Schizophrenia

Cortical thickness and oscillatory phase resetting: A proposed mechanism of salience network dysfunction in schizophrenia

by Lena Palaniyappan

Lena Palaniyappan MRCPsych, Kathrin Doege PhD, Pavan Mallikarjun MRCPsych, Elizabeth Liddle PhD, Peter Francis Liddle PhD MRCPsych.
Psychiatriki, 2012 (in press)

Abstract:
Background: Schizophrenia is characterised by both electrophysiological abnormalities and consistent... more Abstract:
Background: Schizophrenia is characterised by both electrophysiological abnormalities and consistent changes in the structure of cortical grey matter. But the relationship between these two observations is largely unknown. Structural changes reported in schizophrenia include reduced grey matter volume, thickness and surface area in several cortical regions, but most frequently in the insula and anterior cingulate cortex. These two regions together constitute an intrinsic brain circuit known as the ‘Salience Network’, which has a key role in stimulus processing.  During stimulus processing tasks, evoked activity is noted using electroencephalography (EEG). Phase resetting of ongoing oscillations contributes to this evoked activity.
Methods: In this study, we investigated the relationship between the cortical thickness in the Salience Network (measured using MRI) and the degree of phase resetting observed during an oddball task (measured using EEG) in 18 patients with schizophrenia and 20 healthy controls. 
Results: In patients with schizophrenia the reduced thickness in the Salience Network was associated with the inefficient phase resetting of theta oscillations.
Conclusions: Our findings suggest that the grey matter reduction seen in the Salience Network in patients with schizophrenia has substantial functional consequences. In particular, the structural defect of the insula that is seen in schizophrenia is likely to be associated with less efficient recruitment of brain circuits for processing information. This implies a possible mechanism by which disruptions in the intrinsic Salience Network can result in a general disturbance in salience detection seen in schizophrenia.

Cortical thickness in neuropsychologically near-normal schizophrenia

by Derin Cobia

Self-reported empathy deficits are uniquely associated with poor functioning in schizophrenia

by Derin Cobia

Memoir and the Diagnosis of Schizophrenia: Reflections on The Centre Cannot Hold; Me, Myself, and Them; and the ‘Crumbling Twin Pillars’ of Kraepelinian Psychiatry.

by Angela Woods

Mental Health Review (2011) Volume 16(3) pages 102-106

'I suffer in an unknown manner that is hieroglyphical’. Jung and Babette en route to Freud and Schreber

by Angela Woods

History of the Present 1(2): 244-258.

This paper was first presented at a conference to mark the 100th anniversary of the death of Daniel Paul Schreber,... more This paper was first presented at a conference to mark the 100th anniversary of the death of Daniel Paul Schreber, reviewed here:
http://historypsychiatry.com/2011/04/26/conference-report-%E2%80%9Cdaniel-paul-schreber-centenary-200-years-of-sonnenstein%E2%80%9D

« The Genocidal Logic of Neoliberalism » (2008)

by Michel Weber

La Stratégie du choc, la montée d’un capitalisme du désastre (The Shock Doctrine : The Rise of Disaster Capitalism) est un essai de Naomi Klein paru en 2007 chez Acte Sud. Ce compte rendu a été publié originellement in Michel Weber et Pierfrancesco Basile (dir.), "Chromatikon IV. Annuaire de la philosophie en procès - Yearbook of Philosophy in Process", Louvain-la-Neuve, Presses universitaires de Louvain, 2008, pp. 199–207.

Seven years after her famous No Logo : No Space, No Choice, No Jobs (2000), Naomi Klein has published The Shock... more Seven years after her famous No Logo : No Space, No Choice, No Jobs (2000), Naomi Klein has published The Shock Doctrine : The Rise of Disaster Capitalism (New York, Metropolitan Books and London, Allen Lane, 2007), now available as a paperback (Penguin, 2008) and recently translated into French (La stratégie du choc. La montée d’un capitalisme du désastre, traduit par Lori Saint-Martin et Paul Gagné, Arles, Actes Sud, 2008). In this utterly lucid study, Klein’s triune thesis is bold enough : economical war (the neoliberal controlled demolition of the state), state terrorism (the systematic destruction of culture with bombs, abductions, torture, assassinations…) and “democratic” free market are three facets of the enforcement of the same ideology.

