- Email: [email protected]
Sertralline as and adjunctive to neuroleptics in chronic schizophrenia
1905
165-1451
1997;42: IS-297S
Subtyplng schlzophrenla-eyelld conditional discrimination learning in schizophrenic patients
K. Dantendorfer. D. Maiertlofer. E. Hofer. M. Serlm. J. Windhaber, H. Katschnlg. Department of Psychiatry. University of Vienna, Austria Introduction: In schizophrenia (SZ) abnormalities in brain morphology and/or function have been described for such different brain areas as the frontal lobes. the temporal lobes. the basal ganglia. the parietal lobes or the corpus callosum. Equally heterogenous have been the neuropsychological deficits found with standardized test batteries. Two of the most difficult to control factors in testing cognitive functions were the influence of patients' motivation and attention on test results. Recent reports suggest. that memory and leamlng deficits seem to be more specific to SZ than preViously accepted. Conditional discrimination leamlng based on eyelid conditioning has been shown to be selectively sensitive In testing temporal lobe function and has the advantage of making minimal demands on attentlonal capacities and motivation. Methods: In our ongoing study, an eyelid conditional discrimination learn• ing task (Daum et al•• Behavioral Neuroscience 1991: 3: 396-408) Is used to examine healthy controls and two groups of SZ patients (DSM·III·R paranoid type SZ with predominant positive symptoms and disorganized type with predominant thought disorders). The occurrence of the first conditioned reo sponse (FCR) and response frequency to reinforced (CRR) and unreinforced trials (CRU) are quantified. Results: 17 controls showed a FCR after 5 ± 2.25 trials as well as a frequency of 32% ± 15.5% CRRs and 14% ± 3% CRUs. Two paranoid type SZ patients tested up to now. showed high rates of CRRs as well as CRUs (CRRlCRU; 23%125% and 29%121%). On the other hand, the two disorganized type patients showed low rates of CRRs and CRUs (CRRlCRU; 2%14% and 40/014%). All four patients had the FCR on unreinforced trials and three of them showed delayed FCRs (trials 9, 14, 17) compared to controls. Conclusions: Our preliminary data suggest, that while paranoid as well as disorganized type schizophrenics show reduced discrimination leamlng capacity, the two subgroups might be differentiated by conditioned response frequencies probably due to differences in temporal lobe functions. Supported by grant no. 5657 JubiiAurnsfonds der Osterr. Nationalbank
165-1461
Poster session m
BIOL. PSYCHIATRY
Simple schizophrenia: Clinical aspects
N. Vicente, B. Rlos. E. Ochoa, H. Diaz. CSM Torre/on de ArrJoz, Madrid, Espa"a Bleuler proposed the subtype simple schizophrenia for the individuals that present fundamental symptoms of schizophrenia but the aocessory symp• toms - hallucinations. delusions and catatonic behavior - are not. The objective 01 this study Is to evaluate the frequency for the diagnosis of simple schizophrenia In psychiatric practice. For that purpose. the authors review all clinical records of patients who were admitted In the Hospital Pslquil1tr1co de Madrid, during the parlod from January 1985 to December 1995. and who had been diagnosed with simple schizophrenia We was collected for all of the Inpatients social and demographic data (age, gender, marital status. level of education. type of living arrangement. occupation and work status). Age at onset of disorder, first manifestations. psychiatric hospitalizations, psychopathological variables, diagnosis according to Bleuler crlterlas, treat• ment administered and clinical state upon release from hospital. Results win be communicated.
165-1471
Sertrallne as an adjunctive to neuroleptic. In chronic schizophrenia M.S. Lee, Y.K. Klm, S.K. Lee, K.W. Suh. Department of Psychiatry, College of Medicine, Korea University, Seoul, Korea
ObJective: To evaluate the dinlcal efficacy of adjuvant sertraJlne treatment In chronic schizophrenic patients, we carried out a double-blind. placebo controlled study. Method: Thirty six Inpatients who fulfilled DSM·III·R criteria for chronic schizophrenia were randomly assigned to sertrallne and placebo groups in • double-blind fashion. The patients received sertrallne 50 mg or placebo for 8 weeks In addition to their routine haloperidol regimen. PANSS. CGI. Simpson-Angus ae were evaluated at 5 points; baseline, 2. 4, 8. and 8 weeks of treatment.
