The Developmental Processes in Schizophrenic Disorders project is an ongoing series of longitudinal follow-through studies of recent-onset schizophrenic patients. This project focuses on the identification of potential vulnerability factors and environmental potentiating factors that are predictors of relapse, social impairment, work impairment, and illness course. The proposed protocols will identify further the nature of vulnerability factors in early components of information processing, allocation of attention, and working memory. The assessment of these variables during states of psychotic relapse as well as clinical remission, compared to normal subjects tested at comparable intervals, will help to discriminate which factors are """"""""stable vulnerability indicators,"""""""" """"""""mediating vulnerability factors,"""""""" and """"""""episode indicators"""""""". Further study of these variables during treatment with the atypical neuroleptic, risperidone, will determine whether risperidone can normalize these vulnerability factors, given its effectiveness in treating negative symptoms. The relationship of deficits in information processing to abnormalities in brain structures thought to be associated with these cognitive functions will also be examined through Magnetic Resonance Imaging (MRI). The project also seeks to examine the specificity of these relationships to schizophrenia by comparison to patients with bipolar disorder. Schizophrenic patients from the first cohort (Sample 1) will be reassessed at an average of 8 years from their initial outpatient testing, to examine the stability of vulnerability indicators and their relationship to long-term outcome and follow--up diagnosis. Follow-up MRIs, on a subset of this cohort, will be examined for a) evidence of neurodegeneration and b) the relationship of structural changes to any changes in vulnerability measures. The first, phase of the project involves repeated measurements over the first outpatient year, during which schizophrenic patients are maintained on a standardized dosage of neuroleptic. The intra-individual areas that are assessed include symptomatology, information processing performance, psychophysiology, structural brain abnormalities, social behavior, and antipsychotic medication blood levels. Assessments of possible environmental factors are also completed in the areas of stressful life events, social support, and use of coping strategies. The second phase involves the continued study of the recent-onset schizophrenic sample during a second year in which patients participate in double-blind medication trials with risperidone, which appears to have some advantages relative to traditional neuroleptics. Long-term follow-up assessments of Sample 1 patients will be staggered over the five grant years to ensure consistency of follow-up interval across patients.
Showing the most recent 10 out of 135 publications
