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Schizophrenia Bulletin Nov 2012
Topics: Delusions; Hallucinations; Humans; Schizophrenia, Paranoid; Suicidal Ideation
PubMed: 22516149
DOI: 10.1093/schbul/sbr075 -
Schizophrenia Bulletin Sep 2012
Topics: Awareness; Delusions; Female; Hallucinations; Hospitalization; Humans; Imagination; Interpersonal Relations; Metaphor; Narration; Prodromal Symptoms; Projection; Schizophrenia; Schizophrenia, Paranoid; Schizophrenic Psychology; Sick Role; Suicidal Ideation
PubMed: 22461482
DOI: 10.1093/schbul/sbs051 -
Romanian Journal of Morphology and... 2016Paranoid schizophrenia with long-term course is a challenge for the clinical and therapeutic research, particularly because chronic course is difficult to identify due...
Paranoid schizophrenia with long-term course is a challenge for the clinical and therapeutic research, particularly because chronic course is difficult to identify due to the high rate of mortality in this category of patients. The therapeutic stability on an antipsychotic molecule (haloperidol) is indeed an exception, since the current trend in the case of unfavorable course is based on therapeutic versatility and polypharmacy. Haloperidol is the first-generation antipsychotic that is referred in the therapeutic guidelines as the "golden standard" regarding its efficacy on positive symptoms. The research in fundamental and molecular psychopharmacology has shown the aggressivity of this molecule on the secondary and tertiary signaling chains, including mitochondrial alterations. On male patients with paranoid schizophrenia (positive symptoms) and a chronic course of more than 35 years who received exclusively haloperidol, our study demonstrated an negative outcome with the loss of social functioning, persistence of positive symptoms, chronic extrapyramidal symptoms and mild cognitive impairment. The neuroimaging evaluations have shown atrophy in the temporal poles, posterior ventriculomegaly, cerebellar atrophy and calcification on choroid plexus and pineal gland. The difference between the histological changes induced by haloperidol on animal model and the ones on the patients in our study is located in the frontal cortex, thus suggesting the presence of two neurobiological models of schizophrenia in men: fronto-striatal and temporal-limbic-striatal. The persistence of extrapyramidal symptoms during the treatment with haloperidol may be considered as a clinical marker of the risk for negative outcome and a potential indication for the therapeutic switch.
Topics: Aged; Animals; Demography; Haloperidol; Humans; Male; Rats, Wistar; Schizophrenia; Time Factors; Tomography, X-Ray Computed; Treatment Outcome
PubMed: 27516021
DOI: No ID Found -
Frontiers in Psychiatry 2020This study aimed to assess hypothalamic-pituitary dopaminergic (DA), noradrenergic (NA), thyroid (HPT), and adrenal (HPA) activity in schizophrenia, in schizoaffective...
BACKGROUND
This study aimed to assess hypothalamic-pituitary dopaminergic (DA), noradrenergic (NA), thyroid (HPT), and adrenal (HPA) activity in schizophrenia, in schizoaffective disorder, and in bipolar disorder.
METHOD
We investigated a combined approach of hormone responses to (1) apomorphine (APO), a short-acting DA receptor agonist which decreases prolactin secretion (PRL), and stimulates secretion of growth hormone (GH), adrenocorticotropin (ACTH), and cortisol; (2) clonidine (CLO), an alpha 2-adrenoceptor agonist which stimulates GH secretion; (3) 8 AM and 11 PM protirelin (TRH) which stimulates thyrotropin (TSH) secretion; and (4) dexamethasone which suppresses cortisol secretion, in 13 hospitalized healthy male controls and 39 untreated male inpatients: 13 with DSM-IV paranoid schizophrenia, 13 with DSM-IV schizoaffective disorder (bipolar subtype, depressed at the time of the study), and 13 with DSM-IV bipolar disorder (depressed).
RESULTS
Compared to controls, paranoid schizophrenic patients showed (1) lower APO-induced ACTH and cortisol stimulation, and (2) higher post-dexamethasone cortisol values. Compared to controls, schizoaffective and bipolar patients showed (1) lower ΔΔTSH values (i.e., difference between 11 PM and 8 AM TRH-TSH responses), (2) lower APO-induced PRL suppression, (3) lower CLO-induced GH stimulation, and (4) higher post-dexamethasone cortisol values.
