Consenso de asma sob a forma de um mapa conceitual / Guidelines of asthma in the form of a concept map

Objetivo: o presente trabalho tem por objetivo apresentar sobre a forma de mapa conceitual o consenso de asma na Pediatria. Métodos: foi realizada a revisão do consenso GINA e apresentaram-se conjuntos de ideias e conceitos sobre o tema sob a forma de um mapa conceitual. Resultados: a asma é definida como doença inflamatória crônica de via aérea inferior. Seu diagnóstico em crianças é clínico e deve basear-se em história de sintomas característicos, exame físico e evidência de limitação variável do fluxo aéreo expiratório. A avaliação da asma baseia-se no controle dos sintomas após o tratamento adequado e na minimização dos riscos futuros que contribuem para a ocorrência de exacerbações e gravidade da sintomatologia. De acordo com nível de controle pode ser classificada em controlada, parcialmente controlada e fora de controle. O tratamento visa ao controle dos sintomas e à redução dos riscos futuros, mormente exacerbações ("crises"). O componente terapêutico não farmacológico fundamenta-se em tentar controlar os fatores de risco potencialmente evitáveis e o tratamento farmacológico é dividido em etapas que variam de um a cinco, com utilização de broncodilatadores de curta ação nas crises além corticoides inalatórios associados ou não a broncodilatadores de longa duração, antagonistas de leucotrienos e ainda anti-IgE na etapa 5. Conclusões: o médico, ao se deparar com uma criança com asma, deve acompanhar periodicamente a sua evolução, verificar os problemas e dificuldades existentes para o tratamento de maneira individualizada, adequando e analisando a resposta terapêutica passo a passo.(AU)

Objective: the present study aims to present in the form of a conceptual map consensus of asthma in Pediatrics. Methods: the GINA consensus review was performed. Issues and concepts about the theme were presented in the form of a map. Results: Asthma is defined chronic inflammatory disease of the lower airway. The diagnosis of asthma in children is clinical and must be based on a history of characteristic symptoms, physical examination, and evidence of expiratory air flow limitation. The evaluation of asthma is based on symptoms controls after proper treatment and the decrease of future risks that contribute to the occurrence of exacerbations and severity of symptoms. According to level of control can be classified into controlled, partly controlled and out of control. Treatment aims to control symptoms and reduce future risks; non-pharmacological treatment is based on trying to control the potentially avoidable risk factors; The pharmacological treatment is divided into steps ranging from 1 to 5 with use of short-acting bronchodilators for exacerbations, inhaled corticosteroids associated or not with the long-acting bronchodilators; leukotriene antagonists and also anti IgE in step 5. Conclusions: The doctor when faced with a child with asthma should periodically monitor its progress, check the problems and difficulties for the treatment analyzing therapeutic response step by step(AU)

Development of graphomotor fluency in adults with ADHD: Evidence of attenuated procedural learning.

PURPOSE: The present study sought to determine if adults with ADHD demonstrate reduced graphomotor learning relative to controls. METHOD: Twenty-eight control adults (n=14) and adults with ADHD (n=14) were recruited and wrote a novel grapheme on a digitizing tablet 30 times. Participants with ADHD were counterbalanced on and off stimulant medication. RESULTS: Control participants, F(1,13)=13.786, p=.003, ω(2)partial=.460, and participants with ADHD on medication, F(1,13)=10.462, p=.007, ω(2)partial=.387, demonstrated significant improvement in graphomotor fluency with equivalent practice whereas participants with ADHD off medication did not, F(1,12)=0.166, NS. CONCLUSIONS: Results indicate that graphomotor program learning in adults with ADHD may occur more slowly than typically developing peers. Findings have implications for providing accommodations to adults with ADHD, potential benefits of stimulant medication, and using digitizing technology as a neuropsychological assessment instrument.

Decreased susceptibility to false memories from misinformation in hormonal contraception users.

Sex hormones are increasingly implicated in memory formation. Recent literature has documented a relationship between hormones and emotional memory and sex differences, which are likely related to hormones, have long been demonstrated in a variety of mnemonic domains, including false memories. Hormonal contraception (HC), which alters sex hormones, has been associated with a bias towards gist memory and away from detailed memory in women who use it during an emotional memory task. Here, we investigated whether HC was associated with changes in susceptibility to false memories, which may be related to the formation of gist memories. We tested false memory susceptibility using two well-validated false memory paradigms: the Deese-Roediger-McDermott (DRM) task, and a story-based misinformation task. We found that hormonal contraceptive users were less susceptible to false memories compared to non-users in the misinformation task, and no differences were seen between groups on the DRM task. We hypothesise that the differences in false memories from the misinformation task may be related to hormonal contraceptive users' memory bias away from details, towards gist memory.

