Nonschizophrenic Patients Research Articles

Subtypes of negative symptoms: The primary subtype in schizophrenic and non-schizophrenic patients

1. The specificity of negative symptoms remains an open question and requires further research. 2. Subtyping negative symptoms has been showed to be a very relevant point for the identification of primary negative symptoms and for their pharmacotherapy. Negative symptoms as a whole have been demonstrated in schizophrenic and non-schizophrenic patients, but these studies did not report about the primary and secondary subtypes. 3. The present study is the first one investigating primary negative symptoms in schizophrenic and non-schizophrenic patients. 84 consecutively admitted psychiatric patients have been studied 5 years after their discharge. 4. All negative symptoms (including the primary subtype) according to Carpenter (Kirkpatrick et al. 1989) and Andreasen (Andreasen 1981) could be identified in all diagnostic groups.

Assessing positive and negative symptoms in children and adolescents.

The purpose of this study was to test the reliability and validity of a new assessment instrument for positive and negative symptoms in severely disturbed children and adolescents (Kiddie-PANSS). The Positive and Negative Syndrome Scale for adult schizophrenia was modified through successive field trials on the basis of developmental characteristics of children and adolescents. The scale was then given to 34 inpatients (19 children, mean age = 9.35 years, and 15 adolescents, mean age = 14.33 years) with DSM-III-R diagnoses of schizophrenia, psychosis not otherwise specified, schizoaffective, affective, conduct, personality, and developmental disorders determined independently by child psychiatrists. All patients with schizophrenia were placed in the schizophrenic group, and all others were placed in a general inpatient group. The Kiddie-PANSS ratings were given by three trained child psychiatrists after a 30-35-minute structured interview. The Achenbach Child Behavior Checklist, the Scale for the Assessment of Positive Symptoms, and the Scale for the Assessment of Negative Symptoms were also administered in order to determine criterion-related association. Intraclass correlation coefficients revealed that all subscales and total psychopathology were reliably assessed among raters. The Kiddie-PANSS and Scale for the Assessment of Positive Symptoms/Scale for the Assessment of Negative Symptoms correlated with one another, indicating criterion-related association. Differences on measures of positive, negative, and general psychopathology, as measured by the Kiddie-PANSS, between the patients with schizophrenia and the general inpatient group were highly significant. The Kiddie-PANSS shows good interrater reliability and criterion-related validity. In a cohort of inpatient children and adolescents the scale successfully differentiated schizophrenic patients from nonschizophrenic patients.

Depression and the experience of psychological deficits in schizophrenia

A study of the relationships between depression and the subjective experience of psychological deficits was carried out in a group of 50 schizophrenic patients selected from a population of long-term mentally ill patients. Experience of psychological deficits was associated with depression, and furthermore the temporal relationships between the phenomena supported the hypothesis that experience of psychological deficits is associated with vulnerability to depression in schizophrenia. In addition, the patients' self-reporting of depressed mood and negative cognitions was congruent with an observer's assessment of depression. These findings indicate that subjective experiences of deficits characteristic of the schizophrenic illness confer vulnerability to depression, but nonetheless the patients' experience of depression resembles that typical of depressed non-schizophrenic patients.

Assessment of alcoholism among dually diagnosed psychiatric inpatients

Alcohol is an increasingly abused substance among psychiatric inpatients, and the extent to which alcohol dependence history is documented and the alcoholism subsequently treated is a compelling issue. This study is a retrospective review of the extent to which alcohol dependence history was obtained, and if applicable, whether a diagnosis and/or treatment plan were made, for acute psychiatric inpatients. For these purposes, an original instrument was constructed. Our results indicate that the predominant focus for acute inpatients is on diagnostic assessment of the severity of the alcohol problem, reflecting the need to deal with those issues requiring the most immediate attention. For patients with schizophrenia, attention to alcoholism diagnosis and treatment was less than that for nonschizophrenic patients. The implications of these findings are discussed with reference to the evaluation and treatment of dually diagnosed patients, along with further directions for research.

Stability in Backward Masking Performance in Schizophrenics, Affectively Disturbed Patients, and Normal Subjects

The purpose of the present longitudinal study was to investigate the stability of backward masking performance in schizophrenics and nonschizophrenic psychotic patients. Twenty-two schizophrenics, eight nonschizophrenics, and 14 normal controls were tested three times, with an interval of 1 year between each test session. A standard stimulus duration procedure was used. The relative onset intervals between the target and the mask was 16.5 msec or 33 msec. A no mask condition was presented before the two masking conditions. Results showed that masking performance is a stable phenomenon, for both psychiatric groups and for normal controls. Significant differences were found between schizophrenics and the normal controls, but not between the two psychiatric groups. Vulnerability to masking stimuli as a specific characteristic for schizophrenics is, thus, not supported in the present study. The results suggest that backward masking deficit is an enduring feature of psychotic disturbances.

