Psychiatry and Psychology Commons^™

Learning Without Contingencies Induces Higher Order Asynchrony In Brain Networks In Schizophrenia, Elizabeth L. Martin, Asadur Chowdury, Vaibhav Diwadkar, Sazid Hasan, Munajj Ul-Huq, Shahira Baajour, Dalal Khatib, Usha Rajan, Jeffrey Stanley

Medical Student Research Symposium

Schizophrenia (SCZ) is characterized by both cognitive and reward impairments. A recent study suggests that SCZ is associated with a loss of synchrony between learning and reward circuits (Robison et al., 2019) and higher levels of dis-organization of functional brain networks may underpin failures in learning that characterize SCZ (Hütt et al., 2014). Therefore, here we examined inter-group (HC ≠ SCZ) 4^th order differences in statistical regularity across a connectome of cognition and reward brain circuits. The analyses were conducted on fMRI time series data from a previous learning paradigm (Stanley et al., 2017) with periods of Encoding and …

Patterns Of Cilia Gene Dysregulations In Major Psychiatric Disorders, Wedad Alhassen, Siwei Chen, Marquis Vawter, Brianna Kay Robbins, Henry Nguyen, Thant Nyi Myint, Yumiko Saito, Anton Schulmann, Surya M. Nauli, Olivier Civelli, Pierre Baldi, Amal Alachkar

Pharmacy Faculty Articles and Research

Primary cilia function as cells' antennas to detect and transduce external stimuli and play crucial roles in cell signaling and communication. The vast majority of cilia genes that are causally linked with ciliopathies are also associated with neurological deficits, such as cognitive impairments. Yet, the roles of cilia dysfunctions in the pathogenesis of psychiatric disorders have not been studied. Our aim is to identify patterns of cilia gene dysregulation in the four major psychiatric disorders: schizophrenia (SCZ), autism spectrum disorder (ASD), bipolar disorder (BP), and major depressive disorder (MDD). For this purpose, we acquired differentially expressed genes (DEGs) from the …

Customizing Early Intervention Treatment For Psychosis In The Uthealth - Harris County Psychiatric Center, Alia R Warner, Gordon C Shen, Jane E Hamilton, Luca Lavagnino, Scott D Lane

Faculty, Staff and Student Publications

High-need, high-cost patients include those with diagnosed serious mental illnesses (e.g., schizophrenia; SMI). They often delay or fail to seek treatment. If they receive treatment, care is often sought from generalist settings (e.g., primary care or emergency medicine) or is suboptimal due to the provision of limited, non-evidence-based intervention and lack of communication, integration, and coordination among providers. This results in high aggregate costs and poor outcomes. Value-based health care requires care coordination to address the medical and social needs of this population. We describe a unique early intervention program for SMI that emanates from an inpatient setting: The Early …

Antipsychotic Treatment Experiences Of People With Schizophrenia: Patient Perspectives From An Online Survey, Martha Sajatovic

Faculty Scholarship

Background: This survey examined the experiences of people living with schizophrenia who have used oral antipsychotics (APs). Methods: Adults with self-reported physician-diagnosed schizophrenia (N=200), who were members of an online research participation panel and reported taking one or more oral APs within the last year, completed a cross-sectional online survey that focused on direct report of their experiences regarding APs (eg, symptoms, side effects, adherence). Descriptive analyses were conducted for the total survey sample and for subgroups defined a priori by experience with specific, prevalent side effects. Results: The mean age of the sample was 41.9 (SD=11.0) years, 50% of …

Schizophrenia And Genomics, Tiffini Lasch

Nursing Student Class Projects (Formerly MSN)

There are several advancements in genomics under specific categories, such as cancer and autism. Mental health is one of the leading diseases to cause a significant debt burden in today's society. However, genomics has not translated well into mental health treatment. One area of focus is schizophrenia. Those with schizophrenia suffer from severe and devastating symptoms. The symptoms can lead to harsh complications. Which can make it impossible to function in everyday life. Many believe it is not just genetics alone, but also environmental factors that contribute to schizophrenia. Through large genome-wide associated studies, discoveries are being made. There have …

