scholarly journals Clinical and Dynamic Characteristics оf Therapeutic Remissions after Acute Paranoid Psychoses in Schizophrenic Patients Treated with Antipsychotics of Various Generations

Psychiatry ◽  
2020 ◽  
Vol 18 (2) ◽  
pp. 21-31
Author(s):  
S. A. Stolyarov
Keyword(s):  
Therapeutic Effect ◽  
Negative Symptoms ◽  
Positive Symptoms ◽  
Psychometric Assessment ◽  
Atypical Neuroleptics ◽  
High Quality ◽  
Comparative Aspect ◽  
Icd 10 ◽  
Schizophrenic Patients

Background: the comparative aspect of the clinical-diagnostic and prognostic evaluation of long-term remissions treated with antipsychotics of various generations in patients with shift-like schizophrenia remains poorly studied and retains scientific and practical actuality. The purpose of the study: a comparative study of the therapeutic effect of antipsychotics of different generations on clinical-psychopathological peculiarities and the dynamics of 2-year remissions after acute paranoid states in patients with shift-like schizophrenia. Patients and methods: 34 female patients (average age made up 26.9 years old) were diagnosed in shift-like schizophrenia with a clinical picture of the attack as acute paranoid syndrome (F20.02 according to ICD-10). 16 patients received treatment with typical neuroleptics (TN), other 18 patients received atypical neuroleptics (ATN). The study was conducted as an open prospective, using clinical-psychopathological, clinical-catamnestic and clinical-psychometric methods. The mental state of patients was assessed four times: upon admission to the hospital in acute psychosis (1 point), when entering remission (2 points), after 1 and 2 years of remission (3 and 4 points). In psychometric assessment was used calculated for 1 patient indices of the main total score of all signs (MTS) and main score of 1 sign (MS) of the PANSS scale and its subscales of positive (P), negative (N) and general psychopathological (G) syndromes. Results: at the end of the active treatment with both types of antipsychotics at the 2 point of assessment, was reduced MS of positive symptoms P+G subscales from 3.3 to 1.7 scores on TN and from 3.8 to 2.2 scores on ATN, with a remission and stabilization of the achieved improvement with reduction of MS at 4 points up to 1.5. MS of negative symptoms by the 2 nd  year of remission on ATN decreased from 2.7 to 2.0 in parallel with the reduction of positive signs by P + G; on TN there was an increase in MS indices of subscale N from 2.3 to 2.7 scores. The assessment of negative disorders is discussed as “secondary” negative due to the phenomenologically is assumed with the symptoms of the positive syndrome and the effects of neurolepsy. Conclusion: TN and ATN exhibit a similar “antipsychotic” effect in the treatment of acute paranoid psychoses in shift-like schizophrenia patients with the formation of long-term high quality remissions, stabilization of degrees of reducted productive psychopathological symptoms and with the absence of the progredience disease. To optimize the therapeutic effect of both types of antipsychotics, it is recommended correction of the regime and the term in transition from active to maintenance therapy and prescription of neurolepsy correctors to reduce severity in the picture of “secondary” negative symptoms.

Problems of patients with schizophrenic disorders and of their families

1999 ◽  
Vol 8 (2) ◽  
pp. 117-130 ◽  
Author(s):  
Dino Lanzara ◽  
Ugo Cosentino ◽  
Anna Maria Lo Maglio ◽  
Antonio Lora ◽  
Anna Nicolo ◽  
...  
Keyword(s):  
Mental Health ◽  
Negative Symptoms ◽  
Psychiatric Symptoms ◽  
Principal Component ◽  
Family Burden ◽  
Positive Symptoms ◽  
Explanatory Variables ◽  
Service Information ◽  
Icd 10 ◽  
Schizophrenic Patients

