CLINICAL HANDBOOK OF SCHIZOPHRENIA

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xviPrefaceindividuals with the illness to achieve personally meaningful recovery and to continue togrow as people. The next chapter in this section addresses issues related to gender, followedby a chapter that considers the topic of quality of life, including both subjective and objectiveapproaches to the issue. Two chapters in this section address the topics of religion (andspirituality) and sexuality, both of paramount importance in the lives of many people withand without mental illness, but frequently neglected in books and guidelines describing thetreatment of schizophrenia. One chapter addresses the topic of schizophrenia in AfricanAmericans; the extensive research by this chapter’s author and his group may have importantand useful implications for understanding the complex interrelationships betweenschizophrenia and race/ethnicity. This section concludes with a chapter on ethics, an increasinglycomplex topic in both research and clinical practice as treatment options multiply,and the importance of engaging and empowering individuals with schizophrenia inmaking decisions about their own treatment is now recognized.The treatment of schizophrenia has now evolved to the point that clinicians, individualswith the illness, and their loved ones have numerous choices, and a more hopefulfuture. However, to take advantage of the latest developments in the causes and the treatmentof schizophrenia, the people interested in this topic need an authoritative yet accessibleguide. We hope that our readers will find the Clinical Handbook of Schizophrenia avaluable resource in furthering their understanding of schizophrenia, and in guiding theirtreatment decisions. Ultimately, broad dissemination of scientifically accurate and clinicallyrelevant information is the best means of reducing social stigma against seriousmental illnesses such as schizophrenia.KIM T. MUESERDILIP V. JESTEREFERENCESAmerican Psychiatric Association. (2000). Diagnostic and statistical manual of mental disorders (4thed., text rev.). Washington, DC: Author.Anthony, W. A. (1993). Recovery from mental illness: The guiding vision of the mental health servicesystem in the 1990s. Psychosocial Rehabilitation Journal, 16, 11–23.Apfel, R. J., & Handler, M. E. (1993). Madness and the loss of motherhood: Sexuality, reproduction,and long-term mental illness. Washington, DC: American Psychiatric Press.Bellack, A. S. (2006). Scientific and consumer models of recovery in schizophrenia: Concordance,contrasts, and implications. Schizophrenia Bulletin, 32, 432–442.Deegan, P. E. (1988). Recovery: The lived experience of rehabilitation. Psychosocial RehabilitationJournal, 11, 11–19.Drake, R. E., Goldman, H. H., Leff, H. S., Lehman, A. F., Dixon, L., Mueser, K. T., et al. (2001). Implementingevidence-based practices in routine mental health service settings. Psychiatric Services,52, 179–182.Jeste, D. V., Gladsjo, J. A., Lindamer, L. A., & Lacro, J. P. (1996). Medical comorbidity in schizophrenia.Schizophrenia Bulletin, 22(3), 413–430.Lehman, A. F., & Steinwachs, D. M. (1998). Patterns of usual care for schizophrenia: Initial resultsfrom the Schizophrenia Patient Outcomes Research Team (PORT) client survey. SchizophreniaBulletin, 24, 11–20.Murray, C. J. L., & Lopez, A. D. (Eds.). (1996). The global burden of disease: A comprehensive assessmentof mortality and disability from diseases, injuries, and risk factors in 1990 and projected to2020. Cambridge, MA: Harvard School of Public Health, on behalf of the World Health Organizationand the World Bank, Harvard University Press.Torrey, E. F. (1995). Jails and prisons: American’s new mental hospitals [Editorial]. American Journalof Public Health, 85, 1611–1613.
