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At least 19 recordsLinked to original sources
PubMed1977

Three types of paranoid processes.

In classical descriptive psychiatry the term 'paranoid' is often used ambiguously -- referring to a variety of clinical processes which should be more clearly differentiated. Specifically, in this paper, we have differentiated three distinct sets of clinical phenomena all usually lumped together as 'paranoid': 1. Paranoid from a Sense of Guilt, 2. Paranoid from a sense of Low Self-Esteem, and 3. Paranoid from a Sense of Persecution. These three processes are distinct descriptively, dynamically and genetically. Further, this differentiation is most significant pragmatically as the treatment is different for each type.

Central Nervous System Stimulants↗
PubMed2025

Genetic Differences in Reactivity to the Environment Impact Psychotic-Like and Affective Reactivity in Daily Life.

BACKGROUND AND HYPOTHESIS: Consistent with diathesis-stress models, psychosis research has focused on genetic moderation of adverse environmental exposures. In contrast, the Differential Susceptibility (DS) model suggests that the same genetic variants that increase risk-inducing effects of adverse experiences also enhance beneficial effects from positive experiences. This study examined whether individuals with high genetic susceptibility to the environment showed differential psychotic-like and affective reactivity in response to positive and negative events in daily life. STUDY DESIGN: Experience sampling methodology assessed context (positive and stressful) and momentary levels of paranoia, psychotic-like experiences (PLE), and positive (PA) and negative affect (NA) in 217 non-clinical adults oversampled for schizotypy. Linear mixed models examined whether Polygenic Risk Scores of Environmental Sensitivity (PRS-ES) moderated the impact of current context on subsequent experiences. STUDY RESULTS: PRS-ES moderated positive, but not stressful, context on subsequent levels of momentary paranoia, NA, and PA, but not PLE. Genetic and environmental (G × E) interactions indicated diathesis-stress at lower thresholds of PRS-ES, but a DS model at the highest threshold of the PRS-ES. Participants with elevated PRS-ES showed increased paranoia and NA and decreased PA in subsequent assessments when reporting low levels of positive situations, but also decreased paranoia and NA and increased PA when rating contexts as positive. CONCLUSIONS: Findings support the influence of genetic sensitivity to the environment on psychotic-like and affective reactivity in daily life, particularly in response to positive contexts. This highlights the transdiagnostic protective role of positive experiences and informs ecological momentary interventions.

Humans↗
PubMed1975

Psychoactive drugs. Uses, misuses, and abuses.

The source of knowledge about the use of psychoactive drugs is often biased--being the representative or literature of the pharmaceutical company. Psychotropic drugs and their appropriate usage are discussed, and the basic ingredients of good prescribing habits are examined by focusing on the nonchemical factors that can help determine outcome.

Age Factors↗
PubMed1979

Tardive dyskinesia and the long-term patient.

A psychiatric patient's long-term use of antipsychotic medication often results in the irreversible movement disorder, tardive dyskinesia. The author uses a composite case history as a basis for discussing the symptoms, diagnosis, epidemiology, and treatment of tardive dyskinesia. A number of drugs have been used to treat the disorder, but so far none have been effective. While tardive dyskinesia cannot be cured at this time, the author believes that it can be prevented by treating psychoses with the lowest possible dose of the least toxic drug for the shortest length of time.

Adult↗
PubMed1978

Evaluating clustering methods for psychiatric diagnosis.

This report represents an empirical evaluation of the major clustering approaches on psychiatric diagnostic data. Experienced psychiatrists, using 17 psychopathological variables, developed 88 archetypal psychiatric patients to represent four diagnostic categories (manic-depressive depressed, manic-depressive manic, simple schizophrenic, and paranoid schizophrenic). Ten computerized methods representative of the major clustering approaches and using various measures of similarity between patients were applied to this data set to develop de novo patient groupings. Evaluative criteria included the concordance of clustering output to the structure of the original data, and clustering replicability. Considerable differences were obtained among clustering methods. The best-ranked procedures were nearest centroid sorting methods and complete and centroid linkage hierarchical methods. The overall poorest ranking were obtained for multivariate normal mixture analysis and facial representation of multidimensional points. Further evaluation of cluster analytic methods on real biological and psychosocial data sets yielded similar rankings.

