Brief Psychiatric Rating Scale
Schizophrenia
Antipsychotic Agents
Psychiatric Status Rating Scales
Clozapine
Benzodiazepines
Haloperidol
Risperidone
Psychotic Disorders
Double-Blind Method
Severity of Illness Index
Treatment Outcome
Mental Disorders
Nonresponding schizophrenia: differentiation by neurological soft signs and neuropsychological tests. (1/180)
Schizophrenia patients have higher scores on neurological soft-signs (NSS) and show greater deficits on a variety of neuropsychological tests than normal control subjects and mixed groups of psychiatric patients. Among chronic schizophrenia patients it is unclear which of these types of deficits most strongly differentiates patients who remain consistently symptomatic in spite of treatment with several conventional neuroleptics (nonresponders) as compared with relapsing chronic schizophrenia patients who improve substantially with treatment (relative responders). In this study, 25 nonresponders and 20 relative responders to conventional neuroleptics were compared on an NSS battery and a limited number of neuropsychological tests, which evaluated deficits influenced by functioning of frontal and nonfrontal brain areas. NSS scores showed the largest difference between relative responders and nonresponders, and statistical analyses suggested that NSS scores were the strongest differentiator between the two groups of chronic schizophrenia patients. Scores differentiating the two groups involved deficits influenced by both frontal and nonfrontal functioning. A predominance of negative symptoms in the current clinical picture was highly correlated with high NSS scores. (+info)Fine volumetric analysis of the cerebral ventricular system in schizophrenia: further evidence for multifocal mild to moderate enlargement. (2/180)
We used traditional volumetric regional analysis and a finer anterior-posterior (AP) profile volumetric analysis to examine the cerebral ventricular system in an all-male, demographically matched sample of schizophrenia patients (n = 73) and normal controls (n = 29) using 2.8-mm-thin coronal T1-weighted magnetic resonance images from a 1.5 tesla scanner. Traditional regional analysis was performed on various regions using absolute volumes after adjusting for intracranial volume (ICV) and age. The fine AP profile analysis was done by intrasubject "stacking" of contiguous coronal cross-sectional volumes (adjusted for ICV and age) across the AP plane, intersubject AP alignment of all slices relative to the mammillary bodies, and plotting of slice volumes along the AP plane with 95 percent t-test-based confidence intervals. Schizophrenia subjects had mild to moderate multifocal ventricular enlargement (overall effect size d = 0.48), which was especially prominent in the right posterior temporal horn and, more generally, in the central to posterior portions of the lateral and third ventricles. Schizophrenia subjects also had milder enlargement in the left frontal horn, but no significant differences were found in the anterior temporal horns and the right frontal horn. Post hoc analyses of demographic, clinical, and neuropsychological variables did not account for much variance in the ventriculomegaly observed in the schizophrenia group. The lack of a single locus in the observed ventricular enlargement, the nonsignificant results from schizophrenia subtypes based on regional distributions, and the strong positive correlations among the ventricular regions for the schizophrenia group suggest that the ventriculomegaly seen in this chronic population reflects a single brainwide disease process leading to a multifocal or patchy loss of integrity in brain structure. (+info)Community-based psychosocial rehabilitation and prospective change in functional, clinical, and subjective experience variables in schizophrenia. (3/180)
In a previous study, we found that the intensity, specificity, and longitudinality of community-based psychosocial rehabilitation services were related to superior functional outcomes for individuals diagnosed with schizophrenia. The purpose of this study was to assess the degree to which the intensity and longitudinality of services were related to improvements in subjective experience and clinical outcomes, and to examine the relationships among prospective changes in functional, clinical, and subjective experience variables. One hundred seventy-two individuals diagnosed with a schizophrenia spectrum disorder were followed for 36 months in three distinct models of community-based care. Functional, clinical, and subjective experience outcome data were gathered every 6 months over a 3-year period. Data were analyzed using hierarchical linear modeling (HLM) and P-technique factor analysis. The results indicated that (1) greater service