Somatostatin in the cerebrospinal fluid of schizophrenic patients before and after neuroleptic drug treatment

A radioimmunoassay procedure was used to determine levels of somatostatin-like immunoreactivity in cerebrospinal fluid obtained from 9 schizophrenic patients, 7 patients with other psychiatric disorders, and 10 nonpsychiatric surgical controls. There were no significant differences in mean somatostatin baseline levels between the schizophrenic, and surgical patients. The concentrtion remained almost unaltered after 4 weeks of zuclopenthixol treatment in the schizophrenia group and following various neuroleptic, antidepressant, and anxiolyic medications in the nonschizophrenic patients despite a significant decrease of over psychopathology assessed by the Brief Psychiatric Rating Scale.

Paranoid-nonparanoid differences — psychophysiological parallels

It was predicted that the psychological differences between paranoids and nonparanoids would be parallel by differences in psychophysiological responses to stimuli varying along both informational and motivational dimensions. Skin conductance and heart rate responses to stimuli in a guessing task were measured in a group of paranoid patients and compared with those from non-paranoid and non-patient controls. A group of nonschizophrenic patients on phenothiazine medication served as drug-matched controls. Skin conductance level, response frequency and amplitude data are reported; heart rate response changes were examined by means of times series analysis and reported as first and second deceleration and first and second acceleration components. It was predicted that paranoid patients would show a greater increase in skin conductance measures with cognitive demand, and an increase in acceleratory components of the heart rate to increase in motivational variables. The normal pattern of greater electrodermal responsing to the negative stimuli than the positive, and greater heart rate acceleration to the positive stimuli but not the negative (Fowles, 1980) was predicted to be reversed in schizophrenia patients, and possibly more marked in paranoids. Cognitive manipulations showed the predicted increase in electrodermal and heart rate responding in normal controls. The paranoid subjects showed a similar increase as a function of task demands, but there was no significant difference between the other groups. Motivational manipulations produced increased skin conductance responding and increases in heart rate acceleration components in normal controls, this was not parallelled in the patient groups. All subject groups failed to show greater electrodermal activity to negative than to positive stimuli. Normal controls showed significant heart rate acceleration to positive as compared to negative stimuli, this pattern was reversed in paranoid patients.

CSF and plasma catecholamine metabolites (HVA and MHPG) in schizophrenic and nonschizophrenic patients : Rajiv P. Sharma, Javaid I. Javaid, Kym Faull, P.G. Janicak, James Peterson, J.M. Davis Illinois State Psychiatric Institute, Chicago, IL 60651

CSF and plasma catecholamine metabolites (HVA and MHPG) in schizophrenic and nonschizophrenic patients : Rajiv P. Sharma, Javaid I. Javaid, Kym Faull, P.G. Janicak, James Peterson, J.M. Davis Illinois State Psychiatric Institute, Chicago, IL 60651

Dopamine uptake by platelets from subjects with schizophrenia: A correlation with the delusional state of the patient

The uptake of 3H-dopamine by platelets from patients with a number of psychiatric disorders has been compared with that by platelets from normal volunteers. Overall, 3H-dopamine uptake by platelet-rich plasma (PRP) from 25 schizophrenic subjects did not differ from 3H-dopamine uptake by PRP from 22 nonschizophrenic patients and 61 normal volunteers. In the schizophrenic group, however, there was an increased spread of results with seven values falling outside the range of results observed in the control group. Furthermore, of the patients rated, only for the schizophrenic patients was there an inverse correlation between 3H-dopamine uptake by platelets and the rating for delusions on the Scale for the Assessment of Positive Symptoms. Thus, 3H-dopamine uptake by platelets seems, in some way, to be linked to the delusional state of the patient. Further study of 3H-dopamine uptake by platelets is warranted in a larger and more diverse group of patients to determine the significance of altered dopamine uptake by platelets from some schizophrenic subjects and the correlation between platelet 3H-dopamine uptake and the delusional state of these subjects.

Behavioral and biochemical effects of methylphenidate in schizophrenic and nonschizophrenic patients

The authors examined the specific behavioral and biochemical effects of intravenous methylphenidate in a sample of schizophrenic and nonschizophrenic patients. Twenty drug-free patients participated in a double-blind, placebo randomized study of methylphenidate, with multiple samples of plasma homovanillic acid (HVA) and serum growth hormone (GH) obtained during the infusion procedure. Methylphenidate caused a significant ncreased in positive symptoms that was relatively specific to the schizophrenic patients and was evident even in those with otherwise dormant symptomatology. When behavioral response was correlated with the biochemical responses (i.e., changes in plasma HVA and GH), there was a significant positive relationship between the increase in the BPRS-positive symptoms as well as the hostility/suspiciousness factor, and the increase in GH. These results suggest that the expression of psychotic symptoms may be associated with increased dopaminergic postsynaptic sensitivity, although the nonspecific nature of methyphenidate's actions discourages a stronger interpretation of the results.

