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PubMed1990

[Left hemispheric site of EEG findings in patients with schizophrenic psychoses].

It was the aim of our study to examine the interhemispherical and extrahemispherical integration that is possibly disturbed in patients suffering from schizophrenic psychoses, using an easy method of EEG performance spectral analysis. For this purpose, the EEG at rest and the functional EEG were determined in 69 schizophrenic patients (ICD) and 22 healthy subjects and the EEG reactivity was calculated. Differences especially in alpha-2 reactivity were seen both intrahemispherically and interhemispherically. This supports the concept of left hemispheric dysfunction in patients suffering from schizophrenic psychoses.

Adult↗
PubMed1982

[Notes on the model "universal genesis of psychoses"--aspects of an unconventional interpretation of mental diseases (author's transl)].

The article describes a temporarily closed model of a uniform interpretation of all endogenous psychosyndromes (universal genesis of psychoses) which, however, is capable of extension and modification. This concept, which was developed in 1964, does not postulate a "unitary psychosis" in the narrow sense of the term. It is based mainly on results obtained in traditional psychiatry and combines individual aspects and opinions which are used by other psychiatrists also who share these opinions although mostly they do not employ them as general principles. To substantiate the author's own position, several old and new problems of the doctrine of psychoses are illuminated from a uniform point of view. In this synopsis biologically relevant aspects are emphasized, especially those of the common pathogenetic fundamentals, the common phases of the disease, as well as the agreements in recording of the syndromes. The final section of the study provides a condensed survey of the essential factors and consequences of the concept, supplying details to supplement this brief review.

Atrophy↗
PubMed1987

Effectivity of zotepine in refractory psychoses: possible relationship between zotepine and non-dopamine psychosis.

We reported the results of a survey of patients who suffered from schizophrenia with predominate hallucinatory and delusional states, and who had been unresponsive to a variety of antipsychotics like haloperidol but responded more favorably to zotepine. In 10 of the 22 zotepine-responsive patients in this study, there was marked improvement with zotepine. Considering the results from previous drug treatment, the phenothiazines (especially levomepromazine) surpassed the butyrophenones in efficacy, suggesting that zotepine might resemble levomepromazine clinically. After administration of zotepine, cenesthesic hallucination, behavior caused by hallucination, egorrhoe, affective symptoms, and catatonic symptoms were markedly improved. However, insight into disease and negative symptoms were minimally improved after administration of zotepine. Zotepine was effective in the refractory psychoses due to its potent action on the delusional dynamics, in spite of producing little marked improvement in such main symptoms as hallucination and delusion. The authors speculate that zotepine's potent activity at serotonin-1 receptors may lead to a beneficial effect in refractory psychoses, just as in the case of its antimanic effect.

Adolescent↗
PubMed1998

Combined treatment of schizophrenic psychoses with haloperidol and valproate.

In accordance with a previous study of adjuvant effects of the anticonvulsant carbamazepine (CBZ) on the neuroleptic treatment of schizophrenic psychoses, the effects of valproate (VPA) were tested in a randomly assigned double-blind, placebo-controlled study. Apart from a (statistically nonsignificant) psychopathological deterioration following discontinuation of VPA while on continuous neuroleptic mediation after four weeks and a statistically significant effect on "hostile belligerence", no overall therapeutic effects of the combination of haloperidol (HPD) with VPA were observed under controlled conditions. Unlike the results with CBZ, concomitant use of VPA led to an even higher consumption of haloperidol and biperiden and to a higher rate of extrapyramidal symptoms compared with the corresponding placebo group, although these differences did not attain statistical significance. In regard to use of the sedative neuroleptic chlorprothixene, there was a trend toward lower doses in the VPA group than in the placebo group. From these results, adjuvant effects like those of carbamazepine in the neuroleptic treatment of schizophrenic psychoses could not be confirmed for valproate in the present study. However, the trend toward lower doses of sedative medication and observed effects on "hostile belligerence" may indicate sedative and/or antimanic properties of valproate which have recently been demonstrated in several controlled studies.

Adult↗
PubMed1996

[Is periodic psychosis in adolescence a disease of its own? The differential diagnosis of psychomotor psychoses in childhood and adolescence].

A historically orientated analysis of a disease that must be seen in connection with menstruation is made on the basis of literature on periodical psychoses in adolescence, which are described as nosologically separate disturbances. This relation turns out to be by no means obligatory, and this also applies to the homogeneity of the disease. Psychomotor disturbances of psychopathological importance are described by means of ideally typical cases of disease and presented with a differentiated diagnosis. Psychoses occurring during different periods in childhood and adolescence, do not show any sex-specific differences and no absolute dependence in accordance with the menstruation rhythm, but are mostly connected with a hereditary and also a perinatal strain in childhood. In their acute and long-term progress the psychomotoric disturbances allow a differentiated prognosis and therefore a therapeutic explanation. They can be classified in accordance with the Wernicke-Kleist-Leonhard classification schema as motility psychosis and periodic catatonia. With this in mind, the positive-negative dichotomy of schizophrenic disturbances in childhood and adolescence should be carefully reconsidered.

