Psychology and Neuroscience Faculty Database
Psychology and Neuroscience
Arts & Sciences
Duke University

 HOME > Arts & Sciences > pn > Faculty    Search Help Login pdf version printable version 

Publications [#273397] of Richard S. Keefe

search PubMed.

Journal Articles

  1. Davis, KL; Buchsbaum, MS; Shihabuddin, L; Spiegel-Cohen, J; Metzger, M; Frecska, E; Keefe, RS; Powchik, P (1998). Ventricular enlargement in poor-outcome schizophrenia. Biological Psychiatry, 43(11), 783-793. [doi]
    (last updated on 2019/02/18)

    Abstract:
    Background: A subset of patients with schizophrenia, defined on the basis of longitudinal deficits in self-care, may show a classic ('Kraepelinian') degenerative course. An independent validator of the phenomenologically defined Kraepelinian subtype might be provided by a structural indicator of possible brain degeneration: ventricular size as measured by computed tomography (CT). Methods: To examine whether Kraepelinian patients would show a differential increase in ventricular size over time, two CT scans were conducted at intervals separated by >4 years, an average of 5 years. Fifty-three male patients with DSM-III-R diagnoses of chronic schizophrenia were subdivided into Kraepelinian (n = 22; mean age = 42 ± 8.6 years) and non-Kraepelinian (n = 31; mean age = 38 ± 12.2 years) subgroups. Kraepelinian patients were defined on the basis of longitudinal criteria: >5 years of complete dependence on others for life necessities and care, lack of employment, and sustained symptomatology. Thirteen normal elderly volunteers (mean age = 60 ± 17.8) were also scanned at 4-year intervals. CT measurements were made by raters without knowledge of subgroup membership. A semiautomated computer program was used to trace the anterior horn, lateral ventricles, and temporal horns for each slice level on which they were clearly seen. Results: The ventricles showed a bilateral increase in size over the 4-year interval in the Kraepelinian subgroup, more marked in the left hemisphere than the right. By contrast, neither the non- Kraepelinian subgroup nor the normal volunteers showed significant CT changes from scan 1 to scan 2. Conclusions: Thus, the longitudinal dysfunctions in selfcare that characterize the Kraepelinian patients were associated with an independent indicator of brain abnormality.


Duke University * Arts & Sciences * Faculty * Staff * Grad * Postdocs * Reload * Login