Research Diagnostic Criteria For Schizophrenia Research Articles

Relation of age at onset to duration of episode in unipolar depression.

The purpose of this study was to test the hypothesis that the duration of episodes of unipolar depression increases with age at onset. On the basis of elevated scores on a self-report depression measure, 2,020 persons were selected from a larger community sample to be interviewed and diagnosed using the Schedule for Affective Disorders and Schizophrenia-Research Diagnostic Criteria procedures. Of the 2,020 persons, 865 had a history of one or more episodes of unipolar depression. The potential effects of the following variables (singly and in interaction) on duration of episode were assessed by means of multiway frequency table analysis and chi-square: age at onset, sex of subject, interval since occurrence of the episode, and type of disorder (major vs. minor depressive disorder). The hypothesis that duration of episodes of depression increases with age at onset was not supported. Women were more likely to have multiple episodes, but did not have longer lasting episodes.

Smooth pursuit eye tracking, neuropsychological test performance, and computed tomography in schizophrenia

Smooth pursuit eye movements (SPEM) were measured in 18 patients who met Research Diagnostic Criteria for schizophrenia. Some degree of SPEM impairment was present in most patients. Deviant eye tracking was not related to rating of severity of illness, but was related to recurrent episodes of hospitalization, antipsychotic medication, and lower rating in anxiety and delusions. Worse SPEM tended to be associated with larger lateral ventricles as assessed on computed tomography. Three patients with reversed occipital asymmetry had was related to worse performance in Finger Tapping and in the Trail-Making Test, and to fewer perceived alternations of a Necker cube, suggesting that frontoparietal disturbances are related to poor pursuit eye tracking in schizophrenia.

Adjustment of the Not Guilty by Reason of Insanity (NGRI) Outpatient: An Initial Report

Abstract Adjustment to outpatient treatment of not guilty by reason of insanity (NGRI) patients following discharge from inpatient settings was explored by following 44 subjects in a 2-year, longitudinal study. Data obtained for each subject included demographic characteristics, Schedule for Affective Disorders and Schizophrenia-Research Diagnostic Criteria (SADS-RDC) diagnosis, and Minnesota Multiphasic Personality Inventory (MMPI). Repeated measures included the Schedule for Affective Disorders and Schizophrenia-Change Form (SADS-C), Symptom Checklist 90 (SCL-90), and Holmes ahe Inventory. No recidivism occurred for any crime against persons, 25% of subjects were rehospitalized, and those subjects remaining in outpatient treatment showed a general pattern of stable to modestly improving functioning. Implications for safe and effective community treatment of NGRI acquittees are discussed.

Predictors of depression during the first 6 months of internship

Fifty-five interns, representing 71% of the medicine, obstetrics-gynecology, surgery, and pediatric interns at one medical center for one year, participated in interviews involving the Schedule for Affective Disorders and Schizophrenia-Research Diagnostic Criteria (RDC) and Family History-RDC and completed symptom and attitudinal scales at 6-month intervals. Fifteen (27%) developed a depressive syndrome during the first 6 months of internship. Parental history of depression and high scores of trait neuroticism were significantly associated with onset of depression, but personal history of psychopathology, low capacity for experiencing pleasure, and workload were not.

Cholecystokinin-octapeptide in chronic schizophrenia: A double-blind placebo-controlled study

1. Antipsychotic properties of cholecystokinin have been suggested both in laboratory studies and in some open clinical trials, mainly in patients suffering from chronic schizophrenia. 2. Eighteen patients (14 males, 4 females) meeting Research Diagnostic Criteria for schizophrenia had been receiving neuroleptics at a dosage that had not changed for 3 months, and to which the patients were at best only partially responsive. 3. The patients were randomized into groups that received weekly intravenous injections of 10 μg of CCK-8 or normal saline over 8 weeks. Neuroleptic medication was unchanged for the study. Baseline and weekly assessments were carried out using the Brief Psychiatric Rating Scale (BPRS) and the Schizophrenia Subscale of the Present State Examination (SS-PSE). 4. Analysis of covariance revealed significant differences between CCK-8 and placebo over the study period on the Thought Disturbance Factor and Total Score of the BPRS, and on the Nuclear Syndrome, Total Delusion Factor, and Total Score of the SS-PSE. 5. No important side effects were noted. 6. It is concluded that CCK-8 has definite antipsychotic properties in patients with chronic schizophrenia. Clinical trials in neurolept ic-free patients are warranted.

