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

The utility of the Self-Administered Alcoholism Screening Test (SAAST) in determining alcohol abuse and alcoholism was assessed in a preliminary study of 21 schizophrenic patients during their hospitalization in an acute care psychiatric unit; on admission all met DSM-III-R criteria for schizophrenia and none were detected to have any alcohol-related diagnosis. SAAST scores ranged from 2 to 26 with a mean score of 10.8. Forty-eight percent (10/21) had SAAST scores greater than or equal to 10, indicating "probable alcoholism"; 62% (13/21) scored 8 or higher. Every patient with a SAAST score of 8 or higher also met DSM-III-R criteria for alcohol abuse or dependence on the basis of patient interview, independent chart reviews, and interviews of significant others. In contrast, only half (5/10) of the high SAAST scorers would actually admit to a problem with drinking during the extensive study interviews. Six SAAST items were found to be highly predictive of abuse or alcoholism; the SAAST had greater sensitivity than the interviews. Sixty-two percent (8 of 13) of the schizophrenic patients who met the DSM-III-R criteria for alcohol abuse reported a first degree relative with an alcohol-related problem, in contrast to only 25% of the "nonalcoholic" patients. The patterns of the alcoholic schizophrenic patients' responses on the different SAAST items revealed even greater denial and lack of insight than those of nonschizophrenic alcoholic subjects.
Alcohol Clin Exp Res 1990 Oct
PMID:Utility of the Self-Administered Alcoholism Screening Test (SAAST) in schizophrenic patients. 226 97

Alcohol use disorders are common comorbid conditions in schizophrenia, and their presence is associated with poor adjustment and poor treatment response. Standard alcohol assessment instruments have not been validated for use with schizophrenic patients, and several authors have questioned the validity of these patients' self-reports. A reliable and valid screening procedure for assessing alcohol use is needed. The present study used the following three methods to evaluate a rural sample of 75 outpatients with DSM-III-R schizophrenia or schizoaffective disorder: (1) clinical records; (2) research interviews using standard alcohol assessment instruments; and (3) case managers' ratings. In addition, consensus diagnoses, determined by combining information from all three methods with intensive case reviews, were used to determine the sensitivity and specificity of the other approaches. As expected, clinical evaluations frequently missed alcohol problems. Research interviews and case managers' ratings differentiated between alcoholic and nonalcoholic schizophrenic patients and were highly correlated. Case managers' ratings, which incorporated longitudinal observations of behavior and collateral reports as well as interview data, were more sensitive measures of current alcohol use disorders than research interviews. Subjects frequently manifested alcohol-related problems that interfered with community adjustment without the full dependence syndrome, suggesting that schizophrenic patients may be particularly vulnerable to negative effects of alcohol.
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PMID:Diagnosis of alcohol use disorders in schizophrenia. 233 82

Positron emission tomography permits the study of human brain function. With a positron labelled tracer and a model for quantitation, regional brain metabolism and neuroreceptor characteristics can be determined with PET. Schizophrenia is the most extensively studied psychiatric disorder. Most studies have demonstrated decreased metabolic rates in wide areas of the brain. It is proposed that the metabolic changes observed in the brains of schizophrenic patients are due to a fundamental change in neuronal function. Fewer studies have been performed in other psychiatric disorders. Bipolar depressed patients probably have a decreased brain metabolism. Obsessive compulsive and panic disorders (if sensitive to lactate) have an increased brain metabolism. This is probably also the case for female anorectic patients. Alcohol dependent subjects with a long duration of abuse may have a decreased brain metabolism. Neuroreceptor studies with PET have in one study of psychotropic drug naive schizophrenic patients demonstrated an increase of D2-dopamine receptors. In another study no difference between controls and patients was found. Treatment of schizophrenic patients with conventional doses of neuroleptic drugs results in a D2 receptor occupancy of 65 to 85 per cent, suggesting that there is no need for high dose treatment in schizophrenic patients. The studies reviewed clearly demonstrate that PET is a valuable tool in psychiatric research.
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PMID:Positron emission tomography in psychiatry. 252 39

