Serum creatinphosphokinase (CPK) in endogenic psychoses]

Creatinphosphokinase (CPK) was determined in 141 patients with manic-depressive and schizophrenic psychoses. In general endogenic psychoses of the manic and depressive type as well as chronic schizophrenias show normal CPK values. In acute cases of paranoid-halluzinatory schizophrenias normal values are predominant. In catatonic schizophrenias, as a rule, clearly increased enzyme activities are found. Thise increased values suggest a postulated somatic disease as a cause of the psychosis. Thus, the determination of CPK provides a useful aid in the diagnosis and control of the course of catatonic schizophrenic.     

Family Therapy of Schizophrenics with High Risk of Relapse

Three families that demonstrated factors associated with relapse of florid symptoms in a schizophrenic family member underwent a course of 25 sessions of behavioral therapy in a multi-family group. Details of the treatment and assessment procedures are presented along with evidence of significant beneficial change in two families. The problem of providing continuing care for schizophrenic patients and their families is discussed.     

精神分裂症病人对成人面部表情的辨别

本文对比研究了精神分裂症病人和正常人对成人面部表情辨别的水平,发现精神分裂症病人存在着表情辨别障碍。病程长、以阴性症状为主的病人易出现这种障碍。表情辨别障碍是一种情绪障碍,属阴性症状。     

New findings in the study of schizophrenia]

The paper gives a survey on the results of research on etiology and course of schizophrenia. The results of etiological research have not, as yet, progressed so far as to provide measures of primary prevention, whereas the results of research into the course of schizophrenia have already led to practical consequences for therapy resp. rehabilitation of schizophrenic patients. In future, with a decrease in the number of long-stay hospitalizations, the number of schizophrenic out-patients, resp. of prolonged periods of out-patient treatments will increase accordingly. Thus hitherto known influencing factors and treatment strategies will also be due to change. According to present knowledge, etiology, psychopathology, course and outcome of schizophrenia represent a very complex and variable, multifactorially initiated process, in which illness-related and environment-related factors concur. Drafts of new models and instruments for the assessment of this process and subsequent disabilities as well as methodological difficulties herewith are reported.     

Patientenpfade im psychiatrischen Ma?regelvollzug �C Intensivere Behandlung, k��rzerer Freiheitsentzug?

This article reports on the results of two workshops which attempted to register and characterize clinical pathways in special hospitals for schizophrenic offenders. The starting point for both workshops was the analysis of the stages and elements which naturally constitute long-term therapy in schizophrenic patients. Based on this analysis it was aimed to develop standardized operating procedures: which mode of action is most sensible in which phase of treatment? How to respond to the different problems arising during therapy? How to prevent therapeutic stagnation? How to retain up-to-date knowledge on the patient? How to manage a faster and more effective transfer into outpatient care? This article focuses particularly on the course of patientsduring the process of in-patient care in special hospitals for schizophrenic offenders.     

Violent behavior in schizophrenic patients: relationship with clinical symptoms

Considerable evidence suggests that violent behavior observed in schizophrenic patients is motivated by psychotic symptomatology. The understanding of violence in schizophrenic patients requires consideration of psychiatric symptomatology. Objective: This study investigated the relationship between violent behavior and psychiatric symptomatology in schizophrenic patients. Method: One hundred and thirteen patients were recruited. Thirteen patients were excluded due to concomitant substance abuse six months prior to the assessment. Diagnoses were based on the SCID‐I. Psychotic symptom severity was assessed with the PANSS. Violent behaviors were assessed with the OAS. Results: Violent behaviors were associated with more severe psychotic symptomatology including hallucinations, delusions, excitement, poor impulse control, and thinking disturbances. Conclusions: Patients with exacerbation of psychotic symptomatology have an increased risk of violent behavior. It is necessary to determine which subtypes of hallucinations and delusions are implicated in the association of schizophrenia and violent behavior. Violent behavior in schizophrenic patients is a heterogeneous phenomenon best explained in the context of specific symptoms associated with violence and course of illness. The retrospective assessment of the variables raises methodological questions concerning the reliability of measurement of the impact of psychotic symptoms on violence. Aggr. Behav. 00:1–10, 2005. © 2005 Wiley‐Liss, Inc.     

