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BMJ Case Reports Jan 2013Kallmann syndrome (KS) is a genetically heterogeneous and rare disorder characterised by the combination of hypothalamic hypogonadism and anosmia/hyposmia, a variable...
Kallmann syndrome (KS) is a genetically heterogeneous and rare disorder characterised by the combination of hypothalamic hypogonadism and anosmia/hyposmia, a variable degree of intellectual disability and several somatic anomalies. In about one-third of the patients, mutations have been identified in at least seven different genes. Virtually no data are available about possible neuropsychiatric symptoms in KS. Here, a young adult male is described with a previous clinical diagnosis of KS and recent paranoid schizophrenia of which positive, but not negative symptoms, fully remitted upon treatment with antipsychotics. Neither genome-wide array analysis nor mutation analyses disclosed imbalances or mutations in any of presently known KS disease genes. This is the first report on a patient with KS and paranoid schizophrenia in whom extensive genetic analyses were performed. It is concluded that further studies are warranted in order to elucidate a possible increased risk for psychiatric symptoms in patients with KS.
Topics: Adult; DNA; DNA Mutational Analysis; Diagnosis, Differential; Humans; Kallmann Syndrome; Magnetic Resonance Imaging; Male; Mutation; Phenotype; Schizophrenia, Paranoid
PubMed: 23329708
DOI: 10.1136/bcr-2012-007387 -
Psychological Medicine Jun 2009Identification of emotional facial expression and emotional prosody (i.e. speech melody) is often impaired in schizophrenia. For facial emotion identification, a recent... (Comparative Study)
Comparative Study
BACKGROUND
Identification of emotional facial expression and emotional prosody (i.e. speech melody) is often impaired in schizophrenia. For facial emotion identification, a recent study suggested that the relative deficit in schizophrenia is enhanced when the presented emotion is easier to recognize. It is unclear whether this effect is specific to face processing or part of a more general emotion recognition deficit.
METHOD
We used clarity-graded emotional prosodic stimuli without semantic content, and tested 25 in-patients with paranoid schizophrenia, 25 healthy control participants and 25 depressive in-patients on emotional prosody identification. Facial expression identification was used as a control task.
RESULTS
Patients with paranoid schizophrenia performed worse than both control groups in identifying emotional prosody, with no specific deficit in any individual emotion category. This deficit was present in high-clarity but not in low-clarity stimuli. Performance in facial control tasks was also impaired, with identification of emotional facial expression being a better predictor of emotional prosody identification than illness-related factors. Of those, negative symptoms emerged as the best predictor for emotional prosody identification.
CONCLUSIONS
This study suggests a general deficit in identifying high-clarity emotional cues. This finding is in line with the hypothesis that schizophrenia is characterized by high noise in internal representations and by increased fluctuations in cerebral networks.
Topics: Adult; Analysis of Variance; Depressive Disorder; Emotions; Facial Expression; Female; Humans; Male; Middle Aged; Pattern Recognition, Visual; Psychiatric Status Rating Scales; Schizophrenia, Paranoid; Schizophrenic Psychology; Speech Perception; Switzerland; User-Computer Interface; Young Adult
PubMed: 19000339
DOI: 10.1017/S0033291708004704 -
Neuropsychopharmacologia Hungarica : a... Mar 2008Since the beginning of the 19th century, delusions have been classified mainly by their content or theme. Clinical psychopathological investigation requires additional... (Review)
Review
Since the beginning of the 19th century, delusions have been classified mainly by their content or theme. Clinical psychopathological investigation requires additional variables that will allow investigators to describe the structure of delusional experience more accurately. Delusions are multidimensional constructs that may change across the various mental disorders. Several authors have developed rating scales with the aim to measure individual dimensions of delusional structure. In this paper, common rating scales are mentioned and the main characteristics of the Simple Delusional Syndrome Scale (SDSS) are summarized. The SDSS scale consists of 7 items (logical organization, systemization, stability, conviction, influence on the action, extension, and insertion), scored from 1 to 5. Results of the statistical analysis confirm good psychometric characteristics of the scale, Cronbach coefficient alpha=0.8327. The SDSS may contribute to a better understanding and diagnostics of delusional disorders and, using statistical methods, can help quantify the relationship between the delusional syndrome and the primary disease process. The SDSS scale may also be utilized in the assessment of changes occurring in delusional syndromes depending on the therapeutic effect of psychopharmacological drugs.
