scholarly journals Paliperidone to Treat Psychotic Disorders

2021 ◽  
Vol 13 (3) ◽  
pp. 343-358
Author(s):  
Hormazd D. Minwalla ◽  
Peter Wrzesinski ◽  
Allison Desforges ◽  
Joshua Caskey ◽  
Brittany Wagner ◽  
...  
Keyword(s):  
Cognitive Impairment ◽  
Schizoaffective Disorder ◽  
Negative Symptoms ◽  
Psychotic Disorders ◽  
Drug Information ◽  
The United States ◽  
Mental Illnesses ◽  
Positive Symptoms ◽  
Review Of The Literature ◽  
Second Generation Antipsychotics

Purpose of Review: This is a comprehensive review of the literature regarding the use of paliperidone in the treatment of schizophrenia and schizoaffective disorder. It covers the background and presentation of schizophrenia and schizoaffective disorder, as well as the mechanism of action and drug information for paliperidone. It covers the existing evidence of the use of paliperidone for the treatment of schizophrenia and schizoaffective disorder. Recent Findings: Schizophrenia and schizoaffective disorder lead to significant cognitive impairment. It is thought that dopamine dysregulation is the culprit for the positive symptoms of schizophrenia and schizoaffective disorder. Similar to other second-generation antipsychotics, paliperidone has affinity for dopamine D2 and serotonin 5-HT2A receptors. Paliperidone was granted approval in the United States in 2006 to be used in the treatment of schizophrenia and in 2009 for schizoaffective disorder. Summary: Schizophrenia and schizoaffective disorder have a large impact on cognitive impairment, positive symptoms and negative symptoms. Patients with either of these mental illnesses suffer from impairments in everyday life. Paliperidone has been shown to reduce symptoms of schizophrenia and schizoaffective disorder.

Motherhood and Schizophrenic Illnesses: A Review of the Literature

2003 ◽  
Vol 37 (1) ◽  
pp. 24-30 ◽  
Author(s):  
Peter Bosanac ◽  
Anne Buist ◽  
Graham Burrows
Keyword(s):  
Life Events ◽  
Schizoaffective Disorder ◽  
Psychotic Disorders ◽  
Current Knowledge ◽  
Mental Illnesses ◽  
Review Of The Literature ◽  
Schizoaffective Disorders ◽  
Life Event ◽  
Retrospective Nature ◽  
The Impact

Objective: To provide an overview of the current knowledge on the impact of motherhood on women with schizophrenia and schizoaffective disorder. Method: The published literature was selectively reviewed and assessed, based on a complete MEDLINE and PsychLIT (1971 to current) search, including English and non-English journals and books. Results: Research to date into motherhood and schizophrenic illnesses has been limited by a number of methodological constraints, limiting the ability to draw conclusions and the prevention of relapses and mother-infant difficulties. These constraints have included: a paucity of prospective studies with initial, antenatal recruitment; variable definitions of the length of the puerperium; significant changes in psychiatric classification; the heterogeneity of postpartum psychotic disorders, with the majority being mood or schizoaffective disorder rather than schizophrenia; selection biases inherent in studying mother-baby unit inpatients; difficulties in life events research in general, such as its retrospective nature and confounding, illness factors; and the specificity versus non-specificity of childbirth as a unique or discrete life event. Conclusions: Further study is required to explore: the impact of child care, parenting and having a partner on the course of women with schizophrenic and schizoaffective disorders during the first postpartum year; whether women with postpartum relapses of these mental illnesses are likely to have slower recoveries than those women with the same diagnoses but without young children; and protective factors against postpartum relapse.

Evaluation of positive and negative symptoms in schizophrenia

1986 ◽  
Vol 1 (2) ◽  
pp. 108-122 ◽  
Author(s):  
Nancy C. Andreasen ◽  
William M. Grove
Keyword(s):  
Negative Symptoms ◽  
The United States ◽  
Psychotic Symptoms ◽  
Positive Symptoms ◽  
University Of Iowa ◽  
Normal Functions ◽  
Subsequent Investigation ◽  
The University ◽  
The Relationship ◽  
Positive And Negative Symptoms

