Search PubMed⌕ Search

Biomedical subjects

M Harrow

Publications and source records attributed to M Harrow.

At least 55 records · Page 3Linked to original sources
PubMed1989

Cyclothymic mood swings in the course of affective disorders and schizophrenia.

The authors assessed cyclothymic mood swings and psychosocial adjustment in 38 unipolar depressed, 27 bipolar, 35 schizophrenic, and 27 other psychiatric patients 4 years after hospital discharge and in 153 normal control subjects. The patients were significantly more cyclothymic at follow-up than the control subjects, but there were no differences in cyclothymia between the diagnostic groups. Cyclothymic patients showed significantly poorer posthospital functioning than noncyclothymic patients. These findings raise questions concerning the scope of the hypothesized cyclothymic-bipolar spectrum. Minor mood swings in a variety of patients with poor posthospital adjustment may reflect persistent vulnerability to psychopathology.

Adaptation, Psychological↗
PubMed1987

Schizophrenic thought disorder at follow-up. A persistent or episodic course?

This follow-up investigation examined the course of thought disorder in early, young schizophrenic, other psychotic, and nonpsychotic patients. Patients were assessed for the severity of thought disorder at index hospitalization and at two and four years after hospital discharge. Follow-up evaluations included assessments of adjustment and short-term outcome. Schizophrenic patients showed more thought disorder than nonschizophrenic patients at all three periods. Almost 40% (16/41) of the schizophrenic patients exhibited persistent thought disorder symptoms after the acute phase and an additional 37% (15/41) showed an episodic thought disorder course. Across diagnoses, patients who were thought disordered at both follow-ups demonstrated higher rates of unemployment and rehospitalization than did patients in non-thought-disordered and episodic thought disorder groups. To date, 25% (16/65) of psychotic nonschizophrenic patients showed persistent thought disorder courses similar to schizophrenia, while another 40% (24/65) showed remitting thought disorder symptoms more common to nonpsychotic patients.

Adult↗
PubMed1987

Process-reactive dimension and outcome for narrow concepts of schizophrenia.

The data presented by the authors suggest a more successful prediction of outcome by the process-reactive dimension when it is applied to schizophrenic patients defined according to broad concepts of schizophrenia (e.g., DSM-II) than to narrow concepts of schizophrenia (e.g., DSM-III). Research indicates that the DSM-III is more likely than the DSM-II diagnosis to be composed of "poor prognosis" schizophrenia, as defined by the classical prognostic indicators. In general, the overall results could support the views of Herron and others that the process-reactive dimension is more valuable as a predictor for a schizophrenia spectrum than for modern, narrow concepts of schizophrenia. However, while recent data of the authors indicate that DSM-III schizophrenic patients show poorer outcome than DSM-II schizophrenic patients, they also indicate that (1) DSM-III schizophrenic patients still show heterogeneity in prehospital functioning and outcome, and (2) other prognostic indexes, such as the Zigler-Phillips Scale and the Vaillant-Stephens Scale, have some efficacy in predicting course and outcome among DSM-III schizophrenic patients. Data on prehospital functioning and outcome are discussed in terms of two contrasting models--a developmental model and a natural history model of the course of schizophrenia.

Humans↗
PubMed1987

The prognostic relevance of delusions in depression: a follow-up study.

To determine whether delusional depression has a different clinical course from other types of depression, the authors followed up 31 unipolar delusional depressed patients, 28 unipolar nonpsychotic depressed patients, and 51 schizophrenic patients 14 months after hospital discharge. Patients were assessed on 1) overall outcome, 2) psychotic, anxiety-neurotic, and depressive symptoms, 3) social and work functioning, and 4) rehospitalization. The delusional depressed patients showed significantly more mood-incongruent delusions at follow-up. Surprisingly, the nonpsychotic depressed patients exhibited more depressed mood and significantly more anxiety at follow-up. The findings suggest that the diagnostic distinction between delusional and nonpsychotic depression is relevant to the clinical course of major depression.

Adaptation, Psychological↗
PubMed1986

A longitudinal study of thought disorder in manic patients.

