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Query: UMLS:C0085632 (apathy)
 4,089 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

We analyzed the association of clinical findings with impaired functional status, i.e., activities of daily living (ADLs), in a sample of 240 patients diagnosed with Alzheimer's disease by NINCDS/ADRDA or DSM-III-R criteria. Logistic regression models were used to determine independent predictors of both the number of ADL impairments and number of ADL impairments characterized as moderate to severe. Two psychiatric problems, behavioral disorders and apathy, as well as a history of hypertension were significantly associated with ADL impairment independent of age, sex, race, and cognitive impairment. Behavioral disorders and apathy were also significantly associated with moderate to severe ADL impairment, but hypertension was not significant at this level.
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PMID:Functional status and clinical findings in patients with Alzheimer's disease. 143 Aug 52

Regional cerebral blood flow (rCBF) during the resting state was measured using the 133Xe inhalation technique in 39 patients diagnosed as having schizophrenic disorder according to the DSM-III criteria and 30 age- and sex-matched healthy volunteers. All the patients were receiving neuroleptic medication. The bilateral hemispheric mean flow values in the schizophrenic patients decreased significantly and the relative flow distribution reduced significantly only in the left frontal region compared to the controls. The lower the left frontal blood flow in schizophrenics, the more pronounced were the negative symptoms including blunted affect, avolition-apathy and inattention. These results suggest that the negative symptoms in schizophrenics are related to left frontal lobe dysfunction.
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PMID:Left hypofrontality correlates with blunted affect in schizophrenia. 148 49

The basal ganglia are recognized as putative mediators of certain cognitive and behavioral symptoms of major depression. Moreover, patients with basal ganglia lesions have repeatedly exhibited significant affective symptomatology, including apathy, depressive mood, and psychosis. Using high resolution, axial T2 intermediate magnetic resonance images, and a systematic sampling stereologic method, we assessed putamen nuclei volumes in 41 patients with major depression (DSM-III) and 44 healthy volunteer controls of similar age. Depressed patients had significantly smaller putamen nuclei compared with controls. Age was negatively correlated with putamen size in both groups. These results are the first demonstration of diminished putamen volumes in depression and further support a role for basal ganglia structures in the etiopathogenesis of depression.
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PMID:A magnetic resonance imaging study of putamen nuclei in major depression. 176 44

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

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

The frequencies of 15 self-reported symptoms of cocaine withdrawal were compared in 75 subjects to the symptoms listed as criteria by DSM-III and DSM-III-R for either amphetamine or cocaine withdrawal. Three of the four most frequently reported symptoms, depression (75%), sleep disturbance (71%), and fatigue (69%), corresponded to DSM-III and DSM-III-R criteria. The only other DSM-III symptom, increased dreaming (33%), was infrequently reported, lending support to its deletion by DSM-III-R. Physical withdrawal symptoms, which are generally unappreciated in cocaine withdrawal, were reported by 64% of the sample. Neither the DSM-III criteria nor the new DSM-III-R criteria include other frequent symptoms which might contribute to relapse and impaired functioning, such as craving (69%), apathy/amotivation (67%), and restlessness (64%). Thus, these criteria may be too narrowly defined for treatment purposes.
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PMID:A comparison of self-reported symptoms and DSM-III-R criteria for cocaine withdrawal. 318 56

The diagnostic criteria for schizophrenia have been extensively changed by the third edition of the Diagnostic and Statistical Manual of Mental Disorders, recently adopted by the American Psychiatric Association (DSM III). To receive this diagnosis, the patient must have onset of illness before age 45 years, have had a chronic course, manifest the presence of characteristic symptoms, such as delusions, hallucinations, or loose associations during a phase of the illness, and have experienced a downhill social and vocational course; affective disorders and organic brain syndrome must be carefully excluded. The utilization of this "narrow" definition has caused a major shift toward increasing the diagnosis of affective disorders and decreasing the diagnosis of schizophrenia in the United States. The etiology of schizophrenia is still uncertain, but recent research has elucidated one subgroup of schizophrenic patients who have subtle indices of neurological damage and a clinical course similar to that found in dementia. Dopamine excess in the mesolimbic system is the predominant inferred cause for the majority of schizophrenia cases, and antipsychotic medications all rely on dopamine receptor blockade for their efficacy. Antipsychotic medications are effective in schizophrenia but are less potent against such negative symptoms as apathy, neglect of personal hygiene, and social withdrawal.
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PMID:Schizophrenia. 613 80

