The Effect of Clozapine on Cognition and Psychiatric Symptoms in Patients with Schizophrenia

1993 ◽  
Vol 162 (1) ◽  
pp. 43-48 ◽  
Author(s):  
Terry E. Goldberg ◽  
Richard D. Greenberg ◽  
Suzanne J. Griffin ◽  
James M. Gold ◽  
Joel E. Kleinman ◽  
...  
Keyword(s):  
Problem Solving ◽  
Cognitive Deficits ◽  
Psychiatric Symptoms ◽  
Psychotic Symptoms ◽  
Cognitive Disability ◽  
Memory Functions ◽  
Not Otherwise Specified ◽  
Level Problem ◽  
Attention Memory ◽  
Rate Limiting

Psychiatric symptoms and cognition were assessed in 13 patients with schizophrenia, one patient with schizoaffective disorder, and one patient with psychosis not otherwise specified while they received a conventional neuroleptic and again after an average of 15 months on clozapine. Despite improvements in psychiatric symptoms, attention, memory, and higher-level problem-solving were essentially unchanged. This suggests that certain cognitive deficits are relatively independent of psychotic symptoms in schizophrenia, and are probably central and enduring features of the disorder. Cognitive disability appeared to have been rate-limiting in the sample's rehabilitation, as patients' social and vocational adjustment remained marginal during the study. We also observed that treatment with clozapine was associated with a decline in some memory functions; the potent anticholinergic properties of the drug may have been responsible for this.

scholarly journals Case Report: Severe Adolescent Major Depressive Syndrome Turns Out to Be an Unusual Case of Anti-NMDA Receptor Encephalitis

2021 ◽  
Vol 12 ◽  
Author(s):  
Alexander Moldavski ◽  
Holger Wenz ◽  
Bettina E. Lange ◽  
Cathrin Rohleder ◽  
F. Markus Leweke
Keyword(s):  
Cognitive Deficits ◽  
Psychiatric Symptoms ◽  
Previous History ◽  
Rapid Onset ◽  
Depressive Syndrome ◽  
Psychotic Symptoms ◽  
Major Depressive ◽  
Abnormal Movements ◽  
Nmdar Encephalitis ◽  
Initial Symptoms

Anti-N-methyl-D-aspartate receptor (NMDAR) encephalitis is a neuroinflammatory condition mediated by autoantibodies against the GluN1 subunit of the receptor. Clinically, it is characterized by a complex neuropsychiatric presentation with rapidly progressive psychiatric symptoms, cognitive deficits, seizures, and abnormal movements. Isolated psychiatric manifestations of anti-NMDAR encephalitis are rare and usually dominated by psychotic symptoms. We present a case of an 18-year-old female high school student—without a previous history of psychiatric disorders—with a rapid onset severe depressive syndrome. Surprisingly, we found pleocytosis and anti-NMDAR autoantibodies in the cerebrospinal fluid (CSF), despite an otherwise unremarkable diagnostic workup, including blood test, clinical examination, and cranial magnetic resonance imaging (MRI). After intravenous immunoglobulins treatment, a complete remission of the initial symptoms was observed. In a follow-up 5 years later, the young woman did not experience any relapse or sequelae. Anti-NMDAR encephalitis can present in rare cases as an organic disorder with major depressive symptoms without distinct concomitant psychotic or neurological symptoms. A clinical presentation such as a rapid onset of symptoms, distinct disturbance in the thought process, restlessness, and cognitive deficits should prompt screening for NMDAR- and other neural autoantibodies to rule out this rare but debilitating pathology.

Les manifestations psychiatriques dans la démence: perspective phénoménologique

1993 ◽  
Vol 38 (10) ◽  
pp. 671-677 ◽  
Author(s):  
Isabelle Paquette
Keyword(s):  
Major Depression ◽  
Cognitive Deficits ◽  
Clinical Characteristics ◽  
Depressive Symptomatology ◽  
Psychiatric Symptoms ◽  
Memory Loss ◽  
Psychotic Symptoms ◽  
Neuropsychological Evaluations ◽  
Operational Criteria ◽  
Psychiatric Manifestations

