Toward Illness Phase–Specific Pharmacotherapy for Schizophrenia

Coronavirus disease 2019 (COVID-19) is a viral infection that causes various respiratory, gastrointestinal, and vascular symptoms. The acute illness phase lasts for about 2-3 weeks. However, there is increasing evidence that a percentage of COVID-19 patients continue to experience long-lasting symptoms characterized by fatigue, dyspnea, myalgia, exercise intolerance, and sleep disturbances, difficulty concentrating, anxiety, fever, headache, malaise, and vertigo. Similar symptoms are reported by patients who having myalgic encephalomyelitis/ chronic fatigue syndrome (ME/CFS). ME/CFS pathology is not known: it is thought to be multifactorial, resulting from the dysregulation of multiple systems in response to a particular trigger. There is a resemblance between post-acute COVID-19 symptoms and ME/CFS. However, at present, there is inadequate evidence to establish COVID-19 as an infectious trigger for ME/CFS. Further research is required to determine the natural history of this condition, as well as to define risk factors, prevalence, and possible interventional strategies. Keywords: chronic fatigue syndrome, COVID-19, human coronavirus, myalgic encephalomyelitis, post-infectious fatigue, review.

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Antecedents of suicide in people with schizophrenia

The British Journal of Psychiatry ◽

10.1192/bjp.173.4.330 ◽

1998 ◽

Vol 173 (4) ◽

pp. 330-333 ◽

Cited By ~ 24

Author(s):

Hannele Heilä ◽

Erkki T. Isometsä ◽

Markus M. Henriksson ◽

Marti E. Heikkinen ◽

Mauri J. Marttunen ◽

...

Keyword(s):

Suicide Attempts ◽

Active Phase ◽

Psychological Autopsy ◽

Next Of Kin ◽

Autopsy Study ◽

Treatment Relationship ◽

Prevention Project ◽

History Of ◽

Illness Phase ◽

Previous Suicide Attempt

BackgroundSuicides among people with schizophrenia are commonly believed to be impulsive and to occur unexpectedly.MethodAs part of the National Suicide Prevention Project in Finland, a nationwide psychological autopsy study, suicide victims with DSM-III-R schizophrenia (n=86; n=64 in the active illness phase) and others (n=1 109; n=666 without any evidence for psychosis) were compared for communication of suicidal intent (CSI), as well as previous suicide attempts known by the next of kin and/or an attending health care professional during the latest treatment relationship.ResultsMore victims with schizophrenia (84%) had a history of previous CSI, and/or had made previous suicide attempt(s) than others (70%). Also, victims with active illness schizophrenia (56%) had more CSI and/or had made suicide attempts during their last three months than victims with no psychosis (41%).ConclusionsCSI and/or suicide attempts occur at least as often in people with schizophrenia as in those without schizophrenia, even in the active phase of the illness.

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The Quick Inventory of Depressive Symptomatology (Clinician and Self-Report Versions) in Patients With Bipolar Disorder

CNS Spectrums ◽

10.1017/s1092852900029230 ◽

2010 ◽

Vol 15 (6) ◽

pp. 367-373 ◽

Cited By ~ 10

Author(s):

Ira H. Bernstein ◽

A. John Rush ◽

Trisha Suppes ◽

Yakasushi Kyotoku ◽

Diane Warden

Keyword(s):

Bipolar Disorder ◽

Major Depressive Disorder ◽

Depressive Symptoms ◽

Depressive Disorder ◽

Depressive Symptomatology ◽

Self Report ◽

General Interest ◽

Major Depressive ◽

Sad Mood ◽

Illness Phase

ABSTRACTIntroduction: The clinical and self-report versions of the Quick Inventory of Depressive Symptomatology (QIDS-C16 and QIDS-SR16) have been well studied in patients with major depressive disorder and in one recent study using patients with bipolar disorder. This article examines these measures in a second sample of 141 outpatients with bipolar disorder in different phases of the illness.Methods: At baseline, 61 patients were depressed and 30 were euthymic; at exit, 50 were depressed and 52 were euthymic. The remaining patients (at baseline or exit) were in either a manic or mixed phase and were pooled for statistical reasons.Results: Similar results were found for the QIDS-C16 and QIDS-SR16. Scores were reasonably reliable to the extent that variability within groups permitted. As expected, euthymic patients showed less depressive symptomatology than depressed patients. Sad mood and general interest were tne most discriminating symptoms between depressed and euthymic phases. Changes in illness phase (baseline to exit) were associated with substantial changes in scores. The relation of individual depressive symptoms to the overall level of depression was consistent across phases.Conclusion: Both the QIDS-SR16 and QIDS-C16 are suitable measures of depressive symptoms in patients with bipolar disorder.

