Abstract:
:In recent years, early intervention services have attempted to identify people with a first episode of psychosis as early as possible, reducing the duration of untreated psychosis and changing the timing of delivery of interventions. The logic of early intervention is based partly on accessing people in a more treatment responsive stage of illness in which psychosocial damage is less extensive, and partly on remediating a putatively active process of neuroprogression that leads to pathophysiological, symptomatic and structural changes, hence improving symptomatic and functional outcomes. However, as in other areas of health care, earlier identification of new patients may mean that different treatment approaches are indicated. The corollary of early detection is that the sequence and complexion of treatment strategies for first episode psychosis has been revaluated. Examples include the minimal effective dosage of antipsychotic medication and the content of psychosocial interventions. With the substantial reductions of DUP now seen in many early psychosis services, based on clinical staging and stepped care principles, it is even possible that the immediate introduction of antipsychotic medication may not be necessary for all first episode psychosis cases, but that potentially safer interventions, which may be more acceptable to many patients, such as comprehensive psychosocial intervention, may constitute effective treatment at least for a subgroup of patients. In this paper, we review this theoretical background and describe a randomised controlled trial currently underway at the Early Psychosis Prevention and Intervention Centre (EPPIC) in Melbourne designed to test outcomes for first episode psychosis patients in response to two different treatments: intensive psychosocial intervention plus antipsychotic medication versus intensive psychosocial intervention plus placebo. This is a theoretically and pragmatically novel study in that it will provide evidence as to whether intensive psychosocial intervention alone is sufficient for a subgroup of first episode psychosis patients in a specialised early intervention service, and provide a test of the heuristic clinical staging model. By experimentally manipulating duration of untreated psychosis, the study will also provide a methodologically strong test of the effect of delaying the introduction of antipsychotic medication, as well as helping to disentangle the effects of antipsychotic medications and the putative neurobiological processes associated with brain changes and symptom profiles in the early phase of psychotic disorders. The study has been carefully crafted to satisfy critical ethical demands in this challenging research domain.
journal_name
Schizophr Resjournal_title
Schizophrenia researchauthors
Francey SM,Nelson B,Thompson A,Parker AG,Kerr M,Macneil C,Fraser R,Hughes F,Crisp K,Harrigan S,Wood SJ,Berk M,McGorry PDdoi
10.1016/j.schres.2010.02.1071subject
Has Abstractpub_date
2010-06-01 00:00:00pages
1-10issue
1-3eissn
0920-9964issn
1573-2509pii
S0920-9964(10)01166-7journal_volume
119pub_type
杂志文章,评审abstract:BACKGROUND:Many patients recovering from a first psychotic episode will discontinue medication against medical advice, even before a 1-year treatment course is completed. Factors associated with treatment adherence in patients with chronic schizophrenia include beliefs about severity of illness and need for treatment, ...
journal_title:Schizophrenia research
pub_type: 杂志文章
doi:10.1016/j.schres.2005.10.016
更新日期:2006-03-01 00:00:00
abstract:BACKGROUND:The P300 event-related potential (ERP) component, which reflects cognitive processing, is a candidate biomarker for schizophrenia. However, the role of P300 in the pathophysiology of schizophrenia remains unclear because averaged P300 amplitudes reflect both genetic predisposition and current clinical status...
journal_title:Schizophrenia research
pub_type: 杂志文章
doi:10.1016/j.schres.2017.04.001
更新日期:2018-02-01 00:00:00
abstract::The first phase of the Consortium on the Genetics of Schizophrenia (COGS-1) showed performance deficits in learning and memory on the California Verbal Learning Test, Second Edition (CVLT-II) in individuals with schizophrenia (SZ), compared to healthy comparison subjects (HCS). A question is whether the COGS-1 study, ...
