BOOK
Schizophrenia: Advances and Current Management, An Issue of Psychiatric Clinics of North America, E-Book
(2016)
Additional Information
Book Details
Abstract
This issue of the Psychiatric Clinics, edited by Dr. Peter F. Buckley, examines advances and current management in the treatment of Schizophrenia. The topics covered in this issue include, but are not limited to: Duration of Untreated Psychosis (DUP) and Longitudinal Perspectives on DUP; Neuroinflammation and Schizophrenia; Emerging Treatments for Schizophrenia; Treatment-Resistant Schizophrenia; Comorbidities and Schizophrenia; Recovery from Schizophrenia; and the latest in schizophrenia research.
Table of Contents
| Section Title | Page | Action | Price |
|---|---|---|---|
| Front Cover | Cover | ||
| Schizophrenia:Advances and Current Management\r | i | ||
| Copyright\r | ii | ||
| Contributors | iii | ||
| EDITOR | iii | ||
| AUTHORS | iii | ||
| Contents | vii | ||
| Preface: Converging Perspectives on Schizophrenia\r | vii | ||
| Does Biology Transcend the Symptom-based Boundaries of Psychosis?\r | vii | ||
| Are We Really Impacting Duration of Untreated Psychosis and Does It Matter?:\rLongitudinal Perspectives on Early Intervention from the Irish Public Health\rServices\r | vii | ||
| The Case for Adjunctive Monoclonal Antibody Immunotherapy in Schizophrenia\r | vii | ||
| Redefining Medication Adherence in the Treatment of Schizophrenia: How Current\rApproaches to Adherence Lead to Misinformation and Threaten Therapeutic\rRelationships\r | viii | ||
| Update on New and Emerging Treatments for Schizophrenia\r | viii | ||
| Treatment-Resistant Schizophrenia\r | viii | ||
| Transcending Psychosis: The Complexity of Comorbidity in Schizophrenia\r | viii | ||
| Detecting and Managing Adverse Effects of Antipsychotic Medications: Current State of Play\r | ix | ||
| Recovery in Schizophrenia: What Consumers Know and Do Not Know\r | ix | ||
| What Does Mental Health Parity Really Mean for the Care of People with Serious Mental Illness?\r | ix | ||
| What’s Hot in Schizophrenia Research?\r | x | ||
| PSYCHIATRIC CLINICS OF\rNORTH AMERICA\r | xi | ||
| FORTHCOMING ISSUES | xi | ||
| September 2016 | xi | ||
| December 2016 | xi | ||
| March 2017 | xi | ||
| RECENT ISSUES | xi | ||
| March 2016 | xi | ||
| December 2015 | xi | ||
| September 2015 | xi | ||
| Preface: Converging Perspectives on Schizophrenia\r | xiii | ||
| Does Biology Transcend the Symptom-based Boundaries of Psychosis? | 165 | ||
| Key points | 165 | ||
| INTRODUCTION | 166 | ||
| AN HISTORICAL PERSPECTIVE | 166 | ||
| PROBLEMS WITH KRAEPELIN’S DISTINCTION | 166 | ||
| SYNDROMES VERSUS DISEASES | 167 | ||
| CAN BIOLOGICAL MEASURES HELP CLARIFY THE SITUATION? | 168 | ||
| MAJOR FINDINGS | 169 | ||
| RECONCEPTUALIZATION: START WITH THE BIOLOGY | 170 | ||
| TAKE-HOME MESSAGES, AND THE FUTURE | 170 | ||
| REFERENCES | 172 | ||
| Are We Really Impacting Duration of Untreated Psychosis and Does It Matter? | 175 | ||
| Key points | 175 | ||
| THE CONCEPT OF DURATION OF UNTREATED PSYCHOSIS AND ITS RELATIONSHIP TO OUTCOME | 176 | ||
| Concept of Duration of Untreated Psychosis | 176 | ||
| Measurement of Duration of Untreated Psychosis | 177 | ||
| Relationship of Duration of Untreated Psychosis to Clinical and Functional Outcome | 177 | ||
