Current Research on the Genetic Contributors to Schizophrenia

In this article, we review genetic research on schizophrenia to illustrate current strategies, findings, challenges, and future directions in the study of a relatively common, severe psychopathological phenotype. Family, twin, and adoption studies indicate that overall genetic effects on schizophrenia are both important and complex. Although efforts to identify specific causal genetic variants have utilized the full range of molecular and analytic techniques, results have been modest. Several putative common genetic variants of small effect appear to be implicated along with some extremely rare variants of potentially large effect. It seems clear that most of the genetic contributors to the liability to schizophrenia, as well as nongenetic ones, remain to be identified. New strategies give reason for optimism that our understanding of the causes of this tragic disorder will continue to increase.

Clozapine for treatment-resistant agitation in dementia

Few studies have examined the potential role of clozapine in treatment of agitation in dementia patients who have previously failed to respond to standard pharmacotherapy. We conducted a systematic chart review of all elderly patients admitted to our inpatient unit between 2001 and 2004. Of them, 16 dementia patients were treated with clozapine for treatment-resistant agitation, and their charts were blindly rated by 3 clinicians on the Clinical Global Impression (CGI) Scale, Brief Agitation Rating Scale (BARS), and the Cohen-Mansfield Agitation Inventory-Short Form (CMAI-SF). Overall, clozapine therapy seemed beneficial in treatment-resistant agitation in dementia patients.

Level of cognitive impairment predicts mortality in high-risk community samples: the memory and medical care study

Over the course of 3 years, the authors investigated the relationship between severity of cognitive impairment and mortality in a community sample of 498 elders at high risk for cognitive impairment. Subjects were classified as having no cognitive disorder, mild cognitive impairment, or dementia, based on a validated battery of four neuropsychological tests. Severity of impairment was based on Mini-Mental State Examination scores. Additional data were obtained from subjects' knowledgeable informants and Medicare records. Kaplan-Meier survival estimates and Cox hazard proportion analysis of the sample revealed that presence of cognitive impairment increases mortality in a fashion that parallels the severity of the impairment.