Topics: Delusions; Humans; Psychiatric Status Rating Scales; Psychometrics; Schizophrenia, Paranoid; Syndrome; Treatment Outcome
PubMed: 18771017
DOI: No ID Found -
Psychiatry Research Dec 2004Numerous imaging studies have shown structural brain abnormalities in schizophrenia. Recently, voxel-based morphometry enabled whole brain analysis beyond the regions of...
Numerous imaging studies have shown structural brain abnormalities in schizophrenia. Recently, voxel-based morphometry enabled whole brain analysis beyond the regions of interest (ROI). Regional gray matter concentrations of magnetic resonance (MR) images from 35 patients with paranoid schizophrenia were compared with those from 35 age- and sex-matched controls, and their clinical correlations were explored using voxel-based morphometry. Gray matter concentrations in the patients were significantly reduced in the left insular and dorsolateral prefrontal regions, and bilaterally in the medial frontal, anterior cingulate, inferior frontal and superior temporal regions. On the other hand, gray matter concentrations in the bilateral cerebellum and right striatum were significantly increased in the patients compared with controls. A negative correlation between the score for the severity of 'lack of insight and judgment' and gray matter concentrations in the left posterior and right anterior cingulate and bilateral inferior temporal regions including the lateral fusiform gyri was found. These results suggest the important roles of the paralimbic structures in the pathophysiology of schizophrenia and the involvement of the perceptual and monitoring systems in the mechanism of insight.
Topics: Adult; Cerebral Cortex; Cerebrospinal Fluid; Cognition Disorders; Diagnostic and Statistical Manual of Mental Disorders; Female; Functional Laterality; Humans; Male; Schizophrenia, Paranoid; Severity of Illness Index; Socioeconomic Factors
PubMed: 15664796
DOI: 10.1016/j.pscychresns.2004.05.001 -
Psychopathology 2010Cluster analysis has had limited success in establishing whether there are subtypes of schizophrenia. Grade of membership (GoM) analysis is a multivariate statistical...
BACKGROUND/AIMS
Cluster analysis has had limited success in establishing whether there are subtypes of schizophrenia. Grade of membership (GoM) analysis is a multivariate statistical technique which has advantages when, as in schizophrenia, individuals conforming to pure types are uncommon and mixed forms are frequent.
METHODS
GoM analysis was applied to 118 chronic schizophrenic patients. The patients were of all clinical subtypes, including 13 with simple schizophrenia. Both current and 'lifetime' symptoms were assessed, and two different rating systems were used.
RESULTS
Specifying 3 pure types resulted in robust findings across analyses. One pure type corresponded to paranoid schizophrenia, one to simple schizophrenia and the third combined elements of hebephrenic and catatonic schizophrenia. Specifying 4 pure types split the original 3 pure types in ways which were not clinically intuitive.
CONCLUSION
GoM analysis divides schizophrenia into subtypes along conventional lines, with the proviso that hebephrenic and catatonic schizophrenic patients are not separable, at least in the chronic stage of the illness.
Topics: Adult; Aged; Chronic Disease; Diagnosis, Differential; Female; Humans; Male; Middle Aged; Psychiatric Status Rating Scales; Psychometrics; Schizophrenia; Schizophrenia, Catatonic; Schizophrenia, Disorganized; Schizophrenia, Paranoid; Schizophrenic Psychology; Syndrome; Young Adult
PubMed: 19940542
DOI: 10.1159/000260044 -
Psychiatry Research Oct 1981Studies on HLA antigens in schizophrenia have produced conflicting results, but there has been greater agreement when clinical subtypes of the disorder have been...
Studies on HLA antigens in schizophrenia have produced conflicting results, but there has been greater agreement when clinical subtypes of the disorder have been separated. In view of this, we reassessed 68 previously studied patients with hospital diagnoses of schizophrenia and, while blind to their HLA types, used operational criteria to define clinical subtypes. We compared and combined the results with those from all available similar studies. Those of our patients who fulfilled operational criteria for paranoid schizophrenia showed a nonsignificant increase in HLA A9 as compared with controls. The magnitude of the increase was similar to that from all previous reports, and when data from all sources were combined, the evidence for an association between HLA A9 and paranoid schizophrenia was consistent and highly significant. Patients who were diagnosed as suffering from hebephrenic schizophrenia showed significant increases in HLA A1 and B8 compared with controls. An association between hebephrenia and A1, but not B8, remained on combining the results with those of other studies.