| How Might Duration of Untreated Psychosis Influence Clinical and Functional Outcome? | 178 | ||
| FUNDAMENTAL ISSUES REGARDING EARLY INTERVENTION | 179 | ||
| Duration of Untreated Psychosis as Tractable to Early Intervention Within Public Health Services | 179 | ||
| How Can Duration of Untreated Psychosis Be Reduced? | 179 | ||
| How Effective Is Reduction in Duration of Untreated Psychosis? | 180 | ||
| How Clinically Effective Is Early Intervention? | 180 | ||
| How Cost-Effective Is Early Intervention? | 181 | ||
| HOW “EARLY” SHOULD EARLY INTERVENTION BEGIN? | 182 | ||
| Intervention During the “High-Risk” State | 182 | ||
| FUTURE DIRECTIONS: A STATE OF CLINICAL EQUIPOISE | 182 | ||
| ACKNOWLEDGMENTS | 183 | ||
| REFERENCES | 183 | ||
| The Case for Adjunctive Monoclonal Antibody Immunotherapy in Schizophrenia | 187 | ||
| Key points | 187 | ||
| INTRODUCTION | 187 | ||
| PRENATAL AND PREMORBID IMMUNE RISK FACTORS FOR SCHIZOPHRENIA | 189 | ||
| IMMUNE DYSFUNCTION IN SCHIZOPHRENIA | 190 | ||
| PREVIOUS TRIALS OF ADJUNCTIVE ANTI-INFLAMMATORY OR IMMUNOMODULATORY AGENTS IN SCHIZOPHRENIA | 191 | ||
| PSYCHOSIS AS A SIDE EFFECT OF IMMUNOTHERAPY | 192 | ||
| EVIDENCE FOR ADJUNCTIVE MONOCLONAL ANTIBODY IMMUNOTHERAPY IN PSYCHIATRIC DISORDERS | 192 | ||
| CONSIDERATIONS IN CLINICAL TRIALS OF ADJUNCTIVE MONOCLONAL ANTIBODY IMMUNOTHERAPY IN SCHIZOPHRENIA | 193 | ||
| SUMMARY | 195 | ||
| REFERENCES | 196 | ||
| Redefining Medication Adherence in the Treatment of Schizophrenia | 199 | ||
| Key points | 199 | ||
| INTRODUCTION | 200 | ||
| DEFINITION OF ADHERENCE | 200 | ||
| Adherence Definition Does Not Include Medication Attitude or Intent | 201 | ||
| The Definition of Adherence Is Silent About Efficacy of the Intervention | 201 | ||
| DIRECT AND INDIRECT CONSEQUENCES OF NONADHERENCE | 202 | ||
| ESTABLISHING EFFICACY: WHAT IS THE “DOSE-RESPONSE” CURVE OF MEDICATION GAPS? | 202 | ||
| MISINFORMATION AS AN INDIRECT COMPLICATION OF RELUCTANCE TO DISCLOSE NONADHERENCE | 203 | ||
| ADHERENCE AS A THREAT TO THE THERAPEUTIC RELATIONSHIP | 203 | ||
| The Adherence Interview: Better Information, Better Alliance | 204 | ||
| Glass Half Full or Empty? The Dangers in “Overselling” Medication Benefits | 205 | ||
| ADHERENCE INTERVENTIONS | 206 | ||
| REDUCING FREQUENCY OF MEDICATION GAPS | 207 | ||
| Work on Establishing Medication Routines | 207 | ||
| SHIFT THE EMPHASIS TO THE IMPORTANCE OF ACCURATE INFORMATION | 207 | ||
| Making It Safe to Disclose Adherence Challenges | 207 | ||
| Greater Use of Long-acting Antipsychotics as a Better Information Platform | 209 | ||
| ADDRESSING ADHERENCE TO STRENGTHEN THE THERAPEUTIC RELATIONSHIP | 209 | ||
| Assessing Patient Experience with Adherence Issues with Other Clinicians | 210 | ||
| Harm Reduction Approaches When Intentional Nonadherence Is Likely | 211 | ||
| Responding When Nonadherence Is Being Considered | 211 | ||
| Responding When Recent Nonadherence has Happened and Now Is Disclosed | 211 | ||
| Responding When the Patient Intends to Stop Medication No Matter What | 212 | ||
| SUMMARY | 212 | ||
| ACKNOWLEDGMENTS | 213 | ||
| REFERENCES | 213 | ||
| Update on New and Emerging Treatments for Schizophrenia | 217 | ||
| Key points | 217 | ||
| INTRODUCTION | 217 | ||
