ABSTRACT
Neuroleptic drugs block brain dopamine receptors and are effective in treating psychoses of diverse origins. This finding has become a cornerstone of the dopamine theory of schizophrenia, but clinical studies relating schizophrenia, per se, to brain dopamine metabolism have ranged from controversial to negative. This article presents new evidence that cerebrospinal fluid levels of the dopamine metabolite homovanillic acid are related to the severity of psychosis in schizophrenia. These results support the concept that homovanillic acid levels in cerebrospinal fluid vary as a function of psychosis rather than being related to the diagnosis of schizophrenia per se.
Subject(s)
Homovanillic Acid/cerebrospinal fluid , Psychotic Disorders/cerebrospinal fluid , Schizophrenia/cerebrospinal fluid , Schizophrenic Psychology , Adult , Aged , Brain/metabolism , Dopamine/metabolism , Humans , Male , Middle Aged , Psychiatric Status Rating Scales , Psychotic Disorders/diagnosis , Psychotic Disorders/psychology , Reference Values , Schizophrenia/diagnosisABSTRACT
The present pilot study examined the ability of parental communication deviance (CD) to predict relapse in schizophrenic patients in the 1-year period after hospital discharge. Measures of CD were obtained from verbatim transcripts of family problem-solving discussions for 20 schizophrenic patients and their parents at an initial assessment and before the patients' hospital discharge. Relapse was assessed using the Brief Psychiatric Rating Scale at 3-month intervals after discharge. Findings indicated that parental CD measured at an assessment immediately before the patient's release from the hospital was moderately correlated (r = .49, p < .05) with relapse in the 1-year follow-up period. Results are discussed with respect to the possible role of parental CD as an environmental stressor in the period after discharge. Potential contributors to parental CD, including genetically transmitted cognitive deficits and stress resulting from resuming the care-giver role, are also discussed.
Subject(s)
Communication , Hospitalization , Parent-Child Relations , Schizophrenia/diagnosis , Adult , Caregivers/psychology , Cognition Disorders/diagnosis , Cognition Disorders/psychology , Communication Barriers , Female , Follow-Up Studies , Humans , Male , Pilot Projects , Probability , Problem Solving , Psychiatric Status Rating Scales , Recurrence , Schizophrenia/rehabilitation , Schizophrenic Psychology , Stress, Psychological/diagnosis , Stress, Psychological/psychologyABSTRACT
Accurate assessment of negative symptom changes in schizophrenic patients is crucial to determining the efficacy of new treatments. The present study examined the sensitivity to change over the course of hospitalization in negative symptomatology assessed by the Scale for the Assessment of Negative Symptoms (SANS), the Negative Symptom Assessment (NSA), and an expanded version of the Brief Psychiatric Rating Scale (BPRS) in a sample of 60 schizophrenic patients. Symptoms were assessed when the patients were acutely ill and again when they were stabilized. Effect sizes were compared across all three rating scales. The retardation factor of the BPRS had a relatively small effect size (0.32). Effect size for the total NSA was 0.78 and ranged from 0.38 to 0.87 for the SANS. Individual factors had moderate to large effect sizes that ranged from 0.18 to 0.91 for both scales. Separate analyses were performed to calculate effect sizes for a five-factor version of the NSA and to examine only those symptoms specified in DSM-IV (alogia, affective flattening, and avolition). Effect sizes relatively comparable to those found for the entire SANS and NSA scales were found for the separate calculations. Results indicate that the addition of a negative symptom assessment instrument to research protocols increases the ability to detect changes in negative symptoms with substantially fewer subjects than would be required with the BPRS retardation factor alone.
Subject(s)
Depression/diagnosis , Psychiatric Status Rating Scales/statistics & numerical data , Schizophrenia/diagnosis , Schizophrenic Psychology , Adult , Antipsychotic Agents/therapeutic use , Depression/classification , Depression/psychology , Female , Humans , Male , Middle Aged , Observer Variation , Psychometrics , Reproducibility of Results , Schizophrenia/classification , Schizophrenia/drug therapy , Treatment OutcomeABSTRACT
Considerable research on the family's contribution to the psychopathology and coping of mentally ill offspring has focused on disturbed parental communication patterns, in which parents are unable to share a common focus of attention and meaning with their children. This style of communication has been referred to as communication deviance (CD - Wynne and Singer 1963). Specifically, CD refers to instances in which speakers leave ideas incomplete, use language in an odd manner, use unclear referents, contradict previously made statements with little explanation, or make unintelligible or tangential statements.
