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From phenomenological and experimental perspectives, research in schizophrenia has emphasized deficits in “higher” cognitive functions, including attention, executive function, as well as memory. In contrast, general consensus has viewed dysfunctions in basic perceptual processes to be relatively unimportant in the explanation of more complex aspects of the disorder, including changes in self-experience and the development of symptoms such as delusions. We present evidence from phenomenology and cognitive neuroscience that changes in the perceptual field in schizophrenia may represent a core impairment. After introducing the phenomenological approach to perception (Husserl, the Gestalt School), we discuss the views of Paul Matussek, Klaus Conrad, Ludwig Binswanger, and Wolfgang Blankenburg on perception in schizophrenia. These 4 psychiatrists describe changes in perception and automatic processes that are related to the altered experience of self. The altered self-experience, in turn, may be responsible for the emergence of delusions. The phenomenological data are compatible with current research that conceptualizes dysfunctions in perceptual processing as a deficit in the ability to combine stimulus elements into coherent object representations. Relationships of deficits in perceptual organization to cognitive and social dysfunction as well as the possible neurobiological mechanisms are discussed. [ABSTRACT FROM PUBLISHER]

Delusion has always been a central topic for psychiatric research with regard to etiology and pathogenesis and to diagnosis, treatment, and forensic relevance. Throughout the history of psychiatry as a scientific discipline, there has been dissent on the issue of whether chronic delusion is a nosological entity of its own or just a specific type of another mental disorder, e.g. schizophrenia, mania, or personality disorder, and there already is a considerable literature on this. This article seeks to elucidate the central lines of thought that have governed the scientific debate on delusions and delusion-associated phenomena since the early 19th century. Special attention is given to the practical relevance of these theoretical considerations for forensic questions and psychiatric research. Due to the complex features of delusions, research in this area may well become paradigmatic for many other complicated psycho(patho)logical phenomena, e.g. consciousness, hallucinations and psychotic depression. Copyright © 2006 John Wiley & Sons, Ltd. [ABSTRACT FROM AUTHOR]

The study describes the Cardiff Anomalous Perceptions Scale (CAPS), a new validated measure of perceptual anomalies. The 32-item CAPS measure is a reliable, self-report scale, which uses neutral language, demonstrates high content validity, and includes subscales that measure distress, intrusiveness, and frequency of anomalous experience. The CAPS was completed by a general population sample of 336 participants and 20 psychotic inpatients. Approximately 11% of the general population sample scored above the mean of the psychotic patient sample, although, as a group, psychotic inpatients scored significantly more than the general population on all CAPS subscales. A principal components analysis of the general population data revealed 3 components: “clinical psychosis” (largely Schneiderian first-rank symptoms), “temporal lobe disturbance” (largely related to temporal lobe epilepsy and related seizure-like disturbances) and “chemosensation” (largely olfactory and gustatory experiences), suggesting that there are multiple contributory factors underlying anomalous perceptual experience and the “psychosis continuum.” [ABSTRACT FROM PUBLISHER]

The article discusses the neural correlates of relational memory in schizophrenia using functional magnetic resonance imaging. Schizophrenia affects cognition and causes impairment of the memory. But, memory deficits related to schizophrenia is minimal and is limited to the episodic and relational forms of memory. A study revealed that schizophrenia is represented by a specific deficit of relational memory due to the impaired function of the parietal cortex and hippocampus.