journal_title:Schizophrenia research
pub_type: 杂志文章,多中心研究
doi:10.1016/j.schres.2014.10.029
更新日期:2015-04-01 00:00:00
abstract::Psychotic-like experiences (PLEs) are part of a continuum of psychosis. Previous longitudinal studies highlighted a relationship between peripheral inflammation during childhood and onset of PLEs in adulthood. In this study, we tested if this association is mediated by internalising and externalising symptoms experien...
journal_title:Schizophrenia research
pub_type: 杂志文章
doi:10.1016/j.schres.2020.11.009
更新日期:2020-12-01 00:00:00
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journal_title:Schizophrenia research
pub_type: 杂志文章,多中心研究
doi:10.1016/j.schres.2013.11.031
更新日期:2014-02-01 00:00:00
abstract:OBJECTIVE:Several risk factors of venous thromboembolism (VTE) and pulmonary embolism (PE) were found in patients with schizophrenia. Therefore, we hypothesize that the incidences of VTE and PE are relatively higher among schizophrenia patients in comparison with the general population. METHOD:For this population-base...
journal_title:Schizophrenia research
pub_type: 杂志文章
doi:10.1016/j.schres.2015.01.012
更新日期:2015-03-01 00:00:00
abstract:BACKGROUND:Neuropsychological impairment is common in schizophrenia and psychotic bipolar disorder. It has been hypothesized that the pathways leading to impairment differ between disorders. Cognitive impairment in schizophrenia is believed to result largely from atypical neurodevelopment, whereas bipolar disorder is i...
journal_title:Schizophrenia research
pub_type: 杂志文章
doi:10.1016/j.schres.2018.10.009
更新日期:2019-04-01 00:00:00
abstract::Patients with schizophrenia exhibit impairments in prepulse inhibition (PPI) of the startle response. Available data suggest that atypical antipsychotics may be more effective than typical antipsychotics in improving PPI deficits in schizophrenia. However, previous studies have used between-subjects rather than longit...
journal_title:Schizophrenia research
pub_type: 杂志文章
doi:10.1016/j.schres.2009.09.035
更新日期:2009-12-01 00:00:00
abstract::MicroRNAs (miRNAs) are small non-coding RNAs that mainly function as negative regulators of gene expression (Lai, 2002) and have been shown to be involved in schizophrenia etiology through genetic and expression studies (Burmistrova et al., 2007; Hansen et al., 2007a; Perkins et al., 2007; Beveridge et al., 2010; Kim ...
journal_title:Schizophrenia research
pub_type: 杂志文章
doi:10.1016/j.schres.2012.06.038
更新日期:2012-10-01 00:00:00
abstract::The effects of gut microbiota on the central nervous system, along its possible role in mental disorders, have received increasing attention. Here we investigated differences in fecal microbiota between 28 patients with first-episode psychosis (FEP) and 16 healthy matched controls and explored whether such differences...
journal_title:Schizophrenia research
pub_type: 杂志文章
doi:10.1016/j.schres.2017.04.017
更新日期:2018-02-01 00:00:00
abstract:OBJECTIVE:Despite an increased risk for suicide among individuals diagnosed with psychotic disorders, risk factors for completed suicide remain largely unexamined in this population. Using a case-control design, this study aimed to investigate clinical and behavioural risk factors for suicide completion in schizophreni...
journal_title:Schizophrenia research
pub_type: 杂志文章
doi:10.1016/j.schres.2006.02.025
更新日期:2006-05-01 00:00:00
abstract::The aim of this paper is to summarize ultrastructural evidence for glutamatergic dysregulation in several linked regions in postmortem schizophrenia brain. Following a brief summary of glutamate circuitry and how synapses are identified at the electron microscopic (EM) level, we will review EM pathology in the cortex ...
journal_title:Schizophrenia research
pub_type: 杂志文章
doi:10.1016/j.schres.2020.01.016
更新日期:2020-01-31 00:00:00
abstract::Recent transcriptomic, proteomic and metabolomics studies have highlighted an abnormal cerebral glucose and energy metabolism as one of the potential pathophysiological mechanisms of schizophrenia. This raises the possibility that a metabolically-based intervention might have therapeutic value in the management of sch...
