Turning the spotlight on apathy: identification and treatment in schizophrenia spectrum disorders

Among negative symptoms, apathy is central to the impairments in real-life functioning in schizophrenia spectrum disorders (SSD). Thus, optimizing treatment for apathy appears key to improve outcomes. In treatment research, however, negative symptoms are typically studied as a unifactorial construct. We, therefore, aim to shed necessary light on the status of apathy identification and treatment in SSD. </p

Turning the spotlight on apathy: identification and treatment in schizophrenia spectrum disorders

Among negative symptoms, apathy is central to the impairments in real-life functioning in schizophrenia spectrum disorders (SSD). Thus, optimizing treatment for apathy appears key to improve outcomes. In treatment research, however, negative symptoms are typically studied as a unifactorial construct. We, therefore, aim to shed necessary light on the status of apathy identification and treatment in SSD. </p

Prescriptions of psychotropic and somatic medications among patients with severe mental disorders and healthy controls in a naturalistic study

Psychotropic and somatic medications are both used in treating severe mental disorders (SMDs). Realistic estimates of the prevalence of use across medication categories are needed. We obtained this in a clinical cohort of patients with SMD and healthy controls (HCs). Prescriptions filled at Norwegian pharmacies the year before and after admittance to the Thematically Organized Psychosis (TOP) study were examined in 1406 patients with SMD (mean age 32.5 years, 48.2% women) and 920 HC (34.1 years, 46.2% women). Using data from the Norwegian Prescription Database (NorPD), the number of users in different anatomical therapeutic chemical (ATC) categories was compared using logistic regression. Population estimates were used as reference data. Use of antipsychotics (N05A), antiepileptics (N03A), antidepressants (N06A), anxiolytics (N05B), hypnotics and sedatives (N05C), anticholinergics (N04A), psychostimulants, attention deficit hyperactivity disorder and nootropic agents (N06B) and drugs for addiction disorders (N07B) was significantly more prevalent in patients with SMD than HC. Use of diabetes treatment (A10), antithrombotic drugs (B01), beta blockers (C07), lipid modifiers (C10), and thyroid and endocrine therapeutics (H03) was also more prevalent in patients with SMD, but with two exceptions somatic medication use was comparable to the general population. Among HC, there was low prevalence of use for most medication categories. Patients were using psychiatric medications, but also several types of somatic medications, more often than HC. Still, somatic medication use was mostly not higher than in the general population. The results indicate that HC had low use of most medication types.</p

Additional file 1: Table S1. of A history of childhood trauma is associated with slower improvement rates: Findings from a one-year follow-up study of patients with a first-episode psychosis

Childhood trauma prevalence divided into gender. Additional file 1: Table S1 shows the prevalence of childhood trauma divided into gender. Females report more sexual and emotional abuse than males. Table S2. Childhood trauma prevalence divided into schizophrenia and affective psychoses. Additional file 1: Table S2 shows the prevalence of childhood trauma divided into schizophrenia and affective psychoses. Patients with schizophrenia report more often physical abuse and physical neglect compared to patients with an affective psychoses. (DOCX 17 kb

Increased amygdala activity in <i>CACNA1C</i> SNP rs1006737 risk allele carriers.

<p>Carriers of the <i>CACNA1C</i> SNP rs1006737 risk allele A have significantly increased activity in the left amygdala in the total sample (x = −24, y = −2, z = −14; FWE P = 0.026) and BD subgroup (x = −24, y = 0, z = −14; FWE P = 0.041), and non-significantly increased activity in the right amygdala in the total sample (x = 26, y = 0, z = −16) and BD subgroup (x = 22, y = 0, z = −20) compared with GG homozygotes during a negative faces paradigm. Abbreviations: BD, bipolar disorder; FWE, family-wise error. Threshold for significance in <a href="http://www.plosone.org/article/info:doi/10.1371/journal.pone.0056970#pone-0056970-g001" target="_blank">Figure 1</a> is set to Nominal P<0.05 within the ROI.</p

Results for <i>CACNA1C</i> SNP rs1006737 (AA+AG>GG) effect on amygdala activation in a sample of bipolar disorder and schizophrenia cases and healthy controls.

<p>Abbreviations: BD, bipolar disorder; SZ, schizophrenia; CTR, healthy controls; FWE, Family-wise error rate; n.s., non-significant.</p><p>Only nominally significant results (Nominal P = <0.05) are shown.</p

Cluster 3.defined by SNP1 = CACNG2_rs2179871 = 2.

<p>Cluster 3 contains 41 patients, 49 combinations of 3 SNP genotypes, and 65 SNP genotypes.</p><p>a) GT = genotype for SNP2 and SNP3 (0: Normal homozygote.1: Heterozygote. 2: Variant homozygote); b) Dummy ID.</p

Cluster 4. defined by SNP1 = KCNQ3_rs2469515 = 2.

<p>Cluster 4 contains 37 patients, 32 combinations of 3 SNP genotypes, and 53 SNP genotypes.</p><p>a) GT = genotype for SNP2 and SNP3 (0: Normal homozygote.1: Heterozygote. 2: Variant homozygote); b) Dummy ID.</p

Number of hospital admissions for patients with bipolar disorder in Copenhagen.

<p>Each box represents one patient.</p

Cluster 1. defined by SNP1 = AVPR1B_rs33976516 = 1.

<p>Cluster 1 contains 41 patients, 46 combinations of 3 SNP genotypes, and 58 SNP genotypes.</p><p>a) GT = genotype for SNP2 and SNP3 (0: Normal homozygote.1: Heterozygote. 2: Variant homozygote); b) Dummy ID.</p