Biomedical subjects

J Marengo

Publications and source records attributed to J Marengo.

6 recordsLinked to original sources

PubMed1994

Depression in schizophrenia: are neuroleptics, akinesia, or anhedonia involved?

To investigate the presence of a full depressive syndrome in schizophrenia years after the acute phase and factors linked to these depressive syndromes, 75 schizophrenia and schizoaffective patients and 32 patients with bipolar affective disorders were studied prospectively at index hospitalization and followed up 4.5 years later as part of the Chicago Followup Study. Over 30 percent of the schizophrenia patients showed full depressive syndromes during the followup year. Schizophrenia patients on neuroleptics were significantly more likely to show full depressive syndromes than those not on neuroleptics during the followup year. This relationship held after the level of posthospital psychosis was controlled. The data suggest that neuroleptic use is one factor linked to the depressive-like syndromes found in the posthospital phase in non-chronic schizophrenia samples. The results did not support the view that these depressive-like syndromes are only a function of akinesia, although they suggest that akinesia is probably one factor involved. The data indicate a strong link between neuroleptic use and anhedonia. These data suggest that one factor involved in the depressive-like symptoms found in schizophrenia patients could be interference by neuroleptics with the mesolimbic dopamine reinforcement system or the dopamine reward system.

Affective Symptoms↗

PubMed1994

Classifying the courses of schizophrenia.

The purpose of this review was to examine current strategies for classifying the courses of schizophrenia. Although a number of course classifications have evolved over the past two decades, the field has not addressed fully the complex issue of course description. This review compared previously published prototypes for describing the long-term courses of schizophrenia to identify variations and consistencies in course descriptions. Across investigations, differences were found in the number of courses described, in the structure of course categories, in the relative emphasis on syndrome symptoms versus syndrome change, and in documenting specific course features (i.e., illness onset, illness outcome, and types of symptoms). Interstudy comparisons of long-term illness patterns therefore are limited and cumulative statements on prognosis will remain problematic until some standardization is introduced. A minimal set of course parameters that should be documented in future studies include (1) the rate of syndrome onset; (2) postonset patterns of psychotic and residual symptoms; (3) postonset patterns of social, work, and self-care activities; and (4) outcome. Descriptive domains for assessing these parameters are offered. Future research should be directed toward (1) developing a standard schizophrenia course classification that is more representative than the current DSM and Research Diagnostic Criteria classifications; (2) using a broadened domain of symptom patterns to characterize short- and long-term courses of schizophrenia; (3) increasing course reports with a focus on patients who demonstrate intermediate illness courses; and (4) exploring factors that converge with particular course types.

Activities of Daily Living↗

PubMed1991

European versus U.S. data on the course of schizophrenia.

OBJECTIVE: The present research attempts to add to the existing body of data on the course of schizophrenia by comparing the findings of a prospective study of a group of U.S. schizophrenic patients with data from two European studies. METHOD: Seventy-four U.S. patients given the diagnosis of schizophrenia according to Research Diagnostic Criteria were longitudinally assessed at hospitalization and at three intervals up to 10 years after illness onset. The longitudinal criteria for type of onset, course of illness, and outcome were derived from the European studies of Manfred Bleuler and Luc Ciompi. The type of onset, course of illness, and outcome of the U.S. patients were compared with those of the patients in the two European studies. RESULTS: A lower rate of acute onset and of episodic illness was found in the U.S. patients, but the relative frequency of a number of major overall course patterns was similar across studies. CONCLUSIONS: Despite many potential threats to comparability, the results of the European and U.S. longitudinal studies of the course of schizophrenia were fairly congruent in terms of the relative rate with which patients fell into the categories established by Bleuler and Ciompi. These results are encouraging in that they point to the possibility of estimating the rate of occurrence of particular expressions of the overall course of schizophrenia.

Cross-Cultural Comparison↗

PubMed1986

The early course of schizophrenic thought disorder.

The current investigation studied the early course of positive thought disorder and its relationship to other aspects of schizophrenic outcome. Forty-eight schizophrenics diagnosed using the Research Diagnostic Criteria (RDC), 51 psychotic nonschizophrenics, and 67 nonpsychotic patients were studied at index hospitalization and at a 1.5-year followup. Most thought-disordered schizophrenics and other psychotic patients showed some reduction in thought pathology between index hospitalization and followup (p less than .02). A larger percentage of schizophrenics than other psychotic and nonpsychotic showed thought disorder at the acute phase and at followup assessment (p less than .05), although only a subgroup of 27 percent of the schizophrenics showed severe thought disorder at followup. At followup, severely thought-disordered schizophrenics showed residual signs of psychosis and poor functioning in other areas. Positive thought disorder in schizophrenics at followup most often occurred within the context of an unremitted illness and was less frequently due to a new, acute episode of disturbance. Continuously thought-disordered schizophrenics exhibited more severe impairments in life adjustment at 1.5-year followup than did episodic or nonthought-disordered schizophrenics (p less than .02). The results suggest that severe thought disorder is a persistent characteristic in a subgroup of early schizophrenics.

Acute Disease↗

PubMed1985

Thought disorder. A function of schizophrenia, mania, or psychosis?

Does thought disorder emerge solely as a function of psychosis, or is it a function of diagnosis? The present research investigated whether thought disorder is more frequent in specific diagnostic groups, such as schizophrenia and mania, than in other types of psychotic disorders. The frequency and severity of positive thought disorder was assessed in 324 Research Diagnostic Criteria and DSM-III schizophrenics, manics, other psychotic patients, and nonpsychotic patients, and a normal comparison group. Fifty-seven percent of the sample were first hospital admissions. Patients were tested at the acute phase of their disorder, within the first 2 weeks of hospitalization, with three cognitive tests. Scores from these three tests were scaled to obtain a composite index of the severity of positive thought disorder. Diagnostic factors were more salient to the severity of disordered thinking than was psychosis. Thought disorder was significantly more frequent in schizophrenia and mania than in other psychotic disorders (p less than .05). The frequency of patients with severe thought disorder was reduced as one moved down the hierarchy of manic, schizophrenic, schizoaffective, and depressed psychotic disturbances (p less than .001). Rather surprisingly, the current research suggests that nonpsychotic manic patients may be as thought disordered as psychotic manic patients at acute phases of disturbance. This would indicate that the presence of positive thought disorder in mania is not primarily a function of most of these patients' being psychotic at the acute phase of disturbance. Thought disorder was not simply a function of psychosis.(ABSTRACT TRUNCATED AT 250 WORDS)

Acute Disease↗

PubMed1983

Disordered thinking.

To evaluate formulations that thought disorder at the posthospital phase identifies a subgroup of nuclear schizophrenics with poor outcomes, 77 patients from a longitudinal project were followed up on major dimensions of psychopathology linked to nuclear schizophrenia. The data indicate that (1) schizophrenics were more thought disordered than were nonschizophrenics at the posthospital phase; (2) thought-disordered schizophrenics had only slightly poorer scores on classic prognostic indicators associated with poor outcomes; (3) a subgroup of early chronic schizophrenics were not severely thought disordered; (4) almost all severely thought-disordered schizophrenics demonstrated clear evidence of delusional activity at follow-up; and (5) thought-disordered schizophrenics had poorer outcomes. The overall results fit in with formulations that a severe thought disorder is one of several major features of schizophrenia. The data suggest that posthospital thought disorder identifies a subgroup of poor-outcome schizophrenics, although some non-thought-disordered schizophrenics also show poor outcomes.

Adult↗