Year: 2008
Type: other
Abstract: introduction described in this thesis.An important characteristic of patients studied in this thesis is the specific life phase; they are adolescents or young adults.Adolescence is the period in human life that is characterized by brain maturation and a transition to independent adult functioning.It is a critical period for the neurodevelopment of brain regions associated with impulsivity, motivation and addiction (Chambers et al 2003), making adolescents and young adults more vulnerable for substance use disorders, but morbidity of an obsessive-compulsive disorder (OCD) (Berman et al 1998, Fenton et al 1986).OCD is characterized by recurrent, persistent, and intrusive thoughts or images that cause anxiety or distress (obsessions) and/or repetitive behaviors or mental acts aimed at reducing this distress or anxiety (compulsions).The response of OCD patients to selective serotonin re-uptake inhibitors (SSRI's) has led to the Recent studies estimate the prevalence of type 2 diabetes mellitus (DM II) among patients with schizophrenia around 10-15%, which is 2-3 times higher than in the reference population (Holt et al 2005).Moreover, the incidence in patients using antipsychotic medication is estimated between 1.5% and 4.4% per year (Citrome et al 2004, Leslie et al 2004).The aetiology of disturbances in glucose metabolism in patients with schizophrenia is uncertain.Influences of factors associated with treatment with antipsychotic medication are important.However, several reports suggest that the vulnerability for disturbances in glucose metabolism may also be associated to the disorder schizophrenia.Recently it was shown that first-episode, drug-naive patients with schizophrenia had higher levels of plasma glucose, insulin, and cortisol than age-and sex-matched controls (Ryan et al 2003).This finding The first part focuses on the effect of olanzapine and risperidone on subjective well-being, craving for and use of cannabis, and treatment continuation in patients with recent onset schizophrenia and related disorders.Part I consists of 5 chapters.Chapter 1.1 is a review of the literature on different neurobiological theories on vulnerability concerning drug abuse and schizophrenia in adolescence.Chapter 1.2 describes the effects of olanzapine and risperidone on initial subjective well-being in young patients with schizophrenia, and the effect of these antipsychotics on the use of and craving for cannabis.Chapter 1.3 reports on early withdrawal in the double-blind randomized clinical trial with olanzapine and risperidone performed in adolescents with first psychosis.Chapter 1.4 presents data from one-year follow up after the initial double blind trial with olanzapine and risperidone.Chapter 1.5 describes the relationship between early improvement of subjective well-being and enduring symptomatic remission during a 5 year follow up of first episode schizophrenia.Part II.Obsessive-Compulsive Symptoms in recent onset schizophreniaThe second part investigates the genetic background of obsessive-compulsive symptoms and the effect of olanzapine and risperidone on the induction and severity of these symptoms.Part II consists of two chapters.Chapter 2.1 presents data of obsessive-compulsive symptoms (OCS) from a randomized double blind study in young patients with recent-onset schizophrenia or related disorders.Olanzapine is compared with risperidone.Chapter 2.2 reports on the role of the catechol-o-methyltransferase gene as a modifier gene in schizophrenia by testing the association between the functional Val 158 Met and obsessive-compulsive symptoms in patients with recent onset schizophrenia.Ryan MC, Flanagan S, Kinselle U, et al.The effects of atypical antipsychotics on visceral fat distribution in first episode, drug-naive patients with schizophrenia.
Author: Lonneke J. M. van Nimwegen
Language: English
Subfield: Psychiatry and Mental health
Field: Medicine
Domain: Health Sciences
Open Access status: green
OpenAlex ID: W2237159244