Clinical Neuroscience

[Schizophrenia or schizophrenias]

DRIETOMSZKY Jenő1, BRUNECKER Györgyi2

MAY 01, 1967

Clinical Neuroscience - 1967;20(05)

[In analysing the development of the concept of "schizophrenia", both in terms of its professional history and its theoretical basis, authors adopt Nyirő's position that "...we cannot speak of schizophrenia, only of schizophrenics..." In the sense of Sternberg's concept, they narrow down their position by stating that a nosological approach and Leonhardian taxonomy are essential requirements for a substantive answer to the question.]

AFFILIATIONS

  1. Gerontológiai Kutatóintézet
  2. Országos Ideg-és Elmegyógyintézet

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Further articles in this publication

Clinical Neuroscience

[Statistical processing of 15 years of ES material from the Psychiatric Clinic of the Budapest Medical University]

ORVOSI Kara

[In the struggle for the cure of mental illnesses, for the health of the human mind, one of the central issues was therapeutic optimism, therapeutic activitas. The sick person and society as a whole expect the best possible restitution from the doctor, and the doctor's duty as a practitioner is to take responsibility, to take the lead, to apply the most modern methods of treatment. ]

Clinical Neuroscience

[Resuscitation and neuropsychiatric therapy experiences with electrostimulator]

FORNÁDI Ferenc, BARTOS Valéria, ZSOMBÓK György, KAFFKA Károly

[The authors describe their joint research with Nyirő on the therapeutic value of transcerebral electrostimulation. Their experience: 1. electrostimulation is essential not only in the treatment of respiratory paralysis following electrotrauma, but also in the prevention and treatment of certain complications of psychiatric so-called major somatic treatments; 2. it is also a new treatment option for hormone-refractory hypothalamic syndromes, such as amenorrhoea, using more mitigated current parameters. ]

Clinical Neuroscience

[The problems of the psychoanalytical distinguishing between typical and atypical types of drunkenness]

HUSZÁR Ilona, IRÁNYI Jenőné

[In their communication, the authors deal with the differentiation of acute, typhoidal intoxication states from atypical (pathological) intoxication states, emphasising the sociological importance of the differentiation and defining the legal basis for the differentiation. The work of Nyirő on the subject is discussed in detail, followed by a discussion of the symptoms of atypical intoxication and their diagnostic significance. They also analyse all the external and internal factors that may play a role in the development of atypical drunkenness. It is considered possible to distinguish between the two forms of intoxication only by examining all the factors in each case in context, but it is stressed that a sharp dividing line cannot always be drawn. ]

Clinical Neuroscience

[The role of exogenous factors in psychiatric disorders ]

IVÁN László, TAKÁCS László, PETHŐ Bertalan

[Authors discuss the psychopathological significance of isolation or deprivation. They draw attention to these specific exogenous factors and stress the importance of a multidimensional approach in their interpretation. Using both the literature and their own clinical experience, they aim to outline certain conclusions on this topic. ]

Clinical Neuroscience

[Superstition and psychosis]

FORNÁDI Ferenc, VARGA Ervin, POHL Ödön

[The authors analyse the mystical and superstitious experiences of psychotic and neurotic patients and their interpretation in 5 cases. They relate the symptoms to environmental influences (childhood experiences, cultural and social influences). ]

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[Tracing trace elements in mental functions]

JANKA Zoltán

[Trace elements are found in the living organism in small (trace) amounts and are mainly essential for living functions. Essential trace elements are in humans the chromium (Cr), cobalt (Co), copper (Cu), fluorine (F), iodine (I), iron (Fe), manganese (Mn), molybdenum (Mo), selenium (Se), zinc (Zn), and questionably the boron (B) and vanadium (V). According to the biopsychosocial concept, mental functions have biological underpinnings, therefore the impairment of certain neurochemical processes due to shortage of trace elements may have mental consequences. Scientific investigations indicate the putative role of trace element deficiency in psychiatric disorders such in depression (Zn, Cr, Se, Fe, Co, I), premenstrual dysphoria (Cr), schizophrenia (Zn, Se), cognitive deterioration/de­mentia (B, Zn, Fe, Mn, Co, V), mental retardation (I, Mo, Cu), binge-eating (Cr), autism (Zn, Mn, Cu, Co) and attention deficit hyperactivity disorder (Fe). At the same time, the excess quantity (chronic exposure, genetic error) of certain trace elements (Cu, Mn, Co, Cr, Fe, V) can also lead to mental disturbances (depression, anxiety, psychosis, cognitive dysfunction, insomnia). Lithium (Li), being efficacious in the treatment of bipolar mood disorder, is not declared officially as a trace element. Due to nutrition (drinking water, food) the serum Li level is about a thousand times less than that used in therapy. However, Li level in the red cells is lower as the membrane sodium-Li countertransport results in a Li efflux. Nevertheless, the possibility that Li is a trace element has emerged as studies indicate its potential efficacy in such a low concentration, since certain geographic regions show an inverse correlation between the Li level of drinking water and the suicide rate in that area. ]

Clinical Neuroscience

TLR4 (Toll-like receptor-4) expression and frontal-cingulate volumes in schizophrenia

