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PubMed1985

A contribution to the validity of Leonhard's classification of endogenous psychoses.

The author made a clinical-genetical study of the schizophrenias and cycloid (schizoaffective) psychoses following the Leonhardian classification, using the traditional pedigree analysis and multiple threshold method. According to the latter method--on the basis of phenotypical correlations--the systematic schizophrenias could be clearly distinguished from the cycloid psychoses, while the non-systematic category presumably occupies a genetical position between the two former categories.

Adolescent↗
PubMed1987

Onset of functional psychoses in later middle age. Social-psychiatric considerations.

The onset of functional psychosis occurring in later middle age (45-64 years) was studied by comparing the life situation and personal history of 74 Turku patients admitted to the mental hospital for the first time with the corresponding information obtained for randomly selected controls of the same age and of the same sex. The annual first admission rate of functional psychoses was 81 per 100,000; there was no difference between men and women. The rate was highest in unmarried individuals and lowest in married individuals (167 vs. 56 per 100,000). Measured by many different indicators, the patients' prepsychotic social development had been clearly poorer than that of the controls during the corresponding period. Almost all patients had had a precipitating life change during the last 5 years preceding the onset of psychosis. Objective losses had occurred more often in the group of affective psychoses than in the other diagnostic groups. In the case of childhood losses, on the other hand, there were no difference between patients and controls or between the diagnostic groups.

Age Factors↗
PubMed1988

A prospective study of postpartum psychoses in a high-risk group. 3. Relationship to mental health characteristics during pregnancy.

Within a sample of 88 pregnant women with a history of nonorganic psychosis, mental health characteristics during pregnancy, assessed prospectively through interviews and psychiatric records, were studied in relationship to the development of 25 postpartum psychotic episodes (PPPs) occurring during the first 6 months postpartum. Cases with PPP onset within 3 weeks of delivery (mostly affective or cycloid psychoses) evidenced more frequent tension-anxiety and excitement at interviews during pregnancy than did diagnostically comparable cases not developing PPPs. Cases with PPP onset later than 3 weeks postpartum (mostly schizophrenic-like psychoses) were not more frequently disturbed than were diagnostically comparable cases not developing PPPs. An absence of both affective symptoms and common fears represented a sign of increased PPP-risk in these later onset cases. The subsample of actively disturbed cases who were in contact with a psychiatrist during pregnancy were at notably increased risk for a PPP during the total 6-month period.

Affective Disorders, Psychotic↗
PubMed1989

The incidence of negative symptoms in early schizophrenia, mania and other psychoses.

Despite increasing interest in negative symptoms in schizophrenia there has been little work on their incidence in early schizophrenia or in other psychoses. This study examined 79 nondepressive psychotics within 2 years of onset of illness, diagnosed by Research Diagnostic Criteria and assessed for negative symptoms using the Scale for the Assessment of Negative Symptoms. Marked negative symptoms were observed in nearly half of patients diagnosed as suffering definite schizophrenia and were rarely found in other psychoses. Negative symptoms were not significantly correlated with positive symptoms, depression or exposure to neuroleptics, but were correlated with developing extrapyramidal side effects.

Adult↗
PubMed1994

The influence of community-based psychiatry in Copenhagen on the treatment of chronic psychoses.

Several factors influence the outcome of prevention of relapse in patients with chronic psychoses--mainly schizophrenia. A key word in the prophylactic treatment is compliance. Compliance is primarily related to drug treatment, but seen in a broader perspective it depends on the circumstances under which the treatment is offered. From 3 cohort investigations in Copenhagen mainly including patients with chronic psychoses, it seems as if community-based psychiatry in Copenhagen possesses some of the ingredients--high professional standard, continuity, care and support--that are considered to improve the outcome of treatment. However, suicidality and social isolation are some of the important areas that need further attention.

Chronic Disease↗
PubMed1999

Compliance in psychoses.

OBJECTIVE: To review the literature on compliance in psychoses and to evaluate the significance of the different compliance components presented. METHOD: Different definitions of the term compliance were first gathered. A search covering the years 1974-1997 was conducted in Medline and PsycLit databases using the keywords 'schizophrenia' or 'psychosis' and 'compliance'. The studies that took compliance into account as a separate variable were collected for further analysis. RESULTS: Unpleasant side-effects of medication, attitudes towards medication, delusional symptoms, substance abuse, insight, and supportive family environment were found to have the strongest correlation with compliance. The influence of cognitive impairment is not clearly proven. Integrated, cognitive-behavioural and psychoeducational treatment models include several methods to improve therapeutic alliance and compliance. CONCLUSION: As the majority of the studies have concentrated on neuroleptic treatment, the medication-related factors are best documented. In clinical practice, treatment compliance is based on patient-related, medication-related and interactional factors, such as treatment model and therapeutic alliance. Difficulties with insight and cognitive functioning are specific patient-related factors in the treatment of psychoses.

