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SECTION EDITOR
Brian Miller, MD: Schizophrenia

Brian Miller, MD, MPH, Schizophrenia Section Editor for Psychiatric Times, is an Assistant Professor on a research tenure track in the Department of Psychiatry and Health Behavior at Georgia Regents University.  He earned a BS in mathematics from Vanderbilt University, a combined MD/MPH degree from The Ohio State University, and a PhD in psychiatric epidemiology from the University of Oulu (Finland). He completed his general psychiatry residency and fellowship in psychotic disorders at GRU, where he served as Chief Resident, and joined the faculty in 2010.

Dr Miller’s  current research focuses on inflammation/ cytokines as a potential clinical state and relapse predictive marker in schizophrenia, and is funded by an NIMH K23 Mentored Patient-Oriented Research Career Development Award and the NIH Clinical Loan Repayment Program Award. He has been recognized with several young investigator awards, the 2010 Laughlin Fellowship from the American College of Psychiatrists, and a 2011 Exemplary Psychiatrist Award from the National Alliance on Mental Illness.


 
NEWS
Genes Dictate Folate Benefit in Schizophrenia (CME/CE)
www.medpagetoday.com - 3/7/13
Mentally Ill Face High Risk for Homicide (CME/CE)
www.medpagetoday.com - 3/5/13
5 Psych Disorders Have Common Genetics (CME/CE)
www.medpagetoday.com - 2/26/13
 
PATIENT RESOURCES
Schizophrenia: MedlinePlus
www.nlm.nih.gov - 2/13/13
Schizophrenia
Fatal Foodborne Clostridium perfringens Illness at a State Psychiatric Hospital Louisiana, 2010
www.cdc.gov - 8/16/12
antibody was also negative. Patient 2.The second decedent was an ambulatory black man aged 41 years with a history of schizophrenia, hypertension, gastroesophageal reflux disorder, and frequent constipation. ... perfringens in stomach and colon tissue.
Announcements: Living Well with Chronic Illness: a Call for Public Action
www.cdc.gov - 5/3/12
The nine conditions include arthritis, cancer survivorship, chronic pain, dementia, depression, type 2 diabetes, posttraumatic disabling conditions, schizophrenia, and vision and hearing loss.
 
CLINICAL TRIALS
Depakote ER Plus an Atypical Antipsychotic Vs. an Atypical Antipsychotic Alone in the Treatment of Schizophrenia
www.clinicaltrials.gov -
Evaluating a Collaborative Care Model for the Treatment of Schizophrenia (EQUIP)
www.clinicaltrials.gov -
Safety Study With Paliperidone ER Extended-Release (ER) Tablets in Geriatric Patients With Schizophrenia
www.clinicaltrials.gov -
 
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Schizophrenia
 
FEATURED CONTENT

Eliciting the Phenomenon of Schizophrenia From an Autobiographical Narrative
August 27, 2012

In spite of a psyche that was increasingly blurring the boundaries between fantasy and reality, this lawyer and professor graduated from Vanderbilt with a perfect academic record.

Brain on Fire: An Interview With Susannah Cahalan on Anti–NMDA Receptor Autoimmune Encephalitis
January 23, 2013

Recently, Psychiatric Times spoke with author Susannah Cahalan about her recently published memoir, which explores a subject of vital importance to psychiatrists. At the height of her disease, nothing distinguished her from a person with schizoaffective disorder or schizophrenia—the only difference came later: when she was cured.

CAINS Can—Study Shows Tool Is Effective in Assessing Negative Symptoms
February 13, 2013

The Clinical Assessment Interview for Negative Symptoms (CAINS) is an effective tool in measuring negative symptoms in schizophrenia, according to a recent study.

 
TEST YOUR KNOWLEDGE

Schizophrenia Quiz
September 7, 2010

Do you know the comorbidity rates for OCD in the schizophrenia population? Does early onset schizophrenia have any effect on disease severity? These questions and more from this week's quiz.

Schizophrenia Quiz
July 27, 2010

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 week's quiz.

