Group Of Chronic Schizophrenic Patients Research Articles

Regulation of m 1 muscarinic receptors and nNOS mRNA levels by autoantibodies from schizophrenic patients

In this paper we demonstrate that, circulating antibodies from schizophrenic patients interacting with cerebral M 1 muscarinic acetylcholine receptors (M 1 mAChRs), can act as an inducer of m 1 mAChR-mRNA, and neuronal nitric oxide synthase (nNOS) mRNA gene expression of rat frontal cortex. The different signaling pathways involved in the autoantibody's actions, were characterized. As previously reported serum autoantibodies from schizophrenic patients reacted against neural cells surface inhibiting the binding of the specific mAChR radioligand to rat cerebral frontal cortex membrane. Moreover, by ELISA using M 1 synthetic peptide (with identical aminoacid sequence to human M 1 mAChR) as coating antigen we demonstrated the reactivity against the second extracellular loop of human cerebral M 1 mAChR. The corresponding affinity-purified anti M 1 peptide IgG (anti M 1 peptide IgG) from schizophrenic patients by stimulation of M 1 mAChR exerted an increase in m 1 mAChR-mRNA and nNOS-mRNA levels, that significantly correlated with the accumulation of phosphoinositides (IPs) and activation of NOS (α = 0.05). All these effects were blunted by pirenzepine and mimicked the action of the authentic agonist. Concurrent analysis of the effects of nNOS, phospholipase C (PLC) and calcium/calmodulin (CaM) inhibition on both, m 1 mAChR-mRNA and nNOS-mRNA levels, showing that antibody up-regulation mRNA level is under the control of endogenous nitric oxide (NO) signaling system. On the basis of our results, the activation of M 1 mAChR by schizophrenic autoantibody appears to induce nNOS-mRNA expression and reciprocally, the activation of NOS up-regulates m 1 mAChR gene expression. These results gave support to the participation of an autoimmune process in a particular group of chronic schizophrenic patients.

The experience of basic emotions in schizophrenia with and without affective negative symptoms.

A diminished ability to experience emotion could be a key characteristic of the negative symptomatology in schizophrenia. We examined the frequency of basic emotions in everyday life as well as emotion control in various groups of chronic schizophrenic patients. Self-report questionnaires (Differential Emotions Scale [DES], Emotion Control Questionnaire [ECQ]) were provided to healthy controls and three groups of schizophrenia patients (n=88), i.e., affectively flat patients, anhedonic patients, and patients not suffering from affective negative symptoms. Patients with affective negative symptoms experienced the positive emotions interest and joy less frequently than healthy subjects or patients without affective negative symptoms. All schizophrenia patients felt fear more often and tended to feel disgust more frequently than healthy subjects. The frequency of guilt and anger experiences increased with the chronicity of the disease. Anhedonic patients manifested more emotion inhibition than healthy controls and exhibited an affectivity pattern consistent with Meehl's model of anhedonia.

Season of birth and inflammatory response system in schizophrenia

Infective agents (e.g., viruses) together with functional alterations of the immune system have been hypothesized to be implicated in the multifactorial pathogenesis of schizophrenia. The viral hypothesis of schizophrenia has been supported by the observation of birth peaks in winter seasons, prenatal exposure to virus epidemics and specific geographic patterns. On the other hand, not all the data published have shown consistent results supporting the immune hypothesis. Thus, it is likely that immune response factors may play a role in the pathogenesis of the disease only in specific subgroups of patients. The aim of the study was to investigate for the presence of differences of IL-6, IL-6R, gp130 and CC16 among four groups of chronic schizophrenic patients categorized according to the season of birth. We hypothesized that patients born in winter and spring would have had increased values of these cytokines. No significant differences were found among the four groups in any of the measures considered. These preliminary results appear to exclude a major role of the season of birth in determining reported interleukins system alterations in chronic schizophrenia.

Effect of clozapine on motor function in schizophrenic patients

It is well established that clozapine is less likely than typical antipsychotic drugs to cause clinically discernible extrapyramidal side-effects. There is a paucity of data, however, on clozapine's motor effects. In this report we compare normal controls to groups of chronic schizophrenic patients treated with either typical antipsychotic drugs or with clozapine. Motor function was measured with a target-matching task, a test relying on submaximal sustained force control. Results indicated that patients on clozapine performed with significantly lower accuracy (greater variability) of force control. Even though the clozapine patients were treatment resistant to typical antipsychotic drugs, and many had a history of tardive dyskinesia, we postulate that the observed deficit is likely due to clozapine treatment rather than to earlier treatments or other factors. The observed force control deficit may be the result of an increase in myoclonus and a generally lower level of overall motor activity.

