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PubMed2000

Hypoxic-ischemia-related fetal/neonatal complications and risk of schizophrenia and other nonaffective psychoses: a 19-year longitudinal study.

OBJECTIVE: Epidemiologic evidence linking obstetric complications to schizophrenia has been positive but inconclusive. One reason for the lack of conclusive evidence may be the inconsistency in measuring disturbances of fetal/neonatal brain development based on general obstetric markers of maternal health. The authors used data from the National Collaborative Perinatal Project to examine the relationship between schizophrenia and other nonaffective psychoses and a theoretically derived measure of hypoxic-ischemia-related fetal/neonatal complications. METHOD: Six hundred ninety-three men and women (average age 23) born to a community sample of women between 1959 and 1966 were followed up an average of 19 years after early childhood assessments. Subjects with DSM-IV schizophrenia and other nonaffective psychoses were identified using the Diagnostic Interview Schedule and best-estimate consensus diagnoses. RESULTS: Hypoxic-ischemia-related fetal/neonatal complications were associated with a doubling of the risk of developing a psychotic disorder, compared with no relevant complications (6.9% versus 1.4%). When mood disorders were excluded from the group of psychotic diagnoses, the risk of schizophrenia and other nonaffective psychoses associated with hypoxic-ischemia-related fetal/neonatal complications was strikingly elevated, compared with no relevant complications (5.75% versus 0.39%). Nonpsychotic mood disorders were unrelated to these fetal/neonatal complications. Schizophrenia and other nonaffective psychoses were most strongly associated with hypoxic-ischemia-related fetal/neonatal complications of disordered growth and development. CONCLUSIONS: The data show a strikingly elevated, graded, independent risk of schizophrenia and other nonaffective psychoses associated with this classification of antecedent hypoxic-ischemia-related fetal/neonatal complications.

Adolescent↗
PubMed2000

Attention, memory, and motor skills as childhood predictors of schizophrenia-related psychoses: the New York High-Risk Project.

OBJECTIVE: Childhood neurobehavioral deficits in offspring of schizophrenic, affectively ill, and psychiatrically normal parents were evaluated as predictors of schizophrenia-related psychoses in adulthood. METHOD: The offspring were tested with neurobehavioral measures at 7-12 years of age and assessed in mid-adulthood for axis I diagnoses. The relationships of childhood deficits in attention, verbal memory, and gross motor skills to adulthood schizophrenia-related psychoses were examined in separate path analyses by using logistic regression equations. Sensitivity and specificity were determined for each of the childhood dysfunctions. RESULTS: For the offspring of schizophrenic parents, childhood deficits in verbal memory, gross motor skills, and attention identified 83%, 75%, and 58%, respectively, of the subjects with schizophrenia-related psychoses; 50% were identified by all three variables combined. False positive rates in subjects who did not develop schizophrenia-related psychoses ranged from 18% for those with deficits in attention during childhood to 28% for those with deficits in memory. The three variables had low deficit rates in the offspring of the other two parental groups and were not associated with other psychiatric disorders in any group. CONCLUSIONS: Schizophrenia-related psychoses in adulthood are distinguished in subjects at risk for schizophrenia by childhood deficits in verbal memory, gross motor skills, and attention. The findings suggest that deficits in these variables are relatively specific to schizophrenia risk and may be indicators of the genetic liability to schizophrenia.

Adolescent↗
PubMed2001

Karl Bonhoeffer and the concept of symptomatic psychoses.

With the description and classification of Symptomatic psychoses in 1908, Karl Bonhoeffer laid the foundation for a categorization into exogenous and endogenous psychoses. This opened new pathogenic and psychopathologic horizons in connection with the aetiology of psychoses, as was particularly exemplified by Bonhoeffer in the 'catatonic psychoses'. Later, his concept of Symptomatic psychoses was further developed. Especially the symptom of an impaired consciousness as a diagnostic criterion in delirium underwent a critical discussion. However, Bonhoeffer's basic positions have not even now lost their significance. They find their representation in a modified form in all of the recent classification systems ICD-10 and DSM-IV. The study of pathogenic, clinic-psychopathologic, classificatory and therapeutic perspectives in detail, following Bonhoeffer's example, remains an important task for neuropsychiatry in the present as well as the future.

Classification↗
PubMed2001

Twin study of symptom dimensions in psychoses.