Resulta: The groups were controlled for age. gender, and length or lDness.. There were no significant differences between total PANSS and three PANSS factors (positive. negative, general) scores, CGI, and 5-A scaJe scores lit any point during sertraline and placebo treatment. Conclusion: This placebo controlled study showed no significant eft'ec:a of sertraline on negative and positive symptoms in chronic SChizophi _lie patients.
165-14S
I schizophrenic Impairment of Inhibition of unattended stimuli In patients during selective attention
H. Isono, R. Kanamorl' , A. Iwanami. Y. Okajima, K. Kamijlma. ~ of Psychiatry. Showa University SChool of Medicine, Tokyo, Japan, , Department of Neuropsychiatry. Dokkyo University SChool of MBdicine" Tochigi. Japan Previous researchers have Indicated that schizophrenic patients show en Inability to Ignore irrelevant stimuli when attending to stimun from one designated source. To examine the hypothesis that schizophrenic pabents exhibit the abnormalities of ERPs for unattended stimuli, which may refted an Inability to inhibit irrelevant or unattended stimuli, auditory eventof'8lated potentials (ERPs) were recorded during a dichotic listening task In 1819m1ttecf schizophrenic patients (14 males and 4 females, mean age 32.8 ~) and In 18 age-matched normal controls (15 males and 3 females, mean age 31.8 years). In schizophrenic patients. P300 amplitude for attendel2 target was significantly smaller than that In controls. They also exhibited reduced positive potentials between 200 and 400 rns in ERPs for unattended non·target. These results suggested that schizophrenic patients lack Ihe ability to Inhibit unattended or irrelevant stimuli, in addition to Irnpainnerc d "context closure" In the Information processing.
165-1491
Thought disorder and P300 component of event-related potentials In schizophrenia
Y. Okajlma, H. lsono, A. Iwanami, K. Kamijima Department of ~ Showa University School of Medicine, Tokyo, Japan The relationships between thought disorder and P300 component or 8'VWIt• related potentials (ERPs) In schizophrenia were examined. Methods: Subjects were 19 medicated schizophrenic patients ciagnosed according to DSM·IV criteria (12 males and 7 females. mean age 33.8 years). Thought disorder In these subjects was evaluated ac:cording 10 "Harrow's thought disorder scale", which uses WAIS comprehension lest and the Gortlam proverb test. Auditory ERPs were recorded cIuring the two tasks (a standard oddball task and a novel task). Subjects were ~ to press a button In response to target stimuli. P300 amplitude and 1at8nCy were measured at the most positive peak between 250 and 500 after tl'lI stimulus onset. The P300 at pz for the target stimuli in the oddball task _ defined as P3b. The P300 at Cz for the novel task was defined as P3a. Results: Thought disorder scores on WAIS comprehension test __ well correlated with P3b amplitude. P3b amplitude in patients with thoughI disorder was significantiy smaller than that in patients without thoughI disorder. The two groups did not differ significantly in P3a amplitude.. These results suggested that P3b was associated with the fundamental ~ In schizophrenia.
