Catherine Kane

Family management of schizophrenia: A comparison of behavioral and supportive family treatment

This paper reports a comparison of behavioral and supportive family treatment for family management of schizophrenia. The family project applied two psychoeducational approaches to a highly “treatment resistant” population of young adults afflicted with chronic mental illness. The study compares and contrasts the effects of behavioral and supportive family management programs on clinical outcomes. Clinical improvements were associated with both family interventions. Discussion is provided on the relevance of this work to the growing body of evidence concerning the efficacy of psychoeducational family intervention for the management of schizophrenia.

Familial and sporadic schizophrenia: visual evoked potential differences.

Introduction The hete~genei~ of ~~zop~nia has been iong recognized (Tsuang 1975), and various methods of subclassification have been developed, including combinations of clinical and biological measures (Jeste 1982; Buchsbaum et al. 1983). Elec~ophysiological literature relevant to subtyping in schizophrenia includes: findings of varying electrodermal responses of patients depending on the severity of emotional withdrawal and disorganization (Straube 1979; Bernstein et al. 1981); evoked potential differences between chronic and acute patients, patients with differing clinical symptoms (Landau et al. 1975; Shagass 1980), and familial versus nonfamilial patients (Romani et al. 1986); lateral asymmetries of electroencephalogram (EEG) variables in patients with specific clinicai symptoms (Serafetinides et al. 198 1); and different patterns of evoked potentials and EEG variables in neuroleptic-responsive and unresponsive patients (Saletu 1977; hi1 et al. 1981). The utility of the familial/sporadic distinction in psychosis has recently been reviewed and may be a useful strategy for determining more homogeneous subgroups (Lewis et al. 1987). In the current study, we tested the hypothesis that visual evoked potential (VEP) latencies are prolonged in psychotic patients with a positive family history of psychosis (FH PGS) when compared to equaliy ill patients without a family history of psychosis (FH NEG).

A comparison of short-term psychoeducational and support groups for relatives coping with chronic schizophrenia

The differences between two short-term, multifamily group intervention programs for relatives of hospitalized chronic schizophrenics were examined in a nonequivalent comparison group design. The psychoeducational intervention consisted of interactive instructional activities. The support group intervention consisted of nonstructured discussions. Analysis of covariance on adjusted posttest means indicated a differential treatment effect for depression and satisfaction for the psychoeducational group. The findings suggest that the process of a support group may not be compatible with a short time frame.

Visual evoked potential correlates of positive/negative symptoms in schizophrenia

Previous studies of schizophrenic patients have found evoked potential (EP) correlates of clinical symptomatology, including EP differences between subtypes of schizophrenia. In the current study, 14 medicated male schizophrenics underwent flash visual evoked potentials (VEP) and were clinically rated for positive and negative symptoms. We tested the hypothesis that positive symptoms would be associated with VEP latency reduction and negative symptoms with latency prolongation. Patients were divided into predominantly positive symptom and predominantly negative symptom groups using a combination of positive and negative symptom ratings. Patients with predominantly positive symptoms exhibited reduced latencies when compared with predominantly negative symptom patients. Similarly, significant negative correlations between positive symptom ratings and P200 latency variables were found. Correlations between negative symptom measures and P200 latencies (in the opposite direction) were also noted, but were less significant. These relationships persisted when confounders were statistically controlled for. The results are consistent with previous findings of evoked potential correlates of clinical symptomatology, especially those finding EP latency correlates of psychosis severity and affective blunting. The findings are discussed in relationship to concepts relevant to psychosis, including arousal, sensory gating, and the dopamine hypothesis.

Intensive inpatient treatment of young adult chronic patients.

Young adults with chronic mental disorders have become a major concern among mental health professionals during the past decade. Many of these patients require frequent hospitalizations, are noncompliant with treatment, experience behavioral crises that threaten themselves or others, abuse drugs and alcohol, and alienate their families and support systems. The authors describe an intensive inpatient program for young adult chronic patients who have repeatedly failed to respond to community-based and standard state hospital care and appear to need extended institutional care. The program, which integrates psychiatric and rehabilitation strategies, has succeeded in increasing the amount of time these patients remain in the community. Although the goal for such patients remains a community-based treatment program, the value of an extended period of active inpatient treatment for some patients may be overlooked in current planning for them.