The aim of this article is to review the recent trials of α7 nicotinic acetylcholine receptor (α7 nAChR) agonists and positive allosteric modulators (PAMs) on the treatment of cognitive decline in schizophrenia. α7 Nicotinic acetylcholine receptor abnormalities in schizophrenia and clinical implications of α7 nAChR agonists and PAMs are also discussed.. SSSFT staff can use the OVID link, or you can request a copy of this article by replying to this email. Please ensure you are clear which article you are requesting.
Accumulating evidence suggests an involvement of oxidative stress in the pathophysiology of schizophrenia. This offers a hypothesis-derived therapeutic approach to hinder oxidative damage and its clinical sequelae. α-Lipoic acid (ALA) is a powerful natural antioxidant indicated to treat diabetic neuropathy. SSSFT staff can use the OVID link, or you can request a copy of this article by replying to this email. Please ensure you are clear which article you are requesting.
Letter. SSSFT staff can use the OVID link, or you can request a copy of this article by replying to this email. Please ensure you are clear which article you are requesting.
This research suggests that contrary to popular opinion delaying exposure to cannabis does not appear to reduce the chances of using more of the drug as an older teenager. However, it does suggest that there does not appear to be a strong relationship between developing psychosis as a trigger to stop using cannabis. Again, this won’t come as a surprise to those working with this age group in the mental health or drug field as they will have witnessed this with the young people they encounter as part of their work.
Several studies and meta-analyses have shown that mortality in people with schizophrenia is higher than that in the general population but have used relative measures, such as standardised mortality ratios. We did a systematic review and meta-analysis to estimate years of potential life lost and life expectancy in schizophrenia, which are more direct, absolute measures of increased mortality. Please contact the library to request a copy of this article - http://bit.ly/1Xyazai
Letter. SSSFT staff can use the OVID link, or you can request a copy of this article by replying to this email. Please ensure you are clear which article you are requesting.
Service data indicates that from a sample of 102 service users 80.4% had their families involved in their care.
In line with offering a combined healthy eating and physical activity programme the service is also piloting the Supporting Health and Promoting Exercise (SHAPE) physical health intervention programme, which uses the expertise of nutritionists, exercise physiologists and health trainers. It is a structured and intensive 12-week course with follow-up over 12 months, which includes a group educational programme and individually tailored exercises sessions.
Throughout the life stages of women with schizophrenia-spectrum disorders (SSD), lower estrogen levels are associated with more severe disease course. At perimenopause in the mid-forties, estrogen levels decline to remain persistently low after menopause. This period is hypothesized to increase relapse risk and reduce antipsychotic effectiveness in preventing relapse.
Commentary on: Chou AIW, Wang Y-C, Lin C-L, et al. Female schizophrenia patients and risk of breast cancer: a population-based cohort study. Schizophrenia Research 2017;188:165–171.
What is already known on this topic
Research into rates of breast cancer in women with schizophrenia shows conflicting results, with reports of increased, decreased and the same risk as the general population. This is despite women with schizophrenia possibly being at increased risk of breast cancer through use of antipsychotic medications, many of which increase prolactin, a hormone involved in cellular differentiation of the mammary glands. This study1 investigated rates of breast cancer in individuals with schizophrenia compared with the general population.. To read the full article, log in using your NHS OpenAthens details.
Commentary on: Chou AIW, Wang Y-C, Lin C-L, et al. Female schizophrenia patients and risk of breast cancer: a population-based cohort study. Schizophrenia Research 2017;188:165–171.
What is already known on this topic
Research into rates of breast cancer in women with schizophrenia shows conflicting results, with reports of increased, decreased and the same risk as the general population. This is despite women with schizophrenia possibly being at increased risk of breast cancer through use of antipsychotic medications, many of which increase prolactin, a hormone involved in cellular differentiation of the mammary glands. This study1 investigated rates of breast cancer in individuals with schizophrenia compared with the general population.. To read the full article, log in using your NHS OpenAthens details.
Two £25 vouchers are up for grabs in the library’s ‘Making the Most of Information’ survey.