 
LATEST FEATURES
May 23, 2013
The Role of Biological Tests in Psychiatric Diagnosis
"Psychiatric diagnosis is certainly imperfect -- but so is much of diagnosis throughout medicine. And whatever the current limitations, psychiatric diagnosis is useful and essential. There are no 'paradigm shifts possible til we learn a lot more. To imply otherwise is misleading and confusing to... More »
May 22, 2013
The Paradox of Choice: When More Medications Mean Less Treatment
Two problems persist in the treatment of severe mental illness that constitute a barrier to effective patient-centered care: excessive reliance on a limited number of antipsychotic medications at the expense of other effective treatments, and the underutilization of other evidence-based treatment... More »
May 21, 2013
Refinements in ECT Techniques
With ECT‚ the response rate for treatment-refractory patients is sobering‚ and the treatment is not without risks and adverse effects. More »
May 15, 2013
The British Psychological Society Enters the Silly Season
The British Psychological Society has issued a press release that rivals the silliness of DSM-5 and the National Institute of Mental Health. More »
May 10, 2013
NIMH vs DSM 5: No One Wins, Patients Lose
The flat out rejection of DSM-5 by National Institute of Mental Health is a sad moment for mental health--and an unsafe one for our patients. The APA and NIMH are both letting us down, failing to be safe custodians for the mental health needs of our country. More »
May 7, 2013
The Electroencephalogram in the Management of Psychiatric Conditions
The electroencephalogram (EEG) has a limited but definitive role in understanding and managing psychiatric conditions. When the presentation is unusual, a neurological workup that includes an EEG is essential. More »
Showing 1 - 6 of 713 results.
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JOURNAL SCAN
In individuals with schizophrenia, duration and severity of mental illness, health status, mutuality, employment and household income influence quality of life
ebn.bmj.com - 12/11/12

Commentary on: HsiaoCYHsiehMHTsengCJ. Quality of life of individuals with schizophrenia living in the community: relationship to socio-demographic, clinical and psychosocial characteristics J Clin Nurs 2012;21:2367–76.

Implications for practice and research

  • The quality of relationships with

    • Financial reinforcers for improving medication adherence: findings from a meta-analysis.
    pubmed.gov - 9/1/12
    Increasingly, financial reinforcement interventions based on behavioral economic principles are being applied in health care settings, and this study examined the use of financial reinforcers for enhancing adherence to medications.|Electronic databases and bibliographies of relevant references were searched, and a meta-analysis of identified trials was conducted. The variability in effect size and the impact of potential moderators (study design, duration of intervention, magnitude of reinforcement, and frequency of reinforcement) on effect size were examined.|Fifteen randomized studies and 6 nonrandomized studies examined the efficacy of financial reinforcement interventions for medication adherence. Financial reinforcers were applied for adherence to medications for tuberculosis, substance abuse, human immunodeficiency virus, hepatitis, schizophrenia, and stroke prevention. Reinforcement interventions significantly improved adherence relative to control conditions with an overall
    Microduplications disrupting the MYT1L gene (2p25.3) are associated with schizophrenia.
    pubmed.gov - 8/1/12
    Childhood-onset schizophrenia (COS) is a rare severe form of schizophrenia that may have greater salient genetic risk. Despite evidence for high heritability, conclusive genetic causes of schizophrenia remain elusive. Recent genomic technologies in concert with large case-control cohorts have led to several associations of highly penetrant rare copy number variants (CNVs) and schizophrenia. We previously reported two patients with COS who carried a microduplication disrupting the PXDN and MYT1L genes at 2p25.3. This rate of duplications within our COS population (N=92) is significantly higher than that in 2026 healthy controls (P=0.002). As a replication, we report a meta-analysis of four recently published studies that together provide strong evidence for an association between variably sized microduplications involving the MYT1L gene and schizophrenia. None have reported this separately. Altogether, among 5325 patients and 9279 controls, 10 microduplications were observed: nine in
    The nature of dopamine dysfunction in schizophrenia and what this means for treatment.
    pubmed.gov - 8/1/12
    Current drug treatments for schizophrenia are inadequate for many patients, and despite 5 decades of drug discovery, all of the treatments rely on the same mechanism: dopamine D(2) receptor blockade. Understanding the pathophysiology of the disorder is thus likely to be critical to the rational development of new treatments for schizophrenia.|To investigate the nature of the dopaminergic dysfunction in schizophrenia using meta-analysis of in vivo studies.|The MEDLINE, EMBASE, and PsycINFO databases were searched for studies from January 1, 1960, to July 1, 2011.|A total of 44 studies were identified that compared 618 patients with schizophrenia with 606 controls, using positron emission tomography or single-photon emission computed tomography to measure in vivo striatal dopaminergic function.|Demographic, clinical, and imaging variables were extracted from each study, and effect sizes were determined for the measures of dopaminergic function. Studies were grouped into those of
    The age at onset of psychosis and tobacco use: a systematic meta-analysis.
    pubmed.gov - 8/1/12
    There is a well-established but poorly understood association between tobacco use and psychotic illness. The aim of this study was to determine whether tobacco use is associated with an earlier age at onset of psychotic illness.|Peer-reviewed publications in English reporting the age at onset of psychosis in tobacco-using and non-tobacco-using groups were located using searches of CINAHL, EMBASE, MEDLINE, PsycINFO and ISI Web of Science, and were supplemented by papers located by manual searches and unpublished data obtained by correspondence with primary researchers. A total of 29 samples reported age at onset data in a consecutive series of patients with a diagnosis of schizophrenia related psychosis or first episode psychosis. Information on study design, study population and effect size was extracted independently by three authors. A random effects meta-analysis was performed.|There was no significant difference between smokers and non-smokers in age at the onset of psychosis
     
