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)

Bipolar disorder is a common, chronic and severe mental disorder, affecting approximately 2% of the adult population. Bipolar disorder causes substantial psychosocial morbidity that frequently affects the patient's marriage, children, occupation, and other aspects of the patient's life. Few studies have examined the functional impairment in patients with affective illness. Earlier outcome studies of mania reported favorable long-term outcomes. However, modern outcome studies have found that a majority of bipolar patients evidence high rates of functional impairment. These low reports of functional recovery rates are particularly surprising. The basis for such limited functional recovery is not entirely clear. Factors associated with functional dysfunction include presence of inter-episode symptoms, neuroleptic treatment, lower social economic class, and lower premorbid function. Cognitive dysfunction, a symptom domain of schizophrenia, has been identified as an important measure of outcome in the treatment of schizophrenia. Recently, there has been some suggestion that there may be impaired neuropsychological performance in euthymic patients with recurring mood disorders. Whether impaired neuropsychological performance in associated with the functional impairment in bipolar patients who have achieved syndromal recovery is an intriguing question. The literature on functional impairment and cognition in bipolar disorder is reviewed.
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PMID:Functional impairment and cognition in bipolar disorder. 1102 10

Recent advances in stem cell technology are expanding our ability to replace a variety of cells throughout the body. In the past, neurological diseases caused by the degeneration of neuronal cells were considered incurable because of a long-held 'truism'; neurons do not regenerate during adulthood. However, this statement has been challenged, and we have now found much evidence that the brain is indeed capable of regenerating neurons after maturing. Based on this new concept, researchers have shown neural differentiation of stem cells and recovery of function following transplantation of these cells into the brain. These results may promise a bright future for clinical applications of stem cell strategies in neurological diseases; however, we must consider the pathophysiological environments of individual diseases that may affect stem cell biology. Before we begin to develop clinical applications, we must consider environmental factors that have not been discussed in the current preclinical studies. Here, we study cases of Alzheimer's disease and schizophrenia and discuss the effects of environmental factors under disease conditions.
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PMID:Neuroreplacement therapy and stem cell biology under disease conditions. 1452 50

Investigation of neuropsychological functioning in bipolar disorder provides a potential link from the prominent cognitive symptoms of the disorder to the underlying neural mechanisms. Continuous performance measures of sustained attention have yielded consistent findings in bipolar disorder patients. There are impairments that appear to be both state- and trait-related. Impaired target detection may represent one of the most sensitive markers of illness course in bipolardisorder. It is unrelated to residual mood symptomatology and medication status, and is present in patients with good functional recovery. The impairment in target detection is exacerbated in the manic state, and is accompanied by an increased rate of false responding. Sustained attention deficit is present early in the course of the disorder, but becomes more pronounced with repeated episodes. This cognitive profile, of an early-onset, state-modulated, trait marker, is distinct from the profile of attentional disruption seen in schizophrenia or unipolar depression. The state- and trait-related impairments may be differentially associated with the ascending dopamine and noradrenaline projections.
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PMID:State- and trait-related deficits in sustained attention in bipolar disorder. 1514 34

The role of natural idiotypic (Id-Abs) and anti-idiotypic (AId-Abs) autoantibodies against neuroantigens observed in different neurological disorders is not fully understood. In particular, limited experimental evidence has been provided concerning the qualitative and quantitative serological response after acute injuries of the central nervous system or during chronic mental diseases. In this study, we analyzed the specific Id-Abs and AId-Abs serological reactivities against 4 neuro-antigens in a large population of patients with ischemic stroke, schizophrenia, as well as healthy individuals. Patients with ischemic stroke were tested at different time points following the acute stroke episode and a correlation was attempted between autoantibodies response and different patterns of functional recovery. Results showed variable and detectable Id-Abs and AId-Abs in different proportions of all three populations of subjects. Among patients with different functional recovery after ischemic stroke, a difference in time-related trends of Id-Abs and AId-Abs was encountered. Our observations suggest that changes in the production of natural neurotropic Abs may engender a positive homeostatic, beside a possible pathogenic effect, in specific neurological disorders.
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PMID:Dialectics and implications of natural neurotropic autoantibodies in neurological disease and rehabilitation. 1533 Apr 51

Schizophrenia is a severe, debilitating mental illness characterised by a progressive decline of the patient's functioning and relationship with the outside world. Although some patients recover, the illness more usually follows a chronic relapsing course. The long-standing nature of the illness gives rise to a variety of issues, such as poor general health and non-adherence to treatment, which can have a significant impact on the clinical effectiveness of antipsychotic therapy. It is therefore important that clinicians consider the wider aspects of clinical effectiveness, such as functional recovery, individual well-being, treatment adherence and patient satisfaction, when assessing the clinical effectiveness of antipsychotic therapy. Of the atypical antipsychotics currently available to treat chronic schizophrenia, clinical experience and results from clinical trials suggest that quetiapine can provide a broad range of symptomatic relief with minimal clinically significant adverse events. This, in turn, may lead to greater patient satisfaction, increased adherence and an improved treatment outcome. As with all atypical antipsychotics, the key to clinical effectiveness is appropriate dosing. Data from recent studies suggest that an appropriate target dose for quetiapine for many adults with schizophrenia is 600 mg/day.
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PMID:Clinical effectiveness in adults with chronic schizophrenia. 1557 64

