The comparative efficacy and long-term effect of clozapine treatment on neuropsychological test performance

Previous studies have suggested that clozapine may improve neuropsychological test performance. The current study was designed to examine the comparative efficacy and the long-term effect of clozapine (versus haloperidol), on neuropsychological test performance. Neuropsychological measures of executive/attention, visuospatial, and memory function were administered to schizophrenic patients at baseline, at the end of a 10-week double-blind study, and after 1 year of open clozapine treatment. Symptoms and function ratings were obtained at the same time points. The 10-week double-blind study revealed significant group-by-time interactions for two measures: Categorical Fluency and WAIS-R Block Design. At the end of 1 year of open treatment there were significant improvements in Verbal Fluency, Mooney Faces Closure, and WAIS-R Block Design performance, and trend improvements in Stroop Color-Word Interference, Category Fluency, and WMS-R Logical Memory performance. Improvements in neuropsychological performance were unrelated to symptom changes. Change in selected neuropsychological measures were significantly correlated with improvement in quality of life. The results suggest that long-term clozapine treatment may have beneficial effects on a broad range of cognitive functions.

Neuropsychological impairments in deficit vs nondeficit forms of schizophrenia

BACKGROUND

Previous studies have suggested that functional impairments of the frontal and parietal lobes are related to the deficit symptoms of schizophrenia. The purpose of the current study was to examine whether neuropsychological measures of frontal and parietal lobe function differentiated deficit from nondeficit patients. Neuropsychological measures of temporal lobe function were used as contrast measures.

METHODS

The performance of 18 deficit and 21 nondeficit schizophrenic patients was examined on neuropsychological measures of executive, visuospatial, and memory functions, selected on the basis of their association with lesions of either the frontal, parietal, or temporal lobes. The results from the schizophrenic subgroups were compared with the results on the same measures obtained from 30 normal controls.

RESULTS

Deficit patients performed more poorly than nondeficit patients on two frontal lobe measures, the Stroop Color-Word Interference and Trails Making B tests, and one parietal lobe measure, the Mooney Faces Closure Test. There were no differences in performance on the temporal lobe measures between the two groups. Both groups performed more poorly on the tests than the normal controls.

CONCLUSIONS

The results suggest that deficit patients may have greater performance impairments on neuropsychological measures associated with frontal and parietal neuropsychological abnormalities.

Irrational reactions to negative outcomes: evidence for two conceptual systems

According to cognitive-experiential self-theory (CEST), individuals have 2 systems for processing information, a rational system and an experiential system. Research conducted under norm theory (NT) has provided impressive evidence of an if only (IO) effect associated with postoutcome processing of aversive events that are highly consistent with formulations in CEST. Two studies involving vignettes adapted from NT were conducted that tested 4 hypotheses and corollaries derived from CEST. It was demonstrated, in support of hypotheses, that the IO effect can be obtained with ratings of one's own and of a protagonist's specific behaviors, as well as with ratings of a protagonist's diffuse emotions (the usual procedure); that a rational orientation decreases the IO effect; that increasing the intensity of outcomes increases it; and that priming the experiential system reduces people's ability to subsequently think rationally. The theoretical and research implications of these findings are discussed.

Irrational reactions to negative outcomes: Evidence for two conceptual systems

According to cognitive-experiential self-theory (CEST), individuals have 2 systems for processing information, a rational system and an experiential system. Research conducted under norm theory (NT) has provided impressive evidence of an if only (IO) effect associated with postoutcome processing of aversive events that are highly consistent with formulations in CEST. Two studies involving vignettes adapted from NT were conducted that tested 4 hypotheses and corollaries derived from CEST. It was demonstrated, in support of hypotheses, that the IO effect can be obtained with ratings of one's own and of a protagonist's specific behaviors, as well as with ratings of a protagonist's diffuse emotions (the usual procedure); that a rational orientation decreases the IO effect; that increasing the intensity of outcomes increases it; and that priming the experiential system reduces people's ability to subsequently think rationally. The theoretical and research implications of these findings are discussed.

[Morphology of free immature germ cells in human testis, epididymis and ejaculate]

The distribution and fine structure of free immature germ cells and their degenerated forms in the human testis, epididymis, and ejaculate were investigated by means of semithin sections under the light microscope and by means of thin sections under the electron microscope. If spermatogenesis is normal, among the free immature germ cells, spermatids and spermatocytes I can be found in the testis. In cases of disorganized or very reduced germinal epithelium, in addition to all the normal cell forms of spermatogenesis, numerous morphologically altered and degenerated free immature germ cells are present. In these cells vacuoles, nuclear tubuli, and a special structure of the endoplasmic reticulum are particularly remarkable. Spermatocytes II and normal and aberrant forms of spermatids are present in the epididymis. Aberrations of the spermatids are especially numerous--for example multinucleated cells, abnormalities of nuclear condensation and acrosome vesicle, abundant cytoplasm in combination with a small nucleus, and a great number of lipid droplets in the cytoplasm. In comparison with the testis, the number of cell ghosts and anucleated components of cytoplasm is increased. The variety of cell types is decreased in the ejaculate. Only spermatids are distinctly demonstrable. Primary spermatocytes are characterized by exceptional abundant endoplasmic reticulum. Cells with eccentrically placed dense nuclei are not similar to any of the cell forms in spermatogenesis. The fine structure of many cells appears faded. Often the cells are degenerated or only recognizable as shadow forms. Two forms of anucleated components of the cytoplasm are distinguishable. These are interpreted as epididymal secretory blebs or cell fragments. Spermatophages are described in the rete testis, epididymis and ejaculate.