Psychiatry and Psychology Commons^™

Effects Of Independent Versus Dependent Stressful Life Events On Major Symptom Domains Of Schizophrenia, Yizhou Ma, Joshua Chiappelli, Mark D Kvarta, Heather Bruce, Andrew Van Der Vaart, Eric L Goldwaser, Xiaoming Du, Hemalatha Sampath, Samantha Lightner, Jane Endres, Akram Yusuf, Alexa Yuen, Samantha Narvaez, Danny Campos-Saravia, Peter Kochunov, L Elliot Hong

Faculty, Staff and Student Publications

We evaluated two models to link stressful life events (SLEs) with the psychopathology of schizophrenia spectrum disorders (SSD). We separated SLEs into independent (iSLEs, unlikely influenced by one's behavior) and dependent (dSLEs, likely influenced by one's behavior). Stress-diathesis and stress generation models were evaluated for the relationship between total, i- and d- SLEs and the severity of positive, negative, and depressive symptoms in participants with SSD. Participants with SSD (n = 286; 196 males; age = 37.5 ± 13.5 years) and community controls (n = 121; 83 males; 35.4 ± 13.9 years) completed self-report of lifetime negative total, i- and …

Representation Of Racial And Ethnic Minorities And Their Preferences For Mood Stabilizing Treatment Selection For Bipolar Disorder: A Systematic Review, Francisco J. Barrera, Manuel Gardea, Juan Garzon, Ryan Toledo, Ana Paula Bonner, Andrea Maraboto, Mark Frye, Ihsan Salloum

Research Symposium

Background: The use of second-generation antipsychotics for bipolar disorder (BD) has increased in the past years¹Concerns on potential serious medical side effects and need for blood level monitoring of some traditional mood stabilizers along with other factors have influenced this change. Shared decision-making (SDM) strategies have been implemented in clinical settings due to their ability to engage patients in the process of treatment selection.² Within minority groups with mental illnesses, socioeconomic factors, individual concerns, and cultural variations in clinical presentations, are often overlooked or misrepresented when assessing the patient’s treatment preferences. Although several studies evaluating the …

Evidence Of Neurovascular Water Exchange And Endothelial Vascular Dysfunction In Schizophrenia: An Exploratory Study, Eric L Goldwaser, Danny J J Wang, Bhim M Adhikari, Joshua Chiappelli, Xingfeng Shao, Jiaao Yu, Tong Lu, Shuo Chen, Wyatt Marshall, Alexa Yuen, Mark Kvarta, Yizhou Ma, Xiaoming Du, Si Gao, Osamah Saeedi, Heather Bruce, Patrick Donnelly, Hugh O'Neill, Alan R Shuldiner, Braxton D Mitchell, Peter Kochunov, L Elliot Hong

Faculty, Staff and Student Publications

BACKGROUND AND HYPOTHESIS: Mounting evidence supports cerebrovascular contributions to schizophrenia spectrum disorder (SSD) but with unknown mechanisms. The blood-brain barrier (BBB) is at the nexus of neural-vascular exchanges, tasked with regulating cerebral homeostasis. BBB abnormalities in SSD, if any, are likely more subtle compared to typical neurological insults and imaging measures that assess large molecule BBB leakage in major neurological events may not be sensitive enough to directly examine BBB abnormalities in SSD.

STUDY DESIGN: We tested the hypothesis that neurovascular water exchange (Kw) measured by non-invasive diffusion-prepared arterial spin label MRI (n = 27 healthy controls [HC], n = …

Csf1r Regulates Schizophrenia-Related Stress Response And Vascular Association Of Microglia/Macrophages, Ling Yan, Yanli Li, Fengmei Fan, Mengzhuang Gou, Fangling Xuan, Wei Feng, Keerthana Chithanathan, Wei Li, Junchao Huang, Hongna Li, Wenjin Chen, Baopeng Tian, Zhiren Wang, Shuping Tan, Alexander Zharkovsky, L Elliot Hong, Yunlong Tan, Li Tian

Faculty, Staff and Student Publications

BACKGROUND: Microglia are known to regulate stress and anxiety in both humans and animal models. Psychosocial stress is the most common risk factor for the development of schizophrenia. However, how microglia/brain macrophages contribute to schizophrenia is not well established. We hypothesized that effector molecules expressed in microglia/macrophages were involved in schizophrenia via regulating stress susceptibility.

