Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0085632 (apathy)
 4,089 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Comorbid alcohol use disorders are common in schizophrenia. Although a variety of explanatory hypotheses involving self-medication have been proposed, few data available regarding schizophrenic patients' subjective experiences while using alcohol. We report interview data from 75 DSM-III-R schizophrenic outpatients regarding their subjective responses to alcohol. Over half of our sample reported that alcohol improved social anxiety, tension, dysphoria, apathy, anhedonia, and sleep difficulties. Other nonpsychotic experiences were frequently improved as well. In contrast, no more than 15% of subjects reported that alcohol relieved any specific psychotic symptom; similar proportions of subjects reported that alcohol aggravated psychotic symptoms. Reporting that alcohol had a positive effect on nonpsychotic experiences was associated with having lifetime alcohol use disorders. Reporting that alcohol relieved psychotic symptoms was associated both with having lifetime alcohol use disorders and with the number of psychotic symptoms reported. We discuss the implications of these findings for understanding alcohol abuse and dependence among schizophrenics.
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PMID:Subjective experiences related to alcohol use among schizophrenics. 155 69

In order to clarify the characteristic psychopathology of chronic methamphetamine (MAP) psychosis, the clinical symptoms of 11 chronic MAP psychotics were compared with those of the same number of chronic schizophrenics matched for sex and age. The positive symptoms were almost similar in both groups. However, the negative symptoms evaluated by the Scale for the Assessment of Negative Symptoms (SANS) differed considerably. According to the SANS, the scores of avolition-apathy, anhedonia-asociality and attentional impairment were moderately high in both groups. The scores of affective flattening or blunting and alogia were lower in the MAP group than those in the schizophrenia group. The SANS scores of negative symptoms increased in accordance with the age of onset in the MAP group, while such a correlation was not observed in the schizophrenia group. Furthermore, detailed clinical observations of the patients revealed the following differences between the two groups: 1) spontaneous affective expression during the interviews was more vivid in the MAP group compared to the schizophrenia group, and 2) affective expressions or interpersonal behaviors changed immediately depending on the situation in the MAP group. From the viewpoint of clinical psychopathology, a group of MAP psychotics whose hallucinatory-delusional state persisted for a long period of one month or more after cessation of MAP use seemed to differ from either chronic schizophrenics or patients with acute MAP psychosis. The author proposed that this group of patients should be a clinical entity and be called as "residual methamphetamine psychosis."
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PMID:Chronic schizophrenia-like states in methamphetamine psychosis. 207 12

The positive and negative symptoms were analyzed in 115 schizophrenic patients (DSM-III-R criteria) through correlative and factorial analyses, in order to test the positive-negative hypothesis of schizophrenia. The intercorrelative analysis showed high intercorrelations between negative, but low or no correlations between positive symptoms (excepting delusions with hallucinations), which implies that the group of positive symptoms may represent more than one type of symptom complex. This results were confirmed by factorial analysis which identified three distinct clusters of symptoms: the negative syndrome (affective flattening, alogia, abolition-apathy, and anhedonia-asociality), the disorganizative syndrome (positive formal thought disorder, and attentional impairment) and the positive syndrome (delusions and hallucinations). No inverse relations were observed between positive and negative syndromes. This results no support the bipolar-independence hypothesis of the positive-negative distinction in schizophrenia and they need to be confirmed through external validators.
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PMID:[Positive and negative schizophrenic symptoms: a reanalysis of the dichotomous model of schizophrenia]. 207 47

