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Figure 1.1
Brain MRI images showing grey-matter volume reductions in first-episode schizophrenia subjects compared to healthy controls using Voxel Based Morphometry (VBM). [From the University of

Pittsburgh.]

Figure 5.3
Significance probability mapping [184] test areas of decrease in FDG relative metabolic rate and D2 receptor binding.

(A)

(B)

Figure 24.3
Fluorescence in-situ hybridization showing the presence of both 22q11.2 regions (a) and the deletion (b) with the
Figure 24.5
Ideogram of Chromosome 22, with a listing of all the commercially available probe (Vysis, Gaithersburg, MD. Courtesy: genes in the 1.5 Mb interval in the q11.2 region, thought to be Mark Pettenati, PhD, Department of Pediatrics, Wake Forest

critical for schizophrenia. The genes denoted in red are thought to University School of Medicine.)

be most likely related to psychosis.

Section 3

Organic syndromes of schizophrenia:

12Toxicpsychosis

Rajeev Kumar and Jeffrey C. L. Looi

Facts box

r
Toxic psychosis is characterized by the
A number of terms have been used in literature to
presence of psychotic symptoms usually

describe psychosis associated with acutely impaired
associated with acutely impaired cognitive
cognitive functions
[1].
These include toxic psy-functions.

chosis, acute brain syndrome, acute organic psychosis,
r

acute confusional state, ICU psychosis, metabolic
A number of centrally active prescription
encephalopathy, toxic confusional state, and delirium.

drugs taken in excessive amount can cause
The multiple terms used to denote this state lead

neurotoxicity.

r

to confusion both in clinical and research practice.

Clinical manifestations include delirium with
Therefore, the more recent psychiatric diagnostic and
features of altered consciousness,

classification systems (DSM-IV and ICD-10) opted
impairment of general cognitive functions,

to use the term “delirium.” This chapter reviews the
acute onset, fluctuating course, nocturnal