METHODS: We recruited a cohort of first episode schizophrenia (FES) patients (n = 51) and age- and sex-paired healthy controls (HCs) (n = 46) with evaluated stress perception. We performed blood RNA-sequencing (RNA-seq) and brain magnetic resonance imaging, and measured plasma level of colony stimulating …

Dynamic Functional Thalamocortical Dysconnectivity In Schizophrenia Correlates To Antipsychotics Response, Mi Yang, Liju Liu, Hongmei Cui, Chijun Deng, Weisen Xiong, Guocheng Zhao, Shulin Du, Thomas R Kosten, Huafu Chen, Zezhi Li, Xiangyang Zhang

Faculty, Staff and Students Publications

Although many studies have showed abnormal thalamocortical networks in patients with schizophrenia (SCZ), the dynamic functional thalamocortical connectivity of individuals with SCZ and the effect of antipsychotics on this connectivity have not been investigated. Drug-naïve first-episode individuals with SCZ and healthy controls were recruited. Patients were treated with risperidone for 12 weeks. Resting-state functional magnetic resonance imaging was acquired at baseline and week 12. We identified six functional thalamic subdivisions. The sliding window strategy was used to determine the dynamic functional connectivity (dFC) of each functional thalamic subdivision. Individuals with SCZ displayed decreased or increased dFC variance in different thalamic …

Development Of Schizophrenia In A Genetically Predisposed Individual Following Covid-19, Sung Kang, Jonathan Yuh, Timothy Wong

Rowan-Virtua Research Day

We present a patient who is a 56-year-old female with a psychiatric history of anxiety disorder and a medical history of hypercholesterolemia and hyperthyroidism, who was admitted to the hospital after a witnessed seizure at an inpatient psychiatric facility. This patient’s family history is significant for her mother experiencing unspecified psychotic disorder that required psychiatric hospitalization. Our patient was first admitted to the psychiatric hospital after exhibiting worsening paranoid delusions and hallucinations that began several months prior. The patient had reportedly begun locking herself in the restroom and screaming “get out, they’re spying on me”, referring to her next-door neighbors …

The Relationship Between Quality Of Life And Functionality In Patients With Schizophrenia – A Preliminary Report, Vlad Dionisie, Mihnea Costin Manea, Manea Mirela, Lavinia Steluta Bonciu, Sorin Riga, Maria Gabriela Puiu

Journal of Mind and Medical Sciences

This research aimed to investigate the relationship between quality of life and level of functioning in a group of Romanian patients with schizophrenia. A cross-sectional, observational, prospective study on 47 patients with schizophrenia was conducted. Socio-demographic and clinical data were documented and WHOQOL-BREF and Life Skills Profile-16 instruments were further administered. To examine the correlation between variables, Person correlation test was employed. The mean age of the sample was 38.32±12.32 years and 66% of the patients were males. Significant correlations were found between all aspects of the quality of life (physical health, psychological, social relationships and environmental health) and total …

Glutamate, And Its Relationship To Task-Induced Functional Connectivity In The Human Brain: A Focus On Schizophrenia, Kathleen Liu Young, John Kopchick, Jeffrey Stanley, Vaibhav Diwadkar

Medical Student Research Symposium

Glutamate is the brain’s major excitatory neurotransmitter mediating both neuroplasticity and network function (Zhou & Danbolt, 2014). Basal glutamate (Glu) measured using proton magnetic resonance spectroscopy (1H-MRS) provides insight into a region’s density of neuropil related to the glutamatergic system. Moreover, given the role of glutamate in mediating brain network function, Glu levels may play a role in the brain’s functional connectivity (FC), which is typically estimated from functional magnetic resonance imaging (fMRI) time series data. These questions converge when considering the clinical syndrome of schizophrenia (SCZ). Patients with SCZ show abnormalities in basal Glu in the hippocampus and prefrontal …

