Search PubMed⌕ Search

Biomedical subjects

J de Leon

Publications and source records attributed to J de Leon.

At least 55 records · Page 3Linked to original sources
PubMed1995

Oral tardive dyskinesia: validation of a measuring device using digital image processing.

The present study was performed to investigate the reliability and validity of a new device for the assessment of oral dyskinesias by means of digital image processing. Twenty schizophrenic patients with tardive dyskinesia (TD) and ten healthy controls were studied. In patients instrumental scores were compared to different clinical rating scale scores. Measurements were repeated after 2 weeks under the same circumstances to assess test-retest stability. Instrumental scores discriminated well between normal subjects and dyskinetic patients and correlated significantly with clinical ratings (r = 0.63). The test-retest correlations showed a correspondence not larger than 40%, detecting thus the fluctuation of the TD intensity over time. These results suggest that our device is a reliable and easy to handle technique for the assessment of TD. Furthermore, the ability of the device to analyze the frequency distribution of movements makes it a useful tool for the quantitative and qualitative analysis of TD.

Adult↗
PubMed1995

Treatment of polydipsia and hyponatremia in psychiatric patients. Can clozapine be a new option?

Polydipsia occurs frequently in chronic schizophrenic patients, some of whom develop intermittent hyponatremia. Most therapeutic efforts have tried to control the hyponatremia. Four schizophrenic patients, followed for more than one year, showed improvement on clozapine. Case 1 was an outpatient without history of hyponatremia who improved from polydipsia and psychosis. The last three were inpatients with polydipsia, intermittent hyponatremia, and psychosis who showed minimal improvement of psychosis but significant decrease in polydipsia and water intoxication. Case 2 relapsed to polydipsia when clozapine was discontinued on two occasions. Case 3 demonstrated polyuria during 39% of days before clozapine and in 0% of days after two weeks of clozapine. In case 4, most baseline sodium levels were abnormal, but all became normal after clozapine. A time-series analysis for intervention effects showed a significant effect of clozapine (p = .017). The limited information provided by these case reports suggest the need for controlled studies of the clozapine effect on polydipsic patients.

Adult↗
PubMed1995

Positive and negative symptoms/syndromes in schizophrenia: reliability and validity of different diagnostic systems.

The paper explores the reliability, concurrent validity and overlap of some positive/negative symptom rating scales and typological criteria in 100 schizophrenic patients. Rating scales include Andreasen's Scales for the Assessment of Positive and Negative Symptoms, Abrams and Taylor's Scale for Emotional Blunting, and Kay's Positive and Negative Syndrome Scale. Criteria for categorizing individual patients include Andreasen's and Kay's criteria for positive and negative types of schizophrenia as well as Carpenter's criteria for the deficit syndrome. The correlations among positive as well as among negative scales were high. The agreement among criteria tended to be lower. Both positive scales showed low internal consistency. Kay's negative scale had the greatest internal consistency, which suggests that it is measuring a homogeneous syndrome. All negative symptom scales and categorical syndromes identified a group of patients who were single and exhibited schizoid or schizotypal pre-morbid personality disorders, poor premorbid sexual/social adjustment, poor response to neuroleptics and poor prognosis.

Adolescent↗
PubMed1995

Schizophrenia and smoking: an epidemiological survey in a state hospital.

OBJECTIVE: The authors sought to determine whether smoking is related to schizophrenia or neuroleptic treatment. METHOD: Cigarette smoking was measured in all patients hospitalized at a state hospital (N = 360) and compared in relation to gender and diagnosis (schizophrenic versus nonschizophrenic). RESULTS: The overall frequency of smoking was 79% (N = 284). Male schizophrenic patients had the highest frequency of smoking, followed by male nonschizophrenic patients, female schizophrenic patients, and female nonschizophrenic patients, respectively. Schizophrenia and polydipsia were associated with both smoking and heavy smoking. CONCLUSIONS: After correction for other variables, schizophrenia appears to increase the risk of being both a smoker and a heavy smoker. There was a possible association between high doses of neuroleptics and smoking but only for nonschizophrenic patients.