To study the persistence of thought disorder in manic patients, 34 manic patients were compared with 30 schizophrenic and 30 nonpsychotic patients on four indexes of thought pathology at two phases of disorder: during the acute inpatient phase and one year after hospitalization. Patients were also compared with a control sample of 34 normal subjects. The data indicated that during the acute in hospital phase, both manic and schizophrenic patients were severely thought disordered; at follow-up, a subsample of manic patients showed severe thought disorder; despite the severe thought disorder found at follow-up in some manic and schizophrenic patients, both groups showed a significant reduction of thought pathology at follow-up; and there was a trend for a larger reduction of thought disorder in manic than in schizophrenic patients. The difference, however, was not significant when initial levels of severity were controlled.

Adolescent↗
PubMed1986

Predictors of outcome in schizophrenia: the process-reactive dimension.

Premorbid social-sexual competence and the process-reactive dimension, as assessed by the Phillips Scale, were investigated as predictors of posthospital adjustment in a prospective study of two samples of 141 young, early phase schizophrenics (a private hospital sample and a state hospital sample). The Phillips Scale predicted subsequent outcome at significant levels for one of the two samples of DSM-II schizophrenics (a "broad" construct of schizophrenia). It did not predict outcome as well for DSM-III schizophrenics (a "narrow" construct of schizophrenia). Mixed results emerged from separate analyses of first-admission schizophrenics only and for male schizophrenics only. The data indicated that marital status accounts for some of the positive relationship between the Phillips Scale and later outcome. A more focused measure of prehospital social adjustment successfully predicted social functioning at followup for both DSM-II and DSM-III schizophrenics (p less than .05). There were some significant and near-significant relationships, but overall results suggest that when the influence of chronicity and marital status is reduced, the relationship between the Phillips Scale and subsequent outcome is less robust than was once thought.

Adult↗
PubMed1986

The early course of schizophrenic thought disorder.

The current investigation studied the early course of positive thought disorder and its relationship to other aspects of schizophrenic outcome. Forty-eight schizophrenics diagnosed using the Research Diagnostic Criteria (RDC), 51 psychotic nonschizophrenics, and 67 nonpsychotic patients were studied at index hospitalization and at a 1.5-year followup. Most thought-disordered schizophrenics and other psychotic patients showed some reduction in thought pathology between index hospitalization and followup (p less than .02). A larger percentage of schizophrenics than other psychotic and nonpsychotic showed thought disorder at the acute phase and at followup assessment (p less than .05), although only a subgroup of 27 percent of the schizophrenics showed severe thought disorder at followup. At followup, severely thought-disordered schizophrenics showed residual signs of psychosis and poor functioning in other areas. Positive thought disorder in schizophrenics at followup most often occurred within the context of an unremitted illness and was less frequently due to a new, acute episode of disturbance. Continuously thought-disordered schizophrenics exhibited more severe impairments in life adjustment at 1.5-year followup than did episodic or nonthought-disordered schizophrenics (p less than .02). The results suggest that severe thought disorder is a persistent characteristic in a subgroup of early schizophrenics.

Acute Disease↗
PubMed1986

Schizophrenic thought disorder at followup: its persistence and prognostic significance.

To assess the prominence, persistence, and prognostic significance of positive thought disorder in schizophrenia, we studied a large sample of psychiatric inpatients at the acute phase and then followed them up twice--1 1/2-2 years and 4 years after hospital discharge. Positive thought disorder was more prominent at the acute phase in schizophrenic and manic patients than in other types of psychotic and nonpsychotic disorders. At followup, positive thought disorder did not persist for all schizophrenics, but a significantly larger percentage of schizophrenic than other psychotic and nonpsychotic patients followed a course in which positive thought disorder was either persistently or episodically present. Positive thought disorder, when seen after the acute phase, was related to concurrent functioning, and predicted subsequent poorer outcome and functioning for both schizophrenic and nonschizophrenic patients. Positive thought disorder was one of several central features of the active schizophrenic disorder. Among schizophrenics, it was related to other major types of psychopathology, especially delusions, another positive symptom with cognitive-ideational elements. Severe positive thought disorder after the acute phase indicated a sustained episode, and suggested a more severe type of schizophrenia with a poorer prognosis.

