Lewis Alan Opler

Lewis Alan Opler
Long Island University | LIU · Department of Psychology (Post)

M.D., Ph.D.

About

159
Publications
226,275
Reads
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27,889
Citations
Citations since 2017
2 Research Items
8128 Citations
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201720182019202020212022202302004006008001,0001,2001,400
201720182019202020212022202302004006008001,0001,2001,400
201720182019202020212022202302004006008001,0001,2001,400
Introduction
Consultant, ProPhase LLC Consultant, The PANSS Institute LLC Special Adjunct Research Professor-Long Island University-PreDoctoral Program in Clinical Psychology Co-author of the Positive and Negative Syndrome Scale (PANSS) Co-author of the Symptoms of Trauma Scale (SOTS)
Additional affiliations
April 1999 - November 2010
Office of Mental Health
Position
  • Director-Research Division, New York State Office of Mental Health
January 1995 - June 1997
Fordham University
Position
  • Research Associate
Description
  • Assisted the leadership at the NIMH funded Hispanic Research Center (HRC) prepare grant involving comparing neuroleptic compliance in Hispanic and non-Hispanic patients in Washington Heights.
July 1987 - June 2015
New York Presbyterian Hospital/Columbia
Position
  • Attending, New York Presbyterian Hospital/Columbia
Education
July 1969 - June 1976
Albert Einstein College of Medicine
Field of study
  • Medical Scientist Training Program
September 1965 - June 1969
Harvard University
Field of study
  • Biochemical Sciences

Publications

Publications (159)
Article
Full-text available
In the Diagnostic and Statistical Manual of Mental Disorders (DSM)-III, DSM-III-R and DSM-IV, the diagnosis of post-traumatic stress disorder (PTSD) requires the presence of three symptom clusters: re-experiencing, avoidance and hyperarousal. The selective serotonin reuptake inhibitors (SSRIs), in particular sertraline and paroxetine, have emerged...
Article
Full-text available
Overview: Psychiatric adverse effects, including aggression, have been reported with the use of statin medications; however, there is little data to support or refute the theory that statins or low serum cholesterol do in fact increase a patient's risk of aggression. Objective: This study examined 1) statin use and increased aggression, measured by...
Article
International Society for CNS Clinical Trials and Methodology convened an expert working-group that assembled consistency/inconsistency flags for the Positive and Negative Syndrome Scale (PANSS). Twenty-four flags were identified and divided based on extent to which they represent error (Possibly, Probably, Very probably or definitely). The flags w...
Article
A new clinician rating measure, the Symptoms of Trauma Scale (SOTS) was administered to adult psychiatric outpatients (46 men, 47 women) with severe mental illness (SMI) who reported a history of trauma exposure and were recently discharged from inpatient psychiatric treatment. SOTS composite severity scores for DSM-IV and DSM-5 posttraumatic stres...
Article
Full-text available
Vitamin D supplementation has become an increasingly popular prescribing practice, despite our limited knowledge of both the definition and degree of deficiency as well as the expected benefits or risks of exogenous administration. Many of the hypothesized benefits of vitamin D supplementation include a variety of improvements in mental health; how...
Article
The aim of this study was to determine whether patient characteristics such as age, sex, race/ethnicity, and frequency of monitoring play a role in clozapine-related blood dyscrasias. This study examined all neutropenic events to identify any potential demographic qualities that may pose increased risk to individuals receiving clozapine treatment i...
Article
Full-text available
The Symptoms of Trauma Scale (SOTS) is a 12-item, interview-based, clinician-rated measure that assesses the severity of a range of trauma-related symptoms. This pilot study evaluated its use and psychometric properties in an outpatient setting that provides treatment to survivors of chronic interpersonal trauma. Thirty participants completed self-...
Article
Full-text available
If treatments for cognitive impairment are to be utilized successfully, clinicians must be able to determine whether they are effective and which patients should receive them. In order to develop consensus on these issues, the International Society for CNS Clinical Trials and Methodology (ISCTM) held a meeting of experts on March 20, 2014, in Washi...
Article
Full-text available
This article reviews the antidepressant actions of ketamine, an N-methyl-D-aspartame glutamate receptor (NMDAR) antagonist, and offers a potential neural mechanism for intranasal ketamine's ultra-rapid actions based on the key role of NMDAR in the nonhuman primate prefrontal cortex (PFC). Although intravenous ketamine infusions can lift mood within...
