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D H Linszen

Publications and source records attributed to D H Linszen.

9 recordsLinked to original sources

Dimensions and subtypes of recent-onset schizophrenia. A longitudinal analysis.

A sample of young patients with schizophrenia was studied in a longitudinal design to investigate the stability of an earlier reported four-dimensional symptom model (positive symptoms, negative symptoms, disorganization, and depression). Symptoms were measured in an acute phase soon after hospitalization, in a remitted stage 3 months later, and in a "mixed" phase 1 year after the second assessment. A different factor structure was found at each measurement, but a stable four-dimensional structure could be defined that closely resembled the factor structure of the first assessment. The symptom dimensions were uncorrelated, except disorganization and depression. Whether meaningful subtypes could be defined using statistical criteria also was investigated. With cluster analysis, four subtypes were defined that could be characterized as follows: rapid treatment responders, slower responders, and two relapse groups. Although some indication of the validity of these subtypes was found, it is concluded that there is a high risk of creating artificial boundaries with this approach.

Adolescent

Cannabis abuse and the course of recent-onset schizophrenic disorders.

OBJECTIVE: We sought to examine the relation between cannabis abuse and the symptomatic course of recent-onset schizophrenia and related disorders. DESIGN: A prospective cohort study over a year using monthly Brief Psychiatric Rating Scale assessments. PARTICIPANTS: Cannabis-abusing patients (n = 24) were compared with nonabusers (n = 69). Eleven patients were mild and 13 were heavy cannabis-abusing patients. RESULTS: Significantly more and earlier psychotic relapses occurred in the cannabis-abusing group (P = .03). This association became stronger when mild and heavy cannabis abuse were distinguished (P = .002). No confounding effect of other variables, eg, other street drugs, was found. In all but one patient, cannabis abuse preceded the onset of the first psychotic symptoms for at least 1 year. CONCLUSIONS: Cannabis abuse and particularly heavy abuse can be considered a stressor eliciting relapse in patients with schizophrenia and related disorders and possibly a premorbid precipitant.

Adolescent

Relapse criteria in schizophrenic disorders: different perspectives.

Relapse and exacerbation of psychotic symptoms were investigated in a prospective study of 88 patients with recent-onset schizophrenia and related disorders. Relapse definitions were derived from expressed emotion and family intervention studies and based on the Brief Psychiatric Rating Scale (BPRS), the Present State Examination, and clinical judgment. Results indicate that research and clinical criteria represent different perspectives on relapse. Clinical criteria provide a validity check that can verify BPRS-rated changes in partially remitted patients.

Adolescent

Symptom dimensions and cognitive and social functioning in recent-onset schizophrenia.

The relationships among symptoms, cognitive functioning and social functioning were investigated in 60 patients with recent-onset schizophrenia. Positive symptoms were unrelated to cognitive measures. Disorganization and depressive symptoms were correlated significantly with Card Sorting performance. Furthermore, only negative symptoms were correlated significantly with social functioning. These results replicate earlier studies with chronic and mixed samples, and support the validity of disorganization as a separate symptom dimension. In contrast to most previous studies, no significant correlations were found between negative symptoms and cognitive measures. However, some evidence was found for a non-linear association between negative symptoms had several cognitive measures. The variation explained by a curvilinear model was not high, but for some cognitive measures this model was clearly superior to a linear model. If replicated, this finding supports the position that cross-sectionally measured negative symptoms cannot be viewed as a unitary concept.

Adolescent

A dimensional and categorical approach to the symptomatology of recent-onset schizophrenia.

Sixty-five patients with recent-onset schizophrenia were assessed with two widely used symptom scales, the Brief Psychiatric Rating Scale-Expanded (BPRS-E) and the Psychiatric Assessment Scale (Manchester scale). Principal components analysis of the BPRS-E scores yielded a four-dimensional structure: positive symptoms, negative symptoms, disorganization, and depression. With the Psychiatric Assessment Scale, three dimensions were found: the positive symptoms (delusions, hallucinations) and disorganization (incoherence) appeared in one dimension. A categorical analysis resulted in predominantly positive, negative, and disorganized clusters, but more than half of the sample could not be allocated to any of these groups.

Adolescent

Art imitates life: Déjà vu experiences in prose and poetry.

the déjà vu experience is a subjective phenomenon that has been described in many novels and poems. Here we review over 20 literary descriptions. These accounts are consistent with the data obtained from psychiatric literature, including various phenomenological, aetiological and psychopathogenetic aspects of the déjà vu experience. The explanations, explicitly formulated by creative authors, include reincarnation, dreams, organic factors and unconscious memories. Not infrequently, an association with defence or organic factors is demonstrable on the basis of psychoanalytic or clinical psychiatric interpretation. The authors recommend that psychiatrists be encouraged to overstep the limits of psychiatric literature and read prose and poetry as well.

Deja Vu

Déjà vu experiences and reduplicative paramnesia.

A schizophrenic patient with different forms of experiences of inappropriate familiarity is described. The authors discuss traumatic experiences as aetiological factors in déjà vu experiences and reduplicative paramnesia. Finally, the differential diagnostic problem in psychotic and dissociative phenomena is stressed.

Adult

The déjà vu experience: remembrance of things past?

The déjà vu experience is a common phenomenon, occurring in pathological as well as nonpathological conditions. It has been defined as any subjectively inappropriate impression of familiarity of a present experience with an undefined past. The authors discuss the epidemiologic data, clinical features, and etiology of the phenomenon of déjà vu. They also review the different hypotheses on the psychopathogenesis of the déjà vu experience and introduce an explanation based on the hologram as a mnestic model.

Brain