Risk And Protective Factors In Schizophrenia

H. HAFNER Schizophrenia Research Unit, Central Institute of Mental Health, Mannheim, Germany The present volume contains the lectures and invited discussions of the sympo sium on "Risk and protective factors in schizophrenia - towards a conceptual model of the disease process", which was held at the International Science Forum of the University of Heidelberg from October 25 to 27, 200l. They are supple mented by a "Summary and outlook", in which Peter Jones gives a brief overview of the results and perspectives featured in the presentations and discussions. The contributions and discussions reflect the open-minded and creative atmosphere at the meeting. The systematically structured program of the symposium continued the tradition of the Search for the Causes of Schizophrenia symposia, which were th started in 1986 on the occasion of the 600 anniversary of the University of Hei delberg and which are co-organized with Prof. Wagner Farid Gattaz/Sao Paulo. The aim of these symposia and their proceedings volumes [6,8-10] has been to reflect the state of the art in schizophrenia research at their time, and they have successfully done so. In contrast, the present symposium pursued a more lim ited objective and was of a different type. It brought together, around a large table at the International Science Forum in Heidelberg, 22 invited speakers and dis cussants and an equal number of young scientists working in the research fields in question, who were thus given an opportunity to listen and to participate.

The understanding of how to reduce risk factors for mental disorders has expanded remarkably as a result of recent scientific advances. This study, mandated by Congress, reviews those advances in the context of current research and provides a targeted definition of prevention and a conceptual framework that emphasizes risk reduction. Highlighting opportunities for and barriers to interventions, the book draws on successful models for the prevention of cardiovascular disease, injuries, and smoking. In addition, it reviews the risk factors associated with Alzheimer's disease, schizophrenia, alcohol abuse and dependence, depressive disorders, and conduct disorders and evaluates current illustrative prevention programs. The models and examination provide a framework for the design, application, and evaluation of interventions intended to prevent mental disorders and the transfer of knowledge about prevention from research to clinical practice. The book presents a focused research agenda, with recommendations on how to develop effective intervention programs, create a cadre of prevention researchers, and improve coordination among federal agencies.

Chapters by distinguished investigators in clinical psychology, psychiatry, and child development, many of whose work led to the new developmental model of psychopathology, provide a unique review of current research on vulnerability and resistance to disorder.

Human migration is a global phenomenon and is on the increase. It occurs as a result of 'push' factors (asylum, natural disaster), or as a result of 'pull' factors (seeking economic or educational improvement). Whatever the cause of the relocation, the outcome requires individuals to adjust to their new surroundings and cope with the stresses involved, and as a result, there is considerable potential for disruption to mental health. This volume explores all aspects of migration, on all scales, and its effect on mental health. It covers migration in the widest sense and does not limit itself to refugee studies. It covers issues specific to the elderly and the young, as well as providing practical tips for clinicians on how to improve their own cultural competence in the work setting. The book will be of interest to all mental health professionals and those involved in establishing health and social policy.

The most comprehensive volume of its kind, The Oxford Handbook of Mood Disorders provides detailed coverage of the characterization, understanding, and treatment of mood disorders. Chapters are written by the world's leading experts in their respective areas. The Handbook provides coverage of unipolar depression, bipolar disorder, and variants of these disorders. Current approaches to classifying the mood disorders are reviewed and contemporary controversies are placed in historical context. Chapter authors offer a variety of approaches to understanding the heterogeneity of the experiences of those who meet criteria for mood disorders, both within and across cultures. The role of genetic and environmental risk factors as well as premorbid personality and cognitive processes in the development of mood pathology are detailed. Interpersonal, neurobiological, and psychological factors also receive detailed consideration. The volume reviews mood disorders in special populations (e.g., postpartum and seasonal mood disorders) as well as common comorbidities (e.g., anxiety, substance use disorders). Somatic and psychosocial treatment approaches receive in-depth coverage with chapters that describe and review empirical evidence regarding each of the most influential treatment approaches. The depth and breadth offered by this Handbook make it an invaluable resource for clinicians and researchers, as well as scholars and students.

Estimates indicate that as many as 1 in 4 Americans will experience a mental health problem or will misuse alcohol or drugs in their lifetimes. These disorders are among the most highly stigmatized health conditions in the United States, and they remain barriers to full participation in society in areas as basic as education, housing, and employment. Improving the lives of people with mental health and substance abuse disorders has been a priority in the United States for more than 50 years. The Community Mental Health Act of 1963 is considered a major turning point in America's efforts to improve behavioral healthcare. It ushered in an era of optimism and hope and laid the groundwork for the consumer movement and new models of recovery. The consumer movement gave voice to people with mental and substance use disorders and brought their perspectives and experience into national discussions about mental health. However over the same 50-year period, positive change in American public attitudes and beliefs about mental and substance use disorders has lagged behind these advances. Stigma is a complex social phenomenon based on a relationship between an attribute and a stereotype that assigns undesirable labels, qualities, and behaviors to a person with that attribute. Labeled individuals are then socially devalued, which leads to inequality and discrimination. This report contributes to national efforts to understand and change attitudes, beliefs and behaviors that can lead to stigma and discrimination. Changing stigma in a lasting way will require coordinated efforts, which are based on the best possible evidence, supported at the national level with multiyear funding, and planned and implemented by an effective coalition of representative stakeholders. Ending Discrimination Against People with Mental and Substance Use Disorders: The Evidence for Stigma Change explores stigma and discrimination faced by individuals with mental or substance use disorders and recommends effective strategies for reducing stigma and encouraging people to seek treatment and other supportive services. It offers a set of conclusions and recommendations about successful stigma change strategies and the research needed to inform and evaluate these efforts in the United States.

