Advances in Schizophrenia Research 2009 (eBook)

Geraldo Busatto Filho, Wagner F. Gattaz (Herausgeber)

eBook Download: PDF

2009 | 2010
XV, 465 Seiten
Springer New York (Verlag)
978-1-4419-0913-8 (ISBN)

Infos

Schizophrenia remains an important challenge to psychiatry, with its causes and underlying brain mechanisms yet to be fully revealed. Currently available treatments are neither universally effective nor without unwanted effects. These aspects, together with the high prevalence of schizophrenia, its often debilitating nature, and the associated family and social burden, make this mental disorder one of the most complex public health issues of our times.

The purpose of the Advances in Schizophrenia Research series is to provide comprehensive periodic reviews of the wide range of research studies carried out around the world, with the dual purpose of solving the schizophrenia puzzle, and providing clues to new forms of treatment and prevention for this disorder. A special feature of the series is its broad scope, virtually encompassing all fields of schizophrenia research: epidemiology and risk factors; psychopathology; diagnostic boundaries; cognition; outcome and prognosis; pathophysiology; genetics; pharmacological and psychological forms of treatment and rehabilitation; community care; and stigmatization.

Inhalt

Preface 5
Contents 7
Contributors 10
Part I Epidemiology And Risk Factors 15
Incidence and Outcome of Schizophrenia Across the Globe 16
Introduction 16
Incidence of Schizophrenia 17
Migration and Risk of Schizophrenia 21
Urbanization and Neighbourhood 24
Outcome of Schizophrenia 26
Perspectives 28
References 28
Gene--Environment Interactions for Searchers: Collaboration Between Epidemiology and Molecular Genetics 31
Introduction 31
Ecogenetics 32
Ecogenetics in Psychiatry 32
Genetic Moderation of Sensitivity to Environment 33
Environmental Impact on DNA Sequence and Methylation 34
Gene--Environment Correlation 35
Confounding of GE by rGE 36
The Environment, Experimental Ecogenetics and Functional Enviromics 38
The Environment and Psychosis 38
Environmental Measurement and Experimental Ecogenetics 38
Box 1 Published Environmental Exposures for Psychosis for which G0E has been Suggested (M+, at least one positive meta-analytic estimate M+/0, inconclusive meta-analytic estimate
Functional Enviromics 41
Epidemiological GE Studies in Psychosis 42
Epidemiological Findings 42
Findings from Twin, Adoption and Family Studies 43
Studies Using a Psychometric Psychosis Liability Approach 43
Summary of Epidemiological GE Studies to Date 45
Epidemiological Replications of Gene--Urbanicity Interaction 45
Future Prospects 45
The Ideal Sample Size for GE Research 52
Biostatistics 52
Which Endophenotypes to Study? 53
Multiple Tests 53
Conclusion 54
References 55
The Natural History of the Course and Outcome of Schizophrenia 63
Background 63
Nature of the Symptom Trajectory Prior to Diagnosis of Disorder 64
A Dynamic Model of Psychosis Evolution: Proneness-Persistence-Impairment Hypothesis 66
Studies of the Course and Outcome of Psychosis: Evidence from Clinical Samples of Patients Diagnosed with Schizophrenia 66
Methodological Difficulties in Defining the Course and Outcome of Schizophrenia After Diagnosis 67
Evidence from Recent Meta-analytical Studies of Outcome of Schizophrenia 69
Future Directions 73
References 74
Impact of Contextual Environmental Mechanisms on the Incidence of Schizophrenia and Other Psychoses 78
Introduction 78
Epidemiological and Clinical Scope of the Chapter 80
Defining Contextual Mechanisms and Variables 82
Variation in the Incidence of Schizophrenia and Other Psychoses 83
Estimates of the Incidence of Schizophrenia 83
Individual-Level Variation in Incidence 84
Temporal Variation in Incidence Rates of Schizophrenia and Other Psychoses 87
Geographical Variation in Incidence Rates of Schizophrenia and Other Psychoses 88
The Role of Contextual Mechanisms on the Incidence of Schizophrenia 89