Assessing The Effect Of Chronic Dopamine Receptor 2 Blockade As A Potential Model Of Secondary Negative Symptoms In Rats Using The Fr5/Chow Feeding Choice Task, Cyrene Nicholas

Honors Scholar Theses

Haloperidol, a dopamine (DA) D2 receptor antagonist, is an antipsychotic drug which is commonly used to treat schizophrenia and other psychiatric disorders. These disorders are often characterized by elevated striatal dopamine, which is speculated to have a role in producing positive symptoms such as hallucinations, delusions, and paranoia, as well as symptoms related to motivational salience and reward prediction. Individuals with schizophrenia also exhibit negative symptoms, such as amotivation, anergia, fatigue, and apathy among others. While some negative symptoms of schizophrenia are inherent to the pathophysiology, other negative symptoms are hypothesized to be partially induced by chronic exposure to antipsychotic …

One-Year Outcome And Adherence To Pharmacological Guidelines In First-Episode Schizophrenia: Results From A Consecutive Cohort Study, Petros Drosos, Kolbjørn Brønnick, Inge Joa, Jan Olav Johannessen, Erik Johnsen, Rune Andreas Kroken, Helen Joy Stain, Wenche Ten Velden Hegelstad, Tor Ketil Larsen

Research outputs 2014 to 2021

© Wolters Kluwer Health, Inc. All rights reserved. Background Remission in schizophrenia is difficult to achieve. Antipsychotic drugs are critical in the treatment of schizophrenia. International guidelines for the pharmacological treatment of schizophrenia recommend a 3-step algorithm with clozapine being the third-line antipsychotic agent. This study investigated the 1-year outcome and the application of the guidelines for the pharmacological treatment of nonremitted first-episode schizophrenia (FES) patients during the first year of follow-up. Methods A sample of 78 FES patients from the Norwegian TIPS (Early Treatment and Intervention in Psychosis) 2 study was assessed at the end of the first year …

Correlates Of Poor Medication Adherence In Chronic Psychotic Disorders, Martha Sajatovic, Carol Blixen, Michelle E. Aebi, Betsy Wilson, Christopher J. Burant, Kristin A. Cassidy, Jennifer B. Levine

Faculty Scholarship

Background Chronic psychotic disorders (CPDs) occur worldwide and cause significant burden. Poor medication adherence is pervasive, but has not been well studied in sub-Saharan Africa. Aims This cross-sectional survey of 100 poorly adherent Tanzanian patients with CPD characterised clinical features associated with poor adherence. Method Descriptive statistics characterised demographic and clinical variables, including barriers to adherence, adherence behaviours and attitudes, and psychiatric symptoms. Measures included the Tablets Routine Questionnaire, Drug Attitudes Inventory, the Brief Psychiatric Rating Scale, the Clinical Global Impressions scale, the Alcohol Use Disorders Identification Test and Alcohol, Smoking and Substance Involvement Screening Test. The relationship between adherence …

Exploring The Heteromeric Interface Of The 5-Ht2a-Mglu2 Receptor Complex, Mohamed Aarif Abdul Kareem

Theses and Dissertations

Schizophrenia is a serious mental disorder characteristic of several neurotransmitters including dopamine, serotonin, and glutamate being in imbalance. Early therapies focused solely on dopamine antagonism and second-generation antipsychotics focused on the dopamine and serotonin systems and their respective G protein coupled receptor (GPCR) proteins. Although debate for dimerization of certain classes of GPCR exist, the establishment of an mGlu2-5-HT_2A heterocomplex, which is implicated in schizophrenia is of interest. Previous studies have used a mutation-based approach to identify transmembrane domain 4 (TM4) as the domain responsible in mGlu2 for mediating heteromerization before narrowing down the individual amino acids responsible for …