Although hallucinations occur in a range of organic and psychiatric conditions, they are not invariably a sign of illness and also occur in “normal“ individuals. Evidence indicates that psychotic hallucinations lie on a continuum with normal experiences, and many more people experience hallucinations than meet criteria for clinical psychosis. In addition to a symptomatic continuum between normal individuals and patients with psychosis, there is evidence that hallucinatory experiences in nonclinical and clinical samples may share the same underlying etiologic influences, including sociodemographic risk factors and neurocognitive mechanisms. Predictors of patient status include beliefs about hallucinations, negative mood, and perceived lack of control. [ABSTRACT FROM AUTHOR]

Some monothematic types of delusions may arise because subjects have unusual experiences. The role of this experiential component in the pathogenesis of delusion is still not understood. Focussing on delusions of alien control, we outline a model for reality testing competence on unusual experiences. We propose that nascent delusions arise when there are local failures of reality testing performance, and that monothematic delusions arise as normal responses to these. In the course of this we address questions concerning the tenacity with which delusions are maintained, their often bizarre content, the patients’ inability to dismiss them, and their often circumscribed character. [ABSTRACT FROM AUTHOR]

This article considers recent arguments on 'dialogism' within the discipline in order to reflect upon the coherency of the institutional position of critical psychology and the conventionalized responses which tend to characterize this position. The main focus of the article explores how arguments about the dialogical self radically reconfigure psychopathology, bringing understandings more in line with those produced across a range of social and cultural practices which `make up' our lives. This shift is explored through considering arguments within science studies and cultural studies of psychiatric culture which are exploring the new forms of subjectivity and psychology being produced within 'flexible capitalism'. The article concludes with an argument which outlines the urgent need for critical psychologists and those interested in criticality to engage with the 'psychological' through frameworks which do not simply reinstate an 'anti-essentialist' mantra. [ABSTRACT FROM AUTHOR]

The article lists terms related to geriatrics that are used in the December 2004 issue of the journal "Psychogeriatrics."

To investigate the effect of exposure to cannabis early in adolescence on subclinical positive and negative symptoms of psychosis.Cross-sectional survey in the context of an ongoing cohort study.Government-supported general population cohort study.A total of 3500 representative 19-year olds in Greece.Subjects filled in the 40-item Community Assessment of Psychic Experiences, measuring subclinical positive (paranoia, hallucinations, grandiosity, first-rank symptoms) and negative psychosis dimensions and depression. Drug use was also reported on.Use of cannabis was associated positively with both positive and negative dimensions of psychosis, independent of each other, and of depression. An association between cannabis and depression disappeared after adjustment for the negative psychosis dimensions. First use of cannabis below age 16 years was associated with a much stronger effect than first use after age 15 years, independent of life-time frequency of use. The association between cannabis and psychosis was not influenced by the distress associated with the experiences, indicating that self-medication may be an unlikely explanation for the entire association between cannabis and psychosis.These results add credence to the hypothesis that cannabis contributes to the population level of expression of psychosis. In particular, exposure early in adolescence may increase the risk for the subclinical positive and negative dimensions of psychosis, but not for depression. [ABSTRACT FROM AUTHOR]

Evidence-based interventions designed to reduce the risk of re-offending, particularly violent re-offending, are commonly offered in correctional systems around the world. The interventions are often based upon the application of several principles of service delivery that have become widely known as the 'what works' approach to offender rehabilitation. The applicability of these principles to forensic psychiatric services has yet to be determined. The aims are to examine the possible application of the 'what works' approach and its implications for forensic mental health practice. The method used was a review of relevant research from both the general offender and forensic psychiatry literature. The principles underlying the 'what works' approach are likely to have utility in service delivery in forensic psychiatry, particularly when a treatment target is a reduction in risk of harm to others. The individualized models of patient care practiced in forensic psychiatry are also likely to have utility in improving treatment outcomes in correctional settings. The conclusion is that an increased interchange of ideas and interventions between the two areas of practice is likely to be of mutual benefit. This is an area that requires significant development. [ABSTRACT FROM AUTHOR]

This article reports a social worker's experience of setting up a hearing voices group in a mental health hospital. The article reviews some of the literature relating to hearing voices and sets this in the context of services in the UK. A brief description of the group is provided and the author suggests such a group is welcomed by participants because they find sharing their experiences of hearing voices helpful. [ABSTRACT FROM AUTHOR]