Adolescent↗
PubMed1992

Multiple-risk cohorts and segmenting risk as solutions to the problem of false positives in risk for the major psychoses.

This paper briefly reviews the past promise, current results, and problems that have resulted from application of the risk group approach to understanding the etiology of the major psychoses. The ultimate objective is to stimulate a change in methods that it is hoped will lead to the knowledge required to warrant intervention. Methods of intervention are not reviewed because it is considered more important at this time to improve our understanding of the life course of these disorders. Interventions can be justified when a body of well-agreed-upon findings has accumulated indicating the developmental pathways to the major psychoses, including the situational contexts. It is assumed that the timing and mode of intervention will be evident when these pathways have been delineated.

Adolescent↗
PubMed2005

Evaluation of diagnostic procedures in Swedish patients with schizophrenia and related psychoses.

We aimed to estimate the value of structured interviews, medical records and Swedish register diagnoses for assessing lifetime diagnosis of patients with schizophrenia. Psychiatric records and diagnostic interviews of 143 Swedish patients diagnosed by their treating physician with schizophrenia and related disorders were scrutinized. Based on record analysis only, or a combined record and interview analysis, DSM-IV diagnoses were obtained by the OPCRIT algorithm. Independent of the OPCRIT algorithm, a standard research DSM-IV diagnosis, based on both record and interview analysis, was given by the research psychiatrist. Concordance rates for the different psychosis diagnoses were calculated. DSM-IV diagnoses based on records only, showed a good to excellent agreement with diagnoses based on records and interviews. Swedish register diagnoses displayed generally poor agreement with the research diagnoses. Nevertheless, 94% of subjects sometimes registered with a diagnosis of schizophrenic psychoses (i.e. schizophrenia, schizoaffective psychosis or schizophreniform disorder) displayed a standard research DSM-IV diagnosis of these disorders. For patients in long-term treatment for schizophrenia in Sweden, psychiatric record reviews should be optimal, cost effective and sufficient for assessment of lifetime research diagnoses of schizophrenia. For these patients a research interview adds little new information. The results further indicate that a Swedish register diagnosis of schizophrenic psychoses has a high positive predictive power to a standard research DSM-IV diagnosis of the disorders. It is concluded that for future Swedish large-scale genetic studies focusing on a broad definition of schizophrenia, it would be sufficient to rely on the Swedish register diagnoses of schizophrenic psychosis.

Adult↗
PubMed2006

Patterns of psychiatric hospitalizations in schizophrenic psychoses within the Northern Finland 1966 Birth Cohort.

We report patterns of hospitalization in schizophrenic psychoses by age 34 in a longitudinal population-based cohort. We test the predictive ability of various demographic and illness-related variables on patterns of hospitalization, with a special focus on the length of the first psychiatric hospitalization. All living subjects of the Northern Finland 1966 Birth Cohort with DSM-III-R schizophrenia (n=88) and other schizophrenia spectrum cases (n=27) by the year 1997 in the Finnish Hospital Discharge Register were followed for an average of 10.5 years. Measures of psychiatric hospitalization included time to re-hospitalization (as continuous and as re-hospitalization within 2 years) and the number of hospital episodes. Length of the first hospitalization, other illness-related and various socio-demographic predictors were used to predict hospitalization patterns. After adjusting for gender, age at first admission and number of hospital days a short (1-14 days) first hospitalization (reference >30 days; adjusted odds ratio 6.39; 95% CI 2.00-20.41) and familial risk of psychosis (OR 3.36; 1.09-10.39) predicted re-hospitalization within 2 years. A short first hospitalization also predicted frequent psychiatric admissions defined as the first three admissions within 3 years (OR 13.77; 3.92-48.36). A short first hospitalization was linked to increased risk of re-hospitalizations. Although short hospitalization is recommended by several guidelines, there may be a group of patients with schizophrenic psychoses in which too short a hospitalization may lead to inadequate treatment response.

Adult↗
PubMed2004

Differences in quality of life and course of illness between cycloid and schizophrenic psychoses - a comparative study.

