Literature review on schizophrenia
2007 jun 15;75(12):t information: see related handout on helping a family member with schizophrenia, written by the authors of this article exemplifies the aafp 2007 annual clinical focus on management of chronic factors, etiology, and pathophysiologydiagnosisdrug treatmentpsychosocial treatmentsprognosisreferencesarticle factors, etiology, and pathophysiologydiagnosisdrug treatmentpsychosocial treatmentsprognosisreferencesschizophrenia is a debilitating mental illness that affects 1 percent of the population in all cultures. There is a 10 percent lifetime risk of suicide in patients with factors, etiology, and pathophysiologydiagnosisdrug treatmentpsychosocial treatmentsprognosisreferencesschizophrenia has a prevalence of 1 percent in all cultures and is equally common in men and women. Parent, child, sibling)6 to 17dizygotic twin17monozygotic twin50information from reference 1family history and schizophreniafamily historyapproximate lifetime incidence (%)none (e. Finnish adoptive family study of schizophrenia has confirmed that genetics plays a major role in the development of schizophrenia. 8 it also found that persons with a genetic risk of schizophrenia are especially sensitive to the emotional climate of their family environment. For example, drugs that cause psychoses similar to the positive symptoms of schizophrenia increase dopaminergic neurotransmission, and almost all antipsychotics decrease dopaminergic neurotransmission. Still, dopaminergic pathways cannot entirely explain the pathophysiology of schizophrenia, and the roles of other neurotransmitters are being investigated. Factors, etiology, and pathophysiologydiagnosisdrug treatmentpsychosocial treatmentsprognosisreferencesschizophrenia is characterized by positive and negative symptoms that can influence a patient's thoughts, perceptions, speech, affect, and behaviors (table 21). Negative symptoms include flattened affect, loss of a sense of pleasure, loss of will or drive, and social /print tabletable 2diagnostic criteria for schizophreniaa.
Relationship to a pervasive developmental disorderif there is a history of autistic disorder or another pervasive developmental disorder, the additional diagnosis of schizophrenia is made only if prominent delusions or hallucinations are also present for at least a month (or less if successfully treated). These symptoms also must be associated with marked social and occupational are five types of schizophrenia: paranoid, disorganized, catatonic, undifferentiated, and residual. A patient is said to have undifferentiated schizophrenia if none of the criteria for paranoid, disorganized, or catatonic types are met. Note, this classic typing of schizophrenia can be limiting because patients often are difficult to classify. Because substance abuse can mimic many signs and symptoms of schizophrenia, diagnosis should not be made if the patient is actively using illicit drugs. Those with severe depression or bipolar disorder also may present with psychotic features; however, the diagnosis of a mood disorder always takes precedence over the diagnosis of /print tabletable 3differential diagnosis of schizophreniaalternative diagnosisdistinguishing featuresbrief psychotic disorderpresence of delusions, hallucinations, disorganized speech, or grossly disorganized or catatonic behavior lasting at least one day but less than one monthdeliriummultiple underlying etiologies; symptoms often similar to positive symptoms of schizophrenia but with a much shorter coursedelusional disorderdelusions are not bizarre, and there are no other characteristics of schizophreniamedical illnessesillnesses that may cause schizophrenia-like symptoms include hepatic encephalopathy, hypoglycemia, electrolyte abnormalities (e. Hyponatremia, hypercalcemia, hypocalcemia, hypomagnesemia), and sepsis; symptoms resolve with treatment of underlying conditionmedication-induced disordermedications that may cause schizophrenia-like symptoms include anticholinergics, anxiolytics, digoxin, phenytoin (dilantin), steroids, narcotics, and cimetidine (tagamet); symptoms resolve with discontinuation of medicationmood disorders with psychotic featuresno major depressive, manic, or mixed episodes have occurred concurrently with active phase symptoms; or, if they have occurred, their total duration has been brief relative to the duration of the active and residual symptomspervasive developmental disorderrecognized during infancy or early childhood; absence of delusions and hallucinationspsychotic disorder nosthis diagnosis is made if there is insufficient information available to choose between schizophrenia and other psychotic disordersschizophreniform disorderlasts one to six months; diagnosis does not require a decline in functioningschizotypal personality disorderpervasive patterns of social and interpersonal deficits beginning in early adulthood; accompanied by eccentric behavior and cognitive or perceptual distortionssubstance abusemultiple substances (e. Hallucinogens, narcotics, alcohol) and withdrawal from these substances can cause delusions and hallucinationsnos = not otherwise 3differential diagnosis of schizophreniaalternative diagnosisdistinguishing featuresbrief psychotic disorderpresence of delusions, hallucinations, disorganized speech, or grossly disorganized or catatonic behavior lasting at least one day but less than one monthdeliriummultiple underlying etiologies; symptoms often similar to positive symptoms of schizophrenia but with a much shorter coursedelusional disorderdelusions are not bizarre, and there are no other characteristics of schizophreniamedical illnessesillnesses that may cause schizophrenia-like symptoms include hepatic encephalopathy, hypoglycemia, electrolyte abnormalities (e. Hallucinogens, narcotics, alcohol) and withdrawal from these substances can cause delusions and hallucinationsnos = not otherwise e the stability of the diagnostic criteria for schizophrenia, diagnosis often changes over time.
