Abstract:
:Schizophrenia affects people of all age groups. Treatment plans for older adults with schizophrenia must consider the effects of age on the course of the illness as well as on the response to antipsychotics and to psychosocial interventions. Positive symptoms of schizophrenia tend to become less severe, substance abuse becomes less common, and mental health functioning often improves. Hospitalizations are more likely to be due to physical problems rather than psychotic relapses. Physical comorbidity is a rule, however, and older age is a risk factor for most side effects of antipsychotics, including metabolic syndrome and movement disorders. We recently reported high rates of adverse events and medication discontinuation along with limited effectiveness of commonly used atypical antipsychotics in older adults. Psychosocial interventions such as cognitive behavioral social skills training are efficacious in improving functioning in older adults with schizophrenia. In formulating treatment plans for this population, a balanced approach combining cautious antipsychotic medication use with psychosocial interventions is recommended. Antipsychotic medications should generally be used in lower doses in older adults. Close monitoring for side effects and effectiveness of the medications and a watchful eye on their risk:benefit ratio are critical. In a minority of patients it may be possible to discontinue medications. Sustained remission of schizophrenia after decades of illness is not rare, especially in persons who receive appropriate treatment and psychosocial support-there can be light at the end of a long tunnel.
journal_name
Schizophr Bulljournal_title
Schizophrenia bulletinauthors
Jeste DV,Maglione JEdoi
10.1093/schbul/sbt043subject
Has Abstractpub_date
2013-09-01 00:00:00pages
966-8issue
5eissn
0586-7614issn
1745-1701pii
sbt043journal_volume
39pub_type
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journal_title:Schizophrenia bulletin
pub_type: 杂志文章
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journal_title:Schizophrenia bulletin
pub_type: 杂志文章
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abstract::A workshop on "Antipsychotics: Past and Future" was convened by the National Institute of Mental Health (NIMH), Division of Services and Intervention Research (DSIR), on July 14, 1998, to review the results of recent antipsychotic drug research, discuss current standards of treatment, and identify areas needing furthe...
journal_title:Schizophrenia bulletin
pub_type:
doi:10.1093/oxfordjournals.schbul.a033387
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journal_title:Schizophrenia bulletin
pub_type: 杂志文章
doi:10.1093/schbul/12.2.262
更新日期:1986-01-01 00:00:00
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journal_title:Schizophrenia bulletin
pub_type: 杂志文章
doi:10.1093/schbul/sbt153
更新日期:2014-09-01 00:00:00
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journal_title:Schizophrenia bulletin
pub_type: 杂志文章
doi:10.1093/schbul/sbj014
更新日期:2006-04-01 00:00:00
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journal_title:Schizophrenia bulletin
pub_type: 杂志文章,meta分析,评审
doi:10.1093/schbul/sbs060
更新日期:2013-07-01 00:00:00
abstract::Schizophrenia is a disabling clinical syndrome found across the world. While the incidence and clinical expression of this illness are strongly influenced by ethnic factors, it is unclear whether patients from different ethnicities show distinct brain deficits. In this multicentre study, we used structural Magnetic Re...
journal_title:Schizophrenia bulletin
pub_type: 杂志文章,多中心研究
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更新日期:2015-11-01 00:00:00
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journal_title:Schizophrenia bulletin
pub_type: 杂志文章
doi:10.1093/schbul/sbr038
更新日期:2012-11-01 00:00:00
abstract::Increased critical stimulus duration among nonpsychotic subjects with Minnesota Multiphasic Personality Inventory 2-7-8 profiles in the Merritt and Balogh letter-discrimination procedure is consistent with the view that this abnormality might be a vulnerability indicator for a poor prognosis, chronic type of schizophr...
journal_title:Schizophrenia bulletin
pub_type: 杂志文章
doi:10.1093/schbul/11.3.344
更新日期:1985-01-01 00:00:00
abstract::Child maltreatment is a widespread public health problem associated with a range of mental health disorders later in life. In order to effectively address these disorders, there is a need to understand more about the mental health consequences of different types of child maltreatment. This study examines the associati...