intensity and the longitudinality of services were associated with improvement in client self-esteem; (2) there was evidence for three distinct factors of prospective rehabilitative change that corresponded to the conceptual domains of clinical, functional, and subjective experience outcomes; and (3) there was no differential program impact on symptom levels or the intrapsychic deficits. In addition, the three-factor model of outcome consisting of functional change, clinical change, and subjective experience change was similar to Strauss and Carpenter's "open-linked" system of outcome in schizophrenia. The implications of these findings for research and practice in the area of community-based rehabilitation for individuals with schizophrenia are discussed. (+info)The blunted plasma cortisol response to apomorphine and its relationship to treatment response in patients with schizophrenia. (4/180)
The adrenocorticotropic hormone (ACTH) and cortisol responses to apomorphine (APO), a direct acting dopamine (DA) agonist, have been reported to be significantly blunted in neuroleptic-free patients with schizophrenia (SCH). This study primarily examined the cortisol, but also the prolactin (PRL) and growth hormone (GH), response to APO in patients with SCH compared to normal controls, as well as the relationship between endocrine measures and response to antipsychotic drug treatment. APO, 0.01 mg/kg, or placebo was administered to 51-98 patients with SCH and 15-25 normal controls. Psychopathology was assessed at the baseline and six weeks after drug treatment. The plasma cortisol response to APO was markedly blunted in patients with SCH compared to normal controls. Patients who responded to six weeks of treatment with antipsychotic drugs had a higher cortisol response to APO compared to non-responders. The plasma GH, but not PRL, response to APO was blunted in male patients with SCH. Neither plasma GH nor PRL responses to APO were related to treatment response at six weeks. These results provide further evidence of dopaminergic dysfunction in SCH. Furthermore, the APO-stimulated cortisol response may be predictive of subsequent clinical response to antipsychotic drug treatment. (+info)Serum IL-1beta, sIL-2R, IL-6, IL-8 and TNF-alpha in schizophrenic patients, relation with symptomatology and responsiveness to risperidone treatment. (5/180)
Activation of the inflammatory response system and varied levels of cytokines in acute schizophrenia have been suggested by recent studies. Psychopharmacologic agents can differentially effect cytokine production, which suggests that therapeutic function of neuroleptics may involve immunomodulation. The present study was carried out to examine: (i) serum concentrations of interleukin (IL)-1beta, soluble interleukin-2 receptor (sIL-2R), IL-6, IL-8 and tumour necrosis factor (TNF)-alpha in schizophrenic patients; (ii) their relation with psychopathological assessment; and (iii) the relation of the initial cytokine levels with responsiveness to risperidone therapy. Thirty-four drug-free schizophrenic patients with acute exacerbation and 23 age- and gender-matched healthy controls were recruited for this study. Psychopathological assessments at admission and throughout risperidone treatment for 60 days were recorded. Serum cytokine concentrations were determined with chemilumunescence assays. According to our results, serum IL-1beta, sIL-2R, IL-6, IL-8 and TNF-alpha concentrations adjusted for age, gender, body mass index and smoking were no different in patients with schizophrenia and controls and among subtypes of schizophrenia. However, the initial TNF-alpha concentrations had a significant effect on Brief Psychiatric Rating Scale and Scale Assessment of Positive Symptoms scores. The initial cytokine concentrations of the patients responsive to risperidone were not significantly different from those of non-responsive patients. The present study demonstrates that plasma levels of IL-1beta, sIL-2R, IL-6, IL-8 and TNF-alpha adjusted for confounding factors are not altered in drug-free schizophrenic patients at acute exacerbation. We suggest that, if cytokine production is altered in schizophrenia, these alterations may not be detectable in systemic circulation. According to our results, the therapeutic effect of risperidone is not related to basal levels of the aforementioned cytokines. However, serum TNF-alpha may contribute to symptomatology in schizophrenia (+info)Factor structure of Bech's version of the Brief Psychiatric Rating Scale in Brazilian patients. (6/180)