OBJECTIVE: Cycloid psychoses represent a nosological entity not adequately recognised by contemporary psychiatry. They present with full recoveries after each psychotic episode and, thus, have a favourable prognosis. METHOD: To verify this clinical observation course, outcome and quality of life (QoL, measured by the German version of the Lancashire Quality of Life Profile) of 33 patients with cycloid psychosis and 44 schizophrenics were compared after a mean time of 13 years since first hospitalisation. For comparison of objective and subjective QoL measures, 48 healthy controls were included. RESULTS: Concerning the course of their disease, schizophrenics were hospitalised significantly longer and received higher neuroleptic doses than patients with cycloid psychosis. The latter displayed significantly better scores in the CGI, GAF, Strauss-Carpenter-Outcome and PANSS scales. In global QoL measures, cycloid psychotic patients were more satisfied with their QoL than schizophrenic patients, and did not differ significantly from healthy controls. CONCLUSION: Cycloid psychoses seem to exhibit a better prognosis than schizophrenia regarding course, outcome, objective, and subjective aspects of QoL. Thus, they appear to present a useful concept deserving more clinical and scientific attention.

Adolescent↗
PubMed1980

Selected aspects of the epidemiology of psychoses in Croatia, Yugoslavia. IV. Representative sample of Croatia and results of the survey.

This is the fourth paper in a series on the epidemiology of psychoses in Croatia, Yugoslavia. Data collected from 1960-1975 on a representative sample of the population of the study area, including the Istrian Peninsula and the northern Adriatic littoral, and the control area, the rest of Croatia, indicate that functional psychotic illnesses are more frequent in the study area, with the highest rates in older population groups. The finding is not associated with coastal or inland residence, with educational level, or with occupational group. Other diseases in excess in the study area are diabetes mellitus, psoriasis, and alcoholism. Nutritional disorders are about equally distributed between study and control areas. Data on extent of cigarette smoking was more prevalent in the study area, cases of functional psychoses smoked no more than the general population.

Adult↗
PubMed1981

Nosology of paranoid schizophrenia and other paranoid psychoses.

The history of nosologic approaches to paranoid schizophrenia and the other paranoid psychoses is traced from the time of Kraepelin. Kraepelin, emphasizing the course of illness, proposed a narrow definition for paranoid dementia praecox (paranoid schizophrenia). He created the entity of paraphrenia for cases with symptoms similar to those in paranoid dementia praecox but without a deteriorating course. Bleuler, emphasizing underlying psychological mechanisms, broadened the concept of paranoid schizophrenia to include nearly all delusional functional psychotic states. After Bleuler, the controversy continued as to whether the paranoid psychoses belonged within or separate from the schizophrenic disorders. Emerging from these historical controversies, current nosologic approaches to paranoid schizophrenia and paranoid psychosis differ substantially. Approaches to paranoid schizophrenia range from broad global criteria, which include patients with thought disorder and affective deterioration (e.g., ICD-9), to narrow criteria such as those proposed by Tsuang and Winokur (1974), which specifically exclude such patients. While some criteria for paranoid psychosis exclude patients with hallucinations or other than persecutory or jealous delusions (e.g., DSM-III), other criteria include such patients.

Adult↗
PubMed1998

Schizophrenic psychoses and the CNTF null mutation.

Genetic susceptibility plays an important role in the development of schizophrenic psychoses, and the neural maldevelopment hypothesis is suggested by neuropathological and neuroimaging findings. We investigated the association between a null mutation in the ciliary neurotrophic factor (CNTF) gene and functional psychoses including schizophrenia and schizoaffective disorder. The frequency of mutant allele was significantly increased in patients with schizoaffective disorder, but not in those with schizophrenia in comparison with controls. The CNTF null mutation resulting in CNTF deficiency may confer potential susceptibility to schizoaffective disorder.

Adult↗
PubMed1990

Drug-resistance phenomena in major psychoses: their discrimination and causal mechanisms.

Drug-resistance phenomena are commonly encountered in psychiatric practice and are of particular concern in the treatment of major psychoses. Of paramount importance is the need to discriminate between drug-resistance problems due to pharmacodynamic factors (i.e., receptor sensitivity) or pharmacokinetic factors (inadequate plasma concentration of the drugs at receptor sites). To exclude the former, plasma level measurements of antidepressant and neuroleptic compounds are desirable. Actually, lack of or poor compliance is a peculiarity (often underestimated) when treating psychotic patients, and the use of the drug plasma level/dose ratio (L/D) approach is useful, particularly with outpatients. Another source of drug resistance stems from the inter-individual metabolic variability, as with haloperidol or anticholinergic drugs, which are used to counteract neuroleptic-induced extrapyramidal side effects. In general, plasma-level measurement is advisable whenever no or poor response is obtained during standard treatments with neuroleptic, antidepressant, or anticholinergic drugs. Finally, this author suggests a four-level discrimination process to determine drug resistance in major psychoses, which includes clinical, pharmacological, pharmacokinetic, and pharmacodynamic factors.

