RESUMO
OBJECTIVE: To identify differences in electroencephalographic parameters in schizophrenia patients with and without a history of suicide attempts. MATERIAL AND METHODS: Eighty-seven inpatients (50 men and 37 women) with paranoid schizophrenia were examined. Suicidal attempts in the anamnesis of patients were verified by a psychiatrist on the basis of clinical interviewing. The severity of psychopathological symptoms was assessed using The Positive and Negative Syndrome Scale (PANSS) based on a five-factor model. Electroencephalogram (EEG) parameters were recorded and evaluated using a 16-channel encephalograph. A clinical and quantitative analysis of the recordings was carried out with the calculation of absolute spectral power indicators for theta, alpha and beta rhythms, as well as the severity of the activation reaction (Berger effect). RESULTS: Significantly higher rates of the PANSS depression factor were revealed in patients with a history of suicide attempts (p=0.016). Clinical analysis of EEG changes did not reveal any significant differences between the groups (p>0.05). The spectral analysis of the EEG showed significant differences only in the spectral power of the beta rhythm in the central (p=0.048) and occipital (p=0.021) leads with closed eyes, which was lower in the group with a history of suicide attempts. The degree of alpha rhythm depression in the occipital leads was also significantly lower in this group (p=0.016). The regression analysis showed that significant correlates of suicidal attempts in patients with paranoid schizophrenia are the PANSS depressive factor (t=2.784; p=0.016) and a deficiency in the activation response to EEG (t=-2.035; p=0.045). CONCLUSION: The results complement previous studies on the relationship between suicidal attempts, clinical symptoms and neurophysiological features of the functioning of the brain of patients with paranoid schizophrenia.
Assuntos
Eletroencefalografia , Esquizofrenia Paranoide , Tentativa de Suicídio , Humanos , Masculino , Feminino , Esquizofrenia Paranoide/fisiopatologia , Adulto , Pessoa de Meia-Idade , Adulto Jovem , Ritmo betaRESUMO
OBJECTIVE: To establish the relationships of functional changes of the brain of patients with schizophrenia with clinical manifestations of the disease and their constitutional and morphological features. MATERIAL AND METHODS: One hundred and eighteen patients with schizophrenia (64 men and 54 women), aged 33 [29; 40], years were examined. The following clinical and dynamic parameters were used: age of manifestation of the disease, duration of the disease, severity of clinical and psychopathological symptoms according to the PANSS. The anthropometric examination of patients was carried out according to V.V. Bunak's method in V.P. Chitetsov's modification for adult samples with calculation of Rees-Eysenk and Tanner indices. The EEG was recorded and analyzed in a state of calm, relaxed wakefulness with closed eyes with the calculation of the absolute spectral power for theta (4-7 Hz), alpha (8-13 Hz) and beta (14-30 Hz) rhythms. RESULTS: Significant (p<0.05) direct correlations between the age of the disease manifestation and the spectral power of the beta rhythm in the frontal leads (Fp1, Fp2, F3 and F4) were revealed. Inverse correlations (p<0.05) were found between the duration of the disease in patients with schizophrenia and the spectral power of the alpha rhythm in the left temporal (T3) and right central leads (C4), the spectral power of the beta rhythm in the parietal-occipital (P3, P4, O1,O2) and temporal leads (T3, T4, T5), the spectral power of the theta rhythm in the left occipital (O1) and posterior temporal leads (T5). Significant inverse correlations were also found between the Tanner index and the spectral power of the alpha rhythm in the frontal and temporal leads, between the Rees-Eysenk index and the spectral power of the theta rhythm in the frontal leads. CONCLUSION: The results indicate the presence of the conjugation of functional changes in the brain of patients with schizophrenia with clinical manifestations of the disease and their constitutional and morphological features. Thus, the assessment of the functional state of the central nervous system in patients with schizophrenia is an important component of the diagnostic search.
Assuntos
Eletroencefalografia , Esquizofrenia , Adulto , Masculino , Humanos , Feminino , Eletroencefalografia/métodos , Esquizofrenia/diagnóstico , Encéfalo/diagnóstico por imagem , Ritmo Teta , Ritmo alfaRESUMO
OBJECTIVE: To study the relationship between the individual components of the metabolic syndrome and cognitive dysfunction in patients with schizophrenia. MATERIAL AND METHODS: A total of 133 patients with schizophrenia were examined. To assess cognitive functioning, the Brief Assessment of Cognition in Schizophrenia (BACS) was used. The components of the metabolic syndrome were determined in accordance with the criteria of the International Diabetes Federation. RESULTS: Hyperglycemia in patients with schizophrenia led to a decrease in cognitive functioning in two domains: verbal fluency (ß=-10.67; p=0.019) and attention stability (ß=-9.519; p=0.043). Abdominal obesity was associated with lower indicators of executive functions (ß=-8.856; p=0.026). CONCLUSION: It is assumed that drug treatment of some components of the metabolic syndrome may affect cognitive functions in patients with schizophrenia.