Of the 40 adolescents with schizophrenia, 32 (80%) were males, and 8 (20%) were females. The mean age was 17.25 years (SD=1.37) at the first entry, and 22 (55%) were Caucasian. Of the 40 parents of adolescents with schizophrenia, 34 respondents were female (85%). The mean age was 46.08 years (SD=4.60), and 23 (57.5%) were Caucasian.

- The topics covered in the six sections of the book are Epidemiology and Environment, Precursors, Pathophysiological Mechanisms, Genetics, Controversies in Schizophrenia, and Treatment. - Reflects the progress made on Schizophrenia since 1986.

The Social Determinants of Mental Health aims to fill the gap that exists in the psychiatric, scholarly, and policy-related literature on the social determinants of mental health: those factors stemming from where we learn, play, live, work, and age that impact our overall mental health and well-being. The editors and an impressive roster of chapter authors from diverse scholarly backgrounds provide detailed information on topics such as discrimination and social exclusion; adverse early life experiences; poor education; unemployment, underemployment, and job insecurity; income inequality, poverty, and neighborhood deprivation; food insecurity; poor housing quality and housing instability; adverse features of the built environment; and poor access to mental health care. This thought-provoking book offers many beneficial features for clinicians and public health professionals: Clinical vignettes are included, designed to make the content accessible to readers who are primarily clinicians and also to demonstrate the practical, individual-level applicability of the subject matter for those who typically work at the public health, population, and/or policy level. Policy implications are discussed throughout, designed to make the content accessible to readers who work primarily at the public health or population level and also to demonstrate the policy relevance of the subject matter for those who typically work at the clinical level. All chapters include five to six key points that focus on the most important content, helping to both prepare the reader with a brief overview of the chapter's main points and reinforce the "take-away" messages afterward. In addition to the main body of the book, which focuses on selected individual social determinants of mental health, the volume includes an in-depth overview that summarizes the editors' and their colleagues' conceptualization, as well as a final chapter coauthored by Dr. David Satcher, 16th Surgeon General of the United States, that serves as a "Call to Action," offering specific actions that can be taken by both clinicians and policymakers to address the social determinants of mental health. The editors have succeeded in the difficult task of balancing the individual/clinical/patient perspective and the population/public health/community point of view, while underscoring the need for both groups to work in a unified way to address the inequities in twenty-first century America. The Social Determinants of Mental Health gives readers the tools to understand and act to improve mental health and reduce risk for mental illnesses for individuals and communities. Students preparing for the Medical College Admission Test (MCAT) will also benefit from this book, as the MCAT in 2015 will test applicants' knowledge of social determinants of health. The social determinants of mental health are not distinct from the social determinants of physical health, although they deserve special emphasis given the prevalence and burden of poor mental health.

Leading researchers address conceptual and technical issues in schizophrenia and suggest novel strategies for advancing research and treatment. Despite major advances in methodology and thousands of published studies every year, treatment outcomes in schizophrenia have not improved over the last fifty years. Moreover, we still lack strategies for prevention and we do not yet understand how the interaction of genetic, developmental, and environmental factors contribute to the disorder. In this book, leading researchers consider conceptual and technical obstacles to progress in understanding schizophrenia and suggest novel strategies for advancing research and treatment. The contributors address a wide range of critical issues: the construct of schizophrenia itself; etiology, risk, prediction, and prevention; different methods of modeling the disorder; and treatment development and delivery. They identify crucial gaps in our knowledge and offer creative but feasible suggestions. These strategies include viewing schizophrenia as a heterogeneous group of conditions; adopting specific new approaches to prediction and early intervention; developing better integration of data across genetics, imaging, perception, cognition, phenomenology, and other fields; and moving toward an evidence-based, personalized approach to treatment requiring rational clinical decision-making to reduce functional disability. Contributors Robert Bittner, Robert W. Buchanan, Kristin S. Cadenhead, William T. Carpenter, Jr., Aiden Corvin, Daniel Durstewitz, André A. Fenton, Camilo de la Fuente-Sandoval, Jay A. Gingrich, Joshua A. Gordon, Chloe Gott, Peter B. Jones, René S. Kahn, Richard Keefe, Wolfgang Kelsch, James L. Kennedy, Matcheri S. Keshavan, Angus W. MacDonald III, Anil K. Malhotra, John McGrath, Andreas Meyer-Lindenberg, Kevin J. Mitchell, Bita Moghaddam, Vera A. Morgan, Craig Morgan, Kim T. Mueser, Karoly Nikolich, Patricio O'Donnell, Michael O'Donovan, William A. Phillips, Wulf Rössler, Louis Sass, Akira Sawa, Jeremy K. Seamans, Steven M. Silverstein, William Spaulding, Sharmili Sritharan, Heike Tost, Peter Uhlhaas, Aristotle Voineskos, Michèle Wessa, Leanne M. Williams, Ashley Wilson, Til Wykes