To take part, just visit http://goo.gl/AdN4ok by Friday 19th February.
Keith Laws discusses new research examining the effectiveness of cognitive behavioural therapy on improving the quality of life of people with schizophrenia. To read the full article, log in using your NHS OpenAthens details.
The neurodevelopmental hypothesis of psychosis suggests that disrupted white matter (WM) maturation underlies disease onset. In this longitudinal study, we investigated WM connectivity and compared WM changes between individuals at ultra-high-risk for psychosis (UHR) and healthy controls (HCs). To read the full article, log in using your SSSFT NHS OpenAthens details. SSOTP - You can request a copy of this article by replying to this email. Please ensure you are clear which article you are requesting.
Schizophrenia is thought to be a neurodevelopmental disorder with pathophysiological processes beginning in the brain prior to the emergence of clinical symptoms. Recent evidence from neuroimaging studies using techniques such as diffusion tensor imaging has identified white matter abnormalities that are suggestive of disrupted brain myelination and neuronal connectivity. Identifying whether such effects exist in individuals at high risk for developing psychosis may help with prevention and early intervention strategies. In addition, there is preliminary evidence for a role of lipid biology in the onset of psychosis, along with well-established evidence of its role in myelination of white matter tracts. As such, this article synthesises the literature on polyunsaturated fatty acids (PUFAs) in myelination and schizophrenia, hypothesizing that white matter abnormalities may potentially mediate the relationship between PUFAs and schizophrenia.
This cross-sectional study uses a large sample of patients with schizophrenia and healthy controls to determine the association of white matter with information Please contact the library to request a copy of this article - http://bit.ly/1Xyazai
This study tested for differences of white matter integrity between treated and never-treated long-term schizophrenia patients, matched on illness duration, and for differential changes in relation to age in these two groups relative to healthy comparison subjects.. Login at top right hand side of page using your MPFT NHS OpenAthens for full text. SSOTP (legacy account)- Please contact the library to receive a copy of this article - http://bit.ly/1Xyazai
Despite the availability of different antipsychotics for the treatment of schizophrenia, in clinical practice it is somewhat of a struggle to identify an antipsychotic medication for individual patients that they are willing to adhere to. Brexpiprazole is a new molecular entity that is a dopamine receptor partial agonist that differs from aripiprazole in terms of greater potency at serotonin 5-HT1A receptors and less intrinsic activity at dopamine D2 receptors.1 Brexpiprazole received approval in the USA for the treatment of schizophrenia in July 2015......To read the full article, log in using your NHS OpenAthens details
Editorial. : Login at top right hand side of page using your SSSFT NHS Athens for full text. SSOTP - You can request a copy of this article by replying to this email. Please ensure you are clear which article you are requesting.
The proportion of people with mental health disorders who participate in clinical research studies is much smaller than for those with physical health disorders. It is sometimes assumed that this reflects an unwillingness to volunteer for mental health research studies. We examined this issue in a large sample of patients with psychosis. Open Access Article
New-onset psychosis is always disconcerting and alarming for patients, families, and clinicians. Although some acute psychotic disorders are brief and resolve in a short period of time, others progress to schizophrenia or bipolar disorder and have a long-term impact on people’s mental health and quality of life. Substance-induced psychotic disorders are brief psychotic syndromes triggered by substance use that persist for days or weeks after intoxication has resolved. Abundant evidence suggests that individuals presenting to mental health services with substance-induced psychotic disorders have a significant risk of later transition to schizophrenia or, more zgenerally, to a chronic psychotic disorder. A recent meta-analysis (1) of 25 studies providing substance-specific estimates of transition to schizophrenia spectrum disorders among more than 34,000 individuals with substance-induced psychotic disorder estimated a pooled transition rate of 25% across all substances, with differential rates depending on the substance.
What are the implications for practice?
We think our study highlights the complicated internal struggles that people with first episode psychosis have with medication.
