SCHIZOPHRENIA IN THE 21ST CENTURY ppt

SCHIZOPHRENIA IN THE 21ST CENTURY Edited by T.H.J. Burne           Schizophrenia in the 21 st Century Edited by T.H.J. Burne Published by InTech Janeza Trdine 9, 51000 Rijeka, Croatia Copyright © 2012 InTech All chapters are Open Access distributed under the Creative Commons Attribution 3.0 license, which allows users to download, copy and build upon published articles even for commercial purposes, as long as the author and publisher are properly credited, which ensures maximum dissemination and a wider impact of our publications. After this work has been published by InTech, authors have the right to republish it, in whole or part, in any publication of which they are the author, and to make other personal use of the work. Any republication, referencing or personal use of the work must explicitly identify the original source. As for readers, this license allows users to download, copy and build upon published chapters even for commercial purposes, as long as the author and publisher are properly credited, which ensures maximum dissemination and a wider impact of our publications. Notice Statements and opinions expressed in the chapters are these of the individual contributors and not necessarily those of the editors or publisher. No responsibility is accepted for the accuracy of information contained in the published chapters. The publisher assumes no responsibility for any damage or injury to persons or property arising out of the use of any materials, instructions, methods or ideas contained in the book. Publishing Process Manager Petra Nenadic Technical Editor Teodora Smiljanic Cover Designer InTech Design Team First published March, 2012 Printed in Croatia A free online edition of this book is available at www.intechopen.com Additional hard copies can be obtained from orders@intechopen.com Schizophrenia in the 21 st Century, Edited by T.H.J. Burne p. cm. ISBN 978-953-51-0315-8    Contents  Preface IX Part 1 Schizophrenia in the 21 st Century 1 Chapter 1 Treatment of Schizophrenia in the 21 st Century: Towards a more Personalised Approach 3 Robert Hunter Chapter 2 Family Caregivers of People with Schizophrenia in East Asian Countries 27 Setsuko Hanzawa Part 2 Clinical Research on Cognition in Schizophrenia 41 Chapter 3 Schizophrenia and Social Cognition: From Conceptual Bases to Therapeutic Approaches 43 Luciana de Carvalho Monteiro, Paula Andreia Martins, Marisa Crivelaro and Mario Rodrigues Louzã Chapter 4 Cognitive Remediation Therapy (CRT): Improving Neurocognition and Functioning in Schizophrenia 69 Rafael Penadés and Rosa Catalán Chapter 5 Metacognitive Dysfunction in Schizophrenia 87 Martin L. Vargas, Juan M. Sendra and Caridad Benavides Chapter 6 Directions in Research into Response Selection Slowing in Schizophrenia 103 D.P. McAllindon and P.G. Tibbo Part 3 Preclinical Research on Schizophrenia 125 Chapter 7 Serotonin-1A Receptors and Cognitive Enhancement in Schizophrenia: Role for Brain Energy Metabolism 127 Tomiki Sumiyoshi and Takashi Uehara VI Contents Chapter 8 From Humans to Animals: Animal Models in Schizophrenia 141 Liesl B. Jones Chapter 9 Behavioral Tests for Evaluation of Information Processing and Cognitive Deficits in Rodent Animal Models of Neuropsychiatric Disorders 153 Ales Stuchlik, Tomas Petrasek, Hana Hatalová, Lukas Rambousek, Tereza Nekovarova and Karel Vales    Preface  This book began as a collection of articles on neuropsychiatric disease, but with a clear focus on Schizophrenia, which is a poorly understood but very disabling group of brain disorders. We now recognize schizophrenia as a disorder of the brain, but despite advances in treatment options we are still a long way from having effective treatments, particularly for cognitive symptoms, and lack effective interventions and ways to prevent this disease. While hallucinations and delusions (positive symptoms of schizophrenia) feature prominently in diagnostic criteria, impairments of memory and attentional processing (cognitive symptoms of schizophrenia) are attracting increasing interest in modern neuropsychiatry. Schizophrenia in the 21 st Century gives an overview of current research on schizophrenia (Part I) and brings together various aspects of clinical research into cognitive symptoms (Part II) and preclinical research in animal models (Part III). Prof. Robert Hunter provides