Schizophrenia: family studies and treatment of spectrum disorders

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.

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Hallucinations Under Psychedelics and in the Schizophrenia Spectrum: An Interdisciplinary and Multiscale Comparison

Schizophrenia Bulletin ◽

10.1093/schbul/sbaa117 ◽

2020 ◽

Vol 46 (6) ◽

pp. 1396-1408 ◽

Cited By ~ 1

Author(s):

Pantelis Leptourgos ◽

Martin Fortier-Davy ◽

Robin Carhart-Harris ◽

Philip R Corlett ◽

David Dupuis ◽

...

Keyword(s):

Brain Imaging ◽

Working Group ◽

Future Research ◽

Schizophrenia Spectrum Disorders ◽

Drug Induced ◽

Computational Approaches ◽

Schizophrenia Spectrum ◽

Multidisciplinary Working ◽

Similarities And Differences ◽

Spectrum Disorders

Abstract The recent renaissance of psychedelic science has reignited interest in the similarity of drug-induced experiences to those more commonly observed in psychiatric contexts such as the schizophrenia-spectrum. This report from a multidisciplinary working group of the International Consortium on Hallucinations Research (ICHR) addresses this issue, putting special emphasis on hallucinatory experiences. We review evidence collected at different scales of understanding, from pharmacology to brain-imaging, phenomenology and anthropology, highlighting similarities and differences between hallucinations under psychedelics and in the schizophrenia-spectrum disorders. Finally, we attempt to integrate these findings using computational approaches and conclude with recommendations for future research.

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Factor Structure of the Bern Psychopathology Scale in a Sample of Patients with Schizophrenia Spectrum Disorders

European Psychiatry ◽

10.1016/j.eurpsy.2015.07.010 ◽

2015 ◽

Vol 30 (7) ◽

pp. 880-884 ◽

Cited By ~ 10

Author(s):

Fabian U. Lang ◽

Annabel S. Stierlin ◽

Katharina Stegmayer ◽

Sebastian Walther ◽

Thomas Becker ◽

...

Keyword(s):

Factor Structure ◽

University Hospital ◽

Future Research ◽

Motor Behaviour ◽

Schizophrenia Spectrum Disorders ◽

Longitudinal Assessment ◽

Symptom Pattern ◽

Schizophrenia Spectrum ◽

Binary Division ◽

Spectrum Disorders

AbstractBackground:The Bern Psychopathology Scale (BPS) is based on a system-specific approach to classifying the psychopathological symptom pattern of schizophrenia. It consists of subscales for three domains (language, affect and motor behaviour) that are hypothesized to be related to specific brain circuits. The aim of the study was to examine the factor structure of the BPS in patients with schizophrenia spectrum disorders.Methods:One hundred and forty-nine inpatients with schizophrenia spectrum disorders were recruited at the Department of Psychiatry II, Ulm University, Germany (n = 100) and at the University Hospital of Psychiatry, Bern, Switzerland (n = 49). Psychopathology was assessed with the BPS. The VARCLUS procedure of SAS® (a type of oblique component analysis) was used for statistical analysis.Results:Six clusters were identified (inhibited language, inhibited motor behaviour, inhibited affect, disinhibited affect, disinhibited language/motor behaviour, inhibited language/motor behaviour) which explained 40.13% of the total variance of the data. A binary division of attributes into an inhibited and disinhibited cluster was appropriate, although an overlap was found between the language and motor behaviour domains. There was a clear distinction between qualitative and quantitative symptoms.Conclusions:The results argue for the validity of the BPS in identifying subsyndromes of schizophrenia spectrum disorders according to a dimensional approach. Future research should address the longitudinal assessment of dimensional psychopathological symptoms and elucidate the underlying neurobiological processes.

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Schizophrenia

10.1093/oxfordhb/9780199797004.013.011 ◽

2014 ◽

Author(s):

Alex S. Cohen ◽

Dallas A. Callaway ◽

Tracey L. Auster

Keyword(s):

Depressive Symptoms ◽

Empirical Investigation ◽

Cognitive Behavioral ◽

Future Research ◽

Schizophrenia Spectrum Disorders ◽

Schizophrenia Spectrum ◽

Treatment Considerations ◽

Spectrum Disorders ◽

New Treatments

Depressive symptoms commonly occur in individuals with schizophrenia-spectrum disorders. Empirical investigation of this comorbidity has revealed a number of interesting and potentially confusing findings. The purpose of this review is to summarize this literature, focusing on clinical, cognitive, behavioral, phenomenological, and neurobiological processes that are common and potentially disparate to these disorders. Additionally, the review will discuss four depression-related paradoxes that have emerged within the schizophrenia literature. It concludes with a brief summary of treatment considerations for patients with schizophrenia with co-morbid depressive symptoms. It is hoped that this chapter can serve as an organizing framework for future research and can help focus efforts on designing new treatments for ameliorating depression-related symptoms in patients with schizophrenia.

