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Biomedical subjects

S C Schulz

Publications and source records attributed to S C Schulz.

At least 73 records · Page 4Linked to original sources
PubMed1986

Minimization and overreaction to tardive dyskinesia.

Psychiatry's response to the risk of tardive dyskinesia (TD) from long-term neuroleptic drug use continues to swing from one extreme (overreaction) to the other (minimization or denial). The potential negative effects on psychiatric practice of these extreme responses are reviewed. We suggest that while concerns about litigation may partially account for the continued overreaction and minimization, a more fundamental explanation is psychiatry's continuing inability to integrate itself fully as a medical discipline. We suggest that four basic concepts about schizophrenia and its long-term treatment need to be accepted before TD can be responded to objectively: schizophrenia is a serious brain disease; neuroleptics are helpful when properly used; there are limits to the value of neuroleptic drugs in the treatment of schizophrenia; and neuroleptic drugs can cause serious side effects.

Antipsychotic Agents↗
PubMed1986

Diagnoses of the relatives of schizotypal outpatients.

Relatives of 22 schizotypal probands were evaluated for lifetime psychiatric diagnoses. Forty-four (N = 44) of the 97 available relatives were interviewed directly using the Diagnostic Interview Schedule. The rates of psychiatric diagnoses were compared with those of sixty-six (N = 66) of 140 relatives of 30 depressed patients. Family history of mental illness was ascertained by the informant method on the remainder of relatives of both proband groups. The rate of depression found in the relatives of schizotypal patients was 52% in those directly interviewed and 25.7% when informants' reports on unavailable relatives are pooled with direct interview data. These rates were not significantly higher than those found for the relatives of depressed probands (34.8% by direct interview and 21% including reports from informants). The high rates of depression in the relatives of schizotypal probands may indicate that schizotypal personality is associated with affective disorder and not only with schizophrenia. However, the high rates may be due to the presence of depressive character traits in relatives, which inflate the rates of dysthymic disorder and other chronic depressive disorders in the relatives of borderline patients.

Adult↗
PubMed1986

Screening for tardive dyskinesia.

A program of routine Abnormal Involuntary Movement Scale (AIMS) examinations is contrasted with a referral system for detection of tardive dyskinesia in an outpatient schizophrenia clinic. Routine clinical use of the AIMS examination may have improved the early detection of tardive dyskinesia, which could result in a decrease in the morbidity associated with this disorder. Routine AIMS examinations also facilitated repeat discussions with patients about tardive dyskinesia, which provide an opportunity to obtain ongoing informed consent for treatment with neuroleptics.

Ambulatory Care↗
PubMed1985

Posttraumatic stress disorder from pentaborane intoxication. Neuropsychiatric evaluation and short-term follow-up.

Fourteen individuals briefly exposed to a toxic industrial compound, pentaborane, were evaluated for neuropsychiatric abnormalities four to 12 weeks after exposure. Results of physical, neurological, and routine laboratory evaluations were normal. Initial and persistent psychiatric symptoms, neuropsychological deficits, electroencephalographic changes, elevated central nervous system neurotransmitter levels, and ventricular brain ratios (computed tomographic scan) provide evidence of central nervous system damage. Seven patients met diagnostic criteria of the Diagnostic and Statistical Manual of Mental Disorders, ed 3, for posttraumatic stress disorder, and seven patients had neuropsychological test evidence of mild brain dysfunction. No statistically significant relationship was found between neuropsychiatric test results and psychiatric diagnoses. These results contradict previous literature that reports most symptom resolution within the first week after exposure to pentaborane. Results suggest that patients suffered a combination of organic brain insult and psychological trauma.

Accidents, Occupational↗
PubMed1985

Brain ventricular size and CSF monoamine metabolites in an adolescent inpatient population.

The cerebrospinal fluid monoamine metabolites, homovanillic acid (HVA) and 5-hydroxyindoleacetic acid (5HIAA), were compared with ventricle-brain ratios (VBRs) in a group of adolescent inpatients who were divided into psychotic and nonpsychotic groups. HVA, 5HIAA, and VBR did not differ significantly between the two groups. There were no significant relationships between these variables in the nonpsychotic group. Psychotic adolescents, however, displayed significant negative correlations between VBR and HVA, and between VBR and 5HIAA. The relationship between VBR and monoamine metabolites appears to occur in psychoses other than schizophrenia, is present early in the course of illness, and probably does not represent a dilutional effect.

Adolescent↗
PubMed1985

Amphetamine response in borderline patients.