SummaryObjective — To evaluate psychopathological symptoms, disabilities and family burden in schizophrenic patients and to analyse predictors of family burden and relatives' satisfaction. Design — Descriptive study of 203 patients with an ICD 10 — F2 diagnosis (schizophrenia and related disorders) in contact with the Desio Department of Mental Health on 31st December 1994. Setting — The Desio Department of Mental Health. Main outcome measures — The patients have been evaluated in three areas: disability (by ADC-DAS), psychiatric symptoms (by 24 items BPRS) and family burden (by Family Problems questionnaire). The outpatient, hospital and residential care contacts of the patients have been collected for six months by our service information system. For each area (DAS, BPRS and FP) a principal component analysis and a rotation of the significant components have been performed. Eleven factors, derived from three scales, have been retained as explanatory variables. Finally, a multiple regression analysis has been performed to assess the influence of explanatory variables on the set of response variables regarding family burden and relatives' satisfaction. Results — One third of patients suffer of moderate-severe positive symptoms, while negative symptoms are less frequent.

Positive and Negative Symptom Course in Chronic Community-Based Patients

1995 ◽  
Vol 166 (5) ◽  
pp. 634-641 ◽  
Author(s):  
Donald M. Quinlan ◽  
David Schuldberg ◽  
Hal Morgenstern ◽  
William Glazer
Keyword(s):  
Maintenance Treatment ◽  
Negative Symptoms ◽  
Positive Symptoms ◽  
Community Based ◽  
Symptom Profile ◽  
Schizophrenic Patients ◽  
Positive And Negative Symptoms ◽  
Over Time

BackgroundThe long-term symptom profile of chronic out-patients was studied.Method. 242 out-patients receiving neuroleptic medications (109 with schizophrenia and 133 non-schizophrenics), were studied for positive (SAPS) and negative (SANS) symptoms at baseline and at 24 months to investigate whether these symptom groups changed over out-patient maintenance treatment.ResultsOverall and within groups, negative symptoms decreased and positive symptoms increased. While the sums of the SANS scores for the schizophrenic patients were initially higher, their mean SANS score dropped more over time (P< 0.001), to show no difference from non-schizophrenics at follow-up. Positive symptoms increased in both groups, although schizophrenics were higher at both times; sub-scales within the SANS showed different patterns of change.ConclusionSupport is found for a multidimensional view of both positive and negative symptoms and for a reconsideration of the notion of ‘progressive downward course’ in schizophrenia.

Neuropsychological correlates of schizophrenic syndromes in patients treated with atypical neuroleptics

2001 ◽  
Vol 16 (6) ◽  
pp. 354-361 ◽  
Author(s):  
S. Moritz ◽  
B. Andresen ◽  
D. Jacobsen ◽  
K. Mersmann ◽  
U. Wilke ◽  
...  
Keyword(s):  
Verbal Fluency ◽  
Negative Symptoms ◽  
Digit Span ◽  
Atypical Neuroleptics ◽  
Schizophrenic Patients ◽  
Trail Making ◽  
Neurocognitive Dysfunctions ◽  
Neurocognitive Tasks ◽  
Negative Syndrome ◽  
Typical Neuroleptics

SummaryThere is widespread evidence that schizophrenic symptomatology is best represented by three syndromes (positive, negative, disorganized). Both the disorganized and negative syndrome have been found to correlate with several neurocognitive dysfunctions. However, previous studies investigated samples predominantly treated with typical neuroleptics, which frequently induce parkinsonian symptoms that are hard to disentangle from primary negative symptoms and may have inflated correlations with neurocognition. A newly developed psychopathological instrument called the Positive and Negative and Disorganized Symptoms Scale (PANADSS) was evaluated in 60 schizophrenic patients. Forty-seven participants treated with atypical neuroleptics performed several neurocognitive tasks.A three-factor solution of schizophrenic symptomatology emerged. Negative symptomatology was associated with diminished creative verbal fluency and digit span backward, whereas disorganization was significantly correlated with impaired Stroop, WCST and Trail-Making Test B performance.Data suggest that disorganization is associated with tasks that demand executive functioning. Previous findings reporting correlations between negative symptomatology and neurocognition may have been confounded by the adverse consequences of typical neuroleptics.

