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R M Bilder

Publications and source records attributed to R M Bilder.

45 records · Page 3Linked to original sources
PubMed1988

Schizophrenic symptoms and deterioration. Relation to computed tomographic findings.

Thirty-two patients with a research diagnosis of chronic schizophrenia were studied using structured clinical scales for premorbid adjustment, clinical symptomatology, and social deterioration. By computed axial tomography (CAT), ventricle-brain ratio (VBR) and cortical atrophy were assessed. The relation between the clinical variables and CAT findings was assessed using linear correlation. CAT-based subgroups were compared using univariate analysis of variance. Previous findings of ventricular enlargement and cortical atrophy in some schizophrenics were replicated. Premorbid asociality and social deterioration were found to have a modest, positive relation with CAT findings but formal thought disorder had a negative relation to ventricle size. There was no relation between the negative symptoms and CAT measures. Within the CAT-positive group the presence of cortical atrophy appeared to be associated with a more severe illness compared with those with ventricular enlargement but the sample sizes were too small to obtain any significant differences.

Adult↗
PubMed1987

Motor perseverations in schizophrenia.

Classical neuropsychological descriptions of prefrontal syndromes emphasize qualitative, productive symptoms, among which the phenomena known as motor perseverations occupy a central position. The now popular assertions that selective prefrontal dysfunction characterizes chronic schizophrenia would be more compelling if such productive symptoms could be reliably elicited in these patients. The present study demonstrated the presence of conspicuous motor perseverations in a sample of chronic schizophrenic inpatients, elicited using techniques that were developed and validated in studies of patients with known frontal lobe lesions. The observedperseverations closely resemble, both in severity and typology, those documented in cases with focal damage to prefrontal cortex. The findings support the contention that prefrontal dysfunction exists in chronic schizophrenia.

Journal Article↗
PubMed1985

Symptomatic and neuropsychological components of defect states.

The distinction between positive and negative symptoms has gained prominence in schizophrenia research, but the construct has not been unequivocally validated. The authors report preliminary findings of investigations in which symptomatic and neuropsychological assessments were conducted in a sample of 32 chronic schizophrenic inpatients. Three distinct clusters of symptoms were identified in correlative analyses. One cluster of symptoms (alogia, attentional impairment, positive formal though disorder, and bizarre behavior) appeared to reflect primarily a disorganization of though independent of current definitions of the positive/negative symptom construct. A second cluster of symptoms (affective flattening, avolition/apathy, and anhedonia) appeared to reflect predominantly blunting of affect and volition. A third cluster (delusions, hallucinations, and "breadth of psychosis") seemed to represent only the florid psychotic features. The first and (to a lesser extent) second clusters of symptoms were selectively associated with neuropsychological impairment. The patterns of neuropsychological deficits correlated with the first cluster of symptoms appeared to be consistent with a process characterized by failure in the development of a normal repertoire of cognitive abilities. It is suggested that the "defect state" may not be a monothetic construct, and that within the domain of "type II" schizophrenia, disturbances of thought may be distinguished from those of affect and motivation.

Adult↗
PubMed1982

Selective effects of cholinergic treatment on verbal memory in posttraumatic amnesia.

The combined effects or orally administered physostigmine and lecithin were assessed in a double-blind study of a single patient with posttraumatic amnesia. Treatment improved verbal recall but not verbal recognition, visual memory, or conceptual reasoning. Both storage and retrieval of words in verbal memory were facilitated. Greater improvement in learning of longer or semantically homogeneous word lists than shorter or semantically mixed lists may indicate that treatment reduced the effects of interstimulus interference. Greater divergence of recognition response biases for semantically homogeneous vs. mixed lists was observed under treatment, reflecting some enhancement of semantic appreciation. Absence of a treatment effect on visual nonverbal memory may be due in part to lateralization of the mesencephalic lesion to the left in this patient. Lack of improvement of encoding capacity, d', or conceptual reasoning may reflect a greater dependence of basal forebrain structures on catecholaminergic than cholinergic mechanisms.

Adult↗
PubMedDate not supplied

Neuropsychological deterioration and CT scan findings in chronic schizophrenia.

Structural abnormalities of the brain, particularly ventricular enlargement and prominence of cortical sulci, have been documented reliably in CT scan investigations of chronic schizophrenic patients. Although the clinical significance of these findings is still obscure, neuropsychological (NP) deficits have emerged as relatively robust correlates of the structural anomalies. Unfortunately, it remains unknown whether the previous findings of NP impairment in association with CT scan abnormalities reflect poor premorbid abilities or deterioration from previously higher levels. This study involved administration of an extensive NP battery and CT scans in a chronic schizophrenic sample. In addition to global and specific scales of NP functions, indices of premorbid ability and deterioration were also employed. The results are consistent with the hypothesis that CT scan findings are associated more with deterioration of functioning than with global measures of NP dysfunction or poor premorbid ability. Conversely, the findings suggest that in patients with normal scans, NP morbidity may be a consequence of failure in the acquisition of a normal cognitive repertoire.

Adult↗