    MEDLINE
    Prevalence and correlates of psychiatric disorders among residents of a juvenile Remand Home in Nigeria: implications for mental health service planning.
    pubmed.gov - 1/10/13
    Research has established that psychiatric disorders are common among children and adolescents within thejuvenile justice system. However, the bulk of these researches had been from the developed countries, with very limited data from sub-Sahara Africa. In a region like sub-Sahara Africa with acute shortage of mental healthcare resources, availability of data on mental health needs of children within the juvenile justice system is about the only way to ensure that they are not excluded from needed services. This study aims to determine the pattern, prevalence and correlates of psychiatric disorders among the residents of a juvenile justice facility in Nigeria and to speculate appropriate policy responses.|Using a cross-sectional comparative study design, 60 consecutive residents of the Ibadan juvenile Remand home and 60 randomly selected age- and gender-matched school going adolescents were evaluated for the presence of current and lifetime psychiatric disorders. The Kiddies Schedule
    Relationship between GSTM1 and GSTT1 polymorphisms and schizophrenia: a case-control study in a Tunisian population.
    pubmed.gov - 1/9/13
    There is substantial evidence found in the literature that supports the fact that the presence of oxidative stress may play an important role in the pathophysiology of schizophrenia. The glutathione S-transferases (GSTs) forms one of the major detoxifying groups of enzymes responsible for eliminating products of oxidative stress. Interindividual differences observed in the metabolism of xenobiotics have been attributed to the genetic polymorphism of genes coding for enzymes involved in detoxification. Thus, in this study we investigated the association of glutathione S-transferase Mu-1 (GSTM1) and glutathione S-transferase theta-1 (GSTT1) gene deletion polymorphisms and schizophrenia in a Tunisian population. A case-control study including 138 schizophrenic patients and 123 healthy controls was enrolled. The GSTM1 and GSTT1 polymorphisms were analyzed by multiplex polymerase chain reaction (PCR). No association was found between the GSTM1 genotype and schizophrenia, whereas the
    Altered functional and structural connectivity in a schizophrenia patient with complete agenesis of the corpus callosum.
    pubmed.gov - 12/31/12
    23288389 2013 01 04 2013 02 19 1535-7228 170 1 Jan 1 Am J Psychiatry 122-3 10.1176/appi.ajp.2012.12060822 Rane Swati S Kose Samet S Gore John C JC Heckers Stephan S eng Case Reports Letter United States Am J Psychiatry 0370512 0002-953X 7782-44-7
    The potential of nicotinic enhancement of cognitive remediation training in schizophrenia.
    pubmed.gov - 12/31/12
    Cognitive deficits in schizophrenia are critically important predictors of long-term psychosocial outcome and are not significantly ameliorated by currently available medications. Cognitive remediation training has shown promise for alleviating cognitive symptoms of schizophrenia, but the clinical significance has often been limited by small effect sizes. Approaches that achieve larger improvement involve time requirements that can be cost-prohibitive within the current clinical care system. This mini-review evaluates the theoretical potential of a pharmacological enhancement strategy of cognitive remediation training with nicotinic acetylcholine receptor (nAChR) agonists. nAChR agonists can facilitate sensory processing, alertness, attention, learning and memory. While these effects may be too subtle and short-lasting to be of clinical relevance as a primary treatment of cognitive deficits, they constitute an ideal effects profile for enhancing training benefits. Several mechanisms
    Genetic correlate of cognitive training response in schizophrenia.
    pubmed.gov - 12/31/12
    Intensive computerized auditory training results in improved cognition for schizophrenia patients, but participants show variation in their cognitive gains and the biological factors that affect the response to training are unknown. Single nucleotide polymorphisms (SNPs) in the catechol-O-methyltransferase (COMT) gene have been related to cognitive function. Here we asked if functional variation in this gene has an impact on the response of schizophrenia patients to cognitive training. We genotyped 48 schizophrenia patients who completed 50 h of computerized cognitive training and analyzed the association between DNA variants in the COMT gene and the improvement in global cognition. Although conventional analyses did not reveal any significant associations, a set-based analysis examining the aggregate effect of common variation in the COMT gene (42 SNPs) suggested association with improvement in global cognition. Eight SNPs, mostly located in the 3' end of the COMT gene, were
     