SummaryMost investigators concur that schizophrenia is probably a heterogeneous group of disorders that share the common features of psychotic symptoms, partial response to neuroleptics, and a relatively poor outcome. The subdivision of schizophrenia into two subtypes, positive versus negative, has achieved wide acceptance throughout the world during recent years. This distinction has heuristic and theoretical appeal because it unites phenomenology, pathophysiology, and etiology into a single comprehensive hypothesis.In spite of its wide appeal, the distinction has a number of problems. These include the failure to distinguish between symptom syndromes and diseases; failure to deal with the mixed patient; failure to take longitudinal course into account; and failure to address conceptually and methodologically the distinction between positive and negative symptoms.This paper focuses primarily on the conceptual basis for two instruments designed to measure positive and negative symptoms, the Scale for the Assessment of Negative Symptoms (SANS) and the Scale for the Assessment of Positive Symptoms (SAPS), originally described in 1982. Since their description, these scales have been used in a variety of other centers. These scales are based on the hypothesis that negative symptoms represent a deficit or diminution in normal psychological functions wliile positive symptoms represent an excess or distortion of normal functions. Reliability data are now available from Italy, Spain, and Japan which suggest that these scales can be used reliably in cultural settings outside the United States. The results of these studies are summarized in this paper. In addition, a replication study involving a new sample of 117 schizophrenics collected at the University of Iowa is described. In this second study of the SANS and SAPS, internal consistency is found to be quite high in the SANS. Thus negative symptoms appear to be more internally correlated with one another than are positive symptoms. The implications of this result are discussed. A principal components analysis is used to explore the relationship between positive and negative symptoms. While the study reported in 1982 suggested that positive and negative symptoms are negatively correlated, in the present study they appear to be uncorrelated. Overall, the results suggest that the SANS and SAPS are useful comprehensive instruments for the evaluation of positive and negative symptoms. The relationship between these symptoms and external validators such as cognitive functioning or CT scan abnormalities will be reported in a subsequent investigation.

scholarly journals Factor Analysis of Negative Symptom Items in the Structured Interview for Prodromal Syndromes

2018 ◽  
Vol 45 (5) ◽  
pp. 1042-1050 ◽  
Author(s):  
Matilda Azis ◽  
Gregory P Strauss ◽  
Elaine Walker ◽  
William Revelle ◽  
Richard Zinbarg ◽  
...  
Keyword(s):  
Factor Analysis ◽  
Functional Outcome ◽  
Negative Symptom ◽  
Negative Symptoms ◽  
Psychotic Disorders ◽  
The United States ◽  
Structured Interview ◽  
Symptom Dimensions ◽  
Increased Risk ◽  
Active Research

Abstract Background Negative symptoms occur early in the clinical high risk (CHR) state and indicate increased risk of conversion to psychotic disorder and poor functional outcome. However, while the negative symptom domain has shown to be parsimoniously explained by a 2-factor construct in schizophrenia, there has yet to be an established factor structure of negative symptoms in CHR. Methods 214 individuals meeting the Structured Interview for Psychosis-Risk Syndromes (SIPS) criteria for CHR were recruited through 3 active research programs in the United States. Exploratory Factor Analysis was conducted on the 6 negative symptom items of the SIPS, and factors were evaluated with respect to functional outcome and depression. Results Factor analysis indicated a 2-factor hierarchical model with 2 negative symptom dimensions reflecting volition (Occupational Functioning and Avolition) and emotion (Expression of Emotion, Experience of Emotion and Social Anhedonia). Linear Regression showed that the emotion factor was associated with poor social function, and the volition factor was associated with poor role function and depression. Conclusions Similar to factor solutions identified in adults diagnosed with psychotic disorders, results indicated that the SIPS negative symptom subscale is not a unidimensional construct. Rather, the SIPS negative subscale has 2 distinct factors that have different associations with clinical outcome and should be interpreted independently. Results have significant relevance for informing the valid assessment and conceptual interpretation of early clinical phenomenology in the psychosis prodrome.

How is Schizophrenia Diagnosed?

Schizophrenia ◽  
2019 ◽  
Author(s):  
Stephen J. Glatt ◽  
Stephen V. Faraone ◽  
Ming T. Tsuang
Keyword(s):  
Negative Symptoms ◽  
Medical Condition ◽  
International Classification Of Diseases ◽  
The United States ◽  
Mental Illnesses ◽  
World Health ◽  
Dsm 5 ◽  
Classification Of Diseases ◽  
Disorganized Speech ◽  
The Individual

The diagnosis of schizophrenia cannot be made based on the results of an ob­jective diagnostic test or laboratory measure, though we and others are working towards this. Instead, clinicians diagnose schizophrenia based on behaviour and psychopathology (including the symptoms described in the previous chapter). These require the subjective interpretation of clinicians, but they can be as­sessed reliably. The definitions of major mental illnesses used by clinicians are presented in the Diagnostic and Statistical Manual (DSM) of the American Psychiatric Association (in the United States) and the World Health Organization’s International Classification of Diseases (ICD) in other countries. These def­initions are updated from time to time to reflect gains in knowledge, or to reflect modern thinking on the similarities and differences between certain disorders. From one edition to the next, some diagnoses are revised, some are added, and some vanish altogether, only to be replaced or absorbed under other diagnoses. The diagnostic criteria for schizophrenia as defined by the most recent version of the DSM (DSM- 5) include the presence of two or more of the following symptoms: delusions, hallucinations, disorganized speech, disorganized or cata­tonic behaviour, and negative symptoms. At least one of the two must be delu­sions, hallucinations, or disorganized speech, while the second symptom type required for diagnosis could be any of the remaining four criteria. The require­ment of delusions, hallucinations, or disorganized speech maintains the resem­blance of the modern- day diagnosis to that first described by the clinician Emil Kraepelin over a century ago. Kraepelin’s discovery that schizophrenia is marked by a chronic and gradually worsening course is seen in modern- day criteria as well. A DSM-5 diagnosis of schizophrenia requires continuous signs of illness for at least 6 months, during which the individual must show at least 1 month of active symptoms (less if well treated). The diagnosis also requires social or work deterioration over a signifi­cant amount of time. Lastly, the diagnosis requires that the observed symptoms are not due to some other medical condition, including other psychiatric disorders such as bipolar disorder or major depressive disorder.

