Handbook of Schizophrenia Spectrum Disorders, Volume II (eBook)

Foreword 5
Schizophrenia Spectrum Disorders: Insights from Views Across 100 years 5
Contents 9
Contributors 12
1 Negative Symptoms Across the Schizophrenia Spectrum: Phenomenological and Neurobiological Perspectives 17
Introduction 18
The Negative Symptoms of Schizophrenia 19
Definition and Assessment 19
Negative Symptoms and Cognitive Dysfunction in Schizophrenia 20
Negative Symptoms in Schizophrenia -- Two Distinct Subdomains 21
Further Refinements of the Negative Symptom Construct 23
Negative Symptoms and Functional Outcomes in Schizophrenia 26
Negative Symptoms in Schizoaffective Disorder 27
Negative Symptoms in the Schizophrenia Prodrome 28
Negative Symptoms in Schizophrenia-Spectrum Personality Disorders 29
Negative Symptoms in the Schizophrenia Spectrum -- Neurobiological Underpinnings 31
Structural and Functional Imaging Studies 31
Investigations of the Deficit Syndrome 33
Neurobiological Correlates of Specific Negative Symptoms in Schizophrenia 34
The Role of Dopamine Dysregulation in the Negative Symptoms of Schizophrenia 36
Neurobiological Correlates of Negative Symptoms in Schizophrenia Spectrum Illnesses 38
Conclusions and Future Directions 38
References 39
2 Neurocognitive Deficits, Negative Symptoms, and Insight in Schizophrenia 49
Definitions and Conceptual History 50
Epidemiology 54
Demographic Variables 54
Breadth of Impairments: Genetics, Family Histories and First Degree Relatives 55
Breadth of Impairments: Schizophrenia Spectrum and Other Disorders 56
Neurobiological Considerations 58
Brain Structural Abnormalities 59
Brain Neurotransmission Abnormalities 61
Functional Changes in Brain Activity 64
Clinical Considerations and Diagnosis 65
Course 70
Premorbid and First Episode (FE) 70
Long Term Course 72
Treatment Considerations 74
Biological Interventions 74
Antipsychotics 74
Second Generation Antipsychotics (SGAs) 74
Other Biological Interventions 75
Psychological Interventions 76
Cognitive Remediation in Schizophrenia 76
Functional Relevance of Cognition, Negative Symptoms and Insight in Schizophrenia 77
Cross Relationships 79
Discussion 80
References 80
3 Stress, Dissociation and Schizophrenia 91
Consciousness and Schizophrenia 91
Bleuler, Janet and the Concept of Schizophrenia 93
Dissociation, Stress Sensitization and Schizophrenia 96
Conclusions and Future Directions 98
References 99
4 Understanding the Role of Emotion in Psychosis: Social Anxiety Disorder in First-Episode Psychosis 104
Introduction 105
Affect and Psychosis: Evidence Towards a Link 105
Social Anxiety Disorder 106
What Is Social Anxiety? 106
Epidemiology 108
Co-morbidity 108
Developmental Psychopathology of Social Anxiety 110
Parenting Style 112
Attachment 113
The Role of Childhood Trauma 115
The Presence of Social Anxiety in Psychosis 116
Prevalence and Phenomenology 116
Social Anxiety and Relationship with Paranoia 117
Social Anxiety in Psychosis: a Psychological Reaction? 118
Clinical Implications and Future Directions 119
Conclusions 120
References 120
5 Face Perception in Schizophrenia Spectrum Disorders: Interface Between Cognitive and Social Cognitive Functioning 126
Introduction 127
Peceptual Processing of Non-affective Facial Information 128
Cortical Processing of Non-affective Facial Information 130
Associations of Affective and Non-affective Face Perception 131
Conclusions and Future Directions 132
References 132
6 Toward a Neuroethology of Schizophrenia: Findings from the Crimean Project 136
Introduction 137
The Crimean Neuroethology Project 141
Method 142
Design 142
Participants 142
Assessments 143
Results 146
Elements of Behaviour 146
Patterns and Dynamic Phenomena of Behaviour 155
Manipulation Activity 157
Typology and Dynamics of Complex Forms of Behaviour 161
Comparative Evolutionary Research 166
Discussion and Future Directions 168
Appendix 1: Research Indices 170