Copying Strategies and Memory on the Complex Figure Test in Psychiatric Patients

We assessed three copying strategies on the Rey-Osterrieth Complex Figure Test among 50 psychiatric patients. The strategies were featural (detail-focused), contextual (framework-focused), and mixed. Reliable classification of each patient's copying strategy showed 7 patients used a featural and 7 patients used a contextual strategy. The remaining 36 used a mixed strategy involving both elements. Analysis indicated that patients who met DSM-III-R criteria for schizophrenia tended to use a mixed strategy. Nonschizophrenic patients also favoured the mixed approach. Moreover, when subjects were divided into groups based on their strategies, there were no differences in copying accuracy. However, the groups differed on immediate and delayed recall of the Complex Figure Test. Patients who adopted a featural strategy on the copy trial had the lowest recall scores. "Process" variables may be important in understanding neurocognitive functioning in schizophrenia; however, there is little evidence that schizophrenic patients use copying strategies consistent with lateralized impairment of brain function.

Behavioral and biochemical effects of methylphenidate infusion in schizophrenic and nonschizophrenic patients

Behavioral and biochemical effects of methylphenidate infusion in schizophrenic and nonschizophrenic patients

Prevalence and risk factors of involuntary movement disorders in a neuroleptic treated population: A comparison between schizophrenic spectrum and non-schizophrenic spectrum patients

Prevalence and risk factors of involuntary movement disorders in a neuroleptic treated population: A comparison between schizophrenic spectrum and non-schizophrenic spectrum patients

Characteristic distribution of alpha 2 wave in electroencephalograms of schizophrenic patients during discriminative tasks: support for the hypofrontality hypothesis of schizophrenia.

In a preliminary study, we noticed that alpha 2 activity in the frontal regions was suppressed less in schizophrenic patients than in other patients during the discriminative tasks. This was confirmed with 37 schizophrenic and 16 nonschizophrenic patients under the treatment of neuroleptics, 15 nonmedicated schizophrenic patients and 32 normal controls. The EEGs in eye-closed resting and during the auditory and visual discriminative tasks were recorded. Alpha 2 power values of the frontal, central, parietal, occipital and temporal regions in every subject group were processed by cluster analysis. During the discriminative tasks, the frontal regions were the most isolated cluster in schizophrenic patients and, in the normal and medicated nonschizophrenic groups, the frontal regions were incorporated in a different cluster. The same result was obtained by different statistical analyses of F-alpha 2 power ratio. The relative abundance of alpha 2 power value shifts from the occipital to the frontal regions during the discriminative tasks in schizophrenic patients. The weakened suppression of alpha 2 waves in the frontal regions by the discriminative tasks in schizophrenic patients supports the hypofrontal hypothesis of schizophrenia.

Cost of Schizophrenia in a Randomized Trial of Home-based Treatment

A randomized trial of acute psychiatric care was conducted to compare home-based interventions with standard care. The setting of the study was a comprehensive urban psychiatric service in London. Sixteen of the 172 patients in the study had schizophrenia--11 in standard care (SC) and 5 in community care (CC). Care for patients with schizophrenia was, on average, twice as expensive as care for nonschizophrenic patients. This large and statistically significant difference was mainly the result of increased inpatient care, which averaged 33 days for the schizophrenic group compared to 7.6 days for non-schizophrenic patients. There was a modest increase in general practice and outpatient contacts among the schizophrenic patients compared with nonschizophrenic patients, but surprisingly little use of day hospital facilities. The SC schizophrenic care cost nearly twice as much as CC care, but this was not a statistically significant difference. These results suggest that provision of active community services for schizophrenic patients may lead to overall savings in care costs, mainly by a reduction in inpatient stays.