The study of psychiatric manifestations in dementia has long been overshadowed by the more classical manifestations of the disease, such as memory loss and other cognitive deficits. In recent years, however, psychiatric symptoms as part of the demential process have attracted interest and research has become more specific. Clinicians are faced with diagnostic, treatment and management difficulties related to affective or psychotic symptoms, which account for much distress and morbidity. Several studies indicate that the prevalence of psychiatric manifestations in clinical populations of patients suffering from dementia is high: 15% to 30% for hallucinations, 15% to 30% for delusions, ten percent to 20% for major depression and 40% to 50% for depressed mood. These figures tend to confirm the hypothesis that psychiatric features in dementia are neither infrequent nor atypical. Thus, researchers have sought to link psychotic or depressive symptomatology with several clinical characteristics of dementia, namely stage, severity, prognosis or cognitive dysfunction. Some recent studies involving extensive neuropsychological evaluations indicate that subgroups of patients can be defined according to psychiatric criteria, as well as cognitive or neurological criteria. Unfortunately, results are inconsistent. Some of the contradictions in the literature are related to poorly defined terms and symptoms, a lack of reliable operational criteria, absence of validation of instruments and scales and heterogeneity of the populations studied. Ambiguous syndromes, such as pseudodementia, while illustrative of certain clinical situations, have not been helpful in categorizing demented patients. The author suggests that research focused on specific and clearly defined psychiatric symptoms in dementia will better serve our comprehension of mixed syndromes.

scholarly journals Multiple Sclerosis Presents with Psychotic Symptoms and Coexists with Hypertrophic Cardiomyopathy

2014 ◽  
Vol 2014 ◽  
pp. 1-4
Author(s):  
Muhammed Emin Özcan ◽  
Bahri İnce ◽  
Hasan Hüseyin Karadeli ◽  
Talip Asil
Keyword(s):  
Multiple Sclerosis ◽  
Demyelinating Disease ◽  
Psychiatric Symptoms ◽  
Short Interval ◽  
Complete Response ◽  
Hypertrophic Obstructive Cardiomyopathy ◽  
Sudden Onset ◽  
Psychotic Symptoms ◽  
Not Otherwise Specified ◽  
The Central Nervous System

Multiple sclerosis (MS) is a demyelinating disease of the central nervous system. Psychiatric symptoms are not infrequent during MS, yet onset of MS with psychosis is rarely encountered. A 27-year-old Caucasian male was admitted due to numbness in his right arm and difficulty in walking. His clinical and laboratorial exams lead to the MS diagnosis. Nine months earlier, he also developed psychotic disorder, not otherwise specified (PD-NOS). His sudden onset of PD-NOS, his rapid and complete response to antipsychotics, and a relatively short interval between psychiatric and neurological signs indicate a high likelihood that PD-NOS was a manifestation of underlying MS. He also suffers from hypertrophic obstructive cardiomyopathy (HOCM). The patient’s neurological complaints were recovered with methylprednisolone (1 g/day, i.v.) given for five days. Glatiramer acetate (1 × 1 tb.s.c.) was prescribed for consolidation and, after nine months of his admission, the patient fully recovered from neurological and psychiatric complaints. Interestingly, very recent studies indicate specific alpha-actinin antibodies in MS and alpha-actinin mutations cause HOCM. Thus, concurrence of MS with HOCM can be even a new syndrome, if further genetic studies prove.

scholarly journals Anosognosia in People with Cognitive Impairment: Association with Cognitive Deficits and Behavioral Disturbances

2015 ◽  
Vol 5 (1) ◽  
pp. 42-50 ◽  
Author(s):  
Antonella De Carolis ◽  
Virginia Cipollini ◽  
Valentina Corigliano ◽  
Anna Comparelli ◽  
Micaela Sepe-Monti ◽  
...  
Keyword(s):  
Cognitive Impairment ◽  
Cognitive Deficits ◽  
Rating Scale ◽  
Motor Behavior ◽  
Psychiatric Symptoms ◽  
Early Stage ◽  
Functional Anatomy ◽  
Night Time ◽  
Behavioral Disturbances ◽  
The Relationship

