scholarly journals Developmental aspects of schizophrenia and related disorders: possible implications for treatment strategies

2007 ◽  
Vol 13 (5) ◽  
pp. 384-391 ◽  
Author(s):  
Eric J. Davies
Keyword(s):  
Adult Life ◽  
Treatment Strategies ◽  
Positive Symptoms ◽  
Schizophrenia Spectrum Disorders ◽  
Developmental Abnormalities ◽  
Developmental Factors ◽  
Schizophrenia Spectrum ◽  
Susceptibility Factors ◽  
Spectrum Disorders ◽  
Neurodevelopmental Hypothesis

Schizophrenia and other schizophrenia-spectrum disorders are neurodevelopmental disorders which may share genetic susceptibility factors and represent differential expressions of an underlying vulnerability. Schizophrenia may have its onset in childhood and can be reliably diagnosed. However, developmental factors modulate disease expression in children. Although the prevalence of schizophrenia in childhood is low, children who develop schizophrenia in adult life may show subtle and non-specific developmental abnormalities, consistent with the neurodevelopmental hypothesis. Studies of the schizophrenia prodrome also demonstrate that abnormalities may be apparent years before the onset of positive symptoms. Such evidence raises the possibility of using preventive approaches in the treatment of schizophrenia. Further advances in our knowledge of the aetiopathology of schizophrenia (and the identification of endophenotypes within the group of schizophrenia and related disorders) may further improve our ability to predict disease development, making implementation of preventive interventions more achievable.

scholarly journals Insight, positive and negative symptoms, hope, depression and self-stigma: a comprehensive model of mutual influences in schizophrenia spectrum disorders

2013 ◽  
Vol 23 (3) ◽  
pp. 271-279 ◽  
Author(s):  
B. Schrank ◽  
M. Amering ◽  
A. Grant Hay ◽  
M. Weber ◽  
I. Sibitz
Keyword(s):  
Negative Symptoms ◽  
Depression Scale ◽  
Epidemiological Studies ◽  
Positive Symptoms ◽  
Schizophrenia Spectrum Disorders ◽  
Schizophrenia Spectrum ◽  
Stigma Of Mental Illness ◽  
Relevant Variables ◽  
Spectrum Disorders ◽  
Positive And Negative Symptoms

Aims.Insight, positive and negative symptoms, hope, depression and self-stigma are relevant variables in schizophrenia spectrum disorders. So far, research on their mutual influences has been patchy. This study simultaneously tests the associations between these variables.Methods.A total of 284 people with schizophrenia spectrum disorders were assessed using the Schedule for the Assessment of Insight, Positive and Negative Syndrome Scale, Integrative Hope Scale, Centre for Epidemiological Studies Depression Scale and Internalized Stigma of Mental Illness scale. Path analysis was applied to test the hypothesized relationships between the variables.Results.Model support was excellent. Strong and mutual causal influences were confirmed between hope, depression and self-stigma. The model supported the assumption that insight diminishes hope and increases depression and self-stigma. While negative symptoms directly affected these three variables, reducing hope and increasing depression and self-stigma, positive symptoms did not. However, positive symptoms diminished self-stigma on a pathway via insight.Conclusions.This study provides a comprehensive synopsis of the relationships between six variables relevant for schizophrenia spectrum disorders. Research implications include the need to investigate determinants of consequences of insight, and the sequence of influences exerted by positive and negative symptoms. Clinical implications include the importance of interventions against self-stigma and of taking a contextualized approach to insight.

scholarly journals Clinical Staging in Schizophrenia Spectrum Disorders

2021 ◽  
Author(s):  
Zsófia Borbála Dombi ◽  
Ágota Barabássy ◽  
Barbara Sebe ◽  
István Laszlovszky ◽  
György Németh
Keyword(s):  
Gold Standard ◽  
State Of The Art ◽  
Treatment Strategies ◽  
Clinical Staging ◽  
Schizophrenia Spectrum Disorders ◽  
The Past ◽  
Schizophrenia Spectrum ◽  
Appropriate Treatment ◽  
Spectrum Disorders ◽  
Staging Model

The aim of this chapter is to summarize the state-of-the-art knowledge of clinical staging in schizophrenia spectrum disorders. Clinical staging has been introduced to psychiatry in the past two decades. Its primary goal is to divide the course of the disorder into recognizable stages based on seriousness, development and symptom characteristics in order to better predict prognosis and to adopt the most appropriate treatment strategies. The first staging model was developed in 1982. Since then several distinct concepts of clinical staging in psychiatry have emerged. To date, there is no clinical consensus regarding which staging model is the gold standard, nonetheless when merging them together an integrated staging concept arises. The integrated staging model of schizophrenia spectrum disorders is composed of four stages. The chapter will introduce the different staging models in a historical order as well as present the integrated staging model detailing the characteristics, timeline and dominating symptoms of each stage. Appropriate treatment strategies for the distinct stages will also be outlined.

scholarly journals Switching antipsychotics: Results of 16-month non-interventional, prospective, observational clinical research of inpatients with schizophrenia spectrum disorders

2017 ◽  
Vol 67 (1) ◽  
pp. 99-112
Author(s):  
Cvetka Bačar Bole ◽  
Mitja Pišlar ◽  
Metka Šen ◽  
Rok Tavčar ◽  
Aleš Mrhar
Keyword(s):  
Clinical Practice ◽  
Psychiatric Hospital ◽  
Adverse Reactions ◽  
Treatment Strategies ◽  
Schizophrenia Spectrum Disorders ◽  
Schizophrenia Spectrum ◽  
Switching Patterns ◽  
Common Causes ◽  
Spectrum Disorders ◽  
Switching Strategies

