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Biomedical subjects

M Harrow

Publications and source records attributed to M Harrow.

At least 73 records · Page 4Linked to original sources
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↗
PubMed1984

Prognosis and outcome using broad (DSM-II) and narrow (DSM-III) concepts of schizophrenia.

The classical prognostic indicators of Vaillant and Stephens, the acute onset of psychotic symptoms, and key demographic factors were investigated as predictors of outcome in a prospective study of 153 schizophrenic patients defined using broad (DSM-II) and narrow (DSM-III) concepts of schizophrenia. Findings indicate: Several established prognostic items did not show strong predictive utility in DSM-II or DSM-III schizophrenia when young, nonchronic patients were studied. For both DSM-II and DSM-III schizophrenic patients, longitudinal assessments of psychotic symptoms, work history, and social functioning predicted their respective assessments at followup. However, the predictive utility of some key prognostic indicators shifted for narrow vs. broad concepts of schizophrenia. Most importantly, sex, which was the most powerful predictor of overall outcome among patients with DSM-II schizophrenia, failed to predict outcome among patients with DSM-III schizophrenia, primarily because many women with favorable outcome did not meet the DSM-III criteria for schizophrenia. DSM-III schizophrenia comprises a more homogeneous group of poor prognosis patients in comparison to DSM-II schizophrenia. Educational level, age at first hospitalization, and work history were successful predictors of outcome (p less than .01) when a new, narrow concept of schizophrenia was used.

Acute Disease↗
PubMed1984

The longitudinal course of schizoaffective disorders. A prospective follow-up study.

To study whether outcome of schizoaffective psychosis is more similar to that of schizophrenia, or major affective disorders, or whether it shows an intermediate pattern between these two disorders, we conducted a prospective follow-up study of 167 patients from two hospitals. Thirty-nine schizoaffective patients, 47 schizophrenic patients, 33 manic patients, and 48 patients with major depressive disorders were assessed during hospitalization and then followed up 1 year after hospital discharge. Standardized assessments were conducted of patients' work functioning, social adjustment, symptom outcome, rehospitalization, treatment at follow-up, and their overall posthospital adjustment. The data indicated the following: a) On both major scales of overall outcome, schizoaffective patients' posthospital adjustment was significantly poorer than that of patients with major affective disorders (p less than .01), and showed a nonsignificant tendency to be better than that of schizophrenics. Only 10 per cent of the schizoaffective patients had very favorable outcomes. b) There were no significant differences in overall outcome between schizoaffective patients who were manic vs. depressed, or mainly affective vs. mainly schizophrenic (p greater than .20). c) Both the schizoaffective and affectively disordered patient groups had significantly better posthospital work functioning than did the schizophrenic patients (p less than .05). d) However, both the schizoaffective and schizophrenic groups had significantly poorer posthospital social functioning than did the affectively disordered patients. Overall, the data suggest that outcome of schizoaffective disorders differs in some ways from that of both schizophrenia and affective disorders.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1984

State dependence of noradrenergic activity in a rapidly cycling bipolar patient.

Plasma levels of the major norepinephrine (NE) metabolite, 3-methoxy-4-hydroxyphenylglycol (MHPG), were measured in a rapidly cycling bipolar patient and her first-degree relatives. The mood state dependence and the reciprocal relationship between noradrenergic and cholinergic activity were investigated by assessing mood, thought disorder, and plasma MHPG following the infusion of physostigmine. A correlation was found between plasma MHPG and mood states, with exceedingly high levels during mania and hypomania. Levels were significantly decreased by ECT or combined lithium and chlorpromazine administration. A pathologic diurnal MHPG pattern was detected during periods of abnormal mood changes. Infusion of physostigmine led to a prompt reduction in MHPG release and a marked decline in mood-state measurements and the overall level of thought disorder. Muscarinic receptors exerting negative feedback control over the synthesis and/or release of NE may have become supersensitive as a consequence of alpha 2-adrenoceptor densensitization.

Adolescent↗
PubMed1983

Disordered thinking.

To evaluate formulations that thought disorder at the posthospital phase identifies a subgroup of nuclear schizophrenics with poor outcomes, 77 patients from a longitudinal project were followed up on major dimensions of psychopathology linked to nuclear schizophrenia. The data indicate that (1) schizophrenics were more thought disordered than were nonschizophrenics at the posthospital phase; (2) thought-disordered schizophrenics had only slightly poorer scores on classic prognostic indicators associated with poor outcomes; (3) a subgroup of early chronic schizophrenics were not severely thought disordered; (4) almost all severely thought-disordered schizophrenics demonstrated clear evidence of delusional activity at follow-up; and (5) thought-disordered schizophrenics had poorer outcomes. The overall results fit in with formulations that a severe thought disorder is one of several major features of schizophrenia. The data suggest that posthospital thought disorder identifies a subgroup of poor-outcome schizophrenics, although some non-thought-disordered schizophrenics also show poor outcomes.

Adult↗
PubMed1983

Word association: multiple measures and multiple meanings.

Investigated the interrelationships between reaction time and three major verbal word association variables (response commonality, idiosyncratic responses, and degree of logical relatedness) in schizophrenics (N = 42) and nonschizophrenic psychiatric controls (N = 30). This study investigated the degree to which these four measures assess similar or different components of associative thought disorder in the same Ss, using both verbal associative measures and a nonverbal performance measure. Results indicated that reaction time was largely independent of all verbal measures in schizophrenics. These data were discussed in regard to the meaning and interpretation of word association test data as a function of choice of dependent variables for measuring associative thought disturbance.

