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Biomedical subjects

W O Faustman

Publications and source records attributed to W O Faustman.

At least 55 records · Page 3Linked to original sources
PubMed1991

Left-handedness in male schizophrenic patients is associated with increased impairment on the Luria-Nebraska Neuropsychological Battery.

Several studies suggest increased mixed and left-handedness in schizophrenia. This is of interest as early cerebral injury can result in increased left-handedness and some investigations have suggested a role for early developmental insult (e.g., birth complications) in schizophrenia. We administered the Luria-Nebraska Neuropsychological Battery (LNNB) to 24 left-handed male schizophrenic patients and a separate group of 24 right-handed schizophrenic patients who were age and education matched to the left-handed patients. The test protocol also was administered to 15 left-handed non-psychiatric control subjects and 15 right-handed controls. Direct comparisons (t-test) of the left- to right-handed schizophrenics revealed that the left-handed patients showed significantly greater impairment on several LNNB measures sensitive to cognitive deficits in schizophrenia. There were no differences between left- and right-handed control subjects. A further 2 X 2 ANOVA pooling all subjects noted several significant interactions between handedness and diagnostic group. The findings suggest a unique interaction between left-handedness and neuropsychological impairment in schizophrenia and could support a relationship between left-handedness, early cerebral insult, and cognitive deficits.

Analysis of Variance↗
PubMed1991

Limbic/mesolimbic connections and the pathogenesis of schizophrenia.

The development of models of the pathogenesis of neuropsychiatric diseases that build on recent advances in chemical neuroanatomy will help to guide future research. The interconnections among limbic, basal ganglia, and cortical structures are used to form the basis of a hypothesis of the pathogenesis of schizophrenia. The adaptive capacity of subcortical dopamine systems is advanced as an explanation of the many states of the disease.

Humans↗
PubMed1991

Symptomatology and cognitive impairment associate independently with post-dexamethasone cortisol concentrations in unmedicated schizophrenic patients.

Serum cortisol concentrations were measured after dexamethasone administration (1 mg) in 21 neuroleptic-free schizophrenic inpatients. Patients were assessed using the Brief Psychiatric Rating Scale and a battery of cognitive tests. A significant correlation was found between negative symptoms and both 8:00 AM and 4:00 PM post-dexamethasone cortisol concentration (PDC). Cognitive impairment on several measures was also correlated with 8 AM PDC, but in an independent manner. Although positive and negative symptoms were unrelated, exploratory analysis revealed a significant inverse correlation between a positive symptom grouping and both 8:00 AM and 4:00 PM PDC.

Adult↗
PubMed1991

MMPI measures of impulsivity and depression correlate with CSF 5-HIAA and HVA in depression but not schizophrenia.

Recent studies have linked impulsivity with CSF concentrations of both 5-hydroxyindoleacetic acid (5-HIAA) and homovanillic acid (HVA). One work found a negative correlation between the MMPI psychopathic deviate (Pd) scale and 5-HIAA in personality disordered men (Brown et al., 1982). We found that the 5-HIAA/Pd correlation extends (P less than 0.05) to unmedicated depressed patients (n = 21). A trend was found between HVA and Pd in depression. There was no relationship between either metabolite and the Pd scale in unmedicated schizophrenics (n = 24). A significant inverse correlation was found between the MMPI depression scale and CSF HVA but not 5-HIAA in the depressed patients.

Adult↗
PubMed1991

Evaluating cognitive impairment in depression with the Luria-Nebraska Neuropsychological Battery: severity correlates and comparisons with nonpsychiatric controls.

Depressed patients often complain of memory and attentional difficulties, and some research suggests an increased incidence of neuropsychological impairment in depression. Yet, many prior studies contain methodological problems, including the following: (1) inclusion of medicated patients, (2) small sample sizes, and (3) tests with unknown psychometric properties. We administered the Luria-Nebraska Neuropsychological Battery (LNNB) to 28 unmedicated inpatients who met Research Diagnostic Criteria for major depression. Twenty of the 28 patients were given additional cognitive measures (e.g., Wechsler Adult Intelligence Scale-Revised, Benton Tests). The depressed patients performed similarly to an age- and education-matched nonpsychiatric reference sample. When data for a subset of the most severely depressed patients were analyzed separately, these patients too were found to perform similarly to matched controls. There were no relationships between Hamilton rating scale measures of depression severity and any cognitive measures among the depressed patients. The results suggest that cognitive functioning in depressed patients does not differ significantly from that in carefully matched controls and is independent of symptom severity.