Cognitive outcomes of preterm infants randomized to darbepoetin, erythropoietin, or placebo.

BACKGROUND: We previously reported decreased transfusions and donor exposures in preterm infants randomized to Darbepoetin (Darbe) or erythropoietin (Epo) compared with placebo. As these erythropoiesis-stimulating agents (ESAs) have shown promise as neuroprotective agents, we hypothesized improved neurodevelopmental outcomes at 18 to 22 months among infants randomized to receive ESAs. METHODS: We performed a randomized, masked, multicenter study comparing Darbe (10 µg/kg, 1×/week subcutaneously), Epo (400 U/kg, 3×/week subcutaneously), and placebo (sham dosing 3×/week) given through 35 weeks' postconceptual age, with transfusions administered according to a standardized protocol. Surviving infants were evaluated at 18 to 22 months' corrected age using the Bayley Scales of Infant Development III. The primary outcome was composite cognitive score. Assessments of object permanence, anthropometrics, cerebral palsy, vision, and hearing were performed. RESULTS: Of the original 102 infants (946 ± 196 g, 27.7 ± 1.8 weeks' gestation), 80 (29 Epo, 27 Darbe, 24 placebo) returned for follow-up. The 3 groups were comparable for age at testing, birth weight, and gestational age. After adjustment for gender, analysis of covariance revealed significantly higher cognitive scores among Darbe (96.2 ± 7.3; mean ± SD) and Epo recipients (97.9 ± 14.3) compared with placebo recipients (88.7 ± 13.5; P = .01 vs ESA recipients) as was object permanence (P = .05). No ESA recipients had cerebral palsy, compared with 5 in the placebo group (P < .001). No differences among groups were found in visual or hearing impairment. CONCLUSIONS: Infants randomized to receive ESAs had better cognitive outcomes, compared with placebo recipients, at 18 to 22 months. Darbe and Epo may prove beneficial in improving long-term cognitive outcomes of preterm infants.

Effects of cerebrolysin on moderate cognitive impairments in cerebral vascular insufficiency (a clinical-electrophysiological study).

The efficacy of treatment with cerebrolysin was studied in 40 patients with cerebral vascular insufficiency. Cerebrolysin (20 daily i.v. infusions of 10 ml in 200 ml of physiological saline) was found to be an effective means of treating this group of patients. Courses of cerebrolysin treatment decreased the severity of memory and attention impairments, improving the overall cognitive status of the patients. Clinical observations and neuropsychological testing were supported by electrophysiological results, in terms of the P300 cognitive evoked potential. The effects of treatment at the doses used here were delayed and were seen three months after completion of treatment.

[Review: executive functioning and cannabis use]. / Revisão: funcionamento executivo e uso de maconha.

OBJECTIVE: Cannabis is the most used illicit drug worldwide, however only a few studies have examined cognitive deficits related to its use. Clinical manifestations associated with those deficits include a motivational syndrome, impairment in cognitive flexibility, inattention, deficits in abstract reasoning and concept formation, aspects intimately related to the executive functions, which potentially exert a central role in substance dependence. The objective was to make a review about consequences of cannabis use in executive functioning. METHOD: This review was carried out on reports drawn from MedLine, SciELO, and Lilacs. DISCUSSION: In studies investigating acute use effects, higher doses of tetrahydrocannabinol are associated to impairments in performance of nonsevere users in planning and control impulse tasks. However, chronic cannabis users do not show those impairments. Although demonstration of residual effects of cannabis in the executive functioning is controversial, persistent deficits seem to be present at least in a subgroup of chronic users after 28 days of abstinence. CONCLUSIONS: The neuropsychological studies found did not have as a main aim the evaluation of executive functioning. A criterial selection of standardized neuropsychological tests, more appropriate study designs as well as concomitant investigations with structural and functional neuroimaging techniques may improve the understanding of eventual neurotoxicity associated with cannabis use.