CONTENTSI. CORE SCIENCE AND BACKGROUND INFORMATIONCHAPTER 1 History of Schizophrenia as a Psychiatric Disorder 3Helen LavretskyCHAPTER 2 Epidemiology 14David J. Castle and Vera MorganCHAPTER 3 Biological Theories 25Jonathan Downar and Shitij KapurCHAPTER 4 Brain Imaging 35Lisa T. EylerCHAPTER 5 Neuropathology 44Daniel G. Stewart and Kenneth L. DavisCHAPTER 6 Genetics 55Stephen J. GlattCHAPTER 7 Environmental Pre- and Perinatal Influences in Etiology 65Lauren M. Ellman and Tyrone D. CannonCHAPTER 8 Psychosocial Factors 74Paul Bebbington and Elizabeth KuipersCHAPTER 9 Psychopathology 82Ipsit V. Vahia and Carl I. CohenCHAPTER 10 Cognitive Functioning 91Gauri N. Savla, David J. Moore, and Barton W. PalmerCHAPTER 11 Course and Outcome 100Heinz Häfner and Wolfram an der Heidenxvii
Page 1: CLINICAL HANDBOOK OF SCHIZOPHRENIA
Page 4 and 5: © 2008 The Guilford PressA Divisio
Page 7 and 8: CONTRIBUTORSDonald Addington, MD, D
Page 9 and 10: ContributorsixGillian Haddock, PhD,
Page 11 and 12: ContributorsxiRoger H. Peters, PhD,
Page 13 and 14: PREFACESchizophrenia is arguably th
Page 15: Prefacexvcorporation of environment
Page 19 and 20: ContentsxixCHAPTER 27 Illness Self-
Page 21: ContentsxxiCHAPTER 59 Sexuality 604
Page 25 and 26: CHAPTER 1HISTORY OF SCHIZOPHRENIAAS
Page 27 and 28: 1. History of Schizophrenia 5ularly
Page 29 and 30: 1. History of Schizophrenia 7PSYCHO
Page 31 and 32: 1. History of Schizophrenia 9The ne
Page 33 and 34: 1. History of Schizophrenia 11Since
Page 35 and 36: 1. History of Schizophrenia 13Belli
Page 37 and 38: 2. Epidemiology 15al., 2006), which
Page 39 and 40: 2. Epidemiology 17not generally fou
Page 41 and 42: 2. Epidemiology 19• Intrauterine
Page 43 and 44: 2. Epidemiology 21function in socia
Page 45 and 46: 2. Epidemiology 23KEY POINTS• Sch
Page 47 and 48: CHAPTER 3BIOLOGICAL THEORIESJONATHA
Page 49 and 50: 3. Biological Theories 27cortex (in
Page 51 and 52: 3. Biological Theories 29unchanged
Page 53 and 54: 3. Biological Theories 31raclopride
Page 55 and 56: 3. Biological Theories 33drives, mo
Page 57 and 58: CHAPTER 4BRAIN IMAGINGLISA T. EYLER
Page 59 and 60: 4. Brain Imaging 37yet to be strong
Page 61 and 62: 4. Brain Imaging 39with neuroleptic
Page 63 and 64: 4. Brain Imaging 41events. However,
Page 65 and 66: 4. Brain Imaging 43KEY POINTS• On
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5. Neuropathology 45TABLE 5.1. Summ
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5. Neuropathology 47schizophrenia i
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5. Neuropathology 49has been report
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5. Neuropathology 51also been demon
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5. Neuropathology 53results, especi
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CHAPTER 6GENETICSSTEPHEN J. GLATTTh
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6. Genetics 57Question 2: What Are
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6. Genetics 59nia. Each individual
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6. Genetics 61degree relatives desp
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6. Genetics 632A receptor (HTR2A) a
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CHAPTER 7ENVIRONMENTAL PRE-AND PERI
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7. Environmental Pre- and Perinatal
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8. Psychosocial Factors 75Steinberg
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8. Psychosocial Factors 77in terms
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8. Psychosocial Factors 79This mode
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8. Psychosocial Factors 81KEY POINT
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9. Psychopathology 83ations; change
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9. Psychopathology 85sity School of
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9. Psychopathology 87or “loose as
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9. Psychopathology 89lished WHO. Th
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CHAPTER 10COGNITIVE FUNCTIONINGIN S
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10. Cognitive Functioning in Schizo
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11. Course and Outcome 101DIAGNOSIS
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11. Course and Outcome 103TABLE 11.
