The prognosis for schizophrenia is much better when patients achieve drug abstinence, including in the domains of depression, quality of life, and community integration.Read More
While research suggests that cannabis use can induce an acute psychotic state, there is controversy about whether it may precipitate psychotic disorders, such as schizophrenia. Here, an update.Read More
Psychiatrists vary in their eagerness to share therapeutic decisions with patients. These authors argue in favor of a radically more collaborative style.Read More
Is the mortality from smoking-related diseases higher in patients with schizophrenia? What decade did the concept of the quality of life with antipsychotics come into being? These questions and more in this quiz.Read More
The Clinical Assessment Interview for Negative Symptoms (CAINS) is an effective tool in measuring negative symptoms in schizophrenia, according to a... More »
Both positive and negative symptoms of schizophrenia combined with those of a mood disorder led to a psychiatric diagnosis; later, a neurological... More »
The new annual suicide rate of 12.0 per 100,000 people translates into 100.8 suicides per day and 1 suicide every 14.3 minutes. Here, you will find... More »
Emotion perception (EP) is impaired in schizophrenia, is stable across clinical state, resistant to antipsychotic treatment and linked to symptom severity. Given its pervasive nature, there is a need to quantitatively examine whether this dysfunction impacts functional outcomes. We used a meta-analytic strategy to combine results from several studies and examine synthesized effect sizes.|A Meta-analysis of Observational Studies in Epidemiology standard was used to extract data following a PubMed and PsychInfo search. Studies reporting correlations between measures of EP and functional outcomes in schizophrenia spectrum disorders were selected. The impact of potential methodological (task type), demographic (sex, age, race, education, marital status) and clinical (age of onset, duration of illness, setting, symptoms, anti-psychotic medication) moderators on effect sizes were examined.|Twenty-five studies met inclusion criteria and included 1306 patients who were 37 years old, with 12
Inhibition of return (IOR) is a phenomenon that involves inhibited or delayed orienting to previously cued locations in favor of attending to novel locations. To date, research on IOR in patients with schizophrenia has generated mixed, and seemingly conflicting, results. Some researchers report patients with schizophrenia exhibit blunted or delayed IOR, while other researchers report normal IOR, in terms of time course and magnitude. This meta-analysis summarizes the literature that has employed an IOR task in patients with schizophrenia and with controls while focusing upon a procedural feature, the use of a cue back to fixation, between the cue and target that is known to be important when executive control has been hampered in non-clinical populations. Fifteen experiments were located yielding a total sample of 362 patients with schizophrenia or schizoaffective disorder and 285 controls. Using a meta-analytic approach, results of the present analyses show that patients with
To clarify the efficacy and tolerability of bupropion sustained release (SR) for the treatment of cigarette smoking in people with schizophrenia.|The first study is a double-blind, placebo-controlled clinical trial with 32 outpatients from the Maryland Psychiatric Research Center. From May 2003 to July 2007, clinically stable people with a DSM-IV diagnosis of schizophrenia or schizoaffective disorder who smoked at least 10 cigarettes per day and who were interested in quitting smoking or cutting down were recruited for participation. All participated in a 9-week support group and were randomly assigned to receive 12 weeks of bupropion SR or placebo. The primary outcome measure was 4 weeks' sustained abstinence over the last 4 study weeks. Secondary outcome measures included decrease in smoking behavior and change in symptoms, neuropsychological performance, and side effects. In the second study, we performed an electronic literature search of MEDLINE in September 2008. Articles in
Our aim in this article is 2-fold: first, to examine the mid-term to long-term data on efficacy, from controlled and naturalistic and other studies, in order to determine if they are consistent with the quantitative meta-analyses of mostly short-term, randomized controlled trials Our second (and most important) aim is to use these and other data to provide guidance about the potential relationship of these differences among antipsychotics to the individual patient's own experience with antipsychotic drugs in the process of shared decision-making with the patients and their significant others.|A search of PubMed, Embase, and PsychINFO was conducted for articles published in English between January 1, 1999, and April 2011, using the search terms double-blind AND randomized AND olanzapine AND (ziprasidone OR risperidone OR quetiapine OR haloperidol OR fluphenazine OR perphenazine OR aripiprazole).|Studies with a duration 3 months or longer, including patients with schizophrenia or
Brain-derived neurotrophic factor (BDNF) regulates the survival and growth of neurons, and influences synaptic efficiency and plasticity. Several studies report reduced peripheral (blood) levels of BDNF in schizophrenia, but findings are inconsistent. We undertook the first systematic review with meta-analysis of studies examining blood BDNF levels in schizophrenia compared with healthy controls, and examined potential effects of age, gender and medication. Included are individual studies of BDNF blood (serum or plasma) levels in schizophrenia (including schizoaffective disorder, or first episode psychosis), compared with age-matched healthy controls, obtained by electronic Medline and Embase searches, and hand searching. The decision to include or exclude studies, data extraction and quality assessment were completed by two independent reviewers. The initial search revealed 378 records, of which 342 were excluded on reading the Abstract, because they did not examine BDNF blood levels