Five Negative Symptom Domains Are Differentially Associated With Resting State Amplitude Of Low Frequency Fluctuations In Schizophrenia, Eun-Jin Cheon, Alie G Male, Bingchen Gao, Bhim M Adhikari, Jesse T Edmond, Stephanie M Hare, Aysenil Belger, Steven G Potkin, Juan R Bustillo, Daniel H Mathalon, Judith M Ford, Kelvin O Lim, Bryon A Mueller, Adrian Preda, Daniel O'Leary, Gregory P Strauss, Anthony O Ahmed, Paul M Thompson, Neda Jahanshad, Peter Kochunov, Vince D Calhoun, Jessica A Turner, Theo G M Van Erp

Faculty, Staff and Student Publications

This study examined associations between resting-state amplitude of low frequency fluctuations (ALFF) and negative symptoms represented by total scores, second-order dimension (motivation and pleasure, expressivity), and first-order domain (anhedonia, avolition, asociality, alogia, blunted affect) factor scores in schizophrenia (n = 57). Total negative symptom scores showed positive associations with ALFF in temporal and frontal brain regions. Negative symptom domain scores showed predominantly stronger associations with regional ALFF compared to total scores, suggesting domain scores may better map to neural signatures than total scores. Improving our understanding of the neuropathology underlying negative symptoms may aid in addressing this unmet therapeutic need …

Brain Ageing In Schizophrenia: Evidence From 26 International Cohorts Via The Enigma Schizophrenia Consortium, Constantinos Constantinides, Laura K M Han, Clara Alloza, Linda Antonella Antonucci, Celso Arango, Rosa Ayesa-Arriola, Nerisa Banaj, Alessandro Bertolino, Stefan Borgwardt, Jason Bruggemann, Juan Bustillo, Oleg Bykhovski, Vince Calhoun, Vaughan Carr, Stanley Catts, Young-Chul Chung, Benedicto Crespo-Facorro, Covadonga M Díaz-Caneja, Gary Donohoe, Stefan Du Plessis, Jesse Edmond, Stefan Ehrlich, Robin Emsley, Lisa T Eyler, Paola Fuentes-Claramonte, Foivos Georgiadis, Melissa Green, Amalia Guerrero-Pedraza, Minji Ha, Tim Hahn, Frans A Henskens, Laurena Holleran, Stephanie Homan, Philipp Homan, Neda Jahanshad, Joost Janssen, Ellen Ji, Stefan Kaiser, Vasily Kaleda, Minah Kim, Woo-Sung Kim, Matthias Kirschner, Peter Kochunov, Yoo Bin Kwak, Jun Soo Kwon, Irina Lebedeva, Jingyu Liu, Patricia Mitchie, Stijn Michielse, David Mothersill, Bryan Mowry, Víctor Ortiz-García De La Foz, Christos Pantelis, Giulio Pergola, Fabrizio Piras, Edith Pomarol-Clotet, Adrian Preda, Yann Quidé, Paul E Rasser, Kelly Rootes-Murdy, Raymond Salvador, Marina Sangiuliano, Salvador Sarró, Ulrich Schall, André Schmidt, Rodney J Scott, Pierluigi Selvaggi, Kang Sim, Antonin Skoch, Gianfranco Spalletta, Filip Spaniel, Sophia I Thomopoulos, David Tomecek, Alexander S Tomyshev, Diana Tordesillas-Gutiérrez, Therese Van Amelsvoort, Javier Vázquez-Bourgon, Daniela Vecchio, Aristotle Voineskos, Cynthia S Weickert, Thomas Weickert, Paul M Thompson, Lianne Schmaal, Theo G M Van Erp, Jessica Turner, James H Cole, Enigma Schizophrenia Consortium, Danai Dima, Esther Walton