Conference Paper
Background: It is well documented in the literature that individuals with schizophrenia are impaired in odor identification. Although less is known about odor hedonic processing within the disease, a few studies demonstrated associations between odor identification and odor hedonic ratings. This pilot study aimed to examine sex differences in assoc...
Article
Emotion plays a critical role in cognition and goal-directed behavior via complex interconnections between the emotional and motivational systems. It has been hypothesized that the impairment in goal-directed behavior widely noted in schizophrenia may result from defects in the interaction between the neural (ventral) emotional system and (rostral)...
Article
Objective To assess sublingual asenapine for acute agitation. Method Agitated adults 18–65 years (any diagnosis) presenting for treatment in an emergency department and found to have a score of ≥14 on the Positive and Negative Syndrome Scale-Excited Component (PANSS-EC) were randomized to receive either a single dose of a sublingual 10 mg tablet of...
Article
Introduction: Clozapine, an atypical antipsychotic with documented efficacy in the management of treatment-resistant schizophrenia, is associated with the risk of adverse hematological outcomes. Of particular concern are reductions in white blood cells (WBC) and absolute neutrophil counts (ANC). Individuals who display moderate leukopenia (3000/mm...
Article
Full-text available
While second-generation antipsychotics treat negative as well as positive symptoms, recovery for persons with schizophrenia remains elusive, in part because there are no FDA-approved medications that treat the cognitive deficits of schizophrenia (CDS). Recent work has identified agents that, when added to antipsychotics, improve cognition in schizo...
Article
Full-text available
Cognitive deficits are a prominent and enduring aspect of schizophrenia, which pose a significant barrier to achieving functional goals. The most promising intervention for treating cognitive impairment is cognitive remediation (CR), a behaviorally based therapy associated with medium effect sizes for cognitive and functional outcomes. However, the...
Article
While second-generation antipsychotics treat negative as well as positive symptoms, recovery for persons with schizophrenia remains elusive, in part because there are no FDA-approved medications that treat the cognitive deficits of schizophrenia (CDS). Recent work has identified agents that, when added to antipsychotics, improve cognition in schizo...
Article
Objective: The purpose of this study was to determine if the drop in white blood cell/absolute neutrophil count for clozapine patients on antibiotics is a normal response to the resolution of infection or if the concurrent administration resulted in an abnormal drop in blood counts and further reduction of white blood cell/absolute neutrophil belo...
Chapter
Antipsychotics can be classified into two general types: traditional antipsychotics (also referred to as first-generation antipsychotics or FGAs and as standard neuroleptics) and atypical antipsychotics (also referred to as second-generation antipsychotics or SGAs). Both traditional and atypical antipsychotics treat positive psychosis symptoms suc...
Article
Zonisamide is an anticonvulsant used as an adjunctive treatment for partial seizures. It has also been used off-label for treatment of mania. Abdoh et al recently reported a very interesting case of psychosis induced by zonisamide. We too observed a case of psychosis induced by zonisamide in a 34-year-old female with bipolar disorder and narcolepsy...
Article
Full-text available
This column describes a series of interventions to decrease antipsychotic polypharmacy in the New York State Office of Mental Health (NYSOMH) network of psychiatric hospitals. Phase 1 consisted of implementation of the Psychiatric Services Clinical Knowledge Enhancement System (PSYCKES), a Web-based application supporting clinical decision making a...
Article
The prevalence of smoking is high in persons with serious mental illness (SMI) despite associated health risks. Persons with SMI die on average 25 years earlier than the general population and an increased focus on wellness, including smoking cessation, has been a goal of federal, state, and municipal governments. The primary objective of this stud...
Article
Full-text available
Although obsessive-compulsive symptoms (OCS) in schizophrenia have been conceptually controversial and clinically challenging, recent evidence suggests that schizophrenia with OCS may constitute a distinct schizophrenic subgroup. Recent epidemiological and clinical findings have shown that the subgroup obsessive-compulsive (OC) schizophrenia is ass...
Article
Previously published case reports have noted severe adverse reactions such as cardiac arrest, respiratory arrest, and sudden death when clozapine (CLZ) and benzodiazepines (BZDs) are used concomitantly. As CLZ and BZD are both used regularly to treat psychiatric illness, it is important to have additional information concerning this potential inter...
