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PubMed1991

Acute psychoses associated with the use of ciprofloxacin and trimethoprim-sulfamethoxazole.

Although adverse drug reactions are a well-recognized cause of mental status changes in the elderly, antimicrobials are rarely implicated. Three patients with serious organic brain disease developed paranoid psychosis after therapy with trimethoprim-sulfamethoxazole or ciprofloxacin was begun. One of the patients was accidently rechallenged and again developed a psychotic reaction. The acute psychoses did not improve with moderate doses of major tranquilizers but resolved completely with drug discontinuation.

Adult↗
PubMed1989

[Evaluation of pathological grounds in the pathogenesis and prognosis of alcoholic psychoses].

Clinico-statistical analysis of the role of pathogenic grounds for prediction of the first attack of alcoholic psychosis and its course was performed in 689 patients with alcoholic psychoses. The patients concentrated within the age group of 20 to 39 years. In the control group (without the pathological grounds) this period is shifted to 35-49 years. The authors concluded that younger patients of the main group are at higher risk of alcoholic psychosis due to the impact of high risk factors on the progress rate of the disease.

Adolescent↗
PubMed1979

[Clinical picture of atypical alcoholic psychoses].

Results of a long-term clinico-catamnestical study of 489 patients with atypical alcoholic psychoses indicate that only the following cases develop atypically; a) where in the framework of separate attacks there is a combination of verbal hallucinosis, diverse more or less systematized delusional ideas (including delusions of influence), separate traits of the syndrome of psychic automatisms and oneiroid episodes; b) where there is a transformation (atypization) of the syndromokinesis from attack to attack; c) where there is a continuation of the process of atypization up to a development of signs of partial or total alcoholic or alcoholic-organic dementia.

Adult↗
PubMed1983

[Protracted psychoses in juvenile psychopath-like heboid schizophrenia (atypical variant of its course)].

A group of 22 patients selected as a result of follow-up examinations of 104 patients with juvenile psychopathlike heboid schizophrenia is described. A specific feature of the disease course in the patients observed consisted in appearance of atypical protracted psychoses after a long-time period of psychopathlike heboid disorders. Peculiarities differentiating this form from the slow-progressive variant of psychopathlike heboid schizophrenia and from paroxysmal schizophrenia with heboid initial stage are presented. The group described occupies an intermediate place between these forms of schizophrenia. A question on the role of aggravation of the disease course with various exogenous adverse factors (noted in all the cases described) is discussed.

Adolescent↗
PubMed1994

[Cannabis and psychoses].

Patients with the combination of cannabis abuse and psychosis are difficult to treat. The intoxicated state has many similarities to schizophrenia. Like other drugs with abuse potential cannabis affects the brain's reward system. It has not been possible to show major structural changes in the cerebrum, but by electron microscopy structural changes can be shown in animals especially in the hippocampus. The drug is taken in order to escape reality, and a vicious circle tending to maintain the person's abuse pattern which includes reduced energy, judgment and memory may be established. Cannabis may cause toxic psychosis, with a tendency to recurrent psychoses with continued abuse. There is no convincing support for the assumption that cannabis can cause chronic functional psychosis following cessation of abuse. Schizophrenic patients who use cannabis are often trying to reduce the discomfort caused by symptoms in the prodromal phase. By continued abuse positive psychotic symptoms are worsened. Antidepressant drugs may diminish the depressive elements of the disease. Some cannabis users are especially sensitive and develop toxic psychosis. Patients with repeated toxic psychosis may erroneously be diagnosed as schizophrenics. It is therefore important to be aware that a psychotic state may be caused by abuse of cannabis, and adjust treatment to this fact.

Humans↗
PubMed1976

[Thiamine deficit in acute alcoholic psychoses].

In 35 females and 22 males with acute alcoholic disorders and in 44 individuals of a control group the author studied the indices of thiamine balance--the content of thiamine and pyruvic acid in the blood and urine, concentration of citric acid in the blood, activity of transketolase of erythrocytes and TDP-effect. The results demonstrated that a thiamide deficiency in excretion and insufficiency in coenzyme functions of oxidative decarboxylation of pyruvic acid and in the pentose cycle is seen not only in alcoholic psychoses, but in the withdrawal syndrome. Sex differences of these indices and their development were not noted. It is assumed that the clinical traits of alcoholic disorders in females are not related to changes in the thiamine metabolism.

Acute Disease↗
PubMed1980

Mean serum creatine kinase activity in patients with functional psychoses.