CONCLUSIONS
Although results must be interpreted with caution because of the small sample, this preliminary study suggests that depressed bipolar and schizoaffective patients share common biological dysregulations, distinct from that of paranoid schizophrenic patients. From a pathophysiological viewpoint, paranoid schizophrenic patients can be characterized by hyposensitivity of the hypothalamic DA receptors (possibly resulting from an increase in presynaptic DA release) associated with increased HPA axis activity, while depressed bipolar and schizoaffective patients can be characterized by hyposensitivity of the pituitary TRH and DA-D receptors (possibly linked to the activation of the hypothalamic TRH and tuberoinfundibular DA neurons, respectively), together with subsensitive postsynaptic α-adrenoreceptors at the hypothalamic level (possibly secondary to an erratic release of NA) and increased HPA axis activity.
PubMed: 33101075
DOI: 10.3389/fpsyt.2020.533872 -
Texas Heart Institute Journal 2003A 66-year-old woman presented with new-onset complete left bundle branch block and congestive heart failure. She had had chronic paranoid schizophrenia for 35 years and...
A 66-year-old woman presented with new-onset complete left bundle branch block and congestive heart failure. She had had chronic paranoid schizophrenia for 35 years and had been taking medications to control her psychiatric disorder for the past 10 years. A 2-dimensional echocardiogram performed at the onset of congestive heart failure showed dilated cardiomyopathy with global impairment of left ventricular function (ejection fraction <0.25). Despite withdrawal of the medications most likely responsible for the heart problems (perphenazine, 2 mg; and amitriptyline, 25 mg), the patient died of refractory congestive heart failure 2 years later. Histologic examination at autopsy showed evidence of persistent toxic myocarditis with fibrosis of the heart and persistent chronic hepatitis. These autopsy findings were considered to be drug related.
Topics: Adrenergic Uptake Inhibitors; Aged; Amitriptyline; Antipsychotic Agents; Female; Heart Failure; Humans; Myocarditis; Perphenazine; Schizophrenia, Paranoid
PubMed: 12638679
DOI: No ID Found -
Industrial Psychiatry Journal Oct 2021Suicide/parasuicide is seen at a greater rate in schizophrenia than in the general population, yet the psychological basis of this risk is poorly understood. It is...
Suicide/parasuicide is seen at a greater rate in schizophrenia than in the general population, yet the psychological basis of this risk is poorly understood. It is estimated that 10% of patients suffering from schizophrenia attempt suicide. The major risk factors implicated are male gender, chronic illness with multiple relapses, family history of suicide, past suicidal and impulsive behavior, negative attitude toward treatment, and concurrent substance use. Treatment must target the identified risk factors for prevention of suicide in these patients. Here, we discuss three cases with self-inflicted cuts over the anterior aspect of the neck and wrists. They were diagnosed to have paranoid schizophrenia and were treated with antipsychotics, on which they showed improvement.
PubMed: 34908696
DOI: 10.4103/0972-6748.328868 -
Schizophrenia Research Feb 2011Previous investigations of the influence of paranoia on facial affect recognition in schizophrenia have been inconclusive as some studies demonstrate better performance...
Previous investigations of the influence of paranoia on facial affect recognition in schizophrenia have been inconclusive as some studies demonstrate better performance for paranoid relative to non-paranoid patients and others show that paranoid patients display greater impairments. These studies have been limited by small sample sizes and inconsistencies in the criteria used to define groups. Here, we utilized an established emotion recognition task and a large sample to examine differential performance in emotion recognition ability between patients who were actively paranoid (AP) and those who were not actively paranoid (NAP). Accuracy and error patterns on the Penn Emotion Recognition test (ER40) were examined in 132 patients (64 NAP and 68 AP). Groups were defined based on the presence of paranoid ideation at the time of testing rather than diagnostic subtype. AP and NAP patients did not differ in overall task accuracy; however, an emotion by group interaction indicated that AP patients were significantly worse than NAP patients at correctly labeling neutral faces. A comparison of error patterns on neutral stimuli revealed that the groups differed only in misattributions of anger expressions, with AP patients being significantly more likely to misidentify a neutral expression as angry. The present findings suggest that paranoia is associated with a tendency to over attribute threat to ambiguous stimuli and also lend support to emerging hypotheses of amygdala hyperactivation as a potential neural mechanism for paranoid ideation.