Antipsychotic Agents↗
PubMed2004

Serum lipids in schizophrenia and other functional psychoses: a general population northern Finland 1966 birth cohort survey.

OBJECTIVE: To compare fasting serum lipid concentrations of subjects with schizophrenia with a comparison group. METHOD: The study sample consists of 5654 members of the northern Finland 1966 birth cohort who participated in the field study with blood samples after overnight fasting and clinical examination in 1997-98. Total cholesterol (TC), high-density lipoprotein cholesterol, low-density lipoprotein cholesterol, triglycerides (TG) and glucose were analyzed. Analysis of variance were used for comparing differences in lipids means between diagnostic categories. RESULTS: Mean fasting TC in subjects with schizophrenia was 20 mg/dl higher than in the comparison group. TC and TG levels in the group of other psychoses resembled the schizophrenia group. CONCLUSION: Blood lipid levels in subjects with schizophrenia and other functional psychoses were high. As these persons are at special risk for hyperlipidemia their lipid levels should be regularly monitored, and cholesterol lowering diet, as well as medication, should be considered.

Adult↗
PubMedDate not supplied

Psychopathological dimensions in childhood and adolescent psychoses: a confirmatory factor analytical study.

The present study explored psychopathological dimensions in psychoses of children and adolescents and the distribution of demographic and clinical variables across different psychopathological domains. This study included 101 consecutive patients aged 6-18 years who had a DSM-IV psychotic disorder (schizophrenia and related disorders or mood disorders). Exclusion criteria included presence of organicity, substance use disorders, and any other childhood disorder. Psychopathology was assessed with Scales for Assessment of Positive and Negative Symptoms. Analysis revealed a four-factor model comprising primary negative, secondary negative, manic and paranoid factors. Patients were regrouped into one of the four factors based on their symptomatology. Patients in these four groups differed in education and age of onset and duration of illness. This study confirmed the existence of a factor structure in psychoses of children and adolescents.

Adolescent↗
PubMed1986

Long-term follow-up of paranoid psychoses.

Approximately 200 out of 301 first-admitted hospitalized patients with paranoid psychoses earlier studied by Retterstøl are still alive. These subjects are at present being interviewed semistructurally by the author, making a total follow-up period of 22-37 years after index admission. Before the interviews, diagnoses at discharge and at previous follow-ups based upon the records are established. Different diagnostic procedures are used. Preliminary results from the first 125 interviews indicate a small change to the worse as to psychopathology during the last 20 years. Outcome in DSM-III schizophreniform disorder, RDC schizoaffective disorders, Kendler's delusional disorders and ICD-9 reactive psychoses differs distinctly from the less favorable outcome in DSM-III schizophrenia.

Adjustment Disorders↗
PubMed1986

Outcome studies on schizophrenic psychoses in Helsinki.

This paper deals with the prognosis of schizophrenic psychoses in Helsinki in 1950-1955, 1960-1965, 1965-1970, 1970-1975, and 1975-1980. The first 4 cohorts each include a sample of 100 patients taken in 1950, 1960, 1965, and 1970. The patients were admitted for the first time to a psychiatric hospital because of schizophrenic and paranoid psychoses. The 1975 material includes all (n = 94) first admissions for schizophrenia, fulfilling the DSM-III criteria of schizophrenia or schizophreniform psychosis.

Adolescent↗
PubMed1989

Classification and outcome in nonschizophrenic, nonaffective delusional psychoses.

In a prospective study of nonschizophrenic, nonaffective delusional psychoses, 46 patients are classified according to ICD-8, DMS-III, Kendler's criteria for delusional disorder, Opjordsmoen's criteria for reactive delusional disorder, and Jørgensen and Jensen's criteria for reactive delusional psychosis. No single diagnostic group includes all patients. About one third of the patients are employed continuously, and less than half the patients have weekly social contacts. At a 2-year follow-up, big differences are revealed between the diagnostic groups as regards (1) signs and symptoms (no signs and symptoms 0-70%), (2) work status (employed continuously 11-60%), and (3) social contacts (weekly social contacts 11-60%). An overwhelming minority (0-25%) have an overall good outcome. To improve the classification of nonschizophrenic, nonaffective delusional psychoses with poor outcome (paranoia) and good outcome (reactive delusional psychosis), a multiaxial and polydiagnostic approach is recommended.

Adolescent↗
PubMed1989

Prediction of clinical course and outcome in delusional psychoses. A multivariate analysis of a 4-year re-follow-up.