Increased serum creatine kinase (CPK) activity has been reported to be present during acute exacerbations of psychosis in the majority of patients with the major "functional" psychoses. It has also been demonstrated that mean serum CPK activity, ie, average daily serum CPK activity, is under genetic control. In this report, we present evidence for an association between the presence of a transient elevation of serum CPK activity beyond the upper limit of normal during psychotic episodes and relatively high mean serum CPK levels during the rest of hospitalization. The magnitude of the transient serum CPK elevation was correlated with mean serum CPK activity in psychotic patients. The mean serum CPK level was also correlated with the terminal innervation ratio, an indication of alpha motor neuron dysfunction. The incidence of serum CPK elevations in first-degree relatives of psychotic patients was significantly greater in patients with high mean serum CPK activity than in those with low mean serum CPK activity. High mean serum CPK activity may be an indication of an increase in permeability of the muscle cell membrane, which in turn may be due to some defect in the neurotrophic regulation of muscle physiology or an independent expression of muscle abnormalities.

Age Factors↗
PubMed1984

Carbamazepine and haloperidol v placebo and haloperidol in excited psychoses. A controlled study.

Carbamazepine has recently been reported to have therapeutic potential in mania. We studied carbamazepine plus haloperidol v placebo plus haloperidol in excited psychoses in a controlled double-blind design. Twenty-three patients completed five weeks of carbamazepine-haloperidol therapy, and 20 patients placebo-haloperidol therapy. Brief Psychiatric Rating Scale ratings showed superior improvement in the group receiving carbamazepine plus haloperidol. This benefit was as apparent in excited schizophrenia as in mania. No unusual toxicity was observed because of the combination of haloperidol with carbamazepine.

Adult↗
PubMed1995

The New York High-Risk Project. Psychoses and cluster A personality disorders in offspring of schizophrenic parents at 23 years of follow-up.

BACKGROUND: We herein present lifetime prevalence rates of psychoses and DSM-III-R cluster A personality disorders in sample A of the New York High-Risk Project, a prospective study following offspring of parents with schizophrenia (HRSz subjects) and affective illness (HRAff subjects) and of psychiatrically normal parents (NC subjects) from midchildhood to adulthood. METHODS: We interviewed the offspring in adulthood with the Schedule for Affective Disorders and Schizophrenia, Lifetime Version, for Axis I disorders and the Personality Disorder Examination for Axis II disorders. RESULTS: Lifetime prevalence rates (+/- SE) of schizophrenia and unspecified psychosis were 11.1% +/- 4.3% and 5.6% +/- 3.1%, respectively, in the HRSz group and 0% in the HRAff and NC groups. Rates of schizoaffective disorder subclassified as mainly schizophrenic, however, were highest in the HRAff group. Rates of psychotic affective disorders did not differ between the HRSz and other groups. Age-corrected morbidity risks were similar to lifetime prevalence rates. Rates of the three cluster A personality disorders did not differ among the groups, but the combined rate was greater in the HRSz and HRAff groups than in the NC group. CONCLUSIONS: Our data strongly support a specific familial liability to narrowly defined schizophrenia that is not shared by families of probands with affective disorder. Schizoaffective disorder and cluster A personality disorders, however, occur in families of both schizophrenic probands and probands with affective disorder. Psychotic affective disorders, which are not increased in HRSz subjects, do not appear to be an expression of the liability to schizophrenia.

Adolescent↗
PubMed2004

Comparison of progressive cortical gray matter loss in childhood-onset schizophrenia with that in childhood-onset atypical psychoses.

BACKGROUND: Recent anatomical brain magnetic resonance imaging (MRI) studies show a striking postpsychotic progressive loss of cortical gray matter (GM) in patients with childhood-onset schizophrenia (COS), which appears greater than that seen for adult patients. However, the diagnostic specificity and the relationship of these changes to drug treatment and cognitive functioning remain unclear. We performed a comparative prospective brain MRI study in patients with COS and pediatric patients with transient psychosis with behavior problems (psychosis not otherwise specified) provisionally considered multidimensionally impaired (MDI). We hypothesized that cortical GM loss would occur in patients with COS but not in adolescents with atypical psychoses. METHODS: Anatomical brain MRI was performed at baseline and follow-up in 19 patients in the MDI group (mean [SD] age of 13.3 [3.1] years); in 23 patients with COS matched for age, sex, IQ score, and drug treatment (mean [SD] age of 13.9 [2.5] years); and 38 healthy control subjects matched for age and sex (mean [SD] age of 13.3 [3.1] years). The mean (SD) follow-up was 2.5 (0.8) years. Volumes of the cerebrum and total and regional GM were obtained by using automated analysis, and percent change in volume across time was calculated. One-way analyses of variance with post hoc Tukey Honestly Significantly Different comparisons were performed to examine group differences in the percent change in GM across follow-up. RESULTS: The COS group had significantly greater total, frontal, temporal, and parietal GM loss than did the MDI or healthy control groups; analysis of variance post hoc P values ranged from.03 to.001. The MDI and control groups did not differ significantly from each other. CONCLUSIONS: The cortical GM volume loss in COS appears diagnostically specific; it was not seen in children and adolescents with atypical psychosis. Because both patient groups had similar early developmental patterns, cognitive functioning, medications, and hospitalizations, this progressive loss appears to be intrinsic to COS. An ongoing neurodevelopmental process and/or brain response specific to the illness could account for these changes.

