Biomedical subjects

M Beiser

Publications and source records attributed to M Beiser.

At least 55 records · Page 3Linked to original sources

PubMed1992

Negative symptoms and the early course of schizophrenia.

To determine the usefulness of including a duration criterion in the definition of "negative" symptoms, the prognostic significance of a longitudinally obtained measure of negative symptoms was compared with a cross-sectionally obtained measure. As predicted, the presence of negative symptoms based on longitudinal observation was associated with most aspects of 18-month course in a group of "first-episode" schizophrenic individuals, whereas cross-sectional levels of negative symptoms were not. The findings suggest that negative symptoms, when operationalized as a trait-like phenomenon, help to portend a poor course of illness.

Adolescent↗

PubMed1992

Clinical correlates of anhedonia and perceptual aberration in first-episode patients with schizophrenia and affective disorder.

We examined the association between scales measuring physical anhedonia, social anhedonia, and perceptual aberration and premorbid functioning, clinical state, and current level of adjustment in 91 psychotic subjects. The patients were examined at the onset of their first psychotic episode and again 18 months later. For patients with schizophrenia, anhedonia was significantly related to premorbid functioning. No association was found between the scales and clinical state or level of adjustment at intake or follow-up. In affective disorder patients, no correlation was found between premorbid functioning (a stable characteristic) and scale scores, but moderately large correlations emerged between the scales and clinical state and level of adjustment at both assessment times. These results suggest that schizophrenic and affective disorder patients endorse items on these scales for different reasons. We hypothesize that for patients with schizophrenia, the scales assess enduring personality characteristics, whereas for the affective disorder patients, they assess clinical condition at the time of testing.

Adolescent↗

PubMed1992

Where are the women in first-episode studies of schizophrenia?

Almost all investigations of first-episode schizophrenia uncover more male than female subjects. Two possible explanations for this observation are (1) first-episode investigations suffer more or less consistent methodologic biases or (2) the incidence of schizophrenia is higher in men than in women. Data from the markers and predictors of schizophrenia (MAP) project, a community-based first-episode study, permitted an investigation of the two alternatives. The results suggest that neither recruitment nor diagnostic vagaries explain the excess of males. Instead, the MAP results, consistent with other recent investigations, suggest that the incidence of schizophrenia is lower in women than in men. The findings are consistent with the literature on gender differences in schizophrenia, which indicates that schizophrenia in women is a less severe disorder than in men. The report includes recommendations for future first-episode investigations to ensure adequate representation of women.

Adolescent↗

PubMed1992

Are males more likely than females to develop schizophrenia?

OBJECTIVE: This study was undertaken to determine whether the incidence of schizophrenia is equivalent for males and females. METHOD: An attempt was made to identify every first-episode case of psychosis in a large Canadian city over a period of 2 1/2 years. A comprehensive referral network was established that included hospital and community settings where psychotic persons might appear. More than 300 potential subjects were identified, 175 of whom underwent a structured psychiatric interview and were assigned diagnoses according to five different diagnostic systems. RESULTS: The incidence of schizophrenia was two to three times higher among males than among females. Even though the use of different diagnostic systems yielded slightly different risk rates, the elevated risk for males remained consistent. There were no differences between the sexes in the incidence of affective psychosis. In comparison with schizophrenia, the incidence rates for mood disorders with psychotic features were sometimes lower and sometimes higher, depending on the diagnostic system used. CONCLUSIONS: The findings, coupled with reports in the past 10 years from other investigators, challenge the conventional belief that the incidence of schizophrenia is the same for the two sexes.

Adolescent↗

PubMed1992

Smooth-pursuit eye tracking in first-episode psychotic patients and their relatives.

We wished to determine the specificity of smooth-pursuit eye tracking dysfunction to schizophrenia and the prevalences of dysfunction among functionally psychotic and normal individuals. Therefore, we investigated pursuit tracking in a large sample of psychotic patients, normal subjects, and first-degree relatives (N = 482). Patients were recruited as part of an epidemiological study of first-episode psychosis that used a broadly based referral network to identify all cases in a major metropolitan area over a 2 1/2-year period. Patients received diagnoses of schizophrenia, schizophreniform disorder, psychotic mood disorder, and paranoid or other psychotic disorder based on the third edition of the Diagnostic and Statistical Manual of Mental Disorders (American Psychiatric Association, 1980). The distribution of tracking performance was bimodal for the schizophrenic patients and their relatives, perhaps reflecting major gene action. Moreover, poor tracking ran in families. Pursuit tracking dysfunction was relatively specific to schizophrenic patients and their relatives and occurred infrequently in other psychotic patients and normal subjects.

