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Schizophrenia is a mental disorder characterized by reoccurring episodes of psychosis that are correlated with a general misperception of reality. Other common signs include hallucinations, delusions, disorganized thinking, social withdrawal, and flat affect. Symptoms develop gradually and typically begin during young adulthood and are never resolved. There is no objective diagnostic test; diagnosis is based on observed behavior, a psychiatric history that includes the person's reported experiences, and reports of others familiar with the person. For a diagnosis of schizophrenia, the described symptoms need to have been present for at least six months or one month. Many people with schizophrenia have other mental disorders, especially substance use disorders, depressive disorders, anxiety disorders, and obsessive–compulsive disorder.
Olanzapine is an atypical antipsychotic primarily used to treat schizophrenia and bipolar disorder. For schizophrenia, it can be used for both new-onset disease and long-term maintenance. It is taken by mouth or by injection into a muscle.
Schizoaffective disorder is a mental disorder characterized by abnormal thought processes and an unstable mood. This diagnosis requires symptoms of both schizophrenia and a mood disorder: either bipolar disorder or depression. The main criterion is the presence of psychotic symptoms for at least two weeks without any mood symptoms. Schizoaffective disorder can often be misdiagnosed when the correct diagnosis may be psychotic depression, bipolar I disorder, schizophreniform disorder, or schizophrenia. This is a problem as treatment and prognosis differ greatly for most of these diagnoses.
Schizotypal personality disorder, also known as schizotypal disorder, is a cluster A personality disorder. The Diagnostic and Statistical Manual of Mental Disorders (DSM) classification describes the disorder specifically as a personality disorder characterized by thought disorder, paranoia, a characteristic form of social anxiety, derealization, transient psychosis, and unconventional beliefs. People with this disorder feel pronounced discomfort in forming and maintaining social connections with other people, primarily due to the belief that other people harbor negative thoughts and views about them. Peculiar speech mannerisms and socially unexpected modes of dress are also characteristic. Schizotypal people may react oddly in conversations, not respond, or talk to themselves. They frequently interpret situations as being strange or having unusual meanings for them; paranormal and superstitious beliefs are common. Schizotypal people usually disagree with the suggestion that their thoughts and behaviors are a 'disorder' and seek medical attention for depression or anxiety instead. Schizotypal personality disorder occurs in approximately 3% of the general population and is more commonly diagnosed in males.
Dr. Thomas McGlashan is an American professor of psychiatry at Yale University, well known for his academic contributions to the study of schizophrenia and other mental illnesses.
Risk factors of schizophrenia include many genetic and environmental phenomena. The prevailing model of schizophrenia is that of a special neurodevelopmental disorder with no precise boundary or single cause. Schizophrenia is thought to develop from very complex gene–environment interactions with vulnerability factors. The interactions of these risk factors are intricate, as numerous and diverse medical insults from conception to adulthood can be involved. The combination of genetic and environmental factors leads to deficits in the neural circuits that affect sensory input and cognitive functions. Historically, this theory has been broadly accepted but impossible to prove given ethical limitations. The first definitive proof that schizophrenia arises from multiple biological changes in the brain was recently established in human tissue grown from patient stem cells, where the complexity of disease was found to be "even more complex than currently accepted" due to cell-by-cell encoding of schizophrenia-related neuropathology.
In medicine, a prodrome is an early sign or symptom that often indicates the onset of a disease before more diagnostically specific signs and symptoms develop. It is derived from the Greek word prodromos, meaning "running before". Prodromes may be non-specific symptoms or, in a few instances, may clearly indicate a particular disease, such as the prodromal migraine aura.
Early intervention in psychosis is a clinical approach to those experiencing symptoms of psychosis for the first time. It forms part of a new prevention paradigm for psychiatry and is leading to reform of mental health services, especially in the United Kingdom and Australia.
In psychiatry, catastrophic schizophrenia or schizocaria is an obsolete term for a rare and acute form of schizophrenia leading directly to a severe and unremitting chronic psychosis and deterioration of the personality. Catastrophic schizophrenia was thought to be the most severe subtype of schizophrenia, as it had "an acute onset and rapid decline into a chronic state without remission". Catastrophic schizophrenia was also referred to as schizocaria, which was defined by Gerhard Mauz as a psychosis that caused the absolute destruction of the core of one's being. The term "catastrophic schizophrenia" has fallen out of use due to a number of reasons, including advances in psychiatric treatment, which led to a significant decline in patients that fit the diagnosis as their symptoms did not reach the severity of catastrophic schizophrenia, along with modern refinement of the definition and subtypes of schizophrenia. This term has not been included in any version of the DSM. In modern terms, catastrophic schizophrenia would likely be defined as 'acute-onset chronic schizophrenia with poor prognosis'.
