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)

We administered the National Institute of Mental Health Diagnostic Interview Schedule to 41 patients with a lifetime history of anorexia nervosa (25 with and 16 without bulimia) and to 49 patients with bulimia alone. Results showed that 77% of the patients with eating disorders had a lifetime diagnosis of DSM-III major affective disorder, a rate significantly higher than that found in comparison groups composed of the first-degree relatives of probands with schizophrenia and bipolar disorder. High lifetime rates of anxiety disorders, substance use disorders, and kleptomania were also observed. By contrast, few cases of personality disorders and no cases of schizophrenia were found. These findings combine with the results of studies of family history, long-term outcome, response to biological tests, and treatment response to suggest that anorexia nervosa and bulimia may be closely related to major affective disorder.
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PMID:Phenomenologic relationship of eating disorders to major affective disorder. 658 Jun 63

This study examined the internal reliability of standardized measures of substance use expectancies and motives in a schizophrenia population (n = 70) and the relationship of these expectancies and motives to alcohol and drug use disorders. Internal reliabilities were uniformly high for the subscales of the expectancy and motive measures. Analyses of the relationship between substance use disorders and expectancies revealed strong substance-specific expectations. Alcohol expectancies were related to alcohol disorders but not to drug disorders; cocaine expectancies were related to drug but not to alcohol disorders; and marijuana expectancies were more strongly related to drug than to alcohol use disorders. In contrast, motives were related to substance use disorders, and self-reported substance use problems were related to expectancies and motives in a non-specific manner. These results suggest that expectancy and motive questionnaires developed for the primary substance abuse population may be valid for psychiatric populations. Research on motives and expectancies may help to clarify the functions of substance abuse in persons with schizophrenia.
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PMID:Expectations and motives for substance use in schizophrenia. 748 68

Gender differences in diagnosis, demographic and family characteristics, and trauma histories among psychiatric outpatients at a Veterans Affairs clinic were examined. Among the 51 women and 46 men, significantly more women had affective disorders and schizoaffective disorder; significantly more men had anxiety disorders, schizophrenia, and substance use disorders. Although women had sharply higher rates than men of every type of trauma except combat trauma, more male veterans received a diagnosis of posttraumatic stress disorder. Men were four times more likely to be married. Women were more likely than men to be the sole caretakers of minor children. These differences have important treatment and policy implications. The findings confirm that recently initiated VA programs recognize important treatment needs of female veterans.
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PMID:Mental health care needs of female veterans. 868 82

Recent studies of the effectiveness of specialized programs that treat substance use disorders in schizophrenia have obtained promising results but have not involved control groups. Interpretation of these apparently positive results is problematic because remission and relapse rates of substance use disorders have not been reported in this population. The present study reports 1-year rates of substance abuse and dependence remission and relapse in a sample of schizophrenics taken from the Epidemiologic Catchment Area study. Results indicated that the prevalence of substance use disorders in schizophrenia remained constant over the year primarily because rates of remission were balanced by rates of relapse. Individuals who developed abuse or dependence over the year were younger, male, and showed increases in depression and risk for hospitalization over the year. Individuals who remitted abuse or dependence were older, female, and showed decreases in depression over the year. Dual diagnosis treatment programs have recently reported higher rates of remission than were evidenced in this sample, thus providing preliminary support for the effectiveness of these treatments.
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PMID:Remission and relapse of substance use disorders in schizophrenia. Results from a one-year prospective study. 820 6

Faced with many patients with comorbid severe mental illness and substance use disorders, a university-affiliated, inner-city community mental health center and a psychosocial rehabilitation center initiated this clinical trial assessing a program to care for these patients. Fifty-four patients, age 18 to 40, with either schizophrenia or major affective disorder and a substance use disorder were randomly assigned to usual community mental health center and rehabilitation services with or without an innovative group and intensive case management program. One-year follow-ups detected no significant advantages on patient outcomes for adding the innovative program to usual services. Failure to engage patients in the experimental program posed a major and enduring barrier to treatment, despite intensive case management. Future efforts must give greater consideration to effective engagement techniques and patients' readiness for active treatment.
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PMID:Rehabilitation for adults with severe mental illness and substance use disorders. A clinical trial. 824 31

Epidemiological studies such as the Epidemiological Catchment Area survey have shown that bipolar or schizophrenic patients are especially prone to display a comorbid substance use disorder. These studies have demonstrated that this comorbidity condition constitutes a major mental health problem owing to its high frequency. The aim of the present study was to assess the prevalence of a comorbid substance use disorder in a sample of psychotic patients, and to compare the pattern of street drug use in schizophrenic, schizoaffective and bipolar patients. Comorbidity of illicit substance use disorders was assessed with the Composite International Diagnostic Interview in 92 consecutive patients fulfilling the DSM III-R criteria for bipolar disorder (BP, n = 40), schizophrenia (S, n = 38) and schizoaffective disorder (SA, n = 14). The lifetime prevalence for any substance use was 25% in the total sample, and did not differ significantly between the three groups, although a higher prevalence was found in SA (BP: 20%, S: 23.7%, SA: 42.9%, NS). The current prevalence (previous six months) was 14.1%, in the total sample (BP: 17.5%, S: 7.9%, SA: 21.4%, NS). In the three diagnostic groups, the most commonly used drug was cannabis, followed by opiates and cocaine. These results do not confirm that schizophrenics might preferentially display abuse or dependence on psychostimulants, and highlight the possible role for the drug choice of the availability of the various illicit drugs in the geographical environment of the subject. Nearly half patients (47.8%) have a lifetime history of abuse or dependence on at least two different drugs. Age at onset of substance use disorder was earlier than or concomitant to that of schizophrenic and/or mood symptoms in most patients. This chronological pattern was the same in the three diagnostic groups. Clinical variables (age at onset, age at first hospitalization, number of hospitalizations) and sociodemographic variables (age, sex, educational level, marital and occupational status) did not significantly differ between patients with a lifetime history of drug abuse or dependence and those without. Patients presenting with a current abuse or dependence were younger than those without. These results confirm in a French sample of schizophrenic and/or mood disordered patients the high frequency of the comorbidity with substance use disorders.
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PMID:[Comparative study of substance dependence comorbidity in bipolar, schizophrenic and schizoaffective disorders]. 870 27