Faculty, Staff and Students Publications

Schizophrenia (SZ) is associated with an increased risk of life-long cognitive impairments, age-related chronic disease, and premature mortality. We investigated evidence for advanced brain ageing in adult SZ patients, and whether this was associated with clinical characteristics in a prospective meta-analytic study conducted by the ENIGMA Schizophrenia Working Group. The study included data from 26 cohorts worldwide, with a total of 2803 SZ patients (mean age 34.2 years; range 18–72 years; 67% male) and 2598 healthy controls (mean age 33.8 years, range 18–73 years, 55% male). Brain-predicted age was individually estimated using a model trained on independent data based on …

In Vivo White Matter Microstructure In Adolescents With Early-Onset Psychosis: A Multi-Site Mega-Analysis, Claudia Barth, Sinead Kelly, Stener Nerland, Neda Jahanshad, Clara Alloza, Sonia Ambrogi, Ole A Andreassen, Dimitrios Andreou, Celso Arango, Inmaculada Baeza, Nerisa Banaj, Carrie E Bearden, Michael Berk, Hannes Bohman, Josefina Castro-Fornieles, Yann Chye, Benedicto Crespo-Facorro, Elena De La Serna, Covadonga M Díaz-Caneja, Tiril P Gurholt, Catherine E Hegarty, Anthony James, Joost Janssen, Cecilie Johannessen, Erik G Jönsson, Katherine H Karlsgodt, Peter Kochunov, Noemi G Lois, Mathias Lundberg, Anne M Myhre, Saül Pascual-Diaz, Fabrizio Piras, Runar E Smelror, Gianfranco Spalletta, Therese S Stokkan, Gisela Sugranyes, Chao Suo, Sophia I Thomopoulos, Diana Tordesillas-Gutiérrez, Daniela Vecchio, Kirsten Wedervang-Resell, Laura A Wortinger, Paul M Thompson, Ingrid Agartz

Faculty, Staff and Students Publications

Emerging evidence suggests brain white matter alterations in adolescents with early-onset psychosis (EOP; age of onset <18 >years). However, as neuroimaging methods vary and sample sizes are modest, results remain inconclusive. Using harmonized data processing protocols and a mega-analytic approach, we compared white matter microstructure in EOP and healthy controls using diffusion tensor imaging (DTI). Our sample included 321 adolescents with EOP (median age = 16.6 years, interquartile range (IQR) = 2.14, 46.4% females) and 265 adolescent healthy controls (median age = 16.2 years, IQR = 2.43, 57.7% females) pooled from nine sites. All sites extracted mean fractional anisotropy (FA), mean …

Supersensitivity Psychosis With Acute Dystonia, Tatiana Nunez, Gabriella Meyerson, Mays Alani, Shahid Elahi, Enrique Vargas

HCA Healthcare Journal of Medicine

Introduction

Supersensitivity psychosis is a phenomenon that occurs with chronic usage of antipsychotics secondary to treatment resistance. At this time, there are no standardized guidelines regarding the management of supersensitivity psychosis.

Case Presentation

We present a case of a patient with schizoaffective disorder who developed supersensitivity psychosis and acute dystonia in response to discontinuing psychotropic medications, including high-dose quetiapine and olanzapine. The patient presented with excessive anxiety, paranoia, bizarre thoughts, and generalized dystonia affecting the face, trunk, and extremities. We treated the patient with olanzapine, valproic acid, and diazepam, which alleviated the psychosis back to baseline and significantly improved the …

Functional Connectivity Signatures Of Nmdar Dysfunction In Schizophrenia—Integrating Findings From Imaging Genetics And Pharmaco-Fmri, Arnim J Gaebler, Nilüfer Fakour, Felix Stöhr, Jana Zweerings, Arezoo Taebi, Mariia Suslova, Juergen Dukart, Joerg F Hipp, Bhim M Adhikari, Peter Kochunov, Suresh D Muthukumaraswamy, Anna Forsyth, Thomas Eggermann, Florian Kraft, Ingo Kurth, Michael Paulzen, Gerhard Gründer, Frank Schneider, Klaus Mathiak