Topics: Age Factors; Genetic Linkage; HLA Antigens; Humans; Schizophrenia, Disorganized; Schizophrenia, Paranoid
PubMed: 6945606
DOI: 10.1016/0165-1781(81)90041-x -
Neuropsychiatry, Neuropsychology, and... Oct 1999The aim of this study is to equalize the influence of age-related changes and to test the hypothesis that specific structural brain changes are mediating the development... (Comparative Study)
Comparative Study
Late-onset paranoid psychosis as a distinct clinicopathologic entity: magnetic resonance imaging data in elderly patients with paranoid psychosis of late onset and schizophrenia of early onset.
OBJECTIVE
The aim of this study is to equalize the influence of age-related changes and to test the hypothesis that specific structural brain changes are mediating the development of unique clinical features in late-onset paranoid psychosis (LOPP).
BACKGROUND
Findings of unique white matter lesions have been recently described in patients with LOPP. These findings have not been consistent, however, when age-matched normal subjects have been used as a control group.
METHOD
Magnetic resonance imaging data were compared in 13 patients with LOPP, mean age 66.33, and 35 elderly patients with early-onset paranoid schizophrenia (PSCH), mean age 63.89. Patients in the LOPP group differed from the PSCH group by the mild degree or absence of negative symptoms, the absence of formal thought disorders, and by prevalence of female patients.
RESULTS
Analysis of the magnetic resonance imaging data revealed statistically significant differences between the LOPP and PSCH groups. White matter hyperintensity was almost threefold more frequent in LOPP than in PSCH groups, 69.2% versus 22.9% respectively. Ventricular enlargement and cortical atrophy were more frequent in the PSCH group, reaching, for moderate to severe abnormalities, 28.6% for ventricular enlargement and 22.9% for cortical atrophy; moderate to severe abnormalities were absent in all 13 patients of the LOPP group.
CONCLUSIONS
These data point to the possibility that late-onset paranoid psychosis is a distinct clinicopathological entity, with white matter hyperintensity mediating the development of LOPP in a significant percentage of the cases. The vascular origin of white matter lesions in LOPP is suggested.
Topics: Age of Onset; Aged; Brain; Cerebrovascular Disorders; Diagnosis, Differential; Female; Humans; Magnetic Resonance Imaging; Male; Middle Aged; Paranoid Disorders; Psychiatric Status Rating Scales; Schizophrenia, Paranoid; Severity of Illness Index
PubMed: 10527107
DOI: No ID Found -
The American Journal of Psychiatry Aug 1997
Topics: Adaptation, Psychological; Attitude of Health Personnel; Humans; Interpersonal Relations; Schizophrenia, Paranoid; Schizophrenic Psychology
PubMed: 9247426
DOI: No ID Found -
Psychiatry Research Apr 2011In schizophrenia, impairments of theory of mind (ToM) may be due to excessive ('overmentalizing') or defective ('undermentalizing') attribution of mental states....
In schizophrenia, impairments of theory of mind (ToM) may be due to excessive ('overmentalizing') or defective ('undermentalizing') attribution of mental states. However, most ToM tests differentiate neither between 'overmentalizing' and 'undermentalizing' nor between cognitive and affective ToM in schizophrenia. This study aimed at differentiating these aspects of ToM in 80 patients diagnosed with paranoid schizophrenia and 80 matched healthy controls using the 'Movie for the Assessment of Social Cognition' (MASC). Outcome parameters comprised 1) error counts representing 'undermentalizing' or 'overmentalizing', 2) decoding of cognitive or emotional mental states and 3) non-social inferencing. Multivariate analysis of covariance (MANCOVA) showed significantly abnormal scores for two dimensions of 'undermentalizing' as well as for cognitive and emotional ToM that were not explained by global cognitive deficits. Scores for 'overmentalizing' did not differ between groups, when age, gender, non-social reasoning and memory were controlled. In schizophrenic patients, negative symptoms were associated with a lack of a mental state concept, while positive symptoms like delusions were associated with 'overmentalizing', supporting respective etiological concepts of delusions.
Topics: Adult; Analysis of Variance; Cognition Disorders; Emotions; Female; Humans; Male; Middle Aged; Neuropsychological Tests; Schizophrenia, Paranoid; Theory of Mind; Video Recording
PubMed: 20947175
DOI: 10.1016/j.psychres.2010.09.006 -
Acta Psychiatrica Scandinavica Sep 2010
Topics: Brain; Diagnosis, Differential; Diagnostic and Statistical Manual of Mental Disorders; Humans; International Classification of Diseases; Prognosis; Psychiatric Status Rating Scales; Schizophrenia; Schizophrenia, Disorganized; Schizophrenia, Paranoid; Schizophrenic Psychology; Treatment Outcome
PubMed: 20649527
DOI: 10.1111/j.1600-0447.2010.01589.x