Adolescent↗
PubMed2003

Open general medical wards versus specialist psychiatric units for acute psychoses.

BACKGROUND: As international healthcare policy has moved away from treating people with severe mental illness in large inpatient psychiatric institutions, beds for people with acute psychiatric disorders are being established in specialised psychiatric units in general hospitals. In developing countries, however, limited resources mean that it is not always possible to provide discrete psychiatric units, either in general hospitals or in the community. An alternative model of admission, used in the Caribbean, is to treat the person with acute psychosis in a general hospital ward. OBJECTIVES: To compare the outcomes for people with acute psychoses who have been admitted to open medical wards with those admitted to conventional psychiatric units. SEARCH STRATEGY: The Cochrane Schizophrenia Group's study-based register was searched (November 2001). This register is compiled from searches of BIOSIS, CINAHL, The Cochrane Library, EMBASE, LILACS, MEDLINE, PsycINFO, PSYNDEX, Sociofile, and many conference proceedings. SELECTION CRITERIA: All relevant randomised or quasi-randomised trials, allocating anyone thought to be suffering from an acute psychotic episode to either acute management on general medical wards, or acute management in a specialist psychiatric unit. The primary outcomes of interest were length of stay in hospital and relapse. DATA COLLECTION AND ANALYSIS: Studies were reliably selected, assessed for quality, and their data would have been extracted. Homogeneous data were to have been synthesised. For binary data, the risk ratios (RR) and 95% confidence intervals (CI) were to have been calculated on an-intention-to-treat basis. If possible, the number needed to treat/harm statistic (NNT/H) was to have been calculated. For continuous data, weighted mean differences (WMD) were to have been calculated and only data from valid scales would have been reported in this review. MAIN RESULTS: We identified no relevant randomised trials. REVIEWER'S CONCLUSIONS: The Caribbean practice of treating people with severe mental illness on general medical wards has been influenced by socio-economic factors rather than evidence from randomised trials. This practice affords an opportunity for a well designed, well conducted and reported randomised trial, now impossible in many other settings.

Acute Disease↗
PubMed1997

New dimensions in the pharmacologic treatment of schizophrenia and related psychoses.

During the past 5 years unprecedented advances have taken place in the psychopharmacology of schizophrenia and related psychoses. Clozapine and risperidone, two prototypic novel antipsychotic drugs, have had a significant impact on the treatment of psychotic disorders. Additionally, they have ushered in another generation of antipsychotic drugs with complex pharmacologic profiles, potentially enhanced efficacy, and more benign side-effect profiles than previously associated with conventional antipsychotic medications. This review highlights these developments, implications for the management of psychotic disorders, and the use of novel antipsychotic drugs in specific clinical subgroups.

Antipsychotic Agents↗
PubMed1982

[Relevant predictors of the 5 year outcome of patients with schizophrenic or similar paranoid psychoses (author's transl)].

In a 5 year follow-up study of 81 patients suffering from schizophrenic or similar psychoses many of the predictors known from the literature concerning the outcome of schizophrenia were confirmed. In accordance with the results of the follow-up study on patients from the International Pilot Study of Schizophrenia (IPSS), long lasting professional disintegration and psychiatric hospitalisation preceding index-admission were of special prognostic importance. However in contrast to this follow-up study, other psychopathological data, especially minus symptoms proved to be of considerable prognostic significance. As a result of stepwise multiple regression analyses, combinations of the 5 best characteristics for each outcome-criterion have been found which explain a significantly greater part of the variance than single characteristics.

Adult↗
PubMed1977

[Assessment of the premorbid personality in endogenous psychoses. A factor-analytical study of the adjective check list of von Zerssen (author's transl)].