Context-Specific Environmental Exposure Variables and the Incidence of Schizophrenia 90
Context-Refining Environmental Exposure Variables and the Incidence of Schizophrenia 93
The Impact of Socioenvironmental Factors for Schizophrenia and Other Psychoses 96
Placing Contextual Mechanisms in Context: From Envirome to Epigenetics 97
Concluding Remarks: Future Directions 100
References 101
Part II Pathophysiology 108
Disinhibition of Prefrontal Cortex Neurons in Schizophrenia 109
Introduction 109
Dopamine Dysfunction in Schizophrenia 110
Glutamate Neurotransmission and Schizophrenia 111
GABA Neurotransmission and Schizophrenia 112
Disinhibition Hypothesis 113
References 116
Brain Anatomical Abnormalities in Schizophrenia: Neurodevelopmental Origins and Patterns of Progression over Time 122
Introduction 122
A Succinct Review of Postmortem Neuropathological Studies of Schizophrenia 123
In Vivo Structural Neuroimaging Studies: Detection of Volumetric Brain Abnormalities in First-Episode Schizophrenia 125
Association Between Focal Brain Developmental Abnormalities and the Diagnosis of Schizophrenia 127
Progression of Morphologic Brain Changes After the Onset of Psychosis 129
Are There State-Dependent Brain Structural Abnormalities in Schizophreniform Psychosis? 138
Brain Abnormalities Associated with the Conversion from Prodromal States to Psychosis 139
Progressive Brain Abnormalities in Schizophrenia: Evidence from Studies Using Other MRI-Based Techniques 140
The Influence of Antipsychotic Treatment on the Progression of Brain Abnormalities in Schizophrenia 142
Novel Approaches: Association Between Gene Polymorphisms and Brain Structural Abnormalities in Schizophrenia 145
Concluding Remarks 146
References 147
The Neuropathology of Schizophrenia: Central Role for the Hippocampus? 158
The Neurodevelopmental Hypothesis of Schizophrenia 158
The Aetiology of Schizophrenia: Implication of Genetic and Environmental Factors 159
Susceptibility Genes for Schizophrenia 160
Neuregulin 1 Gene and Its Effects on BrainHippocampal Function 160
Animal Models for Examining the Central Role of Hippocampus in Schizophrenia and the Neurodevelopmental Hypothesis 162
Neuropathological Findings of Hippocampus in Schizophrenia 163
Results from Design-Based Stereological Investigations 165
Resume: Hippocampus Is Involved in a Neuronal Network That Is Relevant for the Pathophysiology of Schizophrenia 167
References 168
Molecular Neuroimaging, Pathophysiological Mechanisms, and Drug Discovery 175
Introduction 175
Dopamine Dysfunction in Psychosis 175
Glutamate Dysfunction in Psychosis 176
Endocannabinoids and Psychosis 177
Implications for Drug Development 178
References 178
Part III Genetics 181
Animal Models of Schizophrenia: Focus on Hippocampal Disruption of Dopamine System Regulation 182
Introduction 182
Glutamate and the Developmental Model of Schizophrenia 183
Hippocampal Dysfunction and Dopamine System Dysregulation 184
Amphetamine, Stress, and the Hippocampus 188
Stress as an Etiological Factor in the Development of Schizophrenia 189
Conclusion 190
References 191
Genetic and Proteomic Studies in Schizophrenia 199
Introduction 199
DNA Studies 200
Schizophrenia and DNA Polymorphisms: Association Studies 200
DNA Polymorphisms and Brain Morphometry Alterations: Genetic Brain Imaging in Schizophrenia 205
Gene and Protein Expression Studies in Schizophrenia 206
Serial Analysis of Gene Expression in Schizophrenia 207
Proteomic Studies 209
Summary and Conclusions 217
References 219
Neurogenetic Risk Mechanisms of Schizophrenia: An Imaging Genetics Approach 225
Introduction 225
References 235
Progress in Genetic Studies of Schizophrenia 239
Overview of the Current Status of Genetic Studies of Schizophrenia 239
Pharmacogenetics of Schizophrenia 242
Pharmacogenetics of Antipsychotic Treatment Response 243
Pharmacogenetics of Antipsychotic-Induced Tardive Dyskinesia 246
