Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0036341 (schizophrenia)
 60,220 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Increasing age, certain medications such as diuretics, disease processes such as malignant neoplasm and schizophrenia, and a history of hyponatraemia or polydipsia may predispose patients to the development of hyponatraemia. In addition, certain psychotropic medications, including TCAs, MAOIs, carbamazepine, trazodone and neuroleptics, may predispose to hyponatraemia, yet a causative role for most has not been firmly established and the effect is most likely to be more idiosyncratic. The SSRIs have been associated with hyponatraemia in a small number of case reports. The mean age and sex of patients in reported cases is over 70 years and predominantly female, and patients were often receiving concomitant diuretic therapy. The frequency of hyponatraemia in elderly female patients receiving fluoxetine has been estimated to be as high as eight per 1000. The risk of developing hyponatraemia appears to be highest during the first few weeks of treatment. Because of the potential seriousness of hyponatraemia, if an elderly patient receiving an SSRI develops unexplained symptoms during the first few weeks of therapy, it is necessary to measure the serum sodium level.
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PMID:SSRIs and hyponatraemia. 929 54

Data from diverse sources suggest that psychotherapy works by changing the functioning of the brain. This observation is part of a larger phenomenon involving neural plasticity. An extraordinary amount of research is demonstrating that neither gene expression nor the anatomy or physiology of the brain is static. Environment and genetics are in an ongoing interaction with one another, and this mutual influence informs our latest understanding of how psychotherapy appears to affect brain functioning. Research on disorders such as schizophrenia, obsessive-compulsive disorder, cancer, and panic disorder provide convincing data in this regard. For a full understanding of the etiology and pathogenesis of mental illness, as well as its treatment, the psychodynamic dimension of meaning must be incorporated.
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PMID:Dynamic therapy in the decade of the brain. 933 8

Protection of life had long been the ultimate goal of medicine. Recently, patient's subjective judgement and self-determination also became another alternative principle. The situation is the same in psychiatry. Now, most patients with "wish to die" live in community, unless they show strong and urgent suicidal attempt. Meanwhile, "right to die" based on patient's self-determination has been established in the terminal state of cancer. Based on the same logical formulation, the "right to kill oneself" for patients with "intolerable psychological pain", is also asserted. Suicide as a right is now an impending agenda in psychiatry. A case of schizophrenia, who had killed her mother and who had "wish to die", was presented and discussed here. Conclusions were as follows: 1) "Wish to die" was psychologically interpreted as "denial of wish to live". At least, this meant that "wish to die" was unable to be a clear and convincing evidence that "real will" to die actually existed. 2) Nevertheless, the therapist who was overwhelmed by the patient's "wish to die", felt that it was a patient's real will to die. 3) "Wish to die" was not a self-determination to die, but rather a patient's inquiry into the quality of therapy, if the therapist was able to tolerate the wish. 4) If everyone is supposed to have privacy that none can ever intrude, this right should be the one only for limiting excessive intervention of medicine, but not for helping suicide. 5) How to verbalize patient's "wish to live" hidden deeply at the very core of "wish to die" and how to support the patient's "wish to live", had a crucial importance in clinical practice of suicidal patients for therapists to confront "wish to die" together with the patient. 6) In general, it was discussed that the concept of "right to die" in suicide and in terminal states, had to be constructed in some different way.
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PMID:["Wish to die" and "right to die" in a case of schizophrenia]. 958 74

In this paper, we propose a model of social course of schizophrenia based on cross-cultural research on the influence of family, wider social network, work, political economy, and legal and mental health care institutions on the experience of illness. We posit the way these ordinary arrangements of daily living organize the course of schizophrenia in part through cultural processes that affect the body-self in suffering and in part through social processes that establish an intersubjective matrix for the experience of illness. We believe this model can be generalized to other chronic illness such as depression, diabetes, asthma, osteoarthritis, chronic pain syndrome, chronic fatigue syndrome, and even heart disease and cancer. We develop the implications of this anthropological approach for research and practice.
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PMID:The social course of schizophrenia: local and societal factors. 973 76