The behavioral and biological responses to d-amphetamine have been studied extensively in patients with schizophrenia and depression, and to a lesser degree in bipolar affective disorders. Because of theories linking borderline personality disorder to those illnesses, amphetamine, 30 mg, p.o., was administered to eight borderline patients in a double-blind, placebo-controlled study and the results were compared to the responses of normal subjects under identical conditions. Amphetamine led to symptoms of psychosis in four out of eight (50%) borderline patients. No normal subject became psychotic during the procedure. Global ratings of well-being were significantly elevated in the borderline group compared to the normal group. In addition the global response was highly inversely correlated with the patient's score on the Diagnostic Interview for Borderlines. Borderline patients had a nonsignificantly decreased growth hormone response following amphetamine compared to normals. Thus, borderline patients appear to be pharmacodynamically separable from normals.

Adult↗
PubMed1984

Tardive dystonia, catatonia, and electroconvulsive therapy.

Tardive dystonia is a late onset, persistent dystonia associated with neuroleptic therapy. We report improvement of tardive dystonia in a patient who had received electroconvulsive therapy (ECT) for depression. This improvement may be the result of a direct effect of ECT on the brain or the result of an interaction between the neurochemical processes responsible for both tardive dystonia and depression.

Antipsychotic Agents↗
PubMed1984

The neuroendocrine and behavioral response to dextroamphetamine in normal individuals.

Dextroamphetamine 30 mg and placebo were administered by mouth in a double-blind randomized cross-over trial to ten subjects. Behavior was assessed and blood samples analyzed for growth hormone (GH), prolactin (PRL), homovanillic acid (HVA), and amphetamine. There was a statistically significant increase in well-being following d-amphetamine as compared to baseline and placebo on both the Amphetamine Interview Rating Scale and the Hopkins Mood Scale. No subject became psychotic. There was a statistically significant increase in GH from baseline to peak following d-amphetamine ingestion. When compared to placebo, the increase in GH was invariable and statistically significant for the 90-min sampling. PRL decreased from baseline following both d-amphetamine and placebo and there was no significant drug-placebo difference. Serum HVA was measured at baseline and 120 min, for eight subjects. Six subjects had an increase in HVA following d-amphetamine but there was no significant drug effect.

Adult↗
PubMed1984

Beyond the therapeutic window: a case presentation.

The relationship of haloperidol dose and plasma concentration to psychotic symptoms of schizophrenia is described. The authors present evidence supporting a therapeutic window hypothesis, in which an individual patient's course follows an inverted U curve. The clinical implications for dosage strategies are discussed.

Adult↗
PubMed1983

Failure of hemodialysis to diminish psychotic behavior in schizophrenia: behavioral and psychophysiological evaluation.

In a double-blind sham replacement study, eight drug-free schizophrenic patients underwent 10 active and 10 sham hemodialysis for 20 weeks. At the end of the 10 active dialyses, none of the patients appeared to be improved in psychotic, affective, or social symptoms. Active dialysis was associated with a "startle" response in heart rate and skin conductance to auditory stimuli, while sham dialysis was associated with an "orienting" response. Night-recorded sleep electroencephalography was unaffected by active dialysis. Spinal fluid beta-endorphin-like immunoreactivity levels were unchanged after active treatment. The behavioral improvements reported in other studies may be related to "stress," psychotherapeutic support, spontaneous remissions, neuroleptic withdrawal, denial of symptoms, or diagnostic differences. This study did not confirm the claims for hemodialysis as a specific therapeutic intervention in schizophrenia.

Adult↗
PubMed1983

Double-blind evaluation of plasmapheresis in schizophrenic patients: a pilot study.

Interest in the effects and possible mechanisms of hemodialysis on schizophrenic patients has led to a double-blind evaluation of the effects of plasmapheresis on symptoms of schizophrenia. Also, plasmapheresis was felt to be an invaluable tool for investigating the autoimmune theory of schizophrenia. Patients (n = 10) in the study fulfilled Research Diagnostic Criteria for schizophrenia and were randomly assigned to either sham or active plasmapheresis. They were blindly assessed by staff psychiatrists and nurses. Evaluation of the behavioral ratings revealed no significant decrease in psychosis for either the active or sham group. Also, no individual responding patient was identified. This finding complements our group's early negative results of a hemodialysis experiment and casts doubt on a simple autoimmune hypothesis of schizophrenia.

Adolescent↗
PubMed1983

Ventricular enlargement in teenage patients with schizophrenia spectrum disorder.

Recent research has demonstrated statistically significant differences between the ventricular-brain ratios (VBRs) of schizophrenic patients and control subjects. In this study the VBRs of teenage schizophrenic/schizophreniform patients (N = 15) and borderline patients (N = 8) were measured and compared with those of controls of similar ages (N = 18). The schizophrenic group had significantly larger ventricles than the other two groups (p less than .0001). These findings support the hypothesis of previous investigators that ventricular enlargement is present early in the course of schizophrenia.

Adolescent↗