Adult↗
PubMed1991

Clinical factors that may confound the assessment of drug efficacy.

The development of new chemical classes of psychotherapeutic drugs offers the potential for new patterns of drug efficacy as well as decreases in side effects. However, the determination of drug efficacy can be confounded by sample selection and outcome determination factors. The ability of selected clinical factors of both types to affect the outcome of antipsychotic drug trials is reviewed. Suggestions for future clinical drug trials are made.

Clinical Trials as Topic↗
PubMed1990

CSF 5-HIAA, serum cortisol, and age differentially predict vegetative and cognitive symptoms in depression.

Prior studies have shown that both cerebrospinal fluid (CSF) concentrations of 5-hydroxyindolacetic acid (5-HIAA) and serum cortisol levels are related to overall symptom severity in depression. In the present study, 30 unmedicated inpatients meeting Research Diagnostic Criteria (RDC) criteria for depression participated in serum cortisol collection and a lumbar puncture for CSF. A multiple regression evaluated the ability of CSF 5-HIAA, serum cortisol, and age to predict cognitive and vegetative symptom clusters of the Hamilton Rating Scale for Depression. The multiple regression to predict the vegetative symptom cluster was highly significant overall (p = 0.002) and found that age and cortisol but not 5-HIAA predicted vegetative symptoms. The regression to predict the cognitive cluster narrowly missed overall significance (p = 0.06). Both CSF 5-HIAA and serum cortisol predicted cognitive symptoms and 5-HIAA predicted the cognitive cluster more strongly than cortisol. Age did not predict cognitive symptoms. The results suggest a dissociation between serum cortisol levels and CSF 5-HIAA in predicting vegetative and cognitive symptom clusters in depression.

Adult↗
PubMed1990

Correlates of rapid neuroleptic response in male patients with schizophrenia.

Correlates of neuroleptic response latency were assessed in 16 male schizophrenic inpatients during 4 weeks of fixed dose (20 mg/day) haloperidol treatment. Rapid responders showed a mean 40% reduction in Brief Psychiatric Rating Scale (BPRS) positive symptom scores by day 10 of treatment. Rapid responders had significantly lower plasma homovanillic acid (pHVA) concentrations compared to non-rapid responders during week 4 of haloperidol treatment. However, rapid versus non-rapid responders did not differ with respect to demographics, baseline positive or negative BPRS symptom scores, performance on tests of neuropsychological function, or mean plasma haloperidol concentrations.

Adult↗
PubMed1990

Distinguishing depression and negative symptoms in unmedicated patients with schizophrenia.

Depression can occur in schizophrenia but can be difficult to distinguish from negative symptoms of the illness. To evaluate whether concurrent use of the Hamilton Rating Scale for Depression (HRSD) and the Brief Psychiatric Rating Scale (BPRS) could successfully separate depression and negative symptoms, we examined ratings on 69 unmedicated schizophrenic inpatients. A classical BPRS depression subscale score correlated highly (rho = 0.80) with the HRSD total score. The classical BPRS "negative symptom" subscale score was unrelated to both the BPRS and HRSD depression summary measures. Among individual HRSD items, negative symptoms correlated only with work/activities and retardation. The findings suggest that negative and depressive symptoms may be assessed independently.

Adult↗
PubMed1990

Limitations of the Mini-Mental State Examination in predicting neuropsychological functioning in a psychiatric sample.

The present study examined the ability of the Mini-Mental State Examination (MMSE), a cognitive screening test commonly employed in research and clinical applications, to predict level of performance on a comprehensive neuropsychological battery, the Luria-Nebraska Neuropsychological Battery (LNNB). The tests were administered to a diagnostically mixed sample of 90 psychiatric inpatients. Correlations between the tests were statistically significant but modest and the MMSE was not able to detect many patients who demonstrated significant deficits on the LNNB. Additional correlational analyses between the MMSE and the Wechsler Adult Intelligence Scale-Revised in a subset of patients (n = 72) also showed a modest relationship between these instruments. The results suggest that the MMSE may seriously underestimate cognitive impairment in samples exclusively composed of psychiatric patients, making it inappropriate to rely solely on this instrument to distinguish psychiatric patients with and without cognitive deficit.

Adult↗
PubMed1990

5-HIAA in cerebrospinal fluid and deficit schizophrenic characteristics.