165-150
I schizophrenia Pyramidal cell orientation In the hippocampus of
Y. Suzuki' , N. Kurokl 2 , A. Iwanaml', S. Irltan1 2 • K. Kase I, K. Ikeda s" K. Kamljima '. ' Department of Psychiatry. Shows University SChool of Medicine, Tokyo, Japan, 2 Tokyo Metropolitan Matsuzawa HospItat. ToII)o. Japan, 3 Tokyo Institute of Psychiatry. Tokyo, Japan Recently, several neuropathological findings concemlng the hillPOCa!Tllus of schizophrenic brains, suggesting temporal lobe dysfunction, have been reported. Most of these studies revealed an absence of gliosis, and haYe been interpreted as an evidence that schlzophrenta is a neu~ rather than a neurodegenerative disorder. in the present study, ~ cell orientation and density of the hippocampus were examined In 16 schizophrenic patients and 11 normal controls. Approximately 50 ~ cells were analyzed In each portion of the hippocampus (eA1"'-CA4) ~ each SUbject. Pyramidal cells were computed using a Illicrclc:onllu. No significant difference was found in pyramidal cell density In the hi~ between SChizophrenics and controls. but. a significant difference was kuld
165-1451
1997;42: IS-297S
Subtyplng schlzophrenla-eyelld conditional discrimination learning in schizophrenic patients
K. Dantendorfer. D. Maiertlofer. E. Hofer. M. Serlm. J. Windhaber, H. Katschnlg. Department of Psychiatry. University of Vienna, Austria Introduction: In schizophrenia (SZ) abnormalities in brain morphology and/or function have been described for such different brain areas as the frontal lobes. the temporal lobes. the basal ganglia. the parietal lobes or the corpus callosum. Equally heterogenous have been the neuropsychological deficits found with standardized test batteries. Two of the most difficult to control factors in testing cognitive functions were the influence of patients' motivation and attention on test results. Recent reports suggest. that memory and leamlng deficits seem to be more specific to SZ than preViously accepted. Conditional discrimination leamlng based on eyelid conditioning has been shown to be selectively sensitive In testing temporal lobe function and has the advantage of making minimal demands on attentlonal capacities and motivation. Methods: In our ongoing study, an eyelid conditional discrimination learn• ing task (Daum et al•• Behavioral Neuroscience 1991: 3: 396-408) Is used to examine healthy controls and two groups of SZ patients (DSM·III·R paranoid type SZ with predominant positive symptoms and disorganized type with predominant thought disorders). The occurrence of the first conditioned reo sponse (FCR) and response frequency to reinforced (CRR) and unreinforced trials (CRU) are quantified. Results: 17 controls showed a FCR after 5 ± 2.25 trials as well as a frequency of 32% ± 15.5% CRRs and 14% ± 3% CRUs. Two paranoid type SZ patients tested up to now. showed high rates of CRRs as well as CRUs (CRRlCRU; 23%125% and 29%121%). On the other hand, the two disorganized type patients showed low rates of CRRs and CRUs (CRRlCRU; 2%14% and 40/014%). All four patients had the FCR on unreinforced trials and three of them showed delayed FCRs (trials 9, 14, 17) compared to controls. Conclusions: Our preliminary data suggest, that while paranoid as well as disorganized type schizophrenics show reduced discrimination leamlng capacity, the two subgroups might be differentiated by conditioned response frequencies probably due to differences in temporal lobe functions. Supported by grant no. 5657 JubiiAurnsfonds der Osterr. Nationalbank
165-1461
Poster session m
BIOL. PSYCHIATRY
Simple schizophrenia: Clinical aspects
N. Vicente, B. Rlos. E. Ochoa, H. Diaz. CSM Torre/on de ArrJoz, Madrid, Espa"a Bleuler proposed the subtype simple schizophrenia for the individuals that present fundamental symptoms of schizophrenia but the aocessory symp• toms - hallucinations. delusions and catatonic behavior - are not. The objective 01 this study Is to evaluate the frequency for the diagnosis of simple schizophrenia In psychiatric practice. For that purpose. the authors review all clinical records of patients who were admitted In the Hospital Pslquil1tr1co de Madrid, during the parlod from January 1985 to December 1995. and who had been diagnosed with simple schizophrenia We was collected for all of the Inpatients social and demographic data (age, gender, marital status. level of education. type of living arrangement. occupation and work status). Age at onset of disorder, first manifestations. psychiatric hospitalizations, psychopathological variables, diagnosis according to Bleuler crlterlas, treat• ment administered and clinical state upon release from hospital. Results win be communicated.
165-1471
Sertrallne as an adjunctive to neuroleptic. In chronic schizophrenia M.S. Lee, Y.K. Klm, S.K. Lee, K.W. Suh. Department of Psychiatry, College of Medicine, Korea University, Seoul, Korea
ObJective: To evaluate the dinlcal efficacy of adjuvant sertraJlne treatment In chronic schizophrenic patients, we carried out a double-blind. placebo controlled study. Method: Thirty six Inpatients who fulfilled DSM·III·R criteria for chronic schizophrenia were randomly assigned to sertrallne and placebo groups in • double-blind fashion. The patients received sertrallne 50 mg or placebo for 8 weeks In addition to their routine haloperidol regimen. PANSS. CGI. Simpson-Angus ae were evaluated at 5 points; baseline, 2. 4, 8. and 8 weeks of treatment.
