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Am J Psychiatry 1995; 152:731-737
Copyright © 1995 by American Psychiatric Association
Prospective clinicopathologic studies of schizophrenia: accrual and assessment of patients
SE Arnold, RE Gur, RM Shapiro, KR Fisher, PJ Moberg, MR Gibney, RC Gur, P Blackwell and JQ Trojanowski
Department of Psychiatry, University of Pennsylvania School of Medicine, Philadelphia 19104-4283, USA.
OBJECTIVE: The purpose of this study was to characterize the
neuropsychiatric profile of elderly patients with schizophrenia and
establish a patient registry for prospective ante-mortem and post- mortem
studies. METHOD: Medical records of all chronically institutionalized
patients in eight state hospitals who were over the age of 65 and had a
chart diagnosis of schizophrenia (N = 528) were reviewed. Of the potential
subjects, 192 were excluded because of clinical histories inconsistent with
a diagnosis of schizophrenia, 56 because of insufficient information to
establish a psychiatric diagnosis, and 122 because of family members'
refusal to give consent for autopsy in the event of death. To date, 81 of
the remaining 158 patients have undergone neuropsychiatric evaluation with
standard assessment instruments. RESULTS: Mini-Mental State scores of the
81 patients indicated severe dementia, and Functional Assessment Scale
scores showed that patients required assistance with activities of daily
living. All patients were rated as severely ill on the Brief Psychiatric
Rating Scale. Ratings on the Scale for the Assessment of Negative Symptoms
and the Scale for the Assessment of Positive Symptoms indicated a
predominance of negative symptoms over positive. Of 30 patients who have
died to date, research autopsies have been conducted on 26. CONCLUSIONS:
Establishing a well characterized, prospective patient registry for
clinicopathologic studies of schizophrenia is feasible but labor intensive.
Diagnosis of schizophrenia with a high degree of confidence can be achieved
by means of detailed chart review and assessment of current
neuropsychiatric functioning with standard rating instruments. These data
provide a basis for correlations of clinicopathologic factors.
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S. E. Hemby, S. D. Ginsberg, B. Brunk, S. E. Arnold, J. Q. Trojanowski, and J. H. Eberwine
Gene Expression Profile for Schizophrenia: Discrete Neuron Transcription Patterns in the Entorhinal Cortex
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September 1, 2001;
158(9):
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S. E. Arnold, L.-Y. Han, P. J. Moberg, B. I. Turetsky, R. E. Gur, J. Q. Trojanowski, and C.-G. Hahn
Dysregulation of Olfactory Receptor Neuron Lineage in Schizophrenia
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58(9):
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P J de Vries, W G Honer, P M Kemp, and P J McKenna
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May 1, 2001;
70(5):
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Apathy, Anhedonia, and Psychomotor Retardation in Elderly Psychiatric Patients and Healthy Elderly Individuals
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March 1, 2001;
14(1):
11 - 16.
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M. Sajatovic, K. Donenwirth, D. Sultana, and P. Buckley
Admissions, Length of Stay, and Medication Use Among Women in an Acute Care State Psychiatric Facility
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October 1, 2000;
51(10):
1278 - 1281.
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S. E. ARNOLD
Cellular and Molecular Neuropathology of the Parahippocampal Region in Schizophrenia
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June 1, 2000;
911(1):
275 - 292.
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122(4):
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S. E Arnold, J. Q Trojanowski, and P. Parchi
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January 1, 1999;
66(1):
90 - 92.
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Increased F2-isoprostanes in Alzheimer's disease: evidence for enhanced lipid peroxidation in vivo
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12(15):
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S. E. ARNOLD, G. S. SMUTZER, J. Q. TROJANOWSKI, and P. J. MOBERG
Cellular and Molecular Neuropathology of the Olfactory Epithelium and Central Olfactory Pathways in Alzheimer's Disease and Schizophrenia
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November 30, 1998;
855(1):
762 - 775.
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K. D. Tran, G. S. Smutzer, R. L. Doty, and S. E. Arnold
Reduced Purkinje Cell Size in the Cerebellar Vermis of Elderly Patients With Schizophrenia
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September 1, 1998;
155(9):
1288 - 1290.
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Symptoms, Cognitive Functioning, and Adaptive Skills in Geriatric Patients With Lifelong Schizophrenia: A Comparison Across Treatment Sites
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August 1, 1998;
155(8):
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S. E. Arnold, J. Q. Trojanowski, R. E. Gur, P. Blackwell, L.-Y. Han, and C. Choi
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55(3):
225 - 232.
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