Cognitive Function in Schizophrenia: Association with Negative and Positive Symptoms

1996 ◽  
Vol 78 (1) ◽  
pp. 123-128 ◽  
Author(s):  
Ronald A. Capleton
Keyword(s):  
Cognitive Functioning ◽  
Negative Symptoms ◽  
Wisconsin Card Sort Test ◽  
Positive Symptoms ◽  
Word Fluency ◽  
Generation Task ◽  
Card Sort ◽  
Word Generation ◽  
Perseverative Errors ◽  
Schizophrenic Patients

20 schizophrenic patients were classified as having either predominantly negative ( n = 11) or predominantly positive symptoms ( n = 9), utilizing the Scale for the Assessment of Negative Symptoms and the Scale for the Assessment of Positive Symptoms. Cognitive functioning was evaluated in these participants and 10 non-patient controls using a word-fluency test and word-generation task. Finally, all participants were evaluated using the Coglab Card Sort Test, a computerized version of the Wisconsin Card Sort Test. The only reliable difference in performance among groups was on perseverative errors on the Coglab Card Sort Test Schizophrenic participants made significantly more perseverative errors than controls and those classified as having primarily negative symptoms made more perseverative errors than those classified as having predominantly positive symptoms. These findings confirm previous reports with respect to cognitive functioning of schizophrenic patients and are consistent with the hypotheses regarding frontal lobe dysfunction in schizophrenia. These data encourage research with larger samples.

Negative Symptoms at Discharge and Outcome in Schizophrenia

1995 ◽  
Vol 166 (1) ◽  
pp. 61-67 ◽  
Author(s):  
Hai-Gwo Hwu ◽  
Happy Tan ◽  
Chu-Chang Chen ◽  
Ling-Ling Yeh
Keyword(s):  
Clinical Outcome ◽  
Social Functioning ◽  
Symptom Score ◽  
Negative Symptoms ◽  
Positive Symptom ◽  
Positive Symptoms ◽  
Symptom Scores ◽  
Schizophrenic Patients ◽  
Positive And Negative Symptoms

BackgroundThe clinical significance in schizophrenia of positive and negative symptoms at discharge was assessed.MethodOf schizophrenic patients fulfilling DSM–III criteria, 113 were recruited for this study. Personal, social and psychopathological data were collected and all cases were followed up at one and two years after discharge.ResultsThe presence of positive symptoms (64 cases), without concomitant negative symptoms, did not predict the follow-up social function and positive symptom score. Conversely, the presence of negative symptoms (31 cases) predicted worse social functioning (P < 0.05 to P < 0.005) and higher positive symptom scores (P < 0.01) at follow-up using MANOVA. Eighteen cases (15.9%) had neither positive nor negative symptoms and had the best clinical outcome.ConclusionsNegative, but not positive, symptoms assessed at discharge are an important predictor of poor outcome. In addition, negative symptoms may themselves expose a biological vulnerability to the presence of positive symptoms.

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.

Positive and Negative Symptoms in Psychiatry

1986 ◽  
Vol 148 (5) ◽  
pp. 587-589 ◽  
Author(s):  
Michael R. Trimble
Keyword(s):  
Negative Symptoms ◽  
Geographical Location ◽  
Personal Communication ◽  
Thought Disorder ◽  
Positive Symptom ◽  
Positive Symptoms ◽  
Market Research Company ◽  
Research Company ◽  
Schizophrenic Patients ◽  
Positive And Negative Symptoms