Our study highlights how Nurses and Doctors need to try and better understand what it is like to take these drugs and work collaboratively with patients to support them to make informed choices about treatment. Login using your SSSFT NHS Athens for full text. SSOTP - request a copy of the article from the library http://www.sssft.nhs.uk/library
Early intervention services are the established and evidence-based treatment option for individuals with first-episode psychosis. They are time-limited, and care pathways following discharge from these services have had little investigation. We aimed to map care pathways at the end of early intervention treatment in England to determine common trajectories of care.
Laoise Renwick on a systematic review of barriers and facilitators to implementing family support and education in early psychosis intervention programmes.
Open access. Early Intervention in Psychosis (EIP) services have been implemented with the dual aims of preventing harmful outcomes associated with early-onset psychosis and improving prognosis. However, concerns have been raised regarding the ethical implications of involving young people in EIP services. One way to ensure high ethical standards and promote good practice in EIP delivery is through governance of clinical practice. This study aimed to investigate the normative dimensions of good practice in EIP through examination of clinical guideline documents published in England over the past 15 years.
Suzi Gage on a GWAS of lifetime cannabis use, which reveals new risk loci, genetic overlap with psychiatric traits, and a causal influence of schizophrenia.
This article discusses motor behaviors and seeks to explain how research into basal ganglia, cerebellar, and cortico-motor circuit function/dysfunction, grounded in brain circuit-motor behavior relationships, can elucidate our understanding of pathophysiology, provide vital links to other key systems of interest, significantly improve identification and classification, and drive development of targeted individualized treatments. Please contact the library to request a copy of this article - http://bit.ly/1Xyazai
Psychological Medicine; Cambridge Vol. 48, Iss. 16, (Dec 2018): 2776-2785. DOI:10.1017/S0033291718000442
Background
Neurocognitive deficits are often seen as core features of schizophrenia, and as primary determinants of poor functioning. Yet, our clinical observations suggest that individuals who score within the impaired range on standardized tests can reliably perform better in complex real-world situations, especially when performance is embedded within a positive socio-affective context.. To read the full article, log in using your NHS OpenAthens details.
Schizophrenia affects the mental well-being of service users but also their physical and social well-being. This article explores the causes of schizophrenia and how the illness can contribute to self-neglect. The interaction of mental and physical health in people with schizophrenia is explored and how mental health nurses might work with colleagues to help service users to cope. A case study is used to illustrate how healthcare professionals from different backgrounds worked with a service user and his family to help manage his self-care and improve his well-being. To read the full article, log in using your MPFT NHS OpenAthens details.
Evidence from preclinical and clinical studies supports a role for vitamin D deficiency in many mental disorders. In this review, we discuss the role of vitamin D in the aetiology and treatment of schizophrenia and depression and their physical health comorbidities. Although observational studies support a potential association between vitamin D and schizophrenia and depression, sufficient high-quality evidence from clinical trials does not yet exist to establish a place for vitamin D supplementation in optimising clinical response or promoting physical health. Completed randomised controlled trials are needed to provide insights into the efficacy and safety of vitamin D in the management of mental disorders.. To read the full article, log in using your MPFT NHS OpenAthens details.
Psychological Medicine; Cambridge Vol. 49, Iss. 1, (Jan 2019): 75-83. DOI:10.1017/S003329171800051X
Working memory (WM) deficits in schizophrenia (SCZ) have been linked to impairments in the encoding phase that are associated with aberrant neuronal functioning. Similar abnormalities have been observed in unaffected first-degree relatives (REL) and are thus discussed as candidate endophenotypes. The process of WM consolidation – i.e. the formation of durable WM representations – is assumed to be impaired in SCZ, but no study has investigated WM consolidation and neuronal correlates of visual WM encoding in REL before.. To read the full article, log in using your NHS OpenAthens details.
Journal of Abnormal Psychology125.4 (May 2016): 543-549.