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11. Course and Outcome 105DOMAINS O
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11. Course and Outcome 107mation gi
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11. Course and Outcome 109quency of
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11. Course and Outcome 111to a smal
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11. Course and Outcome 113spectivel
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CHAPTER 12DIAGNOSTIC INTERVIEWINGAB
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12. Diagnostic Interviewing 119psyc
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12. Diagnostic Interviewing 121not
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12. Diagnostic Interviewing 123tual
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CHAPTER 13ASSESSMENT OFCO-OCCURRING
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Time-Line Follow-BackThe Time-Line
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Testing and Risk Assessment for Inf
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13. Co-Occurring Disorders 131test
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13. Co-Occurring Disorders 133can i
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CHAPTER 14ASSESSMENT OFPSYCHOSOCIAL
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14. Assessment of Psychosocial Func
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TABLE 14.1. Measures of Psychosocia
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CHAPTER 15TREATMENT PLANNINGALEXAND
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15. Treatment Planning 147WHAT DOES
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15. Treatment Planning 149TABLE 15.
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15. Treatment Planning 151Poor adhe
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Occupational/School Functioning15.
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15. Treatment Planning 155Drake, R.
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CHAPTER 16ANTIPSYCHOTICSERIC C. KUT
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16. Antipsychotics 161for at least
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TABLE 16.3. Dosing of the First-Gen
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16. Antipsychotics 165are not avail
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16. Antipsychotics 167• Therapeut
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17. Side Effects of Antipsychotics
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18. Clozapine 179Plasma concentrati
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TABLE 18.1. Clinical tips for cloza
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18. Clozapine 183linergic effects t
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18. Clozapine 185• Common side ef
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19. Other Medications 187agitation
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19. Other Medications 189Small, ope
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19. Other Medications 191ANTIDEPRES
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19. Other Medications 193sation in
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19. Other Medications 195Citrome, L
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20. Electroconvulsive Therapy 197TA
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20. Electroconvulsive Therapy 199FI
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Missed SeizuresIf no seizure occurs
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20. Electroconvulsive Therapy 203(C
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PART IVPSYCHOSOCIAL TREATMENT
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208 IV. PSYCHOSOCIAL TREATMENTdisin
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210 IV. PSYCHOSOCIAL TREATMENTFIGUR
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212 IV. PSYCHOSOCIAL TREATMENTschiz
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CHAPTER 22FAMILY INTERVENTIONCHRIST
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216 IV. PSYCHOSOCIAL TREATMENTTABLE
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218 IV. PSYCHOSOCIAL TREATMENTcommi
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220 IV. PSYCHOSOCIAL TREATMENTother
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222 IV. PSYCHOSOCIAL TREATMENTtient
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224 IV. PSYCHOSOCIAL TREATMENTButzl
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CHAPTER 23COGNITIVE-BEHAVIORAL THER
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228 IV. PSYCHOSOCIAL TREATMENTThe a
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230 IV. PSYCHOSOCIAL TREATMENTAndre
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234 IV. PSYCHOSOCIAL TREATMENTtion.