Acute Disease↗
PubMed1986

Evaluating bizarre-idiosyncratic thinking: a comprehensive index of positive thought disorder.

A summary of our method of assessing positive thought disorder, or bizarre-idiosyncratic thinking, from two short verbal tests is presented. This measure provides for standardized thought disorder assessments of: the overall presence and severity of thought disorder, and the type of disordered thinking shown. A definition and examples of bizarre-idiosyncratic thinking are provided, along with information on the reliability and validity of the scoring system. A method of establishing subject groups based on the severity of positive thought disorder also is presented--ranging from no thought disorder, to abnormal thinking, to severe formal thought disorder. This measure has been used to assess longitudinal changes in thought disorder symptoms over time and to evaluate relationships between thought disorder, other aspects of psychopathology (such as delusions), and adjustment in other areas of functioning across diagnostic groups.

Humans↗
PubMed1986

Features associated with thought disorder in manic patients at 2-4-year follow-up.

The authors assessed 47 formerly hospitalized manic patients for thought disorder 2-4 years after discharge and studied the relationship between thought disorder and other major clinical variables. Fourteen (30%) of the manic patients showed severe positive thought disorder 2-4 years after hospitalization. Partial correlations and multiple regression analyses indicated that thought disorder at follow-up was most closely related to the presence of manic behavior and psychosis. It was also more frequent in manic patients with poor posthospital functioning and in manic patients with multiple previous manic episodes or a more chronic course of illness.

Adolescent↗
PubMed1985

Paranoid and nonparanoid schizophrenia: drive dominated thinking and thought pathology at two phases of disorder.

A sample of acutely hospitalized paranoid and nonparanoid schizophrenics and another sample of paranoid and nonparanoid schizophrenics studied at follow-up were compared on measures of cognitive functioning, disordered thinking, and drive dominated thinking using the WAIS, the Rorschach test, the object sorting test, and an overall index of outcome functioning (N = 67). Results suggested that cognitive regression is related more to acute psychological disturbance than to the presence or absence of paranoia, that the presence of socialized drive dominated thinking during the acute phase is related to better posthospital adjustment at follow-up, and that paranoid schizophrenics show better cognitive functioning after the acute phase. Results did not support the theory that suggests an etiological relation between homosexual conflict and paranoia.

Adult↗
PubMed1985

The thought behind the words: a view of schizophrenic speech and thinking disorders.

Chaika (1982) has proposed that what is frequently viewed as a schizophrenic thought disorder should more precisely be regarded as a speech disorder. We suggest, however, that one should emphasize constructs concerning disordered schizophrenic thinking. We support this position since the schizophrenic's strange speech can fit into a larger view about his disordered thinking which is grounded in a nomological net involving various different types of strange behavior. Other support comes from (1) the use of tests assessing disordered nonverbal behavior, (2) evidence that schizophrenics intermingle personal concerns (ideas) into their verbalizations, (3) bizarre schizophrenic behavior, and (4) the very large percent of schizophrenics with delusions. There is an intricate link between language--which includes a system of symbols, words, and meanings--and thinking. Thus, we have proposed that the disturbance most frequently observed in schizophrenic verbalizations be viewed as involving conceptual-linguistic activity, and not just a problem of speech activity.

Cognition Disorders↗
PubMed1985

Negative symptoms in schizophrenia: their longitudinal course and prognostic importance.

Negative and positive symptoms were investigated longitudinally in 39 young schizophrenic patients at two followup assessments approximately 2.5 and 5 years after hospital discharge. Negative symptoms, such as flat affect and poverty of speech, which were assessed at the first followup, were found to be effective prognostic signs in schizophrenic patients for predicting later poor role functioning at the second followup. The prognostic importance of negative symptoms was predominantly due to their tendency to occur in patients who were already functioning poorly in social and instrumental areas at the first followup, and who tended to continue doing poorly at the second followup. Contrary to some current hypotheses, positive symptoms, such as delusions and hallucinations, were also found to be prognostic of later deficits in role functioning at the second followup. Negative symptoms appeared to be generally persistent over time, although there was some tendency toward remission. Potential models of the etiology of negative symptoms and their role in schizophrenia are proposed.

