Book contents
- Manual of Inpatient Psychiatry
- Manual of Inpatient Psychiatry
- Copyright page
- Contents
- Contributors
- Preface to the Second Edition
- Foreword: American Inpatient Psychiatry in Historical Perspective
- Chapter 1 The Inpatient with Schizophrenia
- Chapter 2 The Inpatient with Depression
- Chapter 3 The Inpatient with Mania
- Chapter 4 The Inpatient with Borderline Personality Disorder
- Chapter 5 The Inpatient with Dementia
- Chapter 6 The Inpatient with Traumatic Brain Injury
- Chapter 7 The Inpatient with Dual Diagnosis (Co-Occurring Disorder)
- Chapter 8 The Young Adult on the Inpatient Unit
- Chapter 9 Clinical Documentation on the Inpatient Unit
- Index
- References
Chapter 1 - The Inpatient with Schizophrenia
Published online by Cambridge University Press: 05 March 2020
Book contents
- Manual of Inpatient Psychiatry
- Manual of Inpatient Psychiatry
- Copyright page
- Contents
- Contributors
- Preface to the Second Edition
- Foreword: American Inpatient Psychiatry in Historical Perspective
- Chapter 1 The Inpatient with Schizophrenia
- Chapter 2 The Inpatient with Depression
- Chapter 3 The Inpatient with Mania
- Chapter 4 The Inpatient with Borderline Personality Disorder
- Chapter 5 The Inpatient with Dementia
- Chapter 6 The Inpatient with Traumatic Brain Injury
- Chapter 7 The Inpatient with Dual Diagnosis (Co-Occurring Disorder)
- Chapter 8 The Young Adult on the Inpatient Unit
- Chapter 9 Clinical Documentation on the Inpatient Unit
- Index
- References
Summary
Patients with schizophrenia who meet criteria for admission to an inpatient unit are generally quite ill. The so-called positive symptoms of schizophrenia, which can result in threatening behavior and loss of control, are the usual triggers for admission. Some admitted patients will be experiencing a first episode of illness (“first break”), while others are hospitalized with an exacerbation of preexisting schizophrenia. The most obvious – and most disruptive – symptoms are generally related to psychosis, with the loss of reality testing and impaired mental functioning [1, 2]. Psychosis usually presents with hallucinations, delusions, disorganized thinking, and/or bizarre or disruptive behavior (Table 1.1). The onset of illness or worsening of psychotic symptoms may be noticed by a family member, friend, teacher, coworker, employer, or caregiver who sees the patient behaving bizarrely and deteriorating in their ability to function. A patient may be so disruptive in the community that he or she is brought to the emergency department by the police.
- Type
- Chapter
- Information
- Manual of Inpatient Psychiatry , pp. 1 - 27Publisher: Cambridge University PressPrint publication year: 2020
References
Sadock, BJ, Sadock, VA, Ruiz, P, eds. Kaplan & Sadock’s synopsis of psychiatry: behavioral sciences/clinical psychiatry. 11th ed. Philadelphia, PA: Lippincott Williams & Wilkins; 2015.Google Scholar
Sadock, BJ, Sadock, VA, Kaplan, HI. Kaplan & Sadock’s comprehensive textbook of psychiatry. Sadock, Benjamin J, Sadock, Virginia A, eds. 8th ed. Philadelphia, PA: Lippincott Williams & Wilkins; 2004.Google Scholar
Center TA. State Standards for Assisted Treatment: Civil Commitment Criteria for Inpatient or Outpatient Psychiatric Treatment: Treatment Advocacy Center; 2014 [updated October 2014].Google Scholar
Caton, CL, Drake, RE, Hasin, DS, et al. Differences between early-phase primary psychotic disorders with concurrent substance use and substance-induced psychoses. Archives of General Psychiatry 2005;62(2):137–45.Google Scholar
Bromet, E KR, Fochtmann, L, Carlson, G, et al. Diagnostic shifts during the decade following first admission for psychosis. American Journal of Psychiatry 2011;168:1186–94.Google Scholar
Armando, M, Pontillo, M, Vicari, S. Psychosocial interventions for very early and early-onset schizophrenia: a review of treatment efficacy. Current Opinion in Psychiatry 2015;28(4):312–23.Google Scholar
Marshall, M, Rathbone, J. Early intervention for psychosis. The Cochrane Database of Systematic Reviews 2011; (6):Cd004718.Google Scholar
Mokhtari, M, Rajarethinam, R. Early intervention and the treatment of prodrome in schizophrenia: a review of recent developments. Journal of Psychiatric Practice 2013;19(5):375–85.Google Scholar
