ISSN:0951-7367    

出版商:OVID    

年代:2000

数据来源: OVID

摘要:

The genetic analysis of schizophrenia has increasingly focused on localizing susceptibility genes. Converging evidence from linkage studies proposes some areas on the genome (5q, 6p, 6q, 8p, 10p, 13q, 18p and 22q) that may contain contributing genes. Replicated linkage signals are weak, however, as is the strength of the replicated associations with markers of candidate genes. Progress in the Human Genome Project, from improved clinical strategies to reduce complexity, and extension of informative family samples will aid future search for susceptibility genes.

ISSN:0951-7367    

出版商:OVID    

年代:2000

数据来源: OVID

摘要:

Newer antipsychotics have been widely used in schizophrenia for the past 5 years. During this period, controlled clinical trials have improved our understanding of the effectiveness of these agents in different populations of patients with schizophrenia. Other studies have enhanced our understanding of how improvement on these agents is associated with the occupancy of central nervous system receptors. The best understood of the newer agents is clozapine, although clinically important information has become available for risperidone, olanzapine, quetiapine and amisulpride.

ISSN:0951-7367    

出版商:OVID    

年代:2000

数据来源: OVID

摘要:

The recent literature suggests that enriched genetic loading for substance use disorders, a desire to relieve the subjective distress associated with schizophrenia and its treatment, and ‘therapeutic’ effects of nicotine may contribute to the high prevalence rates for substance use disorder and smoking among patients with schizophrenia. Substance use disorder is associated with homelessness, aggression, and violence, and increased medical morbidity and mortality in this population. Comprehensive, integrated, outpatient programs that include assertive outreach, case management, and a longitudinal, stepwise, motivational approach to substance use disorder show the most promise.

ISSN:0951-7367    

出版商:OVID    

年代:2000

数据来源: OVID

摘要:

Studies published since July 1998 will be reviewed. In fMRI studies, the ‘bottom up' approach was applied, i.e. symptoms or neuropsychological dysfunctions in schizophrenia, were related to specific areas of abnormal activation. One study showed that Heschl's gyrus is activated during acoustic hallucinations. Other studies suggested that during speech-related tasks activation is attenuated in the inferior frontal gyrus, during induced sad affects in the amygdala and during standardised motor tasks in the sensory motor cortex. Whereas typical neuroleptics further reduced the activation in this area, atypical compounds did not, which is of high clinical relevance. In future studies ‘top-down' approaches should also be persued in which complex models of the disease can be tested. With respect to magnetic resonance spectroscopy (MRS), the most consistent finding of1H-MRS is a decrease of N-aspertylaspertate, often considered to be a neuronal marker, in various brain areas. Other promising, yet preliminary findings, suggest an alteration of glutamate in schizophrenia. According to31P-MRS studies the phospholipid metabolism and energy-demanding processes can also seem to be altered. Findings, however, are not always unanimous. In the future, technical developments can be expected that will enhance the sensitivity of the determination of compounds.

ISSN:0951-7367    

出版商:OVID    

年代:2000

数据来源: OVID

摘要:

Significant advances have been made in the psychosocial treatment of schizophrenia and other severe mental illnesses. Research provides the strongest support for six different interventions: the assertive community treatment model of case management; the supported employment approach to vocational rehabilitation; family intervention; skills training and illness self-management; cognitive-behavioral therapy for psychotic symptoms; and integrated mental health and substance misuse treatment for ‘dually diagnosed’ patients. Recent research, including randomized clinical trials, provides further support for the effects of these interventions and points to new areas of inquiry, including fidelity to treatment and differential treatment prediction.

ISSN:0951-7367    

出版商:OVID    

年代:2000

数据来源: OVID

摘要:

The rapidly growing interest in early psychosis has three preventive foci. The prepsychotic phase is when most psychosocial impairment develops, but the specifics of treatment remain difficult to research and apply. Although the total duration of untreated illness may be more critical, the duration of untreated psychosis is a more realistic immediate target for strategies of early detection and intervention. The role of duration of untreated psychosis as a causal factor influencing outcome remains to be definitively established, but these strategies are well justified on clinical grounds. Finally, first-episode psychosis is comparatively more treatment responsive than multiepisode psychosis, and intensive phase-specific treatment appears to result in short-term improvements in outcome and cost effectiveness.

ISSN:0951-7367    

出版商:OVID    

年代:2000

数据来源: OVID

摘要:

The novel antipsychotic drugs offer significant advantages over conventional antipsychotic drugs because of their favorable extrapyramidal side-effect profiles. These medications do have some side effects that are clinically significant to our patients with psychotic disorders, however. We summarized the literature from July 1998 through September 1999 on nonextrapyramidal side effects of these medications, focusing on cardiac effects, weight gain, diabetes and impaired glucose tolerance, prolactin elevation, sexual side effects and neuroleptic malignant syndrome.

ISSN:0951-7367    

出版商:OVID    

年代:2000

数据来源: OVID

ISSN:0951-7367    

出版商:OVID    

年代:2000

数据来源: OVID

摘要:

Affective symptoms are common in people with dementia, but are both under-detected and under-treated. These symptoms cause significant distress to the patients and their carers. The fluctuation of these symptoms, their overlap with the clinical features of dementia, and the difficulty for the patients to provide accurate accounts of these symptoms makes identification of these symptoms more difficult. A range of useful, reliable and valid scales has been developed to evaluate these symptoms, however. Depressive symptoms appear to respond well to pharmacological and psychological therapies. Further studies are needed in the management of anxiety symptoms.

ISSN:0951-7367    

出版商:OVID    

年代:2000

数据来源: OVID