Faculty, Staff and Student Publications

Both, pharmacological and genome-wide association studies suggest N-methyl-D-aspartate receptor (NMDAR) dysfunction and excitatory/inhibitory (E/I)-imbalance as a major pathophysiological mechanism of schizophrenia. The identification of shared fMRI brain signatures of genetically and pharmacologically induced NMDAR dysfunction may help to define biomarkers for patient stratification. NMDAR-related genetic and pharmacological effects on functional connectivity were investigated by integrating three different datasets: (A) resting state fMRI data from 146 patients with schizophrenia genotyped for the disease-associated genetic variant rs7191183 of GRIN2A (encoding the NMDAR 2 A subunit) as well as 142 healthy controls. (B) Pharmacological effects of the NMDAR antagonist ketamine and the GABA-A …

Cortical Connectomic Mediations On Gamma Band Synchronization In Schizophrenia, Xiaoming Du, Stephanie Hare, Ann Summerfelt, Bhim M Adhikari, Laura Garcia, Wyatt Marshall, Peng Zan, Mark Kvarta, Eric Goldwaser, Heather Bruce, Si Gao, Hemalatha Sampath, Peter Kochunov, Jonathan Z Simon, L Elliot Hong

Faculty, Staff and Student Publications

Aberrant gamma frequency neural oscillations in schizophrenia have been well demonstrated using auditory steady-state responses (ASSR). However, the neural circuits underlying 40 Hz ASSR deficits in schizophrenia remain poorly understood. Sixty-six patients with schizophrenia spectrum disorders and 85 age- and gender-matched healthy controls completed one electroencephalography session measuring 40 Hz ASSR and one imaging session for resting-state functional connectivity (rsFC) assessments. The associations between the normalized power of 40 Hz ASSR and rsFC were assessed via linear regression and mediation models. We found that rsFC among auditory, precentral, postcentral, and prefrontal cortices were positively associated with 40 Hz ASSR in …

Psychotic Symptom, Mood, And Cognition-Associated Multimodal Mri Reveal Shared Links To The Salience Network Within The Psychosis Spectrum Disorders, Chuang Liang, Godfrey Pearlson, Juan Bustillo, Peter Kochunov, Jessica A Turner, Xuyun Wen, Rongtao Jiang, Zening Fu, Xiao Zhang, Kaicheng Li, Xijia Xu, Daoqiang Zhang, Shile Qi, Vince D Calhoun

Faculty, Staff and Student Publications

Schizophrenia (SZ), schizoaffective disorder (SAD), and psychotic bipolar disorder share substantial overlap in clinical phenotypes, associated brain abnormalities and risk genes, making reliable diagnosis among the three illness challenging, especially in the absence of distinguishing biomarkers. This investigation aims to identify multimodal brain networks related to psychotic symptom, mood, and cognition through reference-guided fusion to discriminate among SZ, SAD, and BP. Psychotic symptom, mood, and cognition were used as references to supervise functional and structural magnetic resonance imaging (MRI) fusion to identify multimodal brain networks for SZ, SAD, and BP individually. These features were then used to assess the ability …

Dysregulation Of Complement System In Neuropsychiatric Disorders: A Mini Review, Danny Perez Sierra, Ashutosh Tripathi, Anilkumar Pillai

Faculty, Staff and Student Publications

Complement system is one of the most important defense mechanisms of the innate immune system. In addition to their roles in immune regulation, complement proteins are also involved in neurodevelopment and adult brain plasticity. Complement dysregulation has been shown in neurodevelopmental disorders including schizophrenia and autism spectrum disorder as well as in mood disorders. A number of clinical as well as genetic studies suggest the role of complement proteins in the cortical thinning and excessive synaptic pruning frequently associated with schizophrenia. The changes in complement proteins are also associated with the pathophysiology of autism spectrum disorder, major depressive disorder and …