1. The cytochrome P450 monooxygenases, CYP2D6, CYP2C19, and CYP2C9, display polymorphism. CYP2D6 and CYP2C19 have been studied extensively, and despite their low abundance in the liver, they catalyze the metabolism of many drugs. 2. CYP2D6 has numerous allelic variants, whereas CYP2C19 has only two. Most variants are translated into inactive, truncated protein or fail to express protein. 3. CYP2C9 is expressed as the wild-type enzyme and has two variants, in each of which one amino acid residue has been replaced. 4. The nucleotide base sequences of the cDNAs of the three polymorphic genes and their variants have been determined, and the proteins derived from these genes have been characterized. 5. An absence of CYP2D6 and/or CYP2C19 in an individual produces a poor metabolizer (PM) of drugs that are substrates of these enzymes. 6. When two drugs that are substrates for a polymorphic CYP enzyme are administered concomitantly, each will compete for that enzyme and competitively inhibit the metabolism of the other substrate. This can result in toxicity. 7. Patients can be readily phenotyped or genotyped to determine their CYP2D6 or CYP2C19 enzymatic status. Poor metabolizers (PMs), extensive metabolizers (EMs), and ultrarapid metabolizers (URMs) can be identified. 8. Numerous substrates and inhibitors of CYP2D6, CYP2C19, and CYP2C9 are identified. 9. An individual's diet and age can influence CYP enzyme activity. 10. CYP2D6 polymorphism has been associated with the risk of onset of various illnesses, including cancer, schizophrenia, Parkinson's disease, Alzheimer's disease, and epilepsy.
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PMID:Polymorphic cytochromes P450 and drugs used in psychiatry. 1031 91

Obesity and overweight are clearly associated with many serious conditions, including type II diabetes mellitus, hypertension, and coronary heart disease. Excess weight also increases the risk of death. Recent evidence suggests that weight gain itself, even if persons remain within the "normal" weight range, also increases the risk of medical illnesses and premature death. Persons who gain 5.0 to 7.9 kg (11 to 17.3 lb) as adults are 1.9 times more likely to develop type II diabetes mellitus and 1.25 times more likely to develop coronary heart disease than those who lose weight or maintain a stable weight after age 18 years. Gaining 11 to 20 kg (24.2 to 44 lb) or more in adulthood increases the risk of ischemic stroke 1.69 to 2.52 times. The relationship between weight gain and breast cancer has been difficult to study, primarily because postmenopausal hormone replacement therapy can mask the effect of weight gain on cancer risk. Accordingly, weight gain in adulthood has been associated with an increased risk of breast cancer only among women who have never used hormone replacement therapy. In addition to its adverse effects on disease outcomes, weight gain also impairs physical functioning, reduces quality of life, and is associated with poor mental health. These psychological and mental health consequences of weight gain can become an added burden for patients with schizophrenia and other mental disorders.
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PMID:Physical and psychological consequences of weight gain. 1054 35

Exposure of food proteins to certain processing conditions induces two major chemical changes: racemization of all L-amino acids to D-isomers and concurrent formation of cross-linked amino acids such as lysinoalanine. Racemization of L-amino acids residues to their D-isomers in food and other proteins is pH-, time-, and temperature-dependent. Although racemization rates of the 18 different L-amino acid residues in a protein vary, the relative rates in different proteins are similar. The diet contains both processing-induced and naturally formed D-amino acids. The latter include those found in microorganisms, plants, and marine invertebrates. Racemization impairs digestibility and nutritional quality. The nutritional utilization of different D-amino acids varies widely in animals and humans. In addition, some D-amino acids may be both beneficial and deleterious. Thus, although D-phenylalanine in an all-amino-acid diet is utilized as a nutritional source of L-phenylalanine, high concentrations of D-tyrosine in such diets inhibit the growth of mice. Both D-serine and lysinoalanine induce histological changes in the rat kidney. The wide variation in the utilization of D-amino acids is illustrated by the fact that whereas D-methionine is largely utilized as a nutritional source of the L-isomer, D-lysine is totally devoid of any nutritional value. Similarly, although L-cysteine has a sparing effect on L-methionine when fed to mice, D-cysteine does not. Because D-amino acids are consumed by animals and humans as part of their normal diets, a need exists to develop a better understanding of their roles in nutrition, food safety, microbiology, physiology, and medicine. To contribute to this effort, this multidiscipline-oriented overview surveys our present knowledge of the chemistry, nutrition, safety, microbiology, and pharmacology of D-amino acids. Also covered are the origin and distribution of D-amino acids in the food chain and in body fluids and tissues and recommendations for future research in each of these areas. Understanding of the integrated, beneficial effects of D-amino acids against cancer, schizophrenia, and infection, and overlapping aspects of the formation, occurrence, and biological functions of D-amino should lead to better foods and improved human health.
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PMID:Chemistry, nutrition, and microbiology of D-amino acids. 1055 72

