Significance of Positive and Negative Syndromes in Chronic Schizophrenia

1986 ◽  
Vol 149 (4) ◽  
pp. 439-448 ◽  
Author(s):  
S. R. Kay ◽  
L. A. Opler ◽  
A. Fiszbein
Keyword(s):  
Hospital Admissions ◽  
Chronic Schizophrenia ◽  
Strongly Correlated ◽  
General Psychopathology ◽  
Developmental Impairment ◽  
Schizophrenic Patients ◽  
History Of ◽  
Patient Stay ◽  
Negative Syndrome

Positive and negative syndromes were studied in relation to demographic, historical, genealogical, clinical, psychometric, extrapyramidal, and follow-up measures of 101 chronic schizophrenic patients. The criterion scales proved to be reliable, normally distributed, and strongly correlated with general psychopathology, but otherwise inversely related to one another. Multiple regression analysis identified sets of 4–6 independent variables that explained 74%-81 % of the scales' variance. A positive syndrome was associated chiefly with productive features, family history of sociopathy, more previous hospital admissions, and longer in-patient stay during the 30-month follow-up period. A negative syndrome correlated with deficits in cognitive, affective, social, and motor spheres, higher incidence of major psychiatric illness but less affective disorder among relatives, lower education, and greater cognitive developmental impairment. The results underscore the importance of genetic and biodevelopmental variables for understanding schizophrenic syndromes.

scholarly journals Spontaneous dyskinesia and parkinsonism in never-medicated, chronically ill patients with schizophrenia: 18-month follow-up

2002 ◽  
Vol 181 (2) ◽  
pp. 135-137 ◽  
Author(s):  
R. G. McCreadie ◽  
R. Padmavati ◽  
R. Thara ◽  
T. N. Srinivasan
Keyword(s):  
Natural History ◽  
Disease Process ◽  
Chronically Ill ◽  
Abnormal Involuntary Movements ◽  
Syndrome Scale ◽  
History Of ◽  
Chronically Ill Patients ◽  
Negative Syndrome ◽  
Over Time

BackgroundSpontaneous dyskinesia and parkinsonism have been reported in never-medicated patients with schizophrenia but there has been no previous study of the natural history of these conditions.AimsTo determine the prevalence of spontaneous dyskinesia and parkinsonism in a group of never-medicated, chronically ill patients with schizophrenia on two occasions separated by an 18-month interval.MethodDyskinesia was assessed by the Abnormal Involuntary Movements Scale using Schooler and Kane criteria for its presence; parkinsonism by the Simpson and Angus scale; and mental state by the Positive and Negative Syndrome Scale for schizophrenia.ResultsThirty-seven patients were examined on two occasions. Nine (24%) had dyskinesia on both occasions, 12 (33%) on one occasion and 16 (43%) on neither occasion. Twenty-one (57%) had dyskinesia on at least one occasion. Thirteen patients (35%) had parkinsonism on at least one occasion.ConclusionsSpontaneous dyskinesia and parkinsonism fluctuate over time. The former was found on at least one occasion in the majority of patients. It is an integral part ofthe schizophrenic disease process.

Effectiveness of Clozapine in Hospitalised People with Chronic Neuroleptic-Resistant Schizophrenia

1995 ◽  
Vol 167 (6) ◽  
pp. 760-764 ◽  
Author(s):  
Moshe Avnon ◽  
Jonathan Rabinowitz
Keyword(s):  
Side Effects ◽  
Psychiatric Hospital ◽  
Chronic Schizophrenia ◽  
Schizophrenic Patients ◽  
Chronic Neuroleptic ◽  
Drop Outs

BackgroundClozapine's effectiveness in reducing symptoms and facilitating discharge among patients with chronic schizophrenia who were resistant to neuroleptics was studied.MethodAll 169 such patients in a public psychiatric hospital were given clozapine. BPRS ratings (0–5 scale) were completed before treatment and 21 months later. Patients were followed for about 2.5 years.ResultsClozapine was discontinued in 37.8% of cases due to non-compliance, non-response, or side-effects. At follow-up 41 % of clozapine recipients and 25.9% of the drop-outs were discharged and remained so, and 33% of recipients and 24.1% of drop-outs were being prepared for discharge. Longer treatment was associated with more improvement. Decline in average BPRS total scores of recipients was significantly more than drop-outs (32.7, s.d. 16.8 v. 12.1, s.d. 14.1, d.f. = 155, t = 7.5, P = 0.000).ConclusionsClozapine appears to be effective for treating some chronic neuroleptic non-responding schizophrenic patients.