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236 IV. PSYCHOSOCIAL TREATMENTnever
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238 IV. PSYCHOSOCIAL TREATMENTwith
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CHAPTER 24SOCIAL SKILLS TRAININGWEN
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242 IV. PSYCHOSOCIAL TREATMENTeach
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244 IV. PSYCHOSOCIAL TREATMENTThe m
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246 IV. PSYCHOSOCIAL TREATMENTCogni
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248 IV. PSYCHOSOCIAL TREATMENT• S
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250 IV. PSYCHOSOCIAL TREATMENTThe d
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252 IV. PSYCHOSOCIAL TREATMENTNone
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254 IV. PSYCHOSOCIAL TREATMENT• I
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256 IV. PSYCHOSOCIAL TREATMENTnance
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260 IV. PSYCHOSOCIAL TREATMENTMcGur
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262 IV. PSYCHOSOCIAL TREATMENTalong
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264 IV. PSYCHOSOCIAL TREATMENTappro
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266 IV. PSYCHOSOCIAL TREATMENTKEY P
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CHAPTER 27ILLNESS SELF-MANAGEMENT T
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270 IV. PSYCHOSOCIAL TREATMENTensur
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272 IV. PSYCHOSOCIAL TREATMENTReduc
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274 IV. PSYCHOSOCIAL TREATMENTgage
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276 IV. PSYCHOSOCIAL TREATMENTTABLE
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278 IV. PSYCHOSOCIAL TREATMENTInnov
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280 IV. PSYCHOSOCIAL TREATMENTpredi
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282 IV. PSYCHOSOCIAL TREATMENTCogni
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284 IV. PSYCHOSOCIAL TREATMENTGoal
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286 IV. PSYCHOSOCIAL TREATMENTthey
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288 IV. PSYCHOSOCIAL TREATMENTas nu
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290 IV. PSYCHOSOCIAL TREATMENTway h
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292 IV. PSYCHOSOCIAL TREATMENTThe r
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294 IV. PSYCHOSOCIAL TREATMENT• T
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296 IV. PSYCHOSOCIAL TREATMENTsetti
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CHAPTER 30SELF-HELP ACTIVITIESFREDE
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300 IV. PSYCHOSOCIAL TREATMENThelp,
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302 IV. PSYCHOSOCIAL TREATMENTbeen
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304 IV. PSYCHOSOCIAL TREATMENTdiagn
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PART VSYSTEMS OF CARE
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310 V. SYSTEMS OF CAREcial to addre
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312 V. SYSTEMS OF CAREneeded servic
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314 V. SYSTEMS OF CAREformed by cas
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316 V. SYSTEMS OF CARE4. Conducting
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318 V. SYSTEMS OF CAREvere mental i
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320 V. SYSTEMS OF CAREents receivin
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322 V. SYSTEMS OF CAREculties in ge
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324 V. SYSTEMS OF CAREIn such a sit
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326 V. SYSTEMS OF CAREFIGURE 32.1.
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328 V. SYSTEMS OF CAREREFERENCES AN
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330 V. SYSTEMS OF CAREDESCRIPTION O
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332 V. SYSTEMS OF CAREfor ACT have
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334 V. SYSTEMS OF CAREvices compare
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336 V. SYSTEMS OF CAREA team leader
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338 V. SYSTEMS OF CAREof leverage t
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340 V. SYSTEMS OF CAREcare of thems
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342 V. SYSTEMS OF CAREframework for
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344 V. SYSTEMS OF CAREaccount the v
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346 V. SYSTEMS OF CAREthat deinstit
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348 V. SYSTEMS OF CARETypes of Resi
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350 V. SYSTEMS OF CARESupportive Ho
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352 V. SYSTEMS OF CAREate assistanc
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CHAPTER 35TREATMENT INJAILS AND PRI
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356 V. SYSTEMS OF CARElikely to rem
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358 V. SYSTEMS OF CAREtitled Effect
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360 V. SYSTEMS OF CAREgering, becau
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362 V. SYSTEMS OF CAREior problems.
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364 V. SYSTEMS OF CAREAmerican Psyc
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CHAPTER 36FIRST-EPISODE PSYCHOSISDO
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36. First-Episode Psychosis 369TABL
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36. First-Episode Psychosis 371have
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36. First-Episode Psychosis 373The
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36. First-Episode Psychosis 375divi
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36. First-Episode Psychosis 377Supp
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36. First-Episode Psychosis 379(200
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37. Treatment of the Schizophrenia
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38. Older Individuals 391TABLE 38.1
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38. Older Individuals 393answer, an
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38. Older Individuals 395rates (69%
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38. Older Individuals 397Patterson,
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39. Aggression, Violence, and Psych
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CHAPTER 40HOUSING INSTABILITYAND HO
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40. Housing Instability and Homeles
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41. Medical Comorbidity 425Medical