BACKGROUND: Symptomatology in psychoses can be summarised as quantitative symptom dimensions, but their genetic basis is unknown. AIMS: To investigate whether genes make an important contribution to symptom dimensions. METHOD: A total of 224 probandwise twin pairs (106 monozygotic, 118 same-gender dizygotic) where probands had psychosis were ascertained from the Maudsley Twin Register in London. Factor analysis was performed on lifetime symptoms rated on the Operational Checklist for Psychotic Disorders (OPCRIT). Correlations of dimension scores within monozygotic and dizygotic pairs concordant for Research Diagnostic Criteria psychoses were performed. Relationships between dimension scores and genetic loading for psychoses were assessed using logistic regression. RESULTS: Patterns of familial aggregation consistent with a genetic effect were found for the disorganised dimension and for some measures of the negative, manic and general psychotic dimensions. Disorganised dimension scores were related significantly to genetic loading for psychoses. CONCLUSIONS: The disorganised dimension, and possibly other symptom dimensions, may be useful phenotypes for molecular genetic studies of psychoses.

Diseases in Twins↗
PubMed2003

Developmental precursors of child- and adolescent-onset schizophrenia and affective psychoses: diagnostic specificity and continuity with symptom dimensions.

BACKGROUND: An increased rate of premorbid impairment has been reported in both child- and adolescent-onset schizophrenic and affective psychoses. AIMS: To examine the evidence for a specific association between premorbid impairment and child- and adolescent-onset schizophrenia, and whether specific continuities exist between premorbid impairments and psychotic symptom dimensions. METHOD: Retrospective case note study of 110 first-episode child- and adolescent-onset psychoses (age 10-17 years). DSM-III-R diagnoses derived from the OPCRIT algorithm showed 61 with schizophrenia (mean age 14.1 years) and 49 with other non-schizophrenic psychoses (mean age 14.7 years). RESULTS: Premorbid social impairment was more common in early-onset schizophrenia than in other early-onset psychoses (OR 1.9, P=0.03). Overall, impaired premorbid development, enuresis and incontinence during psychosis were specifically associated with the negative psychotic symptom dimension. CONCLUSIONS: Premorbid social impairments are more marked in child-and adolescent-onset schizophrenia than in other psychoses. There appears to be developmental continuity from premorbid impairment to negative symptoms.

Adolescent↗
PubMed1999

No interaction between serotonin transporter gene and dopamine receptor D4 gene in symptomatology of major psychoses.

Previously, we reported an association of the dopamine receptor D4 (DRD4) gene with delusional symptomatology of major psychoses. However, DRD4 variants accounted for only 2% of the phenotypic variance, indicating that contributions from other genes were probable. The serotonin transporter gene is a primary candidate in major psychoses, and a functional polymorphism in the upstream regulatory region of the serotonin transporter gene (5-HTTLPR) has recently been reported to be associated with a number of psychopathological conditions. In the present study we investigated the original cohort of subjects to evaluate the 5-HTTLPR possible influence on the psychopathology of major psychoses in interaction with DRD4. Four hundred and sixty-one inpatients affected by major psychoses were assessed by the Operational Criteria Checklist for Psychotic Illness (OPCRIT) and were also typed for the 5-HTTLPR and DRD4 variants using polymerase chain reaction techniques. Mania, depression, delusion, and disorganization were the four symptomatologic factors used as phenotype definition. 5-HTTLPR variants did not significantly influence the previously reported association of DRD4 with delusional symptoms. No interaction was observed on the other symptom factors. The serotonin transporter gene does not, therefore, interact with DRD4 in determining the symptomatology of major psychoses.

Adolescent↗
PubMed1975

[Course of atypical psychoses].

An attempt was made to classify the atypical psychoses according to cross-sectional psychopathological criteria. We were able to separate two groups from a group of benign schizophrenics. The latter served more as a comparison group and were in every way similar to the nuclear group, except for a better social prognosis. Group C (atypical manic depressive illnesses) which was closer to manic depressive illness than the other two groups, differs from it by thought disorders and delusional experiences. In the further course of the illness, after a few schizophrenic symptoms had appeared once or repeatedly during the acute stage, the typical features of manic depressive illness came more and more to the fore. In group A (mixed psychotic syndrome) manic depressive and schizophrenic symptom complexes appeared for quite some time during the acute stage with approximately equal clarity and significance. In the further course, during which manic depressive phases as well as schizophrenic thrusts can make their appearances, one can often see the development of a 'hypomanic defect'. Systematised delusions, as well as grimacing and circumstantiality, can also persist frequently. On the whole, however, it is difficult to recognize the defect states from their original state once the illness has settled down. A classification of the atypical psychoses and their differentiation from typical manic depressive illness or nuclear schizophrenia is necessary, at least, because of the worse, respectively better, social prognosis of the atypical psychoses. This investigation should be continued further by using as control groups bi- and unipolar affective psychoses and nuclear schizophrenics with a severe course. The subgroups of the atypical psychoses will be used to evaluate different long-term therapies in a further study.

Adult↗
PubMed1977

[Acute psychoses of advanced age].