Assuntos
Transtornos Cognitivos , Disfunção Cognitiva , Síndrome Metabólica , Esquizofrenia , Humanos , Esquizofrenia/complicações , Esquizofrenia/tratamento farmacológico , Síndrome Metabólica/complicações , Transtornos Cognitivos/diagnóstico , Transtornos Cognitivos/etiologia , Transtornos Cognitivos/psicologia , Testes Neuropsicológicos , Disfunção Cognitiva/etiologia , CogniçãoRESUMO
The dopamine, serotonin and glutamate systems are jointly involved in the pathogenesis and pharmacotherapy of schizophrenia. We formulated a hypothesis that polymorphic variants of the GRIN2A, GRM3, and GRM7 genes may be associated with the development of hyperprolactinemia in patients with schizophrenia taking conventional and atypical antipsychotics as basic treatment. 432 Caucasian patients diagnosed with schizophrenia were examined. DNA was isolated from peripheral blood leukocytes using the standard phenol-chloroform method. For pilot genotyping, 12 SNPs in the GRIN2A gene, 4 SNPs in the GRM3 gene, and 6 SNPs in the GRM7 gene were selected. Allelic variants of the studied polymorphisms were determined by real-time PCR. The level of prolactin was determined by enzyme immunoassay. Among persons taking conventional antipsychotics, there were statistically significant differences in the distribution of genotype and allele frequencies in groups of patients with normal and elevated prolactin levels for the GRIN2A rs9989388 and GRIN2A rs7192557 polymorphic variants, as well as differences in serum prolactin levels depending on the genotype of the GRM7 rs3749380 polymorphic variant. Among persons taking atypical antipsychotics, statistically significant differences were found in the frequencies of genotypes and alleles of the GRM3 rs6465084 polymorphic variant. An association of polymorphic variants of the GRIN2A, GRM3, and GRM7 genes with the development of hyperprolactinemia in patients with schizophrenia taking conventional and atypical antipsychotics has been established for the first time. The identified associations of polymorphic variants of the GRIN2A, GRM3 and GRM7 genes with the development of hyperprolactinemia in patients with schizophrenia taking conventional and atypical antipsychotics have been established for the first time. These associations not only confirm the close connection of the dopaminergic, serotonergic, and glutamatergic systems in the development of schizophrenia, but also demonstrate the potential of taking into account the genetic component during therapy.
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Antipsicóticos , Hiperprolactinemia , Esquizofrenia , Humanos , Antipsicóticos/efeitos adversos , Dopamina , Hiperprolactinemia/induzido quimicamente , Hiperprolactinemia/genética , Hiperprolactinemia/tratamento farmacológico , Polimorfismo de Nucleotídeo Único , Prolactina/genética , Prolactina/uso terapêutico , Esquizofrenia/tratamento farmacológico , Esquizofrenia/genéticaRESUMO
The authors compared the efficacy of unilateral electroconvulsive therapy in schizophrenia in relation to the leading syndrome and the place of electrode application. In controlling the affective and catatonic syndromes the best effect was achieved when the electrodes were applied to the non-dominant hemisphere. In delirious, hallucinatory-delirious and hallucinatory syndromes, the maximal effect was achieved by the application of electrodes to the dominant hemisphere. The relationship between the effect of local electroconvulsive therapy and the semiotics of the syndromes allows making the most rational use of unilateral electroconvulsive therapy in the differential treatment of schizophrenia.
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Eletroconvulsoterapia/métodos , Esquizofrenia/terapia , Adulto , Automatismo/terapia , Delusões/terapia , Dominância Cerebral , Feminino , Alucinações/terapia , Humanos , Masculino , Esquizofrenia Catatônica/terapia , Esquizofrenia Paranoide/terapia , SíndromeRESUMO
On the basis of comparing the clinical forms of schizophrenia in 132 "parents--children" pairs and 104 pairs of sibs (of 200 families with aggravated heredity) the authors have shown that the discordance phenomenon is associated with the characteristics of the catatonic and simple forms of schizophrenia and the periodic and paroxysmal course of the process, the facts, that prove the phylogenetic connection of the forms and types of the schizophrenia course. The discordance data are in agreement with a chronological random analysis of the schizophrenia diagnoses (with regard to the forms of the disease and the type of its course) made in 1961 to 1976 The diminution of the number of patients with the paroxysmal course of the process and with the catatonic form observed in the last years can be understood from the standpoint of the evolutionary-genetic hypothesis of schizophrenia.
Assuntos
Esquizofrenia/genética , Adolescente , Adulto , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Esquizofrenia Catatônica/genética , Esquizofrenia Hebefrênica/genética , Esquizofrenia Paranoide/genéticaRESUMO
A study of the clinical concordancy in 410 schizophrenic patients (sibs and parents -- children) detected the most frequent coinciding traits of the disease in the sibs and parent -- children pairs. The following traits were attributed to the coinciding features: premorbid schizoid personality traits, a short initial period, a pseudopsychopath syndrome in the initial period, paranoid manifest symptomatology, paranoid form of schizophrenia, a continuous progressive development of the process, apathico-abulic defect symptomatology. It was demonstrated that the variance of traits in the clinical picture of schizophrenia in hereditary loaded families is subjected to the impact of such factors as sex, age, supplementary hereditary loading by psychoses, exogenous factors.
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Esquizofrenia/genética , Adulto , Fatores Etários , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Personalidade , Remissão Espontânea , Esquizofrenia Catatônica/genética , Esquizofrenia Hebefrênica/genética , Esquizofrenia Paranoide/genética , Fatores Sexuais , SíndromeRESUMO
Peculiarities of the clinical picture of schizophrenia were studied in a group of patients in which less than a half (785) patients had the aggravating fact and in two hereditary-aggravated groups: siblings (109 patients) and parents--children (118 pairs). Prognostic significance of the genetic factor, sex and age was studied as related to peculiarities of the clinical picture of schizophrenia. Hereditary aggravation is shown to be of a decisive importance for schizophrenia prognosis.