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Biomedical subjects

J de Leon

Publications and source records attributed to J de Leon.

70 records · Page 4Linked to original sources
PubMed1991

Negative symptoms, defect state and Huber's basic symptoms: a comparison of the concepts.

Comparing Crow's schizophrenia model with the defect state and Huber's basic symptoms shows that this model is an oversimplification of the complex reality of schizophrenic outcomes. The concept of negative symptoms is undermined by several factors, such as differing definitions, other confounding cross-sectional variables (e.g., akinesia and depression), short follow-ups and lack of confirmation by factorial analysis. The longitudinal concept of a defect state, which has been used in long-term follow-up studies, includes enduring symptoms currently classified as positive and negative. Huber's conceptualization of basic symptoms describes prodromal and enduring residual symptoms of schizophrenia associated with structural brain abnormalities. The overlap and lack of equivalence of these concepts and the limited empirical evidence does not allow firm conclusions. New longitudinal studies using clinical, psychosocial, and neuropsychological measures are needed to understand the natural history and etiology of the defect state.

Cross-Sectional Studies↗
PubMed1991

Premorbid personality and positive and negative symptoms in schizophrenia.

The relationship between premorbid personality and schizophrenic symptoms assessed by the Scales for the Assessment of Positive and Negative Symptoms was explored in 115 DSM-III-R schizophrenics. The frequencies of normal, schizoid-schizotypal and other DSM-III-R personality disorders were 44%, 39% and 17%. Affective flattening and alogia were significantly more frequently present and severe in the schizoid-schizotypal group than in the rest of the patients. There were no differences in positive symptoms. It is suggested that, in some cases, negative symptoms are merely the persistence or exacerbation of schizoid traits present prior to the emergence of schizophrenic symptoms. These results should be cautiously interpreted because the premorbid personality was diagnosed in a retrospective way and the negative symptoms were assessed cross-sectionally.

Adult↗
PubMed1991

Clozapine and jaw dyskinesia: a case report.

No convincing case of tardive dyskinesia has been associated with clozapine. We briefly discuss a case of clozapine-induced reversible initial dyskinesia described in the German literature, and we report a case of jaw dyskinesia in a 49-year-old female schizophrenic. The dyskinesia appeared 2 weeks after the patient started clozapine treatment, did not respond to anticholinergic medication, and has continued for more than 1 year while the patient has remained on clozapine treatment. The patient had taken haloperidol (less than or equal to 5 mg/day) for 5 weeks before starting clozapine treatment. These are the only two cases of dyskinesia associated with clozapine use that are known to us. They raise the possibility that clozapine can induce dyskinesia.

Biperiden↗
PubMed1990

Neuroleptic-induced catatonia: neuroleptic malignant syndrome?

1. The authors describe a case report of catatonia syndrome after administration of depot neuroleptics. 2. Differential diagnosis was made between neuroleptic malignant syndrome or catatonic syndrome complicated by infection. The signs and symptoms observed throughout the patient's course are detailed. 3. A critical review is made of bibliography on the topic, with emphasis on the lack of clear clinical description and poor conceptual definition.

Adult↗
PubMed1989

Tyramine and new monoamine oxidase inhibitor drugs.

The hypertensive crisis induced by the ingestion of cheese in subjects undergoing treatment with monoamine oxidase inhibitors (MAOIs) led to their virtual disappearance in many parts of the world. Three strategies to try and diminish the risk of this reaction have been developed: the combination of current (irreversible and non-selective) MAOIs with tricyclic antidepressants, the use of new selective MAOIs, and the use of new reversible MAOIs. The relative effectiveness of these different approaches can be assessed by the tyramine pressor test. The introduction of reversible and selective monoamine oxidase-A (MAO-A) inhibitors looks especially promising clinically.

Antidepressive Agents, Tricyclic↗
PubMed1989

Measurement of negative symptoms in schizophrenia.

This article focuses on the measurement of 'negative symptoms'. Standardized scales used to rate negative symptoms are reviewed and compared, as are the individual items which comprise them. The overlap of negative symptoms, akinesia, and depression is explored, and means are suggested to improve the precision of defining and measuring negative symptoms. Flat affect is the only item present in all negative symptom scales and may overlap with depression and akinesia. Inappropriate affect and attentional disturbance should not be considered negative symptoms. Poverty of speech and anhedonia lack unified definitions, and in some scales, they can also be confounded with depression and akinesia. The psychometric properties of most scales have not been sufficiently studied. The lack of long-term studies of stability of the supposedly enduring negative symptoms is especially worrisome. Carpenter's deficit syndrome consisting of non-secondary negative symptoms lasting more than one year is a promising new step to try and address some of these problems.

Humans↗
PubMed1980

Delayed cutaneous hypersensitivity testing in untreated Hodgkin's disease using a standardized new device.

Delayed cutaneous hypersensitivity to 7 recall antigens has been tested in 32 patients with untreated Hodgkin's disease using a standardized and reproducible system. Anergy to all 7 antigens was observed in 15/32 patients and hypoergy in 4/32 leading to a cumulative deficiency rate of 59%. Although the defect was distributed throughout all stages, substages and histologic types, it seemed to predominate in less favorable forms of the disease as well as in female patients.