Olfactory hallucinations (OHs) are present in a significant minority of people with schizophrenia, yet these symptoms are under-researched and poorly understood. This study aimed to identify the neuropsychological impairments that associate with OHs in schizophrenia. Patients with schizophrenia or schizoaffective disorder were classified into an OH group and a group with auditory-verbal hallucinations (AVHs) and no lifetime history of OHs. Patients were age- and gender-matched to a healthy control group. All participants were assessed using: a test of odor identification; decision-making and socio-emotional tests of orbitofrontal cortex (OFC) and amygdala function; and a battery of standardized executive tests. Patients, as a whole, performed more poorly than controls on the tests of odor identification, emotion processing and executive function, consistent with previous research. Only two tests of OFC functioning: the Object Alternation Task, taken from Oscar-Berman and Zola-Morgan's
Schizophrenia is a severe psychiatric disorder with strong heritability and marked heterogeneity in symptoms, course, and treatment response. There is strong interest in identifying genetic risk factors that can help to elucidate the pathophysiology and that might result in the development of improved treatments. Linkage and genome-wide association studies (GWASs) suggest that the genetic basis of schizophrenia is heterogeneous. However, it remains unclear whether the underlying genetic variants are mostly moderately rare and can be identified by the genotyping of variants observed in sequenced cases in large follow-up cohorts or whether they will typically be much rarer and therefore more effectively identified by gene-based methods that seek to combine candidate variants. Here, we consider 166 persons who have schizophrenia or schizoaffective disorder and who have had either their genomes or their exomes sequenced to high coverage. From these data, we selected 5,155 variants that
Antipsychotic-induced weight gain (AIWG) is a serious side-effect of antipsychotic medication leading to metabolic syndrome and increased cardiovascular morbidity. Unfortunately, there are still no valid predictors to assess an individual's risk to gain weight. Previous studies have indicated an impact of genetic variation in the genes encoding leptin, LEP, and leptin receptor, LEPR, on AIWG, but results have not been conclusive. Thus, we investigated polymorphisms in both genes for an association with AIWG.|A total of 181 schizophrenic and schizoaffective patients treated with various antipsychotics were included. In a small subset of patients, leptin plasma levels were additionally obtained. Five polymorphisms in LEP and LEPR (LEP: rs7799039 (-2548G/A polymorphism), rs10954173, rs3828942; LEPR: rs1327120, rs1137101 (Q223R polymorphism) were genotyped using TaqMan assays. Statistical association with % weight change from baseline weight was performed using ANCOVA with baseline weight
To examine whether deficits in focal lateralized motor system activation would differentiate between subjects with schizophrenia/schizoaffective disorder and subjects with a major depressive episode. Reductions of Bereitschaftspotential amplitude have been described for both diagnostic groups.|We analyzed multi-channel lateralized movement-related potentials (LMRP) during choice reaction movements in 16 schizophrenic/schizoaffective patients in partial remission with predominant negative symptoms, 18 patients with a non-psychotic major depression and two healthy control groups age-matched to the respective patient groups (20/23 subjects).|A significant reduction of lateralized potentials over the (pre-)motor areas immediately preceding and around movement execution was found only in subjects with schizophrenia/schizoaffective disorder but not with a major depressive episode. Reduced LMRP amplitudes correlated with negative symptoms (SANS score). Other movement stages (preceding
To review published cases and prospective studies describing the use of varenicline in patients with schizophrenia and schizoaffective disorder.|PubMed, PsychINFO, and the Cochrane Database were searched in July 2011 using the key words schizophrenia, schizoaffective disorder, psychosis, positive symptoms, negative symptoms, aggression, hostility, suicidal ideation AND varenicline to identify reports published between January 2006 and July 2011 in English.|Five case reports, 1 case series, 1 retrospective study, 10 prospective studies (17 publications), and 1 meeting abstract describing the use of varenicline in patients with schizophrenia or schizoaffective disorder were identified. Review articles and articles describing findings other than the use of varenicline in patients with schizophrenia or schizoaffective disorder were excluded. Thirteen reports were included in the final analysis.|Information on each study's patient population, age, diagnosis, medication treatment, tobacco
Patients who satisfied any of the following criteria on the basis of automated records of physician diagnosis and visits were excluded: diagnosis of bipolar disorder, schizophrenia, or schizoaffective disorder dur- ing ... bipolar disorder
Patients who satisfied any of the following criteria on the basis of automated records of physician diagnosis and visits were excluded: diagnosis of bipolar disorder, schizophrenia, or schizoaffective disorder during the
Primary Care Can't Thrive Without Nurse Practitioners Courtney H. Lyder, ND, May 17, 2013 With a projected shortfall of primary-care physicians, it's time for alternate solutions to patient care. Nurse practitioners are one logical remedy.