Appendix 2: Some Ethological Definitions in the Crimean Neuroethology Project 171
Dynamic Valuation of Behaviour 171
Patterns of Behaviour 171
Some Complex Forms (Contexts) of Behaviour 173
References 174
7 Quality of Life Deficit Is a Core Presentation of Functional Psychoses 180
Health Related Quality of Life 181
HRQL in Functional Psychoses 182
Shaar Menashe Quality of Life Project 182
Design 182
Participants 183
Instruments 184
SZ/SA Patients Versus Healthy Subjects 187
Comparison Between Functional Psychoses 187
Course of HRQL Deficits 188
A 2-Year Follow Up Study 188
A 10-Year Follow Up Study 188
HRQL Models 195
A Conceptual Integrative Model 195
Mediational Model 195
Distress/Protection Vulnerability Model 195
HRQL Impairment Syndrome 196
Conclusions and Future Directions 198
Appendix 1: Quality of Life Enjoyment and Satisfaction Questionnaire -- Abbreviated Version (Q-LES-Q-18) 200
Appendix 2: Distress Scale for Adverse Symptoms (DSAS) 201
Appendix 3: Talbieh Brief Distress Inventory (TBDI) 202
References 203
8 Early Onset Schizophrenia 210
Introduction 211
Symptoms and Diagnosis 212
Etiology and Pathophysiology 213
Assessment 214
Treatment 215
Conclusion and Future Directions 217
References 218
9 Prediction and Early Detection of First-Episode Psychosis 221
Prevention of Psychiatric Disorders 222
The Prodrome of Psychosis 223
Prediction of First-Episode Psychosis 224
Prodromal Criteria of the DSM-III and Its Revision 224
Ultra-High Risk Criteria 225
Transition Rates in UHR Samples 239
UHR-Like Approaches 240
Clinical High Risk Criteria 240
FEPSY Criteria 253
Basic Symptom Criteria 254
Integrative Approaches 256
Early and Late Initial Prodromal State Criteria 256
UHR-BS Criteria 256
Exclusion Criteria 257
Transition Criteria 265
Resume of Current Early Detection 266
Future Directions 267
Risk Enrichment and Stratification 267
At-Risk Criteria and DSM-V 269
Conclusion 270
Appendix: Criteria of the Attenuated Psychotic Symptoms Syndrome Recommended by the DSM-V Development Work Group as of May-17-2010 (http://www.dsm5.org/ProposedRevisions/Pages/proposedrevision.aspx?rid=412#) 271
References 274
10 Schizophrenia Spectrum Disorders in Relation to the Totality of Psychosis: From First Episode to Long-Term Outcome 282
Introduction 283
The Cavan-Monaghan First Episode Psychosis Study 284
Epidemiology 284
Duration of Untreated Psychosis 285
Psychopathology 285
Neuropsychology and Neurological Soft Signs 286
Interim Synthesis -- At the First Episode 286
Long-Term Follow-Up 288
Diagnostic Stability 288
Psychopathology 288
Global Assessment of Functioning 289
Quality of Life 289
Service Engagement 289
Interim Synthesis -- At Long-Term Follow-Up 289
Conclusions and Future Directions 290
References 291
11 Course of Schizophrenia: What Has Been Learned from Longitudinal Studies? 293
Introduction 294
Hypothesized Protective Factors 294
Hypothesized Negative Factors 295
Tools Used 296
Longitudinal Studies 298
Pre-antipsychotic Era Institutionalization Studies 298
Post-antipsychotic Era Institutionalization Studies 299
De-institutionalization Studies 300
Discussion 304
Conclusion and Future Directions 305
References 306
12 Late-Onset Schizophrenia: Epidemiology, Clinical Profile, Prognosis, and Treatment Considerations 313
Late-Onset Schizophrenia, Historical and Diagnostic Issues 314
The Differential Diagnoses 315
Prevalence and Incidence of LOS and VLOSLP 317
Community Surveys 317
Clinical Studies 317
Risk Factors 318
Psychopathology of LOS and VLOSLP 319
Neuropsychology 323
Genetics 323
Brain Imaging 324
Other Studies on Organicity 325
Treatment of LOS and VLOSLP 326
The Prognosis for LOS and VLOSLP 327
The Etiopathology of LOS and VLOSLP 329
Conclusions and Future Directions 330
References 332
13 Neurological and Neuropsychological Endophenotypes in Schizophrenia Spectrum Disorders 336
Neurological Endophenotypes 337
NSS in Schizophrenia 338
