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Biomedical subjects

S C Schulz

Publications and source records attributed to S C Schulz.

At least 19 recordsLinked to original sources
PubMed1992

The relationship of structural brain imaging parameters to antipsychotic treatment response: a review.

Over the last decade, a number of studies have attempted to relate brain morphology to treatment response to neuroleptics. This approach has scientific potential to define subtypes of schizophrenia as well as potential clinical utility. In the present report, a review of 33 studies, including a meta-analysis, is provided. Although the overall test of the effect was not significant, the analysis revealed marked heterogeneity in the results of the various studies. The following factors were significant predictors of effect size: age, illness duration and age of onset of the patient cohort, the percentage of patients with marked structural abnormality included in the study overall, the duration of treatment and the degree of symptom improvement in the study overall. The following factors were unrelated to study effect size: date of study, gender, and the presence of a washout period. In future studies, attention to the parameters utilized in the meta-analysis should help to clarify the strength and generality of the relationship between brain morphology and treatment response.

Adult↗
PubMed1991

Fluoxetine in the treatment of borderline and schizotypal personality disorders.

Twenty-two patients meeting the criteria for borderline or schizotypal personality disorder or both participated in a prospective, nonblind 12-week trial of fluoxetine. There were significant reductions in self-injury and in scores on the Hopkins Symptom Checklist regardless of diagnosis. The results suggest that controlled trials of fluoxetine and investigations of the serotonergic system in these disorders would be useful.

Adult↗
PubMed1990

Change in haloperidol level due to carbamazepine--a complicating factor in combined medication for schizophrenia.

Serum haloperidol levels were measured in patients who received haloperidol alone and, subsequently, haloperidol in combination with carbamazepine or lithium carbonate. Haloperidol levels and the level- dose ratios dropped about 50% in patients receiving carbamazepine. They remained the same in most patients receiving lithium carbonate. One patient receiving added carbamazepine experienced worsening of symptoms; this was associated with a drop in serum haloperidol level. Two other patients receiving added carbamazepine showed significant symptom reduction, although they also sustained drops in serum haloperidol levels. It is not clear whether these two individuals benefited from a primary antipsychotic effect of carbamazepine or from reduction of "toxic" haloperidol levels. Serum levels of antipsychotic medication should be monitored carefully when these medications are prescribed in combination with carbamazepine.

Carbamazepine↗
PubMed1989

Advances in the genetics of schizophrenia: editors' introduction.

In view of the rapid advances in the application of molecular genetics to research in schizophrenia, an effort was made to put these studies into a wider perspective. This issue of the Schizophrenia Bulletin is devoted to the expanded presentation of some of the early genetic linkage findings in schizophrenia, and a broader discussion of the impact of these new techniques on schizophrenia research, as well as the limitations of this approach in a complex disorder.

Chromosomes, Human, Pair 5↗
PubMed1989

Prospects for the genetic analysis of schizophrenia.

This issue of the Schizophrenia Bulletin provides a forum for the presentation of early results and speculative hypotheses based on the application of molecular genetic methods for linkage studies in schizophrenia. Contributors were given the freedom to explore the historical and theoretical perspectives on the genetics of schizophrenia. They were also asked to balance their enthusiasm and cautious skepticism at the new suggestions of linkage involving chromosome 5 (Sherrington et al. 1988). In this overview, the epidemiologic evidence for a genetic factor in schizophrenia and recent linkage studies are briefly discussed. In addition, the potential and limitations of different linkage strategies in schizophrenia are examined.

Chromosomes, Human, Pair 5↗
PubMed1989

Community adjustment of chronic schizophrenic patients in urban and rural settings.

The influence of environmental conditions on the community adjustment of chronic schizophrenic patients who live in boarding homes and other residential facilities was studied using data from medical records and interviews with patients. Seventy-eight patients living in an urban area and 46 patients living in a rural area were included in the study. Compared with rural patients, urban patients were more likely to live in substandard dwellings, to receive less practical support from the home operator, and to report more incongruence with household members and aversive neighborhood conditions. Urban patients showed significantly more psychopathology, functioned more poorly in relationships with others, and had poorer global functioning than rural patients. Except for the physical condition of patients' dwellings, all the environmental conditions measured in the study were significantly associated with some measures of community adjustment regardless of geographic setting.

