Clinical correlates of the deficit syndrome of schizophrenia
Article Abstract:
Schizophrenia is a psychiatric diagnosis where there is high variation among patients in age at onset, symptoms, treatment response and other factors. There have been attempts to classify different types of schizophrenics by symptoms to improve diagnostic accuracy; one such attempt resulted in the deficit and nondeficit distinction. Deficit symptoms are thought to arise from physiological disease processes that weaken emotional activities involved in volition (making choices). These people are thought to have more negative symptoms that result from an increased degree of neurological impairment or brain pathology. The validity of these hypotheses regarding deficit schizophrenic patients was tested. Thirty-four patients were divided into two groups of 17 with a diagnosis of deficit or nondeficit schizophrenia. This distinction required differentiating between primary, enduring negative symptoms and transient secondary negative symptoms. Each patient was then evaluated for premorbid adjustment and degree of neurological impairment. The premorbid adjustment evaluation assessed social, scholastic, and sexual development at four age periods. They found that in the deficit group, premorbid adjustment was significantly worse in childhood and adolescence, and overall, than the nondeficit group. The deficit group was more impaired on each item from each age group evaluated. The deficit patients were also more neurologically impaired than the nondeficit patients, with significant differences measured on four out of five items tested. These differences were in the area of sensory integration, with no differences revealed in motor coordination. This might indicate neurological dysfunction in the parietal cortex of the brain, which has been suggested by earlier studies. The authors feel that these results support the validity of subgrouping schizophrenics in this way. They suggest that the deficit patients are characterized by a disease process with an onset before adolescence. (Consumer Summary produced by Reliance Medical Information, Inc.)
Publication Name: American Journal of Psychiatry
Subject: Psychology and mental health
ISSN: 0002-953X
Year: 1990
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A dilemma born of progress: switching from clozapine to a newer antipsychotic
Article Abstract:
A case study which discusses issues associated with switching from typical antipsychotics to clozapine is presented. The case study involves a man suffering from schizophrenia who showed improvement after using clozapine for more than a year. Clozapine significantly reduced his negative symptoms and enhanced his cognitive status. The drug enabled the withdrawn and seriously disorganized man to be warm and engaging. He was able to leave a psychiatric shelter and live independently in his own apartment.
Publication Name: American Journal of Psychiatry
Subject: Psychology and mental health
ISSN: 0002-953X
Year: 1999
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