Schizophrenia in the 21 Century Edited by T.H.J. Burne docx

SCHIZOPHRENIA
IN THE 21ST CENTURY

Edited by T.H.J. Burne
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Schizophrenia in the 21
st
Century
Edited by T.H.J. Burne


Published by InTech
Janeza Trdine 9, 51000 Rijeka, Croatia

Copyright © 2012 InTech
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First published March, 2012
Printed in Croatia

A free online edition of this book is available at www.intechopen.com
Additional hard copies can be obtained from


Schizophrenia in the 21
st
Century, Edited by T.H.J. Burne
p. cm.
ISBN 978-953-51-0315-8

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Contents
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Preface IX
Part 1 Schizophrenia in the 21
st
Century 1
Chapter 1 Treatment of Schizophrenia in the 21
st
Century:
Towards a more Personalised Approach 3
Robert Hunter
Chapter 2 Family Caregivers of People with Schizophrenia
in East Asian Countries 27
Setsuko Hanzawa
Part 2 Clinical Research on Cognition in Schizophrenia 41
Chapter 3 Schizophrenia and Social Cognition:
From Conceptual Bases to Therapeutic Approaches 43
Luciana de Carvalho Monteiro, Paula Andreia Martins,
Marisa Crivelaro and Mario Rodrigues Louzã
Chapter 4 Cognitive Remediation Therapy (CRT):
Improving Neurocognition
and Functioning in Schizophrenia 69
Rafael Penadés and Rosa Catalán

Chapter 5 Metacognitive Dysfunction in Schizophrenia 87
Martin L. Vargas, Juan M. Sendra and Caridad Benavides
Chapter 6 Directions in Research into Response
Selection Slowing in Schizophrenia 103
D.P. McAllindon and P.G. Tibbo
Part 3 Preclinical Research on Schizophrenia 125
Chapter 7 Serotonin-1A Receptors and Cognitive Enhancement
in Schizophrenia: Role for Brain Energy Metabolism 127
Tomiki Sumiyoshi and Takashi Uehara
VI Contents

Chapter 8 From Humans to Animals:
Animal Models in Schizophrenia 141
Liesl B. Jones
Chapter 9 Behavioral Tests for Evaluation of Information
Processing and Cognitive Deficits in Rodent
Animal Models of Neuropsychiatric Disorders 153
Ales Stuchlik, Tomas Petrasek, Hana Hatalová, Lukas Rambousek,
Tereza Nekovarova and Karel Vales
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Preface
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This book began as a collection of articles on neuropsychiatric disease, but with a clear

focus on Schizophrenia, which is a poorly understood but very disabling group of
brain disorders. We now recognize schizophrenia as a disorder of the brain, but
despite advances in treatment options we are still a long way from having effective
treatments, particularly for cognitive symptoms, and lack effective interventions and
ways to prevent this disease. While hallucinations and delusions (positive symptoms of
schizophrenia) feature prominently in diagnostic criteria, impairments of memory and
attentional processing (cognitive symptoms of schizophrenia) are attracting increasing
interest in modern neuropsychiatry. Schizophrenia in the 21
st
Century gives an overview
of current research on schizophrenia (Part I) and brings together various aspects of
clinical research into cognitive symptoms (Part II) and preclinical research in animal
models (Part III).
Prof. Robert Hunter provides an up to date review of “Treatment of schizophrenia in
the 21
st
Century”. There is a major focus on treatments with antipsychotic medications
and despite advances in neuroscience of schizophrenia, there is still a need for more
effective and safer drugs. However, there is still a place for community-based systems
of care, inpatient services, rehabilitation and psycho-social interventions. In the next
chapter Dr Setsuko Hanzawa offers an insight into attitudes towards the unique
aspects of family caregivers of people with schizophrenia in Japan and Korea, in
“Family caregivers of people with schizophrenia in East Asian countries”.
There are a number of chapters covering various aspects of cognitive symptoms of
schizophrenia in Part II. Luciana de Carvalho Monteiro and colleagues present an
overview of schizophrenia and social cognition and suggest that deficits in social
cognition are observed throughout the course of schizophrenia. Despite
pharmacological and cognitive rehabilitation treatments more research is required to
clarify their impact on social cognition. Following along this theme Drs Rafael Penadés
and Rosa Catalán examine cognitive remediation therapy to improve neurocognitive

outcomes in schizophrenia. Given that cognitive deficits are more closely linked to
functional outcomes than psychiatric symptoms there is a clear need for novel
psychological interventions. Dr Martin Vargas and colleagues continue this theme
providing an overview on metacognitive dysfunction in schizophrenia, which broadly
covers deficits in metarepresentation and executive function. The next chapter by Drs
X Preface

McAllindon and Tibbo examines response selection slowing as a fundamental aspect
of the cognitive deficits of schizophrenia, presenting a detailed review of
neuroimaging studies of response selection in healthy controls and in people with
schizophrenia. Response selection slowing has a long history in schizophrenia
research and may be an endophenotype of schizophrenia, although the promise of
new medications for effective treatments seems a long way off.
Preclincal research into schizophrenia is the focus of Part III. Drs Tomiki Sumiyoshi
and Takashi Uehara specifically address a novel hypothesis linking brain energy
metabolism and disturbances of cognition function, providing evidence for
serotinergic receptors as promising candidates for cognitive enhancers. In the next
chapter Professor Jones reviews the literature on animal models used to study
schizophrenia, with a particular focus on animal models with disruptions to the
hippocampus and the thalamus. The final chapter by Stuchlik and colleagues covers a
range of behavioural tests in rodent animal models that are used to evaluate
information processing and cognitive deficits of relevance to neuropsychiatric
disorders. Although it is not possible to recapitulate all of the features of schizophrenia
in an animal model, preclinical research using animal models is a powerful tool in
understanding the neuroscience of higher cognitive functions and the discovery of
novel drugs aimed at restoring normal cognitive function.
Schizophrenia is a debilitating group of disorders and there is much work to be done
before we understand the neuroscience of schizophrenia and have safe and effective
treatments for all patients. Antipsychotic drugs have largely been effective at treating
the positive symptoms of schizophrenia. However, we do not have adequate

treatments for cognitive dysfunction, which is a core part of the disorder. This book
provides the reader with a diversity of findings examining a range of available
treatment options into cognitive symptoms with evidence presented from both clinical
and preclinical studies.
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Dr. T.H.J. Burne
Queensland Brain Institute,
The University of Queensland,
Australia




Part 1
Schizophrenia in the 21
st
Century