Correlates of risk of suicide in violent and nonviolent psychiatric patients

Article Abstract:

Inwardly-directed and outwardly-directed aggression may have a common underlying basis, as evidenced by research that has found a high correlation between violent behavior and suicidal behavior. Psychological profiles have been done on violent offenders, but they have not generally included a risk assessment for suicide. It is therefore not known if violent people are at increased risk for suicide. Two groups of subjects were studied. The first group, 28 male psychiatric patients in a maximum security prison for violent offenses, was compared with a group of 28 male psychiatric inpatients without a history of violence. The average age of the patients in the two groups was 29 years and 30 years, respectively, and other variables were matched as well. Patients were diagnosed, and risks of violence and suicide were measured, using standard tests. Impulsiveness was measured using an impulsiveness scale, and anxiety and anger were measured. Lack of impulse control, anger, fear, instability, suspiciousness, rebelliousness and anxiety were all factors found to be correlated with risk of suicide. Calmness was negatively correlated with risk of suicide. Interestingly, the violent group showed no correlation between sadness and suicide risk, but the nonviolent group showed a high correlation. This sparked inquiry into the rate of depressive symptoms in the violent group, and a low incidence was found. It is suggested that violent offenders may have inhibited expression of depression and sadness. The overall results show that the risk of suicide in the two groups is sufficiently different to warrant different treatment approaches. Patients in the nonviolent group might be best treated by relieving their depressive symptoms, perhaps by using antidepressant medication. Intervention for patients in the violent group, however, needs to address their underlying impulsiveness and might best be achieved by medications that control behavior and by behavioral techniques. (Consumer Summary produced by Reliance Medical Information, Inc.)

Care and treatment, Mentally ill persons, Risk factors, Suicide, Mentally ill, Violence

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Visual information processing in positive, mixed, and negative schizophrenic syndromes

Article Abstract:

According to T.J. Crow's 1980 theory regarding positive and negative symptoms in schizophrenia, positive symptoms are productive symptoms such as hallucinations or delusions, while negative or deficit symptoms are those such as withdrawal and poor social skills. To shed light on the nature of the fundamental differences between positive and negative symptoms in schizophrenia, 45 men between the ages of 18 and 55 were studied. These men, all schizophrenics, were patients at a state psychiatric facility in New York State. The men were classified into three groups: 15 with the highest positive symptom scores; 15 with the highest negative scores; and 15 in the intermediate range (mixed symptoms). A control group consisted of 15 normal volunteers. All groups were matched for age, ethnicity and marital status. Differences between groups in information processing efficiency were assessed according to three measures: critical stimulus duration (CSD), unmasking interval, and total correct target stimulus detections. The CSD was the minimal time necessary needed to make seven correct identifications of a target stimulus. In the second phase, target stimuli were presented at each subject's previously assessed CSD time. All subjects were assessed on the Cognitive Diagnostic Battery, which is a series of five tests which evaluate the degree of thought disorder in psychiatric patients. Results revealed that all three schizophrenic groups were less efficient information processors than normal subjects. The negative symptom group had significantly longer CSDs, suggesting that the negative syndrome may be linked to more severe cognitive impairment. The patients in this group also demonstrated fewer correct target detections than the positive group. There were no significant differences in rates of improvement over trials between the three symptom groups. No significant differences were found between the positive and mixed groups on any trials. (Consumer Summary produced by Reliance Medical Information, Inc.)

Research, Evaluation, Diagnosis, Testing, Schizophrenia, Cognition disorders, Cognitive disorders, Human information processing, Crow, T. J.

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Significance of cocaine history in schizophrenia

Article Abstract:

In normal subjects, high doses of cocaine have been found to induce acute psychiatric symptoms such as paranoia, hallucinations, agitation, assaultiveness, and severe depression. To explore associations between schizophrenia and cocaine, 51 hospitalized schizophrenic patients were studied. Subjects ranged in age from 19 to 56 years, and 48 were male. All subjects were stabilized on the same medication (chlorpromazine). Subjects were divided into two groups - those with and those without a history of cocaine use. Patients who had used drugs over the past three months, who had major psychiatric disorders or neurological conditions other than schizophrenia, or were mentally retarded, were excluded from the study. Symptoms, depression and overall severity of illness were assessed. Attention deficits were tested and evaluated, and behavioral manifestations during hospitalization were assessed by nursing staff. Results indicated that schizophrenics with a history of cocaine abuse were significantly more depressed, less socialized, and had more memory defects than schizophrenics without such a history. Contrary to expectations, those with a history of cocaine abuse displayed better temporal lobe attention span, were neater in appearance, and had better aggression control. Groups did not differ in severity of illness or in types of schizophrenic symptoms displayed. History of substance abuse was obtained primarily from the patient's themselves and, in most cases, was not substantiated by any other source. There was no urine monitoring for cocaine use during the study. (Consumer Summary produced by Reliance Medical Information, Inc.)

Drug use, Cocaine

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