The present study examines the effects of independent, single pre- and perinatal risk factors and rates of obstetric complications upon the subsequent development of schizophrenia.
This study was ...based on prospectively recorded birth records of 107 cases (82 with schizophrenic disorders and 25 with other psychotic reactions) and 214 controls, individually matched by gender and time and place of birth. Variables univariately associated with significantly elevated risk were entered in a logistic regression model.
A high non-optimality summary score (> or = 7 complications of 34 possible) was a significant risk estimate for the total index group (OR 4.58, 95% CI 1.74-12.03) and the 82 schizophrenic patients (OR 3.67, CI 1.30-10.36). Patients with 2-6 complications also had an increased, although lower, risk (OR 1.67, CI 1.02-2.75). A disproportionate birth weight for body length (OR 3.57, CI 1.77-7.19) and a small head circumference (OR 3.93, CI 1.32-11.71) were the strongest independent risk factors.
A contribution of obstetric complications to the risk of schizophrenia was confirmed. Only aberrations in physical size remained as individual independent risk factors.
The vulnerability‐stress model for schizophrenia posits that relapses are at least partly determined by interacting triggering and protecting psychosocial factors. This study examined social support ...and general coping style in 42 consecutively admitted DSM:III schizophrenic patients, who were followed prospectively for up to four years. In a second part of the study, a subgroup of the patients were interviewed using the Life Event and Difficulty Schedule 9 months after discharge or at relapse. Patients contented with low social integration had a higher relapse rate over four years than patients lacking of social provisions, but wanting more. We found an excess of life events three weeks before relapse compared to events reported in the non‐relapsing group. Suggesting a buffering effect of social factors, time between life event and relapse was significantly extended among patients with a high availability of attachment and a coping strategy characterised of active support seeking.
The CSF levels of HVA and 5-HIAA were determined in 90 drug-free DSM-III-R schizophrenic patients and 47 healthy control subjects, and their predictive value for 5-year outcome was evaluated. CSF was ...collected by lumbar puncture at index admission, and in 37 of the patients a second sample was drawn after approx. 7 weeks of neuroleptic treatment. Outcome was rated prospectively 5 years after index admission by means of the Strauss–Carpenter outcome scale. Schizophrenic patients had significantly lower levels of HVA in the CSF than the control group, but no difference was found for 5-HIAA. The CSF-amine metabolite levels were not correlated with age at admission, age at first symptoms or duration of the disorder. Neither HVA nor 5-HIAA correlated with the total outcome scores at a 1- and 5-year follow-up evaluation. First-admitted previously untreated patients with the poorest 5-year outcome had significantly lower HVA/5-HIAA quotients than those with a good outcome. Furthermore, patients still having a low HVA/5-HIAA quotient after treatment with neuroleptics had a poorer 5-year outcome than patients with an increased quotient. The data indicate that both HVA and 5-HIAA in the CSF, and especially their sensitivity to neuroleptic treatment, have a predictive value for the prognosis in schizophrenia.
Previous PET studies of tyrosine transport have suggested that the transport of tyrosine from blood to brain compartment is not dependent on its plasma concentration in patients with schizophrenia.
...In order to examine this relationship, the transport constant (
K
1) of tyrosine was determined in five patients with schizophrenia and five normals.
l-1-
11CTyrosine was injected i.v. and arterial blood samples were taken during PET scanning. The tyrosine transport was assessed during baseline conditions and after oral administration of
l-tyrosine at a dose (175
mg/kg) that significantly elevated the plasma levels.
K
1 was determined from tracer kinetic modelling .
The transport rate dropped in the normals after tyrosine loading, which is consistent with the prevailing notion that the brain transport system for neutral amino acids works close to saturation, whereas it was virtually unchanged in the schizophrenics. The results demonstrated that tyrosine transport was not saturated in the patients with schizophrenia and thus could lead to elevated brain concentrations of tyrosine.
INTRODUCTION: PECC (Psychosis Evaluation tool for Common use by Caregivers) is a recently developed tool for the longitudinal evaluation and follow-up of psychotic patients. This integrated ...evaluation tool covers different functional and symptomatic outcome measures, which are relevant for both the patient and the planning of interventions. PECC was especially designed to be easily implementable in the daily practice of nursing work. In this study we aimed to evaluate the inter-rater and interscale validity of PECC. RESULTS: The results indicate that both the inter-rater validity and the interscale validity of PECC are satisfactory. CONCLUSION: PECC can now be implemented on a large scale. (Int J Psych Clin Pract 2002; 6: 135-140)
Celotno besedilo
Dostopno za:
DOBA, IJS, IZUM, KILJ, NUK, PILJ, PNG, SAZU, UILJ, UKNU, UL, UM, UPUK
Data were obtained from 46 healthy volunteers, 16 males and 30 females, lumbar punctured at the L4–5 level without strict bedrest prior to puncture. 18 ml of CSF was collected at the puncture, which ...was performed with a 0.9 mm diameter needle.
Contradictory to previous reports, body height did not influence CSF 5-hydroxyindoleacetic acid (5-HIAA) or homovanillic acid (HVA). Age influenced HVA (but not 5-HIAA) in a curvilinear manner in male volunteers and the HVA/5-HIAA ratio in females. In contrast to previously reported correlations between 5-HIAA and HVA, a weak correlation was found, but only in females. In males, body weight related to 5-HIAA and atmospheric pressure to HVA, both in a positive direction.
Our findings are largely contradictory to previous reports, a fact that might, hypothetically, be due to the absence of strict bedrest before puncture. The use of a comparatively wide needle (0.9 mm in diameter) and the amount of 18 ml CSF drawn might, taken together, make at least some contribution to an explanation.
Schizophrenia typically affects individuals in early life and leads to long-term suffering at high cost to both the individual and the community. Structural, functional, and biochemical factors may ...play a role in the pathogenesis and perhaps the course, of schizophrenia. Although early research into the treatment of schizophrenia was not fruitful, the results of recent research, particularly the use of narcoleptics combined with new clinical appreciation of psychosocial factors in chronic psychotic disorders, give reason for hope and optimism.
![N-[11C]Methylspiperone PET,...](http://api.summon.serialssolutions.com/2.0.0/image/issn/XR4PS5YY4K/0925-4927_1872-7506/small "N-[11C]Methylspiperone PET, in contrast to [11C]raclopride, fails to detect D2 receptor occupancy by an atypical neuroleptic")
