D S Lobel | PubMed Health

PubMed1994

Lateralized visual-field inattention in schizophrenia.

Numerous studies have shown impaired verbal functioning in schizophrenic patients as compared with normals. The verbal deficits are generally attributed to damage of the left cerebral hemisphere. This attribution is based on literature which suggests that verbal processing is primarily mediated by the left hemisphere in right-handed humans. This study explored left-hemispheric integrity directly by assessing sustained attention in both the left and right hemispheres of 40 schizophrenic patients with the Weintraub Cancellation Tasks. Patients made significantly more errors of omission on the right visual field than on the left. These results are consistent with cognitive research in schizophrenia by demonstrating selective left-hemispheric impairment relative to right-hemispheric functioning.

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Diagnostic issues in chronic schizophrenia: kraepelinian schizophrenia, undifferentiated schizophrenia, and state-independent negative symptoms.

Data are presented concerning three recent clinical distinctions in schizophrenia: kraepelinian versus non-kraepelinian patients; mixed versus simple undifferentiated subtypes; and state-dependent versus state-independent negative symptoms. Schizophrenic patients who have been ill and dependent on others for the past 5 years ('kraepelinians') were compared to other chronic schizophrenics. The kraepelinian patients met the criteria for schizophrenia by more diagnostic systems than other patients, were less responsive to haloperidol, had more severe negative symptoms and formal thought disorder, and had similarly severe positive symptoms. They also had cerebral ventricles that demonstrated more left-to-right asymmetry and a greater family history of schizophrenia spectrum disorders. Mixed undifferentiated schizophrenic patients, who met criteria for more than one schizophrenic subtype, were compared to simple undifferentiated schizophrenic patients, who met criteria for no subtype. The mixed group was characterized by more severe positive and negative symptoms and formal thought disorder, worse social functioning, and a worse response to haloperidol. In a subgroup of patients who were studied once while in a state of exacerbation and once while in a state of relative remission, the negative symptoms of inattention and affective flattening were state-dependent, while anhedonia-asociality was state-independent.

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