A One Year Prospective Study of the Effect of Life Events and Medication in the Aetiology of Schizophrenic Relapse

Hirsch, Steven R.; Bowen, Jo; Emami, Javad; Cramer, P.; Jolley, Anthony; Haw, Camilla; Dickinson, Mark

doi:10.1192/bjp.168.1.49

Cited by 123 publications

(48 citation statements)

References 19 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…3). Individual variation in minimum dose required in relapse-free maintenance treatment is also difficult to assess, because, in typical cases, relapse does not occur immediately on withdrawal or on dose reduction, but in a probabilistic fashion, sometime in the next year or two [39,54,58,60,69,90,111]. This principle also applies to atypical antipsychotic drugs [47,157].…”

Section: Neuroleptic-resistant Psychosis and Individual Differences mentioning

confidence: 99%

Mechanisms of Action of Antipsychotic Drugs of Different Classes, Refractoriness to Therapeutic Effects of Classical Neuroleptics, and Individual Variation in Sensitivity to their Actions: PART I

Miller

2009

View full text Add to dashboard Cite

Many issues remain unresolved about antipsychotic drugs. Their therapeutic potency scales with affinity for dopamine D2 receptors, but there are indications that they act indirectly, with dopamine D1 receptors (and others) as possible ultimate targets. Classical neuroleptic drugs disinhibit striatal cholinergic interneurones and increase acetyl choline release. Their effects may then depend on stimulation of muscarinic receptors on principle striatal neurones (M4 receptors, with reduction of cAMP formation, for therapeutic effects; M1 receptors for motor side effects). Many psychotic patients do not benefit from neuroleptic drugs, or develop resistance to them during prolonged treatment, but respond well to clozapine. For patients who do respond, there is a wide (>ten-fold) range in optimal doses. Refractoriness or low sensitivity to antipsychotic effects (and other pathologies) could then arise from low density of cholinergic interneurones. Clozapine probably owes its special actions to direct stimulation of M4 receptors, a mechanism available when indirect action is lost.

show abstract

Section: Neuroleptic-resistant Psychosis and Individual Differences mentioning

confidence: 99%

Mechanisms of Action of Antipsychotic Drugs of Different Classes, Refractoriness to Therapeutic Effects of Classical Neuroleptics, and Individual Variation in Sensitivity to their Actions: PART I

Miller

2009

View full text Add to dashboard Cite

show abstract

“…The association of stressful life events (Hirsch et al, 1996) and stressful home environments (Kuipers & Bebbington, 1988) with relapse among people with schizophrenia adds weight to this model and its predictions.…”

Section: Cognitive-behavioural Interventionsmentioning

confidence: 99%

Schizophrenia: early warning signs

Birchwood¹,

Spencer²,

McGovern³

2000

Adv. psychiatr. treat

152

View full text Add to dashboard Cite

Relapse in schizophrenia remains common and cannot be entirely eliminated even by the best combination of biological and psychosocial interventions (Linszen et al, 1998). Relapse prevention is crucial as each relapse may result in the growth of residual symptoms (Shepherd et al, 1989) and accelerating social disablement (Hogarty et al, 1991). Many patients feel ‘entrapped’ by their illnesses, a factor highly correlated with depression (Birchwood et al, 1993), and have expressed a strong interest in learning to recognise and prevent impending psychotic relapse.

show abstract

“…The association between stressful life events and onset and relapse of schizophrenia has been shown previously (Day et al, 1987;Ventura et al, 1989;Malla et al, 1990;Hirsch et al, 1996). Rather than simply peaking in the few weeks before a relapse and acting merely as a trigger, it has been reported that an increased rate of life events occur over a more lengthy period before the onset of psychosis (McDonald and Murray, 2000).…”

Section: Discussionmentioning

confidence: 89%

“…The earliest of these are complications of pregnancy and birth, while late environmental risk factors have been identified as immigrant status, chronic cannabis abuse, and adverse life events (McDonald and Murray, 2000). Many studies have reported an excess of stressful life events in the few weeks before the onset or relapse of schizophrenia (Day et al, 1987;Ventura et al, 1989;Malla et al, 1990;Hirsch et al, 1996). The fine-tuning of the brain connections under the influence of stress and hormones may ultimately lead to neurodegeneration, loss of brain mass, and overt psychosis (Tsuang, 2000).…”

Section: Introductionmentioning

confidence: 98%

Effects of the Adverse Life Events and Disrupted in Schizophrenia-1 (DISC1) Gene Polymorphisms on Acute Symptoms of Schizophrenia

Sayin

Yüksel

Konac

et al. 2013

DNA and Cell Biology

View full text Add to dashboard Cite

The aim of this study was to evaluate the effects of traumatic childhood events and recent adverse life events, as well as the Disrupted in Schizophrenia-1 (DISC1) gene polymorphisms on types of last acute symptoms of patients with schizophrenia. Hundred patients with schizophrenia were given the Childhood Trauma Questionnaire, the Social Readjustment Rating Scale, Scale for Assessment of Positive Symptoms (SAPS), Scale for Assessment of Negative Symptoms (SANS), Brief Psychiatric Rating Scale (BPRS), and Calgary Depression Scale for Schizophrenia (CDSS). The patients' and healthy controls' DISC1 gene was evaluated for the -274G>C, c.791G>A, and c.2110A>T polymorphisms. There was no statistically significant difference with regard to the DISC1 gene polymorphisms between patient and healthy control groups. No significant relationship was found between the -274G>C, c.791G>A, and c.2110A>T haplotypes and development of different acute symptoms of schizophrenia. Having a recent stressful life event significantly affected SAPS (95% confidence interval [CI]=-67.547, -21.473; p=0.00) and BPRS-1 scores (95% CI=-51.405, -6.885; p=0.01), whereas emotional abuse at childhood significantly affected SANS scores (95% CI=-37.300, -10.401; p=0.00). This study shows that features of acute symptoms in schizophrenia are not influenced by the polymorphisms on the DISC1 gene, but are influenced by recent adverse life events and emotional abuse at childhood.

show abstract

A One Year Prospective Study of the Effect of Life Events and Medication in the Aetiology of Schizophrenic Relapse

Cited by 123 publications

References 19 publications

Mechanisms of Action of Antipsychotic Drugs of Different Classes, Refractoriness to Therapeutic Effects of Classical Neuroleptics, and Individual Variation in Sensitivity to their Actions: PART I

Mechanisms of Action of Antipsychotic Drugs of Different Classes, Refractoriness to Therapeutic Effects of Classical Neuroleptics, and Individual Variation in Sensitivity to their Actions: PART I

Schizophrenia: early warning signs

Effects of the Adverse Life Events and Disrupted in Schizophrenia-1 (DISC1) Gene Polymorphisms on Acute Symptoms of Schizophrenia

Contact Info

Product

Resources

About