Biomedical subjects

J T Marengo

Publications and source records attributed to J T Marengo.

9 recordsLinked to original sources

PubMed1997

Longitudinal courses of thought disorder in schizophrenia and schizoaffective disorder.

This research examined the longitudinal courses of thought disorder in schizophrenia, schizoaffective disorder, and other psychotic and nonpsychotic disorders. One-hundred-eighty young psychiatric inpatients were prospectively diagnosed at an early stage of illness and followed up and evaluated for thought disorder at 2, 4.5, and 7.5 years post-index hospitalization. Patterns of thought disorder were examined in relation to diagnosis, index thought disorder, demographic characteristics, prognostic factors, clinical states of psychosis, outcome at followup, and treatment. Courses of frequent and persistent thought disorder were most frequently found in schizophrenia. The prevalence and course of thought disorder over time in schizoaffective disorder laid between those in schizophrenia and those in other psychotic disorders. Demographic factors were not predictive of the course of thought disorder. Diagnosis, the presence of thought disorder at index, pre-index work and academic competence, and pre-index social functioning were associated with courses of thought disorder (when courses were classified as remitted/infrequent and frequent/persistent). The longitudinal relationships between thought disorder and psychosis suggested that, in schizophrenia, thought disorder is not simply a function of psychosis. Thought disorder appeared more closely tied to the presence of psychosis over time in schizoaffective disorder. Increased inquiry into the factors associated with different courses of thought disorder across psychiatric disturbances appears merited.

Adult↗

PubMed1993

Disordered thinking and cerebral dysfunction: laterality effects, language, and intellectual functions.

This report examines two types of thought disorder, bizarre-idiosyncratic thinking and concreteness, in relation to cerebral impairment and psychotropic medication status. Results do not support lateralized dysfunction as a contributing factor for either form of thought disorder. Relationships between specific areas of neuropsychological deficit and thought disorder indicate that intellectual and arithmetic functions are more closely associated with bizarre-idiosyncratic thinking. Further, there were no specific neuropsychological impairments related to concrete thinking, nor was medication status related to either type of thought disorder. Problem-solving or reasoning affects logical orderly cognitive processes more reliably than it affects abstract thinking. Differences between these findings and other research are discussed from the standpoint of how both types of thought disorder are conceptualized and assessed, and how this may influence clinical indications for the use of psychoactive medications.

Journal Article↗

PubMed1991

Early longitudinal course of acute-chronic and paranoid--undifferentiated schizophrenia subtypes and schizophreniform disorder.

This prospective longitudinal study examined symptoms and adjustment at 2 and 4 years posthospital discharge in Research Diagnostic Criteria (RDC) and Diagnostic and Statistical Manual (DSM-III) schizophrenia subtypes and in DSM-III schizophreniform disorder. Delusions, hallucinations, thought disorder, anxiety, depression, and specific areas of community adjustment were assessed at each follow-up. RDC acute and subacute schizophrenia and DSM-III schizophreniform disorder were associated with more satisfactory overall adjustment and lower frequencies of psychotic symptoms over time. No significant differences in the course of symptoms or adjustment were found between paranoid and undifferentiated schizophrenia subtypes. Schizophrenia subtyping schemes based on length of illness features appear more prognostically viable than do symptom-based approaches.

Acute Disease↗

PubMed1991

Two types of thought disorder and lateralized neuropsychological dysfunction.

This report examined positive and negative thought disorder in relation to medication status and cerebral lateralization measures obtained from the Halstead-Reitan Neuropsychological Battery and Wechsler Adult Intelligence Scale in a sample of 59 patients with schizophrenia, schizoaffective and manic disorders, and unspecified functional psychoses. Discriminant function analyses of comparable left- and right-hemisphere variables from the neuropsychological tests were examined for both types of thought disorder, in which presence or absence of psychotropic medications was included as a variable in each analysis. Results indicated a relationship between positive thought disorder and left- but not right-hemisphere variables. Both the left- and right-hemisphere variables were related to negative thought disorder, and these relationships were influenced by the global measures of verbal and performance IQ as well as by medication status. These findings provide qualified support for the left-hemisphere-dysfunction hypothesis, insofar as it is associated specifically with positive thought disorder. Diffuse or bilateral cerebral impairment is more characteristic of negative thought disorder; however, medication status is also equivalent to neuropsychological variables in influencing this relationship.

Adult↗

PubMed1991

Risk for suicide in schizophrenia and other psychotic and nonpsychotic disorders.

