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Research and treatment strategies in first-episode psychoses: The Pittsburgh experience

Published online by Cambridge University Press:  06 August 2018

M. S. Keshavan ,
N. R. Schooler ,
J. A. Sweeney ,
G. L. Haas  and
J. W. Pettegrew
M. S. Keshavan*
Affiliation:
Department of Psychiatry, Western Psychiatric Institute and Clinic, Pittsburgh, Pennsylvania, USA
N. R. Schooler
Affiliation:
Departments of Psychiatry and Neurology, University of Pittsburgh, Pennsylvania, USA
J. A. Sweeney
Affiliation:
Departments of Psychiatry and Neurology, University of Pittsburgh, Pennsylvania, USA
G. L. Haas
Affiliation:
Departments of Psychiatry and Neurology, University of Pittsburgh, Pennsylvania, USA
J. W. Pettegrew
Affiliation:
University of Pittsburgh, Graduate School of Public Health, Pittsburgh, Pennsylvania, USA
*
Correspondence: M. S. Keshavan, Department of Psychiatry, Western Psychiatric Institute and Clinic, 3811 O'Hara Street, Pittsburgh, PA 15213, USA. Fax: (412) 624 4699; e-mail: keshavan+@pitt.edu
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Abstract

Background Studies of first-episode patients allow investigation of the biological basis of psychotic disorders without the potential confounds of prior treatment and illness chronicity. Prospective studies of this population can clarify the impact of illness course and treatment on neurobiology.

Method We summarise preliminary findings from our ongoing magnetic resonance imaging and spectroscopy studies of first-episode schizophrenia patients being conducted prospectively from index evaluations through a period of two years; during this period, patients were treated with either a conventional antipsychotic such as haloperidol, or the atypical risperidone.

Results Baseline neurobiological evaluations in first-episode schizophrenia patients have revealed evidence for structural and functional brain abnormalities consistent with a neurodevelopmental model of this illness. Our preliminary data support the value of risperidone as an antipsychotic drug of first choice among patients with early schizophrenic illness.

Conclusions Focused studies of first-episode patients have the potential to unravel pathophysiology of schizophrenic illness. Such knowledge is critical for more effective early detection, intervention and even prevention of this enigmatic disorder.

Type
Research Article
Information
The British Journal of Psychiatry , Volume 172 , Issue S33: Verging on reality , June 1998 , pp. 60 - 65
Copyright
Copyright © 1998 The Royal College of Psychiatrists 

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