The objective of the present study was to evaluate the factor structure of Bech's version of the Brief Psychiatric Rating Scale (BPRS), translated into Portuguese. The BPRS was administered to a heterogeneous group of psychiatric inpatients (N = 98) and outpatients (N = 62) in a University Hospital. Each patient was evaluated from one to eight times. The interval between consecutive interviews was one week for the inpatients and one month for the outpatients. The results were submitted to factorial analysis. The internal consistency of the total scale and of each factor was also estimated. Factorial analysis followed by normalized orthogonal rotation (Varimax) yielded four factors: Withdrawal-Retardation, Thinking Disorder, Anxious-Depression and Activation. Internal consistency measured by Cronbach's alpha coefficient ranged from 0.766 to 0.879. The data show that the factor structure of the present instrument is similar to that of the American version of the BPRS which contains 18 items, except for the absence of the fifth factor of the latter scale, Hostile-Suspiciousness. (+info)Mood stabilisers plus risperidone or placebo in the treatment of acute mania. International, double-blind, randomised controlled trial. (7/180)
BACKGROUND: Few double-blind trials have examined the efficacy of a combination of a mood stabiliser and an atypical antipsychotic in acute mania. AIMS: To determine the efficacy of risperidone in combination with a mood stabiliser in acute mania. METHOD: Patients taking a mood stabiliser were randomised to 3 weeks' treatment with risperidone (n=75) or placebo (n=76). RESULTS: Young Mania Rating Scale (YMRS) scores improved rapidly with significantly greater reductions at week 1 in the risperidone group compared with the placebo group. At end-point YMRS scores decreased by 14.5 and 10.3 points in the risperidone and placebo groups, respectively. Significant improvements v. placebo (P<0.05) were noted in the risperidone group on several other clinically meaningful measures. Additionally, a post hoc analysis excluding carbamazepine-treated patients (plasma concentrations of risperidone active moiety were 40% lower in this group) revealed significantly greater reductions (P=0.047) in YMRS scores in the risperidone group than in the placebo group. Incidence of adverse events was similar in both groups. CONCLUSIONS: Risperidone is superior to placebo when used in combination with lithium or divalproex in acute mania. (+info)The relationship of clinical factors and environmental opportunities to social functioning in young adults with schizophrenia. (8/180)
This study used data from the long-term experimental evaluation of the Program of Assertive Community Treatment (PACT) to examine the clinical and situational contributors to social functioning in people with schizophrenia. Subjects were 87 young adults with schizophrenia spectrum disorders. Data from two time points, 6 months apart, were used to test models predicting five social outcomes (network size, network reciprocity, sociosexual contact, satisfaction with social relationships, and loneliness) from positive symptoms, work involvement, living situation, and residential mobility. Results indicated that (1) work involvement was associated with larger network sizes over a 6-month period; (2) experiencing an increase in positive symptoms over a 6-month period was associated with the loss of reciprocal network ties, a lessening of satisfaction with social relationships, and an increase in loneliness; and (3) neither living situation nor moving frequently was associated with later social outcomes. These findings suggest strong support for the role of short-term changes in positive symptoms and modest support for the role of work involvement in social outcome. (+info)The Brief Psychiatric Rating Scale (BPRS) is a widely used clinician-rated scale for assessing the severity of psychopathology in individuals with mental illness. It consists of 18 items, each rated on a 7-point scale (1=not present to 7=extremely severe), that measure various symptoms such as depression, anxiety, hostility, hallucinations, and unusual thoughts. The BPRS is often used in research and clinical settings to monitor treatment response and symptom changes over time.
Schizophrenia is a severe mental disorder characterized by disturbances in thought, perception, emotion, and behavior. It often includes hallucinations (usually hearing voices), delusions, paranoia, and disorganized speech and behavior. The onset of symptoms typically occurs in late adolescence or early adulthood. Schizophrenia is a complex, chronic condition that requires ongoing treatment and management. It significantly impairs social and occupational functioning, and it's often associated with reduced life expectancy due to comorbid medical conditions. The exact causes of schizophrenia are not fully understood, but research suggests that genetic, environmental, and neurodevelopmental factors play a role in its development.
