Comparison of Injectable and Oral Antipsychotics in Relapse Rates in a Pragmatic 30-Month Schizophrenia Relapse Prevention Study.

Objective: In a pragmatic clinical trial, this study sought to compare relapses among patients receiving either long-acting injectable or oral second-generation antipsychotics.

Methods: PROACTIVE (Preventing Relapse Oral Antipsychotics Compared to Injectables Evaluating Efficacy), a prior 30-month relapse prevention study, compared use of a long-acting injectable second-generation antipsychotic with use of an oral second-generation antipsychotic by 305 patients with schizophrenia or schizoaffective disorder and found similar rates of first relapse between groups (42% with injectable medication, 32% with oral medication). This study examined subsequent relapses among patients who had relapsed in PROACTIVE and who continued in treatment, follow-up, or both.

Prolongation of ERP latency and reaction time (RT) in simultaneous EEG/fMRI data acquisition.

Background: Recording EEG and fMRI data simultaneously inside a fully-operating scanner has been recognized as a novel approach in human brain research. Studies have demonstrated high concordance between the EEG signals and hemodynamic response. However, a few studies reported altered cognitive process inside the fMRI scanner such as delayed reaction time (RT) and reduced and/or delayed N100 and P300 event-related brain potential (ERP) components.

High-dose oral ziprasidone versus conventional dosing in schizophrenia patients with residual symptoms: the ZEBRAS study.

Uncontrolled studies have suggested that increasing the dose of ziprasidone above the standard maximum daily dose of 160 mg may be more effective for some patients with schizophrenia. To test this hypothesis, we conducted an 8-week, placebo-controlled, fixed-dose escalation trial comparing ziprasidone 160 versus 320 mg/d in individuals with schizophrenia or schizoaffective disorder who remained symptomatic despite treatment with ziprasidone 160 mg/d for at least 3 weeks. Of 75 randomized patients, 42 completed the study.

Verbal and visual-spatial memory impairment in youth at familial risk for schizophrenia or affective psychosis: a pilot study.

Background: Schizophrenia and affective psychoses share several common biological origins, particularly genetic susceptibility. Kraepelin posited that differing clinical expressions in these disorders reflect different etiopathologies. We tested a neuropsychological component of this hypothesis by evaluating verbal memory and visual memory performance in nonpsychotic youth at familial risk for psychosis, taking into account contributions to memory dysfunction including executive processing and psychopathology.

Genetics of the schizophrenias: a model accounting for their persistence and myriad phenotypes.

This article addresses the classic enigma about schizophrenia (SZ). The disease occurs with a lifetime prevalence of 1%, 80% of which is attributable to genetic factors. Females with SZ produce 50% as many children as normals, and males with SZ produce 25%.

Longitudinal consent-related abilities among research participants with schizophrenia: results from the CATIE study.

Objective: Research participants must have adequate consent-related abilities to provide informed consent at the time of study enrollment. We sought to determine if research participants with schizophrenia maintain adequate consent-related abilities during a longitudinal study. If participants lose abilities during a trial they may not be able to judge and protect their interests.

Prevalence of neurological soft signs and their neuropsychological correlates in typically developing Chinese children and Chinese children with ADHD.

This study examined prevalence of soft signs in 214 typically developing Chinese children and investigated whether soft signs are associated with attention deficit hyperactivity disorder (ADHD) in this population. Chinese children with ADHD (N = 54) scored significantly higher than age-matched controls on all three soft signs subscales and motor coordination correlated significantly with Stroop interference. Logistic regression supported the utility of the soft sign scales in discriminating children with ADHD and controls.

Neurological soft signs in individuals with schizotypal personality features.

Objective: The current study attempted to examine the prevalence of neurological soft signs and their relationships with schizotypal traits in individuals with psychometrically defined schizotypal personality disorder (SPD) features.