Somatic Treatments for Psychotic Disorders

2016 ◽  
Author(s):  
Justin C. Ellison ◽  
Jason B. Rosenstock ◽  
Michael J. Marcsisin
Keyword(s):  
Side Effects ◽  
Electroconvulsive Therapy ◽  
Gold Standard ◽  
Psychotic Disorders ◽  
Mood Stabilizers ◽  
Positive Symptoms ◽  
Second Generation Antipsychotics ◽  
Treatment Refractory ◽  
Long Acting ◽  
Somatic Therapies

A variety of somatic therapies can be used to treat individuals suffering from psychosis. Most commonly, providers will prescribe antipsychotics, which generally block dopamine receptors and are particularly useful at reducing positive symptoms. Second-generation antipsychotics have fewer movement side effects than older agents do, but they are more expensive and have more metabolic side effects. Long-acting injectable (LAI) antipsychotics can be useful for improving outcomes, especially in non-adherent patients, and clozapine is the gold standard for treatment-refractory psychosis. Other agents may be useful for adjunct therapy, or in early psychosis, such as antidepressants, mood stabilizers, and benzodiazepines. In this chapter, we will also review other somatic therapies such as electroconvulsive therapy (ECT) and other neuromodulation approaches.

Tardive Dyskinesia and Type II Schizophrenia

1992 ◽  
Vol 160 (2) ◽  
pp. 253-256 ◽  
Author(s):  
Elizabeth J. B. Davis ◽  
Milind Borde ◽  
L. N. Sharma
Keyword(s):  
Cognitive Impairment ◽  
Negative Symptoms ◽  
Chronic Schizophrenia ◽  
Thought Disorder ◽  
Control Group ◽  
Positive Symptoms ◽  
Type Ii ◽  
Formal Thought Disorder ◽  
Schizophrenic Patients ◽  
Male Patients

Cognitive impairment, negative and positive symptoms, primitive release reflexes, and age/temporal disorientation were assessed in 20 male patients meeting the DSM–III–R criteria for chronic schizophrenia and Schooler & Kane's criteria for TD. The control group comprised 20 age-matched male chronic schizophrenic patients without TD. Significant associations were found between TD, cognitive impairment, some negative symptoms, and formal thought disorder. These associations were independent of other illness and treatment variables. The severity of TD correlated significantly with that of cognitive impairment.

scholarly journals Cognitive impairment as a risk factor for psychosis

2005 ◽  
Vol 7 (1) ◽  
pp. 31-38 ◽  
Keyword(s):  
Risk Factor ◽  
Cognitive Impairment ◽  
Cognitive Functioning ◽  
Brain Function ◽  
Negative Symptoms ◽  
Psychotic Disorders ◽  
Epidemiological Studies ◽  
Psychotic Symptoms ◽  
Future Research ◽  
The Relationship

Since the time of Kraepelin and Bleuler, it has been recognized that schizophrenia is associated with a profound and persistent cognitive impairment. This paper reviews the major clinical and epidemiological studies of cognitive functioning in schizophrenia and other psychotic disorders, and presents several possible models to explain the association between cognitive impairment and psychosis. Cognitive impairment is present in the majority of patients with schizophrenia, and, in some, it is already evident in the premorbid stages of the disorder. This cognitive impairment is not secondary to psychotic symptoms, negative symptoms, or socioeconomic status. Cognitive impairment can also be observed in nonpsychotic family members of psychotic patients. On the basis of this evidence, it has been proposed that abnormal cognitive functioning can be considered as a possible causal risk factor for psychosis. Recent studies assessing the relationship between genetic background, cognition, brain function, and schizophrenia are presented here as an outline for future research.