Acute Disease↗

PubMed1991

Relationship of lateral ventricular size to psychophysiological measures and short-term outcome.

To examine clinical and psychophysiological correlates of lateral ventricular size, computerized tomographic (CT) scans were obtained on a sample of 88 patients who had experienced their first psychotic episode. Patients met DSM-III criteria for schizophrenia, schizophreniform disorder, or affective disorder with psychotic features. For patients with schizophrenia, large lateral ventricles were associated with unfavorable outcome. No association between outcome and ventricular size was found in patients with affective or schizophreniform disorder. Patients with mood disorders who had large ventricles consumed significantly greater amounts of alcohol than those with small ventricles. No differences were found between patients with large or small ventricles in premorbid functioning, smooth pursuit eye tracking, or electrodermal activity.

Adolescent↗

PubMed1991

Stability of ventricular size after the onset of psychosis in schizophrenia.

This study examined whether ventricular enlargement in schizophrenia is progressive by scanning 15 schizophrenic patients at the onset of their first psychotic episodes and again 1-3 years later. Sizes of the body of the lateral ventricles, the frontal horns, and the third ventricle were assessed. The results indicated no tendency for the ventricles to get larger in this sample, with lateral ventricular size actually showing a significant decrease across the rescanning interval when the ventricle-to-brain ratio was used as the dependent variable. Methodological issues related to computed tomography and the quantification of ventricular size were considered by developing an alternative method of calculating ventricle-to-brain ratios and examining the reliability of measurements made on a group of 11 medical patients who were scanned twice on the same day.

Adolescent↗

PubMed1991

DSM-III: use of the multiaxial diagnostic system in clinical practice.

The authors report on the use of the DSM-III, several years after its introduction, in the clinical diagnosis of 154 subjects with first onset psychosis. Clinicians usually assigned Axis I diagnoses but used the remainder of the multiaxial system less than one time in three; if a standard recording form was in place, the multiaxial system was used more often. Trainees used the DSM-III most, followed by psychiatrists affiliated with a university and community based clinicians. Agreement between researchers and clinicians on diagnoses was fair to poor. The authors discuss the implications of the acceptance of the complex diagnostic system in routine clinical practice.

Cohort Studies↗

PubMed1990

Anhedonia and perceptual aberration in first-episode psychotic patients and their relatives.

One hundred eighteen psychiatric patients, each experiencing his or her first lifetime episode of psychosis, 125 of their first-degree relatives, and 155 normal subjects were assessed using the physical anhedonia, social anhedonia, and perceptual aberration scales of Chapman et al. (1976, 1978). We hypothesized that psychotic subjects would obtain higher scores on these scales than their relatives and the controls, and we expected the group of relatives to score more deviantly than the normal controls. The physical anhedonia and social anhedonia scales successfully differentiated the psychiatric patients from the relatives and the latter from the normal subjects. These findings testify to the construct validity of the scales and suggest that they tap a predisposition to psychosis. Unexpectedly, the relatives scored lower on the perceptual aberration scale than did the normal controls, perhaps because the relatives adopted a defensive response set.

Adolescent↗

PubMed1990

Major depression and depressive symptomatology among the physically disabled. Assessing the role of chronic stress.

Although it is generally agreed that life stress represents a risk factor for depressive symptomatology, there is less agreement on the significance of such stress for the occurrence of major depression. Indeed, it has been suggested that stress factors of importance for depressive symptoms may be irrelevant for major depression. We report results based on a large sample of physically disabled and nondisabled adults that contradict this suggestion. The physically disabled show seriously elevated rates of both depressive symptomatology and major depressive disorder. Subgroup analyses confirmed the finding on depressive symptomatology within all age-gender groupings and the finding on major depression for young and middle-aged men and women but not for the aged. It is argued that these findings can be attributed to differences in chronic stress associated with disability status. We conclude that chronic stress represents a significant risk factor with respect to both depressive symptomatology and major depressive disorder.

Adult↗

PubMed1990

An update on the epidemiology of schizophrenia.

This report summarizes research in epidemiology and related areas which addresses as yet unresolved issues in schizophrenia. These include the nature of the disorder, environmental and psychosocial risk factors and differences in the course of illness. Unravelling the complexities of etiology, course and appropriate treatment calls for an integration of biological and psychosocial paradigms. The review also illustrates that a broad-based view can generate fruitful hypotheses as well as important alternative explanations for research findings.

Cross-Sectional Studies↗

PubMed1989

Catastrophic stress and factors affecting its consequences among Southeast Asian refugees.