The mean self-reinforcement score of 62 chronic alcoholics was significantly lower than the mean score of 18 age- and sex-matched normal controls. However, both groups scored higher than the mean score of 300 normal undergraduates in a study by Heiby: low self-reinforcement scores do not seem to be unique to alcoholics. In alcoholics, the self-reinforcement scores were significantly correlated with the majority of the MMPI clinical scales: the highest coefficients were with the Social Introversion, Depression, Psychasthenia, and Schizophrenia--lower self-reinforcement level was associated with more psychopathology.
Adv Alcohol Subst Abuse 1989
PMID:Self-reinforcement scores of alcoholics. 271 15

Over a 12-month period in 1985-1986, 325 cases of deliberate self-poisoning were admitted to the Princess Alexandra Hospital in Brisbane. This survey confirms that deliberate self-poisoning remains common, accounting for 19.6% of all admissions to the intensive-care unit, and 5.4% of all medical-ward admissions. In 232 (71.4%) cases formal psychiatric consultation occurred, and some form of follow-up was organized in 227 (69.8%) cases. In the total group, the female-to-male ratio was 1.5 to one. In the 325 cases, a total of 489 substances was consumed. Benzodiazepine agents were consumed the most often (39.5% of all substances), followed by antidepressant drugs (11.7% of substances) and paracetamol (7.2% of substances). Barbiturate drugs, which previously have been shown to be prominent in deliberate self-poisoning, accounted for only 1.6% of the substances that were used in this survey. Alcohol was consumed in almost one-third (31.1%) of cases. The diagnosis of adjustment disorder with depressed mood was the most-frequent primary diagnosis (64.8% of diagnosed cases), followed by personality disorder (16.7% of diagnosed cases), schizophrenia (5.5% of diagnosed cases) and major depression (3.7% of diagnosed cases). Nearly one-half (46.8%) of all cases involved a past history of deliberate self-poisoning. Comparison of the results of this survey with those of past surveys shows that the profile of deliberate self-poisoning is changing. Barbiturate usage has declined markedly with a reciprocal increase in benzodiazepine usage. A review of the prescribing pattern of antidepressant agents in groups of individuals who are at high risk of deliberate self-poisoning is suggested in the light of the frequency of this phenomenon.
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PMID:A survey of deliberate self-poisoning. 271 41

Psychotropic agents are most helpful to opiate addicts when used to treat co-existing psychopathology. While such agents may not impact directly on the addiction itself, they might help keep patients available for rehabilitation efforts since concomitant severe psychopathology has been associated with poorer outcome. Neuroleptics for schizophrenia and lithium for manic disorders are generally agreed upon. Minor tranquilizers for anxiety and MAO inhibitors for depression may be too risky for this population. Tricyclic antidepressants clearly have a role in treating major depression in addicts but the lability of the syndrome over time argues against their routine use until the depression has persisted at least 3 months.
Adv Alcohol Subst Abuse
PMID:The use of psychotropic drugs in the treatment of compulsive opiate abusers: the rationale for their use. 287 Jun 23

Recent advances in brain imaging have allowed a regional examination of brain function using multiple-probe inert gas studies of cerebral blood flow, positron or single photon tomography. Inert gas blood flow methods using inhalation or injection of 133xenon have been used with multiple-probe systems to measure blood flow in 1 to 2 cm regions of lateral cortex. The sensitivity of these systems to neurophysiological stimuli and neurological diseases have been demonstrated in numerous studies of the normal resting state, memory and learning, motor activity and sensory input, dementia, and aphasia, to name some. Positron tomography utilizes cyclotron-produced, short-lived positron-emitting isotopes to label biologically active radiopharmaceuticals. Using positron tomographs capable of quantitative three-dimensional imaging and appropriate tracer-kinetic models, regional metabolic function, including glucose, oxygen, amino acid metabolism, and receptor-binding can be regionally studied throughout the brain. Clinical studies have been performed in dementia, schizophrenia, affective disorders, resting states, and sensory stimulation. Positron tomography offers potentially the greatest variety of studies and highest temporal and spatial resolution of any of the presently available functional brain-imaging modalities. Its principal drawback is the very high cost. Single photon tomography uses gamma-emitting isotopes such as 123iodine and 133xenon to image regional cerebral blood flow and recently receptor function. Although at present it does not have the variety of studies or the technical capabilities of positron tomography, it does provide three-dimensional studies with 1 to 2 cm resolutions throughout the brain at a considerably lower cost than positron tomography. In the future, magnetic resonance studies of blood flow or phosphorus metabolism may add a fourth modality.
Recent Dev Alcohol 1985
PMID:Functional brain imaging. 298 79

