Plasma homovanillic acid, noradrenaline and psychotic symptoms in chronically medicated schizophrenic in patients

2001 ◽  
Vol 13 (2) ◽  
pp. 49-52
Author(s):  
Y. Kaneda ◽  
A. Fujii
Keyword(s):  
Informed Consent ◽  
Patient Group ◽  
Homovanillic Acid ◽  
Psychiatric Symptoms ◽  
Chronic Schizophrenia ◽  
Normal Subjects ◽  
Psychotic Symptoms ◽  
Neuroleptic Medication ◽  
Dsm Iv

SummaryObjective:The authors investigated plasma homovanillic acid (HVA) levels and noradrenaline (NA) in chronically medicated schizophrenic inpatients.Methods:The subjects were 55 inpatients who were diagnosed according to the DSM-IV criteria for schizophrenia. Nine normal subjects were compared to the patient group. Each patient gave informed consent for the research involved in this study. Psychiatric symptoms were assessed using the BPRS.Results:(1) The medicated schizophrenic inpatients had significantly greater plasma NA levels, and higher but nonsignificant plasma HVA levels than the normal subjects.(2) In patients, there was a positive but nonsignificant correlation between the plasma NA levels and positive symptomatology. In contrast, plasma HVA levels were not correlated with either positive or negative symptomatology.Conclusion:On the basis of these results, we hypothesize that, mainly because of their catecholaminergic dysfunction, there is an increase in plasma NA and a tendency for increased plasma HVA in patients with chronic schizophrenia, regardless of long-term neuroleptic medication.

A Profile of Obsessive-Compulsive Symptoms In Schizophrenia

CNS Spectrums ◽  
1997 ◽  
Vol 2 (3) ◽  
pp. 21-25 ◽  
Author(s):  
Linda Porto ◽  
Paul C. Bermanzohn ◽  
Simcha Pollack ◽  
Richard Morrissey ◽  
Samuel G. Siris
Keyword(s):  
Day Treatment ◽  
Active Phase ◽  
Chronic Schizophrenia ◽  
Psychotic Symptoms ◽  
Inclusion Criteria ◽  
Obsessive Compulsive ◽  
Dsm Iv ◽  
Clinically Significant ◽  
Day Treatment Program

AbstractObsessive-compulsive (OC) symptoms and schizophrenia may present, as intertwined phenomena whose relationship remains poorly understood. The purpose of this paper is to provide a detailed phenomenological description of OC symptoms in schizophrenia.Fifty long-term patients with chronic schizophrenia or schizoaffective disorder from a continuing day-treatment program were assessed using the Structured Clinical Interview for DSM-IV and the Yale-Brown Obsessive-Compulsive Scale symptom checklist. Forty-six percent (n=23) reported clinically significant OC symptoms. Twenty-six percent (n=13) met criteria for OCD, from which three subgroups emerged: (1) patients whose OCD was unrelated to their psychotic symptoms, (2) patients whose OCD was related to, but not restricted to, their psychotic symptoms, and (3) patients whose OC symptoms existed on a continuum with their psychosis. The last group tended to incorporate their OC symptoms into delusional beliefs during the active phase of illness and shift to OCD during full or partial remissions. Eight percent met all inclusion criteria for OCD, but their OC symptoms were better accounted for by their psychosis.We conclude that these findings support previous clinical constructs that OCD and schizophrenia are not always dichotomous disorders, but may be interconnected.

The health economic implications of treatment with quetiapine: an audit of long-term treatment for patients with chronic schizophrenia

2001 ◽  
Vol 16 (5) ◽  
pp. 307-312 ◽  
Author(s):  
J. Lynch ◽  
J. Morrison ◽  
N. Graves ◽  
D. Meddis ◽  
M.F. Drummond ◽  
...  
Keyword(s):  
Health Economic ◽  
Case Series ◽  
Chronic Schizophrenia ◽  
Term Treatment ◽  
Revolving Door ◽  
Psychotic Symptoms ◽  
Open Label ◽  
Economic Implications ◽  
Long Term Treatment

