Emerging Treatments in Schizophrenia: Highlights from Recent Supplementation and Prevention Trials
Abstract: In this column we examine the recent literature regarding adjunctive antipsychotic treatment of schizophrenia. We provide a brief introduction outlining the urgent need for new therapeutics, particularly for the treatment of negative and cognitive symptoms of schizophrenia. We then address (by mechanism of action) the most extensively studied adjunctive antipsychotic treatments. We conclude that adjunctive treatments targeting glutamatergic modulation, as well as supplementation with certain vitamins, have the strongest evidence for use in the treatment of schizophrenia. Further, larger randomized, controlled tri...
Source: Harvard Review of Psychiatry - March 1, 2016 Category: Psychiatry Tags: Column Source Type: research
Cognitive Remediation for the Treatment of Cognitive Dysfunction in the Early Course of Psychosis
Abstract: The development of cognitive remediation programs has been a key step toward the creation of a treatment approach to address the cognitive-symptom domain in psychosis. Studies support the efficacy of cognitive remediation in producing moderate effects on cognition at the group level in patients with schizophrenia. Cognitive remediation may harness neuroplasticity in relevant systems that underpin the cognitive functions being addressed. Since neuroplasticity may be greater in people who (1) are younger and (2) have not yet experienced the consequences of long-term psychosis, cognitive remediation may be particula...
Source: Harvard Review of Psychiatry - March 1, 2016 Category: Psychiatry Tags: Reviews Source Type: research
A Cognitive Neuroscience View of Voice-Processing Abnormalities in Schizophrenia: A Window into Auditory Verbal Hallucinations?
Abstract: Auditory verbal hallucinations (AVH) are a core symptom of schizophrenia. Like “real” voices, AVH carry a rich amount of linguistic and paralinguistic cues that convey not only speech, but also affect and identity, information. Disturbed processing of voice identity, affective, and speech information has been reported in patients with schizophrenia. More recent evidence has suggested a link between voice-processing abnormalities and specific clinical symptoms of schizophrenia, especially AVH. It is still not well understood, however, to what extent these dimensions are impaired and how abnormalities in these ...
Source: Harvard Review of Psychiatry - March 1, 2016 Category: Psychiatry Tags: Reviews Source Type: research
Electrophysiological Endophenotypes for Schizophrenia
Abstract: Endophenotypes are quantitative, heritable traits that may help to elucidate the pathophysiologic mechanisms underlying complex disease syndromes, such as schizophrenia. They can be assessed at numerous levels of analysis; here, we review electrophysiological endophenotypes that have shown promise in helping us understand schizophrenia from a more mechanistic point of view. For each endophenotype, we describe typical experimental procedures, reliability, heritability, and reported gene and neurobiological associations. We discuss recent findings regarding the genetic architecture of specific electrophysiological ...
Source: Harvard Review of Psychiatry - March 1, 2016 Category: Psychiatry Tags: Reviews Source Type: research
The Longitudinal Course of Schizophrenia Across the Lifespan: Clinical, Cognitive, and Neurobiological Aspects
We report on positive and negative symptoms, cognition, and findings obtained by neuroimaging. In addition, we perform a meta-analysis of longitudinal studies of cognition in humans. We selected 35 human studies focusing on a narrow SZ phenotype, employing a follow-up duration of six months or more and consistent methodology at the different measurement points. For the meta-analysis on global cognitive change, eight and four studies were used to compare SZ to healthy and psychiatric controls, respectively. We find that the course of SZ is characterized by a constancy or even improvement of positive and negative symptoms an...
Source: Harvard Review of Psychiatry - March 1, 2016 Category: Psychiatry Tags: Reviews Source Type: research
Offspring of Parents with Schizophrenia: A Systematic Review of Developmental Features Across Childhood
This article presents a systematic review of 46 separate papers presenting the results of 18 longitudinal studies that have followed children who are at familial high risk of developing psychotic disorders. The studies suggest that these children do show distinct developmental patterns characterized by higher rates of obstetric complication, neurodevelopmental features such as motor and cognitive deficits, and distinctive social behavior. This review summarizes those findings according to child developmental stages. Twelve of the studies followed offspring into adulthood and examined psychiatric diagnoses. From 15% to 40% ...
Source: Harvard Review of Psychiatry - March 1, 2016 Category: Psychiatry Tags: Reviews Source Type: research
Progress and Future Directions in Research on the Psychosis Prodrome: A Review for Clinicians
Learning Objectives: After participating in this activity, learners should be better able to:
* Assess tools and criteria that can reliably identify imminent risk for a psychotic disorder
* Evaluate longitudinal clinical and psychobiological data that are strengthening individual risk assessment
* Identify interventions that are demonstrating promise for delaying or preventing the onset of psychosis in help-seeking high-risk individuals
Abstract: The psychosis prodrome, or period of clinical and functional decline leading up to acute psychosis, offers a unique opportunity for identifying mechanisms of psychosis on...