Antipsychotic agents are a class of medications used to manage and treat psychosis, which includes symptoms such as delusions, hallucinations, paranoia, disordered thought processes, and agitated behavior. These drugs work by blocking the action of dopamine, a neurotransmitter in the brain that is believed to play a role in the development of psychotic symptoms. Antipsychotics can be broadly divided into two categories: first-generation antipsychotics (also known as typical antipsychotics) and second-generation antipsychotics (also known as atypical antipsychotics).
First-generation antipsychotics, such as chlorpromazine, haloperidol, and fluphenazine, were developed in the 1950s and have been widely used for several decades. They are generally effective in reducing positive symptoms of psychosis (such as hallucinations and delusions) but can cause significant side effects, including extrapyramidal symptoms (EPS), such as rigidity, tremors, and involuntary movements, as well as weight gain, sedation, and orthostatic hypotension.
Second-generation antipsychotics, such as clozapine, risperidone, olanzapine, quetiapine, and aripiprazole, were developed more recently and are considered to have a more favorable side effect profile than first-generation antipsychotics. They are generally effective in reducing both positive and negative symptoms of psychosis (such as apathy, anhedonia, and social withdrawal) and cause fewer EPS. However, they can still cause significant weight gain, metabolic disturbances, and sedation.
Antipsychotic agents are used to treat various psychiatric disorders, including schizophrenia, bipolar disorder, major depressive disorder with psychotic features, delusional disorder, and other conditions that involve psychosis or agitation. They can be administered orally, intramuscularly, or via long-acting injectable formulations. The choice of antipsychotic agent depends on the individual patient's needs, preferences, and response to treatment, as well as the potential for side effects. Regular monitoring of patients taking antipsychotics is essential to ensure their safety and effectiveness.
I must clarify that there is no such thing as "Schizophrenic Psychology." The term schizophrenia is used to describe a specific and serious mental disorder that affects how a person thinks, feels, and behaves. It's important not to use the term casually or inaccurately, as it can perpetuate stigma and misunderstanding about the condition.
Schizophrenia is characterized by symptoms such as hallucinations (hearing or seeing things that aren't there), delusions (false beliefs that are not based on reality), disorganized speech, and grossly disorganized or catatonic behavior. These symptoms can impair a person's ability to function in daily life, maintain relationships, and experience emotions appropriately.
If you have any questions related to mental health conditions or psychology, I would be happy to provide accurate information and definitions.
Psychiatric Status Rating Scales are standardized assessment tools used by mental health professionals to evaluate and rate the severity of a person's psychiatric symptoms and functioning. These scales provide a systematic and structured approach to measuring various aspects of an individual's mental health, such as mood, anxiety, psychosis, behavior, and cognitive abilities.
The purpose of using Psychiatric Status Rating Scales is to:
1. Assess the severity and improvement of psychiatric symptoms over time.
2. Aid in diagnostic decision-making and treatment planning.
3. Monitor treatment response and adjust interventions accordingly.
4. Facilitate communication among mental health professionals about a patient's status.
5. Provide an objective basis for research and epidemiological studies.
Examples of Psychiatric Status Rating Scales include:
1. Clinical Global Impression (CGI): A brief, subjective rating scale that measures overall illness severity, treatment response, and improvement.
2. Positive and Negative Syndrome Scale (PANSS): A comprehensive scale used to assess the symptoms of psychosis, including positive, negative, and general psychopathology domains.
3. Hamilton Rating Scale for Depression (HRSD) or Montgomery-Åsberg Depression Rating Scale (MADRS): Scales used to evaluate the severity of depressive symptoms.