AbstractThe study aims to identify prescribing and switching patterns of antipsychotics in clinical practice. A 16-month, prospective study was conducted at the Psychiatric Hospital Idrija, Slovenia. Inpatients (N = 311) with schizophrenia spectrum disorders were observed. The causes for switching antipsychotics and switching strategies were analyzed. Analyzing a total of 3954 prescriptions, the collected data confirmed that treatment strategies in this psychiatric hospital are very complex. It was found that 37 percent of inpatients had at least one switch. Moreover, switches that included three or more antipsychotics were detected. The most common causes for switching antipsychotics were adverse reactions and inefficacy or lack of efficacy. Among switching options, abrupt switch was recorded several times. As some patients are receiving several antipsychotics at the same time, it is possible that unusual switching occurs in clinical practice. It seems that the choice of switching strategy is also affected by the cause and urgency for switching an antipsychotic.

scholarly journals A state-independent network of depressive, negative and positive symptoms in male patients with schizophrenia spectrum disorders

2018 ◽  
Vol 193 ◽  
pp. 232-239 ◽  
Author(s):  
Geeske van Rooijen ◽  
Adela-Maria Isvoranu ◽  
Olle H. Kruijt ◽  
Claudia D. van Borkulo ◽  
Carin J. Meijer ◽  
...  
Keyword(s):  
Positive Symptoms ◽  
Schizophrenia Spectrum Disorders ◽  
Schizophrenia Spectrum ◽  
Male Patients ◽  
Spectrum Disorders

scholarly journals Schizophrenia: family studies and treatment of spectrum disorders

2000 ◽  
Vol 2 (4) ◽  
pp. 381-391
Keyword(s):  
Family Studies ◽  
Treatment Strategies ◽  
Future Research ◽  
Substantial Part ◽  
Schizophrenia Spectrum Disorders ◽  
Genetic Studies ◽  
Schizophrenia Spectrum ◽  
Common Etiology ◽  
Spectrum Disorders ◽  
Conceptual Foundations

A substantial part of the contribution of genetic studies to the treatment of schizophrenia involves its emphasis on reliable and valid diagnoses. One consequence of this focus is the recognition that schizophrenic illness is broader than the diagnostic entity of schizophrenia itself, and instead consists of a "spectrum" of related disorders. Because some of the symptoms in these disorders differ from each other, they provide an opportunity to determine which ones reflect a common etiology. To the extent that such symptoms are identifiable, they may provide a foundation for treatment and even prevention strategies. In this paper, we focus on a clinical condition - "schizotaxia" - that may reflect the liability for schizophrenia. To characterize the nature and extent of this proposed syndrome, we will review results from family studies in our laboratory, and consider conceptual foundations and criteria for assessment. A more general consideration of treatment strategies for schizophrenia spectrum disorders follows, along with suggestions for future research. Our initial attempts to treat and validate schizotaxia are encouraging, and raise the possibility that early treatment might eventually prevent or attenuate the development of other, more severe disorders in the schizophrenia spectrum, including schizophrenia itself.

scholarly journals Predicting first-episode psychosis patients who will never relapse over 10 years

2018 ◽  
Vol 49 (13) ◽  
pp. 2206-2214 ◽  
Author(s):  
Christy LM Hui ◽  
William G Honer ◽  
Edwin HM Lee ◽  
WC Chang ◽  
Sherry KW Chan ◽  
...  
Keyword(s):  
First Episode Psychosis ◽  
First Episode ◽  
Psychotic Episode ◽  
Positive Symptoms ◽  
Schizophrenia Spectrum Disorders ◽  
Medication Discontinuation ◽  
Schizophrenia Spectrum ◽  
Episode Psychosis ◽  
Spectrum Disorders

AbstractBackgroundAlthough relapse in psychosis is common, a small proportion of patients will not relapse in the long term. We examined the proportion and predictors of patients who never relapsed in the 10 years following complete resolution of positive symptoms from their first psychotic episode.MethodPatients who previously enrolled in a 12-month randomized controlled trial on medication discontinuation and relapse following first-episode psychosis (FEP) were followed up after 10 years. Relapse of positive symptoms was operationalized as a change from a Clinical Global Impression scale positive score of <3 for at least 3 consecutive months to a score of ⩾3 (mild or more severe). Baseline predictors included basic demographics, premorbid functioning, symptoms, functioning, and neurocognitive functioning.ResultsOut of 178 first-episode patients, 37 (21%) never relapsed during the 10-year period. Univariate predictors (p ⩽ 0.1) of patients who never relapsed included a duration of untreated psychosis (DUP) ⩽30 days, diagnosed with non-schizophrenia spectrum disorders, having less severe negative symptoms, and performing better in logical memory immediate recall and verbal fluency tests. A multivariate logistic regression analysis further suggested that the absence of any relapsing episodes was significantly related to better short-term verbal memory, shorter DUP, and non-schizophrenia spectrum disorders.ConclusionsTreatment delay and neurocognitive function are potentially modifiable predictors of good long-term prognosis in FEP. These predictors are informative as they can be incorporated into an optimum risk prediction model in the future, which would help with clinical decision making regarding maintenance treatment in FEP.

Screening Adolescents for Schizophrenia-Spectrum Disorders

2000 ◽  
Author(s):  
B. Cornblatt ◽  
M. Obuchowski ◽  
S. Roberts ◽  
S. Pollack ◽  
L. Erienmeyer-Kimling
Keyword(s):  
Schizophrenia Spectrum Disorders ◽  
Schizophrenia Spectrum ◽  
Spectrum Disorders
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