Source: Harvard Review of Psychiatry - March 1, 2016 Category: Psychiatry Tags: Reviews Source Type: research
History of the Concept of Disconnectivity in Schizophrenia
This article will demonstrate the prescience of Kety’s proposal; advances in our knowledge of brain structure and genetics have shaped our current understanding of the pathophysiology of schizophrenia. Brain-imaging techniques have shown that schizophrenia is associated with cortical atrophy and ventricular enlargement, which progresses for at least a decade after the onset of psychotic symptoms. Cortical atrophy correlates with negative symptoms and cognitive impairment, but not with psychotic symptoms, in schizophrenia. Studies with the Golgi-staining technique that illuminates the entire neuron indicate that cortical ...
Source: Harvard Review of Psychiatry - March 1, 2016 Category: Psychiatry Tags: Perspectives Source Type: research
Introduction
No abstract available (Source: Harvard Review of Psychiatry)
Source: Harvard Review of Psychiatry - March 1, 2016 Category: Psychiatry Tags: Special Issue: The New Natural History of Schizophrenia Source Type: research
The Impact of Resident Duty Hour and Supervision Changes: A Review
Abstract: In 2003 and again in 2011, the Accreditation Council for Graduate Medical Education (ACGME) instituted increasingly stringent requirements governing resident hours and supervision, with the goals of improving patient safety, resident well-being, and resident education. Although the changes initially stemmed from a catastrophic outcome in a patient treated with psychotropic medications and behavioral restraints, and have been in place over a decade, many psychiatrists are not familiar with these changes and with their potential effects and “side effects” on today’s trainees and faculty. The authors review th...
Source: Harvard Review of Psychiatry - January 1, 2016 Category: Psychiatry Tags: Education Source Type: research
Ambivalence About Recovery in a Case of Psychotic Illness: Diagnostic, Treatment, and Cultural Challenges
No abstract available (Source: Harvard Review of Psychiatry)
Source: Harvard Review of Psychiatry - January 1, 2016 Category: Psychiatry Tags: Clinical Challenge Source Type: research
Mind-Body Interactions in Anxiety and Somatic Symptoms
Abstract: Anxiety and somatic symptoms have a high prevalence in the general population. A mechanistic understanding of how different factors contribute to the development and maintenance of these symptoms, which are highly associated with anxiety disorders, is crucial to optimize treatments. In this article, we review recent literature on this topic and present a redefined model of mind-body interaction in anxiety and somatic symptoms, with an emphasis on both bottom-up and top-down processes. Consideration is given to the role played in this interaction by predisposing physiological and psychological traits (e.g., intero...
Source: Harvard Review of Psychiatry - January 1, 2016 Category: Psychiatry Tags: Reviews Source Type: research
The Role of Temperament in the Etiopathogenesis of Bipolar Spectrum Illness
Abstract: Bipolar disorder constitutes a challenge for clinicians in everyday clinical practice. Our knowledge concerning this clinical entity is incomplete, and contemporary classification systems are unable to reflect the complexity of this disorder. The concept of temperament, which was first described in antiquity, provides a helpful framework for synthesizing our knowledge on how the human body works and what determines human behavior. Although the concept of temperament originally included philosophical and sociocultural approaches, the biomedical model is dominant today. It is possible that specific temperaments mig...
Source: Harvard Review of Psychiatry - January 1, 2016 Category: Psychiatry Tags: Reviews Source Type: research
Template to Perpetrate: An Update on Violence in Autism Spectrum Disorder
Conclusions: While no conclusive evidence indicates that individuals with ASD are more violent than those without ASD, specific generative and associational risk factors may increase violence risk among individuals with ASD. Further research would help to clarify or confirm these findings, suggest potential directions for evaluation, treatment, and prevention, and potentially provide compelling empirical support for forensic testimony regarding defendants with ASD charged with violent crimes. (Source: Harvard Review of Psychiatry)
Source: Harvard Review of Psychiatry - January 1, 2016 Category: Psychiatry Tags: Reviews Source Type: research
Oxytocin, Postnatal Depression, and Parenting: A Systematic Review
Conclusions: Oxytocin is potentially useful in improving parental behaviors of mothers with PND, but more research is needed to establish its safety because of the uncertain impact of OT on maternal mood. (Source: Harvard Review of Psychiatry)
Source: Harvard Review of Psychiatry - January 1, 2016 Category: Psychiatry Tags: Reviews Source Type: research