SummaryThis retrospective, case series audit assessed the clinical and health-economic impact of long-term treatment with quetiapine (‘Seroquel’), a new atypical antipsychotic, in patients with chronic schizophrenia.The study design was of a case series format, comprising patients entered from one centre into the open-label extension of a multicentre 6-week efficacy study. Twenty-one patients (15 male, six female; mean age 39 years) were studied, of whom 17 (81%) had been rated as ‘partially responsive’ to previous antipsychotics. Data on hospitalisations and information on symptoms were collected retrospectively for the 12 months before quetiapine treatment was initiated and for the 12 months after.Quetiapine was effective in reducing psychotic symptoms with mean BPRS scores reducing significantly, from 38 to 21 (P < 0.005). Motor function was also significantly improved with mean Simpson scale scores reducing from 15 to 12 (P < 0.005). Average inpatient days were reduced by 11% in year two (97 compared with 109 days) while the overall costs of treatment, including drug costs, fell by 5% (I£20,843 to I£19,827).Four patients had been hospitalised for longer than 5 years before starting quetiapine; these chronically institutionalised patients remained in hospital, despite improved clinical outcomes (mean BPRS scores after treatment of 34, compared with 43 before), for the full 12 months of quetiapine treatment. Were the data from this audit to be re-analysed excluding these four patients then average inpatient days would have been reduced by 33% (45 to 30 days) and overall cost of treatment by 19% (I£8617 to I£7011).This audit suggests that treatment with quetiapine over this 1-year period was associated with both clinical improvements and a decreased usage of inpatient services. The reduction in hospitalisation costs would appear to compensate for the increased cost of drug treatment. Significantly, potential savings appear to be greatest for those patients with a ‘revolving door’ pattern of repeated readmission.

Prevalence of Obesity in Patients Receiving Depot Antipsychotics

1988 ◽  
Vol 153 (2) ◽  
pp. 214-217 ◽  
Author(s):  
T. Silverstone ◽  
Glenyss Smith ◽  
Elizabeth Goodall
Keyword(s):  
Antipsychotic Drugs ◽  
Clinical Importance ◽  
Chronic Schizophrenia ◽  
Psychotic Symptoms ◽  
Drug Induced ◽  
London Borough ◽  
Prevalence Of Obesity ◽  
Depot Neuroleptic ◽  
Depot Antipsychotics

Antipsychotic drugs have long been noted to cause pronounced weight gain, and drug-induced obesity can assume major clinical importance in long-term medication in the management of chronic schizophrenia. Obesity is associated with increased morbidity and may reduce compliance, leading to a return of psychotic symptoms. In a survey of 226 patients attending depot neuroleptic clinics in one inner London borough, it was found that the prevalence of clinically relevant obesity was four times that in the general population.

scholarly journals Steroid induced psychiatric adverse effects: an overview of risk factors, clinical features and management

2020 ◽  
Vol 8 (6) ◽  
pp. 2365
Author(s):  
Anant Parasher ◽  
Jeplin Bez
Keyword(s):  
Adverse Effects ◽  
Steroid Therapy ◽  
Wound Repair ◽  
Glucocorticoid Receptors ◽  
Psychiatric Symptoms ◽  
Immunosuppressive Drugs ◽  
Psychotic Symptoms ◽  
Metabolic Disturbances ◽  
Duration Of Treatment

Corticosteroids have been in use since the past five decades as anti-inflammatory and immunosuppressive drugs for the treatment of several pathologies such as asthma, allergy, rheumatoid arthritis, and dermatological disorders. Adverse effects include growth retardation in children, immunosuppression, hypertension, hyperglycemia, inhibition of wound repair, osteoporosis, metabolic disturbances, glaucoma, and cataracts. The psychiatric effects of steroids are due to the wide expression of Glucocorticoid Receptors in the brain, and their long-term modulation can lead to functional and anatomical alterations along with hippocampal dysfunction. In most cases, the psychiatric symptoms disappear on cessation of steroid therapy; others may require some form of therapeutic management. A search was conducted for clinically relevant articles from 1971 to 2016 by including the terms corticosteroids, mania, depression, psychosis and cognitive defects. About one-fifth of patients receiving high doses of corticosteroids develop psychiatric symptoms. These symptoms are observed to be dose-dependent and generally occur during the first few weeks of therapy. Lithium has a preventive as well as therapeutic role, while antipsychotics are reserved for high risk cases with predominant psychotic symptoms. Psychiatric effects of long term steroid therapy have become increasingly common nowadays due to long duration of treatment of many chronic respiratory and orthopedic illnesses. Reduction in the dose or complete discontinuation of steroid therapy has been proven beneficial in many patients. Among the therapeutic options, lithium has a definitive role, both in the prevention as well as treatment of psychiatric symptoms. Better co-ordination between the physician and psychiatrist can go a long way to improve the quality of life in these patients. 

scholarly journals Experiences of taking neuroleptic medication and impacts on symptoms, sense of self and agency: a systematic review and thematic synthesis of qualitative data