The group of acute psychoses in later life comprises: 1. acute psychotic pictures at the commencement or during the course of organic breakdown; 2. strictly speaking exogenous (symptomatic) psychoses 3. acute psychotic conditions during the processes in particular of endogenous psychoses; and 4. psychoreactive and situationally conditioned psychoses. In all these nosologically heterogeneous forms certain characteristics regarding their appearance and course can be perceived which are related to age a rudimentary type of syndromic pictures, their particular "senile" colouration, a preponderance of short and recurrent psychotic periods, a not infrequent change to dementia, and the occurrence of illnesses typical of old people (amnestic states of disorientation, complete optical illusions, etc.). The outlook for acute psychoses in later life is gloomy (almost 50% fatality); the recognition of basic illnesses causes particular difficulties. Some special clinical forms are being more intensively analysed.

Acute Disease↗
PubMed1989

[Symptomatic mania in HIV infection. 3 cases of classified euphoric psychoses as a sequela of the AIDS disease].

3 case histories of patients with acquired immune deficiency syndrome and acute organic psychoses are reported. Their psychoses can be classified as benefaction or blissfulness psychoses. A handfull of previous reports classify similar acute organic psychoses as symptomatic manias. The respective descriptions make obvious that these psychoses are homogenous among each other and that their contents represent a vivid reflection over a life situation which had been thoroughly changed by the AIDS illness.

Acquired Immunodeficiency Syndrome↗
PubMed1988

[Provoking endogenous psychoses].

For six forms of endogenous psychosis, causal agencies were sought to establish endogenous, physical, and mental provocation. Endocrine causes were found most frequently, 17.5%, in mixed bipolar disorders, followed by cycloid psychoses, 8.5%, which in this respect appear to be closer to the mixed bipolar psychoses, than the unipolar forms at 4.4%. Among the physical causes, the difference in affective psychoses is not particularly great. Cycloid psychoses head the list at 9%. Among the mental causes, pure phase psychoses account for the greatest number, 12.7%, by a wide margin. The three unsystematic forms of schizophrenia revealed a slender link with their causes. Clear distinctions among the causes of the six forms were thus demonstrated.

Bipolar Disorder↗
PubMed1968

[Psychoses in the mentally retarded].

After a study of the clinical peculiarities of psychoses of imbecile children and juveniles (18 cases of episodic psychoses, 15 cases of grafted schizophrenia) the following results were obtained: In the group of episodic psychoses in imbeciles the psychopathological symptom complex had to be subdivided into four subgroups. In the first group there predominated affective phenomena, in the second group disturbances of motion, in the third group delirious, and in the fourth group hallucinatory phenomena. The differential-diagnostic criteria show the difference of the episodic psychoses of imbeciles from schizophrenias (grafted schizophrenias). An early recognition of this form of psychoses is quite important to both the prognosis and choice of therapy.

Adolescent↗
PubMed1982

[Population study of periodic endogenous psychoses (demographic data and comparative features of the clinical course)].

Prevalence and regularities of the course of affective and schizoaffective psychoses (969 observations) were studied. The studies have shown that the intensity of the clinical manifestations of manic-depressive psychoses becomes greater in senior age groups, while in cases of schizoaffective psychoses the patients of those groups show a simplification of the clinical picture and a transition of the disease course to a subclinical level. Studies of some characteristics of the premorbid social adaptation demonstrated that in patients with the affective psychoses the respective indices were higher than in patients with recurrent schizophrenia. The data obtained give one grounds to believe that the hyperadaptation of patients with the affective psychoses is associated with the patients' specific personal turn of mind.

Adult↗
PubMed1981

[The origin of cycloid psychoses].

Hereditary affliction with psychosis is not a marked phenomenon in cycloid psychoses, it is, however, found that parents may promote the outbreak of the disease by their abnormal behaviour. Of greater importance are causes which--unlike other forms of endogenic psychosis--develop their effect in infancy. Inharmonious constellations among brothers and sisters have been found to be essential. It has been proved that in the physiological and psychic development of man the mutual influence of children plays an important role. Paying more attention to the influence exerted by the parents, especially the mother, this law has been overlooked until now. The constellations of brothers and sisters, which are of course an everyday phenomenon, are not effective in themselves, but will only become effective when they coincide in a specific manner with temperaments that in their nature show a certain relationship with psychoses. On the other hand, physical influences do exist in a form that is found in no other type of the so-called endogenous psychoses. As regards their quite peculiar genesis, the demarkation of the cycloid psychoses from the unsystematic forms of schizophrenia, which are mainly hereditary, is indispensable. In the term "schizo-affective psychoses" of the WHO the two forms are unfortunately mixed up.

Adolescent↗
PubMedDate not supplied

[The characteristics of vascular psychoses in the residents of Chernivtsi Province].

