Psychiatry

Beyond remission: redefining the goal of schizophrenia management

 

REVIEWER: Marc-André Roy, MD, Associate Professor of Psychiatry and Neurosciences, Université Laval, Québec City, Canada


Remission vs. functional recovery
Continuum of treatment goals

An important goal of schizophrenia management is to reduce the frequency, severity and duration of psychotic episodes (Hasan et al. World J Biol Psychiatry 2012;13: 318-378; Lehman et al. APA, NGC-3572, 2008). Indeed, it has been shown that about 70-80% of first-episode patients do achieve a remission of psychotic symptoms within the first year of treatment (Lieberman et al. Arch Gen Psychiatry 1993;50:369-376). Among patients receiving maintenance antipsychotic therapy, a systematic review estimated that the one-year recurrence rate was only 3%, compared to a 90% risk of relapse at two years in those who discontinued medication (Zipursky et al. Schizophr Res 2014;152:408-414).    Read More

Suicide: the Toronto experience

 

Over 200 people a year commit suicide in Toronto, Canada, and a coroner’s chart review has analysed the data to determine if there are common features (Sinyor et al. Can J Psychiatry 2014;59:26-33). The sample included 2,886 cases from 1998-2010 in which the coroner ruled that the death was due to suicide. Five clusters were identified based on individual and suicide-specific factors. Read More

From Framingham to Facebook: the contagion of controversy

 

Facebook has recently come under fire for conducting an experiment described as “massive-scale” emotional contagion in the social network. While the idea that Facebook views friends as guinea pigs may be unnerving to some, the controversy has centred on the fact that neither Facebook nor researchers from Cornell University obtained informed consent from the study subjects.

The study results were published in the Proceedings of the National Academy of Sciences despite a lack of institutional review board (IRB) approval (Kramer et al. PNAS USA 2014;111:8788-8790; free full text at www.pnas.org/content/111/24/8788.full.pdf). Read More