2019 ◽  
Vol 55 (2) ◽  
pp. 151-164 ◽  
Author(s):  
Jemima Thompson ◽  
Jacki L. Stansfeld ◽  
Ruth E. Cooper ◽  
Nicola Morant ◽  
Nadia E. Crellin ◽  
...  
Keyword(s):  
Qualitative Data ◽  
Sense Of Self ◽  
Psychotic Symptoms ◽  
Neuroleptic Medication ◽  
Thematic Synthesis ◽  
Beneficial Effects ◽  
Loss Of Autonomy ◽  
Cognitive Slowing ◽  
Qualitative Literature

Abstract Purpose Neuroleptic (antipsychotic) drugs reduce psychotic symptoms, but how they achieve these effects and how the drugs’ effects are experienced by people who take them are less well understood. The present study describes a synthesis of qualitative data about mental and behavioural alterations associated with taking neuroleptics and how these interact with symptoms of psychosis and people’s sense of self and agency. Methods Nine databases were searched to identify qualitative literature concerning experiences of taking neuroleptic medication. A thematic synthesis was conducted. Results Neuroleptics were commonly experienced as producing a distinctive state of lethargy, cognitive slowing, emotional blunting and reduced motivation, which impaired functioning but also had beneficial effects on symptoms of psychosis and some other symptoms (e.g. insomnia). For some people, symptom reduction helped restore a sense of normality and autonomy, but others experienced a loss of important aspects of their personality. Across studies, many people adopted a passive stance towards long-term medication, expressing a sense of resignation, endurance or loss of autonomy. Conclusions Neuroleptic drugs modify cognition, emotions and motivation. These effects may be associated with reducing the intensity and impact of symptoms, but also affect people’s sense of self and agency. Understanding how the effects of neuroleptics are experienced by those who take them is important in developing a more collaborative approach to drug treatment in psychosis and schizophrenia.

the Deleterious Effect of Cognitive Impairment, Negative Symptoms and Functional Disability on Quality of Life in Chronic Schizophrenia

2009 ◽  
Vol 24 (S1) ◽  
pp. 1-1
Author(s):  
E. Elizagárate ◽  
P. Sánchez ◽  
A.B. Yoller ◽  
J. Peña ◽  
N. Ojeda ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Verbal Memory ◽  
Negative Symptoms ◽  
Functional Disability ◽  
Psychiatric Symptoms ◽  
Neuropsychological Functioning ◽  
Chronic Schizophrenia ◽  
Motor Speed

Aims:To examine the relative contributions of psychiatric symptoms, functional disability, neuropsychological functioning and sociodemographic variables to quality of life (QOL) in patients with chronic schizophrenia.Method:We examined 165 hospitalised patients with long term schizophrenia (DSM-IV). Measures of psychiatric symptoms included depression (Calgary depression Scale), insight (David Insight Scale), symptom severity (BPRS) and PANSS (Positive and Negative Symptom Scale). Neuropsychological battery included tests for verbal memory, executive functioning, verbal fluency, working memory, motor speed and processing speed. Functional disability was assessed with the Disability Assessment Schedule (DAS-WHO) and Quality of life was assessed with the Quality of Life Scale.Results:Age, years of evolution, negative symptoms, insight and neuropsychological variables (except motor speed) all were significantly related to level of quality of life. in a multiple regression analysis, entering the neuropsychological functioning, functional disability and negative symptoms generated a model which accounted for a 74.9% of the variance in QOL. Functional disability, as expected, accounted for 56% of the variance, whereas Processing Speed explained an additional 6.2%. Symptom Severity and Verbal Fluency predicted 3.7% and 3.5% of the variance, respectively. Negative symptoms, Verbal Memory and Vocabulary, were also significant predictors in the model, but had less predictive value. However, Positive Symptoms and Sociodemographic Variables did not significantly contribute to predict quality of life.Conclusion:Our findings support the predictive value of neuropsychological functioning, functional disability and severity of negative symptoms in long term quality of life in schizophrenia.

