title: Schizophrenia

text: Scales for specifically assessing the presence of negative symptoms, and for measuring their severity, and their changes have been introduced since the earlier scales such as the PANNS that deals with all types of symptoms. These scales are the "Clinical Assessment Interview for Negative Symptoms" (CAINS), and the "Brief Negative Symptom Scale" (BNSS) also known as second-generation scales. In 2020, ten years after its introduction, a cross-cultural study of the use of BNSS found valid and reliable psychometric evidence for the five-domain structure cross-culturally. The BNSS is designed to assess both the presence and severity and change of negative symptoms of the five recognized domains, and the additional item of reduced normal distress. BNSS can register changes in negative symptoms concerning psychosocial and pharmacological intervention trials. BNSS has also been used to study a proposed non-D2 treatment called SEP-363856. Findings supported the favouring of five domains over the two-dimensional proposition.


title: Schizophrenia

text: An estimated 70% of those with schizophrenia have cognitive deficits, and these are most pronounced in early onset and late-onset illness. These are often evident long before the onset of illness in the prodromal stage, and may be present in early adolescence, or childhood. They are a core feature but not considered to be core symptoms, as are positive and negative symptoms. However, their presence and degree of dysfunction is taken as a better indicator of functionality than the presentation of core symptoms. Cognitive deficits become worse at first episode psychosis but then return to baseline, and remain fairly stable over the course of the illness.


title: Schizophrenia

text: The deficits in cognition are seen to drive the negative psychosocial outcome in schizophrenia, and are claimed to equate to a possible reduction in IQ from the norm of 100 to 70–85. Cognitive deficits may be of neurocognition (nonsocial) or of social cognition. Neurocognition is the ability to receive and remember information, and includes verbal fluency, memory, reasoning, problem solving, speed of processing, and auditory and visual perception. Verbal memory and attention are seen to be the most affected. Verbal memory impairment is associated with a decreased level of semantic processing (relating meaning to words). Another memory impairment is that of episodic memory. An impairment in visual perception that is consistently found in schizophrenia is that of visual backward masking. Visual processing impairments include an inability to perceive complex visual illusions. Social cognition is concerned with the mental operations needed to interpret, and understand the self and others in the social world. This is also an associated impairment, and facial emotion perception is often found to be difficult. Facial perception is critical for ordinary social interaction. Cognitive impairments do not usually respond to antipsychotics, and there are a number of interventions that are used to try to improve them; cognitive remediation therapy is of particular help.


title: Schizophrenia

text: Neurological soft signs of clumsiness and loss of fine motor movement are often found in schizophrenia, which may resolve with effective treatment of FEP.


title: Schizophrenia

text: Onset typically occurs between the late teens and early 30s, with the peak incidence occurring in males in the early to mid twenties, and in females in the late twenties. Onset before the age of 17 is known as early-onset, and before the age of 13, as can sometimes occur, is known as childhood schizophrenia or very early-onset. Onset can occur between the ages of 40 and 60, known as late-onset schizophrenia. Onset over the age of 60, which may be difficult to differentiate as schizophrenia, is known as very-late-onset schizophrenia-like psychosis. Late onset has shown that a higher rate of females are affected; they have less severe symptoms and need lower doses of antipsychotics. The tendency for earlier onset in males is later seen to be balanced by a post-menopausal increase in the development in females. Estrogen produced pre-menopause has a dampening effect on dopamine receptors but its protection can be overridden by a genetic overload. There has been a dramatic increase in the numbers of older adults with schizophrenia.


title: Schizophrenia

text: Onset may happen suddenly or may occur after the slow and gradual development of a number of signs and symptoms, a period known as the prodromal stage. Up to 75% of those with schizophrenia go through a prodromal stage. The negative and cognitive symptoms in the prodrome stage can precede FEP (first episode psychosis) by many months and up to five years. The period from FEP and treatment is known as the duration of untreated psychosis (DUP) which is seen to be a factor in functional outcome. The prodromal stage is the high-risk stage for the development of psychosis. Since the progression to first episode psychosis is not inevitable, an alternative term is often preferred of at risk mental state. Cognitive dysfunction at an early age impacts a young person's usual cognitive development. Recognition and early intervention at the prodromal stage would minimize the associated disruption to educational and social development and has been the focus of many studies.


