First-Rank Symptoms of Schneider in Late Paraphrenia

Howard, Robert; Förstl, Hans; Naguib, Mohsen; Burns, Alistair; Levy, Raymond

doi:10.1192/bjp.160.1.108

Cited by 39 publications

(21 citation statements)

References 15 publications

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“…CT studies [14][15][16] found no significant difference in the lateral and third ventricular changes compared to healthy control subjects. Pearlson et al 17 found insignificant lateral but significant third ventricle enlargement in late-onset schizophrenia.…”

Section: Brain Imagingmentioning

confidence: 70%

The Biology of Psychosis in Older People

Karim¹,

Burns

2003

J Geriatr Psychiatry Neurol

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The nosology, classification, and biological basis of psychosis in the elderly have been much debated. Psychotic features are seen in schizophrenia, affective illness, and dementia in the elderly. This article reviews evidence for the biological basis of psychosis in older people. In schizophrenia, there is evidence of gender differences in brain volume loss and dopamine receptor numbers, possibly linked to estrogen loss in women. Neuroimaging evidence of ventricular brain changes and more dopamine receptors have also been documented. In Alzheimer's disease, genetic factors such as PS1 and ApoE4 have been associated with psychotic symptoms, and histopathological studies have revealed differences in neuronal pathology. Radiological studies have shown right and left hemisphere differences in size, blood flow, and glucose metabolism between psychotic and nonpsychotic patients. In affective illnesses, there is evidence of structural brain changes in psychotic depression. Ample evidence suggests that biological substrates underlie many psychotic symptoms. More research will identify causal links between brain changes, symptom appearance, and the effects of psychosocial factors in their genesis.

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Section: Brain Imagingmentioning

confidence: 70%

The Biology of Psychosis in Older People

Karim¹,

Burns

2003

J Geriatr Psychiatry Neurol

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“…Corey-Bloom et al (1995) and Howard (1992a, 1992b) found larger lateral ventricle size in LOS patients relative to both early-onset schizophrenics and controls, and late-onset schizophrenics did not show the thalamic volume decrease of early-onset schizophrenia (Howard et al 1992a). Staff et al (1999) found right frontotemporal hypoperfusion in 11 AD patients split 60/40 delusions of misidentification/delusions of persecution.…”

Section: Neuropsychological Features and Neuroanatomic Considerationsmentioning

confidence: 96%

Cognitive neuroscience of delusions in aging

Holt¹,

Albert²

2006

Neuropsychiatric Disease and Treatment

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Assessments and clinical understanding of late-onset delusions in the elderly are inconsistent and often incomplete. In this review, we consider the prevalence, neurobehavioral features, and neuroanatomic correlations of delusions in elderly persons -those with documented cognitive decline and those with no evidence of cognitive decline. Both groups exhibit a common phenotype: delusions are either of persecution or of misidentification. Lateonset delusions show a nearly complete absence of the grandiose, mystical, or erotomanic content typical of early onset psychoses. Absent also from both elderly populations are formal thought disorders, thought insertions, and delusions of external control. Neuroimaging and behavioral studies suggest a frontotemporal localization of delusions in the elderly, with right hemispheric lateralization in delusional misidentification and left lateralization in delusions of persecution. We propose that delusions in the elderly reflect a common neuroanatomic and functional phenotype, and we discuss applications of our proposal to diagnosis and treatment.

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“…When compared to normal elderly controls patients with late paranoid disorders have been reported to have larger ventricles (Naguib and Levy, 1987;Rabins et al, 1987), an excess of WMH (Breitner etal., 1990;Harris etal., 1988;Lesser etal., 1992;Miller et al, 1991) and basal ganglia lesions (Breitner etal., 1990;Lesser et al, 1992). There may be a negative association between presence of Schneider's first rank symptoms (considered characteristic of schizophrenia) and cortical atrophy on CT Howard et al, 1992). Ventricular enlargement does not appear to be closely related to either cognitive impairment, illness duration or outcome (Castle and Howard, 1992).…”

Section: Late-onset Paranoid Disordersmentioning

confidence: 96%

Some methodological issues in neuroradiological research in psychiatry

Becker

Retz

Hofmann

et al. 1995

J. Neural Transmission

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An outline is given of some of the methodological issues discussed in neuroradiological research on psychiatric illness. Strengths and shortcomings of magnetic resonance imaging (MRI) in depicting and quantifying brain structures are described. Temporal lobe anatomy and pathology are easily accessible to MRI, whereas limits on anatomical delineation hamper approaches to frontal lobe study. White matter hyperintense lesions are sensitively depicted by MRI, but specificity is limited. Distinction of vascular and primary degenerative dementia is considerably improved by CT and MRI analysis. Computed tomography (CT) and MRI have enhanced the understanding of treatable organic psychiatric disorders, e.g., normal pressure hydrocephalus. Subcortical and white matter pathology has been replicated in CT and MRI studies of late-onset psychiatric disorders, clinical overlap with cerebrovascular disease or neurodegeneration may be of import. Transcranial sonography findings of brainstem structural change specific to unipolar depression may contribute to the understanding of affective psychoses. Magnetic resonance spectroscopy and functional MRI are likely to stimulate psychiatric research in the future.

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First-Rank Symptoms of Schneider in Late Paraphrenia

Abstract: The brains of 41 late paraphrenics, 16 of whom had first-rank symptoms, were examined by CT. Late paraphrenics with first-rank symptoms had significantly less cortical atrophy than those without them.

Cited by 39 publications

References 15 publications

The Biology of Psychosis in Older People

The Biology of Psychosis in Older People

Cognitive neuroscience of delusions in aging

Some methodological issues in neuroradiological research in psychiatry

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