The current understanding of suicidal behaviors is that such behaviors are multidetermined and mental state and trait related. Genetic factors appear to be of great importance, as suggested by the findings of family, twin, and adoption studies. Whether these genetic factors are similar to those involved in the susceptibility to psychiatric disorders closely related to suicidal behavior (eg, manic depressive illness, schizophrenia or substance use disorders) is yet unknown. However, a genetic factor of susceptibility to suicide, independent or additive to the genetic transmission of the psychiatric disorders that are related to suicidal behavior, is strongly suggested by the data of the Copenhagen adoption study and a study of Amish families. Recently, new approaches have been proposed to identify the genetic component of such complex traits. Association studies between genetic markers and a disease phenotype has been successfully applied to several complex disease such as essential hypertension. One candidate gene for suicidal behaviors is the tryptophane hydroxylase (TPH) gene which is the first and possibly rate-limiting enzyme of the metabolic pathway for serotonin. Indeed, altered serotoninergic function in both completed suicide and suicide attempt has been one of the most replicated findings in modern biological psychiatry. In our knowledge, only two studies have tested the association between suicide attempt and the TPH gene and their authors found negative results. Despite these negative results, association studies that use candidate gene remain one of the methods of choice for studying the genetic component of suicidal behaviors.
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PMID:[Epidemiologic and molecular genetic of suicidal behavior]. 913 31

This study of a frequently endorsed, but untested, model of outpatient treatment for persons with coexisting severe mental illness and substance use disorders assessed how the amount of treatment services delivered was related to an individual's global severity of illness, whether different modes of treatment were related to different aspects of illness, how noncompliance with treatment was related to the severity of illness and amount of services delivered, and how the diagnosis of schizophrenia/schizoaffective influenced these issues. Participants with high total severity of illness (TSI) received about twice the number of appointments (20.7 vs. 12.3) per month as those with low TSI scores. Higher TSI was also related to a DSM-IV diagnosis of schizophrenia/schizoaffective, being in a lower "phase" of treatment, representative payee benefit management, homelessness, and more hospitalizations. Participants with higher psychiatric symptom severity received significantly more case management and medication services, but not group therapy or day treatment. Severity of substance use condition was significantly related only to case management. This model of treatment was found to be successful in delivering higher levels of treatment services to those needing them.
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PMID:Illness severity and treatment services for dually diagnosed severely mentally ill outpatients. 916 34

Alcoholism is one of a group of common psychiatric diseases which are well-defined clinically and strongly influenced genetically, but which are likely to be highly heterogeneous in causation, genetically and otherwise. Dopamine is a key neurotransmitter in drug-mediated reinforcement. Based on association studies with the Taq1A downstream marker, the D2 dopamine receptor has been proposed to be the "Reward Deficiency Syndrome Gene." Ser311Cys, a naturally occurring variant which largely inactivates transduction after D2 receptor activation, was abundant (0.16) in a Southwestern American Indian population we studied. Therefore, we were able to provide a critical test of the D2 hypothesis of vulnerability to alcoholism by evaluating Ser311Cys and also the intron-2 STR and Taq1A markers at this locus in a total of 459 subjects, including 373 sib pairs, from large families. The result is that neither alcoholism, substance use disorders nor schizophrenia show a relationship to Ser311Cys genotype, even when the 15 Cys311/Cys311 homozygous individuals are compared to others. Furthermore, sib pair analysis incorporating information across all three sib pair categories: concordant affected, discordant and concordant unaffected revealed no effect of DRD2 genotype or haplotype on alcoholism or substance use disorder.
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PMID:Linkage and association of a functional DRD2 variant [Ser311Cys] and DRD2 markers to alcoholism, substance abuse and schizophrenia in Southwestern American Indians. 1049 Jul 20

Psychiatric disorders are highly prevalent and cause an enormous burden of suffering, loss of productivity, morbidity, and mortality. This article will review prevention of psychiatric disorders in a manner that is relevant to the mental health clinician. Clinicians may increasingly play a role in preventive interventions through (1) identifying individuals at risk, (2) consulting with agencies, school personnel, and employers who may identify individuals at risk, (3) providing treatment that can reduce the chronicity, severity, and total duration of psychiatric illness, and (4) providing mental health care to a specific population within our evolving health care system, in which health promotion and disease prevention play an increasingly important role. Appropriate literature was located by searching the English-language citations since 1985 in Index Medicus (search terms included prevention, preventive psychiatry, early intervention, mental disorders, risk factors, and primary prevention), reviewing several textbooks on psychiatric preventive services, and finding additional sources cited in the reference sections of these publications. This paper presents the public health model of disease prevention, which divides prevention activities into primary, secondary, and tertiary interventions. The model is applied to childhood psychiatric disorders and to adult-onset schizophrenia, depressive disorders, and substance use disorders. The review concludes with a discussion of the implications for the clinician and for public health policy.
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PMID:Prevention of psychiatric disorders. 938 39


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