The diagnosis of schizophrenia, a psychotic disorder, is based on criteria in either the American Psychiatric Association's Diagnostic and Statistical Manual of Mental Disorders, or the World Health Organization's International Classification of Diseases (ICD). Clinical assessment of schizophrenia is carried out by a mental health professional based on observed behavior, reported experiences, and reports of others familiar with the person. Diagnosis is usually made by a psychiatrist. Associated symptoms occur along a continuum in the population and must reach a certain severity and level of impairment before a diagnosis is made. Schizophrenia has a prevalence rate of 0.3-0.7% in the United States
At risk mental state is the clinical presentation of those considered at risk of developing psychosis or schizophrenia. Such states were formerly considered treated as prodromes, emerging symptoms of psychosis, but this view is no longer prevalent as a prodromal period can not be confirmed unless the emergence of the condition has occurred.
Sex differences in schizophrenia are widely reported. Men and women exhibit different rates of incidence and prevalence, age at onset, symptom expression, course of illness, and response to treatment. Reviews of the literature suggest that understanding the implications of sex differences on schizophrenia may help inform individualized treatment and positively affect outcomes.
Mary Cannon is an Irish psychiatrist, research scientist, public figure, and former member of the Cannabis Risk Alliance. She has received the Royal Academy of Medicine in Ireland's "Doctors Award" for psychiatry and is among the most highly cited scientists in the world. Cannon is known for her views on cannabis, being described as 'anti-cannabis'. She is best known in the field of psychiatry for her study of the risk factors for mental illness in young people.
Basic symptoms of schizophrenia are subjective symptoms, described as experienced from a person's perspective, which show evidence of underlying psychopathology. Basic symptoms have generally been applied to the assessment of people who may be at risk to develop psychosis. Though basic symptoms are often disturbing for the person, problems generally do not become evident to others until the person is no longer able to cope with their basic symptoms. Basic symptoms are more specific to identifying people who exhibit signs of prodromal psychosis (prodrome) and are more likely to develop schizophrenia over other disorders related to psychosis. Schizophrenia is a psychotic disorder, but is not synonymous with psychosis. In the prodrome to psychosis, uncharacteristic basic symptoms develop first, followed by more characteristic basic symptoms and brief and self-limited psychotic-like symptoms, and finally the onset of psychosis. People who were assessed to be high risk according to the basic symptoms criteria have a 48.5% likelihood of progressing to psychosis. In 2015, the European Psychiatric Association issued guidance recommending the use of a subscale of basic symptoms, called the Cognitive Disturbances scale (COGDIS), in the assessment of psychosis risk in help-seeking psychiatric patients; in a meta-analysis, COGDIS was shown to be as predictive of transition to psychosis as the Ultra High Risk (UHR) criteria up to 2 years after assessment, and significantly more predictive thereafter. The basic symptoms measured by COGDIS, as well as those measured by another subscale, the Cognitive-Perceptive basic symptoms scale (COPER), are predictive of transition to schizophrenia.
Elaine F. Walker is a psychologist and professor whose research focuses on child and adolescent development, and changes in the brain due to adolescence. Other research interests includes the precursors and neurodevelopment aspects of schizophrenia and other serious mental disorders. She has taken part in writing over 250 articles and six books related to mental health and neuroscience. Walker is the Samuel Candler Dobbs Professor of Psychology and Neuroscience at Emory University.
Ming Tso Tsuang is an American psychiatrist and Distinguished Professor of Psychiatry at the University of California, San Diego. He is considered a pioneering researcher in the genetic epidemiology of schizophrenia and other severe mental disorders. Tsuang has authored and co-authored more than 600 publications and serves as founding and senior editor of the American Journal of Medical Genetics Part B.
Zucker Hillside Hospital is a psychiatric facility that opened in 1926, relocated to its present address in 1941, and was renamed in 1999 to its present name.
Diana O. Perkins is an American professor at the University of North Carolina's (UNC) School of Medicine where she teaches psychiatry; she is a fellow with outreach roles. Her research involves early diagnosis and treatment of schizophrenia. She is noted for publishing a study that demonstrated that using a polygenic risk score (PRS) based on data from genome-wide association studies improved the psychosis risk prediction in persons meeting clinical high-risk criteria.
Carrie Elyse Bearden is an American psychologist and academic. She is a professor at the David Geffen School of Medicine, University of California, Los Angeles, and Director of the UCLA Center for the Assessment and Prevention of Prodromal States, a clinical research program for youth at high risk for psychotic disorders. She is most known for her research taking a ‘genetics first’ approach to study brain mechanisms underlying the development of serious mental illness. Her work has identified biological convergence between genetically and clinically defined high-risk populations.
Osoresnontrine (BI-409306) is a phosphodiesterase 9 inhibitor in development for schizophrenia, attenuated psychosis syndrome, and Alzheimer's disease. A preclinical study suggested that it increases memory in rodents.
References
- 1 2 Cornblatt, Barbara. "Barbara A. Cornblatt, PhD, MBA – Investigator at The Feinstein Institute | Northwell Health". The Feinstein Institute for Medical Research.