To determine the rate of suicide in young, early phase schizophrenics and other psychotic disorders, and to analyze risk factors for suicide, a large sample of patients was prospectively assessed at index hospitalization and then followed up systematically after discharge. Thirty-six patients committed suicide and these patients were compared with those who did not commit suicide for major diagnostic and prognostic factors. Results indicated the following: a) During early years, schizophrenics and other types of psychotic patients were more likely to commit suicide than nonpsychotic patients. b) Similarly, among depressives, psychotic depressed patients were more likely to commit suicide than nonpsychotic depressed patients. c) Schizophrenics and other psychotic patients were especially vulnerable to suicide within the first 6 years of their first hospitalization. d) Among the combined sample of psychotic patients (schizophrenic and other psychotic patients), those at greater risk for suicide were unmarried, white, high IQ, male patients with a more gradual onset of disorder and were of "chronic" Research Diagnostic Criteria subtypes.

Depressive Disorder↗

PubMed1990

Psychological assessment of catatonic schizophrenia.

Probably due to the rarity of the disorder and the general inability of catatonic patients to cooperate with standardized assessment, no data exist documenting the psychological features associated with catatonic schizophrenia that may appear on psychological tests. This study utilized standard assessment techniques to examine clinical hypotheses regarding the psychogenic correlates of catatonic conditions from the performance of one man on psychological tests. In accordance with previous theory, test findings indicated frequent constriction, rigidity, and negativism in conjunction with compulsive traits. Experiences of cognitive and self-fragmentation were juxtaposed with a formal, mechanistic body ego; disorganization and discontinuity were countered with attempts at self-cohesion. Depressed feelings and human interest were apparent, although interpersonal relatedness was frequently characterized by an avoidant, distancing style.

Adult↗

PubMed1987

Schizophrenic thought disorder at follow-up. A persistent or episodic course?

This follow-up investigation examined the course of thought disorder in early, young schizophrenic, other psychotic, and nonpsychotic patients. Patients were assessed for the severity of thought disorder at index hospitalization and at two and four years after hospital discharge. Follow-up evaluations included assessments of adjustment and short-term outcome. Schizophrenic patients showed more thought disorder than nonschizophrenic patients at all three periods. Almost 40% (16/41) of the schizophrenic patients exhibited persistent thought disorder symptoms after the acute phase and an additional 37% (15/41) showed an episodic thought disorder course. Across diagnoses, patients who were thought disordered at both follow-ups demonstrated higher rates of unemployment and rehospitalization than did patients in non-thought-disordered and episodic thought disorder groups. To date, 25% (16/65) of psychotic nonschizophrenic patients showed persistent thought disorder courses similar to schizophrenia, while another 40% (24/65) showed remitting thought disorder symptoms more common to nonpsychotic patients.

Adult↗

PubMed1986

Schizophrenic thought disorder at followup: its persistence and prognostic significance.

To assess the prominence, persistence, and prognostic significance of positive thought disorder in schizophrenia, we studied a large sample of psychiatric inpatients at the acute phase and then followed them up twice--1 1/2-2 years and 4 years after hospital discharge. Positive thought disorder was more prominent at the acute phase in schizophrenic and manic patients than in other types of psychotic and nonpsychotic disorders. At followup, positive thought disorder did not persist for all schizophrenics, but a significantly larger percentage of schizophrenic than other psychotic and nonpsychotic patients followed a course in which positive thought disorder was either persistently or episodically present. Positive thought disorder, when seen after the acute phase, was related to concurrent functioning, and predicted subsequent poorer outcome and functioning for both schizophrenic and nonschizophrenic patients. Positive thought disorder was one of several central features of the active schizophrenic disorder. Among schizophrenics, it was related to other major types of psychopathology, especially delusions, another positive symptom with cognitive-ideational elements. Severe positive thought disorder after the acute phase indicated a sustained episode, and suggested a more severe type of schizophrenia with a poorer prognosis.

Acute Disease↗

PubMed1986

Evaluating bizarre-idiosyncratic thinking: a comprehensive index of positive thought disorder.

A summary of our method of assessing positive thought disorder, or bizarre-idiosyncratic thinking, from two short verbal tests is presented. This measure provides for standardized thought disorder assessments of: the overall presence and severity of thought disorder, and the type of disordered thinking shown. A definition and examples of bizarre-idiosyncratic thinking are provided, along with information on the reliability and validity of the scoring system. A method of establishing subject groups based on the severity of positive thought disorder also is presented--ranging from no thought disorder, to abnormal thinking, to severe formal thought disorder. This measure has been used to assess longitudinal changes in thought disorder symptoms over time and to evaluate relationships between thought disorder, other aspects of psychopathology (such as delusions), and adjustment in other areas of functioning across diagnostic groups.

Humans↗