Because of such validity-research deficits and the ceiling on agreement between instruments imposed by less-than-perfect reliability characteristics of each instrument, it is not appropriate to assume that the semistructured clinician interview is more valid than the epidemiologic interview. The Baltimore ECA site is uniquely situated to address this issue by comparing the outcome of subjects identified with current depression in the 1982 clinical reappraisal interview with those identified by the DIS at the same time to see if the 13-year follow-up is similar to that found over 16 years by Murphy et al. Where do we go from here in improving our diagnostic criteria for DSM-V, constructing better diagnostic instruments, and conducting the next generation of epidemiologic studies? Certainly the categorical diagnostic criteria themselves, without a dimensional symptom level, are never used in clinical treatment trials. Hence the "clinical significance" criteria of significant distress or disability added to DSM-IV should be further refined, with the possible addition of "staging" of disorders. The objective would be to provide a better indication of treatment need and clinical prognosis as in current cancer diagnostic assessments. For epidemiologic studies, the addition of symptom scales and disability assessments to the traditional categorical diagnoses should be helpful in developing community measures of treatment need. Different methods of assessment may be useful for diagnoses in which an impaired perception of reality occurs, such as schizophrenia. With some of these adjustments, it should be feasible to "count" those with clinically significant diagnoses in the community, and thus improve the validity and clinical utility of our diagnoses for predicting clinical course and responsiveness to specific treatments.
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PMID:Community diagnosis counts. 1071 9

This paper reviews the six published incidence studies of the relative risk of cancer in patients with schizophrenia compared with the general population. These studies used: incidence data, register case ascertainment, and controlled for age and sex. It is concluded that schizophrenia is associated with a lower risk of developing cancer. The role of apoptosis (programmed cell death) in cancer and brain development is briefly described. The possibility is explored that increased apoptosis may account for neurodevelopmental abnormalities as well as tumour resistance associated with schizophrenia. The authors propose that p53, a tumour suppressor gene central to regulation of apoptosis, should be investigated as a candidate susceptibility gene in schizophrenia.
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PMID:Apoptosis and schizophrenia: is the tumour suppressor gene, p53, a candidate susceptibility gene? 1072 18

We wish to identify genes associated with disease. To do so, we look for novel genes whose expression patterns mimic those of known disease-associated genes, a method we call Guilt-by-Association (GBA). GBA uses a combinatoric measure of association that provides superior results to those from correlation measures used in previous expression analyses. Using GBA, we have examined the expression of 40,000 human genes in 522 cDNA libraries, and have identified several hundred genes associated with known cancer, inflammation, steroid-synthesis, insulin-synthesis, neurotransmitter processing, matrix remodeling and other disease genes. The majority of the genes thus discovered show no significant sequence similarity to known genes, and thus could not have been identified by homology searches. We present here an example of the discovery of five genes associated with schizophrenia and Parkinson's disease. Of the 40,000 most-abundant human genes, these five genes are the most closely linked to the known disease genes, and thus are prime targets for pharmaceutical intervention.
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PMID:Pharmaceutical target discovery using Guilt-by-Association: schizophrenia and Parkinson's disease genes. 1078 11


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