4. Young Mania Rating Scale (YMRS): A scale used to assess the severity of manic or hypomanic symptoms.
5. Brief Psychiatric Rating Scale (BPRS) or Symptom Checklist-90 Revised (SCL-90-R): Scales that measure a broad range of psychiatric symptoms and psychopathology.
6. Global Assessment of Functioning (GAF): A scale used to rate an individual's overall psychological, social, and occupational functioning on a hypothetical continuum of mental health-illness.
It is important to note that Psychiatric Status Rating Scales should be administered by trained mental health professionals to ensure accurate and reliable results.
Clozapine is an atypical antipsychotic medication that is primarily used to treat schizophrenia in patients who have not responded to other antipsychotic treatments. It is also used off-label for the treatment of severe aggression, suicidal ideation, and self-injurious behavior in individuals with developmental disorders.
Clozapine works by blocking dopamine receptors in the brain, particularly the D4 receptor, which is thought to be involved in the development of schizophrenia. It also has a strong affinity for serotonin receptors, which contributes to its unique therapeutic profile.
Clozapine is considered a medication of last resort due to its potential side effects, which can include agranulocytosis (a severe decrease in white blood cell count), myocarditis (inflammation of the heart muscle), seizures, orthostatic hypotension (low blood pressure upon standing), and weight gain. Because of these risks, patients taking clozapine must undergo regular monitoring of their blood counts and other vital signs.
Despite its potential side effects, clozapine is often effective in treating treatment-resistant schizophrenia and has been shown to reduce the risk of suicide in some patients. It is available in tablet and orally disintegrating tablet formulations.
Benzodiazepines are a class of psychoactive drugs that have been widely used for their sedative, hypnotic, anxiolytic, anticonvulsant, and muscle relaxant properties. They act by enhancing the inhibitory effects of gamma-aminobutyric acid (GABA), the major inhibitory neurotransmitter in the central nervous system.
Benzodiazepines are commonly prescribed for the treatment of anxiety disorders, insomnia, seizures, and muscle spasms. They can also be used as premedication before medical procedures to produce sedation, amnesia, and anxiolysis. Some examples of benzodiazepines include diazepam (Valium), alprazolam (Xanax), clonazepam (Klonopin), lorazepam (Ativan), and temazepam (Restoril).
While benzodiazepines are effective in treating various medical conditions, they can also cause physical dependence and withdrawal symptoms. Long-term use of benzodiazepines can lead to tolerance, meaning that higher doses are needed to achieve the same effect. Abrupt discontinuation of benzodiazepines can result in severe withdrawal symptoms, including seizures, hallucinations, and anxiety. Therefore, it is important to taper off benzodiazepines gradually under medical supervision.
Benzodiazepines are classified as Schedule IV controlled substances in the United States due to their potential for abuse and dependence. It is essential to use them only as directed by a healthcare provider and to be aware of their potential risks and benefits.
Haloperidol is an antipsychotic medication, which is primarily used to treat schizophrenia and symptoms of psychosis, such as delusions, hallucinations, paranoia, or disordered thought. It may also be used to manage Tourette's disorder, tics, agitation, aggression, and hyperactivity in children with developmental disorders.
Haloperidol works by blocking the action of dopamine, a neurotransmitter in the brain, which helps to regulate mood and behavior. It is available in various forms, including tablets, liquid, and injectable solutions. The medication can cause side effects such as drowsiness, restlessness, muscle stiffness, and uncontrolled movements. In rare cases, it may also lead to more serious neurological side effects.
As with any medication, haloperidol should be taken under the supervision of a healthcare provider, who will consider the individual's medical history, current medications, and other factors before prescribing it.
Risperidone is an atypical antipsychotic medication that is primarily used to treat certain mental/mood disorders (such as schizophrenia, bipolar disorder, and irritability associated with autistic disorder). It works by helping to restore the balance of certain natural substances in the brain. Risperidone belongs to a class of drugs called benzisoxazole derivatives.
