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)

Patients treated with atypical antipsychotic drugs commonly gain excess weight. Because obesity is associated with considerable morbidity and decreased life expectancy, treatment of weight gain in these patients is critical. Topiramate, a fairly new anticonvulsant, promotes bodyweight loss in healthy obese subjects, patients with bipolar disorder, and patients with eating disorder. However, there are very few reports about the efficacy of topiramate for weight management in schizophrenic patients. We present the cases of three Taiwanese patients with schizophrenia whose bodyweight increased as a result of atypical antipsychotics treatment, then was controlled by topiramate without aggravation of their psychotic symptoms.
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PMID:Management of atypical antipsychotic-induced weight gain in schizophrenic patients with topiramate. 1619 68

The authors examined the diagnosis before the onset of schizophrenia and retrospectively evaluated the presence/absence of early prodromal symptoms (EPS) and their types (such as depressive symptoms, anxiety symptoms, and obsessive-compulsive [OC] symptoms) and the period from the onset of these symptoms to that of schizophrenia in 219 inpatients with schizophrenia diagnosed according to the DSM-IV(-TR). A diagnosis was made before the onset of schizophrenia in 53 patients (24.2%). The diagnoses were mood disorder in 39 patients, anxiety disorder in seven, obsessive-compulsive disorder (OCD) in three, adjustment disorder in two, and eating disorder in two. EPS were present in 65 (29.7%) of all patients, slightly more frequent in female patients (male:female = 1:1.41). In the group with EPS, depressive symptoms (61.5%) were most frequently observed, followed by anxiety symptoms (23.1%) and OC symptoms (9.2%). The age at onset for each type of symptom was significantly lower for OC symptoms (14.5 +/- 2.4 years) than for the other symptoms (approx. 20 years). The mean period from the onset of each symptom to that of schizophrenia was the shortest for depressive symptoms (2.7 +/- 3.1 years) and the longest (>4 years) for OC symptoms. These results as well as previous studies in Western countries showed that more non-specific and general symptoms are frequently present for some years before the onset of schizophrenia. With consideration of this point, efforts toward early detection of schizophrenia are important.
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PMID:Early prodromal symptoms and diagnoses before first psychotic episode in 219 inpatients with schizophrenia. 1761 Jun 58

The uncertainties of looming adulthood, nostalgia for childhood, and a general malaise explain the crisis of adolescence. Rebellion, conflict, occasional failure at school or in society, and at-risk behaviors are not always signs of future psychiatric illness. In contrast, the physician must be in a position to identify tell-tale signs such as dysmorphophobia, existential anxiety, a feeling of emptiness, and school or social breakdown. Most psychiatric disorders that begin in adolescence are only diagnosed several years after onset. Yet early diagnosis is of utmost importance, as treatment becomes less effective and the long-term prognosis worsens with time. Suicide is the second cause of death during adolescence. All signs of suicidal behavior require hospitalization and evaluation in a psychiatric unit. Antidepressants may be necessary in adolescence. The recent controversy concerning a possible increase in the suicidal risk during antidepressant treatment should not mask the fact that the real public health issue is depression, and not antidepressants. Eating disorders are especially frequent among adolescent girls; it is important to identify psychiatric comorbidities such as schizophrenia, depression and obsessive-compulsive disorders, and to assess the vital risk. Illicit drug and alcohol consumption are frequent during adolescence; for example, close to half of all French adolescents have tried cannabis at least once. Once again, it is important to detect psychiatric comorbidities in substance-abusing adolescents. Phobia is an underdiagnosed anxiety disorder among adolescents; it may become chronic if proper treatment is not implemented, leading to suffering and disability. Finally, two major psychiatric disorders--schizophrenia and bipolar disorder--generally begin in adolescence. Treatment efficacy and the long-term prognosis both depend on early diagnosis. Treatment must be tailored to the individual patient. "Borderline" states are over-diagnosed, hindering more precise diagnosis and delaying appropriate treatment.
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PMID:[Physiological adolescence, pathological adolescence]. 1765 Jul 49