Computed tomography of the brain in patients with acute psychosis and in healthy volunteers.

Evidence has been obtained by computed tomography (CT) that some chronic schizophrenic patients have enlarged cerebral ventricles and other brain abnormalities when compared to other patient groups and to healthy controls (Johnstone et al. (1976), Weinberger et al. (1979)). In order to investigate whether structural brain abnormalities can be demonstrated also in younger patients with acute psychosis we have undertaken a CT study in 46 patients and 46 healthy volunteers. Twenty-eight of the patients fulfilled the Research Diagnostic Criteria for schizophrenia. Nineteen had not been hospitalized for psychiatric reasons before. The lateral and third ventricles were significantly wider in the patients than in the volunteers. In the volunteers there was a significant positive correlation between age and size of the lateral ventricles, whereas in the patients, particularly those fulfilling the criteria for schizophrenia, no such correlation was obtained. These results indicate that schizophrenia may be associated with patho-physiological processes which interfere with the normal age-related enlargement of the ventricles. Signs of cortical atrophy, CSF circulation disturbances and reversed asymmetry of the occipital lobes were more frequent in the patient group then among the controls. These results are in accordance with previously published findings and indicate that structural brain abnormalities can be found in relatively young patients with acute psychosis.

Serum creatine phosphokinase levels in patients meeting the St. Louis research diagnostic criteria for schizophrenia.

In this study 18 patients with a research diagnostic criteria diagnosis of schizophrenia had a mean initial serum creatine phosphokinase level significantly higher than that of 36 control subjects with other RDC diagnoses. There were no corresponding elevations in the serum levels of nondrinking alcoholics or patients with primary or secondary affective disorders. The authors suggest that increased creatine phosphokinase levels in schizophrenic patients may be due to a sudden increase in the substance in the dopaminergic or limbic system due to increased muscle membrane permeability or to sympathetic nervous system or adrenergic dominance.

Attentional and neuromotor functions of schizophrenics, schizoaffectives, and patients with other affective disorders.

Evaluation of attentional and neuromotor functions in 45 patients meeting the Research Diagnostic Criteria for schizophrenia, schizoaffective disorder, and other affective disorders showed that schizoaffectives could not be distinguished from patients with other affective disorders by any of the measures. However, schizophrenics differed from the other diagnostic groups on four measures: they showed significantly more oculomotor, stereognosis, and right-left identification abnormalities and more errors of omission on the attentional task under distraction conditions. The findings of this study are consistent with earlier reports that schizoaffectives are not generally different from patients with other affective disorders in family history, treatment response, or long-term outcome. There is not yet sufficient etiologic or behavioral evidence to indicate that schizoaffective disorder is a valid diagnostic category.

Lithium response in good prognosis schizophrenia.

The authors report the results of a 2-week lithium trial using 31 patients meeting Research Diagnostic Criteria for schizophrenia or schizoaffective disorder who were also diagnosed according to DSM-III criteria. One-third of the patients showed reduction of their schizophrenic-like symptoms during the lithium trial. Seven of the 9 responders (78%) met DSM-III criteria not for schizophrenia but for a schizophreniform disorder. Such patients also met McCabe and associates' criteria for good prognosis schizophrenia. This study lends further support to the growing body of evidence which suggests that schizophreniform disorder and good prognosis schizophrenia may be affective disorders with atypical schizophrenic-like features. The authors cautiously suggest that a lithium trial may be indicated in this subgroup of patients.