The course of anhedonia during 10 years of schizophrenic illness

Although anhedonia has been proposed to be a trait-like characteristic in schizophrenia patients, its persistence and stability have not been tested using multiple assessments over a multiyear period. Specific definitions of anhedonia vary across studies, and relationships between different types of anhedonia as well as their relationship to schizophrenic symptoms over the course of illness have not been addressed. The current research, using prospectively collected longitudinal data covering a 10-year span for 127 individuals with schizophrenic illness, found that (a) physical, but not depressive, anhedonia is a stable characteristic over a 10-year period; (b) physical anhedonia does not show strong and consistent relationships with psychotic, negative, or depressive symptoms; and (c) the relationship between some premorbid characteristics and physical anhedonia are significant even 10 years into the course of illness.     

Functioning of the phonological loop in auditory hallucinations

Two experiments designed to assess the functioning of the phonological store and loop were carried out with schizophrenic patients experiencing auditory hallucinations, schizophrenic patients not experiencing hallucinations and normal subjects. In the first experiment, phonological encoding was assessed. Although both groups of psychiatric patients performed more poorly overall than the normal subjects, there were no significant differences between the performances of the hallucinating and nonhallucinating patients. In the second experiment, the unattended speech effect (a phenomenon thought to reflect the functioning of the phonological store in normal subjects) was assessed in hallucinating schizophrenic patients, non-hallucinating schizophrenic patients and normal controls. The psychiatric patients performed more poorly overall than the normal subjects, but there was no evidence of abnormal functioning of the phonological store or loop in either patient group. Overall, the findings indicate that phonological store and loop abnormalities are not implicated in the experience of auditory hallucinations.     

Results of short-term group psychotherapy of schizophrenic patients

A seven-week group-centered dynamic therapy course was conducted with 12 patients within the framework of a long-term treatment for schizophrenic patients. The purpose and method of treatment and the course of the group sessions are described. Analysis of the Freiburg personality inventory yielded no changes; the degree of agreement between the group mean profile and that of neurotics was striking. Analysis of the Frankfurt complaint questionnaire (Suellwold) revealed a reduction in the number of affirmative answers during and after treatment. The treatment is considered to have had positive results, although it has to be embedded in a more comprehensive treatment plan with supportive individual psychotherapy, psychopharmaceutic treatment and sociotherapy.     

Self-focused attention in schizophrenic patients with and without auditory hallucinations and normal subjects: A comparative study

Self-focused attention has been implicated in a number of psychiatric disorders, but little research has examined this in schizophrenic subjects. In this study, a sample of schizophrenic patients experiencing auditory hallucinations, schizophrenic patients not experiencing auditory hallucinations and normal controls were asked to complete the private self-consciousness subscale of the Self Consciousness Scale. It was found that patients experiencing auditory hallucinations exhibited significantly higher levels of self-focus than those not experiencing hallucinations, although they did not differ from normal subjects. It was also shown that level of self-focus predicted whether or not subjects experienced hallucinations. These results, and their implications, are discussed with reference to the literature.     

Reported childhood trauma and suicide attempts in schizophrenic patients

Childhood traumas are associated with suicidal behavior but this aspect has not been examined in relation to schizophrenia. In this study, 50 chronic schizophrenic patients who had attempted suicide were compared with 50 chronic schizophrenic patients who had never attempted suicide for their scores on the 34-item Childhood Trauma Questionnaire (CTQ). It was found that schizophrenics who had attempted suicide reported significantly higher CTQ scores for emotional abuse, physical abuse, sexual abuse, emotional neglect, and physical neglect than schizophrenics who had never attempted suicide. Therefore, childhood trauma may be a risk factor predisposing schizophrenic patients to attempt suicide.     

Sex differences in completed suicide by schizophrenic patients: a meta-analysis

A meta-analysis was conducted on all studies of suicide mortality in follow-up studies of schizophrenic patients that presented data for male and female patients separately. The percentage of deaths from suicide was significantly greater for the male schizophrenic patients than for the female schizophrenic patients in studies where both sexes were included. Regression equations devised to predict the percentage of deaths from suicide after all of the sample had died estimated that 0.50% of male schizophrenic patients would die from suicide as compared to 0.20% of female schizophrenic patients. Suggestions are made for future research.     

EEG performance spectral mapping during drug therapy in a patient with schizophrenic psychosis

In a paranoid-hallucinatoric patient with chronic course and acute exacerbation a EEG mapping study during neuroleptic treatment was carried out. The typical changes of the alpha power spectra in schizophrenic psychoses as well the normalization after neuroleptic treatment could be found in the alpha map. The changes were in correlation to the clinical state.     

Gains, losses and lateral differences in the hearing of schizophrenic patients.

