摘要 :
Schizophrenia and related psychoses affect about 4% of the population. Most people with schizophrenia live in the community and consult their GPs for their primary care. The treatment of schizophrenia depends on the phase of illne...
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Schizophrenia and related psychoses affect about 4% of the population. Most people with schizophrenia live in the community and consult their GPs for their primary care. The treatment of schizophrenia depends on the phase of illness: acute, chronic or recovered. Early detection of prodromal psychosis and initiation of treatment probably improves long term outcome. Schizophrenia is usually lifelong and requires ongoing antipsychotic medication. GPs have a vital role in managing patients with schizophrenia, providing physical treatment, monitoring medication and supporting patients and their carers. They work in partnership with specialist services.
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BACKGROUND
The Claimant’s son, JP, had a severe
form of schizophrenia for which he
was detained at the Highcroft
Hospital, Birmingham. He suffered
with a treatment-resistant chronic
paranoid schizophrenia and had been
admitted to...
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BACKGROUND
The Claimant’s son, JP, had a severe
form of schizophrenia for which he
was detained at the Highcroft
Hospital, Birmingham. He suffered
with a treatment-resistant chronic
paranoid schizophrenia and had been
admitted to the hospital with delusional
ideation and persecutory ideas
on 3 July 2000 under Section 3 of the
Mental Health Act 1983.
On 5 June 2001, it was recorded
that the deceased was admitted to
George Ward after bouts of aggressive
behaviour. Whilst on the ward on 26
July 2001, the deceased complained
that he had been sexually assaulted
and he was transferred to the intensive
care unit on Meadowcroft Ward. On
27 September 2001 the deceased was
transferred to the Upper Cedar Unit
whilst waiting for a bed at Howard
Court. On 4 October 2001 the
deceased was granted unescorted
leave. The following day his mood
appeared low and he was placed on
15-minute observations, increased to
five-minute observation on 8 October
2001. The following day he
absconded from the ward and was
returned by the police, whom he had
contacted, later that morning.
On 11 October 2001, the deceased
failed to return in time from his
ground leave and future unescorted
leave was deferred until review. On
13 October 2001, the deceased left
the ward without leave. When police
brought him back, he was stating that
he wanted to kill himself. He had
been on the way to the Palisade
Shopping Centre with a view to
killing himself by jumping from a
height. He stated that he had called
the police when he was lost and they
subsequently returned him to the
ward. It was noted there was a continued
risk of self-harm and unpredictable
behaviour.
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摘要 :
Despite the use of antipsychotics to treat schizophrenia for the last several decades, little was understood about their molecular mechanisms of action. In this review, we discuss recent studies that have helped elucidate mechanis...
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Despite the use of antipsychotics to treat schizophrenia for the last several decades, little was understood about their molecular mechanisms of action. In this review, we discuss recent studies that have helped elucidate mechanisms of action of antipsychotics and their potential interplay with genetic, metabolomic, proteomic, and other cellular process-related discoveries in schizophrenia pathology. We also highlight genes that have been identified in multiple studies in both schizophrenia patients and in antipsychotic action that are related to glucose and cellular metabolism, the cytoskeleton, protein synthesis, cell adhesion and synaptic activity. Though some questions of antipsychotic mechanisms of action, such as primary versus off-target effects, remain, the recent gains in understanding how to treat schizophrenia at the molecular level are promising. We propose that these recent insights provide a new and more complete landscape for drug discovery and patient biomarker development.
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This paper explores the basis of schizophrenia from a neuroanatomical systems perspective. This perspective includes an analysis of the literature on the neurochemical, neurotransmitter, morphological, neurophysiological, connecti...
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This paper explores the basis of schizophrenia from a neuroanatomical systems perspective. This perspective includes an analysis of the literature on the neurochemical, neurotransmitter, morphological, neurophysiological, connectional, developmental, neurosurgical, behavioral, neurological, and psychophysical aspects of schizophrenia. The convergence of evidence from these diverse subfields of inquiry are then mapped as interacting circuits throughout the neuraxis. Viewed from these specific and whole brain points of view, several patterns emerge. First, virtually all major brain areas and circuits in the brain have been implicated in the etiology and symptomotology of schizophrenia. This is consistent with the multiple forms of schizophrenia and the constellation of clinical syndromes associated with the different schizophrenias. Second, although numerous, widely dispersed circuits are implicated, all circuits directly impact connections and functions of the dorsal prefrontal cortex, and specifically the cortico-cortical and corticosubcortical pyramidal neuron outputs and loop systems back to these pyramidal neurons. The neuronal systems most intimately associated with regulation of pyramidal neuron function are local GABA-ergic interneuronal inputs, dopaminergic inputs, glutaminergic drive, and differential regulation of excitability and firing of these neurons by the segregated inputs and local receptor and channel properties of the distal vs proximal compartments of the pyramidal neurons. The dorsal and dorsolateral prefrontal cortex appears to be at particular risk to dysregulated inputs, whereas the orbital cortex appears to more protected from hypofunctionality, perhaps due, in part, from a richer array of cortico-cortical inputs, and a relative independence from cerebellar dysmetric influences. Other cortical areas of the temporal lobe are, to a lesser degree, influential in the primary neuronal dysfunctioning in schizophrenia. Thus, although many brain circuits and neurotransmitter systems are implicated in schizophrenia, their ultimate impact on the dorsal prefrontal cortex pyramidal neuron, appear to be the common cause in this disease. < copyright > 2003 Elsevier Science B.V. All rights reserved.
