DSM-III Schizophreniform Disorder Research Articles

A longitudinal MRI study of first-episode schizophrenia: Assessment of cerebral changes and quantitation of ventricular changes

In vitro and in vivo red blood cell (RBC) lithium (Li + ) intracellularlextracellular ratios were determined in 93 DSM-III schizophrenics (SCZ) in 47 DSM-III schizophreniform disorder patients (SF), in 22 DSM-III bipolar manies (M), in 15 affective disorders patients with mood-incongruent psychotic features (AD-MIP), and in 40 normal controls. There were no significant differences among groups in the in vitro Li+ ratio. Similarly, there was no significant difference among patient groups in the in vivo Li+ ratio. Furthermore, there was no significant difference in the mean Li+ ratios between the Li+ -responsive and nonresponsive schizophrenic-like subjects. However, the distribution of Li+ ratios (both in vitro and in vivo) in the Li+ -responsive group was significantly abnormal, showing more ratios in the extremes of the distribution (a platykurtic distribution).

Early longitudinal course of acute^chronic and paranoid^undifferentiated schizophrenia subtypes and schizophreniform disorder.

This prospective longitudinal study examined symptoms and adjustment at 2 and 4 years posthospital discharge in Research Diagnostic Criteria (RDC) and Diagnostic and Statistical Manual (DSM-III) schizophrenia subtypes and in DSM-III schizophreniform disorder. Delusions, hallucinations, thought disorder, anxiety, depression, and specific areas of community adjustment were assessed at each follow-up. RDC acute and subacute schizophrenia and DSM-III schizophreniform disorder were associated with more satisfactory overall adjustment and lower frequencies of psychotic symptoms over time. No significant differences in the course of symptoms or adjustment were found between paranoid and undifferentiated schizophrenia subtypes. Schizophrenia subtyping schemes based on length of illness features appear more prognostically viable than do symptom-based approaches.

Psychiatric morbidity in the relatives of patients with DSM-III schizophreniform disorder: Comparisons with the relatives of schizophrenic and bipolar disorder patients

Risks for psychiatric disorders (RDC) among first degree relatives of DSM-III schizophreniform, bipolar, and schizophrenic probands obtained from an epidemiologic sample using family history methods were examined. The relatives of the schizophreniform probands differed from the relatives of the schizophrenic and bipolar probands. The relatives of schizophreniform probands had significantly higher rates of affective illnesses (with the exception of bipolar illness) than the relatives of schizophrenic probands, and they had a significantly higher rate of psychotic affective disorders than the relatives of the bipolar probands.

RBC lithium transport in the psychoses

In vitro and in vivo red blood cell (RBC) lithium (Li + ) intracellularlextracellular ratios were determined in 93 DSM-III schizophrenics (SCZ) in 47 DSM-III schizophreniform disorder patients (SF), in 22 DSM-III bipolar manies (M), in 15 affective disorders patients with mood-incongruent psychotic features (AD-MIP), and in 40 normal controls. There were no significant differences among groups in the in vitro Li + ratio. Similarly, there was no significant difference among patient groups in the in vivo Li + ratio. Furthermore, there was no significant difference in the mean Li + ratios between the Li + -responsive and nonresponsive schizophrenic-like subjects. However, the distribution of Li + ratios (both in vitro and in vivo) in the Li + -responsive group was significantly abnormal, showing more ratios in the extremes of the distribution (a platykurtic distribution).

Schizophreniform disorder: a diagnostic dilemma.

The DSM-III diagnostic criteria for schizophreniform disorder, mainly based on duration of symptoms, are insufficient to furnish a good treatment strategy. In recent literature, schizophreniform disorder has been grouped either with the schizophrenias or with the affective disorders. Scandinavian researchers have described two other groups of psychotic disorders that resemble schizophreniform disorder. These are the reactive psychosis and the cycloid psychosis. They were found to be different from the schizophrenias and the affective disorders. "Good prognosis" schizophrenia, which has been extensively studied and reported in the literature, is clinically very similar to schizophreniform disorder. The relatively consistent data collected in patients with good prognosis schizophrenia may provide the basis for the additional diagnostic criteria needed in DSM-III schizophreniform disorder.

Relation of clinical symptoms to apomorphine-stimulated growth hormone release in mood-incongruent psychotic patients.

The relationship between dopamine receptor agonist (apomorphine hydrochloride)-stimulated growth hormone (GH) release and psychotic symptoms was examined in 138 schizophrenic or schizoaffective inpatients (Research Diagnostic Criteria) and ten healthy normal volunteers. Patients were divided into three groups: those demonstrating an abnormally large GH response, an average GH response (mean GH response), or an abnormally low GH response. Abnormally large GH responses were associated with higher total psychosis scores. The increased psychosis scores observed in this group were due primarily to an increased incidence of thought disorder. Further analysis revealed a strong, positive correlation between thought disorder and the GH response. The apomorphine-stimulated GH response was also significantly related to duration of illness, an effect independent of age. Consistent with this last result, patients with a diagnosis of a DSM-III schizophreniform disorder demonstrated an elevated GH response.

On the physical properties of red cell ghost membranes in the affective disorders and psychoses: A fluorescence polarization study

Membrane order was measured in the erythrocyte ghost membranes of DSM-III schizophreniform disorder (SF), DSM-III schizophrenic (SCZ) and DSM-III manic (bipolar) (M) patients and a group of age- and sex-matched controls. Fluorescence polarization with the probe 1,6-diphenyl1-1,3,5-hexatriene was used to determine the steady-state fluorescence anisotropy ( r s). The SF group showed a significant increase in r s ( Δr s = 0.037) from the control group. Although the means were not significantly different, 3 of 8 Ms and 5 of 8 SCZs also had r s values > the highest control value. Thermotropic behavior of the membranes was evaluated over the range of 40 to 20°C. No difference among groups in membrane enthalpy was detected. Thus, the differences in r s appear to be associated with differences in entropy. Phosphatidylcholine (PC) levels, which were known to be abnormal in these patients, were compared with the r s values. A significant ( P < 0.001, r= -0.63) linear correlation between r s and membrane PC levels was observed. Overall these data further support the view that unusual membrane biophysical factors may occur with high frequency in the psychoses and affective disorders.

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.

DSM-III Schizophreniformm Disorder

We compared blind ratings of outcome and familial psychopathology across four diagnostic groups to test the validity of DSM-III schizophreniform disorder. Outcome ratings for schizophreniform disorder fell between those for affective disorder and those for schizophrenia. Outcome differences between schizophreniform and schizophrenic groups were no longer significant when patients who received somatic therapy during their index admission were excluded. Furthermore, schizophreniform probands had patterns of familial psychopathology that resembled those for schizophrenic probands more than those for affective disorder probands. In the combined group of schizophrenic and schizophreniform patients, longer illness durations at index admission predicted lower recovery rates. Our data suggests that a shorter specified duration may be appropriate in the definition of schizophreniform disorder.