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

18 RDC-diagnosed schizophrenic patients (11 men, 7 women) were compared to 84 normal men with three computerized neuropsychological methods, assumed to reflect lateralized and frontal cortical functions: (1) Bilateral Finger Tapping and Finger Alternation, (2) Bilateral Trail Making, and (3) passively perceived Necker cube reversals. Schizophrenics differed from normals by (1) inferior Tapping/Alternation but only in the right hand, (2) inferior Trail Making, most pronounced for Form B, and (3) lower frequency of Necker cube reversals. Patients with previous neuroleptic medication and prior psychiatric hospitalizations were inferior in Trail Making and had fewer Necker cube reversals. The findings were interpreted in line with recent models of schizophrenia involving a left-hemisphere dysfunction/over-activation and a frontal dysfunction.
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PMID:Regional cortical dysfunction in schizophrenic patients studied by computerized neuropsychological methods. 406 13

Case histories were reviewed of 25 patients with RDC diagnoses of schizophrenia or schizoaffective disorder who developed a clinical syndrome of depression subsequent to the resolution of their psychotic episodes. Of these patients, 14 were then treated with imipramine and 11 with amitriptyline in addition to their neuroleptic drugs. As a group, the patients did well--48% had a remission of depressive symptoms and an additional 32% improved. Psychotic exacerbation was noted in only one patient. Imipramine seemed more beneficial than amitriptyline in these patients.
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PMID:Response of postpsychotic depression to adjunctive imipramine or amitriptyline. 613 Oct 64

The dexamethasone suppression test (DST) brought to light significantly more non-suppression of cortisol secretion in RDC schizoaffectives of the depressed (89%) and of the manic type (67%) than in RDC schizophrenia (25%). However, only in the RDC endogenous depressives, whose pathological DST rate was 57%, was the thyroid stimulating hormone (TSH) response to thyrotrophin releasing hormone (TRH) found to be significantly "blunted". It is suggested that the DST results can be interpreted as partially validating DSM-III's wide major affective disorder since this concept also encompasses all cases with mood-incongruent psychotic features. Furthermore, it is hypothesized that the coupling of DST non-suppression and TSH "blunting" may be important for defining a valid depressive subgroup within these extended clinical boundaries for affective illness.
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PMID:The dexamethasone suppression test and thyroid stimulating hormone response to TRH in RDC schizoaffective patients. 644 14

In a study of 20 inpatients who met DSM-III criteria for schizophrenia, there was a high incidence of depressed mood (N = 14), DSM-III melancholia (N = 6) and dexamethasone nonsuppression (N = 7). This incidence of positive DSTs (serum cortisol greater than 5 micrograms/dl at 3:30 or 10:00) was significantly higher than the expected rate based on a literature review (35% vs. 4%, p less than .001). A positive DST did not result in all cases in antidepressant pharmacotherapy, nor did a negative result preclude such treatment. Hence, clinicians in the study did not "treat the DST" in the absence of clinical evidence of depression. This study is consistent with others reporting a significant proportion of depressed schizophrenics. However, some studies have claimed no differences in response to dexamethasone between nondepressed and schizophrenic patients. These findings do not support a biological basis for the RDC differentiation of primary and secondary depression and challenge the DSM-III concept of schizophrenia as excluding the diagnosis of major depression. Viewed from a different perspective, the data may support recent reports casting doubt on the specificity of the DST.
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PMID:The dexamethasone suppression test in schizophrenia. 646 27

In addition to genetic findings and treatment response, the course prognosis is also meant to be a possible validating criterion for diagnosis and diagnostic systems. In our study we used the polydiagnostic approach (i.e. the simultaneous application of various criteria for diagnosing a given disorder to one and the same population) to test the ability of several diagnostic systems to create homogeneous groups regarding the course (episodic/chronic). We applied Schneider's FRS, ICD-9, DSM-III, Spitzer's RDC and the Vienna Research Criteria to 90 patients with the diagnosis of delusional syndrome (aside from any nosological classification), who underwent 6-9 years of follow-up. At the index examination, schizophrenia was most frequently diagnosed with Schneider's FRS, which apparently encompasses a very heterogeneous group of patients regarding psychopathology and course. Diagnostic systems which allowed the diagnosis of affective disorders despite the presence of mood-incongruent delusional symptomatology (DSM-III, RDC, Vienna Criteria) or offered the diagnosis of schizoaffective disorder (DSM-III, RDC) succeeded in separating subgroups with an episodic course on a statistically significant level. In ICD-9 this significance appeared only after exclusion of the schizoaffective cases from the group of schizophrenias. Our data thus uphold the old rule of thumb that affective symptomatology apparently has a very high prognostic value regarding the course of the illness and is in this respect superior to productive symptomatology (such as delusions and hallucinations), still taken to be pathognomonic for schizophrenia by some of the diagnostic criteria under study. This aspect warrants further investigation and should be taken into account in the development and improvement of diagnostic manuals (e.g. ICD-10, DSM-IV).
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PMID:Heterogeneity of delusional syndromes: diagnostic criteria and course prognosis. 653 44