Higher CSF 5-HIAA concentrations and lower CSF HVA concentrations have been associated with various measures of slowed motor behaviour and communication in schizophrenic patients. To derive a single, reliable measure of deficit characteristics in schizophrenic patients, we entered four items of the BPRS reflecting negative symptoms, a work history measure derived from the Strauss-Carpenter scale, and three subscale scores of the WAIS-R into a principal-components analysis to derive a single factor score. The CSF 5-HIAA concentrations were within the normal range of values, and correlated directly with this factor score, but CSF HVA concentrations were not associated with the deficit factor score. These findings add support to the hypothesis that brain serotonin function is associated with deficit schizophrenic characteristics.

Adult↗
PubMed1989

Correlations between the MMPI and the Brief Psychiatric Rating Scale in schizophrenic and schizoaffective patients.

Though self-report measures and clinician-based ratings are extensively used to document psychopathology, there has been little work examining the relationship between these different types of measurement techniques. The current work examined the relationship between the Minnesota Multiphasic Personality Inventory (MMPI) and the Brief Psychiatric Rating Scale (BPRS) in patients with schizophrenia and schizoaffective disorder. Correlations were calculated in an initial exploratory sample, and a set of relationships was selected for confirmation in a second sample. The BPRS items of hallucinatory behavior and tension significantly correlated with MMPI measures of psychoticism. BPRS measures of hostility correlated with scale 4 (Psychopathic Deviate) of the MMPI. BPRS and MMPI measures of depression also were related. In contrast, BPRS and MMPI measures thought to reflect negative symptoms were uncorrelated. These results offer behavioral validity for the use of the MMPI in schizophrenic samples and suggest that the two measures tap similar as well as separable symptom constructs thought to be common in schizophrenia.

Adult↗
PubMed1989

Diagnostic and psychopharmacological treatment characteristics of 536 inpatients with posttraumatic stress disorder.

Descriptive information (demographic variables, DSM-III diagnoses, and medications prescribed) was obtained from the discharge summaries of 536 male veteran inpatients who received a diagnosis of posttraumatic stress disorder (PTSD) over a 4-year period. Data comparisons were also made between two types of inpatient programs (specialized PTSD vs. psychiatric ward) to control for program selection biases. Consistent with previous studies, alcohol and substance abuse and/or depression diagnoses occurred concurrently with PTSD. Diagnoses of schizophrenia were more prevalent in the psychiatric wards. Nearly one third of the total sample received an axis II diagnosis, with borderline features most common. Half of all patients received psychopharmacological treatment in addition to psychotherapy. Antidepressants, neuroleptics, and beta-blockers were prescribed most frequently. Directions for future inpatient PTSD research are offered based on the findings.

Adult↗
PubMed1989

Independence of positive and negative symptoms in a population of schizophrenic patients.

Numerous recent studies have divided schizophrenic patients into subgroups based on a predominance of positive or negative symptoms. These works often assume that these symptoms are distributed discontinuously or inversely. In the present work, we sought relationships between positive and negative schizophrenic symptoms in a medication-free inpatient population of schizophrenic patients (N = 61). Measures of positive and negative symptoms were derived from clinical ratings using the Brief Psychiatric Rating Scale. No correlations were found between positive and negative symptoms in the entire group, or in subgroups defined by duration of illness or diagnostic subtype. Furthermore, no correlations were found between positive or negative symptoms and age, age at onset of illness, or duration of illness. These data suggest that positive and negative symptoms vary independently among patients; knowledge about the level of positive symptoms provides no predictive information about negative symptoms. In addition, the distribution of patients showed that a large percentage have a mixture of positive and negative symptoms. Accordingly, methodologies that form restrictive subgroups of patients with exclusively positive or negative symptoms may have little generalizability to schizophrenic populations. The results suggest that schizophrenic patients should not be routinely subtyped as predominantly positive or negative.

Adult↗
PubMed1989

PTSD in minorities.

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Black or African American↗
PubMed1988

Luria-Nebraska performance and symptomatology in unmedicated schizophrenic patients.

Recent attempts at subgrouping schizophrenia have emphasized negative symptoms (e.g., blunted affect, emotional withdrawal), and several works have suggested that patients with negative symptoms show greater cognitive deficits and structural brain abnormalities. However, many of these studies have relied on screening devices or single measures of neuropsychological performance. Accordingly, the present study used the Luria-Nebraska Neuropsychological Battery (LNNB) in assessing 38 unmedicated inpatients with a diagnosis of schizophrenia. The results found no relationship between LNNB performance and symptom ratings derived from clinical interviews using the Brief Psychiatric Rating Scale. The findings show that cognitive performance may be unrelated to symptomatology when a complex battery type test is used.

Adult↗