Background: A subset of patients with schizophrenia, defined on the basis of longitudinal deficits in self-care, may show a classic ("Kraepelinian") degenerative course. An independent validator of the phenomenologically defined Kraepelinian subtype might be provided by a structural indicator of possible brain degeneration: ventricular size as measured by computed tomography (CT).
Methods: To examine whether Kraepelinian patients would show a differential increase in ventricular size over time, two CT scans were conducted at intervals separated by > 4 years, an average of 5 years. Fifty-three male patients with DSM-III-R diagnoses of chronic schizophrenia were subdivided into Kraepelinian (n = 22; mean age = 42 +/- 6 years) and non-Kraepelinian (n = 31; mean age = 38 +/- 12.2 years) subgroups. Kraepelinian patients were defined on the basis of longitudinal criteria: > 5 years of complete dependence on others for life necessities and care, lack of employment, and sustained symptomatology. Thirteen normal elderly volunteers (mean age = 60 +/- 17.8) were also scanned at 4-year intervals. CT measurements were made by raters without knowledge of subgroup membership. A semiautomated computer program was used to trace the anterior horn, lateral ventricles, and temporal horns for each slice level on which they were clearly seen.
Results: The ventricles showed a bilateral increase in size over the 4-year interval in the Kraepelinian subgroup, more marked in the left hemisphere than the right. By contrast, neither the non-Kraepelinian subgroup nor the normal volunteers showed significant CT changes from scan 1 to scan 2.
Conclusions: Thus, the longitudinal dysfunctions in self-care that characterize the Kraepelinian patients were associated with an independent indicator of brain abnormality.
Download full-text PDF |
Source |
|---|---|
| http://dx.doi.org/10.1016/s0006-3223(97)00553-2 | DOI Listing |
Publication Analysis
Top Keywords
Similar Publications
Revisiting Rorschach test and Minnesota Multiphasic Personality Inventory-II patterns in Kraepelinian vs. DSM-wise Schizophrenia: How They Differ and What It Means for Diagnosis.
Sci Prog
July 2024
Department of Psychiatry, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea.
Objective: This retrospective chart review study aimed to investigate the differences in the Rorschach test and Minnesota Multiphasic Personality Inventory (MMPI)-II profiles among patients with Kraepelinian schizophrenia, those with DSM-wise schizophrenia, and controls. Kraepelinian schizophrenia is characterised by a chronic, deteriorative disease course and a predominance of negative symptoms.
Methods: Patients with Kraepelinian schizophrenia were selected based on medical record reviews.
[Application of the Trail Making Test in the schizophrenia research].
Neuropsychopharmacol Hung
June 2024
Nyírő Gyula Országos Pszichiátriai és Addiktológiai Intézet, Pázmány Péter Katolikus Egyetem Pszichológiai Intézet.
Even the Kraepelinian concept of dementia praecox suggests a link between schizophrenia and various cognitive deficits. Although cognitive impairment is not a fundamental symptom of schizophrenia, it is considered to be one of the basic features of the disease. The deficit can affect a number of cognitive domains and is most often specific.
View Article and Find Full Text PDFTracing the Roots of Dementia Praecox: Charles Lasègue and his 1852 Essay "Du Délire De Persécutions" (On Persecutory Delusions).
Schizophr Bull
September 2023
Psychiatry Department, Virginia Commonwealth University, Richmond, VA 980126, USA.
While the evolution of our modern concepts of mania and melancholia over the 19th century is relatively well-understood, no such clear narrative exists for the nonaffective psychotic syndromes that culminated in Kraepelin's concept of dementia praecox in 1899. These narratives were relatively distinct in Germany and France. An important milestone in the French literature is the 1852 essay by the alienist and polymath Charles Lasègue which contained the first detailed modern description of a persecutory delusional syndrome.
View Article and Find Full Text PDFIdentifying common and distinct subcortical volumetric abnormalities in 3 major psychiatric disorders: a single-site analysis of 640 participants.
J Psychiatry Neurosci
June 2022
From the Department of Medical Research, Taipei Veterans General Hospital, Taipei, Taiwan (Tu, Chang); the Department of Psychiatry, Taipei Veterans General Hospital, Taipei, Taiwan (Tu, Chang, Chen, Hsu, Lin, Li, Bai); the Institute of Philosophy of Mind and Cognition, National Yang Ming Chiao Tung University, Taipei, Taiwan (Tu); the Department of Psychiatry, Faculty of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan (Tu, Chen, Hsu, Lin, Li, Su, Bai); the Department of Biomedical Engineering, National Yang Ming Chiao Tung University, Taipei, Taiwan (Chang); the Institute of Brain Science, National Yang Ming Chiao Tung University, Taipei, Taiwan (Lin, Li, Su, Bai); the Department of Psychiatry, Cheng Hsin General Hospital, Taipei, Taiwan (Su)
Background: Subcortical volumetric abnormalities in schizophrenia, bipolar disorder and major depressive disorder (MDD) have been consistently found on a single-diagnosis basis in previous studies. However, whether such volumetric abnormalities are specific to a particular disorder or shared by other disorders remains unclear.
Methods: We analyzed the structural MRIs of 160 patients with schizophrenia, 160 patients with bipolar disorder, 160 patients with MDD and 160 healthy controls.
Challenges and Strategies for Current Classifications of Depressive Disorders: Proposal for Future Diagnostic Standards.
Adv Exp Med Biol
April 2021
Department of Psychiatry, Korea University Ansan Hospital, College of Medicine, Ansan, Republic of Korea.
The Diagnostic and Statistical Manual of Mental Disorder, Fourth Edition (DSM-IV) was revised based on a combination of a categorical and a dimensional approach such that in the DSM, Fifth Edition (DSM-5), depressive disorders have been separated as a distinctive disease entity from bipolar disorders, consistent with the deconstruction of Kraepelinian dualism. Additionally, the diagnostic thresholds of depressive disorders may be reduced due to the addition of "hopelessness" to the subjective descriptors of depressed mood and the removal of the "bereavement exclusion." Manic/hypomanic, psychotic, and anxious symptoms in major depressive disorder (MDD) and other depressive disorders are described using the transdiagnostic specifiers of "with mixed features," "with psychotic features," and "with anxious distress," respectively.
View Article and Find Full Text PDFWant AI Summaries of new PubMed Abstracts delivered to your In-box?
Enter search terms and have AI summaries delivered each week - change queries or unsubscribe any time!