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Diagnosis and treatment in the early illness phase of bipolar disorders

European Archives of Psychiatry and Clinical Neuroscience ◽

10.1007/s00406-008-5009-z ◽

2008 ◽

Vol 258 (S5) ◽

pp. 50-54 ◽

Cited By ~ 26

Author(s):

Michael Bauer ◽

Georg Juckel ◽

Christoph U. Correll ◽

Karolina Leopold ◽

Andrea Pfennig

Keyword(s):

Bipolar Disorders ◽

Diagnosis And Treatment ◽

Illness Phase

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Illness Phase

Encyclopedic Dictionary of Polymers ◽

10.1007/978-1-4419-6247-8_13979 ◽

2011 ◽

pp. 900-900

Author(s):

Jan W. Gooch

Keyword(s):

Illness Phase

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Reward processing electrophysiology in schizophrenia: Effects of age and illness phase

NeuroImage Clinical ◽

10.1016/j.nicl.2020.102492 ◽

2020 ◽

Vol 28 ◽

pp. 102492

Author(s):

Samantha V. Abram ◽

Brian J. Roach ◽

Clay B. Holroyd ◽

Martin P. Paulus ◽

Judith M. Ford ◽

...

Keyword(s):

Reward Processing ◽

Illness Phase

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Reward processing electrophysiology in schizophrenia: Effects of age and illness phase

10.1101/2020.06.18.158469 ◽

2020 ◽

Author(s):

Samantha V. Abram ◽

Brian J. Roach ◽

CB Holroyd ◽

MP Paulus ◽

Judith M. Ford ◽

...

Keyword(s):

Depressive Symptoms ◽

Slot Machine ◽

Outcome Evaluation ◽

Reward Processing ◽

Chronological Age ◽

Reward Anticipation ◽

Related Potentials ◽

Brain Age ◽

Illness Phase ◽

Age Estimates

AbstractBackgroundReward processing abnormalities may underlie characteristic pleasure and motivational impairments in schizophrenia. Some neural measures of reward processing show strong age-related modulation, highlighting the importance of considering age effects on reward sensitivity. We compared event-related potentials (ERPs) reflecting reward anticipation (stimulus-preceding negativity, SPN) and evaluation (reward positivity, RewP; late-positive potential, LPP) across individuals with schizophrenia (SZ) and healthy controls (HC), with an emphasis on examining effects of chronological age, brain age (i.e., predicted age based on neurobiological measures), and illness phase.MethodsSubjects underwent EEG while completing a slot-machine task for which rewards were not dependent on performance accuracy, speed, or other preparatory demands. Slot-machine task EEG responses were compared between 54 SZ and 54 HC individuals, ages 19 to 65. Reward-related ERPs were analyzed with respect to chronological age, categorically-defined illness phase (early; ESZ versus chronic schizophrenia; CSZ), and were used to model brain age relative to chronological age.ResultsIllness phase-focused analyses indicated there were no group differences in average SPN or RewP amplitudes. However, a group x reward outcome interaction revealed that ESZ differed from HC in later outcome processing, reflected by greater LPP responses following loss versus reward (a reversal of the HC pattern). While brain age estimates did not differ among groups, depressive symptoms in SZ were associated with older brain age estimates while controlling for negative symptoms.ConclusionsESZ and CSZ did not differ from HC in reward anticipation or early outcome processing during a cognitively undemanding reward task, highlighting areas of preserved functioning. However, ESZ showed altered later reward outcome evaluation, pointing to selective reward deficits during the early illness phase of schizophrenia. Further, an association between ERP-derived brain age and depressive symptoms in SZ extends prior findings linking depression with reward-related ERP blunting. Taken together, both illness phase and age may impact reward processing in SZ, and brain aging may offer a promising, novel marker of reward dysfunction that warrants further study.

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