Impact of Lithium Therapy on Core Psychotic Symptoms of Schizophrenia

1984 ◽  
Vol 144 (1) ◽  
pp. 64-69 ◽  
Author(s):  
Frank P. Zemlan ◽  
Jack Hirschowitz ◽  
Frederic J. Sautter ◽  
David L. Garver
Keyword(s):  
Early Identification ◽  
Lithium Treatment ◽  
Lithium Therapy ◽  
Thought Disorder ◽  
Psychotic Symptoms ◽  
Formal Thought Disorder ◽  
The Core ◽  
Schizophrenic Patients ◽  
Core Symptoms

SummaryThe authors have previously reported that a sub-group of schizophrenic-like patients respond favorably to lithium therapy: furthermore, psychotic patients who respond to lithium demonstrate appreciable improvement during the first seven days of treatment. The present study investigated which symptoms of schizophrenia improved quickly during lithium treatment. We found that patients who do respond to lithium show significant improvement in the core symptoms of psychosis—hallucinations, delusions and formal thought disorder—during the first seven days of treatment, thus allowing early identification of 88 per cent of schizophrenic patients who ultimately respond to lithium and 91 per cent of those who do not.

New dopaminergic and non-dopaminergic theories in schizophrenia and their therapeutic impact

1997 ◽  
Vol 9 (2) ◽  
pp. 64-67
Author(s):  
R.S. Kahn
Keyword(s):  
Cognitive Deficits ◽  
Negative Symptoms ◽  
Dopamine Neurons ◽  
Psychotic Symptoms ◽  
Positive Symptoms ◽  
The Core ◽  
Schizophrenic Patients ◽  
Core Symptoms ◽  
Influential Theory

The dopamine (DA) hypothesis of schizophrenia, postulating that schizophrenia is characterized by increased dopamine function, has been the most influential theory on the pathogenesis of schizophrenia. It has recently been revised based on the appreciation that the core symptoms of schizophrenia may not be the positive (psychotic) symptoms, but rather the negative symptoms and the cognitive deficits found in schizophrenic patients. This revision has prompted the hypothesis that schizophrenia is characterized by both decreased prefrontal dopamine activity (causing deficit symptoms) and increased dopamine activity in mesolimbic dopamine neurons (causing positive symptoms).Notwithstanding this revision of a role for dopamine in schizophrenia, it has become increasingly evident that dysfunction of other monoaminergic systems may be as important in contributing to the pathophysiology of schizophrenia. Specifically, the putative role of serotonin (5-hydroxytryptamine, 5-HT) in schizophrenia is gaining considerable attention. Several observations, such as the ability of the 5-HT antagonist, ritanserin, to alleviate schizophrenic symptoms and, when added to haloperidol (Haldol®), to decrease its extrapyramidal side-effects (EPS), have stimulated studies into a role of 5-HT in schizophrenia. The finding that clozapine (Leponex®), clinically superior to conventional neuroleptics, is a weak DA2 antagonist but a potent 5-HT1c and 5-HT2 antagonist has further stimulated 5-HT-related research in schizophrenia.

Self-monitoring in patients with schizophrenia

2004 ◽  
Vol 34 (8) ◽  
pp. 1561-1569 ◽  
Author(s):  
GÜNTHER KNOBLICH ◽  
FRANK STOTTMEISTER ◽  
TILO KIRCHER
Keyword(s):  
Hand Movements ◽  
Control Group ◽  
Formal Thought Disorder ◽  
Self Monitoring ◽  
The Core ◽  
Matched Healthy Control ◽  
Healthy Control ◽  
Dsm Iv ◽  
Core Symptoms ◽  
The Relationship

Background. The present study investigated whether a failure of self-monitoring contributes to core syndromes of schizophrenia.Method. Three groups of patients with a DSM-IV diagnosis of schizophrenia (n=27), with either prominent paranoid hallucinatory or disorganization syndrome, or without these symptoms, and a matched healthy control group (n=23) drew circles on a writing pad connected to a PC monitor. Subjects were instructed to continuously monitor the relationship between their hand movements and their visual consequences. They were asked to detect gain changes in the mapping. Self-monitoring ability and the ability to automatically correct movements were assessed.Results. Patients with either paranoid-hallucinatory syndrome or formal thought disorder were selectively impaired in their ability to detect a mismatch between a self-generated movement and its consequences, but not impaired in their ability to automatically compensate for the gain change.Conclusions. These results support the claim that a failure of self-monitoring may underlie the core symptoms of schizophrenia.