Ontrack: A Program Evaluation, Justin Mynatt

Doctoral Projects

OnTrack is a program that provides coordinated specialty care (CSC) services for patients who have experienced their first episode of psychosis (FEP). Appropriately identifying and aggressively treating this vulnerable population, while providing support to both them and their families is critical for improved outcomes. Appropriate treatment of FEP patients can improve their quality of life, preserve brain matter, improve overall functioning, and lessen the burden of the clients’ family who may be involved in their care, such as caregiver strain or financial hardship. The purpose of this project is to evaluate the success of OnTrack, a FEP program, at improving …

Trait Emotional Experience In Individuals With Schizophrenia And Youth At Clinical High Risk For Psychosis, Claire I. Yee, Gregory P. Strauss, Daniel N. Allen, Claudia M. Haase, David Kimhy, Vijay A. Mittal

Psychology Faculty Research

Background: Disturbances in trait emotions are a predominant feature in schizophrenia. However, less is known about (a) differences in trait emotion across phases of the illness such as the clinical high-risk (CHR) phase and (b) whether abnormalities in trait emotion that are associated with negative symptoms are driven by primary (i.e. idiopathic) or secondary (e.g. depression, anxiety) factors. Aims: To examine profiles of trait affective disturbance and their clinical correlates in individuals with schizophrenia and individuals at CHR for psychosis. Method: In two studies (sample 1: 56 out-patients diagnosed with schizophrenia and 34 demographically matched individuals without schizophrenia (controls); sample …

Role Of Naltrexone In Improving Compulsive Drinking In Psychogenic Polydipsia, Sukaina Rizvi, Jeffery Gold, Ali M. Khan

School of Medicine Publications

Psychogenic polydipsia or self-induced water intoxication is a potentially lethal condition seen in many chronic psychiatric patients. This is a literature review based on therapeutic significance of Naltrexone in improving compulsive water drinking behavior in chronic psychiatrically ill patients with psychogenic polydipsia. Naltrexone is an opioid antagonist approved by FDA for alcohol dependence. Extensive literature search provides a line of evidence that suggests correlation of opioid receptor with compulsive water ingestion in animals. However, there is limited data regarding clinical utility of naltrexone in improving psychogenic polydipsia in human species. This review highlights the necessity for further research and trials …

Do Not Miss Your Shot: Improving Follow-Up In Patients Receiving Long-Acting Injectable Medications, Mary O'Hara

Doctor of Nursing Practice Final Manuscripts

Background: Serious mental illness including schizophrenia and bipolar disorder affects 1 in 24 adults in California. These chronic disorders are difficult to treat and often sabotaged by medication nonadherence. Long-acting injectable (LAI) medications are one strategy to combat medication nonadherence. Effectively providing treatment with LAI medications can be challenging at the clinic level.

Objectives: Reduce the number of days without medication by reducing the number of days between injection due date and injection administration for patients receiving LAI medications.

Design: Establish appointments for all injection visits. Standardize visit protocol for injection encounters to optimize provider time. Arrange immediate follow-up and …

A Meta-Analytic Review Of Cognitive Functioning In Negative And Positive Symptoms Of Schizophrenia, Tiffany Forsythe

Electronic Theses and Dissertations

The purpose of the study was to conduct two meta-analytic reviews examining cognitive functioning and schizophrenia. The first review examined the literature comparing the cognitive functioning of schizophrenic patients to healthy controls. A second review examined the cognitive functioning within schizophrenic patients, examining the differences between individuals with primarily positive symptomatology and those with primarily negative symptomatology. The first meta-analysis included 19 studies which assessed 861 schizophrenic patients and 858 healthy volunteers overall. The second meta-analysis included 10 studies comparing the cognitive functioning of 1,263 schizophrenics across positive and negative symptoms. Results of the first review indicated that healthy controls …

Survey Of Primary Care Physicians’ And Pediatricians’ Competency In Identifying Prodromal Symptoms In Schizophrenia And Psychotic Disorders, Mark Shephard, Joanna Petrides

Rowan-Virtua Research Day

• To address whether primary care physicians and pediatricians are equipped to recognize the prodromal symptoms of psychotic disorders

• Patients of primary care physicians exhibited increased help seeking behaviors prior to schizophrenia diagnosis [1]