LI Hua, KÉRI Szabolcs

Evidence suggests that pathogen-associated pattern recognition receptors (Toll-like receptors, TLRs) are implicated in the pathophysiology of schizophrenia. TLRs are important in both peripheral immune responses and neuronal plasticity. However, the relationship between peripheral TLR expression and regional brain volumes is unknown in schizophrenia. We therefore assessed 30 drug-naïve, first-episode patients with schizophrenia. TLR4+/TLR1+ monocytes were measured using flow-cytometry. High resolution magnetic resonance images (T1 MRI) were obtained and analyzed with FreeSurfer. Results revealed significant negative correlations between the percentage of TLR4+ monocytes, mean fluorescent intensities, and brain volumes in frontal and anterior cingulate regions. The measures of TLR1+ monocytes did not show significant relationships with regional brain volumes. These results raise the possibility that abnormal TLR-activation is associated with decreased brain volumes in schizophrenia.

Lege Artis Medicinae

[Psychiatric conditions not only influence the severity of clinical outcome of COVID-19 but also the medication of mental diseases]

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[The disease process in psychiatric patients who contracted SARS-CoV-2 infection might become more severe because of their impaired general health, comorbidities and unhealthy lifestyle. However, among all psychiatric conditions statistically significant correlation with severe and lethal outcome have been found only in schizophrenia with possible association of multiple immune dysfunctions. While the antipsychotic clozapine used in treatment resistant schizophrenia seems to decrease the likelihood of recovery of patients who underwent COVID-19 infection, antidepressants treatment for major depression may result in more favourable outcome. Mainly the antidepressant fluvoxamine has been reliably found effective by inhi­biting cytokine storms observed in some COVID-19 infected patients.]

Clinical Neuroscience

Symptom profiles and parental bonding in homicidal versus non-violent male schizophrenia patients

HALMAI Tamás, TÉNYI Tamás, GONDA Xénia

Objective - To compare the intensity and the profile of psychotic symptoms and the characteristics of parental bonding of male schizophrenia patients with a history of homicide and those without a history of violent behaviour. Clinical question - We hypothesized more intense psychotic symptoms, especially positive symptoms as signs of a more severe psychopathology in the background of homicidal behaviour. We also hypothesized a more negatively perceived pattern (less Care more Overprotection) of parental bonding in the case of homicidal schizophrenia patients than in non-violent patients and non-violent healthy controls. Method and subjects - Symptom severity and symptom profiles were assessed with the Positive and Negative Syndrome Scale in a group of male schizophrenia patients (n=22) with the history of committed or attempted homicide, and another group (n=19) of male schizophrenia patients without a history of violent behaviour. Care- and Overprotection were assessed using the Parental Bonding Instrument (PBI) in a third group of non-violent healthy controls (n=20), too. Results - Positive, negative and general psychopathology symptoms in the homicidal schizophrenia group were significantly (p<0.005) more severe than in the non-violent schizophrenia group. Non-violent schizophrenia patients scored lower on Care and higher on Overprotection than violent patients and healthy controls. Homicidal schizophrenia patients showed a pattern similar to the one in the healthy control group. Conclusions - It seems imperative to register intense positive psychotic symptoms as predictive markers for later violent behaviour. In the subgroup of male homicidal schizophrenia patients negatively experienced parental bonding does not appear to be major contributing factor to later homicidal behaviour.

Clinical Neuroscience

[Multilocus genetic analysis implicates neurodevelopment and immune system in the etiology of schizophrenia]

PULAY Attila József, KOLLER Júlia, NAGY László, MOLNÁR Mária Judit, RÉTHELYI János

[Background - Schizophrenia is a severe psychiatric disorder of poorly understood etiology, characterized by high heritability, multifactorial inheritance and high heterogeneity. Multilocus associaton methods may reduce the genetic heterogeneity and improve the probability of replication between analyses. Objectives - The aims of our study were twofold: 1. To analyse genetic risk factors of schizophrenia by using multilocus genetic tests. 2. To assess the replication probability attributable to the various multilocus tests. Subjects - Discovery set: case-parent trios of unaffected parents and affected probands with a DSM-IV schizophrenia diagnosis (n=16); replication set: schizophrenia cases and unaffected controls (n=5337). Methods - Associations of single nucleotide and indel markers were transferred to gene- and geneset-based associations, furthermore to geneset-enrichment tests and functional annotation cluster analyses in a two-staged designs. Associations with p<0.1 from the discovery set were tested in the replication sample. Familywise p-value correction for multiple comparisons were performed during the replication step. Results - After correction for multiplicity, no significant association or enrichment were detected for gene-based nor canonical pathway analyses, but significant association of the 14q31 cytoband and enrichments of the 5q31 and Xq13 cytobands were found (p_corr: 0.002, 0.006 and 0.048, respectively). Functional annotation clustering yielded statistically significant enrichment scores for clusters of splicing/alternative splicing, neurodevelopment and embryonic development. Improvements in replication probabilty were found with increased test complexity (P_rep: 0, 0.015, 0.21). Conclusions - Our results corroborate the involvement of neurodevelopment, synaptic plasticity and immune mechanisms in the etiology of schizophrenia. Also, our findings indicated improvement of replication probability by using multilocus genetic analyses. ]