The terms positive and negative symptoms have slipped into the language of contemporary psychiatry with comparative ease. It is not uncommon for these expressions to be used with little explanation, both at meeting and in written communications, with the implicit understanding that their meaning is understood and that somehow they are of value to our knowledge of psychopathology. However, that there are no clear guide-lines at present for our use of these terms is shown from a recent survey of psychiatrists' opinions from a market research company (Martin Hamblin Research-Personal Communication). As part of a series of questions asked to many psychiatrists of differing age, geographical location, and status, they were asked about the meaning of these terms, positive and negative symptoms and the proportion of schizophrenic patients having them. Of the categories quoted by Crow (1980–81) as positive symptoms, 68% considered that delusions were positive symptoms, 63% hallucinations, and only 35% thought disorder. In contrast, 18% thought that behaviour disturbance was a positive symptom, a similar figure (15%) being given for passivity feelings. Considerable variation was noted, however, with hallucinations being considered positive by only 33% of London psychiatrists, thought disorder by only 11% of those qualified 16–25 years, and one-quarter of all registrars and psychiatrists from Midland Health Districts considered passivity feelings to fall into this category. Even greater disagreement was recorded for negative symptoms. Thus, the symptom most often associated with this category was apathy, by 52% of respondents. Only 26% considered that withdrawal was a negative symptom, the percentage data for lack of motivation and blunting of affect being 37% and 15% respectively.

Bereitschaftpotential in schizophrenia

1997 ◽  
Vol 171 (1) ◽  
pp. 31-34 ◽  
Author(s):  
Taha Karaman ◽  
Sibel Özkaynak ◽  
Korkut Yaltkaya ◽  
Çetin Büyükberker
Keyword(s):  
Frontal Cortex ◽  
Negative Symptoms ◽  
Symptom Clusters ◽  
Positive Symptoms ◽  
Voluntary Movements ◽  
Healthy Controls ◽  
Late Component ◽  
Subcortical Structures ◽  
Schizophrenic Patients ◽  
Motor Abnormalities

BackgroundSeveral reports have documented the presence of motor abnormalities in schizophrenic patients.MethodThirty schizophrenics and 28 healthy controls were included in the study. Scalp-recorded bereitschaftpotentials (BPs) generated prior to voluntary movements were recorded in all subjects.ResultsThe early (NSI) and late components of BP and peak negativity were reduced in all schizophrenic patients. In particular, the NSI was reduced in patients with positive symptoms, and the late component in patients with negative symptoms.ConclusionsThese findings provide further support for the involvement of frontal cortex, subcortical structures and their connections in schizophrenia, and highlight some differences between positive and negative symptom clusters.

Family History of Schizophrenia and the Relationship of Stress to Symptoms: Preliminary Findings

2001 ◽  
Vol 35 (2) ◽  
pp. 217-223 ◽  
Author(s):  
Ross M. G. Norman ◽  
Ashok K. Malla
Keyword(s):  
Family History ◽  
Negative Affect ◽  
Negative Symptoms ◽  
Positive Family History ◽  
Positive Symptoms ◽  
Daily Stressors ◽  
Schizophrenic Patients ◽  
History Of ◽  
Relationship Of ◽  
The Relationship

Objective: It has been hypothesized that patients with a diagnosis of schizophrenia who have a positive family history for schizophrenia will show greater reactivity of their symptoms to increasing levels of stress or negative affect than will patients without such a family history. In the past this hypothesis has only been tested through manipulations of negative affect in laboratory settings. In this paper we test this hypothesis using longitudinal clinical data. Method: Data were derived from an earlier longitudinal study using monthly assessments of daily stressors (Hassles Scale) and symptom measures (the Scale for the Assessment of Positive Symptoms and the Scale for the Assessment of Negative Symptoms). We compared longitudinal stress to symptom relations in 12 patients with schizophrenia for whom a positive family history of schizophrenia could be identified with 12 matched schizophrenic patients without any known family history of psychiatric illness. Results: There was evidence that patients with a family history of schizophrenia demonstrated a stronger relation between stress and total score on the Scale for the Assessment of Positive Symptoms. This difference appears to have primarily reflected a greater reactivity to stress of reality distortion symptoms in the positive family history group. The two groups did not differ in apparent reactivity to stress of the disorganization and psychomotor poverty dimensions of symptomatology. Conclusions: The results of this study provide support from a naturalistic, longitudinal clinical study for the hypothesis that reactivity to stress of some symptoms of schizophrenia may vary as a function of family history of the disorder.

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