Thought disorder or allusive thinking in the relatives of schizophrenics?

Article Abstract:

Some researchers have concluded that first-degree blood relatives of schizophrenics have an increased rate of thought disorder, a type of cognitive dysfunction. Others believe that the inherited trait is not a thought disorder (an abnormal condition), but a looseness of associations that is also exhibited by some normal persons. Loosening of associations is evident when a person speaks, and is characterized by a sudden shift from one topic to an unrelated topic, while the speaker shows no awareness of the shift. If severe, this can cause the speech to become incoherent. Looseness of associations was later labeled with the term allusive thinking, the presence of which was thought to indicate a genetic predisposition towards schizophrenia. One theory suggested that abstract thinking processes would have to be deficient for a true thought disorder to be present. Yet it has been found that 6 to 12 percent of normal individuals have a significant degree of thought disorder. Some researchers believe that thought disorder occurring in normal persons falls upon a continuum with schizophrenic cognitive disorder. The author reviewed the literature on cognitive function in relatives of schizophrenics and concludes that the most important goal of further research is to determine the cause of looseness of associations in normal subjects. While some researchers are already confident that relatives of schizophrenics have cognitive dysfunction (and thus they want to discover the cause), others are still not convinced that the thinking processes of these relatives differ from those of the normal population. (Consumer Summary produced by Reliance Medical Information, Inc.)

Thought and thinking, Thinking

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Discontinuation of neuroleptic medication in older, outpatient schizophrenics: a placebo-controlled double-blind trial

Article Abstract:

Neuroleptic, or antipsychotic, medications have been proven effective in the treatment of schizophrenia. There is some evidence to suggest that as schizophrenics age, symptoms may naturally decrease in severity, warranting a reduction in medication dose. This information is as yet not usually considered in the long-term maintenance of schizophrenics on neuroleptics. It is also possible that the side effects, such as low blood pressure, may be more prevalent in older schizophrenics, requiring an adjustment in dosage. In a controlled drug study, 35 schizophrenic outpatients aged 52 years or older who were stable on neuroleptic medication were switched to haloperidol, a strong sedative as opposed to a neuroleptic medication. Twelve patients were unable to tolerate the switch and dropped out of the study, and the 23 remaining subjects were randomly assigned to either continued haloperidol therapy or a placebo for six months. Eighteen patients completed the study, of which five of 10 in the placebo group relapsed as compared with one in eight of the haloperidol group. Interestingly, three of the 10 in the placebo group remained stable for the 2.5 years after the study, without medication. Relapse was slow in the subjects who did relapse, and they improved very quickly once started again on neuroleptics. The results of the study generally show that while there are some older schizophrenics who require neuroleptic medications, there are others who do not and may be managed with sedatives. Individual cases should be evaluated on this basis. (Consumer Summary produced by Reliance Medical Information, Inc.)

Methods, Demographic aspects, Clinical trials, Drug therapy, Dosage and administration, Antipsychotic drugs, Antipsychotic agents

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Thought disorder in the relatives of schizophrenics: a meta-analytic review of selected published studies

Article Abstract:

Whether relatives of schizophrenic patients are also likely to suffer from thought disorders has not been determined, although many studies have addressed the issue. Since the issue has relevance for the possible transmission of schizophrenia, researchers performed a type of analysis called 'meta-analysis' of published research findings. This approach calculates the average effect of a variable in all studies in which it has been investigated. Methodological considerations are discussed. Results from 16 studies are briefly summarized. Half found that the relatives of schizophrenics were more thought-disordered than controls, while half found that they were not. Meta-analysis, however, which weights the effect size (that is, the effect of being a relative of a schizophrenic on being thought disordered) by the size of the sample, reveals that, in fact, relatives of schizophrenics are more thought-disordered than controls. That most of the studies included in the analysis were carried out before the advent of modern diagnostic approaches could affect the results. Such a situation exists, however, for all revised psychiatric diagnoses. (Consumer Summary produced by Reliance Medical Information, Inc.)

Research

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