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Trustworthiness judgments are associated with interpersonal functioning in individuals with schizophrenia

Journal of Experimental Psychopathology ◽

10.1177/2043808719827094 ◽

2019 ◽

Vol 10 (1) ◽

pp. 204380871982709

Author(s):

Michal Hajdúk ◽

Dana Krajčovičová ◽

Miroslava Zimányiová ◽

Viera Kořínková ◽

Anton Heretik ◽

...

Keyword(s):

Social Interactions ◽

Social Functioning ◽

Social Cognitive ◽

Cognitive Biases ◽

Interpersonal Functioning ◽

Future Research ◽

Healthy Controls ◽

Schizophrenia Spectrum Disorders ◽

Schizophrenia Spectrum ◽

Spectrum Disorders

Rapid and accurate trustworthiness judgments are important during successful day-to-day social interactions because they can influence the decision whether to approach someone and initiate social interaction. The aim of the present study was to analyze associations between these judgments and self-reported and clinician-rated social functioning. The sample consisted of 48 patients with schizophrenia spectrum disorders and 35 healthy controls matched for age, gender, and educational level. A trustworthiness task, subjective, and clinician-rated scales for social functioning were administered to both samples. Trustworthiness judgments did not differ between patients and healthy controls. Both groups were able to discriminate between trustworthy and untrustworthy faces. Trustworthiness ratings were associated with self-reported and clinician-rated measures of interpersonal functioning in patients with schizophrenia. Despite the absence of differences between groups, in patients with schizophrenia, a tendency to mistrust based on facial appearance was related to worse functional outcome, predominantly in the domain of disturbed interpersonal functioning. This study highlights the importance of future research into social–cognitive biases in schizophrenia.

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Clinical Staging in Schizophrenia Spectrum Disorders

10.5772/intechopen.98276 ◽

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.

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Yoga-Based Group Intervention for In-patients With Schizophrenia Spectrum Disorders—A Qualitative Approach

Frontiers in Psychiatry ◽

10.3389/fpsyt.2021.715670 ◽

2021 ◽

Vol 12 ◽

Author(s):

Theresa Schulze ◽

Eric Hahn ◽

Inge Hahne ◽

Niklas Bergmann ◽

Lukas Marian Fuchs ◽

...

Keyword(s):

Group Intervention ◽

Controlled Trial ◽

Complementary Therapy ◽

Diagnostic Interview ◽

Future Research ◽

Schizophrenia Spectrum Disorders ◽

Subjective Experiences ◽

Structured Interviews ◽

Schizophrenia Spectrum ◽

Spectrum Disorders

Background: Yoga may pose a promising complementary therapy in the multimodal treatment of in-patients with schizophrenia spectrum disorders (SSD). However, to date, no studies have qualitatively examined in-patients' with SSD experiences of Yoga as well as their perceptions of its limitations and benefits as a treatment component. This qualitative study aimed to explore for the first time the mechanisms and processes of Yoga-based Group Intervention (YoGI) for in-patients with SSD in Germany by asking for their subjective experiences. Findings could serve as a preliminary basis for developing an effective and evidence-based YoGI manual tailored to this patient group.Materials and Methods: In total, 25 semi-structured interviews were conducted directly after YoGI, for which responses were either noted down by hand or audio-recorded. The interview guide was pilot-tested and consisted of 14 questions to explore the personal articulated experiences of participation in YoGI from in-patients with SSD. Positive, negative, depressive, and anxiety symptoms were assessed during a diagnostic interview and through questionnaires. The interview data was transcribed, coded by two independent researchers, and analysed using an inductive thematic approach. The research team collaboratively discussed emerging categories to reduce redundancy and form meaningful themes and subthemes.Results: The analysis revealed seven main themes. YoGI was perceived as feasible and focusing on individual adaptation, captured by the theme inclusivity. Nevertheless, participants encountered challenges; thus, physical limitations need to be considered. While practising together, participants experienced interconnectedness and developed a mindful stance as they accepted their limitations and adapted exercises with self-compassion. Patients described that following the flow of the asanas required physical persistence, which ultimately led many participants to experience confidence and relaxation. YoGI affected symptom representation as heightened awareness led participants to notice impeding as well as improved symptoms.Conclusion: YoGI showed various promising effects on in-patients with SSD. Future research should examine to what extent these effects can be sustained and how the mindful approach during YoGI can be transferred to areas outside the Yoga class. Furthermore, a randomised controlled trial could investigate the effectiveness of a manualised YoGI.

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

Acta Pharmaceutica ◽

10.1515/acph-2017-0001 ◽

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.

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

Advances in Psychiatric Treatment ◽

10.1192/apt.bp.106.002600 ◽

2007 ◽

Vol 13 (5) ◽

pp. 384-391 ◽

Cited By ~ 5

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.

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