In order to get information about the premorbid personality of patients with endogenous psychosis, we examined the adjective check list of von Zerssen with regard to form and content on a sample of 126 schizophrenic and 31 affective-psychotic patients. The data gathering occured through retrospective evaluation by a close relative of each patient. One aim of the study was the development of a psychometric instrument in order to construct clinically relevant scales, which would allow us to objectify characterizations of the premorbid personality of patients with psychic illness. Another aim was to test the validity of this instrument by investigating the coherence between the obtained test results and the corresponding clinical psychiatric judgments of experts in the form of diagnoses. Finally, we sought to determine if typical premorbid characteristic features give a predisposition for specific aspects of psychotic diseases, in order to be able to differentiate between diverse psychiatric groups of diagnoses. By means of factor analysis (principal component analysis) with Varimax rotation we came to five easily distinguishable clinical-psychological well interpretable factors, from which we derived five scales. These scales seem to be appropriate for the characterization of premorbid personality traits. They represent the following clinical concepts: (1) cyclothymia, (2) sthenia, (3) anancasm, (4) hostility, (5) schizothymia. Formal examination of the factor-analytical proved scales according to criteria of classic test-theory (item-test correlation, reliability, distribution, intercorrelation) showed that we were able to measure rather independent dimensions of premorbid personality by our five scales with sufficient accuracy. To get evidence for the empirical validity of our scales we compared our test results (1) with three groups of different diagnoses concerning premorbid personality and (2) with the two diagnostic groups of schizophrenia and affective psychoses. We also tried to work out differential aspects within the diagnostic group of schizophrenia for four subgroups. As criteria for validity we sued clinical judgments of psychiatrists both for the premorbid personality and for the diagnosis of the present disease. On the whole our adjective check list turned out be as useful instrument to get a discriminating description of premorbid characteristic features which is better than a global evaluation in form of a single diagnosis. First First indications of the practical importance of our scales are discussed.

Affective Symptoms↗
PubMed1976

[Changes in delusional psychoses. A historical transcultural comparison (author's transl)].

A historical transcultural comparison of paranoid psychoses (ICD 295.3, 297. 0-9) was done by evaluating the data of 200 case histories (I: 100 from 1911, II: 100 from 1973). An interrater reliability test was performed. 1. Stable delusions were: delusions of reference, religious delusions, delusions of persecution. 2. There was a significant increase in hypochondriacal delusions. 3. Megalomania and erotomania decreased. 4. There is in the "old" and "new" group a significant correlation between megalomania and the male sex. 5. The significant correlation between erotomania and the female sex found in the "old" group could not be found in the "new" group. 6. Constancy and change of delusion is due to both sexes, differing in degree, in part contrarotating. 7. The decrease of "sex-specific" delusions (megalomania and erotomania) is due to the sex concerned. 8. With increasing age there is a reduction of delusion themes in group II: delusions of special descent, paranoid identity change, erotomania were not found after age 30. Querulant paranoia did not occur. In group I querulant paranoia did not appear before age 30. 9. There was a significant correlation between megalomania and the item "development in rural country". 10. In our material there was no correlation between delusion and intelligence and religious confession. 11. Paranoid ideas of hypochondriasis and persecution show changes in the thematics (organs, disease, means of persecution) subject to time. 12. A tendency to change of content of the main delusion is discussed.

Age Factors↗
PubMed1976

Diagnosis of functional psychoses. Comparison of clinical and computerized classifications.

The results of a comparison between the clinical diagnoses of 115 probands with functional psychoses, made on the basis of careful clinical history-taking, interviewing and examinations, and those made by computerized evaluation (CATEGO) on the basis of the present state examination (PSE) were presented. The clinical diagnoses of the project psychiatrist and the provisional classification resulting from the application of the CATEGO program to the PSE symptom profiles were in an overall concordance of 82%. In a second step the 20 cases with differences in diagnoses were reevaluated on the basis of the full history and psychopathology and a syndrome checklist was completed. This reevaluation led to a practically full diagnostic agreement.

Adult↗
PubMed1988

The causes of functional psychoses as seen by patients and their relatives. II. The relatives' point of view.

The concepts of relatives of patients suffering from functional psychoses regarding the causes of the illness were investigated using the same methodological approach as with the patients. Relatives, like patients, favoured psychosocial over biological explanations. However, when compared pairwise the concordance between relatives and patients was very low. Some methodological refinements recommended for further research are proposed.

Adult↗