Visual integration dysfunction characterizes schizophrenia, but prior studies have not yet established whether the problem arises by the first psychotic episode or worsens with illness duration. To investigate the issue, we compared chronic schizophrenia patients (SZs), first episode psychosis patients (FEs), and well-matched healthy controls on a brief but sensitive psychophysical task in which subjects attempted to locate an integrated shape embedded in noise. To read the full article, log in using your NHS OpenAthens details
Approximately one-third of patients with a psychotic disorder experience visual hallucinations (VH). While new, more targeted treatment options are warranted, the pathophysiology of VH remains largely unknown. Previous studies hypothesized that VH result from impaired functioning of the vision-related networks and impaired interaction between those networks, including a possible functional disconnection between the primary visual cortex (V1) and higher-order visual processing regions. Testing these hypotheses requires sufficient data on brain activation during actual VH, but such data are extremely scarce. To read the full article, choose Open Athens “Institutional Login” and search for “Midlands Partnership”.
Many patients with psychotic disorders have persistent paranoid ideation and avoid social situations because of suspiciousness and anxiety. We investigated the effects of virtual-reality-based cognitive behavioural therapy (VR-CBT) on paranoid thoughts and social participation.. Please contact the library to request a copy of this article - http://bit.ly/1Xyazai
VR may be an effective environment for psychosis patients with agoraphobia. Although patients are aware that VR environments are not real, they very closely match real-world experiences and allow for greater engagement with treatment (Lambe et al., 2020). Psychosis patients are more likely to enter situations within VR that they would otherwise find incredibly distressing in the real world and this allows a safe space for experimentation (Lambe et al., 2020).
Open access. Persecutory delusions may be unfounded threat beliefs maintained by safety-seeking behaviours that prevent disconfirmatory evidence being successfully processed. Use of virtual reality could facilitate new learning.
Aims- To test the hypothesis that enabling patients to test the threat predictions of persecutory delusions in virtual reality social environments with the dropping of safety-seeking behaviours (virtual reality cognitive therapy) would lead to greater delusion reduction than exposure alone (virtual reality exposure).
The study by Daniel Freeman and colleagues published yesterday in the British Journal of Psychiatry looks at using virtual reality to reduce persecutory delusions. I am a medical student in Oxford where the majority of the authors of this research work (*conflict of interest alert*).
Freeman and colleagues suggest one reason why people continue to believe their delusions is that they engage in safety behaviours (things that make them feel safe) which prevent them from discovering and processing evidence that disproves their beliefs.
Virtual reality may offer a way to challenge unfounded beliefs by exposing people to evidence that disproves their delusions and encourages them to stop their safety behaviours.
Psychiatric Rehabilitation Journal Vol. 41, Iss. 1, (Mar 2018): 39-45.
Objective: To examine whether video-based mobile health (mHealth) interventions are feasible, acceptable, understandable, and engaging to people with schizophrenia.. To read the full article, log in using your NHS OpenAthens details.
This study is a good starting point for the researchers to continue their investigations. But it's far too early to be able to tell whether this intervention will ever be introduced into clinical practice in the future.
Some evidence suggests that off-label use of mirtazapine (15 mg) is effective in treatment of acute antipsychotic-associated akathisia (AAA). We analyzed whether a lower dose of mirtazapine (7.5 mg) maintained its antiakathisia properties while exhibiting better tolerability in patients with schizophrenia and mood disorders who developed acute AAA. . MPFT staff can use the OVID link, or you can request a copy of this article by replying to this email. Please ensure you are clear which article you are requesting.
Open access. Comment. Robert Howard and colleagues should be commended for doing the first randomised controlled trial of an antipsychotic agent in patients diagnosed with very late-onset schizophrenia-like psychosis. Individuals with this diagnosis are notoriously difficult to engage in treatment.....
Neuropsychology (Mar 25, 2019). DOI:10.1037/neu0000540
Objective: The present study aimed to comprehensively study the specific neurocognitive constructs underlying verbal memory deficits and their neuroanatomical correlates in first episode psychosis (FEP) patients. Method: A total of 218 FEP patients and 145 healthy participants were examined with the Rey Auditory Verbal Learning Test (a widely used verbal memory measure that provides a range of performance indexes to evaluate memory) and voxel-based morphometry (a neuroimaging analysis technique that allows investigation of focal differences in brain anatomy).. To read the full article, log in using your NHS OpenAthens details.