Conceptual sequencing and disordered speech in schizophrenia.
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This study examined associations between impairments of attention, memory, and conceptual sequencing ability, and specific schizophrenia thought and language symptoms. Speech samples of stable schizophrenia outpatients were assessed for frequencies of six different types of communication failures. The classification of types of failures was based on hypothesized differences in underlying cognitive process. Frequencies of the four types of communication failures believed to involve language structural weaknesses all were significantly and fairly strongly related to conceptual sequencing ability. In addition, regression analyses indicated that each of these four types of communication failures was associated with a unique configuration of attentional, memorial, and conceptual sequencing processes. In contrast, the two types of communication disturbances not suggestive of language structural problems were not positively associated with any of the cognitive weaknesses assessed. (+info)
Distress attributed to negative symptoms in schizophrenia.
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The purpose of the study was to examine (1) to which negative symptoms schizophrenia patients attribute distress and (2) whether clinical variables can predict the levels of reported distress. With the help of a research assistant, 86 hospitalized patients completed a self-rating scale for negative symptoms. The 21 items of the self-rating scale were taken from the Scale for the Assessment of Negative Symptoms (SANS). A psychiatrist rated the patients on a number of scales, including the SANS. When patients reported particular symptoms, they were asked whether those symptoms bothered or distressed them. Answers to this question were highly dependent on the type of symptom involved. Distress was most often attributed to symptoms in the subscale avolition-apathy. Patients were also asked how much they were bothered or distressed. Again, high levels of distress were most often attributed to items in the subscale avolition-apathy. A summary score was developed for the level of reported distress: the distress score. Regression analysis showed that distress scores were not associated with the observed severity of negative symptoms or with the level of psychiatric disability. High distress scores were best predicted by the combination of high scores for depression and high scores for insight into positive symptomatology. However, this model explained only a quarter of the variance in distress scores. (+info)
First person account: I and I, dancing fool, challenge you the world to a duel.
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The article that follows is part of the Schizophrenia Bulletin's ongoing First Person Account series. We hope that mental health professionals-the Bulletin's primary audience-will take this opportunity to learn about the issues and difficulties confronted by consumers of mental health care. In addition, we hope that these accounts will give patients and families a better sense of not being alone in confronting the problems that can be anticipated by persons with serious emotional difficulties. We welcome other contributions from patients, ex-patients, or family members. Our major editorial requirement is that such contributions be clearly written and organized, and that a novel or unique aspect of schizophrenia be described, with special emphasis on points that will be important for professionals. Clinicians who see articulate patients with experiences they believe should be shared might encourage these patients to submit their articles to Schizophrenia Bulletin, First Person Accounts, EEI Communications, 66 Canal Center Plaza, Suite 200, Alexandria, VA 22314.-The Editors. (+info)
Pathology and compensation during visual signal processing in schizophrenia--spatial analysis of event-related potentials.
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Correlations between measures of attention and topographical abnormalities of evoked cortical potentials elicited during the Continuous Attention Test (CAT) were assessed in 50 schizophrenic patients, compared to 50 healthy subjects. For each group and for each CAT condition evoked responses consisted of six successive epochs (segments) of stable spatially configured potentials. Quantitative descriptors of those configurations (Lehmann 1987) were referred to the CAT data. In patients: (1) segments III-V were delayed, (2) in the non-target condition, diminished global field power (GFP) emerged, coexisting either with lower amplitude of posterior potentials in segment I and II or with lower amplitude of a central positive potential in segment V, (3) an altered topographic pattern of responses to the target stimulus occurred. In healthy subjects detection of the target (as compared to the non-target condition) was associated with a shift of the location of the positive potential in segments IV and V from a central towards the prefrontal area. In patients, in segment V a similar shift reached frontal, but not prefrontal areas, and additionally, the central areas remained active. Delayed latency and low GFP in segment V in the non-target condition in patients correlated with poor CAT performance. A more posterior location of the positive centroid in segment V during detection of the target correlated with better CAT results, and the associated GFP increase with less prolonged reaction time. The data revealed a possible compensatory role of central and frontal areas in the face of weakened prefrontal functions in schizophrenia. (+info)
Changes in regional cerebral blood flow due to cognitive activation among patients with schizophrenia.