Article
Cannabis and comorbidity; cognitive remediation and clozapine; glycine and gliosis; prenatal exposures and paternal age; receptors and recovery; prodrome and phospholipids; urbanicity and unemployment—these and many other topics are covered in The American Psychiatric Publishing Textbook of Schizophrenia, in 23 chapters by 59 carefully selected exp...
Article
Full-text available
We examined risk factors for long-term homelessness among newly homeless men and women who were admitted to New York City shelters in 2001 and 2002. Interviews were conducted with 377 study participants upon entry into the shelter and at 6-month intervals for 18 months. Standardized assessments of psychiatric diagnosis, symptoms, and coping skills;...
Article
The treatment of PTSD and schizophrenia remains complex and understudied. A comprehensive treatment approach is essential when one treatment modality is not helpful. In some cases, certain forms of psychosocial interventions succeed when pharmacotherapy is less successful. Recovery must include mutual collaboration and respect between client and th...
Article
Studies indicate a significant prevalence of OC-schizophrenia, a large proportion of which is clinically unrecognized, and its association with greater neuropsychological impairments, increased negative symptoms, and poorer clinical course. Although OC phenomena in schizophrenia have been recognized for a long time, too few systematic studies have...
Article
Because of similarities in symptoms, it can often be difficult to diagnose comorbid psychiatric disorders in people with schizophrenia. This issue is addressed here by articles about comorbidities including psychosis, obsessive-compulsive disorder, aggressive and violent behavior, posttraumatic stress disorder, depression, and general medical illne...
Article
Three hundred thirty-three elderly schizophrenic inpatients were rated on the Positive and Negative Syndrome Scale (PANSS), and those remaining in the hospital after 1 year (N = 267) were rated and followed for an additional year. Based on previous studies showing that aggressive episodes and hostile behavior predicted inability to discharge schizo...
Article
Improved compliance with pharmacotherapy was achieved in treating Hispanic outpatients with psychotic disorders when recognition of culturally based differences between patients and psychiatrists led to modifications in prescribing practices. Unacculturated Hispanic outpatients experienced akathisia as an increase in "nerviosismo." Addressing this...
Article
Full-text available
Both epidemiological findings and clinical observations and have shaped our thinking as regards to the neuropathology of schizophrenia. Epidemiological findings implicating environmental risk factors, including maternal dietary deficiency and urban birth place, suggest schizophrenia is a developmental disorder, whereas clinical observations gave ri...
Article
This study examined gender differences in the relationship of homelessness in schizophrenia to symptom severity, risk behaviors, and prognostic features. Four hundred subjects with schizophrenia were studied: 100 homeless men, 100 homeless women, 100 never homeless men, and 100 never homeless women. Assessments included derivation of five symptom f...
Article
Whether conceptualized as comorbid ADD with psychosis or as a distinct diagnostic entity--ADD psychosis--patients with features of both ADD and psychosis benefit from treatment with psychostimulants. It is hypothesized that psychostimulants have their therapeutic effect via amelioration of frontal lobe dysfunction.
Article
Literature searches dating back to 1968 were conducted through Psychlit and Medline services to review the scientific literature on EEG biofeedback treatment of ADD. While anecdotal and case reports cite promising evidence, methodological problems coupled with a paucity of research precludes any definitive conclusions as to the efficacy of enhanced...
Article
Full-text available
We describe the impact of a psychosocial intervention, critical time intervention (CTI), on the cardinal symptom dimensions of schizophrenia, namely negative, positive, and general psychopathology. Ninety-six men with schizophrenia and other psychotic disorders who were discharged from a homeless shelter were randomly assigned to receive either CTI...
Article
Full-text available
This study identified risk factors for homelessness among indigent urban adults without dependent children and with no history of psychotic illness. We conducted a matched case-control study, stratified by sex, of 200 newly homeless men and women and 200 indigent men and women with no history of homelessness. Newly homeless case subjects were recru...
Article
We describe the impact of a psychosocial intervention, critical time intervention (CTI), on the cardinal symptom dimensions of schizophrenia, namely negative, positive, and general psychopathology. Ninety-six men with schizophrenia and other psychotic disorders who were discharged from a homeless shelter were randomly assigned to receive either CTI...
Article
Full-text available
Expert Consensus Guidelines for Schizophrenia 1999
Article
Interest in the relationship between culture and medicine and psychiatry is of long standing. The cultural identity of mental health professionals and patients, the patients' cultural perception of what constitutes mental illness, the patients' psychosocial, socioeconomic, and cultural milieu, and the cultural factors that impinge on a good treatme...
