Long-Term Continuity of Antipsychotic Treatment for Schizophrenia: A Nationwide Study

2021 ◽  
Author(s):  
Jose M. Rubio ◽  
Heidi Taipale ◽  
Antti Tanskanen ◽  
Christoph Correll ◽  
John M. Kane ◽  
...  
Keyword(s):  
Antipsychotic Treatment ◽  
Nationwide Study

scholarly journals Principals between exploitation and exploration: Results of a nationwide study on ambidexterity of school leaders

2020 ◽  
pp. 174114322094570
Author(s):  
Marcus Pietsch ◽  
Pierre Tulowitzki ◽  
Colin Cramer
Keyword(s):  
Dynamic Environments ◽  
Management Research ◽  
Data Set ◽  
Term Survival ◽  
Leadership And Management ◽  
Nationwide Study ◽  
Efficiency Control ◽  
Exploitation And Exploration ◽  
Discontinuous Innovation

Both organizational and management research suggest that schools and their leaders need to be ambidextrous to secure prosperity and long-term survival in dynamic environments characterized by competition and innovation. In this context, ambidexterity refers to the ability to simultaneously pursue exploitation and exploration and thus to deliver efficiency, control and incremental improvements while embracing flexibility, autonomy and discontinuous innovation. Using a unique, randomized and representative data set of N = 405 principals, we present findings on principals’ exploitation and exploration. The results indicate: (a) that principals engage far more often in exploitative than in explorative activities; (b) that exploitative activities in schools are executed at the expense of explorative activities; and (c) that explorative and ambidextrous activities of principals are positively associated with the (perceived) competition between schools. The study brings a novel perspective to educational research and demonstrates that applying the concept of ambidexterity has the potential to further our understanding of effective educational leadership and management.

scholarly journals Treatment-resistant schizophrenia characterised by dopamine supersensitivity psychosis and efficacy of asenapine

2021 ◽  
Vol 14 (4) ◽  
pp. e242495
Author(s):  
Nagara Takao ◽  
Toshiya Murai ◽  
Hironobu Fujiwara
Keyword(s):  
Animal Studies ◽  
Significant Proportion ◽  
Antipsychotic Treatment ◽  
High Dose ◽  
Receptor Density ◽  
Treatment Resistant ◽  
Psychomotor Activity ◽  
Receptor Blockers ◽  
Dopamine Supersensitivity

Dopamine supersensitivity psychosis (DSP) frequently arises with long-term antipsychotic treatment and accounts for a significant proportion of treatment-resistant schizophrenia. The mechanism underlying DSP is thought to be a compensatory increase in dopamine receptor density in the striatum caused by long-term antipsychotic treatment. Previous animal studies have reported that antipsychotics increase serotonin 5-HT2A receptor density in the striatum and that 5-HT2A receptor blockers suppress dopamine-sensitive psychomotor activity, which may be linked to the pathophysiology of DSP. In this paper, we describe a patient who was hospitalised with treatment-resistant schizophrenia. Following treatment with high-dose antipsychotic polypharmacy for 10 weeks, the patient experienced worsening of psychotic and extrapyramidal symptoms. The patient was then started on second-generation antipsychotic asenapine while other antipsychotics were tapered off, resulting in improvement of these symptoms. Retrospectively, we presumed that the high-dose antipsychotic polypharmacy caused DSP, which was effectively treated by the potent 5-HT2A receptor antagonism of asenapine.

scholarly journals Epidemiological trends of pre-malignant gastric lesions: a long-term nationwide study in the Netherlands

Gut ◽  
2007 ◽  
Vol 56 (12) ◽  
pp. 1665-1670 ◽  
Author(s):  
A C de Vries ◽  
G A Meijer ◽  
C W N Looman ◽  
M K Casparie ◽  
B E Hansen ◽  
...  
Keyword(s):  
The Netherlands ◽  
Gastric Lesions ◽  
Nationwide Study ◽  
Epidemiological Trends

78 High Adenocarcinoma Risk After Diagnosis of Gastric MALT Lymphoma: A Long-Term Nationwide Study

2008 ◽  
Vol 134 (4) ◽  
pp. A-12
Author(s):  
Lisette G. Capelle ◽  
Annemarie C. de Vries ◽  
Caspar W. Looman ◽  
M.K. Casparie ◽  
Gerrit A. Meijer ◽  
...  
Keyword(s):  
Malt Lymphoma ◽  
Gastric Malt Lymphoma ◽  
Nationwide Study

Beyond the facts in schizophrenia: closing the gaps in diagnosis, pathophysiology, and treatment

