SCHIZOPHRENIA: PSYCHOPATHOLOGY AND COGNITION
The Laboratory for Clinical and Experimental Psychopathology
The Dr. John C. Corrigan Mental Health Center
An Affiliate of the West Roxbury-Brockton Veterans Administration Medical Center
Department of Psychiatry, Harvard Medical School
Theo C. Manschreck, MD, MPH, Roger Boshes, MD, Brendan A. Maher, PhD, Patricia Deldin, PhD
Meredith Hanrahan-Boshes, RN, Jakob Linnet, PhD, Steven F. Candela, MA, Brooks Casas, MA
Our research program investigates the mechanisms underlying the symptoms and disturbances in schizophrenia and related psychoses, the heritability of these features, the potential for remediation with somatic and other treatment modalities, and the proposed causes for their occurrence. Central areas of study include the cognitive or information processing disturbances (e.g. in language, memory, attention, etc.) and neuromotor features of these disorders. The main focus of our research has been to develop precise, preferably laboratory based measures that capture the kinds of cognitive disturbances we observe clinically. Using these measures, we explore the nature of cognitive and neurological abnormalities to determine how they manifest themselves and how they are related to other cardinal psychopathologic features (for example, formal thought disorder, delusions, sensory abnormality and emotional responses). These efforts have been complemented by the recent development of a Psychophysiology Laboratory, primarily devoted to the study of Event Related Potentials, in collaboration with Patricia Deldin, PhD, Associate Professor of Psychology in the Department of Psychology, Harvard University.
A second focus of our research is the development of more effective pharmacotherapies and evidence-based clinical guidelines for the administration of antipsychotic medications. The search for more reliable measures of behavior complements these parallel investigations of the relative efficacy and tolerability of a growing array of antipsychotic agents. The ability to accurately measure and analyze multiple indices of cognitive and motor function during treatment with a specific drug yields information about clinical response, underlying pathology and diagnostic subtypes.
Key Words Schizophrenia, Treatment, Motor Abnormalities, Cognitive Abnormalities, Laboratory Based Measurement
Grant Support Support for this work comes from the National Institute of Mental Health, the MA Department of Mental Health, and industry sources, including: NIMH N01MH90001 Comparative effectiveness of antipsychotic medications in patients with schizophrenia: Clinical antipsychotic trials of intervention effectiveness (CATIE) (TCM); Lilly protocol F1D-US-HGGD(c) Cost-effectiveness and functional outcomes of olanzapine in the treatment of schizophrenia in usual clinical practice: a randomized clinical study (TCM).
Project Sites The Laboratory for Clinical and Experimental Psychopathology, Dr. John C. Corrigan Mental Health Center. Department of Psychiatry, Harvard Medical School; Department of Psychology, Harvard University, Cambridge, MA.
Project Director Theo C. Manschreck, MD, MPH, Medical and Research Director, John C. Corrigan Mental Health Center, Professor of Psychiatry, Harvard Medical School. Address: Corrigan Mental Health Center, 49 Hillside Street, Fall River, MA 02720. Email: Theo.Manschreck@dmh.state.ma.us.
Contact Person Meredith Hanrahan-Boshes, RN, Clinical Research Coordinator. Tel. No. (508) 235-7351. FAX (508) 677-4419. Email Address: Meredith.Hanrahan-Boshes@dmh.state.ma.us .
Training Opportunities Currently, we have one post-doctoral fellow, five graduate student fellows (two of whom are pursuing their doctoral-level research at our facility), four senior honors thesis students, and four research assistants working in our laboratory. There are numerous opportunities for research training at all levels and we encourage interested undergraduates, graduates students, and fellows to join in our research endeavors.
Representative Publications .
Boshes, RA & Manschreck, TC. Review of anti-psychotic medication administration: a proposal of intermittent dosing. Schizophrenia Bulletin (in press).
Maher BA & Manschreck, TC. Lateralization, memory, and language in schizophrenia: some facts and an artifact. In Lenzenweger MF & Dworkin RH (Eds) Origin and Development of Schizophrenia: Advances in Experimental Psychopathology. Washington, DC: American Psychological Association.
Manschreck, TC. Delusional disorder and shared psychotic disorder. In: Kaplan HI, Sadock, BJ (eds). Comprehensive Textbook of Psychiatry, Seventh Edition. Baltimore, MD: Williams and Wilkins, Vol I: 1243-1264, 2000.
Manschreck TC, Maher BA, Candela SF, Redmond DA, Yurgelun-Todd DA, Tsuang M. Impaired verbal memory is associated with impaired motor performance in schizophrenia: Relationship to brain structure. Schizophrenia Research, 43: 21-32, 2000.
Manschreck TC, Redmond DA, Candela SF, Maher BA. The effects of clozapine on symptoms, cognition, and functional outcome in schizophrenia. Journal of Neuropsychiatry and Clinical Neurosciences, 11: 481-489, 1999.