Psychotic-like experiences and depressive symptoms in a community sample of adolescents

2011 ◽  
Vol 26 (6) ◽  
pp. 396-401 ◽  
Author(s):  
M. Barragan ◽  
K.R. Laurens ◽  
J.B. Navarro ◽  
J.E. Obiols
Keyword(s):  
Depressive Symptoms ◽  
Negative Symptoms ◽  
Psychotic Disorders ◽  
Social Withdrawal ◽  
Community Sample ◽  
Principal Component ◽  
Positive Symptoms ◽  
Principal Component Factor Analysis ◽  
Positive Experiences ◽  
Affective Flattening

AbstractPurposeStudies of psychotic-like experiences (PLEs) within community samples of adolescents have explored predominantly positive experiences. There is a paucity of research examining the prevalence and correlates of negative PLEs, and whether particular subtypes of negative PLEs can be identified among the general population of adolescents. This study examined the association of both positive and negative PLEs with depressive symptoms, including detailed analysis of subtypes of positive and negative psychosis dimensions.MethodA community sample of 777 adolescents (50.9% girls: mean age 14.4 years) completed a questionnaire assessing positive and negative PLEs and depressive symptoms.ResultsPrincipal component factor analysis identified four factors of positive symptoms (persecutory ideation, grandiose thinking, first-rank/hallucinatory experiences and self-referential thinking), and three factors of negative symptoms (social withdrawal, affective flattening, and avolition). Depressive symptoms were associated positively with persecutory ideation, first-rank/hallucinatory experiences, social withdrawal, and avolition, whereas grandiose thinking related negatively with depressive symptoms. Neither self-referential thinking nor affective flattening related to self-reported depression.ConclusionsThese findings support the view that not all types of positive and negative PLEs in adolescence are associated with depression and, therefore, they may not confer the same vulnerability for psychotic disorders.

scholarly journals Effectiveness of Integrated Neurocognitive Therapy on Cognitive Impairment and Functional Outcome for Schizophrenia Outpatients

2018 ◽  
Vol 2018 ◽  
pp. 1-9 ◽  
Author(s):  
Andreana De Mare ◽  
Miriam Cantarella ◽  
Giovanni Galeoto
Keyword(s):  
Cognitive Impairment ◽  
Functional Outcome ◽  
Effect Size ◽  
Negative Symptoms ◽  
Social Cognitive ◽  
Meta Analysis ◽  
Positive Symptoms ◽  
Global Functioning ◽  
Cognitive Domains ◽  
Treatment Research

Cognitive impairment is highly prevalent in patients with schizophrenia and schizoaffective disorder. Many interventions have been developed to treat cognitive deficit, since it has a strong impact on functional outcome; however, there are no integrated interventions targeting multiple neuro- and social-cognitive domains with a particular focus on the generalization of the effects of therapy on the functional outcome. Recently, a group of experts has developed a cognitive remediation group therapy approach called Integrated Neurocognitive Therapy (INT), which includes exercises to improve the MATRICS (Measurement and Treatment Research to Improve Cognition in Schizophrenia) neuro- and social-cognitive domains. This systematic review and meta-analysis aimed to assess the efficacy of this approach. We conducted a search of PubMed, Scopus, Web of Science, and PsycINFO to select primary studies evaluating INT in schizophrenic and schizoaffective patients. The primary outcomes of the meta-analysis included negative and positive symptoms and global functioning. Two randomized controlled trials met inclusion criteria. A total of 217 participants were included. Based on the results from the Positive and Negative Syndrome Scale (PANSS), a significant pooled effect size was observed for negative symptoms, which demonstrated not only an improvement in the patients treated immediately after therapy but also a permanence of positive results at a 9–12-month follow-up. On the other hand, no significant effect size was observed for positive symptoms. In addition, a significant pooled effect size was found for Global Assessment of Functioning (GAF), which shows how INT’s integrated approach has lasting positive implications on patients’ functional outcome. We concluded that INT might be an effective treatment for negative symptoms and global functioning in patients with schizophrenia, compared to treatment as usual (TAU).

Patient Psychopathology and Expressed Emotion in Schizophrenia

1990 ◽  
Vol 157 (6) ◽  
pp. 877-880 ◽  
Author(s):  
Shirley M. Glynn ◽  
Eugenia T. Randolph ◽  
Spencer Eth ◽  
George G. Paz ◽  
Gregory B. Leong ◽  
...  
Keyword(s):  
Schizoaffective Disorder ◽  
Negative Symptoms ◽  
Expressed Emotion ◽  
Psychiatric Symptoms ◽  
Full Range ◽  
Positive Symptoms ◽  
Anxious Depression ◽  
Relationship Of ◽  
The Relationship

The relationship of a full range of psychiatric symptoms to EE was examined in 40 men with BPRS and SANS diagnoses of schizophrenia or schizoaffective disorder. Patients from high-EE families had significantly higher ratings of positive symptoms, anxious depression, and overall psychopathology, but not negative symptoms, than did those from low-EE families. In predicting relapses of schizophrenia, account may need to be taken of an interaction between subtle differences in symptoms and relatives' attitudes.

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