Augmented gamma band auditory steady-state responses: Support for NMDA hypofunction in schizophrenia

by Casey Gilmore

Jordan P. Hamm, Casey S. Gilmore, Brett A. Clementz. In Press in 'Schizophrenia Research'

Individuals with schizophrenia (SZ) have deviations in auditory perception perhaps attributable to altered neural... more Individuals with schizophrenia (SZ) have deviations in auditory perception perhaps attributable to altered neural oscillatory response properties in thalamo-cortical and/or local cortico-cortical circuits. Previous EEG studies of auditory steady-state responses (aSSRs; a measure of sustained neuronal entrainment to repetitive stimulation) in SZ have indicated attenuated gamma range (≈40Hz) neural entrainment. Stimuli in most such studies have been relatively brief (500-1000ms) trains of 1ms clicks or amplitude modulated pure tones (1000Hz) with short, fixed interstimulus intervals (200-1000ms). The current study used extended (1500ms), more aurally dense broadband stimuli (500-4000Hz noise; previously demonstrated to elicit larger aSSRs) with longer, variable interstimulus intervals (2700-3300ms). Dense array EEG (256 sensor) was collected while 17 SZ and 16 healthy subjects passively listed to stimuli modulated at 15 different frequencies spanning beta and gamma ranges (16-44Hz in 2Hz steps). Results indicate that SZ have augmented aSSRs that were most extreme in the gamma range. Results also constructively replicate previous findings of attenuated low frequency auditory evoked responses (2-8Hz) in SZ. These findings (i) highlight differential characteristics of low versus high frequency and induced versus entrained oscillatory auditory responses in both SZ and healthy stimulus processing, (ii) provide support for an NMDA-receptor hypofunction-based pharmacological model of SZ, and (iii) report a novel pattern of aSSR abnormalities suggesting that gamma band neural entrainment deviations among SZ may be more complex than previously supposed, including possibly being substantially influenced by physical stimulus properties.

Coping Strategies in Aymara Caregivers of Patients with Schizophrenia

by Claudia Miranda

Deinstitutionalization has forced families of patients with schizophrenia to take responsibility of informal care,... more Deinstitutionalization has forced families of patients with schizophrenia to take responsibility of informal care, without having the tools to exert their role properly. The aim of this study was to evaluate the coping strategies of caregivers of patients with schizophrenia, belonging to the Aymara ethnic group, (aborigines who are located on the highlands of Northern Chile). The studied sample comprised 45 caregivers of patients with schizophrenia users of the Mental Health Service of Arica, Chile. The results from the Family Coping Questionnaire (FCQ) show that both, Aymara and non-Aymara caregivers use the same coping strategies except for spiritual help which is more likely to be used by Aymara. This strategy might be related with the worldview they possess, thus the relation with the deities has a meaningful importance in the way of explaining and coping with different phenomena.

From the Problem of the Nature of Psychosis to the Phenomenological Reform of Psychiatry. Historical and Epistemological Remarks on Ludwig Binswanger’s Psychiatric Project, Medicine Studies, 2012 (DOI) 10.1007/s12376-012-0076-x

by Elisabetta Basso

This paper focuses on one of the original moments of the development of the “phenomenological” current of psychiatry,... more This paper focuses on one of the original moments of the development of the “phenomenological” current of psychiatry, namely, the psychopathological research of Ludwig Binswanger. By means of the clinical and conceptual problem of schizophrenia as it was conceived and developed at the beginning of the twentieth century, I will try to outline and analyze Binswanger’s perspective from a both historical and epistemological point of view. Binswanger’s own way means of approaching and conceiving schizophrenia within the scientific, medical, and psychiatric context of that time will lead us to grasp the epistemological stakes at the origins of his project of reforming psychiatry by means of phenomenology. I will finally attempt to upgrade and update Binswanger’s project in light of the current reappraisal of phenomenology within the ongoing debate on psychopathology engaged by studies in the field of science and philosophy of mind.