This medication can decrease aggression and schizophrenic symptoms such as hallucinations, delusional thinking, and hostility. It may also help to improve your mood, thoughts, and behavior. Some forms of risperidone are also used for the treatment of irritability in children and adolescents with autistic disorder (a developmental disorder that affects communication and behavior).
It's important to note that this is a general medical definition, and the use of risperidone should always be under the supervision of a healthcare professional, as it can have potential side effects and risks.
Psychotic disorders are a group of severe mental health conditions characterized by distorted perceptions, thoughts, and emotions that lead to an inability to recognize reality. The two most common symptoms of psychotic disorders are hallucinations and delusions. Hallucinations are when a person sees, hears, or feels things that aren't there, while delusions are fixed, false beliefs that are not based on reality.
Other symptoms may include disorganized speech, disorganized behavior, catatonic behavior, and negative symptoms such as apathy and lack of emotional expression. Schizophrenia is the most well-known psychotic disorder, but other types include schizoaffective disorder, delusional disorder, brief psychotic disorder, shared psychotic disorder, and substance-induced psychotic disorder.
Psychotic disorders can be caused by a variety of factors, including genetics, brain chemistry imbalances, trauma, and substance abuse. Treatment typically involves a combination of medication, therapy, and support services to help manage symptoms and improve quality of life.
The double-blind method is a study design commonly used in research, including clinical trials, to minimize bias and ensure the objectivity of results. In this approach, both the participants and the researchers are unaware of which group the participants are assigned to, whether it be the experimental group or the control group. This means that neither the participants nor the researchers know who is receiving a particular treatment or placebo, thus reducing the potential for bias in the evaluation of outcomes. The assignment of participants to groups is typically done by a third party not involved in the study, and the codes are only revealed after all data have been collected and analyzed.
A Severity of Illness Index is a measurement tool used in healthcare to assess the severity of a patient's condition and the risk of mortality or other adverse outcomes. These indices typically take into account various physiological and clinical variables, such as vital signs, laboratory values, and co-morbidities, to generate a score that reflects the patient's overall illness severity.
Examples of Severity of Illness Indices include the Acute Physiology and Chronic Health Evaluation (APACHE) system, the Simplified Acute Physiology Score (SAPS), and the Mortality Probability Model (MPM). These indices are often used in critical care settings to guide clinical decision-making, inform prognosis, and compare outcomes across different patient populations.
It is important to note that while these indices can provide valuable information about a patient's condition, they should not be used as the sole basis for clinical decision-making. Rather, they should be considered in conjunction with other factors, such as the patient's overall clinical presentation, treatment preferences, and goals of care.
Treatment outcome is a term used to describe the result or effect of medical treatment on a patient's health status. It can be measured in various ways, such as through symptoms improvement, disease remission, reduced disability, improved quality of life, or survival rates. The treatment outcome helps healthcare providers evaluate the effectiveness of a particular treatment plan and make informed decisions about future care. It is also used in clinical research to compare the efficacy of different treatments and improve patient care.
A mental disorder is a syndrome characterized by clinically significant disturbance in an individual's cognition, emotion regulation, or behavior. It's associated with distress and/or impaired functioning in social, occupational, or other important areas of life, often leading to a decrease in quality of life. These disorders are typically persistent and can be severe and disabling. They may be related to factors such as genetics, early childhood experiences, or trauma. Examples include depression, anxiety disorders, bipolar disorder, schizophrenia, and personality disorders. It's important to note that a diagnosis should be made by a qualified mental health professional.
Psychometrics is a branch of psychology that deals with the theory and technique of psychological measurement, such as the development and standardization of tests used to measure intelligence, aptitude, personality, attitudes, and other mental abilities or traits. It involves the construction and validation of measurement instruments, including the determination of their reliability and validity, and the application of statistical methods to analyze test data and interpret results. The ultimate goal of psychometrics is to provide accurate, objective, and meaningful measurements that can be used to understand individual differences and make informed decisions in educational, clinical, and organizational settings.