Remediation of cognitive deficits in schizophrenia

Article Abstract:

Many studies have indicated that functional and structural brain impairments are involved in schizophrenia. In particular, abnormalities in the dorsolateral prefrontal cortex have been associated with schizophrenia, and it has been demonstrated that compared with normal subjects, an increased blood flow in this region of the brain occurs in schizophrenics during the performance of tasks that utilize the region. The Wisconsin Card Sorting Test has been used to measure brain functioning in the dorsolateral prefrontal cortex; the test involves classifying by color, shape, or number simple geometric forms. Results of studies have found that schizophrenics have trouble with this test, and some research has indicated that they cannot be taught to perform this type of task, although other studies have indicated that these patients can be successfully coached to improve their performance. This study investigated 16 schizophrenic patients who were given the Wisconsin Card Sorting Test with standard instructions. Another 12 schizophrenic patients were given the same test, but with special instructions and rehearsal. The subjects in the first group performed poorly on the test; their performance was comparable to that of patients with prefrontal brain damage. In contrast, the second group had a much higher level of performance; scores were close to normal. In addition, the second group continued to score well when subsequent trials were performed on the same day and one day later. These results indicate that schizophrenic patients can benefit from remedial assistance in cognitive performance as measured by the Wisconsin Card Sorting Test. However, the duration of the effect of remedial assistance is not known and the neurological impairments that may be involved are still unclear. The therapeutic usefulness of training schizophrenic patients to improve cognitive processes still requires more research. (Consumer Summary produced by Reliance Medical Information, Inc.)

Psychological aspects, Testing, Cognition, Schizophrenics, Cognition disorders, Cognitive disorders, Cognitive tests

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Cold agglutinin autoantibodies in psychiatric patients: their relation to diagnosis and pharmacological treatment

Article Abstract:

Several investigations have attempted to link aspects of humoral immune function to schizophrenia. Cold agglutinins are autoantibodies primarily related to immunoglobulins (Ig) of the IgM class. Along with IgG, IgM antibodies provide the bulk of specific humoral immunity against bacteria and viruses. High titers (blood concentrations) of cold agglutinins are usually associated with infections. An earlier study found that schizophrenic patients tended to have positive cold agglutinin titers. To further assess this finding, 166 psychiatric patients and 37 healthy volunteers who served as controls were studied. Ninety of the patients were diagnosed with schizophrenia, 54 with manic-depressive disorder, and 22 with major depression. All patients were in good physical condition. None had a history of substance abuse. Venous blood samples were assessed according to the cold agglutinin titration method. Data analysis showed that significantly more schizophrenic patients (42.2 percent) tested positive for cold agglutinin titers than did the manic-depressive patients (11.1 percent), depressed patients (9 percent) or controls (8.1 percent). No differences in cold agglutinin titers were found between subtypes of schizophrenic patients. Although these findings suggest that positive cold agglutinin titers are associated with schizophrenia, it still cannot be assumed that viral or autoimmune factors are implicated, since alterations in the humoral immune systems of patients in the study may have been related to undetected viral or autoimmune processes unrelated to schizophrenia. (Consumer Summary produced by Reliance Medical Information, Inc.)

Measurement, Depression, Mental, Depression (Mood disorder), Immunoglobulins

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Individual differences in serum sodium levels in schizophrenic men with self-induced water intoxication

Article Abstract:

The serum sodium levels of eight hospitalized chronic schizophrenic men with polydipsia (excessive thirst) and recurrent water intoxication were analyzed. Morning sodium values varied greatly among the patients. Afternoon sodium levels were consistently lower than morning levels and had a strong correlation to an increase in body weight. Neither morning or afternoon sodium values correlated with fluid intake. Excessive thirst and daily fluctuations in body weight and serum sodium levels continued in each patient throughout a 12-month observation period. Symptoms of water intoxication were uncommon and appeared to be more related to the degree of decrease in serum sodium levels than the actual sodium value. A 10 percent or greater drop in serum sodium level was accompanied by severe symptoms, such as stupor. Low serum sodium levels which caused symptoms were noted to return to baseline (normal) spontaneously by the following morning without fluid restriction. It is noted that schizophrenic patients with polydipsia adapt to chronic low sodium levels in various ways and no standard sodium level can be ascertained, but rather should be determined on an individual basis. Restricting fluids and supplementing sodium can be either advantageous or dangerous, depending upon the patient's unique adaptation response. The goal of treatment should be to prevent rapid and excessive overhydration, with periodic fluid restriction if body weight increases greater than five to seven percent from the morning baseline.

Care and treatment, Research, Water intoxication, Overhydration, Water-electrolyte imbalances, Fluid-electrolyte imbalance

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