Aims: To investigate, in a group of subjects at an early stage of cognitive impairment, the relationship between anosognosia and both cognitive and behavioral symptoms by exploring the various domains of insight. Methods: One hundred and eight subjects affected by cognitive impairment were consecutively enrolled. The level of awareness was evaluated by means of the Clinical Insight Rating Scale (CIRS). Psychiatric symptoms were evaluated using the Italian version of the Neuropsychiatric Inventory (NPI), whereas memory (memory index, MI) and executive (executive index, EI) functions were explored using a battery of neuropsychological tests and qualified by means of a single composite cognitive index score for each function. Results: A significant positive correlation between the total NPI score and global anosognosia score was found. Furthermore, both the MI and EI scores were lower in subjects with anosognosia than in those without anosognosia (p < 0.001 and p < 0.007, respectively). When the single domains of the CIRS were considered, anosognosia of reason of visit correlated with the EI score (r = -0.327, p = 0.01) and night-time behavioral disturbances (r = 0.225; p = 0.021); anosognosia of cognitive deficit correlated with depression (r = -0.193; p = 0.049) and the MI score (r = -0.201; p = 0.040); anosognosia of functional deficit correlated with the MI score (r = -0.257; p = 0.008), delusions (r = 0.232; p = 0.015) and aberrant motor behavior (r = 0.289; p = 0.003); anosognosia of disease progression correlated with the MI score (r = -0.236; p = 0.015), agitation (r = 0.247; p = 0.011), aberrant motor behavior (r = 0.351; p = 0.001) and night-time behavioral disturbances (r = 0.216; p = 0.027). Conclusions: Our study suggests that, in the early stage of cognitive impairment, anosognosia is associated with both cognitive deficits and behavioral disorders according to the specific functional anatomy of the symptoms.

Cocaine Dependence Produce Psychiatric Symptoms - a Case Report

2009 ◽  
Vol 24 (S1) ◽  
pp. 1-1
Author(s):  
M. Stankovic ◽  
S. Vucetic-Arsic ◽  
S. Alcaz ◽  
J. Cvejic
Keyword(s):  
Clinical Features ◽  
Male Patient ◽  
Psychiatric Symptoms ◽  
Cocaine Dependence ◽  
Psychotic Symptoms ◽  
Personal Contact ◽  
Outpatient Unit ◽  
Special Hospital ◽  
First Time ◽  
The Brain

Aim:We want to present a polymorphic clinical features like: hallutinations, paranoid ideas, agitation and violence as a result of prolonged cocaine intranasal consumption.Methods:We exposed a 30-year old male patient with ICD-X diagnostic criteria for cocaine dependence (intranasal consumption) that treated in the outpatient unit of Special Hospital of Addicitons, Belgrade, Serbia from April to July 2008. We used the medical records, psychical examination, psychiatric interwievs, standard blood sampling and cocaine urine detections sample (positive).Results:Observations a specific and polymorphic clinical features with presence of psychotic symptoms after cocaine consumptions in our male patient, for the first time after 5 years of cocaine dependence: auditory hallucinations (two- voice speakers), paranoid persecution ideas and suspiciousness, agitation with appearance of vegetative symptomatology (palpitations, sweating, pupil dilatation), extremely violence behavior to other people, complete social reductions (“armed to the outside world”, refused any personal contact and isolated from friends and family, permanent outdoor checking). There was an intensive fear too and impaired judgment.Conclusions:Permanent cocaine consumption can result with produce a numerous of psychiatric symptoms and syndromes as our experience does. It is similar to the findings of other studies and papers reviewed. It is suppose that cocaine has numerous effects on important neurotransmitters in the brain, such as increase as well as the release of dopamine and it related with aggressiveness, hallucinations and other psychiatric symptoms.