The Efficacy of Vitamin E in the Treatment of Tardive Dyskinesia: A Double-Blind Placebo Controlled Study

DOI: http://dx.doi.org/10.5915/26-2-16367 Our aim in this study was to investigate the efficacy of vitamin E in the treatment of tardive dyskinesia in a group of chronic schizophrenic patients. Thirty-eight chronic schizophrenic inpatients with tardive dyskinesia were selected for a double-blind trial of Vitamin E versus placebo (Vitamin E: N=18). Tardive dyskinesia was rated by a blind-trained rater using the Abnormal Involuntary Movement Scale (AIMS) at baseline and after treatment. The AIMS scores in the Vitamin E cohort decreased significantly after treatment while the AJMS scores in the placebo cohort were not different after placebo. The results replicate the short-term effectiveness of Vitamin E in the treatment of tardive dyskinesia in a larger group of chronic schizophrenic patients.

The Effect of Nutritional Education on the Shopping and Eating Habits of a Small Group of Chronic Schizophrenic Patients Living in the Community

Eleven people with chronic schizophrenia were the subjects of an 8-week study which asked three research questions. How did these individuals with a chronic mental illness function as deinstitutionalised persons? Did participation in a 6-week nutritional education programme affect cognitive performance and behaviour? And did the nutritional education package require further refinement? This experiment produced qualitative data which were analysed using descriptive statistics and evaluation of questionnaires. The pre-test and post-test scores of the subjects suggested that improved nutritional knowledge did not relate to attitudes or to the shopping and eating behaviour of people with chronic schizophrenia living in the community. A future need to address this lack of generalisation of skills was identified.

Tardive Dyskinesia: a Five Year Follow-Up*

A group of chronic schizophrenic patients receiving prolonged treatment with neuroleptics was assessed in 1978 at an outpatient clinic to determine the prevalence of Tardive Dyskinesia. Those with TD were reassessed after two and five years with regard to change in TD severity. The Smith scale was used every time and, on the last assessment, the AIMS scale and videotaped interviews were added. Because of the high attrition rate, results, though interesting, cannot be generalized.

Serum concentration of depot neuroleptics in tardive dyskinesia.

Using radioimmunoassay techniques, serum levels of depot neuroleptics, fluphenazine and flupenthixol, were estimated in two groups of chronic schizophrenic patients with, and without, tardive dyskinesia. There were high significant difference in dose-related serum levels of either drug between the groups. The hypothesis that patients with tardive dyskinesia develop the syndrome because they do not metabolise neuroleptics as efficiently as those without the syndrome was not supported by the data.

Tardive dyskinesia and perceptual dysfunction.

There is equivocal evidence for a relationship between neuroleptic-induced tardive dyskinesia and central nervous system (CNS) dysfunction. Using the Bender-Gestalt test as the dependent measure, we hypothesized that a group of chronic schizophrenic patients with tardive dyskinesia would show more perceptual dysfunction than those without. Our results supported this hypothesis. CNS dysfunction is discussed in terms of a possible predisposition to tardive dyskinesia.

The effects of neuroleptic drugs on 5-hydroxytryptamine induced platelet aggregation in schizophrenic patients.

1 The effects of treatment with a range of neuroleptic drugs on 5-hydroxytryptamine (5-HT) induced platelet aggregation in vivo were examined in a group of recently admitted psychiatric patients and in a larger group of chronic schizophrenic patients. 2 Five of seven recently admitted patients treated with chlorpromazine showed enhanced aggregation. Four of seven patients treated with fluphenazine, flupenthixol, trifluoperazine and haloperidol showed enhancement. 3 Enhanced aggregation responses were observed in only 20% of chronic schizophrenic patients being treated with a neuroleptic drug. 4 The relationship between changes in platelet aggregation and clinical changes in recently admitted patients was variable and platelet aggregation responses were not predictive of response to treatment. 5 Chronic schizophrenic patients with enhanced aggregation showed significant week to week variation in platelet aggregation response. Variability of responses was not related to the drug used or to the dose administered. There was some evidence that higher plasma concentrations of neuroleptic drugs were associated with enhanced platelet aggregation responses. 6 Treatment with neuroleptic drugs leads to enhancement of platelet aggregation responses induced by 5-HT. The frequency and reliability with which such responses can be elicited is unpredictable and the value of platelet aggregation responses as an empirical guide to treatment with neuroleptic drugs is therefore open to question.

Early auditory information processing in schizophrenia: A preliminary report

Numerous theorists have postulated that incoming environmental information is altered with schizophrenic illness, due to aberrant sensory processing in subcortical systems. Brainstem evoked potential recordings were obtained during passive auditory information processing in groups of chronic schizophrenic patients, affective disordered patients, and normals. These neuroelectric measures of brainstem and midbrain functioning suggest that the three study groups do not statistically differ in terms of latency characteristics. It is noteworthy, however, that a particular subset of chronic schizophrenic patients yielded latency characteristics falling more than one standard deviation from the total population mean under all experimental conditions.

Sensory integration with chronic schizophrenics: a pilot study.

The use of sensory integrative techniques with a group of chronic schizophrenic patients is described through the process of conducting a pilot study at the Douglas Hospital Center of Montreal in 1975. The purpose of the study was to determine whether stimulating the sensory integrative processes of the central nervous system would effect any behavioral changes in non-paranoid schizophrenics. Based on the theory of Lorna Jean King, the paper delineates the plan of the study, the testing battery developed for evaluating patients, and the program of activities utilized during the project. Results of the study and a critique of the methods employed are also included.

