PMID:Lithium carbonate use in children and adolescents. A survey of the literature. 62 8

The classification of functional psychoses has traditionally been dichotomous with schizophrenia and manic-depressive disorder, which are considered separate entities. However, the psychiatric literature is replete with descriptions of psychoses with mixed features. A variety of names has been applied to these psychoses, including the term "schizo-affective." Confusion exists regarding the nature of these psychoses, much of it resulting from a tendency to limit investigation to an acute view of symptom complexes. This article examines the schizo-affective states across a variety of dimensions, including the acute symptomatologic picture, response to lithium carbonate therapy, follow-up studies, family history, and genetics. While the term "schizo-affective," as commonly used, probably describes a heterogeneous group of psychoses, considerable evidence supports the hypothesis that at least a subgroup of these psychoses has a definite relationship to the major affective disorders.
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PMID:Schizo-affective psychosis: fact or fiction? A survey of the literature. 78 71

It has recently been suggested that patients with mania are often misdiagnosed as having schizophrenia. The authors report a favorable clinical response to lithium carbonate in a father and son with an apparent schizo-affective syndromes may respond favorably to lithium but caution that a favorable response in such cases does not absolutely confirm a diagnosis of mania.
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PMID:A favorable response to lithium carbonate in a "schizo-affective" father and son. 93 74

The authors undertook a chart review to examine the use of the diagnosis of schizophrenia, schizo-affective type, in clinical practice. Of 27 patients given this diagnosis over a 3-year period, 13 were found to have evidence of bipolar course in their illnesses. For both the bipolar and unipolar groups, the most striking finding in first-degree relatives was the prominence of affective conditions. The bipolar group had a statistically significant earlier age for first psychiatric treatment and previous number of hospitalizations. Symptoms noted on admission were mostly affective, and the schizophrenic symptoms reported were noted by authors to be considered overinclusive or unreliable by many clinicians. Both groups received treatment with antipsychotic and antidepressant medication. Six of 13 bipolar patients and no unipolar patients were treated with lithium carbonate. Five bipolar patients met research criteria of Feighner et al. (1972) for primary affective illness and another met the criteria for schizophreniform illness. One unipolar patient met criteria for probable primary affective illness and another met the criteria for probable schizophreniform illness. The authors concluded that the diagnosis of schizo-affective illness, as used in day to day clinical practice, does not identify a group of schizophrenic patients nor a homogeneous patient group, and when both affective and schizophrenic features appear in a patient with a bipolar illness, the diagnosis of manic-depressive illness, not schizophrenia, should be given first consideration.
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PMID:Bipolar course in schizo-affective illness. 97 45

To choose differentiated therapy, 62 patients suffering from refractory schizophrenia were administered bromocriptine in a dose of 7.5-15 mg/day after they had been placed on placebo. According to the bromocriptine test, the treatment was changed in 53 patients. After the occurrence of the picture of hallucinatory stupor remission was attained with the aid of less doses of neuroleptics given before. In patients who responded to bromocriptine by anxious excitation, the health status noticeably improved after administration of anxiolytics and lithium carbonate. Those patients in whom bromocriptine eliminated psychosis were treated later with the drugs belonging to the group of monosubstituted benzamides.
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PMID:[The use of the bromocriptine test in schizophrenia patients resistant to neuroleptic therapy]. 135 22

The value of lithium carbonate as an adjunctive treatment of resistant schizophrenia was tested in a 4-week clinical trial using a single-blind, randomized, consent design. Treatment and control groups were drawn from a population of detained patients in an English special (maximum security) hospital. The 2 groups were comparable in terms of age, sex, severity of symptoms, length of hospitalization and concurrent neuroleptic dosage. The addition of lithium carbonate to the treatment regimen did not result in symptomatic improvement in patients completing the treatment protocol. The ethical and practical difficulties raised by the trial are discussed.
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PMID:Lithium carbonate in chronic schizophrenia--a brief trial of lithium carbonate added to neuroleptics for treatment of resistant schizophrenic patients. 168 94

The immune system is proposed as the key to understanding the etiology and treatment of psychosocial disease. There is a dense communication network between the immune system and the central nervous system (CNS). Immune cell cytokines, via direct action on the CNS, induce fever, alter sleep, pain perception and pituitary hormone release and reduce appetite and activity in animals. Interleukin-2 and interferon given to humans result in global behavioral and cognitive pathology. Activation of the immune system by pathogens produces global cognitive and behavioral pathology also. Recently, controlled trials have demonstrated that diet can cause psychosocial disease, presumably by an immune mechanism. Immune system abnormalities have been identified in manic-depressive psychosis, schizophrenia and alcoholism. Lithium carbonate is not only prophylactic for all three of these diseases, but it also powerfully stimulates the immune system. This is proposed as the mechanism of lithium's therapeutic effect. The antipsychotics, haloperidol and the phenothiazines, affect the immune system also. The rapid development of AIDS dementia complex can be explained by the remarkable influence the immune system has on the CNS.
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PMID:The immune system is a key factor in the etiology of psychosocial disease. 205 27


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