Cases of body image pathology are often misdiagnosed. Recognition of the obsessional annoyance with body image, especially with primary and secondary sex characteristics (skoptic syndrome), is important in making a differential diagnosis with other psychiatric and gender identity disorders. We have reported the successful use of lithium carbonate in treating two cases of skoptic syndrome. The initial low dosage (600 mg./day) resulted in dramatic reversal of obsessional thoughts of self-mutilization and self-castration. Increased dosages (900 mg./day) are still well below those usually used for manic-depressive illness. Our choice of lithium carbonate was prompted by our experience in successfully treating other forms of sexually related dysphorias at low doses, its ability to act rapidly, and the minimal side effects. These changes have been dramatic and lasting. In addition, there was marked lessening of dysthymia and intense anhedonia manifested by severe isolation, listlessness, and apathy. We believe that these cases are important to report in order that psychotherapists make better differential diagnoses of psychiatric disorders related to body image pathology and gender identity disorders. We also feel it is important to report a medication which was found effective in reducing the threat of self-mutilating behavior and making patients more receptive to psychotherapy. These cases increase our understanding of sexually obsessive and compulsive drives and some methods which have been found efficacious in reducing these symptoms.
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PMID:Skoptic syndrome: the treatment of an obsessional gender dysphoria with lithium carbonate and psychotherapy. 211

The influence of the D1 antagonist SCH 23390 on the motivational properties of rewarding (morphine, nicotine and diazepam) and aversive (naloxone, phencyclidine and picrotoxin) drugs was studied in the rat in a two-compartment place-conditioning paradigm, which included a pre-conditioning test for spontaneous place-preference. The specific D1 dopamine-receptor antagonist SCH 23390 (0.05 mg/kg SC), paired with both compartments or, separately, with the preferred or with the non-preferred compartment, failed to affect the spontaneous unconditioned preference of the animal. Pairing of morphine (1.0 mg/kg SC), nicotine (0.6 mg/kg SC) or diazepam (1.0 mg/kg IP) with the less preferred compartment induced significant preference for that compartment. Pairing of SCH 23390 (0.05 mg/kg SC) with both compartments completely blocked the place-preference induced by morphine, nicotine and diazepam. Naloxone (0.8 mg/kg SC), phencyclidine (2.5 mg/kg SC) or picrotoxin (2.0 mg/kg IP) paired with the preferred compartment elicited place-aversion. Pairing of SCH 23390 (0.05 mg/kg SC) with both compartments abolished also the place-aversion induced by naloxone, phencyclidine and picrotoxin. The results indicate that blockade of dopamine transmission blocks the motivational properties of rewarding as well as aversive stimuli. It is suggested that neuroleptics rather than simply blocking the rewarding impact of positive reinforcers (anhedonia, lack of pleasure) exert a more general influence on conditioned behaviour by blocking the affective impact of negative as well as positive reinforcers (apathy, lack of motivation).
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PMID:SCH 23390 blocks drug-conditioned place-preference and place-aversion: anhedonia (lack of reward) or apathy (lack of motivation) after dopamine-receptor blockade? 257 27

In an effort to investigate reports of possible benefits of trihexyphenidyl on residual schizophrenic symptoms, the drug was administered to five chronic schizophrenic patients with predominantly negative symptoms. These patients were simultaneously receiving various antipsychotic agents without extrapyramidal side effects. There was a marked improvement in four of the five patients, mainly in the areas of affective flattening, anhedonia-asociality, and avolition-apathy. Three of these four patients also reported a reduction in excessive dreaming and nightmares experienced prior to the introduction of trihexyphenidyl. Common pathogenetic mechanisms for negative schizophrenic symptoms and excessive dreaming are discussed. In view of these findings, an investigation of the therapeutic benefits of anticholinergic agents in the treatment of negative schizophrenic symptoms, and the use of decreased dreaming as a possible marker of response, is warranted.
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PMID:Treatment of negative schizophrenic symptoms with trihexyphenidyl. 337 47