• Primary care physicians in numerous countries have shown a lack of sufficient knowledge related to diagnosing and treating schizophrenia [2,3,4,5,6]

• Unclear if primary care physicians in the United States are adequately trained and prepared to recognize prodromal signs of schizophrenia, and diagnose and treat a variety of psychotic disorders

The Effects Of Two Novel Anti-Inflammatory Compounds On Prepulse Inhibition And Neural Microglia Cell Activation In A Rodent Model Of Schizophrenia, Heath W. Shelton

Electronic Theses and Dissertations

Recent studies have shown elevated neuroinflammation in a large subset of individuals diagnosed with schizophrenia. A pro-inflammatory cytokine, tumor necrosis factor-alpha (TNFα), has been directly linked to this neuroinflammation. This study examined the effects of two TNFα modulators (PD2024 and PD340) produced by our collaborators at P2D Bioscience, Inc., to alleviate auditory sensorimotor gating deficits and reduce microglial cell activation present in the polyinosinic:polycytidylic (Poly I:C) rodent model of schizophrenia. Auditory sensorimotor gating was assessed using prepulse inhibition and microglial activation was examined and quantified using immunohistochemistry and confocal microscopy, respectively. Both PD2024 and PD340 alleviated auditory sensorimotor gating deficits …

Cannabis And Psychosis Through The Lens Of Dsm-5, Nathan T. Pearson, James H. Berry

Faculty & Staff Scholarship

Evidence for an association between cannabis and psychosis has been documented in literature in many forms including experimental studies, epidemiological data, and case series. The association has implications for psychotic outcomes ranging from mild to severe and occurring over minutes to years. Due to the huge variety of exposures and outcome measures reported, creating a coherent account of all the available information is difficult. A useful way to conceptualize these wide-ranging results is to consider the association between cannabis and psychosis as it occurs within the context of widely used DSM-5 diagnoses. In the present review we examine cannabis/psychosis associations …

Is The Use Of Omega-3 Polyunsaturated Fatty Acids As Adjunctive Therapy Effective In Reducing Symptom Severity In Adult Schizophrenia Patients?, Desiree Goenaga

PCOM Physician Assistant Studies Student Scholarship

OBJECTIVE: The objective of this selective EBM review is to determine whether or not the use of omega-3 polyunsaturated fatty acids (PUFA) as adjunctive therapy is effective in reducing symptom severity in adult schizophrenia patients.

STUDY DESIGN: A selective review of three peer-reviewed, double-blind, randomized, placebo-controlled trials published between the years of 2008 and 2016.

DATA SOURCES: All three randomized control trials were published in English and were selected from peer-reviewed journals via EmBase and PubMed based on relevance to the clinical question posed above and that the outcomes measured in the studies mattered to patients, or were “patient oriented.” …

Does Metacognitive Training Improve The Quality Of Life In Patients With Schizophrenia?, Amy Wei

PCOM Physician Assistant Studies Student Scholarship

Objective: The objective of this selective EBM review is to determine whether or not “Does metacognitive training (MCT) improve the quality of life in patients with schizophrenia?”

Study Design: Systematic review of three randomized controlled trials (RCTs) published in peer-reviewed journals between 2010-2014, all in the English language; two of which were published in 2014 and one in 2010.

Data Sources: Three randomized controlled trials found using PubMed.

Outcomes Measured: Quality of life with a focus on social relationships was assessed using the Brief Quality of Life Questionnaire of the World Health Organization (WHOQOL-BREF) or Quality of Life Scale (QLS). …

Identifying Patients And Clinical Scenarios For Use Of Long-Acting Injectable Antipsychotics – Expert Consensus Survey Part 1, Martha Sajatovic

Faculty Scholarship

Objective: To assess expert consensus on barriers and facilitators for long-acting injectable antipsychotic (LAI) use and provide clinical recommendations on issues where clinical evidence is lacking, including identifying appropriate clinical situations for LAI use. Methods: A 50-question survey comprising 916 response options was distributed to 42 research experts and high prescribers with extensive LAI experience. Respondents rated options on relative appropriateness/importance using a 9-point scale. Consensus was determined using chi-square test of score distributions. Mean (standard deviation) ratings were calculated. Responses to 29 questions (577 options) relating to appropriate patients and clinical scenarios for LAI use are reported. Results: Recommendations …

