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)

Management of bipolar disorder in many ways is similar to the management of schizophrenia in that the goals in the treatment of both disorders are to avoid rehospitalization, manage behavioral symptoms, and promote functional recovery. This review will define functional recovery in bipolar disorder, discuss relapse prevention, and consider some implications for treatment. The most notable implication for treatment is that clinicians need to use stricter criteria when defining recovery in bipolar disorder. Recovery should not be defined merely by symptomatic remission or even syndromal remission; rather, recovery should include symptomatic recovery, syndromal recovery, functional recovery, and a return to an acceptable quality of life for the patient.
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PMID:Defining and achieving recovery from bipolar disorder. 1696 84

The long-term goals of treating both bipolar disorder and schizophrenia are to achieve remission, promote functional recovery, prevent relapse, and improve patients' subjective response. To meet these goals in patients with bipolar disorder, management of the acute episodes of mania, depression, and mixed symptomatology is necessary and may help to maintain favorable patient behavior and avoid hospitalization. In this review, the definitions of remission, recovery, and relapse are compared and contrasted between bipolar disorder and schizophrenia to highlight the similarities and, most notably, the differences in assessments between the two conditions. The implications for the treatment of bipolar disorder stem from the ideology that underlies many of the studies in schizophrenia.
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PMID:Outcomes to monitor when treating bipolar disorder or schizophrenia. 1710 69

Remission is a realistic goal for patients with schizophrenia, and, if sustained remission without relapse can be achieved, then patients may attain functional recovery. With each relapse, recovery can be slowed and the course of illness worsened. The risk of self-harm and harm to others increases with each psychotic episode. The chance of relapse is decreased if pharmacotherapy continues uninterrupted, and one strategy to ensure continuous treatment is using long-acting injectable antipsychotic medications. Achieving remission of schizophrenia is clinically meaningful because, besides symptom control, remission allows for improved vocational and social functioning. Functional recovery without relapse allows patients to return to work, sustain interpersonal relationships, and lead more productive lives. Therefore, achieving the goals of remission and recovery is in the best interest not only of patients with schizophrenia but also of society.
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PMID:Treatment strategies to prevent relapse and encourage remission. 1828 75

This cross-sectional study examined the relationships between clinical and neuropsychological variables and self-reported quality of life (QoL) in 30 euthymic bipolar I patients, 23 remitted schizophrenic patients, and 23 healthy controls. Participants were administered the World Health Organization Quality of Life Measure-Abbreviated Version (WHOQOL-BREF) to assess QoL. Moreover, a broad neuropsychological battery was also administered. Bipolar disorder (BD) and schizophrenia patients demonstrated significantly lower scores on the physical, psychological, and social domains of the WHOQOL-BREF compared with controls, but there were no significant differences between the two patient groups on those domains. More symptomatic BD patients reported worse QoL, especially in the physical and environmental domains, which was also associated with worse neurocognitive performance. In schizophrenic patients, neurocognitive performance was not associated with self-reported QoL, but more symptomatic patients reported lower QoL. Substantial impairments in QoL, similar in severity, were found in both patient groups. In patients with schizophrenia, QoL was more strongly related to levels of psychopathology, whereas in BD patients, both psychopathology and neurocognitive deficits were strongly associated with lower QoL. Clinical recovery is essential in schizophrenia and BD. The association between cognitive functioning and QoL in bipolar patients suggests that these patients may also benefit from psychological interventions addressed to improve cognitive deficits and enhance the functional recovery.
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PMID:Quality of life in bipolar type I disorder and schizophrenia in remission: clinical and neurocognitive correlates. 1848 88

Remission is a realistic goal for patients with schizophrenia, and, if sustained remission can be achieved, then patients may eventually attain functional recovery. The chance of relapse is decreased if patients are adherent to their pharmacotherapeutic treatment regimen. This case explores how to prevent relapse for a patient with schizophrenia and comorbid substance use disorder who is nonadherent to an oral atypical antipsychotic. To help the patient achieve treatment goals, intervention strategies such as switching medications and implementing psychosocial therapies are considered.
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PMID:Relapse prevention in patients with schizophrenia. 1850 84

