Predicting outcome in schizoaffective psychosis

Article Abstract:

To better evaluate the prognosis for psychiatric patients with the diagnosis of schizoaffective (SA) psychosis, a condition that includes both schizophrenia and an affective (emotional) disorder, investigators conducted a retrospective study of 68 patients discharged from one psychiatric facility during a 25-year period. Interviews were carried out primarily by telephone with former patients (62 percent) or their significant others. The follow-up study was carried out an average of 15 years after discharge. The variable that measured outcome was ''sum'' global functioning since the time of discharge, formed by rating subsequent hospitalizations, social and work functioning, and the prevalence of symptoms since discharge. This information constituted the basis for rediagnosis based on the criteria of DSM-III (Diagnostic and Statistical Manual, third edition): using these standards, 19 patients were schizoaffective manic, 33 were schizoaffective depressed, and 16 were schizoaffective bipolar. Results showed that, while no variable was a strong predictor of the outcome of SA, people with more skills prior to their first hospitalization were functioning better than those with fewer skills. Factors that predicted poorer outcome were the presence of bizarre delusions, concreteness (impaired ability to think abstractly), and inappropriate affect. The results imply that SA may be a composite of psychiatric disorders that lies somewhere between schizophrenia and the mood disorders. Patients with more of the schizophrenic component have a more chronic disorder. (Consumer Summary produced by Reliance Medical Information, Inc.)

Prognosis, Identification and classification

---

Multiple versus single antipsychotic drug treatment in chronic psychosis

Article Abstract:

When antipsychotic drugs were first introduced over 30 years ago, several types were often prescribed for each patient. However, it is now considered preferable to use only one antipsychotic medication, rather than a combination. Patients who have been treated with a combination regimen for years may not actually derive any benefit from the additional drug or drugs. This study evaluated 14 inpatients at a state mental hospital who were suffering from chronic, steady-state psychosis (12 had schizophrenia and two had schizoaffective disorders). They had been hospitalized for an average of five years and had been psychotic for at least 10 years; the average age was 36. The patients took part in a one-year clinical trial in which one of their two antipsychotic medications was discontinued; this was achieved by tapering the dose very gradually, while monitoring behavior. Six of the 14 subjects were successfully switched to one drug without clinical deterioration (and also without improvement, they simply remained the same), while the other eight subjects showed a marked clinical decline while receiving only one drug. The latter were returned to the original drug combination. It is concluded that each patient should be evaluated individually and carefully regarding the number of antipsychotics used for treatment, and that some patients cannot be successfully maintained on only one antipsychotic medication. (Consumer Summary produced by Reliance Medical Information, Inc.)

Drug therapy, Dosage and administration, Psychoses, Psychotic disorders

---

Recurrence of puerperal psychosis not prevented by prophylactic progesterone administration

Article Abstract:

Puerperal psychosis (psychosis associated with childbirth) occurs with a much higher incidence in subsequent pregnancies than in the first one, so prevention is a high priority. Progesterone (a female hormone) has been suggested as a prophylactic agent against this disorder, but it cannot be recommended with confidence. The case history is provided of a psychologically stable woman who became psychotic after the birth of her first child, and was treated with chlorpromazine, a tranquilizer. Just before the delivery of her second child, she began treatment with progesterone; however, psychosis recurred. During her third pregnancy, the patient sought advice regarding prevention of another psychotic episode. Therapy with thioridazine (an antipsychotic drug) began soon after delivery and continued for four months. Psychosis was prevented. The possible effects of drugs upon puerperal psychosis are briefly discussed. Neuroleptic drugs, which are commonly used to treat psychoses, act on systems in the brain that contain dopamine (a neurotransmitter); such an approach may also be appropriate for the prevention of this type of psychosis. (Consumer Summary produced by Reliance Medical Information, Inc.)

Case studies, Prevention, Puerperal psychoses, Thioridazine

Similar abstracts:

• Abstracts: Anger and hostility in depression. Evidence for a menstrual-linked artifact in determining rates of depression
• Abstracts: Prediction of adult-onset schizophrenia from childhood home movies of the patients. Sex differences in olfactory function in schizophrenia
• Abstracts: Remediation of cognitive deficits in schizophrenia. Cold agglutinin autoantibodies in psychiatric patients: their relation to diagnosis and pharmacological treatment
• Abstracts: The evolution of the self-psychological approach to depression. Anti-psychoanalytic cultural forces in the development of western civilization
• Abstracts: Comparison of successful, unsuccessful, and relapsed Vietnam veterans treated for posttraumatic stress disorder

This website is not affiliated with document authors or copyright owners. This page is provided for informational purposes only. Unintentional errors are possible.