Schizophrenic patients, whether newly admitted to hospital or institutionalized, exhibited ear differences in absolute threshold. Right ear thresholds were superior to left ear thresholds especially at frequencies above 2 kHz, but deteriorated in the course of the day or as a result of repeated testing. These effects were attributed to the dynamics of left hemisphere processes which in schizophrenia appear susceptible to inhibition and fatigue, effects that may be endocrine related. Relative to control subjects institutionalized schizophrenic patients showed superior hearing below 1 kHz and inferior hearing above 2 kHz.     

Effects of increasing cognitive load on sustained attention tasks in schizophrenic disorders and schizotypy

In this study we analyze the attentional performance using different cognitive load attentional tasks: low-load cognition (0-CPT) and high-load cognition (DS-CPT). Participants were a group of schizophrenic patients and two groups of normal population psychometrically classified as low schizotypy and high schizotypy according to the SPQ. Our results show that schizophrenic patients were more sensitive to increments on cognitive load, being their attentional performace worse than the rest of the groups. The lack of significant findings in vigilance on the schizotypal traits group is discussed in terms of conceptual and methodological issues about the utility of psychometric strategies to identify vulnerable populations within the spectrum of the schizophrenic disorders.     

Suicidal tendencies in schizophrenic patients hospitalized for the first time

180 (15%) patients from 1208 first-hospitalized schizophrenic patients had suicidal tendencies. Our findings show that the suicidal tendencies of schizophrenic patients have their own features. These conclusions can be supported by the differences between the determinants of the suicidal tendencies of schizophrenic and non-schizophrenic population; such different determinants are: sex, age, family and suicidal method. Suicidal tendencies are more frequent among patients without formal thought disturbances. We explain this fact with an "incoherence of decision processes". The features of the suicidal tendencies of schizophrenic patients are based on the grounds of psychosis own dynamic.     

Family Therapy in Trouble: Psychoeducation as Solution and as Problem

The authors cite clinical literature attesting to the importance of recognizing the family, rather than the individual, as the proper locus of conceptualizing, diagnosing, and treating mental illnesses. Specifically with regard to severe psychiatric illnesses, in particular schizophrenia, family dysfunction contributes to the emergence of the illness, significantly affects its course, and strongly influences the achievement and maintenance of treatment gains. Currently, a movement is afoot to limit sharply the amount and kind of treatment offered to schizophrenic patients and their families. Rooted in a “medical model” or “biogenic” view of the etiology of schizophrenia, this school of thought prescribes psychoeducation as the family treatment of choice. The present article looks at some misconceptions regarding treatment that prompted a widespread turning away from psychoanalytically oriented family psychotherapy for schizophrenic patients and their families, examines the reductionism (biological and behavioral) inhering in the exclusive use of psychoeducation, and looks at the clinical dangers of such reductionism. Finally, it proposes that family psycho-therapists should not abandon a concern with the inner lives of severely ill patients and their families in the face of spuriously generalized claims made by reductionist researchers.     

Theory of Mind in schizophrenia: first person vs third person perspective

Patients suffering from schizophrenia have an impaired meta-representation also known as Theory of Mind (ToM). Moreover, the presence of delusions or other positive symptoms of schizophrenia has been correlated to poor ToM performances. Lack of insight is a common symptom of schizophrenia and can be considered a critical manifestation of impaired ToM abilities. In particular, the present study addresses the role of perspective ToM ability in schizophrenic patients. Thirty severely delusional schizophrenic patients completely lack insight when interviewed about their delusions. Seven subsequently gain insight about their mental state when perspective is shifted from the first person to third person. These data suggest that in some delusional schizophrenic patients, it may be possible to gain access to and modify their mental states.     

Normal time course of auditory recognition in schizophrenia, despite impaired precision of the auditory sensory ("echoic") memory code

Prior studies have demonstrated impaired precision of processing within the auditory sensory memory (ASM) system in schizophrenia. This study used auditory backward masking to evaluate the degree to which such deficits resulted from impaired overall precision versus premature decay of information within the short-term auditory store. ASM performance was evaluated in 14 schizophrenic participants and 16 controls. Schizophrenic participants were severely impaired in their ability to match tones following delay. However, when no-mask performance was equated across participants, schizophrenic participants were no more susceptible to the effects of backward maskers than were controls. Thus, despite impaired precision of ASM performance, schizophrenic participants showed no deficits in the time course over which short-term representations could be used within the ASM system.