Adolescent↗
PubMedDate not supplied

Dysmorphophobia: body dysmorphic disorder or delusional disorder, somatic subtype?

The DSM-III-R proposes to divide dysmorphophobia into two separate disorders: delusional disorder, somatic subtype and dysmorphic disorder. We believe that this distinction of delusional and nondelusional is impossible from a phenomenological point of view, and that dysmorphophobic beliefs are better classified as overvalued ideas. The concept of dysmorphophobia and its relationship to monosymptomatic hypochondriacal psychoses and DSM-III-R categories is reviewed. A case report is described to support these arguments.

Adult↗
PubMedDate not supplied

Formal thought disorder in schizophrenia: a factor analytic study.

The Thought, Language and Communication Scale (TLC) was studied in a sample composed of 115 DSM-III-R schizophrenic patients admitted to an acute inpatient unit. A principal component analysis with varimax rotation was performed to explore the possibility of the existence of syndromes within the formal thought disturbances. Seven factors were found to have eigen values greater than 1 and five showed appropriate internal consistency. The first factor, or disorganization factor, was close to the Scale for the Assessment of Positive Symptoms (SAPS) formal thought disturbance subscale. The second, or negative factor (perseveration, poverty of speech and content), was moderately correlated with poor premorbid functioning and poor response to neuroleptic treatment. The third and fourth factors were, respectively, formed by stilted speech plus word approximations, and neologisms plus clanging. The fifth factor (distractibility and blocking), as well as the first two factors, were correlated to the Scale for the Assessment of Negative Symptoms (SANS) attention subscale.

Adult↗
PubMedDate not supplied

Positive versus negative schizophrenia and basic symptoms.

In a sample of 71 Research Diagnostic Criteria (RDC) schizophrenic patients, the relationship among the basic symptoms measured by the Frankfurt Complaint Questionnaire and Andreasen and Olsen's types of schizophrenia was studied. The results do not support an overlap between negative and basic symptoms; rather, basic symptoms appear to be more frequent in patients with positive symptoms. Basic symptoms were consistently correlated to formal thought disturbances, but the values were only moderate (r = .3).

Adult↗
PubMedDate not supplied

Delusion of parasitosis or chronic tactile hallucinosis: hypothesis about their brain physiopathology.

The abnormal belief of having the skin infested by parasites is a syndrome with different etiologies. Approximately 12% of cases are induced by another patient with the same syndrome. In noninduced cases, two physiopathological brain mechanisms have been proposed: a delusion, or a primary abnormal tactile sensation with a secondary delusional elaboration. These two hypotheses have been characterized by Berrios as cognitive and sensorialist approaches, respectively. Although modern literature defines this syndrome as a delusion, early literature, particularly German, described both approaches, and even emphasized the sensorialist approach, classifying it as a chronic tactile hallucinosis. A thorough review of the literature suggests both mechanisms may be possible.

Brain↗
PubMedDate not supplied

A study of bedside screening procedures for cognitive deficits in chronic psychiatric inpatients.

The Mini-Mental State Examination (MMSE) and the Trail Making Test, part B (TMT-B) were compared for screening cognitive deficits in a sample of 104 psychiatric inpatients at a long-term hospital. The TMT-B classified 84% of the patients as impaired. The classic MMSE cutoff score (< or = 23) using serial sevens and spelling classified 42% and 24% of the patients respectively, as impaired. The new MMSE cutoff classified 71% as impaired. Education, gender, and medication may influence impairment when using the MMSE classic cutoff scores. In TMT-B only, impairment was influenced by chronicity. The TMT-B was able to distinguish patients impaired in the MMSE. The TMT-B, therefore, may be more useful than the MMSE to screen for cognitive deficits in chronic psychiatric inpatients.

Adult↗
PubMedDate not supplied

The relationship between menstrual cycle phases and suicide attempts.

OBJECTIVE: The validity of prior studies on the menstrual cycle and suicide attempts assumes that suicidal women accurately describe their cycles. The three objectives of this study were 1) to explore whether prior inconsistencies are due to the effects of sample selection and method of assessment of the menstrual cycle, 2) to assess the relationship between the menstrual cycle phase and suicide attempts, and 3) to establish the role of sexual hormones in suicide attempts. METHODS: The original sample included 134 women who came to the emergency room of a general hospital after a suicide attempt. One hundred eight female blood donors were recruited as control subjects. The menstrual cycle was divided into follicular, midcycle, and luteal phases using two clinical methods and serum hormonal assessment. Dividing the follicular phase into menstrual and nonmenstrual phases was also considered. RESULTS: Two of 11 previously used sampling methods produced a sample size similar to that of the hormonal assessment. kappa values between the two clinical and the endocrinological methods were low (0.40-0.50). The number of suicide attempts during the follicular phase (particularly during the menstrual phase) was significantly higher than expected. CONCLUSIONS: Despite the inability to control for other variables and limitations, the results of this study suggest that sample selection could introduce biases and that studies relating psychiatric symptomatology and menstrual cycle phases need to use hormonal determinations. New studies are needed to verify that suicide attempts are more frequent during the follicular phase (particularly during the menstrual phase).

Adult↗