The dementia of dementia praecox

Abstract

A group of 18 long‐stay patients with a diagnosis of schizophrenia were compared with a group of 10 age‐matched subjects who had been institutionalized by reason of physical disease, on performance on tests of intellectual function; and with a group of agematched healthy subjects, both on tests of intellectual function, and radiographically, using the technique of computerized axial tomography (EMI scan) of the brain. By comparison with the normal controls the patients with schizophrenia had increased cerebral ventricular size (assessed as cross‐sectional area) and, by comparison with both control groups, showed substantial impairments on intellectual testing. The differences in ventricular area between patients and controls remained significant (P < 0.01) after four patients who had been leucotomized had been excluded. Within the non‐leucotomized patient group ventricular area was unrelated to previous neuroleptic medication, ECT or insulin coma therapy, but there was a significant relationship between ventricular area and intellectual impairment (P < 0.01). Intellectual impairment, as assessed by the Withers & Hinton test battery, the Inglis paired associate learning test, and the digits‐backward test, was greater (P < 0.05) in patients with negative features (affective flattening, retardation, poverty of speech) than in those without such features. Premorbid occupational histories suggested that nearly all of these patients had at one time functioned at an adequate intellectual level. The findings suggest that within the group of patients with schizophrenia there is a subgroup whose illnesses have hitherto been considered typically schizophrenic, who have severe intellectual impairment associated with evidence of structural brain disease. The size of this subgroup and the significance of the cerebral changes remain to be determined.

Investigating relationships between cortical thickness and cognitive performance in patients with schizophrenia and healthy adults

“…Later however, general intellectual deficits in chronic schizophrenia were demonstrated by Johnstone et al (1978), who also suggested that the cognitive dysfunction was primary and not secondary to institutionalization or symptoms of the disease. Since then, a growing interest in the field and acknowledgment of its importance has emerged.…”

30 Years on: How the Neurodevelopmental Hypothesis of Schizophrenia Morphed Into the Developmental Risk Factor Model of Psychosis

“…1 However, his ideas were soon displaced by Kraepelin's conceptualization of dementia praecox as an adult onset neurodegenerative disorder, 2 a view which held sway for nearly a century. Indeed, in the late 1970s, when Johnstone et al 3,4 demonstrated that people with chronic schizophrenia had lateral ventricular enlargement and cognitive deficits, they interpreted their findings as confirming "the dementia of dementia praecox. "…”

Cannabis and Neurological Soft Signs in Schizophrenia: Absence of Relationship and Influence on Psychopathology

“…They are thought to be probably related to impairments in specific brain areas, such as the cerebellar (motor co-ordination), the temporal (sensory integration) and the frontal (complex motor acts). Similar widespread alterations have been supposed to be involved in the pathogenesis of schizophrenic negative symptomatology, often associated with cognitive deterioration, lateral ventricular enlargement and widespread brain abnormalities, suggesting a more 'organic' aetiology for this clinical dimension than for the others [34][35][36][37]. Finally, it seems that NSS frequently occur in conjunction with negative symptomatology [38][39][40][41] and chronic course of schizophrenia [31,[42][43][44], while they are relatively unaffected by neuroleptic treatment, having also been found in drug-free and first episode patients [45][46][47].…”