Dissociative identity disorder in psychiatric inpatients.

Objective: The aim of this study was to replicate reports of a high rate of dissociative identity disorder in psychiatric inpatients.

Method: Subjects were 100 randomly selected women, 16-50 years old, who had recently been admitted to an acute psychiatric hospital. Diagnoses were made by two interviewers through use of the Structured Clinical Interview for DSM-IV Dissociative Disorders.

Neurocognitive impairment in schizophrenia and how it affects treatment options.

Objective: To review the roles played by neurocognitive assessment in the treatment of schizophrenia and in the design of treatment research strategies.

Method: A review of the literature and summaries of clinical and research implications are presented, with directions for future research.

Results: Neurocognitive deficits are now targets of antipsychotic drug treatment and should increasingly be used to refine both theory and clinical practice by considering the effects of treatments at the level of neural systems.

Absence of regional hemispheric volume asymmetries in first-episode schizophrenia.

Objective: The goal of this study was to determine whether patients experiencing their first episode of schizophrenia differ from healthy subjects in regional cerebral hemispheric volumes or asymmetries.

Method: Regional volumes corresponding to prefrontal, premotor, sensorimotor, occipitoparietal, and temporal lobes in each hemisphere were measured on contiguous coronal magnetic resonance images in 70 patients experiencing their first episode of schizophrenia and in 51 healthy comparison subjects.

Results: Patients did not differ from the comparison subjects in regional or total hemispheric volumes, but they had abnormal hemispheric asymmetries.

Cerebral morphometry and clozapine treatment in schizophrenia.

Studies of brain morphology in schizophrenia may be informative about basic pathophysiologic processes, provide clinically useful indicators of treatment response, and lead to the identification of markers for selective treatment effects. This paper reviews findings from magnetic resonance imaging studies of patients with schizophrenia conducted at Hillside Hospital, with special attention to (1) findings that have helped distinguish patients who respond well to typical neuroleptics from those who have gone on to trials of clozapine, (2) the capacity of morphological measures to predict clozapine treatment response, and (3) the possibility that selective hypertrophy of striatal structure may be caused by chronic treatment with typical neuroleptics, but not by clozapine.

Relation of plasma fluphenazine levels to treatment response and extrapyramidal side effects in first-episode schizophrenic patients.

Objective: The aim of this study was to determine the relation between plasma fluphenazine levels and clinical response in first-episode schizophrenic patients.

Method: Data from 36 first-episode schizophrenic or schizoaffective inpatients diagnosed according to the Research Diagnostic Criteria were evaluated. The patients received open, standardized treatment with fluphenazine, 20 mg/day, for at least 4 weeks.

Hippocampus-amygdala volumes and psychopathology in chronic schizophrenia.

Volumes of the mesiotemporal structures (hippocampus-amygdala complex) were measured in 19 men who were chronic multiepisode schizophrenics and 18 age-matched healthy controls using T1-weighted contiguous coronal magnetic resonance images of 3.1-mm width. Using the level of the mammillary bodies as an anatomical landmark, the whole hippocampus-amygdala complex was divided into an anterior section (mainly containing amygdaloid tissue) and a posterior section (mainly containing the hippocampal formation).

Black and white dementia caregivers: a comparison of their adaptation, adjustment, and service utilization.

We compared black (n = 33) and white (n = 119) caregivers of dementia patients on indices of adaptation, adjustment, and utilization of supportive services. Black and white caregivers differed most notably on marital and financial/insurance status, but there were few differences between them in their adaptation to dementia responsibilities. Black caregivers, however, evidenced less burden and less desire to institutionalize their relatives and were more likely to report more unmet service needs than were whites.

Antipsychotic medication effects on neuropsychological functions.

The investigator of antipsychotic drug effects on neuropsychological functions faces a range of conceptual, methodological, and technical obstacles. Some of these hurdles are pointed out in a brief review of existing literature, and a more detailed consideration of instrumentation issues is presented. The need for hypothesis-driven assessment strategies is highlighted.

Early separation anxiety and adult agoraphobia.

The authors compared 137 adult patients who had agoraphobia with 81 patients who had either simple or social phobia for a history of childhood and adolescent separation anxiety. Female agoraphobics reported significantly more childhood separation anxiety than female combined simple and social phobics; males showed no significant difference between diagnostic groups. The reported prevalence of separation anxiety in adolescence was relatively low, but agoraphobics of both sexes reported significantly more separation anxiety than combined simple and social phobics.