Lithium withdrawal Trial in Chronic Schizophrenia

1982 ◽  
Vol 141 (4) ◽  
pp. 401-406 ◽  
Author(s):  
N. J. Delva ◽  
F. J. J. Letemendia ◽  
A. W. Prowse
Keyword(s):  
Chronic Schizophrenia ◽  
Schizophrenic Patients ◽  
One Year ◽  
Lithium Withdrawal

SummarySix schizophrenic patients treated with lithium and neuroleptics for at least two years had their lithium medication stopped. Two patients relapsed within two weeks, and four did not after one year of follow-up.

A Role for EMDR in the Treatment of Trauma in Patients Suffering From a Psychosis: Four Vignettes

2014 ◽  
Vol 8 (1) ◽  
pp. 19-24 ◽  
Author(s):  
Richard Laugharne ◽  
Deborah Marshall ◽  
Jon Laugharne ◽  
Alan Hassard
Keyword(s):  
Hospital Admissions ◽  
Anxiety And Depression ◽  
Psychotic Symptoms ◽  
Ptsd Symptoms ◽  
Treatment Needs ◽  
Psychotic Illness ◽  
Functional Psychosis ◽  
History Of

Many patients with a functional psychosis are likely to have a history of trauma and symptoms of posttraumatic stress disorder (PTSD); some may be traumatized by their psychotic symptoms. We present a series of vignettes to describe eye movement desensitization and reprocessing (EMDR) treatment of 4 patients suffering from a functional psychotic illness who had a significant history of trauma. After receiving EMDR, each patient showed an improvement in their PTSD symptoms and reported an improvement in the quality of their lives. Follow-up at 3–6 years indicated that the treatment effects were maintained, with changes evident in elimination of trauma-related delusions, reduction in anxiety and depression, fewer hospital admissions, and overall improved quality of life. Because a history of trauma and PTSD symptoms are more frequent in patients with a psychosis, and trauma may be an etiological component of psychosis, EMDR treatment needs to be researched and explored as a treatment opportunity.

scholarly journals A.6 Vagus Nerve Stimulation in patients with therapy resistant generalized epilepsy

2021 ◽  
Vol 48 (s3) ◽  
pp. S15-S15
Author(s):  
AS Suller Marti ◽  
SM Mirsattari ◽  
KW MacDougall ◽  
D Steven ◽  
A Parrent ◽  
...  
Keyword(s):  
Vagus Nerve ◽  
Nerve Stimulation ◽  
Vagus Nerve Stimulation ◽  
Hospital Admissions ◽  
Focal Epilepsy ◽  
Limited Information ◽  
Best Response ◽  
History Of ◽  
Generalized Epilepsy

Background: For patients with generalized epilepsy who do not respond to anti-seizure medications, the therapeutic options are limited. Vagus nerve stimulation (VNS) is a treatment mainly approved for therapy resistant focal epilepsy. There is limited information on the use of VNS on generalized epilepsies, including Lennox Gastaut Syndrome(LGS) and genetic generalized epilepsy(GGE). Methods: We identified patients with a diagnosis of Lennox-Gastaut Syndrome or Genetic Generalized Epilepsy, who underwent VNS implantation, between1997 and July 2018. Results: A total of 46 patients were included in this study with a history of therapy resistant generalized epilepsy. The mean age at implantation was 24 years(IQR= 17.8-31 years) and 50%(n=23) were female. The most common etiologies were GGE in 37%(n=17) and LGS in 63%(n=29). Median follow-up since VNS implantation was 63 months(IQR:31-112.8months). 41.7%(n=12) of the LGS group became responders, and 64.7%(n=11) in the GGE group. The best response in seizure reduction was seen in generalized tonic-clonic seizures. There was a reduction of seizure-related hospital admissions from 89.7%(N=26) pre-implantation, to 41.4%(N=12) post-implantation (p<0.0001). The frequency of side effects due to the stimulation was similar in both groups(62.1% in LGS and 61.1% in GGE). Conclusions: VNS is an effective treatment in patients with therapy resistant generalized epilepsy, especially GGE.