an up to date review of “Treatment of schizophrenia in the 21 st Century”. There is a major focus on treatments with antipsychotic medications and despite advances in neuroscience of schizophrenia, there is still a need for more effective and safer drugs. However, there is still a place for community-based systems of care, inpatient services, rehabilitation and psycho-social interventions. In the next chapter Dr Setsuko Hanzawa offers an insight into attitudes towards the unique aspects of family caregivers of people with schizophrenia in Japan and Korea, in “Family caregivers of people with schizophrenia in East Asian countries”. There are a number of chapters covering various aspects of cognitive symptoms of schizophrenia in Part II. Luciana de Carvalho Monteiro and colleagues present an overview of schizophrenia and social cognition and suggest that deficits in social cognition are observed throughout the course of schizophrenia. Despite pharmacological and cognitive rehabilitation treatments more research is required to clarify their impact on social cognition. Following along this theme Drs Rafael Penadés and Rosa Catalán examine cognitive remediation therapy to improve neurocognitive outcomes in schizophrenia. Given that cognitive deficits are more closely linked to functional outcomes than psychiatric symptoms there is a clear need for novel psychological interventions. Dr Martin Vargas and colleagues continue this theme providing an overview on metacognitive dysfunction in schizophrenia, which broadly covers deficits in metarepresentation and executive function. The next chapter by Drs X Preface McAllindon and Tibbo examines response selection slowing as a fundamental aspect of the cognitive deficits of schizophrenia, presenting a detailed review of neuroimaging studies of response selection in healthy controls and in people with schizophrenia. Response selection slowing has a long history in schizophrenia research and may be an endophenotype of schizophrenia, although the promise of new medications for effective treatments seems a long way off. Preclincal research into schizophrenia is the focus of Part III. Drs Tomiki Sumiyoshi and Takashi Uehara specifically address a novel hypothesis linking brain energy metabolism and disturbances of cognition function, providing evidence for serotinergic receptors as promising candidates for cognitive enhancers. In the next chapter Professor Jones reviews the literature on animal models used to study schizophrenia, with a particular focus on animal models with disruptions to the hippocampus and the thalamus. The final chapter by Stuchlik and colleagues covers a range of behavioural tests in rodent animal models that are used to evaluate information processing and cognitive deficits of relevance to neuropsychiatric disorders. Although it is not possible to recapitulate all of the features of schizophrenia in an animal model, preclinical research using animal models is a powerful tool in understanding the neuroscience of higher cognitive functions and the discovery of novel drugs aimed at restoring normal cognitive function. Schizophrenia is a debilitating group of disorders and there is much work to be done before we understand the neuroscience of schizophrenia and have safe and effective treatments for all patients. Antipsychotic drugs have largely been effective at treating the positive symptoms of schizophrenia. However, we do not have adequate treatments for cognitive dysfunction, which is a core part of the disorder. This book provides the reader with a diversity of findings examining a range of available treatment options into cognitive symptoms with evidence presented from both clinical and preclinical studies.  Dr. T.H.J. Burne Queensland Brain Institute, The University of Queensland, Australia . years ago. Thus in the second Schizophrenia in the 21 st Century 4 decade of the 21 st Century, the ‘Dopamine Hypothesis’ is still the dominant paradigm, and a newly introduced antipsychotic. lower in the longer term (Johnstone, 1993). Schizophrenia in the 21 st Century 6 The term schizophrenia is of course rather imprecise, and is defined clinically rather than on the basis. in schizophrenia due to many factors but including reduced or absent insight into the nature of their mental change. About half of people with schizophrenia do not adhere to treatment in the