Sexual dysfunction is prevalent among psychiatric patients and may be related to both the psychopathology and the pharmacotherapy. The negative symptoms of schizophrenia limit the capability for interpersonal and sexual relationships. The first-generation antipsychotics cause further deterioration in erectile and orgasmic function. Due to their weak antagonistic activity at D2 receptors, second-generation antipsychotics are associated with fewer sexual side effects, and thus may provide an option for schizophrenia patients with sexual dysfunction. Depression and anxiety are a cause for sexual dysfunction that may be aggravated by antidepressants, especially selective serotonin reuptake inhibitors (SSRIs). SSRI-induced sexual dysfunction may be overcome by lowering doses, switching to an antidepressant with low propensity to cause sexual dysfunction (bupropion, mirtazapine, nefazodone, reboxetine), addition of 5HT2 antagonists (mirtazapine, mianserin) or coadministration of 5-phosphodiesterase inhibitors. Eating disorders and personality disorders, mainly borderline personality disorder, are also associated with sexual dysfunction. Sexual dysfunction in these cases stems from impaired interpersonal relationships and may respond to adequate psychosexual therapy. It is mandatory to identify the specific sexual dysfunction and to treat the patients according to his/her individual psychopathology, current pharmacotherapy and interpersonal relationships.
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PMID:The impact of mental illness on sexual dysfunction. 1839 59

In recent years, there has been an increase in obesity in the general population in both adults and children. Certain mental disorders have been found to co-occur with overweight and obesity. These include binge-eating disorder and bulimia nervosa (nonpurging type), bipolar disorder, certain forms of major depressive disorder, and some severe, chronic mental illness (ie, schizophrenia and schizoaffective disorder). At the same time, some studies have also found that obesity co-occurs with certain mental disorders--specifically binge-eating disorder and mood disorders in females. The co-occurrence of psychiatric disorders (ie, mood and psychotic disorders), binge eating, and overweight or obesity has important public health implications for the treatment of patients with mental disorders, especially since many psychotropic agents can have adverse effects on appetite, binge eating, and weight. Physicians need to keep 2 key points in mind: 1) The treatment of mental disorders in patients with obesity may be different from the treatment of such patients who are not obese, and 2) The treatment of obesity that co-occurs with psychopathology may be different from obesity that is not comorbid with psychopathology.
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PMID:The relationship between severe mental illness and obesity. 1966 51

Based on the important role of neurotrophic factors in brain development and plasticity and reports of association between schizophrenia and the gene neurotrophic tyrosine kinase receptor 3 (NTRK3), we investigated associations of bipolar disorder with polymorphisms in NTRK3. Recently, our group reported evidence for a possible association of NTRK3 polymorphisms with hippocampal function and schizophrenia. In the present study, we used a homogenous Norwegian case-control sample (the TOP study) consisting of 194 patients diagnosed with bipolar disorder and 336 healthy controls genotyped on the Affymetrix Genome-wide Human SNP Array 6.0. In total 149 markers were investigated for SNP-disease association. Polymorphisms in over 20 markers were nominally associated with bipolar disorder, covering intron 5 to intron 12. Interestingly, our markers appeared to be located close or within the linkage regions reported in schizophrenia, early-onset major depressive disorder and eating disorder, supporting the hypothesis that some genes influence risk beyond traditional diagnostic boundaries.
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PMID:Intron 12 in NTRK3 is associated with bipolar disorder. 2055 28

Background. Topiramate (TPM) is a new antiepileptic drug that is used mainly in the treatment of refractory partial epileptic seizures. There are some studies reporting TPM's effectiveness in the treatment and maintenance of some psychiatric illnesses such as acute mania, some other affective disorders, post-traumatic stress disorder and binge-eating disorder. On the other hand, it has been shown that TPM may cause mild to moderate cognitive impairment and is thought to be responsible for a series of neuro-psychiatric signs and symptoms. Some of the available articles that have mentioned the relationship of psychotic symptoms and topiramate usage are discussed. Objective. The present paper aims to discuss a case of psychotic exacerbation purported to occur after TPM administration and to review specifically the literature on TPM's potential for inducing psychotic symptoms. The patient presented here is thought to be an undiagnosed schizophrenia patient until his admission to our clinic (Department of Psychiatry, Gazi University Medical School) with TPM-exacerbated psychotic symptoms. Conclusions. The current findings are still subject to controversy because of the presence of both individual case reports and case series on the association between appearance of psychotic symptoms and TPM usage.
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PMID:Topiramate-induced psychotic exacerbation: case report and review of literature. 2494 Jul 28