Antidepressive Agents↗
PubMed1999

An open trial of olanzapine in patients with treatment-refractory psychoses.

Olanzapine's structural similarities to clozapine and the results of premarketing clinical trials suggested potential usefulness in treating patients with treatment-refractory psychoses. Sixteen inpatients from the state hospital with severe, refractory schizophrenic or schizoaffective psychoses received olanzapine in a prospective, 12-week, open-label trial. The olanzapine dose was 10 mg/day for at least the first 6 weeks and never exceeded 20 mg/day. Mood stabilizers and other antipsychotic agents were discontinued before olanzapine was started. Patients frequently became more agitated within the first several weeks of initiating treatment, requiring the increased use of benzodiazepines and often leading to the discontinuation of olanzapine. Two patients improved significantly. Overall, significant clinical improvement was noted only for motor side effects. This study concluded that olanzapine was not effective in this heterogeneous group with chronic, severe, treatment-resistant psychosis when used in this manner. Further research is needed to explain the tendency toward agitation upon transition to olanzapine, which is reminiscent of reported risperidone complications. Clinicians should be alert for this complication and should minimize concomitant medication changes that might add to the risk of emergent agitation.

Adult↗
PubMedDate not supplied

Plasma interleukin-1 beta and sleep architecture in schizophrenia and other nonaffective psychoses.

OBJECTIVE: It has been reported that sleep deprivation may enhance interleukin (IL)-1 beta production of healthy subjects. Furthermore, patients with acute psychoses have been reported to exhibit higher levels of IL-1 beta than healthy controls. The present study examined polysomnographic sleep and morning IL-1 beta plasma values in 20 drug-free patients with acute nonaffective psychoses. METHODS: Ten patients with DSM-III diagnosis of schizophrenia, five with delusional disorder, and five with atypical psychosis underwent polysomnographic sleep registrations and their morning blood levels of IL-1 beta were measured. RESULTS: IL-1 beta values correlated negatively with the length of the sleep period (p = 0.010) and the relative time of rapid eye movement (REM) sleep (p = 0.038), and positively with REM latency (p = 0.043). CONCLUSIONS: It is concluded that reduced sleep, possibly especially reduced REM sleep, may be a reason for increased morning IL-1 beta values in these patients. Additional studies on IL-1 beta in psychiatric patients should consider the possibility of sleep disturbances as a possible explanation for deviations in IL-1 beta levels.

Adolescent↗
PubMed1996

Postictal psychosis: a comparison with acute interictal and chronic psychoses.

We studied 30 patients with postictal psychosis and compared them with 33 patients with acute interictal psychosis and 25 patients with chronic psychosis. All patients had either complex partial seizures (CPS) or EEG temporal epileptogenic foci. Patients with postictal psychosis had a high incidence of psychic auras and nocturnal secondarily generalized seizures. The most striking feature that distinguished postictal psychosis from both acute interictal and chronic psychoses was phenomenological: the relatively frequent occurrence of grandiose delusions as well as religious delusions in the setting of markedly elevated moods and feeling of mystic fusion of the body with the universe. In addition, postictal psychosis exhibited few schizophreniform psychotic traits such as perceptual delusions or voices commenting. Reminiscence, mental diplopia, and a feeling of impending death were also fairly frequent complaints of patients with postictal psychosis. Interictal acute psychosis and chronic epileptic psychosis were psychopathologically similar. Although acute interictal and chronic epileptic psychoses could simulate schizophrenia, postictal psychosis results in a mental state quite different from that of schizophrenic psychosis.

Adult↗
PubMed1991

A followup study of manic-depressive and schizoaffective psychoses after systemic family therapy.

The authors report the results of a followup study of manic-depressive and schizoaffective psychoses after systemic family therapy. They describe the development of inpatient relapse rates, familial interactional patterns, and prescriptions of medication in a sample of 30 cases treated with family therapy and followed up after a mean interval of 3 years. Finally, they assess the effectiveness of systemic family therapy with manic-depressive and schizoaffective psychoses.

Adolescent↗
PubMed1976

A method for testing differences in morbidity risk for affective psychoses.

A modified method for testing differences between two proportions is described and its use for testing differences in the morbidity risk for affective psychoses is discussed. The method is based upon the u test for comparisonof two proportions. An example of the application of the method to study sex differences in morbidity risk for affective psychoses in parents of probands with unipolar depression and manic-depressive psychosis presented.

Bipolar Disorder↗