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Antipsychotics,previously known as neuroleptics and major tranquilizers,are a class of psychotropic medication primarily used to manage psychosis,principally in schizophrenia but also in a range of other psychotic disorders. They are also the mainstay,together with mood stabilizers,in the treatment of bipolar disorder. Moreover,they are also used as adjuncts in the treatment of treatment-resistant major depressive disorder.
Psychosis is a condition of the mind that results in difficulties determining what is real and what is not real. Symptoms may include delusions and hallucinations,among other features. Additional symptoms are incoherent speech and behavior that is inappropriate for a given situation. There may also be sleep problems,social withdrawal,lack of motivation,and difficulties carrying out daily activities. Psychosis can have serious adverse outcomes.
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.
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.
Neuropsychiatry is a branch of medicine that deals with psychiatry as it relates to neurology,in an effort to understand and attribute behavior to the interaction of neurobiology and social psychology factors. Within neuropsychiatry,the mind is considered "as an emergent property of the brain",whereas other behavioral and neurological specialties might consider the two as separate entities. Those disciplines are typically practiced separately.
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.
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.
The GABAA beta-2 subunit is a protein that in humans is encoded by the GABRB2 gene. It combines with other subunits to form the ionotropic GABAA receptors. GABA system is the major inhibitory system in the brain,and its dominant GABAA receptor subtype is composed of α1,β2,and γ2 subunits with the stoichiometry of 2:2:1,which accounts for 43% of all GABAA receptors. Alternative splicing of the GABRB2 gene leads at least to four isoforms,viz. β2-long (β2L) and β2-short. Alternatively spliced variants displayed similar but non-identical electrophysiological properties. GABRB2 is subjected to positive selection and known to be both an alternative splicing and a recombination hotspot;it is regulated via epigenetic regulation including imprinting and gene and promoter methylation GABRB2 has been associated with a number of neuropsychiatric disorders,and found to display altered expression in cancer.
The glutamate hypothesis of schizophrenia models the subset of pathologic mechanisms of schizophrenia linked to glutamatergic signaling. The hypothesis was initially based on a set of clinical,neuropathological,and,later,genetic findings pointing at a hypofunction of glutamatergic signaling via NMDA receptors. While thought to be more proximal to the root causes of schizophrenia,it does not negate the dopamine hypothesis,and the two may be ultimately brought together by circuit-based models. The development of the hypothesis allowed for the integration of the GABAergic and oscillatory abnormalities into the converging disease model and made it possible to discover the causes of some disruptions.
Barbara A. Cornblatt is Professor of Psychiatry and Molecular Medicine at Hofstra Northwell School of Medicine. She is known for her research on serious mental disorders,with a specific focus on psychosis and schizophrenia. Her efforts to find treatments to help youth with mental illness led to the development of the Recognition and Prevention Program,which she founded in 1998.
1q21.1 deletion syndrome is a rare aberration of chromosome 1. A human cell has one pair of identical chromosomes on chromosome 1. With the 1q21.1 deletion syndrome,one chromosome of the pair is not complete,because a part of the sequence of the chromosome is missing. One chromosome has the normal length and the other is too short.
1q21.1 duplication syndrome or 1q21.1 (recurrent) microduplication is a rare aberration of chromosome 1.
Childhood schizophrenia is similar in characteristics of schizophrenia that develops at a later age,but has an onset before the age of 13 years,and is more difficult to diagnose. Schizophrenia is characterized by positive symptoms that can include hallucinations,delusions,and disorganized speech;negative symptoms,such as blunted affect and avolition and apathy,and a number of cognitive impairments. Differential diagnosis is problematic since several other neurodevelopmental disorders,including autism spectrum disorder,language disorder,and attention deficit hyperactivity disorder,also have signs and symptoms similar to childhood-onset schizophrenia.
The imprinted brain hypothesis is an unsubstantiated hypothesis in evolutionary psychology regarding the causes of autism spectrum and schizophrenia spectrum disorders,first presented by Bernard Crespi and Christopher Badcock in 2008. It claims that certain autistic and schizotypal traits are opposites,and that this implies the etiology of the two conditions must be at odds.
Celso Arango is a psychiatrist who has worked as a clinician,researcher,and educator in psychiatry and mental health,notably in the field of child and adolescent psychiatry,psychosis,and mental health promotion.
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.
Sabine Bahn is a professor of Neurotechnology,Professor &Director of the Bahn Laboratory at The University of Cambridge,a Professor of Translational Neuropsychiatry at Erasmus Medical Centre
Paolo Fusar-Poli is an Italian and British medical doctor,psychiatrist,and Professor at the Institute of Psychiatry,Psychology and Neuroscience,King's College,London and at the Department of Brain and Behavioral Sciences,University of Pavia.
Diana Prata is a Portuguese neuroscientist who concentrates on identifying the biological basis of human behaviour. She reported the first evidence that schizophrenia-risk genes can also predispose to bipolar disorder and has also investigated reasons why people respond differently to antipsychotic medications. She is head of the Biomedical Neuroscience Lab at the University of Lisbon.
DiGeorge syndrome,also known as 22q11.2 deletion syndrome,is a syndrome caused by a microdeletion on the long arm of chromosome 22. While the symptoms can vary,they often include congenital heart problems,specific facial features,frequent infections,developmental delay,intellectual disability and cleft palate. Associated conditions include kidney problems,schizophrenia,hearing loss and autoimmune disorders such as rheumatoid arthritis or Graves' disease.