Adult↗
PubMed1995

Is poor insight in psychotic disorders associated with poor performance on the Wisconsin Card Sorting Test?

OBJECTIVE: The purpose of this study was to test whether poor insight in patients with psychotic disorders is correlated with their performance on the Wisconsin Card Sorting Test. METHOD: The subjects included 52 psychotic patients (35 of whom had schizophrenia) given diagnoses according to DSM-III-R criteria. Their scores on the Wisconsin Card Sorting Test (number of categories and perseverative responses) were compared with those on three items measuring poor insight: lack of feeling ill, lack of insight, and uncooperativeness. RESULTS: None of the six correlations between scores on the two measures of the neuropsychological test and the three items measuring insight was significant. CONCLUSIONS: In spite of its limitations, this study suggests that poor insight may not be associated with poor performance on the Wisconsin Card Sorting Test.

Adult↗
PubMed1995

Misidentification syndromes in schizophrenia: case reviews with implications for classification and prevalence.

Misidentification syndromes represent false, delusionally-based identification of self and/or others. These are variants of the Capgras Syndrome. Although the frequency of misidentification syndromes in schizophrenic populations has not yet been established, the authors believe this syndrome is more prevalent than previously described. Seven of twenty-five (28%) consecutive patients admitted to a chronic clozapine unit with a variant of misidentification syndrome will be described. Their symptoms are categorised according to traditional classification, and Silva's proposed nomenclature. Problems inherent in these classifications are discussed. The need for a more systematic classification of misidentification syndromes is emphasised. Longitudinal studies of misidentification syndrome, and the development of a standardised assessment tool for clinicians who treat chronically psychotic patients, are encouraged.

Adult↗
PubMed1994

An empirical analysis of latent structures underlying schizophrenic symptoms: a four-syndrome model.

Various models of schizophrenia have postulated two syndromes (i.e., positive and negative), although other exploratory factor analyses have suggested a disorganization syndrome. We conducted a confirmatory factor analysis (CFA) on Schedule for the Assessment of Positive Symptoms (SAPS) and Schedule for the Assessment of Negative Symptoms (SANS) items and subscales to assess the latent structure of symptoms reflecting underlying pathological processes. The sample included 253 DSM-IIIR schizophrenic inpatients. Fourteen different models with one, two, three, or four syndromes were compared using CFA for "goodness of fit." The three-syndrome models displayed better fitness than any of the one- or two-syndrome models. All of the three-syndrome models shared the positive and negative dimensions; the third dimension in these three-syndrome models was either the disorganization or Strauss' relational dimensions. In the reported data, a four-syndrome model, including positive, disorganization, negative, and relational dimensions, showed excellent fitness. Despite its limitations, this study suggests the need to explore the validity of a four-syndrome model. The positive-negative model fits poorly with the data.

Adolescent↗
PubMed1994

Polydipsia and water intoxication in psychiatric patients: a review of the epidemiological literature.

Polydipsia among chronic psychiatric patients is poorly understood and underdiagnosed. It may have three stages: simple polydipsia, polydipsia with water intoxication, and physical complications. Epidemiological surveys have used staff reports and polyuria measures to identify polydipsic patients. Water intoxication has been screened by chart review, weight, or serum sodium data. According to these surveys, polydipsia, not explained by medically induced polyuria, may be present in more than 20% of chronic inpatients. Up to 5% of chronic inpatients had episodes of water intoxication although mild cases may have been missed. Single time point surveys show that 29% of polydipsic patients had presented water intoxication. Methodologically limited clinical studies suggest that polydipsia with water intoxication rather than simple polydipsia may be associated with poor prognosis in schizophrenia. Epidemiological surveys found polydipsia with water intoxication to be associated with chronicity, schizophrenia, smoking, some medications, male gender, and white race. New pathophysiological models need to elucidate these findings.

Chronic Disease↗
PubMed1994

Schizophrenic syndromes associated with treatment response.

