RESUMEN
Response to neuroleptic drug treatment in ten chronic schizophrenic patients with enlarged cerebral ventricles was compared with ten similar patients with normal ventricles. The groups were closely matched for age, age at onset of illness, years of illness and hospitalization, drug dosage, and plasma neuroleptic concentration as measured by radioreceptor assay. Response was significantly worse in the patients with enlarged ventricles. This finding supports the notion that ventricular enlargement is clinically relevant in patients with chronic schizophrenia and that patients with this abnormality may have a biologically different illness than similar patients without it.
Asunto(s)
Ventrículos Cerebrales , Esquizofrenia/tratamiento farmacológico , Adulto , Antipsicóticos/uso terapéutico , Ventriculografía Cerebral , Femenino , Humanos , Masculino , Escalas de Valoración Psiquiátrica , Esquizofrenia/diagnósticoRESUMEN
Plasma prolactin concentrations in 17 drug-free chronic schizophrenic patients correlated inversely with ratings of their psychopathology. An inverse relationship between psychotic symptoms and plasma prolactin concentrations was particularly clear in patients with normal cerebral ventricular size as determined by computed tomography. The psychosis-prolactin relationship did not hold for schizophrenic patients with large ventricular size. These data suggest that the degree of psychosis is related to dopaminergic activity insofar as this is reflected by plasma prolactin concentrations, especially in schizophrenic patients with normal ventricular size. These findings lend further support to the hypothesis that ventricular size is a meaningful factor in subtyping chronic schizophrenic patients.
Asunto(s)
Prolactina/sangre , Esquizofrenia/sangre , Psicología del Esquizofrénico , Adulto , Ventriculografía Cerebral , Enfermedad Crónica , Deluciones/sangre , Deluciones/psicología , Dopamina/metabolismo , Femenino , Alucinaciones/sangre , Alucinaciones/psicología , Humanos , Masculino , Pensamiento/fisiologíaRESUMEN
As a test of the hypothesis that neuroleptics can induce a psychosis secondary to dopamine receptor supersensitivity, we examined the behavioral ratings of 20 symptomatic chronic schizophrenic patients who were withdrawn from neuroleptic drugs and maintained drug free for 4 wk. We hypothesized that, if supersensitivity existed, it might be reflected in a drug-free course characterized by an initial phase of exacerbation followed by improvement (a "hump"). Four patients had such a course. No patient had the inverse of this hypothesized course (improvement followed by relapse). The implications of this finding and problems inherent in testing the supersensitivity psychosis hypothesis are discussed.