2011 ◽  
Vol 20 (4) ◽  
pp. 317-327 ◽  
Author(s):  
H. Nasrallah ◽  
R. Tandon ◽  
M. Keshavan
Keyword(s):  
Clinical Manifestations ◽  
Antipsychotic Treatment ◽  
Past Century ◽  
Disease Entity ◽  
Closing The Gaps ◽  
Distinct Disease ◽  
Extreme Variability ◽  
Biological Substrates ◽  
Single Disease Entity

Background.Although schizophrenia has been considered a distinct disease entity for the past century, its precise definition and etio-pathophysiology remain obscure and its treatment remains unsatisfactory. In this review, we summarize our state of knowledge about the etiology, pathophysiology, clinical features, and treatment of schizophrenia.Methodological Issues.The inadequacy of the major conceptual models of schizophrenia is a major roadblock in providing a coherent explanation for the known facts of this illness, despite these limitations and its changing definitions, the construct of schizophrenia does convey useful information: (i) patients diagnosed as having schizophrenia do have areal disease– they experience both suffering and disability; (ii) a diagnosis of schizophrenia does suggest adistinctive clinical profile– a characteristic long-term course; an admixture of positive, negative, and cognitive symptoms; (iii) a diagnosis of schizophrenia has clear treatment and prognostic implications – likelihood of benefit from antipsychotic treatment and likelihood of incomplete recovery; and (iv) schizophrenia satisfies criteria for a valid diagnostic entity better than almost any other psychiatric diagnosis.Discussion.On the other hand, the concept of schizophrenia has serious shortcomings. First, it is not a single disease entity – it has multiple etiological factors and pathophysiological mechanisms but common phenotypic features. Second, its clinical manifestations are so diverse that its extreme variability has been considered by some to be a core feature. Third, its boundaries remain ill defined and not clearly demarcated from other clinical entities.Conclusions.A necessary next step is to deconstruct schizophrenia as an entity into component dimensions –endophenotypes linked to unique etiological and pathophysiological processes that may yield unique treatment targets. Innovative approaches are needed to elucidate the biological substrates of these entities because such clarity is vital for replicable research. We conclude by identifying the critical gaps in our knowledge, and unmet needs in our approaches to care, and outline steps that can move the field forward.

scholarly journals Characteristics of the corpus callosum in chronic schizophrenia treated with clozapine or risperidone and those never-treated

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Bo Tao ◽  
Yuan Xiao ◽  
Hengyi Cao ◽  
Wenjing Zhang ◽  
Chengmin Yang ◽  
...  
Keyword(s):  
White Matter ◽  
Corpus Callosum ◽  
Clinical Symptoms ◽  
Diffusion Tensor ◽  
Structural Characteristics ◽  
Chronic Schizophrenia ◽  
Cross Sectional Study ◽  
Antipsychotic Treatment ◽  
Cross Sectional

Abstract Background The corpus callosum (CC) deficits have been well documented in chronic schizophrenia. However, the long-term impacts of antipsychotic monotherapies on callosal anatomy remain unclear. This cross-sectional study sought to explore micro- and macro-structural characteristics of the CC in never-treated patients and those with long-term mono-antipsychotic treatment. Methods The study included 23 clozapine-treated schizophrenia patients (CT-SCZ), 19 risperidone-treated schizophrenia patients (RT-SCZ), 23 never-treated schizophrenia patients (NT-SCZ), and 35 healthy controls (HCs). High resolution structural images and diffusion tensor imaging (DTI) data for each participant were obtained via a 3.0 T MR scanner. FreeSurfer was used to examine the volumes and fractional anisotropy (FA) values of the CC for each participant. Results There were significant deficits in the total and sub-regional CC volume and white matter integrity in NT-SCZ in comparison with healthy subjects. Compared with NT-SCZ, both CT-SCZ and RT-SCZ showed significantly increased FA values in the anterior CC region, while only RT-SCZ showed significantly increased volume in the mid-anterior CC region. Moreover, the volume of the mid-anterior CC region was significantly smaller in CT-SCZ compared to HCs. No correlations of clinical symptoms with callosal metrics were observed in schizophrenia patients. Conclusions Our findings provide insight into micro- and macro-structural characteristics of the CC in chronic schizophrenia patients with or without antipsychotics. These results suggest that the pathology itself is responsible for cerebral abnormalities in schizophrenia and that chronic exposure to antipsychotics may have an impact on white matter structure of schizophrenia patients, especially in those with risperidone treatment.

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