Comparative Neurobiological and Neuropsychological Deficits in Adolescent and Adult Schizophrenic and Nonschizophrenic Patients

A group of 24 adolescents and young adults were classified according to four measures using Research Diagnostic Criteria on the dimension of the severity of their schizophrenic syndrome. Independent assessments by the Gottschalk-Gleser Social Alienation-Personal Disorganization Scale and the Abrams-Taylor Emotional Blunting Scale corroborated that the definite schizophrenic group (n = 7) was significantly more schizophrenic than the not schizophrenic group (n = 12), but not more so than the probably schizophrenic group (n = 5). The Halstead-Reitan Category Test and Rhythm Test significantly differentiated the definite schizophrenic group from the not schizophrenic group with respect to cognitive impairment. The Gottschalk-Gleser Cognitive Impairment Scale did not indicate a significant difference in cognitive function between these patient groups. The computerized EEG revealed a significantly higher percent of EEG abnormalities among the definite and probably schizophrenic groups than the not schizophrenic group of patients. These findings are analyzed and discussed.

Interhemispheric transfer of information and schizophrenia

The interhemispheric transfer of stereognostic information was investigated in four groups of subjects: paranoid schizophrenics, non-paranoid schizophrenics, non-schizophrenic psychiatric patients, and normals. Previous work has raised the possibility that schizophrenia is characterised by a dysfunction of the corpus callosum, but there are several methodological problems associated with this research. A comparison of inter-manual and same-hand conditions on the experimental task revealed no evidence for impaired transfer of information in the schizophrenic groups. However, the performance of the non-paranoid schizophrenic group was markedly inferior to all other groups on the right hand/right hand no transfer condition, consistent with a left hemisphere dysfunction. Possible reasons for the failure to replicate previous findings are discussed.

Eye movements in acute, chronic, and remitted schizophrenics

Eye movements in 10 acute schizophrenics, 50 chronic schizophrenics, 20 remitted schizophrenics, 25 methamphetamine psychotics, 21 temporal lobe epileptics with left-sided spike focus (l-focus), 12 temporal lobe epileptics with right-sided spike focus (r-focus), and 50 normal controls were examined with an eye mark recorder while they viewed geometric figures. The eye movements while viewing an original “S”-shaped figure for 15 sec were analyzed. Each schizophrenic group and methamphetamine psychotics had significantly less eye fixations than the normal controls and temporal lobe epileptics (r-focus and l-focus). The chronic schizophrenics had significantly shorter mean eye scanning length (MESL) than the other six groups. Each subject was then shown two other figures slightly different from the original and was requested to compare them with the original. After comparing them, the subjects were asked the question, “Are there any other differences?” The 5-sec eye movements during the response to this question were scored using the Responsive Search Score (RSS). The schizophrenic groups had a significantly lower RSS than the nonschizophrenic patient groups and the normal controls. In the chronic schizophrenics, there was a significant negative correlation between the RSS and negative symptoms. These results suggest that the MESL can be an indicator of a chronic process of schizophrenia, and that lowering of the RSS may be nosologically specific indicator for schizophrenia.

Pharmacological effects of methylphenidate on plasma homovanillic acid and growth hormone

The acute pharmacological actions of methylphenidate, a potent psychotogenic stimulant, were studied by measuring plasma homovanillic acid (HVA) and serum growth hormone (GH) as indices of presynaptic and postsynaptic functions, respectively. Twenty psychiatric inpatients participated in a double-blind, placebo-randomized study of methylphenidate infusion. Multiple samples of plasma HVA and GH were measured before and up to 24 hours after both methylphenidate and placebo infusions. There was a robust and significant GH response during the 2-hour postmethylphenidate period when compared to placebo. The peak response was significantly greater in male patients than in female patients. Although there were no changes in plasma HVA during the 2 hours following the infusion, there was a significant decrease in HVA 24 hours after methylphenidate as compared to preinfusion baseline values. Plasma HVA values also tended to be lower 24 hours after methylphenidate when compared to the corresponding postplacebo value. Schizophrenic patients did not differ significantly from nonschizophrenic patients in their physiological or biochemical responses.

Information processing: a new model for understanding cognitive disturbances in psychiatric patients

Information processing models are influenced by the information sciences and by computer technology, which progressed in the 1960s and 1970s. During the last decade these models have formed the theoretical basis for much of the experimental research on cognitive dysfunctions in psychiatric patients. An essential element in all of these models is that information is processed in several discrete stages. Different experimental paradigms have been developed in order to tap information about the processes taking place in each of these stages. Most of the research so far on pathological groups has been done on schizophrenic patients. Some deficits found in schizophrenics seem to be symptom-related. This is the case with performance deficits on the Continuous Performance Test with low processing load. Other dysfunctions might be vulnerability indicators, such as deficit performance on the forced choice Span of Apprehension task and the Continuous Performance Test with high momentary processing load, backward masking, serial recall for items that involve active rehearsal, and eye movement dysfunctions. However, information processing deficits do not seem to be specifically related to schizophrenia. Deficits can be found in other psychiatric syndromes too, especially in manic patients. Generally speaking, the dysfunctions emerge in a milder form in nonschizophrenic patients.