“organic Personality Disorder” as Part of Early Neuropsychiatric Manifestations in Huntington’s Disease - a Case Report

2009 ◽  
Vol 24 (S1) ◽  
pp. 1-1
Author(s):  
J. Maia
Keyword(s):  
Huntington's Disease ◽  
Huntington’S Disease ◽  
Psychiatric Symptoms ◽  
Age Of Onset ◽  
Neuropsychiatric Symptoms ◽  
Personality Change ◽  
Psychotic Symptoms ◽  
Autosomal Dominant Disorder ◽  
Neuropsychiatric Manifestations ◽  
Psychiatric Manifestations

Huntington's Disease (HD) is an inherited autosomal dominant disorder characterized by motor, cognitive and psychiatric symptomatology, being considered a paradigmatic neuropsychiatric disorder that includes all three components of the "Triadic Syndromes": dyskinesia, dementia and depression.Firstly described in 1872 as an "Hereditary Chorea" by George Huntington only in 1993 was its responsible gene identified. A person who inherits the HD gene will sooner or later develop the disease. the age of onset, early signs and rate of disease progression vary greatly from person to person.Neuropsychiatric symptoms are an integral part of HD and have been considered the earliest markers of the disease, presenting sometimes more than 10 years before a formal diagnosis is done. Patients may experience dysphoria, mood swings, agitation, irritability, hostile outbursts, psychotic symptoms and deep bouts of depression with suicidal ideation. Personality change is reported in 48% of the cases, with the paranoid subtype being described as the most prevalent. the clinical case presented illustrates a case of HD which started with insidious psychiatric symptoms and an important personality change.Despite a wide number of medications being prescribed to help control emotional, movement and behaviour problems, there is still no treatment to stop or reverse the course of the disease. Furthermore, psychiatric manifestations are often amenable to treatment, and relief of these symptoms may provide significant improvement in patient's and caregivers quality of life.A greater awarness of psychiatric manifestations of HD is essential to an earlier diagnosis and an optimized therapeutic approach.

scholarly journals Perceived functioning, well-being and psychiatric symptoms in patients with stable schizophrenia treated with long-acting risperidone for 1 year

2005 ◽  
Vol 187 (2) ◽  
pp. 131-136 ◽  
Author(s):  
W. Wolfgang Fleischhacker ◽  
Jonathan Rabinowitz ◽  
Georg Kemmler ◽  
Mariëlle Eerdekens ◽  
Angelika Mehnert
Keyword(s):  
Mental Component Summary ◽  
Psychiatric Symptoms ◽  
Short Form ◽  
Mental Component Summary Score ◽  
Well Being ◽  
Psychotic Symptoms ◽  
Open Label ◽  
Sf 36 ◽  
Patient Reported ◽  
Long Acting

BackgroundThe extent to which antipsychotics improve patients' well-being is uncertain.AimsTo examine psychopathology and patient-rated functioning and well-being in patients treated with risperidone.MethodIn a 1-year, open-label, international multicentre trial of long-acting risperidone in 615 stable adult patients with schizophrenia, self-rated functioning and well-being were measured every 3 months using the Short Form 36-item questionnaire (SF–36). Psychopathology was quantified using the Positive and Negative Syndrome Scale (PANSS).ResultsSignificant improvements were found on the SF–36 mental component summary score and vitality and social functioning scales. PANSS and mental component summary scores were moderately correlated.ConclusionsPatient-reported functioning and well-being appear to differ from investigator-rated psychotic symptoms. Patient-rated well-being should be assessed with symptoms to help measure treatment outcomes.

Transfer of Training between Working Memory Task and Attentional Task

2016 ◽  
pp. 147-165
Author(s):  
Ting Guo ◽  
Yanna Ren ◽  
Xiaotong Zhu ◽  
Hong Chen ◽  
Satoshi Takahashi ◽  
...  
Keyword(s):  
Working Memory ◽  
Problem Solving ◽  
Empirical Evidence ◽  
Cognitive Training ◽  
Cognitive Functions ◽  
Cognitive Abilities ◽  
Memory Task ◽  
Cognitive Disorders ◽  
Training Effects ◽  
Attention Memory

The present studies indicate that training effects in a certain domain may result in the acquired skills being transferred to other domains that require similar abilities. Cognitive training involves structured exercises that are prescribed and undertaken with the purpose of enhancing cognitive abilities, such as attention, memory, and problem solving. In contrast to symptomatic pharmacotherapy, non-pharmacological approaches may further improve patients' situations. Our aim was to summarize the empirical evidence for the rehabilitation of individuals with cognitive disorders by using training tasks to enhance specific cognitive functions to combat against cognitive degradation and transfer the benefits to other widely used domains.

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