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Biomedical subjects

R R Lewine

Publications and source records attributed to R R Lewine.

At least 37 records · Page 2Linked to original sources
PubMed1990

Reflections on Saugstad's "social class, marriage, and fertility in schizophrenia".

Saugstad (1989) recently proposed a neurodevelopmental model of schizophrenia and manic depressive illness that emphasizes the importance of biological maturation. Early maturation is proposed to be critical to manic-depressive illness and late maturation to schizophrenia. There are three goals of the comments that follow: (1) to place the neurodevelopmental theory in a broader context of ongoing research in sex differences in psychopathology; (2) to address some conceptual ambiguities in the model, especially with respect to within-schizophrenia comparisons; and (3) to offer a suggestion for a critical test of a maturation hypothesis of schizophrenia.

Bipolar Disorder↗
PubMed1990

Sexual dimorphism, brain morphology, and schizophrenia.

The study of sexual dimorphism in brain morphology may help delineate subtypes of schizophrenia based, in part, on sex; yield insight into the relationship between brain structure and behavior; and provide a neurodevelopmental context for studying the ontogenesis of schizophrenia. Preliminary findings from an ongoing study of sex differences in brain morphology and neuropsychological performance in schizophrenia suggest that schizophrenic males are characterized by multiple morphological deviations; this may represent an extreme form of normal sexual dimorphism in brain morphology. The role of brain morphology deviation in the ontogenesis of schizophrenia is discussed.

Adult↗
PubMed1990

A discriminant validity study of negative symptoms with a special focus on depression and antipsychotic medication.

If the construct validity of the negative symptom syndrome is to be established, the conceptual and operational overlap between negative symptoms and other syndromes such as depression and the effects of medication must be explained. The author assessed 26 patients with schizophrenia and 21 patients without schizophrenia, most of whom had depression, at the end of an average 2-week drug washout period and after approximately 2 months of psychotropic medication administration. Negative symptoms were remarkably consistent in patients with schizophrenia despite pharmacological intervention. In contrast, the patients without schizophrenia manifested significant decreases in negative symptoms.

Adult↗
PubMed1989

Fluphenazine decanoate: a clinical problem?

The authors compared the medical records of 20 randomly selected schizophrenic patients who were receiving fluphenazine decanoate with the records of 20 other randomly selected schizophrenic patients who were receiving oral medications only. The fluphenazine decanoate group had a significantly higher mean chlorpromazine equivalent dose (2010 +/- 836) than the oral medication group (373 +/- 384). The two groups did not, however, differ on any of the other variables studied. The findings, in addition to reports in the literature, suggest that the use of fluphenazine decanoate may come at the inadvertent cost of a significantly higher dose of antipsychotic medications in a subgroup of patients.

Antipsychotic Agents↗
PubMed1985

An empirical test of a Kraepelinian vs. a Bleulerian view of negative symptoms.

Confirmatory factor analysis was used to test a Kraepelinian vs. a Bleulerian interpretation of negative symptoms. The former focuses on absolute loss of functioning, while the latter emphasizes the qualitative loss of organization. Contrary to expectation, neither theory was confirmed, but rather three independent factors emerged: apathy, psychomotor retardation, and loss of goal. The implications of these findings for subtyping schemes and the conceptualization of negative symptoms are discussed.

Adolescent↗
PubMed1984

Lateral ventricular size, psychopathology, and medication response in the psychoses.

Using computed tomography, lateral ventricular size was determined in 45 schizophrenic and 22 affective disorder patients, and was found in both patient groups to be greater than that of 62 similarly aged headache controls. While drug-free, the 15 schizophrenics with ventricles 1 standard deviation greater than the age-corrected control mean tended to have less positive symptomatology than the 30 schizophrenics with smaller ventricles. There was no differences between these two schizophrenic groups in negative symptomatology. Amongst the depressed affective disorder patients, those with larger ventricles tended to be diagnosed as psychotic more often than those with smaller ventricles. Response to neuroleptic treatment was assessed in the 35 schizophrenics who had received conventional neuroleptics for at least 5 weeks. Those schizophrenics with ventricles 2 standard deviations greater than the age-corrected control mean showed less improvement than those with smaller ventricles and on some measures appeared to deteriorate. No such relationship between ventricle size and drug response could be detected in the affective disorder patients.

