Schizophrenia/Psychosis

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It's often believed--even by mental health care professionals--that people with mental illnesses could be employed in low-level jobs. Studies and demonstration projects have shown, however, that these individuals can sustain employment in high-level positions with the proper training and support.

There may be exciting new treatments for psychiatric disorders in the coming years due to advances in genetic testing. However, the increased cost of drug development and the current regulatory climate has had a chilling effect on taking risks and pursuing novel strategies.

In July, the President's New Freedom Commission on Mental Health issued a document that is likely to shape the nation's mental health policies for decades. The commission's charge was to study inadequacies in the current mental health system and make specific recommendations for addressing these problems without increasing government spending on mental health care.

Results from three statewide studies of the clinical practices for assessing and treating children and adolescents with a primary diagnosis of conduct disorder, ADHD or bipolar I disorder demonstrate gender and ethnic differences only for those diagnosed with conduct disorder. The implications of these findings and their similarities to the literature on adults with psychiatric disorders are discussed.

Can olanzapine (Zyprexa) delay or even prevent psychosis in patients with prodromal symptoms of schizophrenia? A new study being conducted in four research centers in North America is attempting to answer that question. Prevention Through Risk Identification Management and Education (PRIME) uses several new scales developed specifically for this study to identify and rate symptoms of prodromal symptoms to assist in early intervention research.

The inability to create an accurate picture of self-awareness is a feature in many mental illnesses, such as schizophrenia, autism, ADHD, personality disorders and substance abuse. At a Kansas City, Mo., conference, researchers begin to establish a biological basis for self-awareness and hope to isolate the deficits in the brain that causes abnormal functioning.

There are many factors that contribute to patients with schizophrenia not taking their medication, including side effects and lack of education. What can clinicians do to help their patients adhere to treatment? Should clinicians be spending more time educating their patients? How will long-acting medications affect adherence issues?

The idea that drug response could be based on a patient's genetic background first surfaced over 100 years ago. Since then, technology has advanced to the point where prescribing medications based on a patient's genetic makeup no longer seems like science fiction. This article looks at the latest research on the pharmacogenetics of psychotropic medications and shows how far we still have to go.

Schizophrenia is a devastating psychiatric disorder that affects 1% of the population worldwide. Patients often suffer their first psychotic outbreak in their late teens or early 20s. Despite advances in neuroleptic drugs, many patients' symptoms remain refractory to treatment, with recurrent episodes of auditory and visual hallucinations, bizarre delusions, depression, and social withdrawal that can last an entire lifetime.

The World Trade Center attack changed the face of the United States and of psychiatry. Men and women of the cloth and of the clinic came together to care for the stricken masses. Yet, members of the clergy do not always refer congregants who exhibit duress to the psychiatrist, nor do psychiatrists refer patients to the clergy. What keeps these two fields apart? What is best for your patient?

The atypical antipsychotics have become the treatment of choice for patients with psychotic and other behavioral disorders. However, case reports, retrospective studies and epidemiological data suggest that these medications may be associated with new-onset type 2 diabetes and diabetic ketoacidosis.

Honors

HonorsThe National Alliance for Research on Schizophrenia and Depression (NARSAD) recently honored outstanding psychiatric researchers.

Standardized test scores and adaptive functioning will now be used to determine who may be sentenced to death and who may not. Yet, legal and psychiatric experts continue to challenge each other to define mental retardation. Some say that retardation can be feigned and used to weaken the power of the death penalty. Others say the issue will not arise.

Medication and psychotherapy or counseling can be safely and effectively combined in patients with substance use and other psychiatric disorders. Differentiating between substance-induced psychiatric disorders and pre-existing psychiatric disorders facilitates the successful treatment of dually diagnosed patients. Find out what the latest research offers in the prognosis of psychiatric disorders and substance use.

Treatment with psychopharmaceuticals may prove problematic for pregnant women. The decision to discontinue medications or to adjust dosages to minimize the risk to the fetus has to be addressed. The dynamic balance of treatment options, maternal concerns and practitioner responsibility depends upon staying abreast of the latest research in psychopharmacology and pregnancy.