Topics: Adult; Anger; Discrimination, Psychological; Emotional Intelligence; Facial Expression; Female; Humans; Interpersonal Relations; Male; Middle Aged; Pattern Recognition, Visual; Psychiatric Status Rating Scales; Schizophrenia, Paranoid; Social Adjustment
PubMed: 21112186
DOI: 10.1016/j.schres.2010.11.006 -
Comptes Rendus Biologies Feb 2005Schizophrenia is a biologically based disorder characterised by false perceptions (hallucinations) and false beliefs (delusions). The underlying physiological cause of... (Review)
Review
Schizophrenia is a biologically based disorder characterised by false perceptions (hallucinations) and false beliefs (delusions). The underlying physiological cause of these mental abnormalities remains unknown. There is increasing evidence that one class of symptom, the 'made experiences' including delusions of alien control and thought insertion, is associated with abnormalities in the mechanism that predicts the outcome of intended actions (the forward model). For these patients active movements feel like passive movements. As a result these patients do not feel in control of their actions. However, comparison with various neurological disorders, such as those associated with parietal lobe lesions, suggest that this abnormal experience is not sufficient to explain the feeling that some other agent is controlling is one's actions. Preliminary evidence suggests that patients with schizophrenia have an exaggerated sense of agency. In combination with the feeling of not being in control, this exaggerated sense of agency could explain delusions of alien control in which the patient attributes his own actions to another agent. Little is yet know about the neural basis of the predictive mechanisms that create the feeling that we are in control of our movements. Such prediction requires integration of information about intended movements generated in frontal cortex with sensory processing in posterior regions of the brain. Measures of functional connectivity suggest that long-range interactions between frontal and posterior regions are abnormally reduced in patients with schizophrenia. Further research is needed to explore the precise involvement of long-range connections in the mechanisms of forward modelling.
Topics: Animals; Delusions; Hallucinations; Humans; Models, Neurological; Reproducibility of Results; Schizophrenia; Schizophrenia, Paranoid; Schizophrenic Psychology
PubMed: 15771003
DOI: 10.1016/j.crvi.2004.10.012 -
Neuropsychobiology 2009Motor symptoms are frequent in schizophrenia and relevant to the diagnosis of subtypes. However, the assessment has been limited to observations recorded in scales and...
BACKGROUND
Motor symptoms are frequent in schizophrenia and relevant to the diagnosis of subtypes. However, the assessment has been limited to observations recorded in scales and experimental designs. The aim of this study was to use wrist actigraphy to obtain motor activity data in 3 schizophrenia subtypes.
METHODS
In total, 60 patients with schizophrenia (35 paranoid, 12 catatonic, 13 disorganized) were investigated using continuous wrist actigraphy over 24 h in an inpatient setting on average 38 days after admission. Data of the wakeful hours of the day were analyzed.
RESULTS
The activity level was predicted by schizophrenia subtype and by the type of antipsychotic medication. The movement index and mean duration of uninterrupted immobility were found to be predicted only by the schizophrenia subtype. Age, gender, duration of illness and chlorpromazine equivalents did not contribute to the variance of the activity data. A MANOVA demonstrated the significant differences in the 3 parameters between schizophrenia subtypes (p = 0.001). Patients with catatonic schizophrenia had lower activity levels, a lower movement index and a longer duration of immobility than those with paranoid schizophrenia.
CONCLUSIONS
Schizophrenia subtypes can be differentiated using objective measures of quantitative motor activity. The increased duration of immobility appears to be the special feature of catatonic schizophrenia.
Topics: Actigraphy; Adult; Antipsychotic Agents; Diagnosis, Differential; Female; Humans; Linear Models; Male; Middle Aged; Motor Activity; Multivariate Analysis; Schizophrenia, Catatonic; Schizophrenia, Disorganized; Schizophrenia, Paranoid; Severity of Illness Index; Sleep; Time Factors; Wakefulness; Wrist
PubMed: 19752582
DOI: 10.1159/000236448 -
Case Reports in Psychiatry 2014The prevalence of diagnostic comorbidity between psychosis and anxiety disorders has been found to be considerable. Cognitive models of psychosis suggest that anxiety...
The prevalence of diagnostic comorbidity between psychosis and anxiety disorders has been found to be considerable. Cognitive models of psychosis suggest that anxiety does not arise directly from positive symptoms of schizophrenia but rather from an individual interpretation of such experiences. In the United Kingdom, cognitive-behavioural therapy for psychosis (CBTp) has been recommended within clinical guidelines as a psychological treatment of choice for those diagnosed with schizophrenia. However, despite empirical evidence supporting CBTp, the treatment provision remains infrequent and not routinely available. This case describes a successful implementation of CBTp. Sixteen sessions were delivered to a 40-year-old male with diagnoses of paranoid schizophrenia and comorbid anxiety, focusing primarily on cognitive restructuring of paranoid appraisals of auditory hallucinations and behavioural experiments employed progressively via graded exposure to anxiety-inducing stimuli. Standardised measurements, behavioural frequency sampling, and subjective data indicated a considerable reduction in both paranoia and anxiety. Also, the client's psychosocial functioning improved substantially. This report indicates that the treatment may help those with experiences of psychosis and comorbid anxiety reach a significant improvement in their quality of life and offers an encouraging and innovative perspective on direct engagement with the content of paranoia and voices at the onset of therapy.
PubMed: 25302129
DOI: 10.1155/2014/124564