The effect of prolonged administration of hydroxyurea on morbidity and mortality in adult patients with sickle cell syndromes: results of a 17-year, single-center trial (LaSHS)

Blood ◽  
2010 ◽  
Vol 115 (12) ◽  
pp. 2354-2363 ◽  
Author(s):  
Ersi Voskaridou ◽  
Dimitrios Christoulas ◽  
Antonios Bilalis ◽  
Eleni Plata ◽  
Konstantinos Varvagiannis ◽  
...  
Keyword(s):  
Sickle Cell ◽  
Hospital Admissions ◽  
Fetal Hemoglobin ◽  
Acute Chest Syndrome ◽  
Prolonged Administration ◽  
Probability Of Survival ◽  
Transfusion Requirements ◽  
History Of

The aim of this prospective study was to evaluate the long-term efficacy and safety of hydroxyurea (HU) in patients with sickle cell disease (SCD). Thirty-four patients with sickle cell anemia (hemoglobin S [HbS]/HbS), 131 with HbS/β0-thal, and 165 with HbS/β+-thal participated in this trial. HU was administered to 131 patients, whereas 199 patients were conventionally treated. The median follow-up period was 8 years for HU patients and 5 years for non-HU patients. HU produced a dramatic reduction in the frequency of severe painful crises, transfusion requirements, hospital admissions, and incidence of acute chest syndrome. The probability of 10-year survival was 86% and 65% for HU and non-HU patients, respectively (P = .001), although HU patients had more severe forms of SCD. The 10-year probability of survival for HbS/HbS, HbS/β 0-thal, and HbS/IVSI-110 patients was 100%, 87%, and 82%, respectively, for HU patients and 10%, 54%, and 66%, for non-HU patients. The multivariate analysis showed that fetal hemoglobin values at baseline and percentage change of lactate dehydrogenase between baseline and 6 months were independently predicted for survival in the HU group. These results highlight the beneficial effect of HU, which seems to modify the natural history of SCD and raise the issue of expanding its use in all SCD patients.

Cognitive Group Therapy for Paranoid Schizophrenics: Applying Cognitive Dissonance

1998 ◽  
Vol 12 (1) ◽  
pp. 3-12 ◽  
Author(s):  
Joseph Levine ◽  
Yoram Barak ◽  
Ilana Granek
Keyword(s):  
Group Therapy ◽  
Cognitive Dissonance ◽  
Control Group ◽  
Positive Symptoms ◽  
Wide Acceptance ◽  
Syndrome Scale ◽  
Schizophrenic Patients ◽  
Supportive Group ◽  
Negative Syndrome

Psychotherapy with paranoid schizophrenics is a hard and often unrewarding task. Individual and group therapies are usually supportive only and are not aimed at changing the paranoid mode of thinking. Although cognitive therapy has been applied in schizophrenic patients, it has not gained wide acceptance. Cognitive dissonance postulates that individuals experience discomfort and tension when holding two dissonant beliefs simultaneously. We here present the group therapy of six schizophrenic paranoids treated by modified cognitive group therapy implementing cognitive dissonance as the vector of change. A control group of six age- and sex-matched paranoid schizophrenics was treated by supportive group therapy. Analysis of the results, using the Positive and Negative Syndrome Scale (PANSS), during therapy and at follow-up of 4 weeks demonstrates statistically significant improvement in total PANSS score as well as in the positive symptoms subscale.

scholarly journals Suicide attempts in bulimia nervosa: Personality and psychopathological correlates

2009 ◽  
Vol 24 (2) ◽  
pp. 91-97 ◽  
Author(s):  
Laura Forcano ◽  
Fernando Fernández-Aranda ◽  
Eva Álvarez-Moya ◽  
Cynthia Bulik ◽  
Roser Granero ◽  
...  
Keyword(s):  
Eating Disorder ◽  
Alcohol Abuse ◽  
Bulimia Nervosa ◽  
Suicide Attempts ◽  
Future Research ◽  
Strongly Correlated ◽  
Suicide Attempters ◽  
General Psychopathology ◽  
History Of Childhood ◽  
History Of

AbstractBackgroundLittle evidence exists about suicidal acts in eating disorders and its relation with personality. We explored the prevalence of lifetime suicide attempts (SA) in women with bulimia nervosa (BN), and compared eating disorder symptoms, general psychopathology, impulsivity and personality between individuals who had and had not attempted suicide. We also determined the variables that better correlate with of SA.MethodFive hundred sixty-six BN outpatients (417 BN purging, 47 BN non-purging and 102 subthreshold BN) participated in the study.ResultsLifetime prevalence of suicide attempts was 26.9%. BN subtype was not associated with lifetime SA (p = 0.36). Suicide attempters exhibited higher rates on eating symptomatology, general psychopathology, impulsive behaviors, more frequent history of childhood obesity and parental alcohol abuse (p < 0.004). Suicide attempters exhibited higher scores on harm avoidance and lower on self-directedness, reward dependence and cooperativeness (p < 0.002). The most strongly correlated variables with SA were: lower education, minimum BMI, previous eating disorder treatment, low self-directedness, and familial history of alcohol abuse (p < 0.006).ConclusionOur results support the notion that internalizing personality traits combined with impulsivity may increase the probability of suicidal behaviors in these patients. Future research may increase our understanding of the role of suicidality to work towards rational prevention of suicidal attempts.