Alvarez-Jimenez, M, O’Donoghue, B, Thompson, A, et al. Beyond clinical remission in first episode psychosis: thoughts on antipsychotic maintenance vs. guided discontinuation in the functional recovery era. CNS Drugs 2016;30(5):357–68.Google Scholar
Starzer, MSK, Nordentoft, M, Hjorthoj, C. Rates and predictors of conversion to schizophrenia or bipolar disorder following substance-induced psychosis. American Journal of Psychiatry 2018;175(4):343–50.Google Scholar
Walker, EF, Grimes, KE, Davis, DM, Smith, AJ. Childhood precursors of schizophrenia: facial expressions of emotion. American Journal of Psychiatry 1993;150(11):1654–60.Google Scholar
Walker, EF, Lewine, RR, Neumann, C. Childhood behavioral characteristics and adult brain morphology in schizophrenia. Schizophrenia Research 1996;22(2):93–101.Google Scholar
Roy, MA, Walsh, D, Kendler, KS. Accuracies and inaccuracies of the family history method: a multivariate approach. Acta Psychiatrica Scandinavica. 1996;93(4):224–34.Google Scholar
Haahr, U, Friis, S, Larsen, TK, et al. First-episode psychosis: diagnostic stability over one and two years. Psychopathology. 2008;41(5):322–9.Google Scholar
Cheniaux, E, Landeira-Fernandez, J, Versiani, M. The diagnoses of schizophrenia, schizoaffective disorder, bipolar disorder and unipolar depression: interrater reliability and congruence between DSM-IV and ICD-10. Psychopathology 2009;42(5):293–8.Google Scholar
Ayuso-Gutiérrez, JL, del Río Vega, JM. Factors influencing relapse in the long-term course of schizophrenia. Schizophrenia Research 1997;28(2–3):199–206.Google Scholar
Leucht, S, Komossa, K, Rummel-Kluge, C, et al. A meta-analysis of head-to-head comparisons of second-generation antipsychotics in the treatment of schizophrenia. American Journal of Psychiatry 2009;166(2):152–63.Google Scholar
American Diabetes Association, American Psychiatric Association, American Association of Clinical Endocrinologists, North American Association for the Study of Obesity. Consensus development conference on antipsychotic drugs and obesity and diabetes. Diabetes Care 2004;27(2):596–601.CrossRefGoogle Scholar
Henderson, DC. Weight gain with atypical antipsychotics: evidence and insights. Journal of Clinical Psychiatry 2007;68 (Suppl 12):18–26.Google Scholar
Newcomer, JW. Second-generation (atypical) antipsychotics and metabolic effects: a comprehensive literature review. CNS Drugs. 2005;19 (Suppl 1):1–93.CrossRefGoogle ScholarPubMed
Invega [package insert]. Titusville, NJ: Ortho-McNeil-Janssen Pharmaceuticals, Inc.; 2009.Google Scholar
Risperdal [package insert]. Titusville, NJ: Ortho-McNeil-Janssen Pharmaceuticals, Inc.; 2009.Google Scholar
Abilify [package insert]. Tokyo: Otsuka Pharmaceutical Co, Ltd.; 2009.Google Scholar
Seroquel XR [package insert]. Wilmington, DE: AstraZeneca Pharmaceuticals LP; 2009.Google Scholar
Seroquel [package insert]. Wilmington, DE: AstraZeneca Pharmaceuticals LP; 2009.Google Scholar
Geodon [package insert]. New York, NY: Pfizer, Inc.; 2009.Google Scholar
Zyprexa [package insert]. Indianapolis, IN: Eli Lilly and Company; 2009.Google Scholar
Briffa, D, Meehan, T. Weight changes during clozapine treatment. Australian and New Zealand Journal of Psychiatry 1998;32(5):718–21.Google Scholar
Prakash, A, Lamb, HM Zotepine: a review of its pharmacodynamic and pharmacokinetic properties and therapeutic efficacy in the management of schizophrenia. CNS Drugs. 1998;9(2):153–75.Google Scholar
Brown, CS, Farmer, RG, Soberman, JE, Eichner, SF. Pharmacokinetic factors in the adverse cardiovascular effects of antipsychotic drugs. Clinical Pharmacokinetics 2004;43(1):33–56.Google Scholar
McKeage, K, Plosker, GL. Amisulpride: a review of its use in the management of schizophrenia. CNS Drugs. 2004;18(13):933–56.Google Scholar
Stollberger, C, Huber, JO, Finsterer, J. Antipsychotic drugs and QT prolongation. International Clinical Psychopharmacology 2005;20(5):243–51.Google Scholar
Bishara, D, Taylor, D. Upcoming agents for the treatment of schizophrenia: mechanism of action, efficacy and tolerability. Drugs. 2008;68(16):2269–92.CrossRefGoogle ScholarPubMed
Kane, JM, Fleischhacker, WW, Hansen, L, Perlis, R, Pikalov, A, 3rd, Assuncao-Talbott, S. Akathisia: an updated review focusing on second-generation antipsychotics. Journal of Clinical Psychiatry 2009;70(5):627–43.Google Scholar
Haddad, PM, Dursun, S. Selecting antipsychotics in schizophrenia: lessons from CATIE. Journal of Psychopharmacology 2006;20(3):332–4.Google Scholar