Percent of those who were initially diagnosed with schizophrenia had their diagnosis changed during subsequent hospitalizations, and 32. Percent of those who were initially diagnosed with another illness were later diagnosed with schizophrenia. Organic disorders, psychotic disorders, and major depression were the diagnoses most commonly changed to schizophrenia. The crucial difference between schizophrenia and delirium is the timing; signs and symptoms of schizophrenia generally develop over weeks to months, whereas delirium usually has a much more rapid onset. Because many medical illnesses can cause delirium, the diagnosis of new-onset schizophrenia should be made cautiously in patients who have an existing serious medical also are racial disparities in the diagnosis of schizophrenia. For example, black persons are more likely than other racial groups to have symptoms attributed to schizophrenia,13 and hispanics are more likely to be diagnosed with major depression when presenting with psychotic symptoms. A complete history chronicling the development of signs and symptoms is crucial when diagnosing schizophrenia. Factors, etiology, and pathophysiologydiagnosisdrug treatmentpsychosocial treatmentsprognosisreferencesindividual, group, and family treatments have been developed as therapies for persons with schizophrenia. These treatments are based on early findings that family environments that were high in “expressed emotion” (either critical and rejecting or emotionally overinvolved) were associated with relapse in patients with schizophrenia.
However, a recent review suggested that there are weaknesses in many family intervention studies, and that there is a need for additional investigation. Are several psychosocial rehabilitative interventions that have been shown to be effective in improving the quality of life in patients with schizophrenia. Studies have shown that individual cognitive behavior therapy for schizophrenia reduces positive and negative symptoms,43 but currently there is no evidence that it reduces relapse rates. Patients with schizophrenia have a high rate of substance abuse, and those with substance abuse have their first hospitalizations at earlier ages, have more frequent hospitalizations, and have more interpersonal and family discord. 52accelerated heart disease is the most common cause of death in patients with schizophrenia; the risk of dying from cardiovascular disease is two to three times higher than in the general population. 54 nicotine has a possible positive effect on cognitive functioning in patients with schizophrenia, which may explain the high rate of smoking. 55suicide also is a common cause of death in patients with schizophrenia; it has a 10 percent lifetime risk. Mortensen pb,Effects of family history and place and season of birth on the risk of schizophrenia. Wahlberg ke,Gene-environment interaction in vulnerability to schizophrenia: findings from the finnish adoptive family study of schizophrenia.
Trierweiler sj,Clinician attributions associated with the diagnosis of schizophrenia in african american and non-african american patients. Lieberman ja,For the clinical antipsychotic trials of intervention effectiveness (catie) iveness of antipsychotic drugs in patients with chronic schizophrenia. Leucht s,Relapse prevention in schizophrenia with new-generation antipsychotics: a systematic review and exploratory meta-analysis of randomized, controlled trials. Correll cu,Lower risk for tardive dyskinesia associated with second-generation antipsychotics: a systematic review of 1-year studies. Tammenmaa ia,Systematic review of cholinergic drugs for neuroleptic-induced tardive dyskinesia: a meta-analysis of randomized controlled trials. Kinon bj,Olanzapine treatment for tardive dyskinesia in schizophrenia patients: a prospective clinical trial with patients randomized to blinded dose reduction periods. Salokangas rk,To be or not to be married—that is the question of quality of life in men with schizophrenia. Domino ef,N-methyl-d-aspartate antagonists as drug models of schizophrenia: a surprising link to tobacco smoking. De hert m,Risk factors for suicide in young people suffering from schizophrenia: a long-term follow-up study.