Is facial emotion recognition impairment in schizophrenia identical for different emotions? A signal detection analysis

by Graham Pluck

Negative symptoms: the ‘pathology’ of motivation and goal-directed behaviour

by Graham Pluck

Selective attention to facial emotion and identity in schizophrenia

by Guy Tiberghien

Effects of emotion and identity on facial affect processing in schizophrenia

by Guy Tiberghien

Processing emotional expression and facial identity in schizophrenia

by Guy Tiberghien

Gaze direction determination in schizophrenia

by Guy Tiberghien

Use of the process dissociation procedure to study the contextual effects on face recognition in schizophrenia: Familiarity, associative recollection and discriminative …

by Guy Tiberghien

Impairment not only in remembering but also in knowing previously seen faces and words in schizophrenia

by Guy Tiberghien

FAMILIARITY AND RECOLLECTION IN SCHIZOPHRENIA

by Guy Tiberghien

Mental health acts that require dangerousness for involuntary admission may delay the initial treatment of schizophrenia

by Christopher Ryan

Large, M., O. Neilssen, C. J. Ryan, and R. Hayes. 2008. Mental health acts that require dangerousness for involuntary admission may delay the initial treatment of schizophrenia. Social Psychiatry and Psychiatric Epidemiology 43: 251-256.

Introduction: A long duration of untreated psychosis (DUP) is associated with a worse prognosis, an increased risk of... more Introduction: A long duration of untreated psychosis (DUP) is associated with a worse prognosis, an increased risk of suicide and may be linked to serious violence. Mental health laws that require patients to be dangerous to themselves or to others before they can receive involuntary psychiatric treatment may make it more difficult to treat patients in their first episode of psychosis.

Methods: The mean and median DUP reported in studies of schizophrenia related psychoses were examined. A comparison was made between the DUP reported from jurisdictions that had an obligatory dangerousness criterion (ODC) and those with other criteria for involuntary treatment.

Results: The average mean DUP in samples from jurisdictions with an ODC was 79.5 weeks, but was only 55.6 weeks in those jurisdictions that did not have an ODC (P < 0.007).

Conclusions:  Mental health laws that require the patient to be assessed as dangerous before they can receive involuntary treatment are associated with significantly longer DUP. As reducing DUP is an intervention that can improve the prognosis of schizophrenia, this finding suggests that mental health laws should be amended to allow
treatment on grounds other than dangerousness, at least in the crucial first episode of psychosis.

The predictive value of risk categorization in schizophrenia

by Christopher Ryan

Large, Matthew M., Christopher James Ryan, Michael Paton, Olav Nielssen, and Swaran Singh. 2011. The predictive value of risk categorization in schizophrenia. Harvard Review of Psychiatry 19: 25-33.

Background: Risk assessment is increasingly used to inform decisions regarding the psychiatric treatment of patients... more Background: Risk assessment is increasingly used to inform decisions regarding the psychiatric treatment of patients with schizophrenia and other serious mental disorders.

Aims: To examine the theoretical limits of risk assessment and risk categorization as applied to a range of harms known to be associated with schizophrenia.

Methods: Using known rates of suicide, homicide, self-harm, and violence in schizophrenia, a hypothetical tool with an unrealistically high level of accuracy was used to calculate the proportion of true- and false-positive risk categorizations.

Results: Risk categorization incorrectly classified a large proportion of patients as being at high risk of violence toward themselves and others.

Conclusion: Risk assessment and categorization have severe limitations. A large proportion of patients classified as being at high risk will not, in fact, cause or suffer any harm. Unintended consequences of inaccurate risk categorization include unwarranted detention for some patients, failure to treat others, misallocation of scarce health resources, and the stigma arising from patients’ being labeled as dangerous.