The distinction between positive and negative symptoms has gained prominence in schizophrenia research, but the construct has not been unequivocally validated. The authors report preliminary findings of investigations in which symptomatic and neuropsychological assessments were conducted in a sample of 32 chronic schizophrenic inpatients. Three distinct clusters of symptoms were identified in correlative analyses. One cluster of symptoms (alogia, attentional impairment, positive formal though disorder, and bizarre behavior) appeared to reflect primarily a disorganization of though independent of current definitions of the positive/negative symptom construct. A second cluster of symptoms (affective flattening, avolition/apathy, and anhedonia) appeared to reflect predominantly blunting of affect and volition. A third cluster (delusions, hallucinations, and "breadth of psychosis") seemed to represent only the florid psychotic features. The first and (to a lesser extent) second clusters of symptoms were selectively associated with neuropsychological impairment. The patterns of neuropsychological deficits correlated with the first cluster of symptoms appeared to be consistent with a process characterized by failure in the development of a normal repertoire of cognitive abilities. It is suggested that the "defect state" may not be a monothetic construct, and that within the domain of "type II" schizophrenia, disturbances of thought may be distinguished from those of affect and motivation.
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PMID:Symptomatic and neuropsychological components of defect states. 403 4

Sixty-seven schizophrenic chronic outpatients (DSM-III-R criteria) were examined to study the relationship between symptoms through intercorrelational and factor analysis. Three factors were identified and associated with clusters of symptoms: factor 1 (affective flattening, alogia, avolition-apathy and anhedonia-asociality), factor 2 (formal thought disorder and bizarre behaviour) and factor 3 (hallucinations and delusions). Strong associations between factor 1 and high functional impairment were found. In this population, the segregation of the symptoms could fit into a three-syndrome model, these results agree with findings obtained from samples in which acute symptoms predominated.
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PMID:Analysis of positive and negative symptoms in schizophrenia. A study from a population of long-term outpatients. 748 94

Clozapine has proven to be more effective than typical antipsychotics in treatment-refractory schizophrenic patients, and some evidence suggests that it may be particularly useful in treating the negative symptoms of schizophrenia. However, it is unclear whether this observation reflects improvement in "primary" or "secondary" negative symptoms. We hypothesized that a portion of clozapine's effect on negative symptoms would be related to an improvement in positive (psychotic and disorganization) symptoms, a decrease in extrapyramidal side effects (EPSE), and/or a decrease in depressive symptoms. The remainder of its effect would be related to a direct effect on the neural circuits or pathologic processes responsible for the negative symptoms. Twenty-nine treatment-refractory schizophrenics treated with clozapine for 6 weeks were studied. The core negative symptoms measured by the Scale for the Assessment of Negative Symptoms ([SANS] affective flattening, anhedonia/asociality, avolition/apathy, and alogia) all improved with clozapine treatment. Overall, there was a 31% improvement in negative symptoms, a 32% improvement in psychotic symptoms, and a 35% improvement in disorganization. The improvement in negative symptoms was correlated with improvement in disorganization, but not with improvement in psychotic symptoms, depression, or drug-induced EPSE. Although there was a correlation between improvement in negative symptoms and improvement in disorganization, there was a suggestion that the two are changing in parallel, but are independent of each other. It appears that at least a portion of clozapine's effect on core negative symptoms is mediated through a direct effect on the underlying pathophysiology of schizophrenia associated with negative symptoms.
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PMID:Clozapine's effect on negative symptoms in treatment-refractory schizophrenics. 814 34

After 5 weeks of haloperidol, positive symptoms in drug-naive schizophrenic patients substantially subsided. Negative symptoms, although with a different temporal pattern, decreased after the fifth week of haloperidol treatment; specifically, a decrease was seen in anhedonia and affective flattening, whereas avolition-apathy and attentional impairment presented no changes. Alogia showed a decrease during the third week and a trend to return to placebo scores during weeks 4 and 5. Changes in affective flattening, alogia and attentional impairment correlated with changes in positive symptoms. During placebo, plasma homovanillic acid (HVA) correlated with negative symptoms and with changes presented by negative symptoms between the first and the fifth treatment week. These data show that negative symptoms respond differentially to neuroleptics and suggest that avolition-apathy may represent a different behavioral component of the schizophrenia process.
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PMID:Differential effects of haloperidol on negative symptoms in drug-naive schizophrenic patients: effects on plasma homovanillic acid. 846 Dec 69


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