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41. Medical Comorbidity 427search s
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41. Medical Comorbidity 429TABLE 41
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41. Medical Comorbidity 431Caring f
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41. Medical Comorbidity 433Counseli
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41. Medical Comorbidity 435REFERENC
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CHAPTER 42INTELLECTUAL DISABILITYAN
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42. Intellectual Disability and Oth
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CHAPTER 43TRAUMA AND POSTTRAUMATICS
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43. Trauma and Posttraumatic Stress
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CHAPTER 44MANAGEMENT OFCO-OCCURRING
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44. Management of Co-Occurring Subs
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CHAPTER 45PARENTINGJOANNE NICHOLSON
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45. Parenting 473THE IMPACT OF PARE
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TABLE 45.1. Antipsychotic Medicatio
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Guidelines for Prescribing Antipsyc
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45. Parenting 479provide safe space
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CHAPTER 46CHILDREN AND ADOLESCENTSJ
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46. Children and Adolescents 483pri
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46. Children and Adolescents 485TRE
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46. Children and Adolescents 487Als
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46. Children and Adolescents 489KEY
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CHAPTER 47SUICIDEMARNIN J. HEISELSu
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TABLE 47.1. Selected Risk Factors f
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Clinical Course and Symptoms of Sch
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47. Suicide 497those with schizoaff
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47. Suicide 499assessment tools can
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47. Suicide 501yet focused on suici
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47. Suicide 503ACKNOWLEDGMENTSI gra
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PART VIIPOLICY, LEGAL,AND SOCIAL IS
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508 VII. POLICY, LEGAL, AND SOCIAL
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CHAPTER 49INVOLUNTARY COMMITMENTJON
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CHAPTER 50JAIL DIVERSIONJOSEPH P. M
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PART VIIISPECIAL TOPICS
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560 VIII. SPECIAL TOPICStion, restr
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562 VIII. SPECIAL TOPICSsion criter
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564 VIII. SPECIAL TOPICSbased on ev
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CHAPTER 55RECOVERYDAVID ROELARRY DA
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568 VIII. SPECIAL TOPICSatric disab
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570 VIII. SPECIAL TOPICSA RECOVERY
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572 VIII. SPECIAL TOPICSassumes fro
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574 VIII. SPECIAL TOPICSDeegan, P.
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576 VIII. SPECIAL TOPICSwhereas ado
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578 VIII. SPECIAL TOPICSalence of d
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580 VIII. SPECIAL TOPICS• Because
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582 VIII. SPECIAL TOPICScovering pa
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584 VIII. SPECIAL TOPICSGoldberg, 1
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586 VIII. SPECIAL TOPICSthe quality
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588 VIII. SPECIAL TOPICSof-life mea
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590 VIII. SPECIAL TOPICSBecker, M.,
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CHAPTER 58SPIRITUALITY AND RELIGION
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594 VIII. SPECIAL TOPICSbe related
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596 VIII. SPECIAL TOPICSmore or les
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598 VIII. SPECIAL TOPICSing with bo
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600 VIII. SPECIAL TOPICSExpressive
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602 VIII. SPECIAL TOPICSconsumer ab
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CHAPTER 59SEXUALITYALEX KOPELOWICZR
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606 VIII. SPECIAL TOPICSmay result
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608 VIII. SPECIAL TOPICSTABLE 59.1.
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610 VIII. SPECIAL TOPICSThis second
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612 VIII. SPECIAL TOPICSFIGURE 59.1
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614 VIII. SPECIAL TOPICSTo overcome
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CHAPTER 60SCHIZOPHRENIA INAFRICAN A
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618 VIII. SPECIAL TOPICSTABLE 60.1.
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620 VIII. SPECIAL TOPICSPHARMACOTHE
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622 VIII. SPECIAL TOPICSered a part
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CHAPTER 61ETHICSABRAHAM RUDNICKCHAR
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626 VIII. SPECIAL TOPICSinterests c
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628 VIII. SPECIAL TOPICSticipant re
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630 VIII. SPECIAL TOPICSvide an eth
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632 IndexAmerican CorrectionalAssoc
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634 IndexChildren/adolescents, 481-
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636 IndexDepressive symptoms, 106,
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638 IndexFirst-episode psychosis, 1
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640 IndexInformation technology, he
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642 IndexMotor symptoms, DSM-IV-TR,
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644 IndexPregnancydosing strategies
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646 IndexRisk factorsfor co-occurri
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648 IndexSTG. See Superior temporal
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650 IndexUrine testingfor nicotine
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