Jones, PB, Barnes, TRE, Davies, L, et al. Randomized controlled trial of the effect on quality of life of second- vs. first-generation antipsychotic drugs in schizophrenia: cost utility of the latest antipsychotic drugs in schizophrenia study (CUtLASS 1). Archives of General Psychiatry 2006;63(10):1079–87.Google Scholar
Lewis, S, Lieberman, J. CATIE and CUtLASS: can we handle the truth? The British Journal of Psychiatry 2008;192(3):161–3.Google Scholar
Lieberman, JA, Stroup, TS, McEvoy, JP, et al. Effectiveness of antipsychotic drugs in patients with chronic schizophrenia. The New England Journal of Medicine 2005;353(12):1209–23.Google Scholar
DRUGDEX® System Greenwood Village, CO: Thomson Reuters (Healthcare) Inc.; n.d. Available from: www.thomsonhc.com.Google Scholar
Lieberman, JA, Tasman, A. Handbook of psychiatric drugs. Chichester, England; Hoboken, NJ: John Wiley & Sons; 2006.Google Scholar
Risperdal Consta [package insert]. Titusville, NJ: Janssen Pharmaceuticals, Inc.; 2007.Google Scholar
Invega Sustenna [package insert]. Titusville, NJ: Janssen Pharmaceuticals, Inc.; 2017.Google Scholar
Invega Trinza [package insert]. Titusville, NJ: Janssen Pharmaceuticals, Inc.; 2015.Google Scholar
Abilify Maintena [package insert]. Tokyo: Otsuka Pharmaceutical Co, Ltd.; 2018.Google Scholar
Abilify Aristada [package insert]. Dublin, Ireland: Alkermes, Inc.; 2018.Google Scholar
Luedecke, D, Schottle, D, Karow, A, Lambert, M, Naber, D. Post-injection delirium/sedation syndrome in patients treated with olanzapine pamoate: mechanism, incidence, and management. CNS Drugs 2015;29(1):41–6.Google Scholar
Kane, JM, Aqid, O, Baldwin, ML, et al. Clinical guidance on the identification and management of treatment-resistant schizophrenia. Journal of Clinical Psychiatry 2019;80(2):e1–9. 10.4088/JCP.18com12123.Google Scholar
Petrides, G, Malur, C, Braga, R, Bailine, S. Electroconvulsive therapy augmentation in clozapine-resistant schizophrenia: a prospective, randomized study. FOCUS The Journal of Lifelong Learning in Psychiatry 2019;published online: January 10, 2019, https://doi.org/10.1176/appi.focus.17106.CrossRefGoogle Scholar
Citrome, L. Agitation III: pharmacologic treatment of agitation. In: Glick, RL, Berlin, JS, Fishkind, AB, Zeller, SL, eds. Emergency psychiatry: principles and practice. Philadelphia: Wolters Kluwer Health/Lippincott Williams & Wilkins; 2008.Google Scholar
Battaglia, J. Pharmacological management of acute agitation. Drugs 2005;65(9):1207–22.Google Scholar
Kay, SR, Fiszbein, A, Opler, LA. The positive and negative syndrome scale (PANSS) for schizophrenia. Schizophrenia Bulletin 1987;13(2):261–76.Google Scholar
Swift, RH, Harrigan, EP, Cappelleri, JC, Kramer, D, Chandler, LP. Validation of the behavioural activity rating scale (BARS): a novel measure of activity in agitated patients. Journal of Psychiatric Research 2002;36(2):87–95.Google Scholar
Bourgeois, M, Swendsen, J, Young, F, et al. Awareness of disorder and suicide risk in the treatment of schizophrenia: results of the international suicide prevention trial. American Journal of Psychiatry 2004;161(8):1494–6.Google Scholar
Clarke, M, Whitty, P, Browne, S, et al. Suicidality in first episode psychosis. Schizophrenia Research 2006;86(1–3):221–5.Google Scholar
Hill, M, Freudenreich, O. Clozapine: key discussion points for prescribers. Clinical Schizophrenia & Related Psychoses 2013;6(4):177–85.Google Scholar
Kane, JM. Strategies for making an accurate differential diagnosis of schizoaffective disorder. The Journal of Clinical Psychiatry 2010;71(Suppl 2):4–7.Google Scholar
Chien, WT, Yip, AL. Current approaches to treatments for schizophrenia spectrum disorders, part I: an overview and medical treatments. Neuropsychiatric Disease and Treatment 2013;9:1311–32.Google ScholarPubMed
Chien, WT, Leung, SF, Yeung, FK, Wong, WK. Current approaches to treatments for schizophrenia spectrum disorders, part II: psychosocial interventions and patient-focused perspectives in psychiatric care. Neuropsychiatric Disease and Treatment 2013;9:1463–81.Google Scholar
Warner, R. Recovery from schizophrenia and the recovery model. Current Opinion in Psychiatry 2009;22(4):374–80.Google Scholar
Kidd, SA, McKenzie, KJ, Virdee, G. Mental health reform at a systems level: widening the lens on recovery-oriented care. Canadian Journal of Psychiatry [Revue Canadienne de Psychiatrie] 2014;59(5):243–9.Google Scholar