The 'basic' symptoms of schizophrenia

Article Abstract:

Based on results of neurologic and psychological studies, the basic symptoms of schizophrenia are thought to be related to impairments in information-processing and to genetically linked biochemical disturbances of the limbic system of the brain, which is largely responsible for motion and memory. Perceptual disturbances seem to be the basis of delusions, while cognitive disturbances are thought to lead to acoustic hallucinations. A data analysis of subjectively experienced complaints and disorders of 450 schizophrenic patients with an average illness duration of 22.4 years demonstrated that negative or deficit symptoms can be divided into several categories. Direct negative symptoms include complaints about physical and mental exhaustion, and decreased resiliency and efficiency. In response to these deficits, patients report that they stop making efforts to continue normal activities. Indirect negative symptoms such as insomnia, tension, obsessional thought patterns and attention deficits are secondary symptoms linked to direct negative symptom-stressors. Patients report that they often become overly sensitive and interpret social interactions as insulting or negative, and that they tend to brood over problems. Both direct and indirect symptoms tend to make patients defensively avoidant and to withdraw socially. A third category involves thought and perceptual disorders. Patients can have intrusive ideas that impinge on cognitive processes or can experience blurred vision or hypersensitivity to visual and acoustic stimuli. The last category involves disturbed bodily sensations (e.g., feeling that a body part is deformed or missing). The data also suggest a more favorable outcome if therapy begins early in the illness. (Consumer Summary produced by Reliance Medical Information, Inc.)

Psychological aspects, Cognition disorders, Cognitive disorders, Human information processing

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Regional brain metabolism during auditory hallucinations in chronic schizophrenia

Article Abstract:

To examine whether auditory hallucinations in schizophrenic patients involve increases in neuronal and metabolic activity of the language systems of the brain, hallucinating and nonhallucinating male schizophrenic patients and a comparison group of 10 normal volunteers were studied. Nine of the patients had persistent hallucinations despite treatment with neuroleptics (antipsychotic drugs). Ten patients had responded to neuroleptics and recovered from hallucinations. All patients were given thorough physical and neuropsychological assessments, with data from the normal volunteers serving as control values. Patients and volunteers underwent positron emission tomography (PET), an imaging technique that can measure differences in the blood supply and metabolism of different areas of the brain by measuring glucose uptake. The two patient groups were shown to be well matched in terms of age, education, neuroleptic use, age of onset of schizophrenia, and intelligence. PET demonstrated that when they were speaking or listening, normal volunteers had higher rates of glucose metabolism than patients did in the left temporal and Broca's regions of the brain - areas shown by prior research to be important in the generation of speech and grammatical structure. Auditory hallucinations were shown to be associated with a pattern of metabolic activity in seven areas of the brain related to language and nonverbal vocal expression, although no single brain region differentiated the hallucinating from nonhallucinating group. This pattern suggests that abnormal glucose metabolism of the anterior cingulate and superior temporal regions of the brain may be involved in auditory hallucination. (Consumer Summary produced by Reliance Medical Information, Inc.)

PET imaging, Positron emission tomography, Glucose metabolism, Hallucinations and illusions, Hallucinations

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A magnetic resonance imaging study of schizophrenia: brain structure and clinical symptoms

Article Abstract:

Historically there has been an ongoing attempt to correlate schizophrenia with diseases that cause structural changes to the brain, and evidence of such a relationship has been found. Magnetic resonance imaging (MRI) is an improvement over the techniques used in the past to visualize the brain and its structures, in that it offers superior resolution and the ability to see areas of the brain that were not possible before. In order to study the brain structures of schizophrenic patients and normal controls and assess the relationship between clinical symptoms and the structures, 31 schizophrenic subjects and 33 controls matched for sex and age completed a series of questionnaires and had MRIs of their brain taken. Questionnaires rated clinical symptoms of a psychiatric nature; a measure of intelligence was included as well. Differences were found in the brain structures of schizophrenics versus controls, suggesting that there are abnormal changes in the brains of schizophrenics. For example, schizophrenics tended to have enlarged ventricles and brain atrophy. There was also a correlation between severity of illness and evidence of structural change; more change was associated with more severe symptoms. Causality was not investigated specifically, but it is suggested that the lack of a correlation between changes and length of illness is evidence that structural changes may precede illness. (Consumer Summary produced by Reliance Medical Information, Inc.)

Analysis, Brain, Magnetic resonance imaging, Schizophrenics

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