Early interventions in risk groups for schizophrenia: what are we waiting for?

Sommer, Iris; Bearden, Carrie E.; Dellen, Edwin van; Breetvelt, Elemi J.; Duijff, Sasja N.; Maijer, Kim; Amelsvoort, Thérèse van; Haan, Lieuwe de; Gur, Raquel E.; Arango, Celso; Díaz‐Caneja, Covadonga M.; Vinkers, Christiaan H.; Vorstman, Jacob

doi:10.1038/npjschz.2016.3

Cited by 118 publications

(87 citation statements)

References 119 publications

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“…Moreover, more refined measures of cognition and behavior, in combination with other predictors, may improve our capacity to identify those at high risk for later disorder and provide opportunities for early intervention. While one aim of intervention may eventually be to attempt the ambitious goal of preventing later psychosis (Sommer et al, 2016), childhood interventions can also be reasonably designed to improve the functional capacity of children with clear behavioral or cognitive impairments (Seidman and Nordentoft, 2015), such as family-oriented cognitive behavioral interventions for those with behavior problems (Uher et al, 2014). …”

Section: Discussionmentioning

confidence: 99%

The interplay of childhood behavior problems and IQ in the development of later schizophrenia and affective psychoses

Agnew-Blais

Seidman

Fitzmaurice

et al. 2017

Schizophrenia Research

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Schizophrenia and affective psychoses are both associated with impaired social functioning, but the extent to which childhood behavioral impairments are present prior to onset of illness is less well studied. Moreover, the concurrent relationship of childhood behavior problems and premorbid IQ with subsequent psychotic disorder has not been established. We investigated whether childhood behavior problems are associated with increased risk for adult schizophrenia or affective psychosis, independently and in combination with IQ. The study included individuals with schizophrenia (N=47), affective psychoses (N=45) and non-psychotic controls (N=1,521) from the New England Family Study. Behavior problems were prospectively assessed from standardized clinician observations at ages 4 and 7. IQ was assessed with the Stanford-Binet at age 4 and the Wechsler Intelligence Scale for Children at age 7. We found externalizing problems at age 4 and externalizing and internalizing problems at age 7 were associated with later schizophrenia, and both internalizing and externalizing problems at ages 4 and 7 were associated with later development of affective psychoses. Lower IQ at ages 4 and 7 was associated with schizophrenia, while lower IQ was associated with affective psychoses at age 7 only. Examined simultaneously, both lower IQ and behavior problems remained associated with risk of schizophrenia, while only behavior problems remained associated with affective psychoses. Behavior problems appear to be a general marker of risk of adult psychotic disorder, while lower childhood IQ is more specific to risk of schizophrenia. Future research should clarify the premorbid evolution of behavior and cognitive problems into adult psychosis.

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Section: Discussionmentioning

confidence: 99%

The interplay of childhood behavior problems and IQ in the development of later schizophrenia and affective psychoses

Agnew-Blais

Seidman

Fitzmaurice

et al. 2017

Schizophrenia Research

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“…In contrast, negative symptoms typically remain stable across the course of schizophrenia along with cognitive impairment, 3 although some studies have suggested that some newer-generation antipsychotic medications have higher efficacy than FGAs against negative symptoms. 4 Increased negative symptoms and cognitive impairment are longitudinal predictors of poor social functioning in schizophrenia.…”

Section: Introductionmentioning

confidence: 99%

Blonanserin versus haloperidol in Japanese patients with schizophrenia: A phase 3, 8‐week, double‐blind, multicenter, randomized controlled study

Harvey

Nakamura

Murasaki³

2019

Neuropsychopharm Rep

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Objective This Japanese, multicenter, randomized, double‐blind trial, evaluating the efficacy and safety of blonanserin compared with haloperidol in patients with schizophrenia, was previously published by Murasaki in the Japanese language. In this article, we present the results of the trial based on full analysis dataset instead of per protocol dataset formerly reported and discuss the findings in light of the latest knowledge of pharmacological treatment for schizophrenia. Methods A total of 265 patients were randomized to receive blonanserin (8 to 24 mg/d) or haloperidol (4 to 12 mg/d) twice daily for 8 weeks. Efficacy assessments included the Clinical Global Impressions—Improvement (CGI‐I) and the Positive and Negative Syndrome Scale (PANSS). Results Blonanserin was not inferior to haloperidol with a margin of 10% with respect to the improvement rate on CGI‐I at end of study (60.5% vs 50.0%, P < 0.001). The decrease in the PANSS total score did not differ between the drugs (−10.3 vs −7.1). For the PANSS negative symptom score, the decrease was significantly greater with blonanserin than with haloperidol (P = 0.006). Blonanserin was well tolerated. The incidence of adverse events was similar for the two drugs. Extrapyramidal adverse events, sedation, hypotension, and prolactin increase were rarer with blonanserin than with haloperidol. No clinically important weight gain was observed. Conclusions Blonanserin is as effective as haloperidol for the treatment of schizophrenia. Blonanserin is more effective for negative symptoms with a lower risk of extrapyramidal symptoms compared with haloperidol.

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“…Moreover, reduced cognitive and motor function occurs prior to psychosis onset, suggesting potential vulnerability markers (Bora et al, 2014; Dean et al, 2014; Sommer et al, 2016). Clarifying the nature of specific neurocognitive deficits among youth at ultra high-risk (UHR) for psychosis is essential for establishing early identification and prevention/intervention strategies (Bora et al, 2014).…”

Section: Introductionmentioning

confidence: 99%

Self-reported sleep disturbances associated with procedural learning impairment in adolescents at ultra-high risk for psychosis

Lunsford‐Avery

Dean

Mittal

2017

Schizophrenia Research

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Sleep disturbance contributes to impaired procedural learning in schizophrenia, yet little is known about this relationship prior to psychosis onset. Adolescents at ultra high-risk (UHR; N = 62) for psychosis completed the Pittsburgh Sleep Quality Index (PSQI) and a procedural learning task (Pursuit Rotor). Increased self-reported problems with sleep latency, efficiency, and quality were associated with impaired procedural learning rate. Further, within-sample comparisons revealed that UHR youth reporting better sleep displayed a steeper learning curve than those with poorer sleep. Sleep disturbances appear to contribute to cognitive/motor deficits in the UHR period and may play a role in psychosis etiology.

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Early interventions in risk groups for schizophrenia: what are we waiting for?

Cited by 118 publications

References 119 publications

The interplay of childhood behavior problems and IQ in the development of later schizophrenia and affective psychoses

The interplay of childhood behavior problems and IQ in the development of later schizophrenia and affective psychoses

Blonanserin versus haloperidol in Japanese patients with schizophrenia: A phase 3, 8‐week, double‐blind, multicenter, randomized controlled study

Self-reported sleep disturbances associated with procedural learning impairment in adolescents at ultra-high risk for psychosis

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