Adolescent↗
PubMed1983

Assessment of negative and positive symptoms in schizophrenia.

Reliable, convenient rating scales to assess negative and positive symptoms in schizophrenia are necessary to evaluate further the theoretical and clinical importance of this division of symptoms and signs. The authors describe the application of the Rasch model, a probabilistic, item-independent, and sample-independent test construction procedure to the development of scales for both types of symptoms. The scales for negative and positive symptoms, which are based separately on the Schedule for Affective Disorders and Schizophrenia-Current (SADS-C) and the Nurses' Observation Scale for Inpatient Evaluation (NOSIE), demonstrated excellent reliability and temporal stability (i.e., yielded a rank order of patients that remained stable over time). The pattern of interscale correlations supports the view that positive symptoms, cognitive-affective negative symptoms, and social withdrawal are independent of one another.

Adult↗
PubMed1982

How families evaluate mental health professionals, resources, and effects of illness.

Evaluations by families (of chronically mentally ill individuals) of mental health professionals and resources were solicited through a mail survey. The respondents, largely better educated, white, and female, indicated a generally high level of dissatisfaction. Emotional support, information, and aftercare resources were identified as particular areas of concern. The survey findings present a challenge to mental health professionals to reconsider the effects of chronic mental illness on the family and the needs of the non-ill family members.

Adult↗
PubMed1982

A dialogue among patients, families, and professionals. Overview and reflections.

What seems to be a general dissatisfaction with the mental health system is discussed in the context of the inevitable problems created by chronic mental illness. Patients, families, and professionals can, instead of blaming each other for such problems, acknowledge the common difficulties and begin to seek new strategies. Each of us has unique strengths to share, but to do so requires moving beyond traditional roles.

Chronic Disease↗
PubMed1981

High-risk-for-schizophrenia research: sampling bias and its implications.

The use of parental diagnosis in risk-for-schizophrenia identification has inadvertently resulted in two major sampling biases: an overrepresentation of females among index parents and a 100 percent concordance for schizophrenia between affected target offspring and their parents. The overrepresentation of females among index parents may increase the heterogeneity of the schizophrenic sample by virtue of either misdiagnosis or inclusion of atypical, schizoaffective schizophrenics. Thus, the target samples studied in current high-risk research are not only psychometrically unrepresentative of all schizophrenics, but also may contain a substantial number of offspring with atypical, largely affective schizophrenias. Complementary risk identification strategies are discussed, and the nature of the schizophrenias as a heterogeneous group of disorders is emphasized.

Adolescent↗
PubMed1981

Sex differences in age at first hospital admission for schizophrenia: fact or artifact?

Reports that men develop schizophrenia earlier than women could be a clue to major factors in the pathological processes of schizophrenia or they could be diagnostic artifacts. The authors evaluated the effect of alternative diagnostic systems on age at first admission for schizophrenia, depression, and personality disorder. They found that the age-sex disproportion is specific to schizophrenia and occurs irrespective of the diagnostic system. An unexpected relationship between diagnostic system and sex differences in the rate of schizophrenia obtained, however: the broadest and narrowest sets of criteria yielded approximately equal proportions of females and males, but intermediate systems yielded a significantly greater proportion of males than females.

Adolescent↗
PubMed1979

Sex differences in schizophrenia: a commentary.

A critique is offered of Samuels' article suggesting that reported sex differences in concordance rates for schizophrenia are either methodological artifacts or a function of sociological processes. Evidence of sex differences in age of onset, clinical expression, concordance rates among primary relatives, and premorbid competence is cited. Finally, it is concluded that sex differences in schizophrenia offer important clues to the development of the disorder and should be considered in future theories of schizophrenia.

Age Factors↗
PubMed1979

Parents of schizophrenic individuals: what we say is what we see.

The language used to describe the families of schizophrenic individuals is reviewed briefly. It is suggested that this language has negative connotations and is a legacy of past theory interpreting parents as primary causal agents in schizophrenia. If we are to engage the families of schizophrenic patients in cooperative therapeutic endeavors, we must begin to speak to and about those families in more neutral terms.

Adult↗