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- ↑ Jonas, Rachel K.; Montojo, Caroline A.; Bearden, Carrie E. (March 1, 2014). "The 22q11.2 deletion syndrome as a window into complex neuropsychiatric disorders over the lifespan". Biological Psychiatry. 75 (5): 351–360. doi:10.1016/j.biopsych.2013.07.019. PMC 3875621 . PMID 23992925.
- ↑ D, Sun; Crk, Ching; A, Lin; Jk, Forsyth; L, Kushan; A, Vajdi; M, Jalbrzikowski; L, Hansen; Je, Villalon-Reina; X, Qu; Rk, Jonas; T, van Amelsvoort; G, Bakker; Wr, Kates; Km, Antshel; W, Fremont; Le, Campbell; Kl, McCabe; E, Daly; M, Gudbrandsen; Cm, Murphy; D, Murphy; M, Craig; J, Vorstman; A, Fiksinski; S, Koops; K, Ruparel; Dr, Roalf; Re, Gur; Je, Schmitt; Tj, Simon; Nj, Goodrich-Hunsaker; Ca, Durdle; As, Bassett; Ewc, Chow; Nj, Butcher; F, Vila-Rodriguez; J, Doherty; A, Cunningham; Mbm, van den Bree; Dej, Linden; H, Moss; Mj, Owen; Kc, Murphy; Dm, McDonald-McGinn; B, Emanuel; Tgm, van Erp; Ja, Turner; Pm, Thompson; Ce, Bearden (August 4, 2020). "Large-scale mapping of cortical alterations in 22q11.2 deletion syndrome: Convergence with idiopathic psychosis and effects of deletion size". Molecular Psychiatry. 25 (8): 1822–1834. doi:10.1038/s41380-018-0078-5. PMC 6292748 . PMID 29895892.
- ↑ Lin, Amy; Vajdi, Ariana; Kushan-Wells, Leila; Helleman, Gerhard; Hansen, Laura Pacheco; Jonas, Rachel K.; Jalbrzikowski, Maria; Kingsbury, Lyle; Raznahan, Armin; Bearden, Carrie E. (August 1, 2020). "Reciprocal Copy Number Variations at 22q11.2 Produce Distinct and Convergent Neurobehavioral Impairments Relevant for Schizophrenia and Autism Spectrum Disorder". Biological Psychiatry. 88 (3): 260–272. doi:10.1016/j.biopsych.2019.12.028. PMC 7354903 . PMID 32143830.
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- ↑ Bearden, Carrie E.; Wu, Keng Nei; Caplan, Rochelle; Cannon, Tyrone D. (July 4, 2011). "Thought disorder and communication deviance as predictors of outcome in youth at clinical high risk for psychosis". Journal of the American Academy of Child and Adolescent Psychiatry. 50 (7): 669–680. doi:10.1016/j.jaac.2011.03.021. PMC 3124656 . PMID 21703494.
- ↑ Do, Perkins; L, Olde Loohuis; J, Barbee; J, Ford; Cd, Jeffries; J, Addington; Ce, Bearden; Ks, Cadenhead; Td, Cannon; Ba, Cornblatt; Dh, Mathalon; Th, McGlashan; Lj, Seidman; M, Tsuang; Ef, Walker; Sw, Woods (February 1, 2020). "Polygenic Risk Score Contribution to Psychosis Prediction in a Target Population of Persons at Clinical High Risk". The American Journal of Psychiatry. 177 (2): 155–163. doi:10.1176/appi.ajp.2019.18060721. PMC 7202227 . PMID 31711302.
- ↑ Cao, Hengyi; Chén, Oliver Y.; Chung, Yoonho; Forsyth, Jennifer K.; McEwen, Sarah C.; Gee, Dylan G.; Bearden, Carrie E.; Addington, Jean; Goodyear, Bradley; Cadenhead, Kristin S.; Mirzakhanian, Heline; Cornblatt, Barbara A.; Carrión, Ricardo E.; Mathalon, Daniel H.; McGlashan, Thomas H.; Perkins, Diana O.; Belger, Aysenil; Seidman, Larry J.; Thermenos, Heidi; Tsuang, Ming T.; van Erp, Theo G. M.; Walker, Elaine F.; Hamann, Stephan; Anticevic, Alan; Woods, Scott W.; Cannon, Tyrone D. (September 21, 2018). "Cerebello-thalamo-cortical hyperconnectivity as a state-independent functional neural signature for psychosis prediction and characterization". Nature Communications. 9 (1): 3836. Bibcode:2018NatCo...9.3836C. doi:10.1038/s41467-018-06350-7. PMC 6155100 . PMID 30242220.
- ↑ "Accelerating Medicines Partnership (AMP) Schizophrenia (SCZ) Principal Investigators". AMP SCZ.
- ↑ "Samuel Gershon Junior Investigator Award".
- ↑ "Grand Challenges | Team Member Spotlight Series: Carrie Bearden, PhD". November 15, 2023.
- ↑ "Associate for Psychological Science Fellows".
- ↑ "43 UCLA scholars among most highly cited researchers for 2021". UCLA.
- ↑ "George M Thompson Award for Distinguished Service".
- ↑ "UCLA Brain Research Institute (BRI)".
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