To explore the possible role of serotonin (5-HT) in the etiology of schizophrenia, platelet 5-HT concentrations were determined in 41 schizophrenic (and schizoaffective, mainly schizophrenic) patients diagnosed by the RDC and 34 normal controls. There was a significant difference between the patient and control groups with the 16 paranoid, 11 undifferentiated, and 8 schizo-affective depressed patients having significantly higher mean platelet 5-HT concentrations than the controls. An analysis of variance considering the effect of race, sex, and diagnosis demonstrated a significant difference between black patients and black controls but no significant difference between white patients and white controls. Within the patient sample, platelet 5-HT concentrations were positively correlated with severity of auditory hallucinations (on the PSE) and negatively correlated with lack of insight (on the PSE) and conceptual disorganization (on the BPRS). In a subsample of 21 patients, there was no relationship between platelet 5-HT and CT findings of either enlarged ventricles or cortical atrophy.
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PMID:Platelet serotonin levels in schizophrenia: relationship to race and psychopathology. 661 45

Most recent research has failed to demonstrate that first-rank symptoms (FRS), globally or individually, have any ability to predict outcome. yet, some findings have suggested that misidentification of person (Personenverkennung) and/or thought insertion and/or made impulses on the one hand, and voices commenting on the other, might be associated with a good and a poor prognosis, respectively, in schizophrenia. In the present study, FRS, weighted with respect to prognosis on the basis of this hypothesis, were used to arbitrarily set up subsamples of RDC schizo-affective disorders in terms of several predicted outcome categories. However, no differences came to light between various RDC schizo-affective groupings defined in this way with respect to total outcome mean scores. In contrast, however, a significant difference on this prognostic measure was found when RDC schizo-affective probands with any type of FRS were compared with those lacking FRS, the latter group having the lower or better outcome score.
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PMID:Prognostic prediction in RDC schizo-affective disorder on the basis of first-rank symptoms weighted in terms of outcome. 662 28

A total of 368 clinical diagnoses were given to 298 patients hospitalized in two Swiss psychiatric institutions during the years 1960-1981. Clinical charts of these patients were scrutinized and all patients were diagnosed anew using the Research Diagnostic Criteria. The clinical diagnoses, strongly influenced by Bleuler and expressed in ICD-9 nomenclature, as well as the diagnoses obtained with the help of RDC, were compared with each other. Considerable differences were found regarding the diagnostic agreement in different diagnostic categories investigated. The most important finding of the study is a tendency to overdiagnose schizophrenic disorders clinically to the disadvantage of affective - mainly depressive - disorders and to overvalue the schizophrenic as compared with the affective - first of all depressive - symptomatology, respectively. This finding may have practical therapeutic consequences.
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PMID:Clinical diagnostic practice reviewed. A comparison of clinical and RDC diagnoses. 672 3

A group of 759 patients with final DSM-I and -II diagnoses of schizophrenia was identified among a cohort of 1494 adults who were hospitalized between 1965 and 1972. Admission EEG recordings were done in each patient during waking, activation procedures, drowsiness, and sleep. All cases were reclassified according to the Feighner et al. criteria, and relationships between the EEG, reassigned diagnosis, and outcome were examined. One-third of the schizophrenics were rediagnosed as having affective, organic, or other disorders. EEG abnormalities predicted diagnostic change and relatively favorable prognosis. Mean alpha frequencies were slower in schizophrenics than in patients with other DSM I-II disorders, and less in patients with Feighner et al. diagnoses of schizophrenia than in some rediagnosed categories. In 1980-82, matched samples from the original cohort with affective, schizophrenic, and mixed Feighner et al. diagnoses were followed and evaluated blindly with the SADS-L. RDC follow-up diagnoses were significantly correlated with the index EEG findings in terms of higher alpha average frequencies proportional to the amount of affective psychopathology. A subgroup of high functioning individuals within the RDC schizophrenic category was identified with affective symptomatology early in the course of illness, normal EEGs, and high alpha average frequencies. Patients with a consistent diagnosis of schizophrenia according to the three nosologic systems were shown to function better in some areas if the index EEG was abnormal. Discriminant function analysis established that DSM-I and -II categories possessed the greatest long-term predictive accuracy which was enhanced by the EEG diagnosis and alpha average to a level of more than 50%. The Feighner et al. and RDC diagnostic systems were not as relevant for prediction of long-term follow-up status.
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PMID:Electroencephalographic findings in relation to diagnostic constructs in psychiatry. 673 70

The authors interviewed 17 adolescent inpatients and their mothers with the Schedule for Affective Disorders and Schizophrenia for School-Aged Children and Adolescents, Epidemiological Version (K-SADS-E), a semistructured interview that generates RDC and DSM-III diagnoses for major affective disorders and nonaffective psychoses and DSM-III diagnoses for dysthymic, cyclothymic, and other selected disorders. Five of the patients (29%) satisfied DSM-III criteria for bipolar disorder or atypical bipolar (bipolar II) disorder, although these diagnoses had not been identified in the hospital charts. These data support previous findings that bipolar disorder occurs moderately frequently in adolescent inpatients, although it is often unrecognized. Moreover, the disorder can be readily identified with structured diagnostic methods.
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PMID:Use of a structured diagnostic interview to identify bipolar disorder in adolescent inpatients: frequency and manifestations of the disorder. 684 81


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