Effects on mental health of the stress of being interned in a refugee camp were assessed in a community survey of 1348 Southeast Asians. The impact on depressive mood proved significant but short-lived. Social support derived from the ethnic community and from an intact marriage moderated the risk of developing depressive symptoms, apparently by enhancing a sense of identity and belongingness. A psychological coping mechanism--avoidance of the past--buffered the impact of camp stress on depressive symptoms. While refugees brought into the country under private sponsorship were expected to have a mental health advantage compared to those admitted under government sponsorship, this hypothesis was not confirmed. Private sponsorship, carried out by individuals or groups whose religion differed from the refugees they were supporting, acted as a source of stress.

Acculturation↗

PubMed1989

The role of social relationships in the course of first-episode schizophrenia and affective psychosis.

The Markers and Predictors of Psychosis study at the University of British Columbia addresses the role of psychosocial factors, such as social relationships, in predicting the short-term course of first-episode schizophrenia. Before their first episode of illness, schizophrenic subjects had fewer and less satisfactory social relationships than subjects with affective psychosis and a matched, normal comparison group. Nonfamily social resources were positively associated with good prognosis for both psychotic groups. While involvement with family members also predicted good prognosis among subjects with affective psychosis, family involvement had a negative association with outcome among schizophrenic subjects.

Adolescent↗

PubMed1988

Influences of time, ethnicity, and attachment on depression in Southeast Asian refugees.

The author reports on a study investigating the question of whether certain phases of resettlement are accompanied by an elevated risk for depression in Southeast Asian refugees in Canada. In general, the longer the Southeast Asian refugees remained in Canada, the better their mental health. However, unmarried or otherwise unattached Laotians and Vietnamese refugees experienced high levels of depression 10-12 months after arrival. Two years after the initial investigation, this group, disadvantaged by a lack of social resources, continued to be more depressed than other refugees.

Acculturation↗

PubMed1988

Refining the diagnosis of schizophreniform disorder.

Schizophreniform disorder, a potentially useful construct, is difficult to operationalize either for clinical or research purposes. According to DSM-III-R, schizophreniform disorder is descriptively identical to schizophrenia, differing only in duration of symptoms. This study suggests several features that, at initial examination, differentiate schizophreniform disorder from schizophrenia, such as higher DSM-III axis V ratings, lack of flattened affect, and better rapport with the examiner. The data suggest that when defined according to appropriate clinical criteria, schizophreniform disorder can be distinguished from either schizophrenia or affective disorder.

Adolescent↗

PubMed1988

Ventricular and sulcal size at the onset of psychosis.

To determine whether abnormalities in brain morphology are present at the onset of illness, patients with schizophrenia, schizophreniform and bipolar disorders, and major depression who were experiencing their first episodes of psychosis were compared with normal and medical control subjects. The schizophrenic patients had larger third ventricles but not larger lateral ventricles or cortical sulci than the normal subjects. The other psychotic patients did not differ from the normal group on these measures. A different pattern of results emerged when the medical patients were used for comparison, indicating that the choice of control group can influence the findings of computerized tomography studies.

Adolescent↗

PubMed1988

Choice of comparison group and findings of computerised tomography in schizophrenia.

The literature indicates that whether or not schizophrenic patients are reported to have significant lateral ventricular enlargement depends on control, and not schizophrenic-group values. This discrepancy does not result from differences in age, the ratio of males to females, the number of control subjects used in each study, or whether control groups are comprised of normal subjects or medical patients. However, medical-patient controls tend to have smaller ventricles than do normal individuals. Thus, we assessed lateral- and third-ventricle size and the degree of cortical atrophy in 30 normal volunteers, 30 medical patients, and 30 chronic schizophrenic patients. The use of a medical control group seemed to result in underestimates of ventricle and sulcal size in the normal population and, therefore, overestimates of these values in schizophrenic groups.

Adolescent↗

PubMed1987

Changing time perspective and mental health among Southeast Asian refugees.

Little is known about the psychological mechanisms people employ in adapting to extreme circumstances such as becoming refugees. Case studies of refugees making up part of a sample of 1348 persons relocated from Southeast Asia to Vancouver, British Columbia, suggest that altering one's perception of time may be an adaptive strategy. During periods of acute stress, refugees seem to focus on the present to the relative exclusion of past and future. The reemergence of past and future into consciousness brings about a risk for developing depression. Epidemiological data corroborate inferences from case material, demonstrating that refugees are more present-oriented than the indigenous population. A "Nostalgic" time orientation, preoccupation with the past, is associated with elevated depression scores. Contrasts are drawn between nostalgia, a maladaptive pattern, and memory, which is an inevitable part of the process of personality integration.

Acculturation↗