Blood levels of neuroleptic drugs in nonresponding chronic schizophrenic patients.

Blood levels of butaperazine were measured in schizophrenic patients who were chronic nonresponders to their psychotropic medication. The blood levels were compared with those in patients who had shown a better clinical response to this neuroleptic. Nonresponders had two to seven times lower levels of butaperazine in plasma and RBCs after a single dose or chronic dosing. Some of the patients later treated with thioridazine or haloperidol had lower plasma levels of these neuroleptics also. No significant differences were found between nonresponders and relative responders in either the alpha- or beta-phase half-life of butaperazine in plasma and RBCs after administration of a single dose of the drug. Butaperazine and thioridazine levels were not related to previously administered amounts of neuroleptic drugs. These findings do not support the hypothesis that low blood levels are the result of faster systemic metabolism of the drug after it reaches the central circulation. Our results suggest that low blood levels of neuroleptics may be one important factor in the poor clinical response of some chronic schizophrenic patients.     

Blood serotonin levels in suicidal schizophrenic patients

A decrease in central serotonin metabolism has been found in suicidal patients. In schizophrenic patients suicidality is predominantly observed as a transient phenomenon being most pronounced during an acute psychotic episode. We investigated blood serotonin levels as a paradigm for serotonin metabolism in suicidal schizophrenic women who were psychotic and compared their data with those of nonsuicidal psychotic schizophrenic women and healthy controls. Blood serotonin was lower in suicidal female schizophrenic patients (0.44 +/- 0.05 mumol/l, n = 17) than in nonsuicidal female schizophrenic patients (0.94 +/- 0.07 mumol/l, n = 17; P less than 0.001) or in healthy women (0.90 +/- 0.02 mumol/l, n = 26; P less than 0.001). These findings support the hypothesis that decreased serotonin metabolism may be associated with suicidal behavior in schizophrenic women.     

Neurologic abnormalities in schizophrenic patients and their families. I. Comparison of schizophrenic, bipolar, and substance abuse patients and normal controls

The prevalence of neurologic abnormalities detectable on standard clinical examination by neurologists blind to diagnosis was compared for DSM-III-diagnosed, age- and sex-matched groups consisting of 24 schizophrenic (SCZ) patients, 24 patients with bipolar affective disorder (MDI) with history of psychosis, 24 patients hospitalized for alcohol or other drug abuse (D/A), and 24 normal volunteers (NL). The SCZ group had significantly more total abnormalities than the other three; both the MDI and D/A groups in turn had more total abnormalities than normal controls. After exclusion of findings due to medication or otherwise unrelated to the pathogenesis of psychiatric illness, only the SCZ-NL, SCZ-MDI, and D/A-NL differences remained significant. When neurologic abnormalities were further restricted to those indicating localized dysfunction of the corticospinal tracts, basal ganglia, or cerebellum, the only two persistent significant differences were between SCZ-NL and SCZ-MDI groups.     

Minor physical anomalies in schizophrenic patients and normal controls

The aim of the study is to investigate the rate and topographical pattern of minor physical anomalies in schizophrenic patients and normal subjects and determine their value in predicting the patient-control status. Seventy-six schizophrenic inpatients (43 men, 33 women) and 82 normal control subjects (42 men, 40 women) were examined for minor physical anomalies on the Waldrop scale. Schizophrenics showed a higher rate for almost all examined anomalies, the differences reaching statistical significance for six of them: fine electric hair, epicanthus, high/steepled palate, tongue with smooth/rough spots, third toe the second, and big gap between I and II toes. They have significantly higher values for 5 out of 6 body regions and for the total anomalies score. Anomalies in schizophrenics show higher prevalence in the craniofacial complex than the periphery, but the periphery is also considerably stigmatized. Seven anomalies distinguish patients from controls, classifying correctly 81.6% of the patients and 82.9% of the controls. Some anomalies show an almost equal rate in the schizophrenics and the controls, while the rate of others is more than 10 times greater in the patients (odds ratios range: 1.0 to 10.9). Viewed within the multifactorial-polygenic threshold model of liability to a disease, minor physical anomalies might reflect a type of neurodevelopmental risk factor, which by interaction with other genetic or environmental factors could result in passing a threshold and producing symptoms of the disorder, at least in one subpopulation of schizophrenics.     

Judging emotions of normal and schizophrenic subjects.