scholarly journals Atypical Antipsychotics in the Treatment of Depressive and Psychotic Symptoms in Patients with Chronic Schizophrenia: A Naturalistic Study

2013 ◽  
Vol 2013 ◽  
pp. 1-7 ◽  
Author(s):  
Marco Innamorati ◽  
Stefano Baratta ◽  
Cristina Di Vittorio ◽  
David Lester ◽  
Paolo Girardi ◽  
...  
Keyword(s):  
Depressive Symptoms ◽  
Mental Disorder ◽  
Atypical Antipsychotics ◽  
Depression Scale ◽  
Chronic Schizophrenia ◽  
Psychotic Symptoms ◽  
Naturalistic Study ◽  
Syndrome Scale ◽  
Negative Syndrome

Objectives. The aim of this naturalistic study was to investigate whether treatment with clozapine and other atypical antipsychotics for at least 2 years was associated with a reduction in psychotic and depressive symptoms and an improvement in chronic schizophrenia patients’ awareness of their illness.Methods. Twenty-three adult outpatients (15 men and 8 women) treated with clozapine and 23 patients (16 men and 7 women) treated with other atypical antipsychotics were included in the study. Psychotic symptoms were evaluated using the Positive and Negative Syndrome Scale (PANSS), depressive symptoms were assessed with the Calgary Depression Scale for Schizophrenia (CDSS), and insight was assessed with the Scale to Assess Unawareness of Mental Disorder (SUMD).Results. The sample as a whole had a significant reduction in positive, negative, and general symptoms, whereas the reduction in depression was significant only for patients with CDSS scores of 5 and higher at the baseline. At the follow-up, patients treated with other atypical antipsychotics reported a greater reduction in depression than patients treated with clozapine, but not when limiting the analyses to those with clinically relevant depression.Conclusions. Atypical antipsychotics may be effective in reducing psychotic and depressive symptoms and in improving insight in patients with chronic schizophrenia, with no differences in the profiles of efficacy between compounds.

scholarly journals Classic ataxia-telangiectasia: the phenotype of long-term survivors

2019 ◽  
Vol 267 (3) ◽  
pp. 830-837 ◽  
Author(s):  
Nienke J. H. van Os ◽  
Marcel van Deuren ◽  
Corry M. R. Weemaes ◽  
Judith van Gaalen ◽  
Helma Hijdra ◽  
...  
Keyword(s):  
Ataxia Telangiectasia ◽  
Hospital Admissions ◽  
Multisystem Disorder ◽  
Medical Treatments ◽  
History Of ◽  
The Many ◽  
Long Term Survivors ◽  
Age Awareness

Abstract Objective Patients with classic ataxia–telangiectasia (A–T) generally die in the second or third decade of life. Clinical descriptions of A–T tend to focus on the symptoms at presentation. However, during the course of the disease, other symptoms and complications emerge. As long-term survivors with classic A–T develop a complex multisystem disorder with a largely unknown extent and severity, we aimed to comprehensively assess their full clinical picture. Methods Data from Dutch patients with classic A–T above the age of 30 years were retrospectively collected. In addition, we searched the literature for descriptions of classic A–T patients who survived beyond the age of 30 years. Results In the Dutch cohort, seven classic A–T patients survived beyond 30 years of age. Fourteen additional patients were retrieved by the literature search. Common problems in older patients with classic A–T were linked to ageing. Most patients had pulmonary, endocrine, cardiovascular, and gastro-intestinal problems. All patients had a tetraparesis with contractures. This led to immobilization and frequent hospital admissions. Most patients expressed the wish to no longer undergo intensive medical treatments, and waived follow-up programs. Conclusions Paucity of descriptions in the literature, and withdrawal from medical care complicate the acquisition of follow-up data on the natural history of long-term survivors. Irrespective of these limitations, we have obtained impression of the many problems that these patients face when surviving beyond 30 years of age. Awareness of these problems is needed to guide follow-up, counselling, and (palliative) care; decisions about life-prolonging treatments should be well considered.

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