Schizophrenia is a severe and debilitating disorder, primarily treated with antipsychotic medications. Weight gain is a serious side-effect associated with most second generation antipsychotic drugs such as clozapine. The mechanism behind clozapine-induced weight gain remains poorly understood, but changes in eating behaviour and energy homeostasis may be involved. Recently, genome-wide association studies have identified a number of genetic variants associated with obesity risk; however the effects of these risk variants on clozapine-induced weight gain have not been investigated. This doctoral thesis focused on the following research questions: (1) Does schizophrenia share a genetic link with obesity? (2) Can various antipsychotics alter the expression of obesity-related genes? (3) What is the initial signalling event by which clozapine could induce a change in mRNA expression of the obesity-related genes? The major findings from this work included that there was no demonstrable association between obesity-related variants and schizophrenia, and that low and intermediate doses of clozapine (0.125 μg/ml and 0.25 μg/ml) induced changes in mRNA expression of a panel of obesity-related genes in U937 cells. This effect was not observed in cells treated with haloperidol. However, the mRNA expression of most obesity-related genes tested was also altered by treatment with olanzapine in most obesity-related genes tested but only in one gene when treated with risperidone. Treatment with 5-HT promoted an increase in mRNA expression of some obesity-related genes, which was similar to the treatment with 0.25 μg/ml clozapine although this effect was not apparent with a combination of clozapine and 5-HT. Changes in mRNA expression in clozapine-treated cells were likely mediated by the IP3 signalling pathway. In conclusion, the mechanism behind weight gain in patients treated with either clozapine or olanzapine is multi-factorial: this study suggests that there may be an additional risk factor that could facilitate antipsychotic-induced weight gain: the altered the mRNA expression of obesity-related genes.

Thesis (M.S.)--Northern Michigan University, 2009. / Bibliography: leaves 101-114.

Adherence to antipsychotic medication in schizophrenia has been shown to predict symptom exacerbations; however, adherence remains poor in this population. The concept of taking medication on a maintenance regime is an example of prospective memory (PM). The current investigation is comprised of three studies in which 59 outpatients diagnosed with schizophrenia completed a comprehensive assessment including measures of PM, executive functioning, comprehension of medication instructions, insight into the need for medication, and environmental variables supporting adherence. An objective measure of medication adherence was also collected during a one-month baseline period. In study 1, medication adherence was conceptualized as a PM task and variables for predicting adherence based on PM literature were examined. Of the hypothesized variables, the interactive effect of PM ability and comprehension of medication instructions was the only predictor of adherence to antipsychotic medication. Comprehension of medication instructions alone was the only predictor of adherence to total psychotropic medication regime. Study 2 investigated the role of executive functions in the awareness of PM deficits and use of compensatory strategies. Results indicated that patients with poorer executive skills were less reliable in their report of PM ability compared to performance on PM measures. However, both fair and poor executive functioning groups reported similar use of compensatory strategies. Lastly, the third study manipulated the specificity of retrieval context for a 5-day habitual PM task intended to mimic medication-taking. The aim of this investigation was to examine the effect of retrieval context specificity and executive functioning on task performance. Results demonstrated that patients categorized as fair executive functioning completed significantly more days of the habitual task than patients categorized as poor executive functioning. There was no difference in performance between patients receiving greater retrieval context specificity versus patients receiving a general context. However, there was a trend for individuals with fair executive functioning to benefit from greater retrieval context specificity, implying that a minimum level of executive skill may be necessary for individuals to recognize the risk of a restricted retrieval interval and/or mobilize additional resources for encoding. Clinical implications are discussed. / text

Objective The study is to explore the relationship between antipsychotics and blood glucose level or lipid level of patients with mental illness in psychiatric outpatient clinic of Queen Mary Hospital. Participants and Methods Case reviews through Clinical Management System were carried out. Total 108 psychotic cases involved in the study. 24 were excluded as the patients did not have any treatment of antipsychotics. 84 patients were qualified for review. 40 females and 68 males involved. Their ages are between 13 and 68. Patients’ demographics information, blood glucose level or lipid level were retrieved. Some important findings are also noted. Data collection carried in May 2014. Results There are no significant changes in fasting blood glucose or lipid level for either typical or atypical antipsychotics. We found that the frequency of checking blood glucose or lipid level was too low and not regular. Risperidone and Olanzapine are the most commonly used in this psychiatric outpatient clinic. Moreover, 9 cases change from psychosis to Paranoid type schizophrenia. The most frequent diagnosis in the clinic is Paranoid type schizophrenia. 36 cases, one third of the samples, are diagnosed as Paranoid type schizophrenia. Conclusions Although we cannot conclude the effect of antipsychotics on blood glucose level or lipid level of patients with mental illness, there is an increasing concern about antipsychotics leading to metabolic problems through the case reviews. We suggest that routine physical health screening, guidelines setting up, predictors should be carried out in the clinic. / published_or_final_version / Psychological Medicine / Master / Master of Psychological Medicine

Not available / text

Thesis (Ph. D.)--Carleton University, 2003. / Includes bibliographical references (p. 187-221). Also available in electronic format on the Internet.

Thesis (M.H.P.A.)--Washington State University, May 2009. / Title from PDF title page (viewed on Apr. 13, 2010). "Department of Health Policy and Administration." Includes bibliographical references (p. 37-46).

Thesis (doctoral)--Lund University, 1997. / Added t.p. with thesis statement inserted.

Thesis (Ph. D.)--University of Texas at Austin, 2004. / Supervisor: M. Lynn Crismon. Vita. Includes bibliographical references. Also available from UMI.

Thesis (M.H.P.A.)--Washington State University, May 2010. / Title from PDF title page (viewed on July 20, 2010). "Department of Health Policy and Administration." Includes bibliographical references (p. 30-35).