| Recently Approved Medications for Schizophrenia | 218 | ||
| Three-month paliperidone palmitate (Invega Trinza) | 218 | ||
| Brexpiprazole (Rexulti) | 220 | ||
| Cariprazine (Vrylar) | 221 | ||
| Aripiprazole lauroxil long-acting injectable (Aristada) | 221 | ||
| Novel Treatments in Schizophrenia | 222 | ||
| Glutamate System | 222 | ||
| Metabotropic glutamate receptor 2/3 agonists | 223 | ||
| Positive allosteric modulators of mGlu2 | 223 | ||
| Ampakines | 223 | ||
| Glycine System | 223 | ||
| Bitopertin | 226 | ||
| Sodium benzoate | 226 | ||
| Phosphodiesterase System | 226 | ||
| Nicotinic Cholinergic System | 227 | ||
| Other Compounds | 230 | ||
| Blonanserin | 230 | ||
| Minocycline | 230 | ||
| Pharmaceutical Pipeline | 231 | ||
| SUMMARY | 231 | ||
| REFERENCES | 232 | ||
| Treatment-Resistant Schizophrenia | 239 | ||
| Key points | 239 | ||
| INTRODUCTION | 239 | ||
| RESISTANCE, RESPONSE, AND REMISSION | 240 | ||
| Treatment Response | 241 | ||
| Treatment Resistance | 241 | ||
| OPERATIONAL DEFINITIONS OF TREATMENT RESISTANCE | 241 | ||
| CONFOUNDING AND COMORBID CONDITIONS | 243 | ||
| CLINICAL FEATURES OF TREATMENT-RESISTANT SCHIZOPHRENIA | 243 | ||
| Demographic Variables | 243 | ||
| Psychopathological Dimensions | 243 | ||
| Cognition | 244 | ||
| Assessment | 244 | ||
| ETIOLOGIC AND PATHOGENIC CORRELATES OF TREATMENT-RESISTANT SCHIZOPHRENIA | 245 | ||
| Structural Brain Abnormalities | 245 | ||
| Functional and Molecular Neuroimaging | 247 | ||
| Genetics | 247 | ||
| Other Biological and Clinical Correlates of Treatment-Resistant Schizophrenia | 248 | ||
| TREATMENT OF TREATMENT-RESISTANT SCHIZOPHRENIA | 249 | ||
| Pharmacologic Treatments | 249 | ||
| Clozapine | 249 | ||
| Alternatives to clozapine | 250 | ||
| Suicide | 250 | ||
| Response and incomplete response to clozapine | 251 | ||
| Predictors of clozapine treatment response | 251 | ||
| Plasma clozapine levels | 251 | ||
| Pharmacogenetics | 251 | ||
| Structural neuroimaging | 251 | ||
| Functional neuroimaging | 252 | ||
| Partial response to clozapine | 252 | ||
| Clozapine antipsychotic augmentation | 252 | ||
| Other Pharmacologic Agents | 253 | ||
| Nonpharmacologic Augmentation Strategies | 253 | ||
| Transcranial magnetic stimulation and transcranial direct current stimulation | 253 | ||
| Electroconvulsive therapy | 253 | ||
| Cognitive behavior therapy | 253 | ||
| SUMMARY | 253 | ||
| NOTE TO READERS | 254 | ||
| REFERENCES | 254 | ||
| Transcending Psychosis | 267 | ||
| Key points | 267 | ||
| CONCEPTUAL ISSUES OF COMORBIDITY IN SCHIZOPHRENIA | 267 | ||
| CLINICAL SUBTYPES | 268 | ||
| NEUROBIOLOGICAL EVIDENCE OF OBSESSIVE–COMPULSIVE PHENOMENA IN SCHIZOPHRENIA | 270 | ||
| Preclinical Studies | 270 | ||
| Clinical Evidence | 271 | ||
| FUTURE PROSPECTS | 271 | ||
| REFERENCES | 272 | ||
| Detecting and Managing Adverse Effects of Antipsychotic Medications | 275 | ||
| Key points | 275 | ||
| INTRODUCTION | 276 | ||
| WEIGHT GAIN | 276 | ||
| Mechanisms | 276 | ||
| First-Generation Antipsychotics | 277 | ||
| Second-Generation Antipsychotics | 277 | ||
| Time Course of Weight Gain | 278 | ||
| Risk Factors | 278 | ||
| Monitoring and Management | 279 | ||
| Switch strategies | 279 | ||
| Behavioral interventions | 279 | ||