Pharmacogenetics of the Antipsychotic-Induced Weight Gain 247
Conclusions 248
References 249
Part IV Psychopathology, Cognition, Outcome 255
Prediction of Psychosis Through the Prodromal Syndrome 256
Introduction 256
Psychosis Prodrome and Clinical Prediction Algorithm 257
Neurobiological Markers of Vulnerability and Progression in the Psychosis Prodrome 260
Conclusions 264
References 265
Schizophrenia as a Cognitive Disorder: Recent Approaches to Identifying its Core Cognitive Components to Aid Treatment Development 272
Introduction 272
Issue 1: Why Are Cognitive Deficits Increasingly Believed to be Core Deficits in Schizophrenia? 272
Persistence over Time and Clinical State 272
Presence Among First-Degree Relatives 274
Cognitive Deficits Predict Onset of Schizophrenia Spectrum Disorder 274
Cognitive Deficits Predict Functional Outcome in Schizophrenia 275
Issue 2: What Are the Key Separable Domains of Cognitive Functioning in Schizophrenia from an Empirical Perspective? 276
Issue 3: What Partitioning of Cognitive Processes Might Bring Us Closer to Neural Underpinnings? 279
Issue 4: In Developing Treatments for Cognitive Deficits in Schizophrenia, Should We Focus on Separable Cognitive Processes or the Generalized Cognitive Deficit? 281
Summary and Implications 284
References 285
Cognitive and Social Processes in Psychosis: Recent Developments 288
Introduction 288
The Cognitive Approach 289
Cognitive Studies of Persecutory Ideation Using Virtual Reality 290
The Cognitive Understanding of Persecutory Delusions 293
Internal Anomalous Experience 293
Negative Affect 294
Reasoning 295
Combining the Factors 295
The Impact of Social Factors 297
Developing Treatments: An Interventionist Causal Model Approach 298
References 299
The Impact of Early Intervention in Schizophrenia 304
Introduction 304
What Is Early Intervention? 304
Impact of Early Intervention 305
Focus 1: The Prodromal Phase 305
Detection of ''The Prodrome'' 305
Intervention in the UHR Stage 306
Focus 2: Reducing Duration of Untreated Psychosis 308
Focus 3: The First Episode of Psychosis and the Recovery Phase 310
Acute Phase 310
Recovery Phase 311
Family Interventions 312
Vocational Interventions 312
Further Issues 313
Future Directions Clinical Staging 314
Conclusion 315
References 316
The Cross-Sectional and Longitudinal Architecture ofINTtie Schizophrenia: Significance forINTtie
Introduction 322
Diagnosis and Classification: From Description to Function, to Brain Modules and Beyond? 323
Cognitive Function as a Criterion for Diagnosis, Course, and Prognosis? 325
Time for Early Diagnosis, Early Intervention and Prevention? 329
Conclusions 331
References 332
Part V Schizophrenia and Other Psychotic Disorders: Boundaries and Similarities 336
Continua or Classes? Vexed Questions on the Latent Structure of Schizophrenia 337
Introduction 337
Review Aims and Method 339
Discontinuity in Clinical Features of Schizophrenia 340
Discontinuities in Biological Risk for Schizophrenia 345
Discontinuities in Psychometric Risk for Schizophrenia 346
Discontinuities in Schizophrenia Endophenotypes 352
Discussion 353
References 355
Integrating the Epidemiology and Pathogenesis of Schizophrenia from the Street to the Striatum: Integrating the Epidemiology and Pathogenesis of Schizophrenia 360
Striatal Dopamine as the Wind of Psychotic Fire 361
Age of Onset and Gender Distribution 361
Abuse of Drugs 362
Susceptibility Genes 363
Obstetric Events 364
Social Adversity 364
Conclusion 365
References 366
Cannabis: A Clue or a Distraction in the Searchfor `Causes' of Psychosis? 370
Introduction 370
A Glut of Narrative and Systematic Reviews 371
What Is a Cause? 372
Why Might Cannabis Use Be Associated with Schizophrenia? 372
Does Cannabis Use Influence the Prevalence of Psychotic Symptoms? 373
Does Cannabis Use Influence Remission from Psychosis? 373
Different Levels of Proof Are Required for Different Scenarios 374
Cannabis-Induced Apathy: What Are the Risks of Doing Nothing? 375