Psychosis in elderly patients is a growing clinical concern because psychotic symptoms most frequently occur as noncognitive manifestations of Alzheimer's disease, as side effects of drug therapy for Parkinson's disease, or as the primary abnormalities in schizophrenia, and the clinical characteristics of psychosis are distinct for each. In planning antipsychotic pharmacotherapy for elderly patients, age-related pharmacokinetic changes, polypharmacy for comorbid diseases, and concerns about the underlying conditions responsible for the psychotic symptoms must be considered. Traditional antipsychotic agents bind to dopamine receptors and effectively relieve positive schizophrenic symptoms but frequently cause tardive dyskinesia and other extrapyramidal symptoms, a problem for elderly patients, particularly for those with Parkinson's disease. Atypical antipsychotics bind to dopamine and serotonin receptors, relieving both positive and negative symptoms, and are less likely to cause extrapyramidal symptoms. The authors review common diagnostics associated with psychosis in the elderly and clinical guidelines to selecting antipsychotic pharmacotherapy. [ABSTRACT FROM AUTHOR]

Objectives. This paper examines the research and theoretical literature on potential links between trauma and psychosis Methods. Three main alternatives are considered; can psychosis cause PTSD, can trauma cause psychosis and could psychosis and PTSD both be part of a spectrum of responses to a traumatic event? The more influential studies considered are critically evaluated and methodological considerations specific to research regarding trauma and psychosis are also examined. Results. Evidence is found in support of each of these relationships, and an integrative approach to conceptualizing the relationships is suggested. Conclusions. Recent conceptualizations of PTSD and psychosis are used to inform the consideration of these different pathways, and the implications for theories of psychosis and trauma and the clinical implications for services for psychotic patients are discussed. [ABSTRACT FROM AUTHOR]

Harry Stack Sullivan's concept of interpersonal psychiatry has been recognized as a landmark in the American psychoanalytic movement, in particular his influence on the development of object-relations theory. He is an influential figure in interpreting the inner experiences of persons with schizophrenia. Psychotic experiences represent a failure of one's self-system and the dissociation dynamism. Delusions and hallucinations are experiences in lost control of self-awareness. The person regresses to dreams or experiences from infancy and childhood in facing spontaneous conflicts and anxiety in interpersonal transaction. As a result, the tripartite self-system is fractured. In this paper, the writer applies Sullivan's concept in interpreting the inner psychotic experiences of a client with schizophrenia. Its implication for clinical social work practice is also discussed. [ABSTRACT FROM AUTHOR]

Assesses the neurodegenerative and neurodevelopmental conceptions of schizophrenia. Types of dementia praecox; Association between schizophrenia and mental retardation (MR); Psychopathologies of patients with MR.

Objective: The existence of cannabis-induced psychosis (CP) remains controversial, partly because of methodological problems. We hypothesize that acute schizophrenia (AS) and CP can have distinct demographic, premorbid and clinical features. Method: We compared 26 patients with CP to 35 with AS, after their cannabis-consumption status was confirmed by repeated urine screens. Patients with CP were assessed after at least 1 week but not more than 1 month of abstinence. Symptoms were evaluated with the Present State Examination (PSE). Results: In group CP, male gender, expansive mood and ideation, derealization/depersonalization, visual hallucinations, and disturbances of sensorium were more frequent than in group AS. Premorbid schizoid personality traits were more frequently associated to AS and antisocial personality traits to CP. Conclusion: The continuous heavy use of cannabis can induce a psychotic disorder distinct from AS. These two clinical entities share some features but they differ in others. [ABSTRACT FROM AUTHOR]