    PRACTICE GUIDELINES
    National Guideline Clearinghouse | Guidelines by Topic: Schizophrenia
    www.guidelines.gov -
    NGC is the National Guideline Clearinghouse.
    National Guideline Clearinghouse | Guidelines by Topic: Schizophrenia, Childhood
    www.guidelines.gov -
    NGC is the National Guideline Clearinghouse.
    National Guideline Clearinghouse | Guidelines by Topic: Schizophrenia and Disorders with Psychotic Features
    www.guidelines.gov -
    NGC is the National Guideline Clearinghouse.
    Summary of the Practice Parameter for the Assessment and Treatment of Children and Adolescents with Schizophrenia | American Academy of Child & Adolescent Psychiatry
    www.aacap.org -
    Summaries. Summary of the Practice Parameter for the Assessment and Treatment of Children and Adolescents with Schizophrenia. ... ABSTRACT. This practice parameter reviews the literature on the assessment and treatment of children and adolescents with
    National Guideline Clearinghouse | Schizophrenia. Core interventions in the treatment and management of schizophrenia in adults in primary and secondary care.
    www.guidelines.gov -
    Schizophrenia. Core interventions in the treatment and management of schizophrenia in adults in primary and secondary care.



     
    FROM PHYSICIANS PRACTICE
    Five Steps to Improving Patient Access
    Judy Capko,  May 21, 2013
    Patient access is getting increased attention through reform initiatives. Here are five steps you can take to make sure patients get appropriate access to care in your office.
    Growing HIPAA Threat – Ignore Windows XP at Your Own Peril
    Marion K. Jenkins,  May 21, 2013
    Chances are good that you have some major ticking software time bombs lurking in your medical practice's computer environment, namely Windows XP and Server 2003.
    Finding Physician Work-Life Balance in the Small Moments
    Jennifer Frank, MD,  May 21, 2013
    At my practice and at home, things are always busy. There's laundry or homework, or a patient with needs.
    Three Areas to Reduce Costs at Your Medical Practice
    Greg Mertz,  May 19, 2013
    By taking a hard look at reducing costs for staffing, overhead, and technology at your medical practice, you may see increased physician compensation.
    Dos and Don’ts for Starting a Physician Blog
    Michael Woo-Ming, MD,  May 18, 2013
    Starting a physician blog can provide your medical practice with marketing benefits, but it's important to do it right.
     

     
     
    COMMENTS
     
    CAREER CENTER


     
    COUCH IN CRISIS

    Parity Laws: Powerful Weapon—or Pipe Dream?
    Psychiatric Times,  May 6, 2013
    Grief and Depression: The Sages Knew the Difference
    Psychiatric Times,  April 29, 2013
    US Physicians and Burnout: Optimistic Psychiatrists Take Heart?
    Psychiatric Times,  April 26, 2013
    Lighting a Candle in Newtown
    Psychiatric Times,  April 17, 2013
    The Obama Plan—Spending Mental Health Money in All the Wrong Places
    Psychiatric Times,  April 12, 2013