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Reversibility of neuropsychological dysfunction in schizophrenia
BIOL PSYCHIATRY 1992,31:61A-252A
86A
56
Longitudinal Course and Treatment Outcome
OUTCOME OF CLOZAPINE TREATMENT AT ONE YEAR IN A STATE HOSPITAL: A CLINICAL REVIEW William H. Wilson Oregon Health Sciences University, Portland, OR 97201. We will report on 40 consecutive patients who began clinical treatment with clozapine at a state hospital in Oregon. The medical records will be reviewed for ! year preceding and 1 year following the initiation of clozapine treatment. Areas to be reviewed include (1) demographics and treatment history, (2) clozapine dose and concurrent medications; (3) adverse drug reactions and side effects, and (4) indications of treatment response such as discharge, hospital privilege level, seclusion and restraint, violent episodes, and community passes. Such a review allows comparison of outcome in a routine public facility with previously reported controlled studies.
57
REVERSIBILITY OF NEUROPSYCHOLOGICAL DYSFUNCTION IN SCHIZOPHRENIA Lauren M. Tompkins, Robe~ S. Goldman, Bradley N. Axelrod, Rajiv Tandon Ann Arbor VA Medical Center and Schizophrenia Program, The University of Michigan, Ann Arbor, MI 48109-0840. Though the presence of neuropsychological deficits in schizophrenia is well established, little is known regarding the potential for remediation of these deficits. Twenty-four schizophrenic (DSM-III-R) and 24 psychiatric controls (DSM-III-R bipolar and major depressive dism~lers), matched for age and intellectual level, were randomly assigned to one of two conditions. In the experimental condition, subjects received instructional cues on measures of executive function (Wisconsin Card Sorting Test), visual-spatial function, memory, and sequencing. The instructional paradigm consisted of providing an organizational schema to facilitate processing of task stimuli across cognilivt: domains. The control condition recuived stand:lrd administration of the neuropsychological tasks, without cues. The findings revealed that schizophrenics who received instructional cueing showed significantly better performance on a number of Wisconsin Card Sorting Test indices (F (I,44) = 14.82, p < 0.01) and the visual-spatial memory task iF (I,44) -- 10.57, p < 0.01). Schizophrenics and affcctives that received cueing also demonstrated nonsignificant trends of improvement on all other neuropsychological measures. The finding that neuropsychological dysfunction in schizophrenia is modiliable with relatively little intervention suggests that schizophrenics may hck selfmonitoring functions necessary to perform diverse cognitive tasks. The results are consistent with recent theories concerniag the role of frontal-striatal and limbic system interactions as mediating cognitive dysfunction in schizophrenia.
58
THE LONGITUDINAL COURSE OF AFFECTIVE ILLNESS: MATHEMATICAL MODELS INVOLVING CHAOS THEORY Mark S. George, Mark Jones, Robert M. Post, Kristin Mikaluskas, Gabriele Leverich NIMH, Bethesda, MD 20817. The past decade has seen the development of the mathematical field of chaos, which allows one to model and understand appar~;ntly orderly systems that do not follow simple linear models. Since Kraepelin's day, clinicians have struggled to better understand and more rigorously describe the life courses of affectively ill individuals. We have further developed a chaos-derived mathematical formula that models the varying life phases of recurrent mood disorders. We have expanded upon the ideas of Bauer and Whybrow who introduced the ~'ormula X,, = rx(I - x) for modeling the life-course of affective illness. In this model,
86A
56
Longitudinal Course and Treatment Outcome
OUTCOME OF CLOZAPINE TREATMENT AT ONE YEAR IN A STATE HOSPITAL: A CLINICAL REVIEW William H. Wilson Oregon Health Sciences University, Portland, OR 97201. We will report on 40 consecutive patients who began clinical treatment with clozapine at a state hospital in Oregon. The medical records will be reviewed for ! year preceding and 1 year following the initiation of clozapine treatment. Areas to be reviewed include (1) demographics and treatment history, (2) clozapine dose and concurrent medications; (3) adverse drug reactions and side effects, and (4) indications of treatment response such as discharge, hospital privilege level, seclusion and restraint, violent episodes, and community passes. Such a review allows comparison of outcome in a routine public facility with previously reported controlled studies.
57
REVERSIBILITY OF NEUROPSYCHOLOGICAL DYSFUNCTION IN SCHIZOPHRENIA Lauren M. Tompkins, Robe~ S. Goldman, Bradley N. Axelrod, Rajiv Tandon Ann Arbor VA Medical Center and Schizophrenia Program, The University of Michigan, Ann Arbor, MI 48109-0840. Though the presence of neuropsychological deficits in schizophrenia is well established, little is known regarding the potential for remediation of these deficits. Twenty-four schizophrenic (DSM-III-R) and 24 psychiatric controls (DSM-III-R bipolar and major depressive dism~lers), matched for age and intellectual level, were randomly assigned to one of two conditions. In the experimental condition, subjects received instructional cues on measures of executive function (Wisconsin Card Sorting Test), visual-spatial function, memory, and sequencing. The instructional paradigm consisted of providing an organizational schema to facilitate processing of task stimuli across cognilivt: domains. The control condition recuived stand:lrd administration of the neuropsychological tasks, without cues. The findings revealed that schizophrenics who received instructional cueing showed significantly better performance on a number of Wisconsin Card Sorting Test indices (F (I,44) = 14.82, p < 0.01) and the visual-spatial memory task iF (I,44) -- 10.57, p < 0.01). Schizophrenics and affcctives that received cueing also demonstrated nonsignificant trends of improvement on all other neuropsychological measures. The finding that neuropsychological dysfunction in schizophrenia is modiliable with relatively little intervention suggests that schizophrenics may hck selfmonitoring functions necessary to perform diverse cognitive tasks. The results are consistent with recent theories concerniag the role of frontal-striatal and limbic system interactions as mediating cognitive dysfunction in schizophrenia.
58
THE LONGITUDINAL COURSE OF AFFECTIVE ILLNESS: MATHEMATICAL MODELS INVOLVING CHAOS THEORY Mark S. George, Mark Jones, Robert M. Post, Kristin Mikaluskas, Gabriele Leverich NIMH, Bethesda, MD 20817. The past decade has seen the development of the mathematical field of chaos, which allows one to model and understand appar~;ntly orderly systems that do not follow simple linear models. Since Kraepelin's day, clinicians have struggled to better understand and more rigorously describe the life courses of affectively ill individuals. We have further developed a chaos-derived mathematical formula that models the varying life phases of recurrent mood disorders. We have expanded upon the ideas of Bauer and Whybrow who introduced the ~'ormula X,, = rx(I - x) for modeling the life-course of affective illness. In this model,