The psychiatric manifestations of Huntington's Disease (HD) include dementia, irritability and apathy, a major affective syndrome, and hallucinosis. The theoretical and practical utility of chorea as a focus of research interest in HD is questioned, whereas the data reviewed suggest that assessments of cognition, functional capacity and motor impairment are better correlated neuropathologically, and are better indicators of disease severity and progress than chorea. The high incidence of major affective disorders on modified DSM III criteria among HD patients (41 per cent) may be explained either as a manifestation of genetic heterogeneity within the HD phenotype or on the basis of genetic linkage between HD and manic depressive illness (MDI). This is supported by the high coincidence of HD and MDI (20 out of 23) among secondary cases of HD ascertained through probands having both disorders, indicating a strong familial clustering of the association. This implies that a young adult at risk for HD who has had episodes of severe depression has considerably more than 50 per cent likelihood of progressing to manifest HD. Although auditory hallucinations appear occasionally in patients with HD, most do not meet current criteria for schizophrenia.
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PMID:Psychiatric features of Huntington's disease: recent approaches and findings. 623 7

The case report discussed here presents the evolution of a conversion disorder (urinary retention) in response to a decision to terminate a pregnancy. According to the "Diagnostic and Statistical Manual of Mental Disorders" (DSM 3), the following are the current criteria for a diagnosis of conversion (psychogenic pain): the predominant disturbance is a loss of or alteration in physical functioning suggesting a physical disorder; psychological factors are judged to be etiologically involved as evidenced by 1 of the following--a temporal relationship exists between an environmental stimulus that apparently related to a psychological conflict or need and the initiation or exacerbation of the symptom, the symptom enables the individual to get support from the environment that otherwise might not be forthcoming, and the symptom enables the individual to avoid some noxious activity; it has been determined that the symptom is not under voluntary control; and the symptom cannot be explained by a known physical disorder or pathophysiologic mechanism. A 25-year old single white woman (para 0, gravida 1) was hospitalized for termination of pregnancy at 22 weeks of gestation. The patient told her physician that she did not know she was pregnant. The operative procedure was uncomplicated, and the patient was discharged. 5 days later she presented to the emergency room with the complaint that she was unable to void. Following catheterization, which recovered 800 mL of urine, the patient returned home. Within 24 hours she again complained of an inability to void. Admission to the gynecological service resulted in a 16-day stay involving a continued inability to void requiring repeated catheterizations. Psychiatric consultation revealed marked immaturity, an inappropriately labile affect, and indifference to her symptoms. A history of occasional substance abuse was elicited. Upon transfer to the psychiatric inpatient service, the patient began to void spontaneously. The reported incidence of psychiatric sequelae after therapeutic or legal abortion is low, but the degree of preabortion emotional difficulty appears in direct proportion to the incidence of postabortion behavioral complications. The selection of a target organ for conversion is often based upon its ability to achieve symbolic representation. In the case presented the anatomic proximity of the bladder and uterus is cogent with the Freudian concent of somatic compliance whereby a previous somatic injury or disease may dictate the conversion focus by reactivation of the original event.
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PMID:Conversion disorder following termination of pregnancy. 684 39

A factor-analytic study of parent ratings of 253 male and female adolescents between the ages of 13 and 17 referred for psychiatric and delinquent problems is reported. Parents rated their children on the Adolescent Form of the Louisville Behavior Checklist. One hundred thirty-seven items were intercorrelated and subjected to a principal component factor analysis and nine factors wre rotated to varimax solution. The nine factors were named: Egocentric-Exploitive, Destructive-Assaultive, Social Delinquency, Academic Disability, Adolescent Turmoil, Apathetic Isolation, Neuroticism, Dependent-Inhibited, and Neurological or Psychotic Abnormality. A second-order analysis revealed two broad-band Internalizing and Externalizing dimensions. The factors were shown to be similar to but different from DSM III categories as well as from other factor-analytic studies of adolescents. This study indicates that much research will be required before a consensus can be reached on the basic dimensions of psychopathology of adolescence.
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PMID:Dimensions of adolescent psychopathology. 740 Apr 63


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