Thirty-two nursing students were shown silent films in which 10 normal and 10 schizophrenic women described a happy, sad, and an angry personal experience. Accuracy in judging the content of films of normal subjects was associated with social detachment and mechanical interests, whereas accuracy in judging the emotions of the schizophrenic subjects was associated with social involvement and nursing interests. Further, the students nurses' ability to relate to patients, as judged by their nursing supervisors, was associated with their ability to accurately identify the nonverbal emotional communications of the schizophrenic patients but not of the normal persons.     

Vasopressin--oxytocin in cerebrospinal fluid of schizophrenic patients and normal controls

Vasopressin and oxytocin seem to be involved in the processes of learning and memory in animals and probably in man. These peptides appear to have opposite effects in that vasopressin improves memory processes and oxytocin produces amnestic effects. We measured these neuropeptides in the cerebrospinal fluid of schizophrenic patients with and without neuroleptic treatment, psychiatrically healthy controls and drug-free patients before and after three weeks' neuroleptic treatment. There were no significant differences in vasopressin concentrations between schizophrenics and controls. No influence of neuroleptic treatment on vasopressin concentrations was detected. In contrast, concentrations of oxytocin were increased in all schizophrenic patients and were higher in those receiving neuroleptic treatment. In addition, oxytocin concentrations increased after three weeks' neuroleptic treatment. Drug-induced increase of oxytocin concentrations may be of significance in the clinically observed amnestic syndromes and debilitation in schizophrenics treated with neuroleptics.     

精神分裂症伤害案的对比研究

目的　探讨精神分裂症患者和精神正常者伤害案的差异。方法　用自制犯罪行为特征调查表对精神分裂症患者和精神正常者各 80例的伤害行为进行对比研究。结果　在伤害致死、伤害对象、作案场所和作案后有无自杀和自首行为等方面 ,两组有显著差异。研究组大多数受幻觉 ,忘想支配下作案 ( 88 6 % ) ,致死率高 ( 4 3 8% ) ,作案对象多为亲属 ( 37 5% ) ,多在家中或在晚上作案 ,少有自首行为。结论　精神分裂症患者伤害案的犯罪特征明显异于正常人 ,此差异与患者病理心理特征有关     

Social functioning and quality of life comparisons between obsessive-compulsive and schizophrenic disorders.

Treatment of obsessive-compulsive disorder has focused almost exclusively on symptom reduction; however, deficits in social functioning and quality of life of individuals with this disorder may contribute more to their "burden," suffering, and disability. To gauge the significance of social dysfunction and quality of life of persons with obsessive-compulsive disorder (OCD), we made comparisons with a group of persons with schizophrenia matched for age and gender. Thirty-one patients with OCD participating in a partial hospital treatment program were compared with 68 schizophrenic outpatients participating in a day rehabilitation program. The Independent Living Skills Survey (ILSS) and Lehman Quality of Life Scale (QOL) were administered before and after treatment for both cohorts. QOL scores were significantly lower for the OCD patients both before and after treatment, but improved significantly during treatment. OCD and schizophrenic patients had similar scores on almost every domain of the ILSS at pretreatment. The OCD patients improved significantly on many of the domains of social and independent living skills as a result of treatment and acquired significantly greater skills by post-treatment than did their counterparts with schizophrenia; however, the performance of social and independent living skills by OCD patients remained less than satisfactory even in domains where they improved. In the areas of job and leisure skills, there were significant group-by-time interactions. We concluded that patients with severe OCD and patients with schizophrenia are equally socially impaired. However, OCD patients experience greater significant functional improvement with multimodal treatment.     

Hyposensitivity to foreign protein in schizophrenic patients

Psychiatric Quarterly -     

Comparison of the visually evoked response in drug-free chronic schizophrenic patients and normal controls.

Thirteen cooperative male drug-free chronic schizophrenic patients, and 11 mentally normal male controls were studied. The VER was recorded from scalp leads O1, O2, Oz, C3 and C4 to combined ear reference (A1--A2). The stimulus was an unpatterned flash of single intensity. Compared to normal controls, there were no consistent differences in wave peak latencies or amplitudes for chronic schizophrenics in any brain area tested. When the chronic schizophrenic patients were separated on the basis of high and low tryptophan uptake, using the Frohman--Gottlieb criteria, the high uptake group exhibited normal VERs while in the occipital regions the low tryptophan uptake group exhibited prolonged latencies and an increased amplitude for wave V when compared to normals. From BPRS scores the high tryptophan subgroup indicated a greater degree of psychopathology than the low tryptophan subgroup. The results obtained do not support an indole hallucinogen hypothesis for process schizophrenia.     

Elevated plasma levels of S-100b protein in schizophrenic patients.

