Risperidone, serotonergic mechanisms, and obsessive-compulsive symptoms in schizophrenia.
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Adult↗
Biomedical subjects
L Kopala
Publications and source records attributed to L Kopala.
Diagnostic reassessment and treatment response in schizophrenia.
BACKGROUND: The reasons for poor treatment response in some patients with schizophrenia remain unclear. It is possible that misdiagnosis of nonschizophrenic disorders as schizophrenia could result in suboptimal pharmacotherapy in some patients. METHOD: To assess this possibility, 110 severely ill, chronic patients with a referral diagnosis of schizophrenia were comprehensively assessed and rediagnosed according to DSM-III-R criteria. Global Assessment of Function (GAF) and Clinical Global Impressions (CGI) ratings were made at admission and at discharge from the ward, after the implementation of individualized treatment plans. RESULTS: The diagnosis of schizophrenia was confirmed in 80 patients (73%) and revised to another type of psychotic illness in 30 patients (27%). The GAF and CGI ratings were similar at admission in patients with confirmed and revised diagnoses. All patients improved by the time of discharge (p = .0001); however, patients with a revised diagnosis improved more than those with confirmed schizophrenia (p = .02). Patients with a revised diagnosis were less likely to require continued hospitalization on chronic care wards (p = .004). At admission, medication regimens were similar in the two groups of patients. At discharge, patients with a revised diagnosis were less likely to have received neuroleptics (p = .007) and more likely to have received antimanic drugs (p = .0002) or electroconvulsive therapy (p = .0004). CONCLUSION: These findings from a clinical sample suggest that diagnostic reassessment is an important first step in the management of apparently refractory schizophrenia.
Adolescent↗
Metabolic subtypes in patients with schizophrenia.
Patterns of regional cerebral glucose metabolism were examined in a group of patients with schizophrenia (n = 17) and normal controls (n = 16) to determine if different metabolic profiles were present. For the patients with schizophrenia, two profiles were found. The first was characterized by a normal "shape" but overall reductions in cerebral metabolism. The second had focal reductions in frontal metabolism. This latter group also had significantly larger frontal horns than the other schizophrenic group. The two groups with schizophrenia did not differ on other attributes or clinical variables. These results are discussed in terms of our understanding of heterogeneity in schizophrenia and etiology.
Adult↗
Regional metabolism in microsmic patients with schizophrenia.
The cerebral glucose metabolism of eight patients with schizophrenia and an olfactory agnosia was compared with that of eight normosmic patients with schizophrenia and eight normal controls. Since all patients were scanned while on their current medication regimen, the duration and dosage of the medication of the two patient groups were compared. Similarly, duration and dosage were correlated with absolute regional metabolic rates. No significant effects were found in these analyses. The patients with schizophrenia had significantly lower rates of frontal metabolism than the normal controls. However, the patients with schizophrenia and an olfactory agnosia had a lower right basal ganglia and thalamic metabolism than the normosmic patients with schizophrenia.
Adult↗
Implications of olfactory agnosia for understanding sex differences in schizophrenia.
In our studies, 50 percent of the male patients with schizophrenia have an olfactory agnosia. This finding is of interest because the olfactory neuroanatomical network involves brain regions found to be abnormal in patients with schizophrenia, and this olfactory deficit appears to be sex dependent. This article reviews conceptual models for assessing olfactory function, describes the neuroanatomical structures involved, and reviews the findings of olfactory performance in patients with neurological dysfunction. The findings are then integrated with neuropathological studies of patients with schizophrenia. Finally, as there is increasing evidence for a sex difference in patients with schizophrenia, a model is suggested to account for these differences based on neuro-developmental and latent lesion hypotheses.
Agnosia↗
A genotype-phenotype research strategy for schizophrenia.
A research strategy which integrates known biological aspects of schizophrenia is proposed. The strategy includes genotype and phenotype components and emphasizes interactions. Its central feature is the comprehensive diagnostic assessment of patients with schizophrenia. Clinical and laboratory based methodologies are applied within the genotype and phenotype components of the strategy. Examples of research from each area and the potential interactions with other aspects of the strategy are presented. The expectation is that a greater understanding of the pathophysiology of schizophrenia will result from the application of the genotype-phenotype strategy and that consequently more efficacious treatments will ultimately be developed.
Chromosome Aberrations↗
Sex differences in olfactory function in schizophrenia.
Olfactory identification and olfactory acuity were measured in 41 schizophrenic patients receiving neuroleptic medication and in 43 normal control subjects. The performance of the male schizophrenic patients was significantly lower than that of the female patients and the male and female normal control subjects. The last three subgroups performed at equivalent levels. These findings are discussed with respect to other reported sex differences in schizophrenia, including frequency of specific neurological signs and structural brain abnormalities, response to neuroleptic medication, and long-term outcome. The findings suggest that the sex of the patient may be a critical variable in understanding the processes of schizophrenia.
Adult↗
Olfactory deficits in schizophrenia.
Olfactory discrimination was measured in patients with schizophrenia who were on neuroleptic medication and was compared with other psychiatric patients receiving neuroleptics and normal controls. The performance of the patients with schizophrenia was significantly lower than the psychiatric and normal controls. The latter two groups performed at equivalent levels. The findings are discussed with respect to olfactory deficits found in patients with cerebral lesions and with abnormalities of specific neurotransmitter systems.
Adolescent↗