The Fertile Intersection Between Schizophrenia Epidemiology and Neurobiology 375
Conclusions 376
References 376
The `Totality' of Psychosis: EpidemiologyINTbreak and Developmental Pathobiology
Introduction 380
The CavanMonaghan First-Episode Study 381
The Challenge of the 'Totality' of Psychosis 381
Major Post Hoc Diagnostic Nodes: Demographics and Psychopathology 382
Major Post Hoc Diagnostic Nodes: Long-Term Follow-Up 383
Major Post Hoc Diagnostic Nodes: Developmental Pathobiology 383
Epidemiology of the 'Totality' of Psychosis 384
Developmental Pathobiology of the 'Totality' of Psychosis 385
Synthesis 386
References 387
Part VI Treatment 389
Comparative Efficacy and Safety of First- and Second-Generation Antipsychotics in the Treatment of Schizophrenia: Facts and Fiction 390
Introduction 390
Do First- and Second-Generation Antipsychotics Differ in Efficacy? 393
Comparing FGAs and SGAs in Overall Efficacy 393
Comparing FGAs and SGAs in Neuroleptic-Refractory Patients 393
Do FGAs and SGAs Differ in Spectrum of Efficacy: Cognitive, Negative, and Mood Symptoms? 394
Making Sense of It All: What Might Explain Contradictory Findings About Differential Efficacy Between SGAs and FGAs? 395
Do First- and Second-Generation Antipsychotics Differ in Adverse Effects? 395
Is the Categorization of Antipsychotics into FGAs and SGAs then Meaningful? 396
Atypicality Is Relevant but SGA/FGA Dichotomization Is Not 397
Implications for Clinical Practice 398
Conclusion 399
References 400
Long-Acting Antipsychotic Medication and the Outcomeof Schizophrenia 403
History 403
Early Use and Utilisation 404
Depots in Current Practice 405
Attitudes 407
Forensic Psychiatry 408
Future Prospects 409
Demonstration of Effect 409
Depots 409
Psychosocial Interventions 411
Conclusions 411
References 412
Modern Community Care Strategies for Schizophrenia Care: Impacts on Outcome 416
Development of the Community Mental Health Team (CMHT) 417
Case Management and CMHTs 418
Community Mental Health Teams (CMHTs) 418
Specialised Teams for Schizophrenia Care 419
Assertive Community Treatment (ACT) Team 419
Box 1 ACT Programme Principles 421
Box 2 ACT Core components 421
Rehabilitation and Recovery Teams 421
Early Intervention Services (EIS) First-Episode Psychosis Teams 422
Dual Diagnosis and Vocational Rehabilitation Services 422
Physical Health Care 423
Community Treatment Orders: Outpatient Commitment 423
Informal Coercion 423
Conclusions 424
References 424
Does Stigma Impair Treatment Response and Rehabilitation inINTtie Schizophrenia? The ``Contribution'' of Mental HealthProfessionals
A Comprehensive Concept of Stigma 428
The Impact of Stigmatisation on Social Networks of Mentally Ill 429
Do Mental Health Professionals Stigmatise Their Patients? 430
Self-Stigma 433
Discussion 434
References 435
Treatment of Schizophrenia: Discussion 438
New Drugs and Old 438
Depot Antipsychotic Drugs, Stigma, and Community Care 441
References 442
Index 443

Produkt-Details

• Erscheint lt. Verlag: 12.11.2009
• Zusatzinfo: XV, 465 p.
• Verlagsort: New York
• Sprache: englisch
• Themenwelt: Geisteswissenschaften ► Psychologie ► Biopsychologie / Neurowissenschaften
• Themenwelt: Geisteswissenschaften ► Psychologie ► Persönlichkeitsstörungen
• Themenwelt: Medizin / Pharmazie ► Medizinische Fachgebiete ► Neurologie
• Themenwelt: Medizin / Pharmazie ► Medizinische Fachgebiete ► Psychiatrie / Psychotherapie
• Schlagworte: Antipsychotics • Community care for schizop • Community care for schizophrenia • Diagnosis of schizophrenia • dopamine • Epidimiology of schizophrenia • Genetics • Genetics of schizophrenia • Incidence of schizophrenia • Intervention • Models of schizophrenia • neurons • Neuropathology of schizophrenia • Pathopsychiolo • Pharmacogenomics in schizophrenia • Prevalence of schizophrenia • Psychiatry • Rehabilitation • Schizophrenia • Syndrom
• ISBN-10: 1-4419-0913-3 / 1441909133
• ISBN-13: 978-1-4419-0913-8 / 9781441909138