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BACKGROUND: The regional cerebral blood flow (rCBF) response to the Wisconsin Card Sort Test (WCST) has been used to assess the functional integrity of the prefrontal cortex in patients with schizophrenia. AIMS: In this study, patients were divided into two groups according to whether they had made few or many perseverative errors on a modified version of the WCST. A control group consisted of normal volunteers. The groups were then compared with respect to rCBF response to WCST activation. METHOD: rCBF was measured during administration of a modified version of the WCST and during a card sorting control task, using single photon emission computerised tomography (SPECT). RESULTS: Performance of the modified WCST was associated with a widespread and substantial increase in rCBF, particularly in the frontal region. The poorly performing group of patients with schizophrenia showed only a modest increase in rCBF in the left anterior cingulate region. CONCLUSION: Subjects with schizophrenia are able to respond to specific neuropsychological challenge with activation of the frontal regions. (+info)
Reappraising insight in psychosis. Multi-scale longitudinal study.
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BACKGROUND: Many patients suffering from psychosis are unaware of their disorder and symptoms. AIMS: To investigate whether insight changes with time, and how it relates to patients' psychopathology, and to examine the correlations between insight scales in patients with psychoses. METHODS: Seventy-five consecutively admitted in-patients with schizophrenia, affective disorder with psychotic symptoms, or schizoaffective disorder were examined after remission of an acute episode and at follow-up (> 6 months). Three different scales were used to assess insight. RESULTS: To some extent, insight into past episodes improved over time in patients with psychosis, regardless of diagnosis. Few significant relationships between insight and psychopathology remained stable at follow-up. The higher the negative and disorganisation dimensions at baseline, the less did attitudes to treatment vary when tested at follow-up. No predictive value for variability of psychopathological dimensions was found for insight dimensions. The insight scales used were highly intercorrelated, suggesting that they measure the same construct. CONCLUSIONS: Insight and psychopathology seem to be semi-independent domains. (+info)
Relationship between psychotic disorders in adolescence and criminally violent behaviour. A retrospective examination.
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BACKGROUND: The interaction between psychosis and violence in adults is an important area of research receiving attention. To date there is little available data examining this relationship in adolescence. AIMS: To investigate the possible relationships between criminally violent types of behaviour, and psychopathology and social factors, among adolescents suffering from a psychotic disorder. METHOD: A retrospective case note study of 39 in-patients diagnosed as having a psychotic disorder and admitted to one of two adolescent psychiatry units (one secure, one open). Cases were divided into a 'violent' and a 'non-violent' group, and these two groups were then compared for social and psychopathological variables. RESULTS: There was no association between recorded psychopathology and criminally violent behaviour. Criminally violent behaviour was associated with a history of emotional or physical abuse, contact with social or mental health services, and previous criminal behaviour. CONCLUSIONS: These findings fail to echo results of studies in adult schizophrenia; they suggest that violent behaviour in psychosis is associated more closely with social factors than with specific symptoms of the psychotic illness. Potential explanations are discussed. (+info)
Non-psychotic psychiatric disorder and subsequent risk of schizophrenia. Cohort study.
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BACKGROUND: Those with schizophrenia often give a history of premorbid non-psychotic psychiatric disorder. AIMS: To investigate the association between non-psychotic psychiatric disorders and the later development of schizophrenia. METHOD: Men aged 18 or 19 years, conscripted to the Swedish army in 1970 (n=50 054) were linked to the Swedish National Psychiatric Case Register. RESULTS: There was an increased risk of schizophrenia in those with ICD-8 diagnoses of neurosis (OR=4.6,95% Cl 3.2-6.9), personality disorder (OR=8.2, 95% Cl 5.4-12.3), alcohol abuse (OR=5.5, 95% Cl 1.7-17.5) or substance abuse (OR=14.0, 95% Cl 7.8-25.0) at age 18. Of those who developed schizophrenia, 38% (95% Cl 32-45) received a diagnosis of non-psychotic psychiatric disorder at age 18. Only those with personality disorder had a significantly increased risk of schizophrenia (OR=2.4, 95% Cl 1.1-5.2) with onset after age 23. CONCLUSIONS: Personality factors could represent an underlying vulnerability to schizophrenia. Other diagnoses occurring before schizophrenia may reflect a prodromal phase of the illness. (+info)