title: Schizophrenia

text: Schizophrenia is described as a neurodevelopmental disorder with no precise boundary, or single cause, and is thought to develop from gene–environment interactions with involved vulnerability factors. The interactions of these risk factors are complex, as numerous and diverse insults from conception to adulthood can be involved. A genetic predisposition on its own, without interacting environmental factors, will not give rise to the development of schizophrenia. The genetic component means that prenatal brain development is disturbed, and environmental influence affects the postnatal development of the brain. Evidence suggests that genetically susceptible children are more likely to be vulnerable to the effects of environmental risk factors.


title: Schizophrenia

text: Estimates of the heritability of schizophrenia are between 70% and 80%, which implies that 70% to 80% of the individual differences in risk to schizophrenia is associated with genetics. These estimates vary because of the difficulty in separating genetic and environmental influences, and their accuracy has been queried. The greatest risk factor for developing schizophrenia is having a first-degree relative with the disease (risk is 6.5%); more than 40% of identical twins of those with schizophrenia are also affected. If one parent is affected the risk is about 13% and if both are affected the risk is nearly 50%. However, the "DSM-5" indicates that most people with schizophrenia have no family history of psychosis. Results of candidate gene studies of schizophrenia have generally failed to find consistent associations, and the genetic loci identified by genome-wide association studies explain only a small fraction of the variation in the disease.


title: Schizophrenia

text: Many genes are known to be involved in schizophrenia, each with small effect and unknown transmission and expression. The summation of these effect sizes into a polygenic risk score can explain at least 7% of the variability in liability for schizophrenia. Around 5% of cases of schizophrenia are understood to be at least partially attributable to rare copy number variations (CNVs); these structural variations are associated with known genomic disorders involving deletions at 22q11.2 (DiGeorge syndrome) and 17q12 (17q12 microdeletion syndrome), duplications at 16p11.2 (most frequently found) and deletions at 15q11.2 (Burnside–Butler syndrome). Some of these CNVs increase the risk of developing schizophrenia by as much as 20-fold, and are frequently comorbid with autism and intellectual disabilities.


title: Schizophrenia

text: The genes CRHR1 and CRHBP are associated with the severity of suicidal behavior. These genes code for stress response proteins needed in the control of the HPA axis, and their interaction can affect this axis. Response to stress can cause lasting changes in the function of the HPA axis possibly disrupting the negative feedback mechanism, homeostasis, and the regulation of emotion leading to altered behaviors.


title: Schizophrenia

text: The question of how schizophrenia could be primarily genetically influenced, given that people with schizophrenia have lower fertility rates, is a paradox. It is expected that genetic variants that increase the risk of schizophrenia would be selected against due to their negative effects on reproductive fitness. A number of potential explanations have been proposed, including that alleles associated with schizophrenia risk confers a fitness advantage in unaffected individuals. While some evidence has not supported this idea, others propose that a large number of alleles each contributing a small amount can persist.


title: Schizophrenia

text: Environmental factors, each associated with a slight risk of developing schizophrenia in later life include oxygen deprivation, infection, prenatal maternal stress, and malnutrition in the mother during prenatal development. A risk is associated with maternal obesity, in increasing oxidative stress, and dysregulating the dopamine and serotonin pathways. Both maternal stress and infection have been demonstrated to alter fetal neurodevelopment through an increase of pro-inflammatory cytokines. There is a slighter risk associated with being born in the winter or spring possibly due to vitamin D deficiency or a prenatal viral infection. Other infections during pregnancy or around the time of birth that have been linked to an increased risk include infections by "Toxoplasma gondii" and "Chlamydia". The increased risk is about five to eight percent. Viral infections of the brain during childhood are also linked to a risk of schizophrenia during adulthood.


title: Schizophrenia

text: Adverse childhood experiences (ACEs), severe forms of which are classed as childhood trauma, range from being bullied or abused, to the death of a parent. Many adverse childhood experiences can cause toxic stress and increase the risk of psychosis. Chronic trauma, including ACEs, can promote lasting inflammatory dysregulation throughout the nervous system. It is suggested that early stress may contribute to the development of schizophrenia through these alterations in the immune system. Schizophrenia was the last diagnosis to benefit from the link made between ACEs and adult mental health outcomes.


title: Schizophrenia

text: Living in an urban environment during childhood or as an adult has consistently been found to increase the risk of schizophrenia by a factor of two, even after taking into account drug use, ethnic group, and size of social group. A possible link between the urban environment and pollution has been suggested to be the cause of the elevated risk of schizophrenia. Other risk factors include social isolation, immigration related to social adversity and racial discrimination, family dysfunction, unemployment, and poor housing conditions. Having a father older than 40 years, or parents younger than 20 years are also associated with schizophrenia.