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The concept of deficit schizophrenia is regarded as one of the most promising attempts to reduce heterogeneity within schizophrenia. This paper summarizes the clinical, neurocognitive, brain imaging and electrophysiological correl...
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The concept of deficit schizophrenia is regarded as one of the most promising attempts to reduce heterogeneity within schizophrenia. This paper summarizes the clinical, neurocognitive, brain imaging and electrophysiological correlates of this subtype of schizophrenia. Attempts to identify genetic and non-genetic risk factors are reviewed. Methodological limitations of studies supporting the efficacy of atypical antipsychotics in the treatment of the syndrome are highlighted. Two decades of research on deficit schizophrenia have failed to prove that it represents the extreme end of a severity continuum in schizophrenia, while some findings support the claim that it may be a separate disease entity.
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摘要 :
The concept of deficit schizophrenia is regarded as one of the most promising attempts to reduce heterogeneity within schizophrenia. This paper summarizes the clinical, neurocognitive, brain imaging and electrophysiological correl...
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The concept of deficit schizophrenia is regarded as one of the most promising attempts to reduce heterogeneity within schizophrenia. This paper summarizes the clinical, neurocognitive, brain imaging and electrophysiological correlates of this subtype of schizophrenia. Attempts to identify genetic and non-genetic risk factors are reviewed. Methodological limitations of studies supporting the efficacy of atypical antipsychotics in the treatment of the syndrome are highlighted. Two decades of research on deficit schizophrenia have failed to prove that it represents the extreme end of a severity continuum in schizophrenia, while some findings support the claim that it may be a separate disease entity.
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摘要 :
Psychiatric rehabilitation for schizophrenia involves utilizing psychosocial interventions to assist persons with the illness to attain their highest level of independent functioning, strongest level of symptom control, and greate...
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Psychiatric rehabilitation for schizophrenia involves utilizing psychosocial interventions to assist persons with the illness to attain their highest level of independent functioning, strongest level of symptom control, and greatest level of subjective life satisfaction. The advent of newer, more well-tolerated antipsychotic medications may mean that more patients then ever are suitable for participation in concurrent psychiatric rehabilitation programs. In this article, the determinants of poor symptom control and social adjustment in schizophrenia are first discussed. Brief overviews of the procedures for the four most-well validated psychiatric rehabilitation strategies (family interventions, cognitive-behavior therapy, social skills training, and vocational rehabilitation) are then presented, with supporting data. Issues of relevance to recent-onset and older patients are then discussed. Finally, the role of individual psychotherapy in rehabilitation and opportunities for research and clinical integration of pharmacologic and psychosocial interventions are described. < copyright > 2003 Elsevier Science B.V. All rights reserved.
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摘要 :
The Schizophrenia International Research Society (SIRS) recently held its first North American congress, which took place in Orlando, Florida from 10-14 April 2019. The overall theme of this year's congress was United in Progress ...
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The Schizophrenia International Research Society (SIRS) recently held its first North American congress, which took place in Orlando, Florida from 10-14 April 2019. The overall theme of this year's congress was United in Progress - with the aim of cultivating a collaborative effort towards advancing the field of schizophrenia research. Student travel awardees provided reports of the oral sessions and concurrent symposia that took place during the congress. A collection of these reports is summarized and presented below and highlights the main themes and topics that emerged during the congress. In summary, the congress covered a broad range of topics relevant to the field of psychiatry today.
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The clinical severity, impact on development, and poor prognosis of childhood onset schizophrenia may represent a more homogeneous group. Positive symptoms in children are necessary for the diagnosis and hallucinations are more of...
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The clinical severity, impact on development, and poor prognosis of childhood onset schizophrenia may represent a more homogeneous group. Positive symptoms in children are necessary for the diagnosis and hallucinations are more often multimodal. In healthy children and children with a variety of other psychiatric illnesses, hallucinations are not uncommon and diagnosis should not be based on these alone. Childhood onset schizophrenia is an extraordinarily rare illness that is poorly understood but seems continuous with the adult onset disorder. Once a diagnosis is affirmed, aggressive medication treatment combined with family education and individual counseling may defer further deterioration.
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