Initiating/Maintaining Long-Acting Injectable Antipsychotics In Schizophrenia/Schizoaffective Or Bipolar Disorder – Expert Consensus Survey Part 2, Martha Sajatovic

Faculty Scholarship

Objective: The aim of this study was to provide recommendations on initiating and maintaining long-acting injectable antipsychotics (LAIs) in individuals with schizophrenia/schizoaffective or bipolar disorder. Methods: A 50-question survey comprising 916 response options was completed by 34 expert researchers and high prescribers with extensive LAI experience, rating relative appropriateness/importance on a 9-point scale. Consensus was determined using chi-square test of score distributions. Results of 21 questions comprising 339 response options regarding LAI initiation, maintenance treatment, adequate trial definition, identifying treatment nonresponse, and switching are reported. Results: Experts agreed that the most important LAI selection factor was patient response/tolerability to previous …

Association Between A Single Nucleotide Polymorphism In Neuregulin-1 And Schizophrenia In Pakistani Patients, Haider Ali Naqvi, Shafqat Huma, Hira Waseem, Kashaf Aqeel Zaidi, Hina Saeed Zuberi, Syed Hani Abidi

Department of Biological & Biomedical Sciences

Objective: To determine the association of single-nucleotide polymorphism8nrg433E1006 in the neuregulin-1 gene associated with schizophrenia.
Methods: This case-control study was conducted at the Fountain House, Lahore, and the psychiatric clinics at the Aga Khan University, Karachi, from 2010 to 2013.The total genomic deoxyribonucleic acid was isolated and single-nucleotide polymorphism8nrg433E1006 was screened by nested polymerase chain reaction followed by sequencing. These sequences, from patients and controls, were aligned with the human neuregulin-1-glial growth factor 2 gene sequence, which served as a reference sequence. The single nucleotide polymorphism genetic algorithm was characterised at position 433 in the neuregulin-1 gene by …

Effort-Related Decision Making In Comt Variant Mice: Pharmacological Studies And Genetic Susceptibility To Motivational Dysfunction, Suzanne Cayer

Honors Scholar Theses

Effort-related decision making tasks in animals can model motivational symptoms in humans, which are a set of symptoms spanning a multitude of neuropsychiatric disorders, such as major depressive disorder and the negative symptoms of schizophrenia. The present studies aimed to evaluate the effort-related effects of the Val158Met polymorphism of human catechol-methyltransferase (COMT), by testing mice carrying either the human COMT Val (n=8) or Met allele (n=8) with Wild-Type control mice (n=15) by using concurrent FR2 and FR4/pellet choice tasks in a touchscreen operant conditioning apparatus. The Val158Met polymorphism has been repeatedly associated with neuropsychiatric disorders, and the Val allele has …

Insane: James Holmes, Clark V. Arizona, And America's Insanity Defense, Eric Collins

Journal of Law and Health

Insanity is a legal term of art that changes definitions depending on the legal standard in American jurisprudence, which explains why a man who mental health professionals described as having an uncontrollable obsession with killing people can be found not insane and guilty. This Note addresses the current state of the Insanity Defense Reform Act of 1984 and its widespread implementation at the state level. Part II supplies background information on the history of the insanity defense and how it has transformed over the years in American jurisprudence. Part III provides an analysis of the of the insanity defense. Part …

"My Bitterness Is Deeper Than The Ocean": Understanding Internalized Stigma From The Perspectives Of Persons With Schizophrenia And Their Family Caregivers., Yin-Ling Irene Wong, Dexia Kong, Lufei Tu, Rosemary Frasso Phd, Msc, Cph

College of Population Health Faculty Papers

Background: It is estimated that 8 million of the Chinese adult population had a diagnosis of schizophrenia. Stigma associated with mental illness, which is pervasive in the Chinese cultural context, impacts both persons with schizophrenia and their family caregivers. However, a review of the literature found a dearth of research that explored internalized stigma from the perspectives of both patients and their caregivers.