Bipolar Disorder↗
PubMed1978

Long-term prognosis and followup in schizophrenia.

The long-term course or natural history of schizophrenia is correlated with differing diagnostic criteria and commonly agreed upon prognostic variables. A review of 38 long-term followup studies of hospitalized schizophrenics reveals that unspecified or Kraepelinian-type schizophrenia has a much worse prognosis than atypical schizophrenia, schizoaffective psychosis, reactive psychosis, or other good premorbid types. Diagnoses based on longitudinal as well as cross-reactional data are more predictive of outcome than cross-sectionally based diagnoses. Drug and psychosocial treatment results must be evaluated in terms of prognostic variables, many of which are incorporated in some currently employed diagnostic criteria. There is no firm evidence that maintenance medication is indicated in some good prognosis patients. The paucity of long-range followups, the inadequacies of outcome assessments, and diagnostic disagreements limit our understanding of the effects of drug treatment, a treatment which is not without dangerous neurological side effects in many patients.

Antipsychotic Agents↗
PubMed1979

Tardive dyskinesia presenting as a psychosis.

Tardive dyskinesia (TD), a movement disorder secondary to neuroleptic medication, is frequently found in psychiatric patients. The authors review reasons why some patients with TD go undetected. In addition, they report on another clinical situation which led to TD going undiagnosed: two cases which developed TD, then incorporated their movement disorder into a delusional system. Their clinicians focused exclusively on their psychosis, missing the underlying neurological disorder. How commonly this occurs in clinical practice is unknown.

Antipsychotic Agents↗
PubMed1977

MMPI changes in briefly hospitalized non-narcotic drug users.

The Minnesota Multiphasic Personality Inventory (MMPI) was administered to 66 non-narcotic drug abusers as part of an intensive study of polydrug abuse. Patients were classified into four primary drug-of-abuse groups using either stimulants, barbiturates, other sedative-hypnotics, or a combination of these drugs. It was readministered to 42 of these patients after 2 weeks' hospitalization. At admission, the group's MMPI profile was consistent with psychosis. At discharge, most of the MMPI T-scores were sharply reduced, and the groups' profile was consistent with sociopathy. The admission MMPI profiles of the four primary drug-of-abuse groups did not differ. At discharge, the stimulant group's profile remained psychotic, while the profiles of the other three groups were not psychotic. Such results raise the possibility of a toxic psychotic effect of chronic non-narcotic drug abuse. The group of stimulant abusers appeared schizophrenic, while the other groups of non-narcotic drug abusers appeared sociopathic.

Amphetamines↗
PubMed1979

Telemetered EEG-EOG during psychotic behaviors of schizophrenia.

In an effort to establish correlations between abnormal behaviors characteristic of schizophrenia and simultaneous cerebral electrical activity, EEGs and electro-oculograms (EOGs) were continuously recorded for 2 to 24 hours by radiotelemetry from 40 patients with schizophrenia and 12 normal control subjects. Trained observers recorded specific behavior patterns permitting visual and computer analysis of EEG during hallucinations, stereotypy, catatonia, psychomotor blocking, and other characteristic manifestations of schizophrenia. Electroencephalographic abnormalities consisting of focal slow or spike activity over either temporal region were found in nearly half of the patients so recorded. In contrast to the EEG during ictal episodes of epilepsy, the abnormal wave forms of schizophrenic patients seldom coincided with episodes of blocking, stereotypy, or other abnormal behaviors. Increased extraocular activity or blinking were recorded in a majority of patients, but were not consistently associated with the abnormal behavior or perceptual events.