Adolescent↗
PubMed1985

The course of psychosis in early phases of schizophrenia.

To study the course of psychosis in early schizophrenia, the authors assessed 111 patients at hospitalization and at one or two follow-ups. The course of psychosis was analyzed separately for broad (DSM-II) and narrow (DSM-III) concepts of schizophrenia. The patients diagnosed with DSM-II improved in psychosis between the first and second follow-ups. Those also diagnosed with DSM-III showed more persistent psychosis; 40% were psychotic at both follow-ups. A subgroup of patients showed improvement in psychosis even after several years of sustained symptoms. The authors discuss the implications of the data for views about the persistence of psychotic symptoms.

Adult↗
PubMed1985

Thought disorder. A function of schizophrenia, mania, or psychosis?

Does thought disorder emerge solely as a function of psychosis, or is it a function of diagnosis? The present research investigated whether thought disorder is more frequent in specific diagnostic groups, such as schizophrenia and mania, than in other types of psychotic disorders. The frequency and severity of positive thought disorder was assessed in 324 Research Diagnostic Criteria and DSM-III schizophrenics, manics, other psychotic patients, and nonpsychotic patients, and a normal comparison group. Fifty-seven percent of the sample were first hospital admissions. Patients were tested at the acute phase of their disorder, within the first 2 weeks of hospitalization, with three cognitive tests. Scores from these three tests were scaled to obtain a composite index of the severity of positive thought disorder. Diagnostic factors were more salient to the severity of disordered thinking than was psychosis. Thought disorder was significantly more frequent in schizophrenia and mania than in other psychotic disorders (p less than .05). The frequency of patients with severe thought disorder was reduced as one moved down the hierarchy of manic, schizophrenic, schizoaffective, and depressed psychotic disturbances (p less than .001). Rather surprisingly, the current research suggests that nonpsychotic manic patients may be as thought disordered as psychotic manic patients at acute phases of disturbance. This would indicate that the presence of positive thought disorder in mania is not primarily a function of most of these patients' being psychotic at the acute phase of disturbance. Thought disorder was not simply a function of psychosis.(ABSTRACT TRUNCATED AT 250 WORDS)

Acute Disease↗
PubMed1984

Outcome in schizoaffective disorders: a critical review and reevaluation of the literature.

A review of a number of major studies of the outcome of schizoaffective disorders, focusing on how schizoaffective disorders should be viewed diagnostically, is presented. An analysis is made of various research methods used, including prospective, retrospective, and prognostic approaches. Results of the analysis suggest that prospective studies are more valuable. The research results on outcome question the thesis that schizoaffective disorders are only affective disorders. Overall, the mixed results reveal that the outcome of schizoaffective disorders is poorer than that of affective disorders and better than that of schizophrenia. Since outcome is one type of validating criterion which can be used for establishing diagnostic categories, the results question aspects of the DSM-III system of categorizing schizoaffective disorders. We suggest that mood-incongruent psychotic symptoms either influence outcome negatively or are associated with other features which influence outcome negatively.

Bipolar Disorder↗
PubMed1984

Negative and positive symptoms in schizophrenia and depression: a followup.

Negative and positive symptoms were investigated in a sample of 72 young schizophrenic and depressed patients at followup approximately 1 1/2 years after hospital discharge. Flat affect, poverty of speech, and psychomotor retardation were included as negative symptoms, and delusions, hallucinations, and florid thought disorder as positive symptoms. Marked negative symptoms were found to occur in a subgroup of schizophrenic subjects at followup, but were infrequent in depressed subjects. Educational difficulties and poor social functioning before initial hospitalization were associated with later negative symptoms at followup for schizophrenic subjects. Negative symptoms were also related to concurrent outcome measures of instrumental and social functioning at followup. Contrary to some hypotheses, negative and positive symptoms, when assessed concurrently, were not at opposite ends of a bipolar continuum. Rather, they appeared to be independent phenomena in schizophrenia during the early posthospital phase. Overall, these results suggest that negative symptoms are important for a subgroup of schizophrenic patients during the early course of their disorder and that they have important correlates with specific aspects of role functioning.

Adolescent↗