| Pharmacologic interventions | 279 | ||
| DIABETES | 280 | ||
| Mechanisms | 280 | ||
| Differential Effects of Antipsychotic Drugs | 281 | ||
| Monitoring and Management | 282 | ||
| HYPERLIPIDEMIA | 282 | ||
| Mechanisms | 283 | ||
| Differential Effects of Antipsychotic Drugs | 283 | ||
| Monitoring and Management | 285 | ||
| CARDIAC ADVERSE EFFECTS | 285 | ||
| Detecting Patients at Risk for Serious Ventricular Dysrhythmias | 285 | ||
| Corrected QT interval prolongation | 285 | ||
| In vitro studies | 285 | ||
| Epidemiologic data | 286 | ||
| Reducing Risk | 286 | ||
| Patient factors | 286 | ||
| Drug interactions | 287 | ||
| Patients with major depressive disorders | 287 | ||
| Cardiovascular factors | 288 | ||
| Risk in children and adolescents | 288 | ||
| Drug-specific factors | 288 | ||
| Long-acting injectables | 288 | ||
| Management of Patients Who Experience Corrected QT Interval Prolongation | 288 | ||
| Further Considerations | 289 | ||
| MORTALITY | 289 | ||
| Mortality in Schizophrenia | 289 | ||
| Mortality in Dementia | 291 | ||
| Managing Mortality Risk in Dementia | 291 | ||
| HYPERPROLACTINEMIA | 292 | ||
| Mechanisms | 293 | ||
| Prevalence | 293 | ||
| Monitoring and Management | 295 | ||
| SEXUAL DYSFUNCTION | 295 | ||
| Mechanisms | 295 | ||
| Prevalence | 296 | ||
| Priapism | 296 | ||
| Monitoring and Management | 297 | ||
| OSTEOPOROSIS | 297 | ||
| Mechanisms | 297 | ||
| Monitoring and Management | 298 | ||
| SUMMARY | 298 | ||
| ACKNOWLEDGMENTS | 299 | ||
| REFERENCES | 299 | ||
| Recovery in Schizophrenia | 313 | ||
| Key points | 313 | ||
| INTRODUCTION | 313 | ||
| RECOVERY AND TRADITIONAL PRACTICES: FINDING PHILOSOPHIC SYNERGY | 314 | ||
| THE ADVANCEMENT OF RECOVERY-ORIENTED PRACTICES | 315 | ||
| Peer-led Interventions | 315 | ||
| Self-management Interventions | 317 | ||
| Strength-based Case Management | 318 | ||
| Supported Housing | 319 | ||
| Supported Employment | 320 | ||
| Recovery Meets Psychopharmacology | 321 | ||
| Advance Directives | 323 | ||
| FUTURE CHALLENGES | 323 | ||
| SUMMARY | 324 | ||
| REFERENCES | 324 | ||
| What Does Mental Health Parity Really Mean for the Care of People with Serious Mental Illness? | 331 | ||
| Key points | 331 | ||
| INTRODUCTION | 331 | ||
| THE PATH TO PARITY | 333 | ||
| PARITY UNDER THE AFFORDABLE CARE ACT: THE VISION | 334 | ||
| PARITY UNDER THE AFFORDABLE CARE ACT: THE REALITY | 335 | ||
| CHALLENGE NUMBER 1: THE ESSENTIAL HEALTH BENEFIT | 336 | ||
| CHALLENGE NUMBER 2: THE INDIVIDUAL MANDATE AND THE SUPREME COURT | 337 | ||
| CHALLENGE NUMBER 3: THE DETERMINATION OF MEDICAL NECESSITY (AND OTHER NONQUANTITATIVE TREATMENT LIMITS) | 338 | ||
| THE INDIVIDUAL’S PATH TO PARITY | 338 | ||
| Gate 1: Capacity to Pay for Care | 339 | ||
| Gate 2: Access to Care | 339 | ||
| Gate 3: Quality of Care | 339 | ||
| Gate 4: Outcomes of Care | 340 | ||
| A FEW CONCLUDING REMARKS | 340 | ||
| REFERENCES | 341 | ||
| What’s Hot in Schizophrenia Research? | 343 | ||
| Key points | 343 | ||
| WHAT’S “HOT” IN BLOOD BIOMARKER STUDIES | 344 | ||
| WHAT’S “HOT” IN BLOOD BIOMARKER STUDIES CONTINUED: THERANOSTICS | 345 | ||
| WHAT’S “HOT” IN BRAIN IMAGING STUDIES | 346 | ||
| WHAT’S “HOT” IN POSTMORTEM STUDIES | 347 | ||
| SUMMARY | 348 | ||
| REFERENCES | 348 | ||
| Index | 353 |