Method: Sixty-four individuals with SPD-proneness and 51 without SPD-proneness were recruited for the present study. The soft signs subscales of the Cambridge Neurological Inventory were administered to all participants; the Schizotypal Personality Questionnaire (SPQ) was administered to SPD-proneness and non-SPD-proneness participants.

Neurological soft signs and their relationships to neurocognitive functions: a re-visit with the structural equation modeling design.

Background: Neurological soft signs and neurocognitive impairments have long been considered important features of schizophrenia. Previous correlational studies have suggested that there is a significant relationship between neurological soft signs and neurocognitive functions. The purpose of the current study was to examine the underlying relationships between these two distinct constructs with structural equation modeling (SEM).

The CATIE schizophrenia trial: results, impact, controversy.

The CATIE (Clinical Antipsychotic Trials for Intervention Effectiveness) Schizophrenia Trial was designed to examine fundamental issues about second-generation antipsychotic (SGA) medications (olanzapine, risperidone, quetiapine, and ziprasidone) - their relative effectiveness and their effectiveness compared to a first-generation antipsychotic (FGA), perphenazine. This article reviews these and other findings from this important trial and offers a perspective regarding their meaning for practice and their significance for the advancement of research in psychiatry. The primary outcome measure, time to discontinuation, served as an index of effectiveness and was remarkably short; only 26% of subjects completed the 18-month trial on the medicine to which they were initially randomized.

Schizotypy and individual differences in the frequency of normal associations in verbal utterances.

Background: Recent empirical evidence [Maher, B.A., Manschreck, T.

Recent advances in the treatment of delusional disorder.

Objective: Often considered difficult to treat in the past, even treatment-resistant, delusional disorder is now regarded as a treatable condition that responds to medication in many instances. Munro and Mok previously reviewed the published record of its treatment to 1994. This review aims to update and extend their observations and to examine the impact of new second-generation antipsychotic agents on the treatment of this condition.

Baseline neurocognitive deficits in the CATIE schizophrenia trial.

Neurocognition is moderately to severely impaired in patients with schizophrenia. However, the factor structure of the various neurocognitive deficits, the relationship with symptoms and other variables, and the minimum amount of testing required to determine an adequate composite score has not been determined in typical patients with schizophrenia. An 'all-comer' approach to cognition is needed, as provided by the baseline assessment of an unprecedented number of patients in the CATIE (Clinical Antipsychotic Trials of Intervention Effectiveness) schizophrenia trial.

Paul E. Meehl's influence on experimental psychopathology: fruits of the nexus of schizotypy and schizophrenia, neurology, and methodology.

Paul E. Meehl made numerous contributions to clinical science and a hallmark of many of these contributions was their integrative nature. Meehl's positions on complex topics, especially one such as schizophrenia, were reflective of input from a variety of disciplines and levels of analysis.

Quantitative assessment of the frequency of normal associations in the utterances of schizophrenia patients and healthy controls.

Background: The intrusion of associations into the utterances of schizophrenic individuals typically disrupts the coherence of the patient's utterances. Recent theoretical formulations of these phenomena have emphasized the hyperactivity) of associational networks in such language disturbance (e.g.

Earlier age of first diagnosis in schizophrenia is related to impaired motor control.

We examined the control of motor behavior in relation to age of first diagnosis (AFD; an approximation of age of onset) in schizophrenia. We hypothesized that earlier AFD reflects increased vulnerability to the disorder, vulnerability that may be indexed by elevated levels of motor abnormality. AFD, symptom and demographic features, motor performance on a line drawing task, and the presence and severity of dyskinesia and extrapyramidal side effects were evaluated in 65 chronic schizophrenia subjects.

Review of antipsychotic medication administration: a proposal of intermittent dosing.

Despite advances in the treatment of schizophrenia, there are substantial gaps in systematically established knowledge concerning the application of antipsychotic agents. We still do not know how antipsychotic drugs work, where they work, how much to prescribe, or how often to prescribe. No consensus exists on the definition of relapse or recovery.