Mismatch negativity (MMN) is an event-related potential measure of auditory change detection. It is widely reported to be smaller in patients with schizophrenia and may not improve along with otherwise successful clinical treatment. The main aim of this report is to explore ways of measuring and presenting four features of frequency-deviant MMN dipole sources (dipole moment, peak latency, brain location and orientation) and to relate these to the processes of psychopathology and illness progression. Data from early onset patients (EOS) at the start of the illness in adolescence, and others who had their first break in adolescence 15 years ago (S-15Y) were compared with two groups of age-matched healthy controls (C-EOS, C-15Y). A four-source model fitted the MMN waveform recorded from all four groups, whether MMN amplitude was more (EOS) or less (S-15Y) reduced. The locations were in the left superior temporal and anterior cingulate gyri, right superior temporal and inferior/mid frontal cortices. Dipole latencies confirmed a bottom-up sequence of processing and dipole moments were larger in the temporal lobes and on the left. Patients showed small dipole location changes that were more marked in the S-15Y than the EOS group (more rostral for the left anterior cingulate, more caudal for the right mid-frontal dipole) consistent with illness progression. The modelling of MMN dipole sources on brain atlas and anatomical images suggests that there is a degree of dissociation during illness between small progressive anatomical changes and some functional recovery indexed by scalp recordings from patients with an onset in adolescence 15 years before compared to adolescents in their first episode.
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PMID:Frontal and temporal sources of mismatch negativity in healthy controls, patients at onset of schizophrenia in adolescence and others at 15 years after onset. 1592 96

Significant symptomatic improvement after a first episode of psychosis is not matched by a similar improvement in functional outcome. Thus, increased attention has been given to psychological intervention, in particular cognitive cognitive-behavioural therapy (CBT), with the hope of enhancing functional recovery. Outcome trials of CBT for schizophrenia are few, in particular for the first episode, and have been occasionally criticised for their lack of significance compared with supportive therapies. We describe a modular CBT approach for those with a first episode of psychosis that addresses adaptation as well as both functional and symptomatic outcome and one that parallels the theoretical shift in CBT that has occurred in the last decade. Guidelines for integrating CBT into an early psychosis service are presented.
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PMID:Implementing cognitive-behavioural therapy for first-episode psychosis. 1605 12

Many patients with schizophrenia have psychological distress and receive some form of psychotherapy. Several different psychotherapeutic approaches for schizophrenia have been developed and studied. Of these approaches, cognitive behavior therapy has the strongest evidence base and has shown benefit for symptom reduction in outpatients with residual symptoms. In addition to cognitive behavior therapy, other approaches include compliance therapy, personal therapy, acceptance and commitment therapy, and supportive therapy. Although usually studied as distinct approaches, the therapies overlap with each other in their therapeutic elements. As psychotherapy for schizophrenia further evolves, it will likely be informed by other psychosocial interventions used with this clinical population. In particular, techniques of remediating cognitive deficits, teaching behavioral skills, and educating about schizophrenia may be incorporated with psychotherapy. Future research may also consider three different goals of psychotherapy with this population: to provide emotional support, to enhance skills for functional recovery, and to alter the underlying illness process.
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PMID:Evidence-based psychotherapy for schizophrenia. 1646 48

Neurocognitive deficits are a core feature of schizophrenia and a significant cause of functional disability. However, targeting these deficits with new treatment approaches will only yield functional improvements if those cognitive operations that are responsible for different dimensions of functional recovery can be identified. A major challenge is that conventional neuropsychological tests, the most practical tools for broadly sampling cognitive functions in treatment trials, are polyfactorial, so that task performance is influenced by multiple cognitive operations. Hence, it is difficult to pinpoint exactly for which cognitive operations a low scoring subject may have poor functionality. We have previously applied in a neuropsychological test battery administered to 220 patients having schizophrenia or schizoaffective disorder, Bayesian statistical methods (yielding partially ordered sets, or posets) designed to mimic the expert analysis of a neuropsychologist by classifying patients into discrete groupings or "states" each having a unique cognitive profile. Here, we report on the association of attributes describing these states (viz. working memory, capacity for divergent thinking, cognitive flexibility and psychomotor speed) with two domains of functional outcome (work/education and residential functioning) rated up to 18 months later. After multiplicity correction, only working memory was associated with work/education outcome. While working memory was not associated with residential outcome, the remaining three attributes were. These findings suggest that different neurocognitive operations may be responsible for different outcome domains. Findings support the use of the poset methodology for clarifying patterns of relationships between discrete neurocognitive attributes and domains of functional outcome.
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PMID:Associating functional recovery with neurocognitive profiles identified using partially ordered classification models. 1669 Feb 54

Nonadherence to medication is a predictor of relapse in patients diagnosed with schizophrenia, and preventing relapse is crucial to achieving the goal of recovery. Long-term treatment with antipsychotics can be effective, although long-term patient response to medication may be difficult to predict from trials that measure response, remission, and relapse rates because they are often too short. Longer trials are needed to fully understand the implications of adherence and symptom remission in patient outcome. Recovery, however, is contingent on the stabilization of the symptoms of schizophrenia and the acquisition of the skills necessary to function in society. Psychosocial interventions, such as family psychoeducation, social skills training, and cognitive-behavioral therapy, used in conjunction with pharmacotherapy are effective in helping to prevent symptom relapse and promote functional recovery in patients with schizophrenia.
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PMID:Relapse prevention and recovery in the treatment of schizophrenia. 1682 93


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