Anorexia Nervosa (AN) is an eating disorder characterised by distorted cognitions about body weight and shape; but little is known about the phenomenological characteristics of these beliefs. In this study, multidimensional and insight-based measurements were used to compare beliefs about body weight and shape in AN to body image dissatisfaction in the general population, and delusional beliefs in schizophrenia. Twenty participants with clinical and sub-clinical AN, 27 participants with schizophrenia and schizoaffective disorder, and 23 healthy controls completed the Brown Assessment of Beliefs Scale and the Psychotic Symptom Rating Scale in relation to a dominant belief regarding body weight/shape (or body dissatisfaction in healthy controls) or a current delusion. All groups completed the Peters Delusions Inventory to assess the prevalence of a range of delusion-like beliefs. Participants with clinical and subclinical AN experienced significantly higher preoccupation and distress for their belief in comparison to both participants with schizophrenia/schizoaffective disorder rating a delusional belief and the healthy controls rating a belief of body dissatisfaction. Both clinical groups were comparable on ratings of belief conviction and disruption. The data raise questions regarding the current frameworks that are used to describe beliefs in AN.
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PMID:A phenomenological investigation of overvalued ideas and delusions in clinical and subclinical anorexia nervosa. 2513 96

Objective. Despite evidence from case series, the comorbidity of eating disorders (EDs) with schizophrenia is poorly understood. This review aimed to assess the epidemiological and clinical characteristics of EDs in schizophrenia patients and to examine whether the management of EDs can be improved. Methods. A qualitative review of the published literature was performed using the following terms: "schizophrenia" in association with "eating disorders," "anorexia nervosa," "bulimia nervosa," "binge eating disorder," or "night eating syndrome." Results. According to our literature review, there is a high prevalence of comorbidity between schizophrenia and EDs. EDs may occur together with or independent of psychotic symptoms in these patients. Binge eating disorders and night eating syndromes are frequently found in patients with schizophrenia, with a prevalence of approximately 10%. Anorexia nervosa seems to affect between 1 and 4% of schizophrenia patients. Psychopathological and neurobiological mechanisms, including effects of antipsychotic drugs, should be more extensively explored. Conclusions. The comorbidity of EDs in schizophrenia remains relatively unexplored. The clearest message of this review is the importance of screening for and assessment of comorbid EDs in schizophrenia patients. The management of EDs in schizophrenia requires a multidisciplinary approach to attain maximized health outcomes. For clinical practice, we propose some recommendations regarding patient-centered care.
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PMID:Eating disorders in schizophrenia: implications for research and management. 2548 52

A strong placebo response in psychiatric disorders has been noted for the past 50 years and various attempts have been made to identify predictors of it, by use of meta-analyses of randomised controlled trials and laboratory studies. We reviewed 31 meta-analyses and systematic reviews of more than 500 randomised placebo-controlled trials across psychiatry (depression, schizophrenia, mania, attention-deficit hyperactivity disorder, autism, psychosis, binge-eating disorder, and addiction) for factors identified to be associated with increased placebo response. Of 20 factors discussed, only three were often linked to high placebo responses: low baseline severity of symptoms, more recent trials, and unbalanced randomisation (more patients randomly assigned to drug than placebo). Randomised controlled trials in non-drug therapy have not added further predictors, and laboratory studies with psychological, brain, and genetic approaches have not been successful in identifying predictors of placebo responses. This comprehensive Review suggests that predictors of the placebo response are still to be discovered, the response probably has more than one mediator, and that different and distinct moderators are probably what cause the placebo response within psychiatry and beyond.
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PMID:Placebo eff ects in psychiatry: mediators and moderators. 2581 49


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