journal_title:Schizophrenia research
pub_type: 杂志文章
doi:10.1016/j.schres.2018.11.011
更新日期:2019-04-01 00:00:00
abstract::Glutamate was quantified by proton magnetic resonance spectroscopy ((1)H-MRS) in the medial frontal lobes of 15 adult siblings of individuals with schizophrenia (HR) and 14 healthy volunteers (HV), all of whom also completed a Continuous Performance Test (CPT). Subjects were free of psychopathology but the HR group sh...
journal_title:Schizophrenia research
pub_type: 杂志文章
doi:10.1016/j.schres.2007.11.028
更新日期:2008-02-01 00:00:00
abstract::The current study investigated whether a previously reported beneficial effect of methadone maintenance therapy (MMT) on antiretroviral adherence is also present in relation to antipsychotic treatment for schizophrenia. Administrative data were linked over a 17-year period for 1996 people who were dually diagnosed wit...
journal_title:Schizophrenia research
pub_type: 杂志文章
doi:10.1016/j.schres.2019.05.031
更新日期:2019-08-01 00:00:00
abstract::In a 12-week randomized open-label trial, adults diagnosed with schizophrenia experiencing inadequate efficacy and/or poor tolerability on risperidone, olanzapine, or aripiprazole were randomized to switch to iloperidone either gradually (ie, down-titration of current therapy over the first 2weeks [to 50% on Day 1, 25...
journal_title:Schizophrenia research
pub_type: 杂志文章,随机对照试验
doi:10.1016/j.schres.2013.11.042
更新日期:2014-03-01 00:00:00
abstract:BACKGROUND:Pharmaceutical companies conduct clinical trials to show the efficacy and safety of new medications for the treatment of schizophrenia. After the new medications are marketed, clinicians treating patients with schizophrenia discover that a considerable number of patients do not respond to these new medicatio...
journal_title:Schizophrenia research
pub_type: 杂志文章,评审
doi:10.1016/j.schres.2017.03.020
更新日期:2017-12-01 00:00:00
abstract::Previous studies have indicated that schizophrenic patients have olfactory deficits. The question as to whether olfactory deficits are due to chronic effects of medication has not been addressed. This is the first paper to report that never-medicated schizophrenic patients also have olfactory deficits. Twenty four nor...
journal_title:Schizophrenia research
pub_type: 杂志文章
doi:10.1016/0920-9964(93)90008-7
更新日期:1993-03-01 00:00:00
abstract::In keeping with the current clinical and research focus on early intervention and the rapid increase worldwide of programs for those experiencing a first episode of psychosis, the development of services for families has to be an integral part of any comprehensive program. Families can and do play a major role in the ...
journal_title:Schizophrenia research
pub_type: 杂志文章,评审
doi:10.1016/j.schres.2005.01.013
更新日期:2005-11-01 00:00:00
abstract::Previous studies suggested that African American patients with psychotic disorders receive higher doses of antipsychotic medication than white patients, are more likely to receive depot antipsychotics, and are less likely to be prescribed second-generation antipsychotics. African-American men in particular may be most...
journal_title:Schizophrenia research
pub_type: 杂志文章
doi:10.1016/S0920-9964(03)00102-6
更新日期:2004-02-01 00:00:00
abstract:BACKGROUND:In schizophrenic psychoses, the normal sexual dimorphism of the brain has been shown to be disrupted or even reversed. Little is known, however, at what time point in emerging psychosis this occurs. We have therefore examined, if these alterations are already present in the at-risk mental state (ARMS) for ps...
journal_title:Schizophrenia research
pub_type: 杂志文章
doi:10.1016/j.schres.2018.03.034
更新日期:2018-09-01 00:00:00
abstract::Abnormalities in resting-state electroencephalogram (rs-EEG) activity have been previously reported in schizophrenia. While most rs-EEG recordings were performed in patients with chronic schizophrenia during eyes closed (EC), only a handful of studies have investigated rs-EEG activity during both EC and eyes open (EO)...
