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Psychiatric Services 09/2008; 59(8):935-6. · 2.38 Impact Factor
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ABSTRACT: The Clinical Antipsychotic Trials of Intervention Effectiveness (CATIE) was designed to assess effectiveness of antipsychotic medication for people with schizophrenia. The authors, who are administrators of the National Alliance on Mental Illness (NAMI), discuss CATIE and related policy and research studies and their implications. CATIE has answered some important questions for consumers and their families and raises many more. The prevalence of medical risk factors in the population with schizophrenia is an important part of advancing prevention. Poor adherence to medications randomly prescribed by CATIE physicians in a blinded procedure is also a key finding and points to the need for individually tailoring medication regimens. Policy makers may be tempted to oversimplify the results of CATIE by restricting access to the costlier second-generation medications. However, doing so will hurt clinical care, and any savings to state and community mental health programs may be illusory. Policy can be constructed to focus on clinical outcomes and not merely restrict access to medications on the basis of cost. Research is urgently needed on a new generation of medications with benign side effects and greater efficacy than their predecessors for people with schizophrenia.
Psychiatric Services 06/2008; 59(5):537-9. · 2.38 Impact Factor
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ABSTRACT: Medical morbidity and mortality rates remain elevated in schizophrenia patients compared with the general population, in part due to potentially reversible medical risk factors. Psychiatrists should address this problem by adopting established strategies for prevention and intervention.
The literature on modifiable medical risk factors relevant to individuals with schizophrenia and corresponding guidelines for prevention and treatment established by expert consensus panels were reviewed.
Schizophrenia patients are at elevated risk for cardiovascular disease due to high rates of cigarette smoking and, increasingly, due to obesity, diabetes, and hypertriglyceridemia. Rates of human immunodeficiency virus infection and infectious hepatitis are also higher in schizophrenia patients. Interventions that have reduced medical morbidity in the general population can be adopted to reduce premature mortality in individuals with schizophrenia.
Patients with schizophrenia have high rates of potentially reversible medical morbidity. Implementation of practice guidelines for identifying and modifying risk factors could substantially improve the health of patients with schizophrenia.
The Journal of Clinical Psychiatry 03/2005; 66(2):183-94; quiz 147, 273-4. · 5.80 Impact Factor
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ABSTRACT: Research has identified misleading and stigmatizing popular beliefs about schizophrenia, but little is known about media images corresponding to these beliefs. Building on Susan Sontag's exploration of cancer in the 1978 book Illness as Metaphor, the authors hypothesize that "schizophrenia" is now more commonly misused. A total of 1740 newspaper articles from 1996 or 1997 that mentioned schizophrenia or cancer were randomly selected and then coded for contextual and metaphorical use. Only 1 percent of articles that mentioned cancer used that illness in a metaphorical way, compared with 28 percent of the articles that mentioned schizophrenia. Results differed by newspaper but not by region. The authors suggest that these inaccurate metaphors in the media contribute to the ongoing stigma and misunderstandings of psychotic illnesses.
Psychiatric Services 11/2003; 54(10):1402-4. · 2.38 Impact Factor
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Administration and Policy in Mental Health 02/2003; 30(3):255-66. · 2.09 Impact Factor