title: Schizophrenia

text: About half of those with schizophrenia use recreational drugs, including cannabis, tobacco, and alcohol excessively. Use of stimulants such as amphetamine and cocaine can lead to a temporary stimulant psychosis, which presents very similarly to schizophrenia. Rarely, alcohol use can also result in a similar alcohol-related psychosis. Drugs may also be used as coping mechanisms by people who have schizophrenia, to deal with depression, anxiety, boredom, and loneliness. The use of cannabis and tobacco are not associated with the development of cognitive deficits, and sometimes a reverse relationship is found where their use improves these symptoms. However, substance use disorders are associated with an increased risk of suicide, and a poor response to treatment.


title: Schizophrenia

text: Cannabis use may be a contributory factor in the development of schizophrenia, potentially increasing the risk of the disease in those who are already at risk. The increased risk may require the presence of certain genes within an individual. Its use is associated with doubling the rate.


title: Schizophrenia

text: The mechanisms of schizophrenia are unknown, and a number of models have been put forward to explain the link between altered brain function and schizophrenia.The prevailing model of schizophrenia is that of a neurodevelopmental disorder, and the underlying changes that occur before symptoms become evident are seen as arising from the interaction between genes and the environment. Extensive studies support this model. Maternal infections, malnutrition and complications during pregnancy and childbirth are known risk factors for the development of schizophrenia, which usually emerges between the ages of 18–25, a period that overlaps with certain stages of neurodevelopment. Gene-environment interactions lead to deficits in the neural circuitry that affect sensory and cognitive functions.


title: Schizophrenia

text: The common dopamine and glutamate models proposed are not mutually exclusive; each is seen to have a role in the neurobiology of schizophrenia. The most common model put forward was the dopamine hypothesis of schizophrenia, which attributes psychosis to the mind's faulty interpretation of the misfiring of dopaminergic neurons. This has been directly related to the symptoms of delusions and hallucinations. Abnormal dopamine signaling has been implicated in schizophrenia based on the usefulness of medications that affect the dopamine receptor and the observation that dopamine levels are increased during acute psychosis. A decrease in D receptors in the dorsolateral prefrontal cortex may also be responsible for deficits in working memory.


title: Schizophrenia

text: The glutamate hypothesis of schizophrenia links alterations between glutamatergic neurotransmission and the neural oscillations that affect connections between the thalamus and the cortex. Studies have shown that a reduced expression of a glutamate receptor – NMDA receptor, and glutamate blocking drugs such as phencyclidine and ketamine can mimic the symptoms and cognitive problems associated with schizophrenia. Post-mortem studies consistently find that a subset of these neurons fail to express GAD67 (GAD1), in addition to abnormalities in brain morphometry. The subsets of interneurons that are abnormal in schizophrenia are responsible for the synchronizing of neural ensembles needed during working memory tasks. These give the neural oscillations produced as gamma waves that have a frequency of between 30 and 80 hertz. Both working memory tasks and gamma waves are impaired in schizophrenia, which may reflect abnormal interneuron functionality. An important process that may be disrupted in neurodevelopment is astrogenesis – the formation of astrocytes. Astrocytes are crucial in contributing to the formation and maintenance of neural circuits and it is believed that disruption in this role can result in a number of neurodevelopmental disorders including schizophrenia. Evidence suggests that reduced numbers of astrocytes in deeper cortical layers are assocociated with a diminished expression of EAAT2, a glutamate transporter in astrocytes; supporting the glutamate hypothesis.


title: Schizophrenia

text: Deficits in executive functions, such as planning, inhibition, and working memory, are pervasive in schizophrenia. Although these functions are separable, their dysfunction in schizophrenia may reflect an underlying deficit in the ability to represent goal related information in working memory, and to utilize this to direct cognition and behavior. These impairments have been linked to a number of neuroimaging and neuropathological abnormalities. For example, functional neuroimaging studies report evidence of reduced neural processing efficiency, whereby the dorsolateral prefrontal cortex is activated to a greater degree to achieve a certain level of performance relative to controls on working memory tasks. These abnormalities may be linked to the consistent post-mortem finding of reduced neuropil, evidenced by increased pyramidal cell density and reduced dendritic spine density. These cellular and functional abnormalities may also be reflected in structural neuroimaging studies that find reduced grey matter volume in association with deficits in working memory tasks.