Genome-Transcriptome-Functional Connectivity-Cognition Link Differentiates Schizophrenia From Bipolar Disorder, Jiayu Chen, Zening Fu, Juan R Bustillo, Nora I Perrone-Bizzozero, Dongdong Lin, Jose Canive, Godfrey D Pearlson, Julia M Stephen, Andrew R Mayer, Steven G Potkin, Theo G M Van Erp, Peter Kochunov, L Elliot Hong, Bhim M Adhikari, Ole A Andreassen, Ingrid Agartz, Lars T Westlye, Jing Sui, Yuhui Du, Fabio Macciardi, Faith M Hanlon, Rex E Jung, Jessica A Turner, Jingyu Liu, Vince D Calhoun

Faculty, Staff and Student Publications

BACKGROUND AND HYPOTHESIS: Schizophrenia (SZ) and bipolar disorder (BD) share genetic risk factors, yet patients display differential levels of cognitive impairment. We hypothesized a genome-transcriptome-functional connectivity (frontoparietal)-cognition pathway linked to SZ-versus-BD differences, and conducted a multiscale study to delineate this pathway.

STUDY DESIGNS: Large genome-wide studies provided single nucleotide polymorphisms (SNPs) conferring more risk for SZ than BD, and we identified their regulated genes, namely SZ-biased SNPs and genes. We then (a) computed the polygenic risk score for SZ (PRSSZ) of SZ-biased SNPs and examined its associations with imaging-based frontoparietal functional connectivity (FC) and cognitive performances; (b) examined the spatial …

Sexual Obsessions In A Patient With Schizophrenia, Mohsin Raza, Barbara L. Gracious

HCA Healthcare Journal of Medicine

Obsessive-compulsive symptoms in schizophrenia are often initially unrecognized or missed entirely in the diagnostic process. Sexual obsession is common in patients with schizophrenia. Therefore, identifying sexual obsession early in treatment has significant implications for appropriate multidisciplinary management and prognosis. We report the case of a Hispanic male in his 20s who presented with self-injurious behavior and worsening psychotic symptoms in the context of a recent diagnosis of schizophrenia and without a past diagnosis or historical symptoms of obsessive-compulsive disorder (OCD). This report elucidates the importance of identifying the underlying cause of self-injurious behavior, which in this young man was due …

Multimodel Order Independent Component Analysis: A Data-Driven Method For Evaluating Brain Functional Network Connectivity Within And Between Multiple Spatial Scales, Xing Meng, Armin Iraji, Zening Fu, Peter Kochunov, Aysenil Belger, Judith Ford, Sara Mcewen, Daniel H Mathalon, Bryon A Mueller, Godfrey Pearlson, Steven G Potkin, Adrian Preda, Jessica Turner, Theo Van Erp, Jing Sui, Vince D Calhoun

Faculty, Staff and Student Publications

Background:

While functional connectivity is widely studied, there has been little work studying functional connectivity at different spatial scales. Likewise, the relationship of functional connectivity between spatial scales is unknown.

Methods:

We proposed an independent component analysis (ICA)-based approach to capture information at multiple-model orders (component numbers), and to evaluate functional network connectivity (FNC) both within and between model orders. We evaluated the approach by studying group differences in the context of a study of resting-state functional magnetic resonance imaging (rsfMRI) data collected from schizophrenia (SZ) individuals and healthy controls (HC). The predictive ability of FNC at multiple spatial scales …

Gender Dysphoria Versus Acute Psychosis: Can One Properly Diagnose Gender Dysphoria Solely During Acute Psychosis?, Kristy A. Fisher, Samantha Scemla, Clara L. Alvarez Villalba, Jessica Kroin

HCA Healthcare Journal of Medicine

Gender dysphoria occurs when a discrepancy between one’s sex assigned at birth and one’s gender identity causes distress or impairment in function, which can lead ultimately to seeking treatment in the forms of psychotherapy, hormonal therapy, and/or gender-affirming surgery. Clinical care guidelines also recommend pharmacological treatment of psychiatric comorbidities if indicated. A review of the current literature demonstrates comorbidity between gender dysphoria and psychosis, including cases of gender dysphoria with schizophrenia and the occurrence of gender dysphoria symptoms during manic or psychotic episodes. The existing literature has yet to specifically examine gender dysphoria amongst individuals with schizoaffective disorder. The authors …