The purpose of the study was to examine the predictive value of clinical and socio-vocational variables of first-admitted patients with delusional psychoses as regards clinical course and outcome, which was illustrated by the dimensions: psychotic symptoms, impairment, remission, and relapse at a 4-year re-follow-up. An excess of patients had poor course and outcome. In the multivariate logistic analysis an independent statistically significant effect was assigned to male sex, low social group, few social contacts, no work, and long duration of psychosis. The most informative clinical and social predictors yielded a maximal information of 19-50% for the different dimensions of course and outcome. One-fifth of the patients had good outcome. Living with others and at the same time having frequent social contacts was a variable with an independent statistically significant effect. The most informative predictors of good outcome yielded a maximal information of 34%. Differences between predictors of 2-year and 4-year course and outcome are discussed. It is concluded that good prognosis is exceptional in patients with delusional psychoses and from a nosological approach attached to patients with reactive psychosis. However, socio-vocational variables at index admission are predictors of higher statistical information than any clinical variable.

Adolescent↗
PubMed1990

Catamnesis of endogenous psychoses according to the differential diagnostic method of Karl Leonhard.

The validity of the current systems of classification of endogenous psychoses has not yet been unambiguously demonstrated using the criterion of prognosis. An alternative to these systems may be seen in the Leonhard classification of endogenous psychoses. In a catamnestic study, 93% of the initial diagnoses and prognoses made between 1969 and 1973 could be confirmed in 1986.

Bipolar Disorder↗
PubMed1979

On schizophrenic psychoses.

The author traces the history of the concept of schizophrenic psychoses from Kraepelin's differentiation of dementia praecox from other mental illness and Bleuler's formulation of schizophrenia through the delimitation of the definition of schizophrenia to current thought on the etiology, treatment, and outcome of schizophrenic psychoses. He stresses the importance of our knowledge of both psychological and hereditary factors and urges that rather than searching only for a single, causal metabolic error we also accept the possibility that schizophrenia occurs in highly human, spiritual spheres and consider the schizophrenogenic influences in the lives and personalities of individual patients.

Diagnosis, Differential↗
PubMed1989

HPA axis hyperactivity and recovery from functional psychoses.

Some patients with functional psychoses follow a chronic, deteriorating course and others recover; at present clinicians have essentially no established factors beyond diagnosis and chronicity to predict which course a psychotic patient might follow. Because data on diagnostic specificity suggested that the dexamethasone suppression test might provide another, much needed prognostic factor, the authors administered these tests to 98 consecutively admitted patients with nonmanic psychoses. High postdexamethasone cortisol levels (6 micrograms/dl or higher) at baseline predicted recovery from psychosis at 1 year, independent of episode chronicity and diagnosis. Diagnosis did not correspond well to test results but was itself an important predictor.

Adult↗
PubMed2000

Premorbid functioning in a national population of male twins discordant for psychoses.

OBJECTIVE: The goal of the current study was to compare premorbid behavioral and cognitive functioning between co-twins discordant for psychotic disorder and between these pairs of twins and pairs of twins with no psychotic disorders. METHOD: The authors linked data from the Israeli Draft Board Registry, which contains cognitive and behavioral assessments of all 16-17-year-old male Israeli twins, with data from the National Psychiatric Hospitalization Case Registry. Pairs of male twins who were healthy at the time of testing but discordant for psychoses later on were compared with one another and with pairs of healthy male twins. RESULTS: The affected twins performed significantly worse than healthy twins on measures of individual autonomy, social functioning, and physical activity and nonsignificantly worse on measures of abstract reasoning. There were no significant differences in cognitive or behavioral scores between the co-twins who did or did not develop psychotic disorders. CONCLUSIONS: The authors conclude that these findings underscore the familial nature of behavioral and cognitive deficits antecedent to psychoses.

Adolescent↗
PubMed1976

Attitude to psychiatric treatment before suicide in schizophrenia and paranoid psychoses.

The purpose of the study was to clarify the attitude of patients with schizophrenia and paranoid psychoses towards hospital personnel and treatment procedures during the two pre-suicidal months. The study was carried out on subjects from south Finland who had committed suicide during a three-year period and had been treated under these diagnoses. The controls included suicides who had received psychiatric treatment for other reasons. A questionnaire was issued to ascertain the opinions of the doctor last in charge of the patient and other personnel. Both groups answered independently, and the opinions given were almost the same. Both groups stated that during the last pre-suicidal months the patients with schizophrenia and paranoid psychoses had shown a more negative or indifferent attitude towards personnel than the controls, and their attitude towards medication had been clearly more negative. Among them there were considerably more patients who had ceased to request support or attention. Thus these patients had developed a degree of despair which manifested itself in a negative attitude towards personnel and treatment.

Attitude of Health Personnel↗