Revisão: funcionamento executivo e uso de maconha / Review: executive functioning and cannabis use

OBJETIVO: A maconha é a droga ilícita mais consumida no mundo, porém ainda existem poucos estudos examinando eventuais prejuízos cognitivos relacionados ao seu uso. As manifestações clínicas associadas a esses déficits incluem síndrome amotivacional, prejuízo na flexibilidade cognitiva, desatenção, dificuldade de raciocínio abstrato e formação de conceitos, aspectos intimamente ligados às funções executivas, as quais potencialmente exercem um papel central na dependência de substâncias. O objetivo do estudo foi fazer uma revisão a respeito das implicações do uso da maconha no funcionamento executivo. MÉTODO: Esta revisão foi conduzida utilizando-se bases de dados eletrônicas (MedLine, Pubmed, SciELO and Lilacs). DISCUSSÃO: Em estudos de efeito agudo, doses maiores de tetrahidrocanabinol encontram-se associadas a maior prejuízo no desempenho de usuários leves em tarefas de controle inibitório e planejamento; porém, este efeito dose-resposta não ocorre em usuários crônicos. Embora haja controvérsias no que se refere a efeitos residuais da maconha, déficits persistentes parecem estar presentes após 28 dias de abstinência, ao menos em um subgrupo de usuários crônicos. CONCLUSÕES: Os estudos encontrados não tiveram como objetivo principal a avaliação das funções executivas. A seleção de testes padronizados, desenhos de estudos mais apropriados e o uso concomitante com técnicas de neuroimagem estrutural e funcional podem auxiliar na melhor compreensão das conseqüências deletérias do uso crônico da maconha no funcionamento executivo.

OBJECTIVE: Cannabis is the most used illicit drug worldwide, however only a few studies have examined cognitive deficits related to its use. Clinical manifestations associated with those deficits include amotivational syndrome, impairment in cognitive flexibility, inattention, deficits in abstract reasoning and concept formation, aspects intimately related to the executive functions, which potentially exert a central role in substance dependence. The objective was to make a review about consequences of cannabis use in executive functioning. METHOD: This review was carried out on reports drawn from MedLine, SciELO, and Lilacs. DISCUSSION: In studies investigating acute use effects, higher doses of tetrahydrocannabinol are associated to impairments in performance of nonsevere users in planning and control impulse tasks. However, chronic cannabis users do not show those impairments. Although demonstration of residual effects of cannabis in the executive functioning is controversial, persistent deficits seem to be present at least in a subgroup of chronic users after 28 days of abstinence. CONCLUSIONS: The neuropsychological studies found did not have as a main aim the evaluation of executive functioning. A criterial selection of standardized neuropsychological tests, more appropriate study designs as well as concomitant investigations with structural and functional neuroimaging techniques may improve the understanding of eventual neurotoxicity associated with cannabis use.

Hug drug or thug drug? Ecstasy use and aggressive behavior.

While clinical studies have established a link between aggression and ecstasy (3,4-methylenedioxymeth-amphetamine [MDMA]), no research has attempted to explore how this link manifests itself in behavioral outcomes. In this research we examine the effects of ecstasy on aggressive and violent behavior in a sample of active users. Data were collected from 260 ecstasy users in Atlanta, Georgia. Data analysis included ordered logit regression to examine the likelihood of engaging in aggressive behavior, controlling for key predictors of aggression independent of ecstasy use. Our results indicate that those with a higher prevalence of lifetime ecstasy use exhibit higher levels of aggressive and violent behavior. However, the effect of lifetime ecstasy use differs by levels of low self-control as a measure of propensity for aggression. Those who exhibit low self-control are more affected by ecstasy use than those who do not in terms of aggression. Our findings add an important dimension to our current knowledge about the relationship between aggression and ecstasy.

Effects of acute caffeine withdrawal on Short Category Test performance in sleep-deprived individuals.

Caffeine is a popular stimulant often used to counter the effects of sleep loss and fatigue. Withdrawal from caffeine may produce mild declines in simple cognitive capacities such as attention and concentration, but it is unclear whether more complex cognitive functions, such as abstract reasoning or concept formation, may be similarly affected. To assess the effect of acute caffeine withdrawal on executive functioning during sleep deprivation, 26 healthy volunteers were administered in double-blind form either repeated doses of caffeine or placebo over two nights of continuous wakefulness. The 108-item Short Category Test was administered after 56 hr. of total sleep deprivation (9 hr. post-caffeine administration). The caffeine group scored significantly more poorly, making approximately 57% more errors on the test than the placebo group. These findings suggest that acute caffeine withdrawal during prolonged sleep deprivation has an adverse effect on abstract reasoning and concept formation.