title: Schizophrenia

text: Positive symptoms have been linked to cortical thinning in the superior temporal gyrus. Severity of negative symptoms has been linked to reduced thickness in the left medial orbitofrontal cortex. Anhedonia, traditionally defined as a reduced capacity to experience pleasure, is frequently reported in schizophrenia. However, a large body of evidence suggests that hedonic responses are intact in schizophrenia, and that what is reported to be anhedonia is a reflection of dysfunction in other processes related to reward. Overall, a failure of reward prediction is thought to lead to impairment in the generation of cognition and behavior required to obtain rewards, despite normal hedonic responses.


title: Schizophrenia

text: Another theory links abnormal brain lateralization to the development of being left-handed which is significantly more common in those with schizophrenia. This abnormal development of hemispheric asymmetry is noted in schizophrenia. Studies have concluded that the link is a true and verifiable effect that may reflect a genetic link between lateralization and schizophrenia.


title: Schizophrenia

text: Bayesian models of brain functioning have been utilized to link abnormalities in cellular functioning to symptoms. Both hallucinations and delusions have been suggested to reflect improper encoding of prior expectations, thereby causing expectation to excessively influence sensory perception and the formation of beliefs. In approved models of circuits that mediate predictive coding, reduced NMDA receptor activation, could in theory result in the positive symptoms of delusions and hallucinations.


title: Schizophrenia

text: Schizophrenia is diagnosed based on criteria in either the "Diagnostic and Statistical Manual of Mental Disorders" (DSM) published by the American Psychiatric Association or the International Statistical Classification of Diseases and Related Health Problems (ICD) published by the World Health Organization (WHO). These criteria use the self-reported experiences of the person and reported abnormalities in behavior, followed by a psychiatric assessment. The mental status examination is an important part of the assessment. An established tool for assessing the severity of positive and negative symptoms is the Positive and Negative Syndrome Scale (PANSS). This has been seen to have shortcomings relating to negative symptoms, and other scales – the "Clinical Assessment Interview for Negative Symptoms" (CAINS), and the "Brief Negative Symptoms Scale" (BNSS) have been introduced. The DSM-5, published in 2013, gives a "Scale to Assess the Severity of Symptom Dimensions" outlining eight dimensions of symptoms.


title: Schizophrenia

text: DSM-5 states that to be diagnosed with schizophrenia, two diagnostic criteria have to be met over the period of one month, with a significant impact on social or occupational functioning for at least six months. One of the symptoms needs to be either delusions, hallucinations, or disorganized speech. A second symptom could be one of the negative symptoms, or severely disorganized or catatonic behaviour. A different diagnosis of schizophreniform disorder can be made before the six months needed for the diagnosis of schizophrenia.


title: Schizophrenia

text: In Australia the guideline for diagnosis is for six months or more with symptoms severe enough to affect ordinary functioning. In the UK diagnosis is based on having the symptoms for most of the time for one month, with symptoms that significantly affect the ability to work, study, or to carry on ordinary daily living, and with other similar conditions ruled out.


title: Schizophrenia

text: The ICD criteria are typically used in European countries; the DSM criteria are used predominantly in the United States and Canada, and are prevailing in research studies. In practice, agreement between the two systems is high. The current proposal for the ICD-11 criteria for schizophrenia recommends adding self-disorder as a symptom.


title: Schizophrenia

text: A major unresolved difference between the two diagnostic systems is that of the requirement in DSM of an impaired functional outcome. WHO for ICD argues that not all people with schizophrenia have functional deficits and so these are not specific for the diagnosis.


title: Schizophrenia

text: Many people with schizophrenia may have one or more other mental disorders, such as panic disorder, obsessive–compulsive disorder, or substance use disorder. These are separate disorders that require treatment. When comorbid with schizophrenia, substance use disorder and antisocial personality disorder both increase the risk for violence. Comorbid substance use disorder also increases risk for suicide.


title: Schizophrenia

text: Sleep disorders often co-occur with schizophrenia, and may be an early sign of relapse. Sleep disorders are linked with positive symptoms such as disorganized thinking and can adversely affect cortical plasticity and cognition. The consolidation of memories is disrupted in sleep disorders. They are associated with severity of illness, a poor prognosis, and poor quality of life. Sleep onset and maintenance insomnia is a common symptom, regardless of whether treatment has been received or not. Genetic variations have been found associated with these conditions involving the circadian rhythm, dopamine and histamine metabolism, and signal transduction.