Resulta: The groups were controlled for age. gender, and length or lDness.. There were no significant differences between total PANSS and three PANSS factors (positive. negative, general) scores, CGI, and 5-A scaJe scores lit any point during sertraline and placebo treatment. Conclusion: This placebo controlled study showed no significant eft'ec:a of sertraline on negative and positive symptoms in chronic SChizophi _lie patients.
165-14S
I schizophrenic Impairment of Inhibition of unattended stimuli In patients during selective attention
H. Isono, R. Kanamorl' , A. Iwanami. Y. Okajima, K. Kamijlma. ~ of Psychiatry. Showa University SChool of Medicine, Tokyo, Japan, , Department of Neuropsychiatry. Dokkyo University SChool of MBdicine" Tochigi. Japan Previous researchers have Indicated that schizophrenic patients show en Inability to Ignore irrelevant stimuli when attending to stimun from one designated source. To examine the hypothesis that schizophrenic pabents exhibit the abnormalities of ERPs for unattended stimuli, which may refted an Inability to inhibit irrelevant or unattended stimuli, auditory eventof'8lated potentials (ERPs) were recorded during a dichotic listening task In 1819m1ttecf schizophrenic patients (14 males and 4 females, mean age 32.8 ~) and In 18 age-matched normal controls (15 males and 3 females, mean age 31.8 years). In schizophrenic patients. P300 amplitude for attendel2 target was significantly smaller than that In controls. They also exhibited reduced positive potentials between 200 and 400 rns in ERPs for unattended non·target. These results suggested that schizophrenic patients lack Ihe ability to Inhibit unattended or irrelevant stimuli, in addition to Irnpainnerc d "context closure" In the Information processing.
165-1491
Thought disorder and P300 component of event-related potentials In schizophrenia
Y. Okajlma, H. lsono, A. Iwanami, K. Kamijima Department of ~ Showa University School of Medicine, Tokyo, Japan The relationships between thought disorder and P300 component or 8'VWIt• related potentials (ERPs) In schizophrenia were examined. Methods: Subjects were 19 medicated schizophrenic patients ciagnosed according to DSM·IV criteria (12 males and 7 females. mean age 33.8 years). Thought disorder In these subjects was evaluated ac:cording 10 "Harrow's thought disorder scale", which uses WAIS comprehension lest and the Gortlam proverb test. Auditory ERPs were recorded cIuring the two tasks (a standard oddball task and a novel task). Subjects were ~ to press a button In response to target stimuli. P300 amplitude and 1at8nCy were measured at the most positive peak between 250 and 500 after tl'lI stimulus onset. The P300 at pz for the target stimuli in the oddball task _ defined as P3b. The P300 at Cz for the novel task was defined as P3a. Results: Thought disorder scores on WAIS comprehension test __ well correlated with P3b amplitude. P3b amplitude in patients with thoughI disorder was significantiy smaller than that in patients without thoughI disorder. The two groups did not differ significantly in P3a amplitude.. These results suggested that P3b was associated with the fundamental ~ In schizophrenia.
165-150
I schizophrenia Pyramidal cell orientation In the hippocampus of
Y. Suzuki' , N. Kurokl 2 , A. Iwanaml', S. Irltan1 2 • K. Kase I, K. Ikeda s" K. Kamljima '. ' Department of Psychiatry. Shows University SChool of Medicine, Tokyo, Japan, 2 Tokyo Metropolitan Matsuzawa HospItat. ToII)o. Japan, 3 Tokyo Institute of Psychiatry. Tokyo, Japan Recently, several neuropathological findings concemlng the hillPOCa!Tllus of schizophrenic brains, suggesting temporal lobe dysfunction, have been reported. Most of these studies revealed an absence of gliosis, and haYe been interpreted as an evidence that schlzophrenta is a neu~ rather than a neurodegenerative disorder. in the present study, ~ cell orientation and density of the hippocampus were examined In 16 schizophrenic patients and 11 normal controls. Approximately 50 ~ cells were analyzed In each portion of the hippocampus (eA1"'-CA4) ~ each SUbject. Pyramidal cells were computed using a Illicrclc:onllu. No significant difference was found in pyramidal cell density In the hi~ between SChizophrenics and controls. but. a significant difference was kuld