An investigation into the sub-acute effects of ecstasy on aggressive interpretative bias and aggressive mood - are there gender differences?

The lowering of serotonin for a period following MDMA use could account for the increases in both self-rated and objective measures of aggression previously found in ecstasy users several days after taking the drug. There is some evidence of gender differences in the acute, sub-acute and long-term effects of MDMA use, and given that gender differences have been found in aggression, it is possible that men may experience more aggression mid-week than women. The aim of this study was to attempt to replicate findings showing increased bias towards aggressive material in ecstasy users several days after using the drug. In addition, to investigate possible gender differences in mid-week aggression. A total of 46 participants were tested: 19 ecstasy users and 27 controls were compared on the night of drug use and 4 days later. On day 4, a task designed to tap cognitive bias toward material with aggressive content was administered. Participants were required to process sentences that could be interpreted as either aggressive or neutral and subsequently remember them in a recognition test. This data set was then combined with the data from Curran et al.'s (2004) study that employed exactly the same procedure. Thus, the data from 107 participants was analysed to investigate gender differences. Ecstasy users recognized more aggressive sentences than controls and tended to react slower to neutral sentences than controls. Ecstasy users also rated themselves as being more aggressive and depressed than controls on day 4. No gender differences were found on any measure of aggression in the combined data set. Both male and female ecstasy users show a bias toward interpretation of ambiguous material in an aggressive manner when compared to controls 4 days after ecstasy use.

Neurocognitive consequences of marihuana--a comparison with pre-drug performance.

In determining the effects of regular marihuana use on neurocognition, abilities within specific relevant cognitive domains prior to regular drug use have not been available. The present study examined effects of current and past regular use of marihuana in subjects for whom pre-drug performance had been ascertained in a prospective, longitudinal fashion. A total of 113 young adults, assessed since infancy, were evaluated using neurocognitive tests for which commensurate measures were obtained prior to the initiation of marihuana smoking. Marihuana users, determined by urinalysis and self-report, were categorized as light (< 5 joints per week) and heavy (> or = 5 joints per week) current users and former users, the latter having used the drug regularly in the past (> or = 1 joint per week) but not for at least 3 months. A third of the subjects were using marihuana on a regular basis at the time of assessment with half being heavy users. Among former, regular users, approximately half had been smoking 5 or more joints per week. Overall IQ, memory, processing speed, vocabulary, attention, and abstract reasoning were assessed. After accounting for potentially confounding factors and pre-drug performance in the appropriate cognitive domain, current regular heavy users did significantly worse than non-users in overall IQ, processing speed, immediate, and delayed memory. In contrast, the former marihuana smokers did not show any cognitive impairments. It was concluded that residual marihuana effects are evident beyond the acute intoxication period in current heavy users after taking into account pre-drug performance but similar deficits are no longer apparent 3 months after cessation of regular use, even among former heavy using young adults.

Comparison of neurocognition between drug-free patients with schizophrenia and bipolar disorder.

It is often difficult to make a differential diagnosis between schizophrenia and bipolar disorder because of the overlapping symptoms. The patients of both disorders have been shown to have neurocognitive deficits. In this study, a computerized battery of neurocognitive tasks, COGLAB, was administered to four participant groups: 30 patients with positive schizophrenia, 22 patients with negative schizophrenia, 27 patients with bipolar disorder, and 28 normal controls. All the patients were drug-free for at least 1 month. The tasks included Mueller-Lyer illusion, reaction time, size estimation, a variant of the Wisconsin Card Sorting Test, backward masking, and Asarnow continuous performance. Discriminant analyses were used to investigate the differences among the four groups. Results indicated that COGLAB correctly classified 73.5% of the cases of negative schizophrenia and bipolar disorder. The best discriminative tasks were card sort, Asarnow continuous performance, and backward masking. The results of this study were also compared with results of a previous study with medicated patients. Neurocognitive tasks had better discriminative power for medicated patients with schizophrenia and bipolar disorder than for drug-free patients. Moreover, medication effects did not seem to significantly change the pattern of the neurocognitive task responses of patients with schizophrenia.

Executive function in schizophrenia: is it linked to psychosis and poor life functioning?

