This is a competing renewal application for a research program that has focused on the development of innovative pharmacological and psychosocial treatment strategies for managing individuals with schizophrenia who are living in the community. The current proposal will extend the investigator's previous work into the arena of vocational activity and rehabilitation. The investigator's experience to date in enhancing psychosocial outcomes with social skills training led him to hypothesize that he can combine skills training with supported employment to improve social adjustment and quality of life. The investigator is also hypothesizing that skills training can improve the relatively poor job tenure of individuals with schizophrenia and schizoaffective disorder who participate in supported employment. The investigator will also study the long-term effectiveness and side effects of two new antipsychotic medications, olanzapine and risperidone, in patients participating in this program. Neurocognitive deficits in schizophrenia appear to be important factors that can interfere with functional outcome in schizophrenia. With this in mind, the investigator will study the relationship between a number of cognitive measures and social and vocational outcome. One hundred-sixty patients with schizophrenia or schizoaffective disorder who are living in the community will be randomly assigned to olanzapine or risperidone. After these patients have been stabilized in their drug condition they will participate in a program of Individual Placement and Support (IPS) as developed by Robert Drake who is the co-principal investigator on this grant. After patients are placed in a job they will be randomly assigned to continued IPS with or without Psychoeducational Skills Training (ST). The ST will consist of six months of skills training using both the Workplace Fundamentals Module and additional clinic and community-based skills training. The investigator will evaluate outcome during the next two years with measures of clinical psychopathology, medication side effects, functional outcomes, and quality of life.

Agency
National Institute of Health (NIH)
Institute
National Institute of Mental Health (NIMH)
Type
Research Project (R01)
Project #
5R01MH041573-14
Application #
6629196
Study Section
Special Emphasis Panel (ZMH1-CRB-B (02))
Program Officer
Hsiao, John
Project Start
1986-07-01
Project End
2005-01-31
Budget Start
2003-02-01
Budget End
2004-01-31
Support Year
14
Fiscal Year
2003
Total Cost
$671,351
Indirect Cost
Name
University of California Los Angeles
Department
Type
Schools of Medicine
DUNS #
092530369
City
Los Angeles
State
CA
Country
United States
Zip Code
90095
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Aravagiri, M; Marder, S R; Wirshing, D et al. (1998) Plasma concentrations of risperidone and its 9-hydroxy metabolite and their relationship to dose in schizophrenic patients: simultaneous determination by a high performance liquid chromatography with electrochemical detection. Pharmacopsychiatry 31:102-9
Aravagiri, M; Yuwiler, A; Marder, S R (1998) Distribution after repeated oral administration of different dose levels of risperidone and 9-hydroxy-risperidone in the brain and other tissues of rat. Psychopharmacology (Berl) 139:356-63
Aravagiri, M; Ames, D; Wirshing, W C et al. (1997) Plasma level monitoring of olanzapine in patients with schizophrenia: determination by high-performance liquid chromatography with electrochemical detection. Ther Drug Monit 19:307-13

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