24July2010
Posted by Anna under: Articles of interest.
NEW YORK (Reuters Health) Jul 20 – Even when a year has passed since a first schizophrenia episode, maintenance therapy is better than intermittent drug treatment, according to results from a randomized trial in Germany.
Clinical practice guidelines already recommend antipsychotic maintenance treatment for at least a year after a first schizophrenia episode. “Based on our findings, patients should be advised to further maintain antipsychotic treatment for at least two years, given the otherwise noticeable higher risk for relapse,” lead author Dr. Wolfgang Gaebel from Heinrich-Heine-University, Duesseldorf, told Reuters Health by e-mail.
Dr. Gaebel and colleagues compared a second year of maintenance treatment versus stepwise drug discontinuation and targeted intermittent treatment in 44 patients who had already completed 12 months of antipsychotic therapy.
There were no relapses in the maintenance treatment group, compared with four relapses (19%) in 21 patients in the intermittent treatment group (p = 0.04), the researchers reported online June 29th in the Journal of Clinical Psychiatry.
23July2010
Posted by Anna under: Articles of interest.
Gene Protects Cognitive Function in SchizophreniaA gene has been found in some people with schizophrenia that can help protect cognitive ability.
While it may put individuals at risk for schizophrenia in the first place, schizophrenic patients with the at-risk gene performed better on certain tests of cognitive function than patients with a less risky variant of the same gene.
Dr. James T.R. Walters of the Medical Research Council for Neuropsychiatric Genetics and Genomics at Cardifff University in Wales, and his colleagues found preserved memory with a variation in the gene known as the Zinc Finger Protein 804A.
Prior research has implicated the Zinc Finger Protein 804A gene (ZNF804A) as a risk factor for schizophrenia. Alleles are different variations of the same gene, and one allele of the ZNF804A gene seems to be more commonly present in patients with psychiatric diagnoses such as schizophrenia and bipolar disorder. While its exact function remains elusive, some researchers suspect that the ZNF804A gene affects communication in the brain……
Reported by Jessica Ward Jones, MD, MPH Associate News Editor
PsychCentral
http://psychcentral.com/news/2010/07/16/gene-protects-cognitive-function-in-schizophrenia/15670.html
Dr. Walter’s results can be found in the July issue of the Archives of General Psychiatry.
Submitted by Anna
22July2010
Posted by Anna under: Articles of interest.
NASAL sprays containing the hormone oxytocin, nicknamed the “cuddle chemical” because it helps mothers bond with their babies, have helped people with schizophrenia.
Although the 15 participants used the sprays for three weeks only, most reported measurable improvements in their symptoms in this the first trial to test oxytocin in schizophrenia. “It’s proof of concept that there’s therapeutic potential here,” says David Feifel at the University of California in San Diego, head of the team running the trial.
Each participant received oxytocin or a placebo for three weeks, then the opposite treatment for three weeks with a week break in between.
On the basis of two standard tests for schizophrenia, taken before and after each block of treatment, participants averaged improvements of around 8 per cent when taking the oxytocin compared with the placebo (Biological Psychiatry, DOI: 10.1016/j.biopsych.2010.04.039).
Reported by Andy Coghlan
NewScientist Health
http://www.newscientist.com/article/mg20727694.300-cuddle-chemical-eases-symptoms-of-schizophrenia.html
submitted by Anna
14July2010
Posted by Anna under: Articles of interest.
Three top neuroscientists are betting big money and their scientific careers on a new approach to studying schizophrenia and other psychiatric diseases. With help from philanthropists, they are launching an institute that will look for treatments by probing early brain development for the origins of mental illness. The nonprofit Lieber Institute for Brain Development will be led by Daniel Weinberger of the National Institute of Mental Health. Ronald McKay of the National Institute of Neurological Disorders and Stroke will be director of basic science. Both will leave government jobs for the new institute, which will be an independent affiliate of the adjacent Johns Hopkins University. The institute’s third founder and elder statesman is Johns Hopkins neuropharmacologist Solomon Snyder. ……
Reported by Jocelyn Kaiser
Science 9 July 2010:
Vol. 329. no. 5988, p. 130
Submitted by Anna
11July2010
Posted by Anna under: Articles of interest.
Adding electroconvulsive therapy (ECT) to clozapine is an effective treatment for patients with clozapine-resistant schizophrenia, researchers reported at the New Clinical Drug Evaluation Unit 50th Anniversary Meeting.
Clozapine is the drug of last resort for patients with treatment-resistant schizophrenia, but up to 70% of patients do not respond, said lead study author Georgios Petrides, MD, from the Zucker Hillside Hospital, Northshore-Long Island Jewish Health System, Glen Oaks, New York.
“We had nothing that works for these patients. They had failed every medication, and they were on clozapine and even then they had psychotic symptoms,” Dr. Petrides told Medscape Psychiatry. “ECT worked before the advent of medications, but we really didn’t have good studies to prove that it did. This is the first ECT study to be done in this population.”
Reported by Fran Lowry
Medscape Medical News
http://www.medscape.com/viewarticle/724040
Submitted by Anna
11July2010
Posted by Anna under: Articles of interest.
Patients with serious and persistent mental illness have significantly more years of potential life lost (YPLL) than do those without the disorders, according to a new retrospective study.
