CLINICAL HANDBOOK OF SCHIZOPHRENIA

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436 VI. SPECIAL POPULATIONS AND PROBLEMSRosenberg, S., Trumbetta, S., Mueser, K., Goodman, L., Osher, F., Vidaver, R., et al. (2001). Determinantsof risk behavior for human immunodeficiency virus/acquired immunodeficiency syndromein people with severe mental illness. Comprehensive Psychiatry, 42(4) 263–271.U.S. Department of Health and Human Services/National Institutes of Health/National Heart, Lungand Blood Institute. (2003). Facts about the DASH eating plan (NIH Publication No. 03-4082).Rockville, MD: Author.
CHAPTER 42INTELLECTUAL DISABILITYAND OTHERNEUROPSYCHIATRIC POPULATIONSRICHARD B. FERRELLTHOMAS W. McALLISTERConditions or disorders that alter the motor, sensory, or mental functions of the centralnervous system (CNS) may also alter the likelihood of CNS-based disorders or illnesses.These conditions or disorders may also change the symptomatic presentation of psychiatricillnesses, such as schizophrenia. They may also affect response to psychopharmacological,psychotherapeutic, and behavioral treatments. CNS disorders that result in intellectualdisability (ID) are a category of such conditions. We think that these ideas areimportant to the proper understanding and treatment of persons with schizophrenia whoalso have ID or other neuropsychiatric illnesses. Conditions such as Alzheimer’s disease,Parkinson’s disease, Huntington’s disease, multiple sclerosis, epilepsy, cerebrovasculardisease, and traumatic brain injury are often associated with psychotic symptoms or maydirectly cause psychosis. In this chapter we use ID as a paradigm or example of a neuropsychiatricdisorder that can occur concomitantly with schizophrenia. ID is not, however,a single disease or even a disease-state, as are the disorders we named earlier. Its causesare often multiple, obscure, speculative, or unknown. Demonstration of anatomical pathologyor of CNS pathophysiology, if it exists, is frequently still beyond the reach of currentscience.Although some evidence points to the increased susceptibility to schizophrenia ofpersons with ID, it is possible that individuals with ID may also develop schizophrenic illnessfor reasons not related to ID. Our ignorance of the causes of both ID and schizophreniastill greatly exceeds our knowledge. Our purpose is to survey important neuropsychiatricissues and recent findings with respect to the evaluation and treatment ofschizophrenia in intellectually disabled people.437
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CLINICAL HANDBOOK OF SCHIZOPHRENIA
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© 2008 The Guilford PressA Divisio
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CONTRIBUTORSDonald Addington, MD, D
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ContributorsixGillian Haddock, PhD,
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ContributorsxiRoger H. Peters, PhD,
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PREFACESchizophrenia is arguably th
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Prefacexvcorporation of environment
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CONTENTSI. CORE SCIENCE AND BACKGRO
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ContentsxixCHAPTER 27 Illness Self-
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ContentsxxiCHAPTER 59 Sexuality 604
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CHAPTER 1HISTORY OF SCHIZOPHRENIAAS
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1. History of Schizophrenia 5ularly
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1. History of Schizophrenia 7PSYCHO
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1. History of Schizophrenia 9The ne
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1. History of Schizophrenia 11Since
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1. History of Schizophrenia 13Belli
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2. Epidemiology 15al., 2006), which
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2. Epidemiology 17not generally fou
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2. Epidemiology 19• Intrauterine
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2. Epidemiology 21function in socia
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2. Epidemiology 23KEY POINTS• Sch
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CHAPTER 3BIOLOGICAL THEORIESJONATHA
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3. Biological Theories 27cortex (in
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3. Biological Theories 29unchanged
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3. Biological Theories 31raclopride
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3. Biological Theories 33drives, mo
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CHAPTER 4BRAIN IMAGINGLISA T. EYLER
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4. Brain Imaging 37yet to be strong
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4. Brain Imaging 39with neuroleptic
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4. Brain Imaging 41events. However,
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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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37. Treatment of the Schizophrenia
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Page 413 and 414: 38. Older Individuals 391TABLE 38.1
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Page 421 and 422: 39. Aggression, Violence, and Psych
Page 433 and 434: CHAPTER 40HOUSING INSTABILITYAND HO
Page 435 and 436: 40. Housing Instability and Homeles
Page 447 and 448: 41. Medical Comorbidity 425Medical
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Page 451 and 452: 41. Medical Comorbidity 429TABLE 41
Page 453 and 454: 41. Medical Comorbidity 431Caring f
Page 455 and 456: 41. Medical Comorbidity 433Counseli
Page 457: 41. Medical Comorbidity 435REFERENC
Page 461 and 462: 42. Intellectual Disability and Oth
Page 469 and 470: CHAPTER 43TRAUMA AND POSTTRAUMATICS
Page 471 and 472: 43. Trauma and Posttraumatic Stress
Page 481 and 482: CHAPTER 44MANAGEMENT OFCO-OCCURRING
Page 483 and 484: 44. Management of Co-Occurring Subs
Page 493 and 494: CHAPTER 45PARENTINGJOANNE NICHOLSON
Page 495 and 496: 45. Parenting 473THE IMPACT OF PARE
Page 497 and 498: TABLE 45.1. Antipsychotic Medicatio
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Page 503 and 504: CHAPTER 46CHILDREN AND ADOLESCENTSJ
Page 505 and 506: 46. Children and Adolescents 483pri
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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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