Humans↗
PubMed1983

Disordered thinking in schizophrenia: intermingling and loss of set.

In a study of schizophrenic thought pathology, potential loss of set and intermingling were examined. The responses of 36 acute psychiatric patients who showed intermingling were analyzed. Intermingling, frequently seen in the speech and thinking of schizophrenic patients, involves the blending of personal material from one's experiences into one's thinking and communication, leading to bizarre and inappropriate speech. The results indicated that intermingling frequently leads to some loss of goal-directed thinking, but not usually to complete loss of set. Patients adopt new sets based partly on the original topic and partly on their own personal idiosyncratic concerns. The apparent "looseness" of schizophrenic patients is based on thematic shifts to idiosyncratic ideas, often from the beginning of their responses, rather than on word-to-word associative looseness. Intermingling of personal concerns typically occurs in a nonfragmented fashion. Schizophrenics and other psychotic patients show significantly more intermingling of personal material in open and undisguised fashion, as though they do not recognize how inappropriate their intermingling appears. The results suggest that although the intrusion of personal material is task inappropriate, it still represents a form of systematic, goal-oriented thinking.

Adult↗
PubMed1983

Neurotic symptoms in the postacute phase of schizophrenia.

To assess the presence and importance of neurotic and depressive symptoms in the posthospital phase of schizophrenia, two samples of schizophrenic and nonschizophrenic patients were studied. The first sample consisted of 278 chronic patients and the second sample consisted of 284 relatively early phase, less chronic, patients. The following results emerged. a) Surprisingly high levels of neurotic/depressive symptoms are found in both schizophrenic and nonschizophrenic patients during the posthospital phase. b) Nonschizophrenic patients experience an equal or greater degree of neurotic symptom discomfort than schizophrenics, and any differences do not reach statistically significant levels. c) Neurotic/depressive symptoms seems to be one key area in which schizophrenics do not function more poorly during the posthospital phase than nonschizophrenic patients. d) The results cut across different social classes, different institutional settings, and different levels of chronicity. These data suggest that neurotic and depressive symptoms may play a greater role in the posthospital functioning of both chronic and nonchronic psychiatric patients than has heretofore been recognized.

Adult↗
PubMed1983

Guilt and conscience in major depressive disorders.

The authors propose definitions of guilt as a self-critical feeling state and of conscience as a set of standards, to permit independent assessment of their prevalence in a sample of 93 depressed, 29 schizophrenic, and 43 normal subjects. Patients with feelings of guilt tended to have a more severe conscience and lower self-esteem. While guilt is prominent in a moderate percentage of depressed patients, negative self-esteem may form one of the cornerstones for depressed patients of all types. The authors propose that the operational definition of psychoanalytic concepts such as guilt and conscience permits a valid and more rigorous test of clinical generalizations.

Adolescent↗
PubMed1983

Goal-directed thinking in schizophrenics' associations.

The relationships between associative structure and higher order cognitive processes in schizophrenia were investigated with a continuous word association technique. The chaining hypothesis involves the derailment of organized thought by response-produced stimuli, and the continuity hypothesis postulates a progressive disorganization of connotative meaning. Neither hypothesis was confirmed, as both schizophrenics and nonschizophrenics maintained the set of guiding responses according to the starting stimuli. Further, both groups showed progressive response disorganization despite the overall higher degree of relatedness in the nonschizophrenics. There was also no differential performance observed when comparing schizophrenics subgrouped by paranoid status and premorbid adjustment.

Adult↗
PubMed1982

Thought pathology in manic and schizophrenic patients. Its occurrence at hospital admission and seven weeks later.

To evaluate the extent and persistence of thought pathology in manic patients, 113 manic, schizophrenic, and nonpsychotic patients were assessed at the acute phase, and a subsample was reevaluated seven weeks later. Another subsample of 55 patients was assessed medication free at the acute phase. Three major indices of thought disorder were used. The data indicate that (1) most hospitalized manics are severely thought disordered; (2) hospitalized manics are as thought disordered as schizophrenics; (3) unmedicated manics are as severely thought disordered as unmedicated schizophrenics; (4) both manics' and schizophrenics' thought disorders improve after the acute phase; (5) even after the acute phase, some manics show severe thought pathology. The results support formulations that thought disorder is not unique to schizophrenia. Some factors involved in manic and schizophrenic thought pathology are similar. There may be a general psychosis factor that cuts across psychotic diagnoses.

Adolescent↗
PubMed1982

Associative thinking in schizophrenia: a contextualist approach.

Explored the question of whether responses that appeared to be highly pathological on the basis of the word association test did indeed reflect an underlying aberrant associative process or whether the associations actually had a greater degree of meaning than was evident from the test (N = 60). Utilizing contextualist techniques designed by the authors, which were analogous to the word association test but yet measured schizophrenic associative thinking in specific contexts that more closely approximated natural language situations, the quality and purposiveness of the schizophrenics' associations were examined. The word association test technique was judged to be inadequate by itself to account for underlying associative processes involved in schizophrenic associative thought disorder. A majority of responses (70% schizophrenic, 81% nonschizophrenic) judged to be pathological on the basis of the word association test alone became meaningful in the context of a sentence created by the Ss to explain purposively their associations. The schizophrenics' experience of a stimulus word and consequent associations to that word became clearer when placed within an appropriate context (i.e., a sentence), rather than examined as isolated semantic features (as in the word association test).

Adult↗