Adult↗
PubMed1989

Rationale for clinical trials of opiate antagonists in treating patients with personality disorders and self-injurious behavior.

A subgroup of patients with personality disorders from the DSM-III-R (American Psychiatric Association 1987) "flamboyant" cluster is characterized by repetitive self-injurious behavior (SIB) apparently not motivated by suicidal intent. After describing the clinical and demographic characteristics of these patients, the clinical and preclinical evidence suggesting the involvement of endogenous opiate systems in this behavior is reviewed. Patients with personality disorders and SIB have been found to have elevated levels of plasma beta-endorphin. However, the available evidence is not sufficient to show whether this is a cause of or a consequence of SIB. Behavioral stereotypies resulting in self-injury in animals and SIB in mentally retarded patients have been shown to be abolished by opiate antagonist administration in a significant proportion of both groups. The available evidence suggests that clinical trials of oral opiate antagonist drugs should be undertaken because of the promise such drugs have in the treatment of this sometimes life-threatening disorder.

Clinical Trials as Topic↗
PubMed1988

Borderline personality disorder: replication of MMPI profiles.

The purpose of this study was to determine whether a particular MMPI profile is associated with borderline personality disorder (BPD). Forty-seven symptomatic volunteers who satisfied DSM-III criteria for borderline and/or schizotypal personality disorder were given the full MMPI. Concordance of MMPI profile for BDP confirmed the findings of four previous studies. Elevations were noted on F, D, PD, PA, PT, and SC. A subject's profile with this pattern is interpreted from item content as generally neurotic, dysthymic, socially withdrawn, suspicious, apathetic toward the future, affectively erratic, unable to anticipate the consequences of his or her own behavior, and unable to judge the social desirability of his or her own behavior. Correlations of the foregoing scales with a total BPD score ranged from .44 to .77, with a multiple R of .80 and a cross validity of .77. The accuracy of predicting actual BPD and non-BPD cases was 89%. Accordingly, the MMPI could be used as a coarse screen for BPD casefinding in that patients with the MMPI profiles above should be selected for more thorough diagnostic workup. In the future, the MMPI might be linked to other variables, such as drug response, to understand further the pathophysiology of BPD.

Adolescent↗
PubMed1988

Changes in EEG mean frequency associated with anxiety and with amphetamine challenge in BPD.

Recent authors have hypothesized that cerebral dysfunction, as reflected in an abnormal EEG, may play an important role in the behavioral symptoms of patients with borderline personality disorder (BPD). Spectral analysis and amphetamine challenge testing are two promising methods for probing the clinical symptomatology of this disorder. In this study, we evaluated the relationship between clinical symptoms and computerized EEG spectral analysis in BPD patients both before and after amphetamine challenge. We found that mean frequency values on spectral analysis consistently correlated with anxiety levels in our patients, but did not correlate with a wide variety of other important symptoms, such as depression or transient psychosis. This result, coupled with our previous negative findings concerning EEG abnormalities in patients with BPD, casts doubt on the etiological relationship of cerebral dysrhythmias to the behavioral pathology of this disorder, but raises interesting questions concerning the relationship of anxiety and mean frequency.

Adult↗
PubMed1988

The amphetamine challenge test in patients with borderline disorder.

The authors used amphetamine as a psychopharmacological probe to investigate the hypothesis that patients with borderline personality disorder are prone to psychosis following ingestion of a dopamine agonist. Sixteen patients with borderline personality disorder participated in the study. Significant increases in the mean total Brief Psychiatric Rating Scale scores and in activation and thought disturbance factors after amphetamine administration were noted in the sample. Patients with diagnoses of both schizotypal and borderline personality disorders worsened transiently with amphetamine administration, but patients with only the borderline diagnosis improved. These results indicate the usefulness of pharmacological probes to further understand DSM-III axis II disorders.

Acute Disease↗