Although suicide, cancer, accidents, liver disease, and septicemia all contributed to increased premature mortality in the study’s mentally ill participants compared with a general population sample, the leading cause of death for both groups was heart disease, according to the researchers.
“We found that a community-based sample of adults with severe and persistent mental illness lost 14.5 years of potential life, a difference of 4.2 years from the [control] sample,” write lead study author Elizabeth E. Piatt, PhD, from the Department of Behavioral and Community Health Sciences at Northeastern Ohio Universities Colleges of Medicine and Pharmacy in Rootstown, and colleagues.
Reported by Deborah Brauser
Medscape Medical News
http://www.medscape.com/viewarticle/724871
Publish in Psychiatr Serv. 2010;61:663-668.
Submitted Anna
11July2010
Posted by Anna under: Articles of interest.
A new study confirms that first-trimester exposure to valproic acid is associated with an increased risk for spina bifida compared with no use of antiepileptic drugs or with use of other antiepileptic drugs.
The study also links first-trimester valproic acid exposure to increased risk for 5 other congenital malformations: atrial septal defect, cleft palate, hypospadias, polydactyly, and craniosynostosis.
Reoported Megan Brooks
CME Author: Désirée Lie, MD, MSEd
Medscape Clinical Briefs
http://cme.medscape.com/viewarticle/723326?src=cmemp&uac=30831FZ
submitted by Anna
11July2010
Posted by Anna under: Articles of interest.
Pregnant women who use antidepressants have a 68% increased risk of miscarriage compared with those who do not take the medications, according to results from a new case-control study.
Reported by Deborah Brauser
CME Author: Désirée Lie, MD, MSEd
Medscape Clinical Briefs
http://cme.medscape.com/viewarticle/723297?src=cmemp&uac=30831FZ
submitted by Anna
11July2010
Posted by Anna under: Articles of interest.
Results of a new study provide the first evidence that early neonatal brain development may be abnormal in males at increased genetic risk for schizophrenia, the researchers say.
Limitations of Study
The relatively small number of study subjects, which had 0.8 power to detect differences in gray matter volume of about 10%, is 1 limitation of the study.
The fact that most of the mothers of the high-risk infants took antipsychotics during pregnancy is another. Studies in nonhuman primates suggest that long-term antipsychotic exposure can affect cortical gray matter volume.
Mothers of high-risk infants were also more likely to have smoked tobacco or used illicit substances while pregnant, which could have confounded the results. Although there were no differences in volumes between the high-risk neonates exposed to maternal smoking and those not exposed.
Reported by Megan Brooks
Medscape Medical News
http://www.medscape.com/viewarticle/724127?src=mpnews&spon=12&uac=30831FZ
Study Published in Am J Psychiatry. Published online June 1, 2010.
Submitted by Anna
29June2010
Posted by Anna under: Articles of interest.
A federal appeals court has ruled that New York State must comply with a lower court’s order to begin immediately transferring thousands of people with mental illness in New York City out of large, institutional group homes and into their own homes and apartments, where they will continue to receive specialized treatment and services.
The decision by a two-judge panel of the United States Court of Appeals for the Second Circuit to lift a stay of the lower court order means that after seven years of litigation, the state must now hurriedly begin the process of developing and executing a plan to create at least 1,500 units of so-called supportive housing a year for the next three years at state expense.
“Certainly it’s a complicated and important process that hopefully won’t get bogged down in bureaucracy,” said Geoff Lieberman, executive director of the Coalition of Institutionalized Aged and Disabled, an organization of adult homes and nursing home residents. “We’re hoping that there are a good number of adult home residents who will be able to move over the next 6 to 12 months.”
A spokesman for Gov. David A. Paterson said the state, wrestling with severe budget deficits, was in the process of determining its next steps.
Last September, Judge Nicholas G. Garaufis of United States District Court in Brooklyn found that the state had violated the Americans With Disabilities Act by keeping approximately 4,300 people with mental illness isolated from the outside world in warehouselike conditions in more than two dozen privately run adult homes. The state pays the homes for their care.
Over the vehement objection of the state and the owners of the homes, Judge Garaufis issued a remedial plan in March.
The plan would give nearly all current and future adult home residents the opportunity to move into supported housing scattered throughout the boroughs, where they would live independently while also receiving assistance like case-management services and visits from psychiatrists and nurses.
The state, which argued that advocates for residents of adult homes had overestimated the demand for and underestimated the cost of supported housing, appealed the decision.
An appeals court judge granted a temporary stay of the lower court’s order, but the court lifted that stay on Wednesday even though the appeal has not been decided. That places the state under the watch of a court monitor to ensure compliance with the ruling in the months before the appeal is heard.
“The expectation under this order is that they will be moving at a fast clip, and housing should be created as this appeal is pending,” said Cliff Zucker, the executive director of Disability Advocates, the nonprofit legal services group that filed the lawsuit. “People are clamoring to leave adult homes and get into supported apartments.”
Maggie McQuillar, a resident of Harbor Terrace Adult Home and Assisted Living on Staten Island, was among those eager to move out of a shared bedroom and live on her own. “I’m a senior citizen with a disability, but I can take care of myself,” said Ms. McQuillar, 68, who said she had diabetes and bipolar disorder.
“I’d be better off in a studio or one-bedroom,” she said. “Once you get here, you sort of get stuck here.”
Reported by A. G. SULZBERGER
The New York Times
Submitted by Anna
