Symptomatic Remission in a Multiracial Urban Population of Older Adults with Schizophrenia

Bankole, Azziza; Cohen, Carl I.; Vahia, Ipsit V.; Diwan, Shilpa; Palekar, Nikhil; Reyes, Pia; Sapra, Mamta; Ramírez, Paul

doi:10.1097/jgp.0b013e31818af801

Cited by 30 publications

(19 citation statements)

References 36 publications

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“…For persons later into illness, greater social isolation and a greater history of trauma is linked to lesser rates of remission (Bankole et al, 2008). Internalized stigma has also been linked to poorer functional status (Yanos et al, 2008).…”

Section: Rates and Correlates Of Recoverymentioning

confidence: 99%

Recovery and Wellness Amidst Schizophrenia: Definitions, Evidence, and the Implications for Clinical Practice

Lysaker

Roe

Buck

2010

J Am Psychiatr Nurses Assoc

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Emerging evidence from longitudinal studies has suggested that many with schizophrenia can meaningfully recover over time. Recovery, though, is not a uniform process but varies from person to person and can involve a range of different experiences including the attainment of psychosocial milestones, the remission of symptoms, and changes in self-experience or personal narrative. To address the issue of recovery from schizophrenia, this article reviews currently evolving definitions of recovery and possible ways to understand recovery as involving both an objective and two subjective dimensions. Emerging operational definitions are explored and then empirical research is reviewed regarding actual rates and forms of recovery. It is concluded that although many with schizophrenia experience significant challenges linked with illness over time, more people than not experience meaningful periods of relative wellness. Implications for how daily practice can reinforce and promote recovery are discussed.

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Section: Rates and Correlates Of Recoverymentioning

confidence: 99%

Recovery and Wellness Amidst Schizophrenia: Definitions, Evidence, and the Implications for Clinical Practice

Lysaker

Roe

Buck

2010

J Am Psychiatr Nurses Assoc

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“…IQ), memory, and to a lesser degree, attention (Mintz et al ., ; Aleman et al ., ; Shad et al ., ; Orfei et al ., ; De Hert et al ., ; Mohamed et al ., ; Trevisi et al ., ; Gerretsen et al ., 2013b, 2013a; Mingrone et al ., ). Positive symptoms attenuate and cognitive function appears to decline with age, while the effects of aging on negative symptoms are mixed (Cohen et al ., , ; Rajji and Mulsant, ; Rajji et al ., ). As such, one's insight into illness may change as a function of the aging process.…”

Section: Introductionmentioning

confidence: 99%

The effects of aging on insight into illness in schizophrenia: a review

Gerretsen

Plitman

Rajji

et al. 2014

Int J Geriat Psychiatry

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Objectives Impaired insight into illness is a prevalent feature of schizophrenia, which negatively influences treatment adherence and clinical outcomes. Little is known about the effects of aging on insight impairment. We aimed to review the available research literature on the effects of aging on insight into illness in schizophrenia, in relation to positive, negative, and cognitive symptoms. Ultimately, we propose a trajectory of insight in schizophrenia across the lifespan. Method A systematic Medline® literature search was conducted, searching for English language studies describing the relationship of insight into illness in schizophrenia with aging. Results We identified 62 studies. Insight impairment is associated with illness severity, premorbid intellectual function (i.e. IQ), executive function, and memory. Insight impairment improves modestly during midlife, worsening again in late life. It tends to fluctuate with each episode of psychosis, likely in relation to worsening positive symptoms that improve with antipsychotic treatment. The relationship between insight impairment and cognitive dysfunction appears to attenuate with age, while the relationship with lower premorbid intellectual function is preserved. The association between impaired insight and negative symptoms is unclear. Conclusions The available literature suggests that the course of insight impairment follows a U-shaped curve, where insight impairment is severe during the first episode of psychosis, modestly improves over midlife, and declines again in late life. Future studies are required to investigate the trajectory of insight into illness and its core domains across the lifespan from prodromal phase to late life.

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“…Of note, changes from the DSM-IV-TR to the DSM-5 emphasize the likely instability of schizoaffective disorder over time. 31–33 Also, the focus of the parent study on psychosocial variables did not include detailed data on medications, dosages, and side effects, potentially consisting of unmeasured factors that might affect differences detected in physical and mental health outcomes. In addition, our measures of hospitalization did not differentiate between psychiatric versus medical hospitalization.…”

Section: Discussionmentioning

confidence: 99%

Characteristics and Service Use of Older Adults with Schizoaffective Disorder Versus Older Adults with Schizophrenia and Bipolar Disorder

Rolin

Aschbrenner²,

Whiteman

et al. 2017

The American Journal of Geriatric Psychiatry

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Objective The purpose of this study was to determine if schizoaffective disorder in older adults is differentiated from schizophrenia and bipolar disorder with respect to community functioning, cognitive functioning, psychiatric symptoms, and service use. Design Secondary analysis of baseline data collected from the Helping Older People Experience Success psychosocial skills training and health management study. Setting Three community mental health centers in New Hampshire and Massachusetts. Participants Adults over the age of 50 (N = 139, mean age: 59.7 years, SD: 7.4 years) with persistent functional impairment and a diagnosis of schizoaffective disorder (N = 52), schizophrenia (N = 51), or bipolar disorder (N = 36). Measurements Health status (36-Item Short Form Health Survey [SF-36]), performance-based community living skills (UCSD Performance-Based Skills Assessment), neuropsychological functioning (Delis-Kaplan Executive Functioning subtests), psychiatric symptoms (Brief Psychiatric Rating Scale, Center for Epidemiologic Studies Depression Scale, Scale for the Assessment of Negative Symptoms), medical severity (Charlson comorbidity index), and acute service use. Results Older adults with schizoaffective disorder had depressive symptoms of similar severity to bipolar disorder, and thought disorder symptoms of similar severity to schizophrenia. Schizoaffective disorder compared with schizophrenia was associated with better community functioning, but poorer subjective physical and mental health functioning as measured by the SF-36. Older adults with schizoaffective disorder had greater acute hospitalization compared with adults with schizophrenia, though their use of acute care services was comparable to individuals with bipolar disorder. Conclusions Findings from this study suggest that schizoaffective disorder in older adults occupies a distinct profile from either schizophrenia or bipolar disorder with respect to community functional status, symptom profile, and acute services utilization.

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Symptomatic Remission in a Multiracial Urban Population of Older Adults with Schizophrenia

Cited by 30 publications

References 36 publications

Recovery and Wellness Amidst Schizophrenia: Definitions, Evidence, and the Implications for Clinical Practice

Recovery and Wellness Amidst Schizophrenia: Definitions, Evidence, and the Implications for Clinical Practice

The effects of aging on insight into illness in schizophrenia: a review

Characteristics and Service Use of Older Adults with Schizoaffective Disorder Versus Older Adults with Schizophrenia and Bipolar Disorder

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