Platelet serotonin concentration and monoamine oxidase activity in unmedicated chronic schizophrenic and in schizoaffective patients.

Elevated blood serotonin, perhaps secondary to reduced platelet MAO, has been reported in a group of chronic schizophrenic patients. We have failed to find elevated platelet serotonin, or any relationship between platelet serotonin and MAO either in a group of unmedicated chronic schizophrenic patients or in a group of schizoaffective patients. Possible reasons for these discrepancies are discussed.

THE DURATION OF MAINTENANCE THERAPY IN CHRONIC SCHIZOPHRENIA

The incidence of relapse was compared between two groups of chronic schizophrenic patients (mean duration periods 19 months and 29.5 months) discontinuing depot neuroleptic injections, and matched controls remaining on depot injections. The results show a higher relapse rate in patients discontinuing injections, significant at the 1% level, in both groups. The proportion of patients improving upon resumption of depot injections confirms the importance of this form of medication in comparison to prescribed oral medication. The results strongly suggest that there is a significant therapeutic gain in continuing maintenance therapy with depot neuroleptic injections for a minimum period of 3 years after the last relapse in a substantial proportion of chronic schizophrenic patients.

Long-acting phenothiazines in the prevention of relapse of schizophrenic patients.

The development of the depot fluphenazine preparations has been a major advance in the drug treatment of schizophrenia, ensuring continuous medication and stimulating the development of adequate community care services, resulting in significant reduction of relapse and readmission. This report compares the incidence of readmissions and the duration of hospital stay in a group of chronic schizophrenic patients who had first received oral medication and then long-acting injectable fluphenazine enanthate and decanoate over identical periods of time. A percentage of 93.3 of the subjects were maintained on continuous treatment for twelve to forty months. The readmission rate was reduced from 191 to 50, and the time spent in hospital from 8,713 to 1,335 days.

Rate of information processing in a schizophrenic and a control group: the effect of increasing task complexity.

In recent years two cognitive models of schizophrenic dysfunction have been elaborated which involve the basic proposition that schizophrenic patients process information at a slower rate than non‐schizophrenic controls (McGhie, 1965; Yates, 1966). Both models predict (1) that schizophrenic patients will make decisions at a slower rate than controls at all levels of task complexity, and (2) that their relative slowness will increase as a function of increasing task complexity. The available evidence is consistent with the first prediction but ambiguous with respect to the second.All previous studies relating to the above issues have utilized discrete reaction time measures. It was hypothesized that a more sensitive test of the predictions would be provided by a continuous performance task involving responding over a longer time period. A study is reported in which a group of chronic schizophrenic patients was compared with a group of non‐schizophrenic control patients on a series of four card‐sorting tasks in which the ‘information to be processed’ was systematically varied. In general, the findings were consistent with expectations.

Behavioral and skin potential response correlations in chronic schizophrenic patients

1. 1. Two groups of chronic schizophrenic patients had a sufficient difference in skin potential response wave form to a loud noise so that they could be rank ordered with respect to normal responses. 2. 2. The skin potential response wave form rank order correlated with the rank order as determined by two behavioral measures of the patient's clinical state. 3. 3. No specific component of the wave form correlated with the clinical state. 4. 4. The skin potential response wave form may provide a physiologic way of following a chronic schizophrenic clinical state.

A follow-up study of intensively treated chronic schizophrenic patients.

Two groups of chronic schizophrenic patients were treated with intensive psychotherapy for a period of two years, starting in 1962 and 1964. Half of the patients also took phenothiazines. Control groups at a local state hospital received phenothiazines but no psychotherapy. A follow-up of the groups on three tests of adjustment, administered at the end of 1967, indicated some trends toward better adjustment by patients who had received psychotherapy but there were no statistically significant differences among the groups.

The relation of two flash and two click thresholds to withdrawal in paranoid and non-paranoid schizophrenics.

Two flash and two click thresholds were measured in a group of chronic schizophrenic patients. The relation between these thresholds and a measure of withdrawal indicated that in non‐paranoid patients the more withdrawn the patient the more he gave evidence of cortical arousal; on the other hand in paranoid patients the relation was in the reverse direction.

Plasma free fatty acid response to insulin in schizophrenia.

Introduction In a previous study 1 12 chronic schizophrenic patients were compared to 7 and, at a later time, to 13 additional normal control volunteers as to the changes in the concentration of plasma free fatty acid (FFA) and blood glucose which followed the intramuscular administration of insulin. In both phases of the previous study, 6 of the 12 schizophrenic patients showed abnormality of FFA response to insulin but no obvious abnormality of glucose response. However, the schizophrenic and normal groups were not strictly comparable. The normal patient group was on the average younger and lighter in weight than the schizophrenic patient group. Furthermore, previous investigators have noted delayed and decreased response of blood glucose to injected insulin in schizophrenic patients. 2-6 In this present study, glucose and FFA sensitivity to insulin are evaluated more fully within the same group of chronic schizophrenic patients by