Forty alcoholic inpatient men were used to evaluate the test-retest reliability and the validity of a new structured diagnostic interview. The Alcohol Research Center (ARC) Intake Interview was constructed from the Schedule of Affective Disorders and Schizophrenia (SADS) parts I and II and from the Diagnostic Interview Schedule family history section by extracting information on diagnoses most likely to be seen in alcoholic patients and by expanding the data set with questions relevant to alcohol and drug use. The test-retest reliability for patients' primary and secondary diagnoses included a kappa of 1.00 for the comparison of interviewers A and B (100% agreement) and of .76 for interviewers A and C. The validity of ARC Intake Interview patient diagnoses as compared to the SADS demonstrated an overall agreement between 91 and 100%. Reliabilities for labeling of families as positive or negative for specific illness in any first-degree relatives revealed a kappa of 1.00; validities on family diagnoses ranged from 77 to 100%, with the ARC Intake Interview identifying more illness in families than the SADS. Although further evaluation of the ARC Intake Interview is needed, this instrument is recommended to investigators attempting to evaluate the clinical course and treatment needs among alcoholics, especially those patients presenting with multiple diagnoses.
J Stud Alcohol 1988 Jan
PMID:A structured diagnostic interview for identification of primary alcoholism: a preliminary evaluation. 334 82

The study population consisted of 1010 in patients and 81 control subjects. Patients suffering from schizophrenia, cerebral atrophy of unknown origin, dementia, depression, mental retardation, and ethanol-induced brain deterioration (alcoholics) were skin tested with 25 micrograms of S-100 protein and neuron-specific enolase isolated from fresh human brain. Evaluation of delayed skin hypersensitivity reactions at 24 hr revealed a high incidence of positive responses to S-100 protein: heavy alcoholism, 96.8%; depression, 94.1%; cerebral atrophy, 92.6%; dementia, 91.2%; schizophrenia, 87.7%; and mental retardation, 69.4%. The incidence of positive reactions to neuron-specific enolase in schizophrenics was 91.6%. Of 58 control subjects tested with S-100 protein, 6.8% were positive, whereas of 23 normal individuals tested with neuron-specific enolase, 6.4% developed mild skin reactions. These data suggest a close relationship between delayed hypersensitivity to neural tissue antigens and immunopsychiatric diseases, and they imply that cell-mediated immune mechanisms are involved in the pathogenesis of certain mental disorders.
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PMID:Neural tissue hypersensitivity in psychiatric disorders with immunologic features. 400 35

A group of 48 inpatient alcoholics were studied using the Schedule for Affective Disorders and Schizophrenia--Life-time Version (SADS-L) and the Brief Standard Self-rating for Phobic Patients. Approximately one-quarter of the patients were diagnosed as suffering from agoraphobia and social and mixed phobias. Approximately 44% were diagnosed as suffering from anxiety disorders and 46% had suffered from an episode of major depression. Data from the self-rating questionnaire were consistent with the diagnostic data. The alcoholics with phobias had experienced more severe dysphoric feelings than nonphobic alcoholics with other psychiatric disorders.
Alcohol Clin Exp Res
PMID:Alcoholism, anxiety disorders, and agoraphobia. 637 23


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