journal_title:Schizophrenia bulletin
pub_type: 杂志文章
doi:10.1093/schbul/sbw175
更新日期:2017-09-01 00:00:00
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journal_title:Schizophrenia bulletin
pub_type: 杂志文章
doi:10.1093/schbul/sbp019
更新日期:2009-05-01 00:00:00
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journal_title:Schizophrenia bulletin
pub_type: 杂志文章
doi:10.1093/schbul/sbx150
更新日期:2018-06-06 00:00:00
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journal_title:Schizophrenia bulletin
pub_type: 杂志文章
doi:10.1093/schbul/sbz060
更新日期:2020-02-26 00:00:00
abstract::Catechol-O-methyl transferase (COMT) is a catabolic enzyme involved in the degradation of a number of bioactive molecules; of principal interest to psychiatry, these include dopamine. The enzyme is encoded by the COMT gene. COMT is located (along with 47 other genes) in a fragment of chromosome 22q11 which when delete...
journal_title:Schizophrenia bulletin
pub_type: 杂志文章,评审
doi:10.1093/schbul/sbm019
更新日期:2007-05-01 00:00:00
abstract::There is controversy over whether childhood trauma (CT) is a causal factor in the development of psychosis. This review aims to identify and critically analyze the association between CT and psychotic disorders. Studies investigating CT and psychotic disorder were identified by searches of electronic databases and man...
journal_title:Schizophrenia bulletin
pub_type: 杂志文章,评审
doi:10.1093/schbul/sbm121
更新日期:2008-05-01 00:00:00
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journal_title:Schizophrenia bulletin
pub_type: 杂志文章
doi:10.1093/oxfordjournals.schbul.a033452
更新日期:2000-01-01 00:00:00
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journal_title:Schizophrenia bulletin
pub_type: 杂志文章
doi:10.1093/schbul/23.1.147
更新日期:1997-01-01 00:00:00
abstract::The literature on schizophrenia has reported a trend toward higher concordance rates for females in both monozygotic and dizygotic same-sexed twins. The validity of this finding is open to question. Rosenthal (1961 and 1962) pointed out that females are more likely than males to become inhabitants of chronic wards. Mo...
journal_title:Schizophrenia bulletin
pub_type: 杂志文章
doi:10.1093/schbul/4.1.14
更新日期:1978-01-01 00:00:00
abstract::The dopamine hypothesis of schizophrenia is usually presented in a static, rather than dynamic fashion. We propose that increased dopaminergic activity may represent a stage of a dynamic schizophrenic process rather than its cause. Dopamine, as well as other neurotransmitters, responds in an adaptive fashion to stimul...
journal_title:Schizophrenia bulletin
pub_type: 杂志文章
doi:10.1093/schbul/9.3.325
更新日期:1983-01-01 00:00:00
abstract::As a result of improving technologies and greatly increased sample sizes, the last 2 years has seen unprecedented advances in identification of specific genetic risk factors for psychiatric phenotypes. Strong genetic associations have been reported at common polymorphisms within ANK3 and CACNA1C in bipolar disorder an...
journal_title:Schizophrenia bulletin
pub_type: 杂志文章
doi:10.1093/schbul/sbp020
更新日期:2009-05-01 00:00:00
abstract::Deluded people differ from nondeluded controls on attributional style questionnaires and probabilistic-reasoning and theory-of-mind (ToM) tasks. No study to date has examined the relations between these 3 reasoning anomalies in the same individuals so as to evaluate their functional independence and potentially inform...
journal_title:Schizophrenia bulletin
pub_type: 杂志文章
doi:10.1093/schbul/sbn069
更新日期:2010-03-01 00:00:00
abstract::Development of schizophrenia relates to both genetic and environmental factors. Functional deficits in many cognitive domains, including the ability to communicate in social interactions and impaired recognition of facial expressions, are common for patients with schizophrenia and might also be present in individuals ...
journal_title:Schizophrenia bulletin
pub_type: 杂志文章
doi:10.1093/schbul/sby139
更新日期:2019-06-18 00:00:00
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journal_title:Schizophrenia bulletin
pub_type: 杂志文章
doi:10.1093/schbul/7.4.571
更新日期:1981-01-01 00:00:00
abstract::Pharmacologic agents currently used or being studied for the treatment of schizophrenia are reviewed. Neuroleptic medications are still the mainstay of treatment, but recent studies suggest new approaches to dosage and to the treatment of acute psychosis. Lithium is beneficial in psychotic illnesses with acute onset a...
journal_title:Schizophrenia bulletin
pub_type: 杂志文章
doi:10.1093/schbul/9.4.504
更新日期:1983-01-01 00:00:00