The ability to think of the long-term consequences of one's behavior and use this information to guide present and future actions, commonly referred to as foresight, is a key higher-order cognitive ability that may be deficient among persons with schizophrenia and substantially limit the degree to which such individuals experience a functional recovery from the disease. This research investigated the neuroanatomical basis of foresight in schizophrenia, in order to identify potential brain regions that may underlie impaired foresight among this population. Participants in the early course of schizophrenia or schizoaffective disorder (N=50) were assessed using structural magnetic resonance imaging and clinician-rated measures of foresight and psychopathology. Voxel-based morphometry was used to examine the relationship between foresight and regional gray matter volume in the ventromedial prefrontal, orbitofrontal and cingulate cortices. Significant positive associations were observed between foresight and gray matter volume density in the right orbitofrontal, ventromedial prefrontal, and posterior cingulate cortices, as well as the left ventromedial prefrontal and anterior cingulate cortices, after correcting for multiple comparisons. These relationships persisted after adjusting for age, gender, illness duration, and psychopathology. Better foresight was most strongly associated with increased gray matter in the right orbitofrontal/ventromedial prefrontal cortex, suggesting that reductions in gray matter volume in this region may be associated with impaired foresight in schizophrenia. Implications and directions for future research are discussed.
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PMID:Neuroanatomical substrates of foresight in schizophrenia. 1860 14

Despite the expansion of available antipsychotic drugs over the past 50 years, functional outcomes for individuals with schizophrenia have not markedly improved. These agents are efficacious for psychosis but do not adequately address other core domains of schizophrenia psychopathology, namely negative symptoms and cognitive impairment, which have a greater impact on functional outcomes, including vocational or academic performance and interpersonal relationships. In addition, treatment-refractory psychosis still precludes functional improvement in many patients. Schizophrenia is a clinical syndrome consisting of these domains, which likely have some disparities in their respective pathophysiologies. This suggests that drug development should look to other molecular targets besides the D2 receptor, which characterizes the mechanism of available medications for schizophrenia. In this report, we review novel pharmacologic approaches that aim to specifically address each individual domain of schizophrenia. The goal of this future pharmacotherapy strategy is to advance outcomes beyond psychosis remission and toward functional recovery.
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PMID:Better pharmacotherapy for schizophrenia: what does the future hold? 1862 75

A number of psychosocial treatments are available for persons with schizophrenia that include social skills training, cognitive behavioral therapy, cognitive remediation, and social cognition training. These treatments are reviewed and discussed in terms of how they address key components of functional recovery such as symptom stability, independent living, work functioning, and social functioning. We also review findings on the interaction between pharmacological and psychosocial treatments and discuss future directions in pharmacological treatment of schizophrenia. Overall, these treatments provide a range of promising approaches to helping patients achieve better outcomes far beyond symptom stabilization.
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PMID:Psychosocial treatments to promote functional recovery in schizophrenia. 1917 70

Compliance and relapse are major issues in the treatment of psychotic disorders. About 50% of subjects with schizophrenia do not comply with treatment and relapse rates of 65% are reported after one year and 80% after two years. Drug treatments are effective against psychotic symptoms, but cannot promote functional recovery or prevent relapses when prescribed alone. The factors influencing compliance include side effects and the patients' awareness of their illness. Psychosocial interventions, cognitive remediation and psychotherapy have been proposed as adjuvant treatments to increase compliance and to decrease the rate of relapse. Most of these interventions have been shown to increase compliance and to decrease the rate of relapse, but the most robust results have been achieved with cognitive behavioral therapy.
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PMID:Patients' health literacy in psychotic disorders. 1930 May 80

Recent studies with brain magnetic resonance imaging (MRI) have scanned large numbers of children and adolescents repeatedly over time, as their brains develop, tracking volumetric changes in gray and white matter in remarkable detail. Focusing on gray matter changes specifically, here we explain how earlier studies using lobar volumes of specific anatomical regions showed how different lobes of the brain matured at different rates. With the advent of more sophisticated brain mapping methods, it became possible to chart the dynamic trajectory of cortical maturation using detailed 3D and 4D (dynamic) models, showing spreading waves of changes evolving through the cortex. This led to a variety of time-lapse films revealing characteristic deviations from normal development in schizophrenia, bipolar illness, and even in siblings at genetic risk for these disorders. We describe how these methods have helped clarify how cortical development relates to cognitive performance, functional recovery or decline in illness, and ongoing myelination processes. These time-lapse maps have also been used to study effects of genotype and medication on cortical maturation, presenting a powerful framework to study factors that influence the developing brain.
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PMID:Mapping gray matter development: implications for typical development and vulnerability to psychopathology. 1979 63


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