Utilitiesjournals in ncbi databasesmesh databasencbi handbookncbi help manualncbi news & blogpubmedpubmed central (pmc)pubmed clinical queriespubmed healthall literature resources... Toall how tochemicals & bioassaysdna & rnadata & softwaredomains & structuresgenes & expressiongenetics & medicinegenomes & mapshomologyliteratureproteinssequence analysistaxonomytraining & tutorialsvariationabout ncbi accesskeysmy ncbisign in to ncbisign : abstractformatsummarysummary (text)abstractabstract (text)medlinexmlpmid listapplysend tochoose destinationfileclipboardcollectionse-mailordermy bibliographycitation managerformatsummary (text)abstract (text)medlinexmlpmid listcsvcreate file1 selected item: 24795289formatsummarysummary (text)abstractabstract (text)medlinexmlpmid listmesh and other datae-mailsubjectadditional texte-maildidn't get the message? Commentshow to join pubmed commonshow to cite this comment:Ncbi > literature > ncbi web site requires javascript to tionresourcesall resourceschemicals & bioassaysbiosystemspubchem bioassaypubchem compoundpubchem structure searchpubchem substanceall chemicals & bioassays resources... Commentshow to join pubmed commonshow to cite this comment:Ncbi > literature > phrenia research and d in web of l menu about this journal ·. Issue ibe totable of contents of contents receive news and publication updates for schizophrenia research and treatment, enter your email address in the box mation email ons to this to cite this te special issue. Hyperprolactinemia and diabetes are more present in women, while hypertension is more prevalent in men with schizophrenia. Familial risk and obstetric complicationsvarious studies have found a higher risk of schizophrenia in relatives of women than in relatives of men [96–98]. These authors studied familial risk in a sample of 354 first-degree relatives of patients with schizophrenia from the roscommon family study who were interviewed personally. The results of pulver and liang [97] showed that relatives of men with schizophrenia who have an age of onset under 17 have a significantly higher risk of schizophrenia.
However, the authors also found an association between age at onset of schizophrenia and familial risk in women. On whether gender differences exist in the incidence of obstetric complications in patients who will develop schizophrenia have been inconsistent. Conclusionsin conclusion, although the extent of gender differences in schizophrenia and first-episode psychosis is a controversial issue, this paper discusses some of the most replicated gender differences in schizophrenia and first-episode psychosis. Several studies indicate that schizophrenia and first-episode psychosis are less incident in women than in men but, in the case of women, it seems that the prognosis of the illness, the social functioning and the response to treatment is better. Moreover, the review shows us that women need more risk factors in order to develop schizophrenia than men (more familial risk, more presence of life events). Social influence of the context and the fact that most of the studies have been done in developed countries is a clear limitation that should be taken into account in the the reviewed literature, we conclude that women with schizophrenia perform better in several areas than men; however, future research should be addressed to study gender differences to clarify the remaining controversial issues. Novel sex-specific treatments could be developed to better meet the needs of people with schizophrenia and first-episode nces. Murray, “sex and schizophrenia: effects of diagnostic stringency, and associations with premorbid variables,” british journal of psychiatry, vol. Selten, “sex differences in the risk of schizophrenia: evidence from meta-analysis,” archives of general psychiatry, vol.
Wallisch, “gender differences of young adults with schizophrenic disorders in community care,” schizophrenia bulletin, vol. Faraone, “gender and schizophrenia: implications for understanding the heterogeneity of the illness,” psychiatry research, vol. Influence of age at onset on social functioning in outpatients with schizophrenia,” european journal of psychiatry, vol. Murray, “differences in distribution of ages of onset in males and females with schizophrenia,” schizophrenia research, vol. Folnegovic-smalc, “schizophrenia in croatia: age of onset differences between males and females,” schizophrenia research, vol. Faizi, “gender differences in age at onset of schizophrenia,” journal of the college of physicians and surgeons pakistan, vol. The impact of familial loading on gender differences in age at onset of schizophrenia,” acta psychiatrica scandinavica, vol. The abc schizophrenia study: a preliminary overview of the results,” social psychiatry and psychiatric epidemiology, vol. Causes and consequences of the gender difference in age at onset of schizophrenia,” schizophrenia bulletin, vol.
