Enhancing Functional Outcomes in Schizophrenia:
Pharmacologic and Nonpharmacologic Strategies
Effective Dates: October 2008 to October 31, 2009
An Interactive, Case-Based CME-Certified Web Activity
ACTIVITY CHAIR
John M. Kane, MD
Professor, Psychiatry, Neurology, and Neuroscience
Albert Einstein College of Medicine
Bronx, New York
Chairman, Psychiatry
The Zucker Hillside Hospital
Glen Oaks, New York
DISTINGUISHED FACULTY
Peter F. Buckley, MD
Professor and Chairman, Psychiatry
Medical College of Georgia
Augusta, Georgia
Philip D. Harvey, PhD
Professor, Psychiatry
Emory University School of Medicine
Atlanta, Georgia
Effective Dates
October 2008 to October 31, 2009
Estimated time to complete activity
30 minutes per module (120 minutes total)
STATEMENT OF NEED
Schizophrenia is a severe, disabling mental illness that affects approximately 2.4 million US adults and is associated with substantial disability and functional impairment. It is estimated that people with untreated psychiatric conditions (including schizophrenia) comprise one-third of the 744,000 US homeless population. Homelessness compromises not only quality of life but also physical safety; the mortality risk among homeless individuals is 3 times higher than in the general population.
In 2002, schizophrenia cost the United States about $63 billion, with a trend toward declining inpatient cost versus increased outpatient and medication costs. Schizophrenia is associated with lifelong functional impairment in social, occupational, and independent living activities, with recurring problems involving adherence, quality of life, and risk for psychotic relapse and rehospitalization. Indeed, functional impairment is now considered a core diagnostic feature of schizophrenia. However, despite the well-established centrality of functional impairment in schizophrenia, patient function has been neglected as a focus and target in both research and treatment.
The understanding of functional impairment in schizophrenia has evolved from a focus on delusions and hallucinations to a focus on a more central role for cognition. Among patients with schizophrenia, 85% score from 1.3 to 2 standard deviations below the mean, compared with samples drawn from the mentally healthy population. There is a correlation between neuropsychological impairment and several domains of functional impairment. Cognitive impairment is strongly associated with the ability of a patient to function in an employment, residential, and social situation. Nevertheless, cognitive impairment is still not included in the DSM-IV-TR’s formal criteria for the diagnosis of schizophrenia. Cognition is only now being recognized as a critical target for new drug research and treatment.
Sponsorship and Support
Sponsored by Veritas Institute for Medical Education, Inc.
Supported by an educational grant from Janssen, administered by Ortho-McNeil Janssen Scientific Affairs, LLC.
Method of Participation
Follow along with the slides and audio, complete the CME Activity Evaluation and Request for Credit Form online, and receive your statement of credit immediately. This activity is provided free of charge to participants. To obtain your CME credit, please complete all modules.
TARGET AUDIENCE
Psychiatrists
LEARNING OBJECTIVES
1. You will be better able to recognize the presence of cognitive impairments in patients with schizophrenia.
2. You will have a greater awareness of the role of measurement tools in assessing cognitive impairment.
3. You will be able to identify types of cognitive impairment and their role in functional outcomes in patients with schizophrenia.
4. You will be better able to select and sequence appropriate pharmacologic therapies to address cognitive impairments and maximize functional outcomes in patients with schizophrenia.
5. You will be better able to utilize nonpharmacologic interventions, such as cognitive and neuropsychiatric rehabilitative techniques and psychoeducation, to address cognitive impairment in patients with schizophrenia.
ACCREDITATION/DESIGNATION OF CREDIT STATEMENTS
Veritas Institute for Medical Education, Inc. is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians.
Veritas Institute for Medical Education, Inc. designates this educational activity for a maximum of 2.0 AMA PRA Category 1 CreditsTM. Physicians should only claim credit commensurate with the extent of their participation in the activity.
FINANCIAL DISCLOSURE
In accordance with the ACCME’s Standards for Commercial Support, all CME providers are required to disclose to the activity audience the relevant financial relationships of the planners, teachers, and authors involved in the development of CME content. An individual has a relevant financial relationship if he or she has a financial relationship in any amount occurring in the last 12 months with a commercial interest whose products or services are discussed in the CME activity content over which the individual has control. Disclosures are as follows:
Peter F. Buckley, MD: AstraZeneca Pharmaceuticals LP; Bristol-Myers Squibb Company; Eli Lilly and Company; Ortho-McNeil Janssen Scientific Affairs, LLC; Lundbeck Research USA, Inc; Pfizer Inc; Solvay Pharmaceuticals Inc; Wyeth Pharmaceuticals (consulting); AstraZeneca Pharmaceuticals LP, National Institute of Mental Health, Pfizer Inc, Solvay Pharmaceuticals Inc, Wyeth Pharmaceuticals (grant/research support); Bristol-Myers Squibb Company; Ortho-McNeil Janssen Scientific Affairs, LLC; Lundbeck Research USA, Inc; Pfizer Inc (honoraria/expenses).
Philip D. Harvey, PhD: Pfizer Inc, Saegis Pharmaceuticals Inc, sanofi-aventis, Solvay-Wyeth Alliance, Vanda Pharmaceuticals Inc, (consulting); Eli Lilly and Company (speakers bureau); AstraZeneca Pharmaceuticals LP, Bristol-Myers Squibb Company (grant/research support).
John M. Kane, MD: Bristol-Myers Squibb Company; GlaxoSmithKline; Eli Lilly and Company; Lundbeck Research USA, Inc; Ortho-McNeil Janssen Scientific Affairs, LLC; Otsuka Pharmaceutical Co, Ltd; Pfizer Inc; PGxHealth; Proteus Applied Technologies; Vanda Pharmaceuticals Inc; Wyeth Pharmaceuticals (consulting); AstraZeneca Pharmaceuticals LP; Bristol-Myers Squibb Company; Eli Lilly and Company; Ortho-McNeil Janssen Scientific Affairs, LLC (speakers bureau).
The staff of Veritas Institute for Medical Education, Inc. has nothing to disclose.
OFF-LABEL/INVESTIGATIONAL USES OF DRUGS DISCLOSURE
Participants are advised that this CME activity will contain references to unlabeled/unapproved/investigational uses of drugs to treat patients with schizophrenia.
DISCLAIMER
The opinions expressed in this activity are those of the presenters and do not necessarily reflect those of Veritas Institute for Medical Education, Inc., or Janssen, administered by Ortho-McNeil Janssen Scientific Affairs, LLC. Please consult the appropriate package insert for full prescribing information on all drug therapies discussed.
Copyright © 2008 Veritas Institute for Medical Education, Inc. All rights reserved.
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