The impetus for this article was the author's experience of illness, necessitating 5 months of hospitalization, 7 weeks of which were spent in a coma in an intensive care unit (ICU). The origins and general characteristics of ICUs are noted. A pastiche of illness narrative is constructed to allow for the author's own comment on his experience. The intensive care syndrome (ICS), a permeable category, continuing the aftermath of surgery and the social, psychological, mechanical, and pharmaceutical effects of the unit itself, is discussed. Dreams of affliction, a component of the ICS , are explored; the prior sociological history of the neglect of dreams, an essential universal, is also pointed out. The author's dream forms and their shamanistic parallels are explored. In Foucautdian language, they are considered a product of the fragmentation of the cosmological spirit, whereas the author was a medical object and mechanical appendage. Nursing is in a strategic position to make patients' dream narratives their own as an aid for understanding illness. [ABSTRACT FROM AUTHOR]

This commentary questions a Cochrane review that examined whether first-rank symptoms are a useful diagnostic tool for differentiating schizophrenia from other psychotic disorders. It concludes that first-rank symptoms are not particularly accurate in this role, although they might be useful initial screening questions in community surveys or waiting-room screening. [ABSTRACT FROM AUTHOR]

This paper deals with the emotive subject of psychiatric misdiagnosis in ethnic minority patients. It discusses the nature of psychiatric illness, the nature of psychiatric diagnoses, why making a diagnosis is thought to be important and current calls for the use of dimensional rather than categorical diagnoses. It details the literature concerning misdiagnosis in people of Caribbean origin living in the UK and uses a wide-based institutional model to generate hypotheses to explain why misdiagnosis may occur. It borrows from developments in epidemiological and psychiatric research and from the literature concerning misdiagnosis of African-American patients in the US, to produce conclusions as to how the misdiagnosis debate can be taken forward.This paper aims to promote the use of diagnoses that are treatment relevant. [ABSTRACT FROM AUTHOR]

Concepts and definitions pertaining to the early course of schizophrenia are reviewed, along with recent illustrative studies of first-episode schizophrenia. Early course parameters of a Norwegian first-episode sample are presented. This sample (=43) demonstrated strong gender differences, with male patients having significantly higher frequency of single marital status, lower educational status, schizophrenia, early age at onset, and lower Global Assessment of Functioning scores the last year before hospitalization. The duration of untreated psychosis (DUP) was long (mean=114 weeks), as in other studies. Longer DUP was associated with poorer work, social, and global functioning in the year before admission, with more insidious onset of psychosis, and with more negative symptoms at first clinical presentation. Longer DUP was not associated with the age at onset of psychosis. These findings were mostly gender independent. The data help to frame questions about why patients can be psychotic for so long before getting help. Finally, suggestions are offered for the definition and measurement of early course parameters for schizophrenia. [ABSTRACT FROM PUBLISHER]

Conventionalpsychodynamic treatment assumptions sometimes warned against direct confrontation of a patient's delusions because delusions were believed to serve defensive functions. Based in part on research findings, some have recently asserted that it can be beneficial for the clinician to challenge a patient's delusional beliefs. Short-term positive results from such confrontations have been reported. I review clinical and research considerations that may aid the clinician in deciding when confrontation may be beneficial. I identify a class of delusions that are unlikely to respond to confrontation. Alternative clinical responses to this class are suggested [ABSTRACT FROM PUBLISHER]

The specific symptoms that have been felt to characterize schizophrenia have varied widely over time and across cultures, as has the diagnostic and prognostic importance placed on these symptoms. In this report, the historical concepts of what constitutes the “characteristic symptoms” of schizophrenia are reviewed in the context of the development of . Through the existing literatures as well as through previously unpublished data sets, the dimensions of reliability, specificity, validity, and descriptive value of the various signs and symptoms used to classify schizophrenia are explored. In addition, the structure of the definition of schizophrenia with that of the proposed revisions of the (ICD-10) are contrasted, demonstrating several potentially meaningful differences, It is concluded that a comprehensive description of the signs and symptoms of schizophrenia should place a strong emphasis on both positive and negative symptoms. Principles and approaches to guide the development of are suggested. [ABSTRACT FROM PUBLISHER]