Heritability and Genetic Correlates of NSS 338
Clinical and Cognitive Correlates of NSS 340
Effects of Medication on NSS 342
MPAs in Schizophrenia 343
Heritability and Genetic Correlates of MPAs 344
Clinical and Cognitive Correlates of MPAs 345
Neuropsychological Endophenotypes 345
Verbal Learning and Memory 347
Attention 348
Executive Function 350
Conclusions and Future Directions 351
References 353
14 The Association of Metacognition with Neurocognition and Function in Schizophrenia: Advances from the Study of Personal Narratives 361
Introduction 362
Theoretical Impetus for Investigating the Relation Between Neurocognition and Metacognition 363
Limitations of Current Research on Metacognition and Neurocognition 363
Three Studies: Neurocognition and Metacognitive Capacities 366
Metacognition, Neurocognition and Functioning 370
Summary, Limitations and Conclusions 372
References 373
15 The Relationship of Acute Transient Psychoses and Schizophrenia 376
Introduction 377
European Views on Acute Transient Psychoses 377
Bouffée Délirante 377
Cycloid Psychoses 378
Psychogenic or Reactive Psychosis 379
Schizophreniform States 380
Modern Psychiatric Classifications 380
Acute and Transient Psychotic Disorders (ICD-10 F23) 381
Shortcomings of ATPD 381
ATPD Is a Composite Category 381
The Subcategories Have Poor Reliability 383
ATPD Bears Little Continuity with the Traditional Categories of European Psychiatry 384
ATPD Does Not Conform to Any Specific Category in DSM-IV 385
Clinical Features 385
Epidemiology 385
Predisposing Factors 386
Precipitating Factors 387
Diagnostic Stability and Outcome 387
The Non-affective Acute Remitting Psychoses 389
Conclusions and Future Directions 390
References 391
16 Schizophrenia and Depression -- Challenging the Paradigm of Two Separate Diseases 397
Introduction 398
Categorical Versus Dimensional Definitions 398
Depressive Symptoms in Schizophrenia 399
Affective Symptoms as Risk Factors and Precursors of Psychosis 400
Depression at the Prodromal Stage of Schizophrenia 401
Depressive Symptoms in Full-Blown Schizophrenia 404
Conclusions and Future Directions 406
References 408
17 Schizo-Obsessive Disorder 411
Introduction 412
Concept and Diagnosis 412
Epidemiology 414
Ethiology 420
Genetic Factors 420
Environmental Factors 421
Phatophysiology 423
Psychopathology 425
Obsessive-Compulsive Symptoms 425
Psychotic Symptoms 427
Neurocognition 438
Treatment 445
Prognosis 447
Conclusions and Future Directions 447
References 449
18 Neurophysiology of Cognitive Dysfunction in Schizophrenia 457
Introduction 458
Basic Neurophysiology 458
Neurophysiology of Perceptual Processes in Schizophrenia 464
Neural Correlates of Visual Processing 464
Neural Processing of Auditory Information 466
The Steady-State Response 467
Sensory Gating 467
N1 468
Neurophysiological Cognitive Markers of Schizophrenia 469
MMN 469
Mechanisms of Cognitive Deficits: The Example of Working Memory 473
Neurophysiology and Molecular Mechanisms of Schizophrenia 476
GABA 476
Glutamate 477
Dopamine 478
Cholinergic System 478
Conclusions and Future Directions 479
References 480
19 Schizophrenia Spectrum Disorders and Risk for Cancer Morbidity and Mortality 489
Introduction 490
Risk Factors 491
Life Style 491
Medication 491
Service-Related Risks 492
Cancer Morbidity 492
Aggregated Rates 493
Breast Cancer 493
Lung Cancer 494
Prostate Cancer 494
Family Studies 495
Cancer in Bipolar and Schizoaffective Disorders 496
Cancer Mortality 497
Cellular and Molecular Explanations 498
Signal Transduction Explanations 499
Apoptosis 500
Psychotropic Drugs Effects 501
Antipsychotics 501
Antidepressants 501
Ascertainment Bias 503
Conclusion and Future Directions 503
References 503
Afterword 512
The Future of the Schizophrenia Construct and Acquisition of New Knowledge 512
References 515
Contents to Volume I 516
Contents to Volume III 518
Contributors to Volume I 520
Contributors to Volume III 525
Index 529