The authors examined the relationship of major aspects of executive function to acute psychosis and long-term outcome in patients enrolled in a 15-year study of the natural history of psychosis. They evaluated 157 patients, including 42 schizophrenic, 42 other psychotic, and 73 nonpsychotic psychiatric patients 15 years after index hospitalization. Patients were administered the Wisconsin Card Sorting Test (WCST) and measures of psychosis and posthospital adjustment. Schizophrenia patients performed significantly worse than both nonschizophrenic psychiatric control groups on WCST indices, regardless of psychosis. Aspects of executive function were impaired in schizophrenia patients with severe deficits in their level of overall functioning and outcome and also in many with only moderate impairment in overall functioning; however, these deficits were seen to a greater degree in schizophrenia patients with very poor overall functioning. Executive function deficits appear to be a core component of schizophrenia rather than an effect of acute psychotic disorganization, and are associated with long-term outcome.

Cognitive impairment in methadone maintenance patients.

Few well-controlled studies have examined psychomotor and cognitive performance in methadone maintenance patients (MMP). In the present study, performance of 18 opioid-dependent MMP was evaluated relative to that of 21 control participants without substance abuse histories. The MMP and control groups were balanced with respect to gender, race, age, years of education, current employment status, current reading level, and estimated IQ score. Recent drug abstinence was verified by urine testing. Participants with a urine screen positive for benzodiazepines or a breathalyzer test positive for alcohol prior to performance testing were excluded. To avoid testing under conditions of acute heroin or cocaine intoxication, but without testing under conditions of acute withdrawal, participants with current use of heroin or cocaine were only required to abstain for 24 h prior to performance testing. MMP exhibited impairment relative to controls in psychomotor speed (digit symbol substitution and trail-making tests), working memory (two-back task), decision making (gambling task), and metamemory (confidence ratings on a recognition memory test); results also suggested possible impairment in inhibitory mechanisms (Stroop color-word paradigm). MMP did not exhibit impairment in time estimation, conceptual flexibility or long-term memory. The wide range of impaired functions is striking, and may have important implications for daily functioning in MMP. Further research is necessary to determine the clinical significance of the impairments in laboratory-based tests for daily performance in the natural environment, as well as to differentiate impairments due to acute methadone dosing, chronic methadone maintenance, chronic poly-drug abuse, and other factors.

Use of a false recognition paradigm in an Alzheimer's disease clinical trial: a pilot study.

We report the first use of a false recognition memory test in a clinical trial of patients with Alzheimer's disease (AD). Tests of false recognition allow measurement of two components of memory: the specific details of a prior encounter with a particular item (item-specific recollection) and the general meaning, idea, or gist conveyed by a collection of items (gist memory). We used a false recognition paradigm with categorized pictures to study the effects of an experimental medication in patients with AD. Because medications to treat AD may preferentially improve gist memory or item-specific recollection, use of this type of paradigm may improve sensitivity for detection of drug effects more than standard memory tests.

AVP (4-8) improves concept learning in PFC-damaged but not hippocampal-damaged rats.

A position reversal task was used to test the memory-enhancing effects of the arginine vasopressin analog [pGlu4, Cyt6] AVP (4-8) at a dose of 1.5 microg/kg. Rats received either sham operations (SHM), medial prefrontal cortex lesions (PFC), or hippocampal lesions (HIP). The peptide was administered daily, via s.c. injection, 30 min prior to training to half of the animals in each group. As expected, all animals performed equally well on the initial position habit and the first reversal. Overall, it was found that AVP (4-8)-treated animals performed significantly better across trials than saline (SAL)-treated animals. Further analysis showed that PFC animals that received AVP (4-8) (PFC+AVP) performed significantly better (at the level of controls) across trials than saline-treated PFC (PFC+SAL) animals. Sham animals that received the AVP (4-8) analog (SHM+AVP) only showed significant improvement on the last two reversals when compared to the sham saline-treated animals (SHM+SAL), which was likely due to a ceiling effect as performance reached high levels early in the reversal task. Trial 2 analysis across reversals revealed enhanced cognitive abilities in both sham groups (SHM+SAL, SHM+AVP) and the PFC+AVP group, but not in the PFC+SAL, HIP+AVP or the HIP+SAL groups. Hippocampal lesioned animals performed poorly on the task and injections of AVP (4-8) did not improve their performance. It is thus concluded that AVP (4-8) enhanced the acquisition of concept learning (win-stay/loose-shift) in this paradigm in PFC-damaged animals and ameliorated the perseverance habit that is often seen in PFC animals on this task. It is suggested that AVP (4-8) might have an enhancing effect on general cognitive abilities that is not limited to memory processes.

Midazolam amnesia and conceptual processing in implicit memory.