- ↑ "Doctors Try a Bold Move Against Schizophrenia". archive.nytimes.com. Retrieved 2020-01-25.
- ↑ Carey, Benedict (2006-05-23). "A Career That Has Mirrored Psychiatry's Twisting Path". The New York Times. ISSN 0362-4331 . Retrieved 2020-01-25.
- ↑ "Recognition and Prevention Program - Understanding Psychosis". www.rapprogram.org.
- ↑ "Zubin Awards". www.wpic.pitt.edu. Retrieved 2020-01-25.
- ↑ "Society for Research in Psychopathology" . Retrieved 2020-01-25.
- ↑ Cornblatt, Barbara. "2/3-Cognitive Behavioral Social Skills Training for Youth at Risk of Psychosis". Grantome.
- ↑ Cornblatt, Barbara. "4/9-Predictors and Mechanisms of Conversion to Psychosis". Grantome.
- ↑ Cornblatt, Barbara. "Characterization of Prodromal Schizophrenia". Grantome.
- ↑ Addington, Jean; Liu, Lu; Buchy, Lisa; Cadenhead, Kristin S.; Cannon, Tyrone D.; Cornblatt, Barbara A.; Perkins, Diana O.; Seidman, Larry J.; Tsuang, Ming T.; Walker, Elaine F.; Woods, Scott W. (2015). "North American Prodrome Longitudinal Study (NAPLS 2): The Prodromal Symptoms". The Journal of Nervous and Mental Disease. 203 (5): 328–335. doi:10.1097/NMD.0000000000000290. ISSN 0022-3018. PMC 4417745 . PMID 25919383.
- ↑ Cannon, Tyrone D.; Cadenhead, Kristin; Cornblatt, Barbara; Woods, Scott W.; Addington, Jean; Walker, Elaine; Seidman, Larry J.; Perkins, Diana; Tsuang, Ming; McGlashan, Thomas; Heinssen, Robert (2008-01-01). "Prediction of Psychosis in Youth at High Clinical Risk: A Multisite Longitudinal Study in North America". Archives of General Psychiatry. 65 (1): 28–37. doi:10.1001/archgenpsychiatry.2007.3. ISSN 0003-990X. PMC 3065347 . PMID 18180426.
- ↑ Woods, Scott W.; Addington, Jean; Cadenhead, Kristin S.; Cannon, Tyrone D.; Cornblatt, Barbara A.; Heinssen, Robert; Perkins, Diana O.; Seidman, Larry J.; Tsuang, Ming T.; Walker, Elaine F.; McGlashan, Thomas H. (2009-09-01). "Validity of the Prodromal Risk Syndrome for First Psychosis: Findings From the North American Prodrome Longitudinal Study". Schizophrenia Bulletin. 35 (5): 894–908. doi:10.1093/schbul/sbp027. ISSN 0586-7614. PMC 2728816 . PMID 19386578.
- ↑ Perkins, Diana O.; Jeffries, Clark D.; Addington, Jean; Bearden, Carrie E.; Cadenhead, Kristin S.; Cannon, Tyrone D.; Cornblatt, Barbara A.; Mathalon, Daniel H.; McGlashan, Thomas H.; Seidman, Larry J.; Tsuang, Ming T. (March 2015). "Towards a Psychosis Risk Blood Diagnostic for Persons Experiencing High-Risk Symptoms: Preliminary Results From the NAPLS Project". Schizophrenia Bulletin. 41 (2): 419–428. doi:10.1093/schbul/sbu099. ISSN 0586-7614. PMC 4332942 . PMID 25103207.
- ↑ Walker, Elaine F.; Trotman, Hanan D.; Pearce, Brad D.; Addington, Jean; Cadenhead, Kristin S.; Cornblatt, Barbara A.; Heinssen, Robert; Mathalon, Daniel H.; Perkins, Diana O.; Seidman, Larry J.; Tsuang, Ming T.; Cannon, Tyrone D.; McGlashan, Thomas H.; Woods, Scott W. (September 15, 2013). "Cortisol Levels and Risk for Psychosis: Initial Findings from the North American Prodrome Longitudinal Study". Biological Psychiatry. 74 (6): 410–417. doi:10.1016/j.biopsych.2013.02.016. PMC 3707958 . PMID 23562006.
- ↑ Tarbox, Sarah I.; Addington, Jean; Cadenhead, Kristin S.; Cannon, Tyrone D.; Cornblatt, Barbara A.; Perkins, Diana O.; Seidman, Larry J.; Tsuang, Ming T.; Walker, Elaine F.; Heinssen, Robert; McGlashan, Thomas H.; Woods, Scott W. (January 30, 2014). "Functional development in clinical high risk youth: Prediction of schizophrenia versus other psychotic disorders". Psychiatry Research. 215 (1): 52–60. doi:10.1016/j.psychres.2013.10.006. PMC 3946851 . PMID 24200216.