Gur, “sex differences in neuroanatomical and clinical correlations in schizophrenia,” american journal of psychiatry, vol. Häfner, “gender aspects in schizophrenia: bridging the border between social and biological psychiatry,” acta psychiatrica scandinavica, vol. Gender differences in premorbid, entry, treatment, and outcome characteristics in a treated epidemiological sample of 661 patients with first episode psychosis,” schizophrenia research, vol. Townsend, “premorbid adjustment in first episode schizophrenia and schizoaffective disorders: a comparison of social and academic domains,” acta psychiatrica scandinavica, vol. Early-onset of symptoms predicts conversion to non-affective psychosis in ultra-high risk individuals,” schizophrenia research, vol. Cannon, “gender differences in symptoms, functioning and social support in patients at ultra-high risk for developing a psychotic disorder,” schizophrenia research, vol. Araya, and nedes group (assessment research group in schizophrenia), “influence of gender on social outcome in schizophrenia,” acta psychiatrica scandinavica, vol. Haro, “complex interaction between symptoms, social factors, and gender in social functioning in a community-dwelling sample of schizophrenia,” psychiatric quarterly, vol. Strauss, “sex differences in schizophrenia and other psychotic disorders: a 20-year longitudinal study of psychosis and recovery,” comprehensive psychiatry, vol.
Möller, “social disability in schizophrenic, schizoaffective and affective disorders 15 years after first admission,” schizophrenia research, vol. Deshpande, “differences among men and women with schizophrenia: a study of us and indian samples,” psychiatry investigation, vol. Sex differences in olfactory identification and wisconsin card sorting performance in schizophrenia: relationship to attention and verbal ability,” biological psychiatry, vol. Andreassen, “sex differences in neuropsychological performance and social functioning in schizophrenia and bipolar disorder,” neuropsychology, vol. Sex differences in neuropsychological functioning among schizophrenia patients,” australian and new zealand journal of psychiatry, vol. Archer, “cognition and global assessment of functioning in male and female outpatients with schizophrenia spectrum disorders,” journal of nervous and mental disease, vol. Weinberger, “lack of sex differences in the neuropsychological performance of patients with schizophrenia,” american journal of psychiatry, vol. Joyce, “comorbid substance use and age at onset of schizophrenia,” british journal of psychiatry, vol. Bromet, “cannabis use and the course of schizophrenia: 10-year follow-up after first hospitalization,” american journal of psychiatry, vol.
Häfner, “cannabis, vulnerability, and the onset of schizophrenia: an epidemiological perspective,” australian and new zealand journal of psychiatry, vol. Munk-jørgensen, “cannabis-induced psychosis and subsequent schizophrenia-spectrum disorders: follow-up study of 535 incident cases,” british journal of psychiatry, vol. Márquez, “gender differences and outcome in schizophrenia: a 2-year follow-up study in a large community sample,” european psychiatry, vol. Haro, “gender differences in response to antipsychotic treatment in outpatients with schizophrenia,” psychiatry research, vol. Dunbar, “risperidone treatment of outpatients with schizophrenia: no evidence of sex differences in treatment response,” canadian journal of psychiatry, vol. O'keane, “antipsychotic-induced hyperprolactinaemia, hypogonadism and osteoporosis in the treatment of schizophrenia,” journal of psychopharmacology, vol. O'keane, “effects of long-term prolactin-raising antipsychotic medication an bone mineral density in patients with schizophrenia,” british journal of psychiatry, vol. Leese, “risk of hip fracture in patients with a history of schizophrenia,” british journal of psychiatry, vol. Rejas, “cardiovascular and metabolic risk in outpatients with schizophrenia treated with antipsychotics: results of the clamors study,” schizophrenia research, vol.
Sahin, “prevalence of metabolic syndrome among inpatients with schizophrenia,” international journal of psychiatry in medicine, vol. Prevalence of the metabolic syndrome in patients with schizophrenia: baseline results from the clinical antipsychotic trials of intervention effectiveness (catie) schizophrenia trial and comparison with national estimates from nhanes iii,” schizophrenia research, vol. The association between age at onset and familial risk in the maryland schizophrenia sample,” genetic epidemiology, vol. Hallmayer, “the impact of gender and age at onset on the familial aggregation of schizophrenia,” european archives of psychiatry and clinical neuroscience, vol. Walsh, “gender and schizophrenia: results of an epidemiologically-based family study,” british journal of psychiatry, vol. Rosenlund, “obstetric complications and their relationship to other etiological risk factors in schizophrenia: a controlled study,” journal of nervous and mental disease, vol. Maier, “the role of obstetric complications in schizophrenia,” journal of nervous and mental disease, vol. Bourgeois, “a comparative study of obstetric history in schizophrenics, bipolar patients and normal subjects,” schizophrenia research, vol.