Prominent theories of implicit memory (D. Schacter, B. Church, & J. Treadwell, 1994) emphasize the dominant role of perceptual processing in mediating priming on perceptual implicit memory tests. Examinations of the effects of conceptual processing on perceptual implicit memory tests have produced ambiguous results. Although a number of investigations (e.g., J. Toth & R. Hunt, 1990) have demonstrated that variations in conceptual processing affect priming on perceptual implicit memory tests, these effects may arise because of the contaminating effects of explicit memory. The current experiment examined this controversy using midazolam, a benzodiazepine that produces a dense, albeit temporary, anterograde amnesia when injected prior to study. The experiment examined whether the effects of generation found on the implicit memory test of perceptual identification were affected by a midazolam injection prior to study. Results demonstrated that midazolam substantially diminished generation effects in free and cued recall, as well as overall performance on these tests, but had no detectable effect on the generation effect in perceptual identification.

The effects of acutely administered low dose sarin on cognitive behaviour and the electroencephalogram in the common marmoset.

Previous studies have suggested that administration of a clinically sign-free dose of sarin to non-human primates gives rise to subtle changes in brain electrical activity as measured by electroencephalography (EEG) several months following exposure. The functional significances of such changes are unclear. The present study monitored EEG by using implantable radiotelemetry, and also assessed the performance of complex behavioural tasks, in non-human primates for up to 15 months following exposure to a low dose of sarin. Baselines of EEG and behaviour were shown to be stable over several months in control animals. The doses of sarin administered caused erythrocyte cholinesterase inhibitions of 36.4% to 67.1%. Overall, no significant changes in EEG patterns were observed although there were increases in beta 2 amplitude which approached significance (p=0.07). No deleterious effects on performance were seen on the touchscreen mediated discrimination tasks presented from the Cambridge Neuropsychological Test Automated Battery (CANTAB). This study illustrates the validity of the approach employed and makes an important contribution to the investigation of the long-term effects of organophosphorous compounds.

Relation between executive cognitive functioning and the adverse consequences of alcohol use in social drinkers.

The purpose of this study was to assess the relation between Executive Cognitive Functioning (ECF) and the adverse consequences of alcohol consumption. ECF encompasses "higher order" cognitive abilities involved in goal-directed behavior, such as attentional control, mental flexibility, planning, and self-monitoring. Impaired ECF has been shown to result in a variety of negative consequences, including excessive drug and alcohol use. Subjects were 79 nonalcoholic male social drinkers between 17 to 30 years of age. ECF was measured using three neuropsychological tests: the Wisconsin Card Sorting Test (WCST), the Conditional Associative Learning Test (CAT), and the Sequential Matching Memory Test (SMMT). Adverse drinking consequences were measured using the Drinker Inventory of Consequences (DrInC). The DrInC assesses drinking consequences in five domains: Physical, Intrapersonal, Interpersonal, Social Responsibility, and Impulse Control. Scores from the neuropsychological tests were reduced into two latent variables: one representing the WCST and the other representing the CAT and SMMT. The results indicated that errors on the CAT/SMMT variable were positively related to adverse consequences in each domain, except for physical consequences. A similar association was found between the WCST variable and impulse control consequences. These findings indicate that performance on tests measuring ECF is related to the severity of drinking consequences. Therefore, prevention and treatment outcomes may be improved by incorporating cognitive habilitation into current interventions.

Language comprehension in schizophrenia: trait or state indicator?

Language comprehension, measured by the Luria-Nebraska Relational Concepts Factor Scale, was evaluated twice in 15 male DSM-III-R schizophrenic patients during a controlled double-blind haloperidol maintenance (without anticholinergics) and placebo replacement protocol. Fifteen male normal controls were tested once. Patients and controls were matched on age and education. Language comprehension was significantly reduced in patients under both pharmacologic conditions, as compared with controls. Patients' comprehension accuracy did not differ significantly between neuroleptic-treatment and placebo replacement conditions. Patients' comprehension accuracy was independent of positive symptoms, anxiety-depression, measures of clinical course, and CSF and plasma monoamines. Comprehension accuracy was also not associated with patients' educational level or WAIS-R measures of their intellectual and short-term memory functioning. Patients' comprehension performance was significantly associated only with the negative symptom anhedonia-asociality during haloperidol maintenance. Thus, language comprehension in schizophrenic patients was independent of changes in pharmacologic treatment and the positive symptoms of psychosis. Results suggest language comprehension may represent a stable or trait characteristic in schizophrenia.