Sequential cross-sectional and 10-year prospective study of severe negative symptoms in relation to duration of initially untreated psychosis in chronic schizophrenia

1995 ◽  
Vol 25 (4) ◽  
pp. 849-857 ◽  
Author(s):  
J. L. Waddington ◽  
H. A. Youssef ◽  
A. Kinsella
Keyword(s):  
Prospective Study ◽  
Negative Symptoms ◽  
Chronic Schizophrenia ◽  
Psychotic Symptoms ◽  
Neuroleptic Treatment ◽  
Cross Sectional ◽  
Illness Onset ◽  
Clinical Correlate ◽  
Sectional Analysis

SYNOPSISCurrent clinical correlates of duration of initially untreated psychotic symptoms were investigated in a cross-sectional analysis followed by a 10-year prospective study among 88 inpatients with a long-standing schizophrenic illness, many of whom had experienced prolonged periods of untreated psychosis due to illness onset and hospital admission in the pre-neuroleptic era. After controlling for the effects of age, and duration and continuity of subsequent neuroleptic treatment, the primary clinical correlate of duration of initially untreated psychosis was muteness. Over the subsequent 10-year-period, no new cases of muteness emerged and some existing cases of muteness partially resolved, though the speech that emerged remained very sparse and revealed generally gross cognitive debility. The pathophysiology underlying active, unchecked psychosis may also constitute an active morbid process that is associated with the further progression of severe negative symptoms and cognitive dysfunction in the long-term.

scholarly journals Antioxidant activity in children with ADHD – a comparison in untreated and treated subjects with normal children

2020 ◽  
Vol 10 (1) ◽  
Author(s):  
Ruchi K ◽  
Anil Kumar S ◽  
Sunil G ◽  
Bashir A ◽  
Prabhat S
Keyword(s):  
Antioxidant Activity ◽  
Normal Subjects ◽  
Long Term Outcomes ◽  
Short Term ◽  
Normal Children ◽  
Children With Adhd ◽  
Hyperactivity Disorder ◽  
Effect Of Therapy ◽  
Dsm Iv

Introduction: Attention deficit hyperactivity disorder (ADHD) is a frequently encountered clinical condition in children. Based on DSM IV-TR criteria it can be sub-classified into three distinct types namely hyperactiveimpulsive, inattentive and combined. Materials and Methods: In the present study, salivary antioxidant activity (AOA) in children with ADHD was compared with age-matched normal control subjects, both as a whole and also with regard to the three subtypes. Additionally, the effect of therapy on the altered AOA levels was investigated following short term (<3 months) and long term (1–3 years) treatments. AOA and catalase activities in the saliva were estimated employing previously reported biochemical procedures. Results: While AOA is decreased in ADHD patients as compared to normal subjects, statistically significant decrease is seen only in the combined and the hyperactive-impulsive subtypes. Restoration of AOA and catalase activities is seen only after sustained therapy and not in the short term. Conclusion: It is concluded that ADHD is associated with decrease in AOA and this should possibly also be addressed for limiting the long term outcomes of this condition.

Outcome of psychiatric symptoms presenting at onset of multiple sclerosis: a retrospective study

2010 ◽  
Vol 16 (6) ◽  
pp. 742-748 ◽  
Author(s):  
Salvatore Lo Fermo ◽  
Rita Barone ◽  
Francesco Patti ◽  
Patrizia Laisa ◽  
Tiziana L Cavallaro ◽  
...  
Keyword(s):  
Multiple Sclerosis ◽  
Psychiatric Symptoms ◽  
Psychiatric Morbidity ◽  
Neurological Symptoms ◽  
Psychotic Symptoms ◽  
Psychiatric Disturbances ◽  
Multiple Sclerosis Diagnosis ◽  
Multiple Sclerosis Onset

Psychiatric disturbances may occur at the onset of multiple sclerosis. However, information on their outcome is lacking. Our objective was to document the characteristics of psychiatric symptoms at presentation of multiple sclerosis and to define the long-term evolution of psychiatric disturbances in these patients. Based on a clinical record analysis of patients with defined multiple sclerosis diagnosis and coming under the care of a university multiple sclerosis centre within the period 1997—2007, patients with both psychiatric and neurological symptoms at presentation were identified. Clinical data at onset and at last follow-up were considered. Among 682 evaluated patients, psychiatric disturbances were associated with multiple sclerosis onset in 16 cases (2.3%). Most patients (56%) presented with a mood disorder with clinical characteristics of a major depressive-like episode, five (32%) had psychotic symptoms. Initial psychiatric disturbances improved later than neurological symptoms, or never fully recovered, regardless of the concomitant use of psychotropic medications. In most of the subjects psychiatric disturbances tended to remain over the follow-up period and at last visit, after a mean follow-up of 7.6 years (±2.3), 14 subjects (87%) had a supplementary diagnosis of psychiatric illness. Psychiatric symptoms at onset of multiple sclerosis may be indicators of possible maintenance of psychiatric morbidity in a sizeable proportion of patients.

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