Age-related changes in formal thought disorder in chronic schizophrenic patients

1996 ◽  
Vol 39 (7) ◽  
pp. 549
Author(s):  
J. Lombardi ◽  
P.D. Harvey ◽  
M. Leibman ◽  
M. Parrella ◽  
L. White ◽  
...  
Keyword(s):  
Thought Disorder ◽  
Formal Thought Disorder ◽  
Chronic Schizophrenic ◽  
Age Related ◽  
Schizophrenic Patients ◽  
Age Related Changes

scholarly journals Faulty Suppression of Irrelevant Material in Patients with Thought Disorder Linked to Attenuated Frontotemporal Activation

2012 ◽  
Vol 2012 ◽  
pp. 1-12 ◽  
Author(s):  
S. M. Arcuri ◽  
M. R. Broome ◽  
V. Giampietro ◽  
E. Amaro ◽  
T. T. J. Kircher ◽  
...  
Keyword(s):  
Language Processing ◽  
Semantic Processing ◽  
Event Related Potential ◽  
Thought Disorder ◽  
Decision Task ◽  
Formal Thought Disorder ◽  
Specific Effects ◽  
Semantic Decision ◽  
Semantic Decision Task ◽  
Schizophrenic Patients

Formal thought disorder is a feature schizophrenia that manifests as disorganized, incoherent speech, and is associated with a poor clinical outcome. The neurocognitive basis of this symptom is unclear but it is thought to involve an impairment in semantic processing classically described as a loosening of meaningful associations. Using a paradigm derived from the n400 event-related, potential, we examined the extent to which regional activation during semantic processing is altered in schizophrenic patients with formal thought disorder. Ten healthy control and 18 schizophrenic participants (9 with and 9 without formal thought disorder) performed a semantic decision sentence task during an event-related functional magnetic resonance imaging experiment. We employed analysis of variance to estimate the main effects of semantic congruency and groups on activation and specific effects of formal thought disorder were addressed using post-hoc comparisons. We found that the frontotemporal network, normally engaged by a semantic decision task, was underactivated in schizophrenia, particularly in patients with FTD. This network is implicated in the inhibition of automatically primed stimuli and impairment of its function interferes with language processing and contributes to the production of incoherent speech.

Tardive Dyskinesia and Type II Schizophrenia

1992 ◽  
Vol 160 (2) ◽  
pp. 253-256 ◽  
Author(s):  
Elizabeth J. B. Davis ◽  
Milind Borde ◽  
L. N. Sharma
Keyword(s):  
Cognitive Impairment ◽  
Negative Symptoms ◽  
Chronic Schizophrenia ◽  
Thought Disorder ◽  
Control Group ◽  
Positive Symptoms ◽  
Type Ii ◽  
Formal Thought Disorder ◽  
Schizophrenic Patients ◽  
Male Patients

Cognitive impairment, negative and positive symptoms, primitive release reflexes, and age/temporal disorientation were assessed in 20 male patients meeting the DSM–III–R criteria for chronic schizophrenia and Schooler & Kane's criteria for TD. The control group comprised 20 age-matched male chronic schizophrenic patients without TD. Significant associations were found between TD, cognitive impairment, some negative symptoms, and formal thought disorder. These associations were independent of other illness and treatment variables. The severity of TD correlated significantly with that of cognitive impairment.

Schizophrenic Thought Disorder

1988 ◽  
Vol 152 (3) ◽  
pp. 310-319 ◽  
Author(s):  
J. Cutting ◽  
D. Murphy
Keyword(s):  
Social Issues ◽  
Practical Knowledge ◽  
Poor Performance ◽  
Thought Disorder ◽  
World Knowledge ◽  
Formal Thought Disorder ◽  
Conversational Discourse ◽  
Independent Components ◽  
Striking Result ◽  
Schizophrenic Patients

It is suggested that schizophrenic thought disorder comprises four relatively independent components: delusion; intrinsic thinking disturbance; formal thought disorder; and deficient real-world knowledge – a new concept. Schizophrenic and neurotic control subjects were given tests of thinking, perception, appreciation of conversational discourse, and social and practical knowledge. Not all deluded schizophrenics had intrinsic thinking disturbance. Those that did tended to have overinclusive categorisation as the most apparent deficit. Formal thought disorder was associated with a poor performance on the test of conversational discourse. The most striking result was that 75% of schizophrenic patients were markedly deficient, relative to neurotic patients, on their knowledge of everyday social issues.

The Assessment of Negative and Positive Features in Schizophrenia

1989 ◽  
Vol 155 (S7) ◽  
pp. 41-44 ◽  
Author(s):  
Eve C. Johnstone
Keyword(s):  
Negative Symptoms ◽  
Normal Function ◽  
Thought Disorder ◽  
List Type ◽  
Type Number ◽  
Formal Thought Disorder ◽  
Clinical Correlates ◽  
Schizophrenic Patients ◽  
The Relationship ◽  
Positive And Negative Symptoms