BACKGROUND: In this study, we examined the possibility that structural damage to the brain may play a role in the pathogenesis of schizophrenia. METHODS: We compared plasma levels of S-100b protein in 20 patients with schizophrenic psychosis and 20 age- and gender-matched healthy blood donors. Concentrations of S-100 protein were determined by microtiter-based immunofluorometric assay detecting predominantly S-100b. RESULTS: Mean concentrations of S-100b protein in blood were significantly (p < or = .001) higher in schizophrenic patients (0.165 +/- 0.138 microgram/L) compared to control subjects (0.054 +/- 0.031 microgram/L). Levels did not correlate with age of onset or duration of psychosis. CONCLUSIONS: Our findings indicate that patients with schizophrenia may suffer ongoing structural damage to cells of the central nervous system, and that the concentration of S-100b protein in plasma may help to identify clinical subgroups in schizophrenia.     

The determination of bufotenin in urine of schizophrenic patients and normal controls

One-dimensional chromatography, quantification without previous qualitative identification and without adequate separation of the tertiary amine fraction have all contributed to the confusion in regard to the identification and quantification of bufotenin. We have used for the positive identification of bufotenin: (1) DACA; (2) diazotized o-tolidine, and (3) OPT. Of the three, the last was found to be the most sensitive and specific since it combines in one test the qualitative identification, separation by two-dimensional TLC and the quantitative estimation—all in one step. In our opinion in view of the high sensitivity of this method it should prove a useful screening tool for the identification and quantification of bufotenin in urine samples collected over an 8-hr period. In our experience with urine samples of normals, in contrast to those of chronic schizophrenics and acute schizophrenics, no bufotenin was found in the urine of any normals even when the normals were on an MAO inhibitor and L-cysteine loading. When bufotenin was identified in chronic schizophrenics, the levels were found to be between 3 and 5 μg in 24-hr urine samples. On these standards the negative results found in normals are rated as zero.     

Blood serotonin in schizophrenic children. A preliminary study.

Blood serotonin levels were measured in schizophrenic children, all of whom showed manifestations of illness in the first 2 years of life, and controls. Serotonin levels were higher in patients (mean = 0.267 mug/ml) than in controls (mean = 0.218 mug/ml), although the difference did not reach statistical significance. Serotonin levels were significantly higher in patients with florid psychosis and those with lower IQs than in patients in remission or partial remission or higher IQs.     

A comparison of verbal fluency tasks in schizophrenic patients and normal controls

Previous studies have reported significant impairment on verbal fluency tasks (semantic and letter) among schizophrenic subjects. However, the possibility of specific categorical deficits has not been adequately investigated. Nor have the effects of task duration, the stability between testing sessions, and the relationship between intelligence and performance on fluency been thoroughly studied. We performed a series of 3 min fluency tasks (semantic/syntactic and letter) to determine whether duration specific or category-specific differences exist between schizophrenic subjects and normal controls. Each subject was tested at three different times as a means of estimating word pool and assessing the stability of fluency output. Subjects were asked to generate exemplars from each of four semantic/syntactic categories (animals, tools, common nouns and verbs) and three letters (G, E and T). Data from 13 schizophrenic subjects and 15 sex-, age- and pre-morbid-IQ-matched control subjects revealed that patients' overall performance on both the semantic and letter fluency tasks was impaired. While differential impairment on specific semantic categories was noted between groups, no differential effects relating to task duration or testing session were present. Further, by comparing the number of novel words produced in the three testing sessions, we found the groups to be equivalent, a finding we take to suggest that schizophrenic patients' lexicon is intact. Covarying current IQ eliminated the group difference robustly for letter fluency, while only marginally for semantic fluency. Our data revealed the presence of impairment in semantic and letter fluency tasks in schizophrenic patients consistent with previous reports, and also that patients were differentially impaired on semantic categories.     

Prolactin responses to neuroleptics in normal and schizophrenic subjects.

The prolactin response to neuroleptics can serve as an index of dopamine blockade in humans. Plasma prolactin increments to single doses of chlorpromazine, and prolactin decrements to single doses of levodopa, were similar in normal and schizophrenic subjects. Antischizophrenic drugs of all chemical classes stimulated prolactin release,while chemically related drugs and other psychotropic agents ineffective in schizophrenia did not. The prolactin response to neuroleptic therapy occurred in all patients, and tolerance did not develop. Within subjects, prolactin responses were graded according to neuroleptic dose, but the upper limit of sensitivity of the response curve was achieved at doses below the therapeutic range. Relative prolactin-stimulating potency in humans of chlorpromazine, thioridazine, trifluoperazine, butaperazine, and haloperidol correlated well with their relative clinical potencies.