Through The Cracks: The Disposition Of Patients With Schizophrenia Spectrum Disorders In The Post-Asylum Era, Briana Tillman, Erin Smith, Alicia Cho, Colt Kennington, Alexandra Kreis

HCA Healthcare Journal of Medicine

This paper aims to explore current disposition options for patients with psychosis in light of shifts toward community care and changes in mental healthcare funding in the post-asylum era and to propose systemic-level improvements based upon local successes. It evaluates critiques of long-term psychiatric care programs, claims of transinstitutionalization to incarceration, shelters, and emergency rooms, and programs initiated to address deinstitutionalization. The authors conclude that while Assertive Community Treatment, Partial Hospitalization Programs, intermediate-level care, and housing interventions can improve outcomes for many persons with psychotic illness, a significant portion of these patients would still be best served in long-term psychiatric …

Homoeopathy As An Add-On Treatment For Schizophrenia - A Case Series, S Karunakara Moorthi, Radhika P, Mohan N. Devasia

Indian Journal of Research in Homoeopathy

Introduction: Schizophrenia is a complex, progressive and severe mental disorder characterised by distortions in thinking, perception, emotions, language, sense of self and behaviour. Conventional medication and cognitive behaviour therapy are used in the treatment of schizophrenia. Homoeopathy can also offer promising results in schizophrenia as evident from the previous studies. Case Summary: Five patients reported at the outpatient department of National Homoeopathy Research Institute in Mental Health, Kerala, India, with symptoms of schizophrenia were treated with individualised homoeopathic medicine as an add-on therapy to conventional medicines. Assessment of the patients was done using three scales: Positive and Negative Syndrome Scale, …

A Life Lived With Schizophrenia: When Mother’S Love Is Kept In The Dark Exploring Maternal Communication And Attachment Organization In Families With Schizophrenia, Myrsini Stefanidou Marini

Electronic Theses and Dissertations

In recent years, research into the transgenerational transmission of attachment styles has shown that a mother’sattachment style often predicts the attachment style of her infant. Fearsome parental behavior has been found to predict disorganized attachment in infants, which is further associated with a range of mental health disturbances in adolescence. Furthermore, regular patterns of disturbed communication between mother and child have also been found to lead to ‘schizophrenic’ thinking and behavior in the child’s life. While acknowledging that genetic and other biological factors contribute to the emergence of schizophrenia, this study focused on disorganized attachment and disturbed communication between mother …

Evaluating The Use Of Long-Acting Injectables As A Method To Improve Treatment Adherence In Patients With Schizophrenia: A Scoping Review, Britney Michelle Holton Msn, Fnp-Bc, Patricia Rena Jones-Purdy Msn, Cnrn, Margaret Harvey Phd, Aprn, Acnp-Bc, Chfn

Doctor of Nursing Practice Projects

Purpose/Background Medication adherence is a major issue for patients suffering from schizophrenia and medication non-adherence can lead to psychiatric morbidity. Although long-acting injectable (LAI) antipsychotics have been shown to improve treatment adherence, most clinicians continue to rely on oral therapies to manage schizophrenia. This scoping review will assess evidence-based literature to determine the relationship between the use of LAIs and medication adherence in patients with schizophrenia.

Methods A literature review was conducted between August 2020 and January 2021 to find studies that have evaluated medication adherence with the use of long-acting injectables in patients with schizophrenia. Relevant literature initially selected …

A Psychopharmacology Review Of Brexpiprazole, Nicole A. Marion

Conspectus Borealis

Brexpiprazole is an antipsychotic drug often used to help treat schizophrenia and major depressive disorder. This review paper breaks down the drugs history including what it is used for, how it is used, and how it was developed. Pharmacokinetics including administration routes, steady states, and metabolism. This review also describes pharmacodynamics, focusing on drug affinity. It will also discuss pharmacological effects pulling evidence from clinical trials. Last this review will describe the toxicology and safety of brexpiprazole.