Article
The Positive and Negative Syndrome Scale (PANSS) is widely used as a method for the assessment of symptoms of schizophrenia but the most complete model of how symptoms are structured has not been determined. Using the methods of confirmatory factor analysis with a large sample of 1233 of schizophrenic subjects this study examined the goodness of fi...
Article
Full-text available
The Positive and Negative Syndrome Scale (PANSS) is widely used as a method for the assessment of symptoms of schizophrenia but the most complete model of how symptoms are structured has not been determined. Using the methods of confirmatory factor analysis with a large sample of 1,233 of schizophrenic subjects this study examined the goodness of f...
Article
Full-text available
While second-generation antipsychotics treat negative as well as positive symptoms, recovery for persons with schizophrenia remains elusive, in part because there are no FDA-approved medications that treat the cognitive deficits of schizophrenia (CDS). Recent work has identified agents that, when added to antipsychotics, improve cognition in schizo...
Article
Full-text available
The Dot Enumeration Perceptual Organization Task (DEPOT) evaluates the validity of 2 specific competing cognitive models of early input dysfunction in schizophrenic individuals: a primary Stage 1, sensory store, perceptual organization deficit vs. a Stage 2, short-term visual memory (STVM) deficit. DEPOT was also designed to assess the hypothesis t...
Article
Full-text available
A study of risk factors for homelessness among the severely mentally ill was extended to include women, and a case-control study of 100 indigent women with schizophrenia meeting criteria for literal homelessness and 100 such women with no history of homelessness was conducted. Subjects were recruited from shelters, clinics, and inpatient psychiatri...
Article
Delusions usually respond to antipsychotic medications. When delusions are present within certain diagnostic categories, however, pharmacotherapy other than or in addition to antipsychotic agents is indicated. Many delusional disorders have been found to respond to pimozide even after failing to respond to other antipsychotic agents. Delusions acco...
Article
Synopsis We recently completed a case–control study of 100 literally homeless and 100 never homeless indigent schizophrenic men in New York City, in which concurrent substance abuse and antisocial personality disorder were widespread. In this paper we probe the correlates of ‘pure’ schizophrenia (single disorder, N = 60), schizophrenia and substanc...
Article
Discusses the phenomena of schizophrenia with apparent obsessive-compulsive (OC) features. Epidemiology and clinical studies are cited, as well as pharmacological and treatment studies. Three clinical cases are presented as examples of the OC component of schizophrenia. The article stresses the strong clinical and epidemiological evidence for the e...
Article
The present study explored possible connections between neuroleptic dose and the positive and negative symptoms of schizophrenic patients. Zero-order correlations between medication dose as measured in CPZ equivalent units and standardized assessments of positive (hallucinations, delusions) and negative (blunted affect, poor rapport) symptoms were...
Article
One hundred homeless schizophrenic men and 100 never homeless schizophrenic men were compared in terms of symptom ratings on the Positive and Negative Syndrome Scale (PANSS), which yields a positive, negative, and general psychopathology scale score, as well as evaluated on a number of other variables. The homeless group obtained significantly high...
Article
Full-text available
To identify risk factors for homelessness among the severely mentally ill, we conducted a case-control study of 100 indigent schizophrenic men meeting criteria for literal homelessness and 100 such men with no homeless history. Subjects were recruited from shelter, clinic, and inpatient psychiatric programs in Upper Manhattan. Clinical interviewers...
Article
This article reviews the antidepressant actions of ketamine, an N-methyl-D-aspartame glutamate receptor (NMDAR) antagonist, and offers a potential neural mechanism for intranasal ketamine's ultra-rapid actions based on the key role of NMDAR in the nonhuman primate prefrontal cortex (PFC). Although intravenous ketamine infusions can lift mood within...
Article
Diverse pharmacologic agents have been reported to be effective in treating negative schizophrenic symptoms (NSS). In light of this large and growing literature, as well as of reconceptualizations of the underlying pathophysiology of NSS, the time may have come to reject models that assume "irreversibility" of NSS. However, flaws in existing studie...
Article
Affective deficits have long been considered a prominent feature of schizophrenia and play a central role in recent theory and research on the pathophysiology of this disorder. However, it has recently been argued that current approaches to the conceptualization and assessment of affective flattening in schizophrenia are confounded by the social an...