Leslie Citrome, M.D., M.P.H., Acting Program Director
Linda Kline, RN, CS, MS, Program Administrator

This Research Program focuses on assessment and effective treatment for patients diagnosed with schizophrenia, schizoaffective disorder or bipolar disorder. Collaboration with the Analytical Psychopharmacology Laboratory, the Center for Advanced Brain Imaging, and other external laboratories allow for new and innovative assessment measures. With clinical research sites at Rockland Psychiatric Center, Manhattan Psychiatric Center, Bronx Psychiatric Center, and Bellevue Hospital, the Program is well positioned for the study of the seriously and persistently mentally ill.

A large study comparing the effects of clozapine, olanzapine, risperidone, and haloperidol has been completed and a series of papers describing the results are in the process of being published. Implemented in collaboration with the University of North Carolina and Duke University, this study is important since it compares the effects of four antipsychotics; previous studies were more limited in scope.

Current work involves research into violent behavior in the mentally ill. Using a unique video recording system installed at the NKI inpatient unit, we analyze the details of individual assaults that the system captures. Neurobiological bases of violent behavior are being studied using molecular genetics and magnetic resonance imaging of the brain. Psychopharmacological approaches to the treatment of violent behavior are pursued in several experimental studies.

Other projects undertaken by the Program include industry sponsored clinical trials of new and novel antipsychotics. The Program was a participant in the Phase II and/or Phase III trials of clozapine, risperidone, sertindole, quetiapine, olanzapine, iloperidone, aripiprazole, valproate, secretin, lamotrigine, and others.

Catechol O-methyltransferase (COMT) is one of the main enzymes in dopamine metabolism. Recent research has demonstrated that a common functional polymorphism controlling COMT activity is associated with cognitive and behavioral phenotypes in patients with schizophrenia. The cognitive and behavioral associations appear to indicate that the same genotype that is associated with increased aggression is also associated with better cognitive performance and with more severe symptoms. Complementary effects of dopamine on stability and flexibility of brain functioning may explain this apparent paradox. Ongoing, NARSAD-funded research conducted by Karen Nolan, Ph.D,is examining the effects of COMT genotype on neurocognitive tasks that are differentially dependent on stabilization or cognitive flexibility in patients with schizophrenia.

For further information, contact Linda Kline at