Methods: We integrated data from standardized scales and narratives from semi-structured interviews obtained from eight family-dyads. Interview narratives about stigma were analyzed using directed content analysis and compared with responses from Chinese versions of the Internalized Stigma …

A Computational Assessment Of Target Engagement In The Treatment Of Auditory Hallucinations With Transcranial Direct Current Stimulation, Won Hee Lee, Nigel I. Kennedy, Marom Bikson, Sophia Frangou

Publications and Research

We use auditory verbal hallucinations (AVH) to illustrate the challenges in defining and assessing target engagement in the context of transcranial direct current stimulation (tDCS) for psychiatric disorders. We defined the target network as the cluster of regions of interest (ROIs) that are consistently implicated in AVH based on the conjunction of multimodal meta-analytic neuroimaging data. These were prescribed in the New York Head (a population derived model) and head models of four single individuals. We appraised two potential measures of target engagement, tDCS-induced peak electric field strength and tDCS-modulated volume defined as the percentage of the volume of the …

Sensory, Motor And Process Skills As Compared To Symptom Severity In Adult Patients With Schizophrenia, Lola Halperin

Occupational Therapy Faculty Publications

Schizophrenia is a serious mental illness affecting millions of Americans. It is characterized by positive and negative symptoms; cognitive impairments; and sensory, motor, and process skill deficits; as well as compromised motor learning, functional difficulties, and diminished quality of life. Neuroscientists attribute the above deficits to abnormal brain development, exaggerated synaptic pruning, and neurodegenerative processes, causing disrupted connectivity and diminished plasticity in the brain, neurotransmitter dysfunction, and impaired sensory processing.

Presently, there is no cure for schizophrenia. Numerous medications and rehabilitation modalities exist; however, many of the affected individuals continue to struggle daily. Recovery of these individuals implies symptom management …

Direct And Indirect Influences Of Defendant Mental Illness On Jury Decision Making, Marie Sabbagh

The Pegasus Review: UCF Undergraduate Research Journal

It is a common misconception that individuals with schizophrenia are significantly more dangerous and violent than individuals free of mental illness. This stigmatization may lead to harsher sentences when people with schizophrenia are involved in criminal activities and sentenced by a jury. This study presented four conditions to which participants were randomly assigned, alone or in a group of three, and were asked to sentence a defendant, either with or without schizophrenia. It was hypothesized that group deliberations would result in more lenient sentences for defendants with schizophrenia as compared to individual deliberations. Furthermore, it was predicted that both group …

Computational Modeling Of Contrast Sensitivity And Orientation Tuning In Schizophrenia, Steven M. Silverstein, Docia L. Demmin, James A. Bednar

MODVIS Workshop

Computational modeling is being increasingly used to understand schizophrenia, but, to date, it has not been used to account for the common perceptual disturbances in the disorder. We manipulated schizophrenia-relevant parameters in the GCAL (gain control, adaptation, laterally connected) model (Stevens et al., 2013), run using the Topographica simulator (Bednar, 2012), to model low-level visual processing changes in the disorder. Our models incorporated: separate sheets for retinal, LGN, and V1 activity; gain control in the LGN; homeostatic adaptation in V1 based on a weighted sum of all inputs and limited by a logistic (sigmoid) nonlinearity; lateral excitation and inhibition in …

Schizophrenia And Its Effects On An American Family: A Call To Action For The 21st Century, Cynthia Newton Captain

Senior Theses

Our country’s healthcare system is at a moral crossroads. The way we treat those whom we call “the homeless” is deplorable. The majority of the homeless are mentally ill and need treatment. Our country needs to treat those with the severe brain diseases of schizophrenia, schizo-affective disorder, and bi-polar disorder just as we would Alzheimer’s disease and Parkinson’s disease. Those with severe mental illness, who have no insight into their illness, should not be allowed to dictate their own treatment. If a homeless person is brought to San Francisco General Hospital and is found to be a schizophrenic in psychiatric …