Hallermann-Streiff Syndrome And Psychosis: A Case Report, Tarvis Peacock, Ubaid Khokhar, Jaclyn Murphy, Zach Murphy

HCA Healthcare Journal of Medicine

Hallermann-Streiff syndrome is a rare genetic congenital disorder, with fewer than 200 cases reported to date, that is characterized by brachycephaly with frontal bossing, micrognathia, a “bird-like” beaked nose, microphthalmia with congenital cataracts, dental abnormalities, hypotrichosis, skin atrophy, and short stature. There is limited data on psychosis in individuals with Hallermann-Streiff syndrome; the information available depicts mania rather than psychosis. This case report reviews the presentation and treatment of psychosis in a 32-year-old male with Hallermann-Streiff syndrome who was involuntarily admitted to an inpatient psychiatric unit for persecutory delusions and hallucinations. The patient’s psychosis responded well to risperidone with a …

An Interventional Pilot Of Customized Adherence Enhancement Combined With Long-Acting Injectable Antipsychotic Medication (Cae-L) For Poorly Adherent Patients With Chronic Psychotic Disorder In Tanzania, Christopher J. Burant, Carol E. Blixen, Kristin A. Cassidy, Jennifer B. Levin, Martha Sajatovic

Faculty Scholarship

Background: Chronic psychotic disorders (CPD) impose a particularly significant burden in resource-limited settings. Combining long-acting antipsychotic medication (LAI) with a customized adherence enhancement intervention (CAE-L) has potential to advance care. Methods: Nineteen adults ≥ age 18 with CPD who self-reported missing ≥20% of antipsychotic medication within the last month were stabilized on oral haloperidol prior to transitioning to monthly haloperidol decanote for 25 weeks. Outcome evaluations were conducted at baseline and Week 25. Primary outcomes were oral medication adherence assessed via the Tablet Routines Questionnaire (TRQ) and LAI injection frequency. Secondary outcomes included CPD symptoms measured by the Brief Psychiatric …

Examination Of Common And Rare Variant Genetic Architecture Of Psychiatric Disorders, Mohammad Ahangari

Theses and Dissertations

Psychiatric disorders are often heterogenous in their manifestation and genome-wide association studies have identified many common risk variants involved in their polygenic architectures with varying degrees of pleiotropy. In recent years, large-scale biobanks have also begun sequencing the genome of their participants to elucidate the role of rare risk variation in the genetic architecture of complex phenotypes, including psychiatric traits. This dissertation sought to better understand the role of both common and rare risk variation in the genetic architecture of psychiatric disorders with a particular focus on schizophrenia and alcohol problems. In the first three analyses, we focused on characterizing …

Telemedicine In Schizophrenia, Stacy H. Williams

MSN Capstone Projects

Schizophrenia is a chronic neurological brain disorder that affects approximately 2.6 million adults in the United States alone. This condition affects twenty million people worldwide according to the World Health Organization. “Patients with schizophrenia often die at a considerably younger age than the rest of the population,” (Wallace, 2017). The treatment of this condition is complex because of the array of different symptoms and presented behaviors. Treatment consists of targeting the symptoms. This is done with medication and psychotherapeutics treatments. ‘Despite continued therapeutic advances, the life expectancy of patients with schizophrenia is reduced by approximately 10-25 years compared to that …

Alcohol Use In Tanzanians With Chronic Psychotic Disorders And Poor Medication Adherence, Emily Simon, Jennifer B. Levin, Carol Blixen, Michelle Aebi, Kristin Cassidy, Martha Sajatovic

Faculty Scholarship

Background: The burden of chronic psychotic disorders (CPDs) in sub-Saharan Africa (SSA) is significant. Poorly medically adherent patients are more likely to have worse outcomes and require more resources. However, factors impacting effective treatment of CPD in this population are unclear. Aim: Examine the relationship between alcohol use and disease management and compare alcohol risk stratification between the Alcohol Use Disorders Identification Test (AUDIT) and Alcohol, Smoking and Substance Involvement Screening Test (ASSIST) in poorly medication adherent Tanzanians with CPD. Setting: Muhimbili National Hospital and ambulatory clinics in Dar es Salaam, Tanzania. Methods: 100 Tanzanians with CPDs and suboptimal medication …