journal_title:Schizophrenia research
pub_type: 杂志文章
doi:10.1016/j.schres.2020.12.014
更新日期:2021-01-08 00:00:00
abstract::Schizophrenia and at-risk populations are suggested to exhibit referential cohesion deficits in language production (e.g., producing fewer pronouns or nouns that clearly link to concepts from previous sentences). Much of this work has focused on transcribed speech samples, while no work to our knowledge has examined r...
journal_title:Schizophrenia research
pub_type: 杂志文章
doi:10.1016/j.schres.2017.04.025
更新日期:2018-02-01 00:00:00
abstract:BACKGROUND:Recent empirical evidence [Maher, B.A., Manschreck, T.C., Linnert, J., Candela, S., 2005. Quantitative assessment of the frequency of normal associations in the utterances of schizophrenia patients and healthy controls. Schizophrenia Research 78, 219-224] shows that schizophrenia patients produce an elevated...
journal_title:Schizophrenia research
pub_type: 杂志文章
doi:10.1016/j.schres.2007.06.009
更新日期:2007-09-01 00:00:00
abstract::Treatment resistant schizophrenia (TRS) is defined by poor or non-response to conventional antipsychotic agents. Functional capacity is defined as the baseline potential of a patient to function in the community, irrespective of actual achievements gained, and has never been studied in TRS. Here, we screened 182 patie...
journal_title:Schizophrenia research
pub_type: 临床试验,杂志文章
doi:10.1016/j.schres.2018.06.030
更新日期:2018-12-01 00:00:00
abstract::Aim Research regarding the effect of antipsychotic medications on the risk of upper respiratory infection (URI) progression to pneumonia in patients with schizophrenia is rare. This study investigated the effect of antipsychotic use on the risk of URI progression to pneumonia in patients with schizophrenia. METHODS:T...
journal_title:Schizophrenia research
pub_type: 杂志文章
doi:10.1016/j.schres.2020.05.013
更新日期:2020-08-01 00:00:00
abstract::Jumping to conclusions (JTC) is the best established cognitive bias in schizophrenia and is increasingly targeted in interventions aimed to improve positive symptoms. To address shortcomings of the standard measure to capture JTC, the beads task, we developed a new variant-the box task-which was subsequently validated...
journal_title:Schizophrenia research
pub_type: 杂志文章
doi:10.1016/j.schres.2020.05.056
更新日期:2020-08-01 00:00:00
abstract::The prevalence of obesity in schizophrenia patients is high, especially in chronic and medicated patients. Few studies have explored the relationships between obesity, cognition and clinical correlates in patients with schizophrenia. This study was designed to assess the prevalence and clinical correlates of obesity a...
journal_title:Schizophrenia research
pub_type: 杂志文章
doi:10.1016/j.schres.2019.10.017
更新日期:2020-01-01 00:00:00
abstract:BACKGROUND:There is increased interest in the impact of new long-acting treatments on health-related quality of life (HRQoL) in patients with schizophrenia. The aim of this study was to evaluate the impact of treatment with subcutaneous injections of RBP-7000, a new sustained-release formulation of risperidone, compare...
journal_title:Schizophrenia research
pub_type: 杂志文章,多中心研究,随机对照试验
doi:10.1016/j.schres.2016.03.020
更新日期:2016-07-01 00:00:00
abstract::Persistent cannabis use among young adults with first episode psychosis (FEP), even those receiving early intervention services, has been associated with poor outcomes. In the United States (US), Coordinated Specialty Care (CSC) has been shown to be more effective at reducing symptoms, improving quality of life and in...
journal_title:Schizophrenia research
pub_type: 杂志文章
doi:10.1016/j.schres.2020.05.035
更新日期:2020-08-01 00:00:00