1. The influence of clinical syndromes (determined by factor analysis) on treatment response was explored in a sample of schizophrenics treated by clinician choice. Patients were obtained from 115 consecutive admissions to an acute inpatient unit and were diagnosed by DSM-III-R criteria. Patients were thoroughly assessed during the first five days of hospitalization using SANS-SAPS, TLC and SEB. Factor analyses of these scales were carried out to explore the existence of syndromes made up of groups of symptoms. All patients were treated with neuroleptics and 70% with biperiden (to exclude akinesia). The response to treatment was measured by the CGI efficacy index. 2. Inappropriate affect, asociality, negative formal thought disturbances and bizarre behavior syndromes showed significant correlation with poor response to treatment. Affective flattening did not display consistent significant correlations with the response to treatment. Visual hallucinations (an infrequent syndrome) and manic thought disorder (a non-specific syndrome) showed significant correlations with better response to neuroleptics. 3. In a stepwise multiple regression model to predict treatment response, asociality and inappropriate affect were the most important predictors. In a discriminant analysis dividing patients between responders and non-responders, the syndromes predicting poor response were more important that those predicting good response.

Adolescent↗
PubMed1993

The test-retest reliability of the Mini-Mental State Examination in chronic schizophrenic patients.

The test-retest reliability of the Mini-Mental State Examination (MMSE) was explored in a sample of 22 inpatients suffering from chronic schizophrenia by DSM-III-R criteria. Patients were tested 4 times during a period of 4-6 weeks. The total score for serial sevens showed consistently significant reliability at about 0.7, and the total score for spelling displayed a lower reliability at about 0.4, which was of borderline significance. In this short period of time, 36% and 27% of the patients shifted between being demented and nondemented when the serial sevens and spelling, respectively, were used to calculate total scores. The MMSE should not be used to categorize schizophrenics as demented or nondemented in biological studies using relatively stable variables.

Adult↗
PubMed1993

Delusions and hallucinations in schizophrenic patients.

The Scale for Assessment of Positive Symptoms was used to measure delusions and hallucinations in 115 DSM-III-R schizophrenics. Our factorial analysis of the hallucinations and delusions resulted in three factors with appropriate internal consistency and frequency: a Schneiderian delusional syndrome, an auditory hallucination syndrome, and a paranoid syndrome that tend to be present in schizophrenics with later onset. These results should be cautiously interpreted due to their cross-sectional nature and to the size of the sample which does not ensure the stability of the factors.

Acute Disease↗
PubMed1993

Negative symptoms and emotional blunting in schizophrenic patients.

BACKGROUND: Emotional blunting and negative symptoms were explored as interchangeable concepts in evaluating schizophrenic patients. METHOD: We evaluated 115 consecutively admitted patients who had DSM-III-R schizophrenia. We performed a principal component analysis of Abrams and Taylor's Scale for Emotional Blunting (SEB) and Andreasen's Scale for the Assessment of Negative Symptoms (SANS) and correlated the subscales derived by factor analyses with demographic and clinical variables. RESULTS: Both scales contained subscales corresponding to poverty of affect and speech and inappropriate affect. The SEB also included an indifference subscale, whereas the SANS included avolition-anhedonia, asociality, and blocking subscales. Poor premorbid functioning was most strongly associated with poverty of affect and speech. Inappropriate affect and anhedonia-avolition-asociality were moderately correlated with poor response to treatment. CONCLUSION: Negative symptoms and emotional blunting are similar concepts, but they are not interchangeable. Flatness and inappropriateness appear to be different affective dimensions with different clinical correlations. Inappropriate affect, inattention, and blocking should not be considered negative symptoms.

Adult↗
PubMed1992

Are there more than two syndromes in schizophrenia? A critique of the positive-negative dichotomy.

A sample of 115 DSM-III-R schizophrenics was studied by means of the SANS and SAPS. A factor analysis from the nine subscales and two symptoms (inappropriate affect and poverty of content) and a review of the previous factor analyses suggest that schizophrenic symptoms cannot be appropriately classified into positive and negative syndromes. The low internal consistency of the SAPS suggests that the positive symptoms are not a homogeneous syndrome. Our results fit better with Liddle's model of three syndromes (negative, delusion-hallucination and disorganisation syndromes). It is argued that we are far from a valid classification of schizophrenic symptoms and the positive-negative dichotomy appears to be an oversimplification.

Adolescent↗