Vascular affections of the brain remain a formidable psychiatric challenge nowadays. According to WHO reports cerebrovascular disorders constitute one of the three chief causes of mortality in the population of the economically developed countries of the world. The most important cause of vascular psychoses is considered to be atherosclerosis and hypertensive disease. Today vascular psychoses have become a most common type of abnormal mental states in young adults (greater then 30-40 years old). The studies made have yielded evidence in support of the psychoses morbidity to be dependent upon particular season of year as well as on the climatic features of the locality. Natural factors have been found out to affect the prevalence of vascular psychoses in Chernivtsi Province. The findings obtained suggest to us a substantial prevalence of atherosclerotic and hypertensive psychoses in the plains-men living under conditions of a mild climate.

Adult↗
PubMed1995

[Quantitative EEG, basic disorders and smoking in etiopathogenetically different groups of paranoid-hallucinatory psychoses--an exploratory study].

We performed an exploratory study of quantitative EEG in aetiopathogenetically different paranoid-hallucinatory psychoses divided into the following groups: a) patients with familial psychoses (n = 12), b) patients with neuropsychological deficits (n = 16), c) patients with alcohol and drug abuse (n = 22) and d) patients with so-called sporadic psychoses (n = 12). We found a significant reduction of relative alpha power in the group with neuropsychological deficits. In the group with familial psychosis there was a significant reduction of absolute delta power and a significant increase of relative beta power and dominant beta frequency, especially for the frontal leads. Patients with drug abuse showed a reduction of absolute beta power and an increase of absolute and relative theta power. The group with sporadic psychosis showed a significant slowing of the dominant beta frequency and a significant increase of the absolute power of fast alpha rhythms. The group with sporadic psychoses showed lowered scores for the paranoid-hallucinatory basic symptom factor. The group with neuropsychological deficits showed the most visceral-somatoform basic symptoms, the highest nicotine consumption, increased dyskinesias and more perinatal complications. This group also showed the highest level of neuroleptic and antiparkinson medication. All in all, the group with neuropsychological deficits showed a complex interaction of somatic-exogenic and medical-iatrogenic factors. Furthermore, there was a significant positive correlation between paranoid-hallucinatory basic symptoms and nicotine abuse and high frequency beta waves.

Adult↗
PubMed1992

Brief reactive psychosis and the major functional psychoses: descriptive case studies in Africa.

In a three-year prospective study of service-based incidence of functional psychoses in Africa, 94 cases of brief reactive psychosis were compared with 56 cases of schizophreniform syndromes, 29 cases of DSM-III schizophrenia and 14 of manic-depressive psychosis. This was supplemented by retrospective study of the same syndromes not in their first episode. Brief reactive psychosis was found to be a composite syndrome. The 50% with preceding depression were a distinct group, in terms of course and demographic features. Of those with intense prodromal anxiety, most were a single episode precipitated by a major life event, a few showed a recurrent long-term pattern. Schizophrenia was heralded, or presented unequivocally months or years later, in 10-20%. The schizophreniform group comprised a range of atypical psychoses intermediate between the transient and major psychoses. The pattern of precipitants and the over-representation of education and paid employment in the acute syndromes, compared with the major psychoses, in a society which was largely first-generation educated, suggested a link with rapid social change.

Adolescent↗
PubMed1988

[Cortisone-induced psychoses].

The records of 15 patients with cortisone psychoses were studied retrospectively. We observed two types of these substance-induced mental disorders: 1. rapidly reversible organic psychoses with peracute onset and 2. cortisone-induced schizophrenic psychoses with prolonged remission and typical follow-up. Depressive moods, dysthymia, anxiety, psychomotor agitation or euphoric symptoms are features occurring in initial states or mild forms of transit syndromes. More severe forms of cortisone induced transit syndromes are dominated by delusions and hallucinations, whereas most severe transit syndromes are characterized by reversible dementia. Females were affected more frequent than males. 40% of our patients developed steroid psychoses after treatment with a daily dose of 5-20 mg prednisolone or its equivalent. Neither dosage nor duration of treatment influenced severity, onset or duration of this mental disorders. Neuroleptic treatment and dose reduction led in 87% of patients to remission within four weeks.

Adult↗
PubMed1986

[Follow-up findings in rural patients after sustaining alcoholic psychoses].

The author has found that (1) alcoholic psychoses are more common in patients weakened as a result of somatic diseases; (2) the use of home-made strong beverages more frequent in rural areas causes alcoholic psychoses; (3) alcoholic psychoses in patients with Stage III chronic alcoholism run a more severe course; (4) to prevent the development of alcoholic psychoses it is necessary that the treatment of alcoholics in narcological rooms of the central regional hospitals be started at the first stage of the disease.

Adult↗