It has become customary to classify the typical abnormalities of the mental state of schizophrenic patients into positive and negative features, with reference to behavioural excesses and deficits. Positive features are pathological by their presence and negative features represent the loss of some normal function. Positive features are generally considered to include delusions, hallucinations and positive formal thought disorder (Fish, 1962). Some studies (e.g. Johnstone et al, 1978) have also included incongruity of affect under this heading. Negative features include affective flattening, poverty of speech, retardation, apathy, lack of sociability. There is some evidence that the clinical correlates of positive and negative features may not be the same (Owens & Johnstone, 1980). Some workers (Andreasen & Olsen, 1982) but not others (Pogue-Geile & Harrow, 1984) have found that among schizophrenic patients positive and negative symptoms were negatively correlated. Although the nature of the relationship between positive and negative features is not entirely established and may not be simple (Wing, 1978) certain generalisations may be applied: (a)Positive features are characteristic of earlier and negative of later phases of the illness (Pfohl & Winokur, 1982).(b)The effects of drugs upon positive features are greater than those upon negative features. Thus neuroleptics produce more marked improvement (Johnstone et al, 1978; Angrist et al, 1980) and amphetamine more marked exacerbation (Angrist et al, 1980) of positive than of negative features.(c)Positive features have been said to be relatively variable and negative features relatively stable (Ovchinnikov, 1968; Snezhnevsky, 1968).

Confabulation in schizophrenia: evidence of a new form?

1996 ◽  
Vol 26 (2) ◽  
pp. 391-399 ◽  
Author(s):  
D. A. Nathaniel-James ◽  
C. D. Frith
Keyword(s):  
Control Subject ◽  
Neuropsychological Tests ◽  
Healthy Subjects ◽  
Thought Disorder ◽  
Response Monitoring ◽  
Response Suppression ◽  
Formal Thought Disorder ◽  
Schizophrenic Patients ◽  
New Ideas ◽  
New Form

SynopsisThis study is an attempt to demonstrate confabulation in schizophrenia. Twelve patients who met DSM-III-R criteria for schizophrenia were matched for age, sex and pre-morbid IQ with 12 volunteers, 9 of whom were normal healthy subjects, with the remainder being depressed patients. To elicit confabulation, subjects were asked to recall narratives. In addition, subjects were examined on a number of neuropsychological tests. Confabulation was denned as recall of information not present in the narrative. Variable amounts of confabulation were observed in all schizophrenics, while only one control subject confabulated. The content and structure of their productions differed from previously reported forms of confabulation in that schizophrenic patients spontaneously rearranged the original narratives to produce new ideas. The amount of confabulation was found to be related to difficulties in suppressing inappropriate responses (Hayling test) and formal thought disorder, but unrelated to understanding of the gist or moral of the narratives. Tentative mechanisms for the process of confabulation are proposed, based on specific difficulties with comprehension, response monitoring and response suppression.

scholarly journals NON PITTING TYPE PEDAL EDEMA WITH LITHIUM: A CASE REPORT

2016 ◽  
Vol 9 (1) ◽  
pp. 323
Author(s):  
Parvathypriya C. ◽  
Jeslyn Mary Philip ◽  
Christeena George ◽  
Lakshmi R.
Keyword(s):  
Affective Disorder ◽  
Dose Escalation ◽  
Lithium Treatment ◽  
Lithium Concentration ◽  
Bipolar Affective Disorder ◽  
Lithium Therapy ◽  
Psychotic Symptoms ◽  
Drug Induced ◽  
Serum Lithium Concentration ◽  
Pedal Edema

<p><strong>Objective: </strong>To report a case of lithium induced bilateral nonpitting pedal edema.</p><p><strong>Methods: </strong>The clinical data of a bipolar affective disorder patient with current episode of mania and psychotic symptoms who experienced bilateral non pitting pedal edema with lithium.</p><p><strong>Results: </strong>The patient was a 29 yr old female who developed bilateral non-pitting type pedal edema with lithium therapy with normal plasma lithium level (0.72mEq/l). She is a known case of bipolar affective disorder (BPAD) was admitted to psychiatry department with episode of mania with psychotic symptoms. She had history of drug induced hypersensitivity reaction with eosinophilia and systemic symptoms (DRESS) with oxcarbazepine and so the drug was discontinued and was started on tablet lithium 400 mg twice daily. On admission here, the dose of lithium was increased to 1200 mg/day. The patient gradually improved but she developed bilateral non-pitting pedal edema. Serum lithium concentration was normal and there were no other early symptoms of lithium toxicity. But as the patient's distress further increased with increasing pedal edema, it was decided to stop lithium altogether and to maintain the patient on tablet quetiapine 800 mg therapy for BPAD. Within one week of stopping lithium the edema on both her feet decreased significantly. Causality was assessed by naranjo causality assessment scale and a probable relationship was obtained between lithium and pedal edema with a score of 6.</p><p><strong>Conclusion: </strong>This case emphasises that regular physical examination and laboratory investigations are important for patients who are on lithium therapy. Clinicians should always be careful while initiating lithium treatment in a patient with respect to the initial dose and dose escalation even after a period of successful therapy with lithium, as minor dose escalation can cause major changes in the serum lithium concentration and thereby the patient’s tolerability to lithium.</p>

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