Adult↗
PubMed1978

Vestibular responses in schizophrenia.

In a study of vestibular responses to caloric stimulation that controlled opportunity for fixation and state of alertness, we evaluated previous findings of diminished nystagmus in schizophrenia. We failed to replicate earlier reports in these respects: (1) None of the psychotic patient groups, when compared with normal controls, showed lower response intensity, latency, or culmination time of the nystagmic response. (2) The schizophrenic groups did not manifest a prevalence of clinically significant asymmetry. We did, however, observe that chronic deteriorated schizophrenics and recent schizophrenics have significantly greater dysrhythmic responses. This diminished orderliness of nystagmus may explain previous reports of absent or diminished nystagmus in the schizophrenics. The results are not compatible with peripheral vestibular disease in schizophrenia, but they may reflect state-related phenomena consistent with disturbances in alertness, which are not necessarily voluntary or motivational in origin.

Acute Disease↗
PubMed1978

Use of antidepressant drugs in schizophrenia.

This review surveys the therapeutic efficacy of tricyclic antidepressants and monoamine oxidase inhibitors in schizophrenic patients. In general, the use of these drugs alone was found not to be warranted in schizophrenia, except perhaps in the so-called pseudoneurotic subgroup. In most cases, combinations of antidepressants and phenothiazines were not more beneficial than phenothiazines alone. In particular, the conditions of agitated patients and patients with histories of social deviance dating back to childhood were often made worse by the addition of an antidepressant. However, when the patients who demonstrated symptoms of clinical depression other than anergia were isolated from several of these studies, it was found that they constituted a subgroup that was often benefited by use of these combinations. Favorable and unfavorable clinical response patterns are discussed, and recommendations for future research are outlined.

Adolescent↗
PubMed1979

Perspectives in chemotherapy of schizophrenic psychoses.

1. The treatment of schizophrenic symptoms has not the same efficacy in acute and chronic phases of the disease and on the various target symptoms of schizophrenia. 2. The ideal antipsychotic drug might have different properties, sometimes contradictory, to be effective both on paranoid and hebephrenic symptoms which seem to be a mirror image of the same disorder. 3. Basic perspectives in the chemotherapy of schizophrenic psychoses must be founded on better methodological considerations in clinical trials, on a better use of antipsychotic drugs with the help of pharmacokinetic data and computerized EEG and also on new neurochemical findings. 4. Recent data on the mode of action of neuroleptics open up new therapeutic classes of drugs. Such are GABA-like drugs and, more recently, beta-blockers.

Acute Disease↗
PubMed1978

Behavioral rhythms in schizophrenia.

Daily behavioral observations were made for several years on 10 male schizophrenic patients and on three male patients with organic brain disorders. Analysis of these data showed strong cyclic components in the five schizophrenic patients with predominantly hebephrenic symptomatology. Period lengths noted were about 2 days, 5 to 6 days, 30 days, and a longer cycle of 40 to 100 days duration. Antipsychotic medications appear to have a suppressant effect, but tricyclic antidepressants may enhance pre-existing rhythms.

Adult↗
PubMed1979

The "neuroleptic" antipsychotic drugs. 1. Mechanisms of action.

The antipsychotic drugs have provided effective and relatively safe treatment of schizophrenia, paranoid illnesses, and manic-depressive conditions marked by psychotic features. These agents are sometimes called "neuroleptic," as virtually all produce signs of extrapyramidal neurologic disorders in addition to their antipsychotic actions; in part, evidently, the neuroleptic effects are an artifact of the means of screening of potential new agents. These agents have a strong and selective antagonistic action on synaptic mechanisms in the brain mediated by dopamine as a neurotransmitter. This antidopamine action almost certainly contributes importantly to their parkinsonism effect (basal ganglia) and their prolactin-elevating (hypothalamic) effect; in addition, antipsychotic actions may be mediated by antidopamine effects, possibly in limbic and other forebrain centers.

Animals↗