title: Schizophrenia

text: To make a diagnosis of schizophrenia other possible causes of psychosis need to be excluded. Psychotic symptoms lasting less than a month may be diagnosed as brief psychotic disorder, or as schizophreniform disorder. Psychosis is noted in "Other specified schizophrenia spectrum and other psychotic disorders" as a DSM-5 category. Schizoaffective disorder is diagnosed if symptoms of mood disorder are substantially present alongside psychotic symptoms. Psychosis that results from a general medical condition or substance is termed secondary psychosis.


title: Schizophrenia

text: Psychotic symptoms may be present in several other conditions, including bipolar disorder, borderline personality disorder, substance intoxication, substance-induced psychosis, and a number of drug withdrawal syndromes. Non-bizarre delusions are also present in delusional disorder, and social withdrawal in social anxiety disorder, avoidant personality disorder and schizotypal personality disorder. Schizotypal personality disorder has symptoms that are similar but less severe than those of schizophrenia. Schizophrenia occurs along with obsessive–compulsive disorder (OCD) considerably more often than could be explained by chance, although it can be difficult to distinguish obsessions that occur in OCD from the delusions of schizophrenia. There can be considerable overlap with the symptoms of post-traumatic stress disorder.


title: Schizophrenia

text: A more general medical and neurological examination may be needed to rule out medical illnesses which may rarely produce psychotic schizophrenia-like symptoms, such as metabolic disturbance, systemic infection, syphilis, HIV-associated neurocognitive disorder, epilepsy, limbic encephalitis, and brain lesions. Stroke, multiple sclerosis, hyperthyroidism, hypothyroidism, and dementias such as Alzheimer's disease, Huntington's disease, frontotemporal dementia, and the Lewy body dementias may also be associated with schizophrenia-like psychotic symptoms. It may be necessary to rule out a delirium, which can be distinguished by visual hallucinations, acute onset and fluctuating level of consciousness, and indicates an underlying medical illness. Investigations are not generally repeated for relapse unless there is a specific "medical" indication or possible adverse effects from antipsychotic medication. In children hallucinations must be separated from typical childhood fantasies. It is difficult to distinguish childhood schizophrenia from autism.


title: Schizophrenia

text: Prevention of schizophrenia is difficult as there are no reliable markers for the later development of the disorder. It is unclear as of 2011 whether treating patients in the prodrome phase of schizophrenia provides benefits. There is a discrepancy between the growth in the implementation of early intervention programmes for psychosis and the underlying empirical evidence.


title: Schizophrenia

text: There is some evidence as of 2009 that early intervention in those with first-episode psychosis may improve short-term outcomes, but there is little benefit from these measures after five years. Cognitive behavioral therapy may reduce the risk of psychosis in those at high risk after a year and is recommended in this group, by the National Institute for Health and Care Excellence (NICE). Another preventive measure is to avoid drugs that have been associated with development of the disorder, including cannabis, cocaine, and amphetamines.


title: Schizophrenia

text: Antipsychotics are prescribed following a first-episode psychosis, and following remission a preventive maintenance use is continued to avoid relapse. However, it is recognized that some people do recover following a single episode and that long-term use of antipsychotics will not be needed but there is no way of identifying this group.


title: Schizophrenia

text: The primary treatment of schizophrenia is the use of antipsychotic medications, often in combination with psychosocial interventions and social supports. Community support services including drop-in centers, visits by members of a community mental health team, supported employment, and support groups are common. The time between the onset of psychotic symptoms to being given treatment – the duration of untreated psychosis (DUP) – is associated with a poorer outcome in both the short term and the long term.


title: Schizophrenia

text: Voluntary or involuntary admission to hospital may be imposed by doctors and courts who deem a person to be having a severe episode. In the UK, large mental hospitals termed asylums began to be closed down in the 1950s with the advent of antipsychotics, and with an awareness of the negative impact of long-term hospital stays on recovery. This process was known as deinstitutionalization, and community and supportive services were developed in order to support this change. Many other countries followed suit with the US starting in the 60s. There still remain a smaller group of people who do not improve enough to be discharged. In some countries that lack the necessary supportive and social services, long-term hospital stays are more usual.


title: Schizophrenia

text: The first-line treatment for schizophrenia is an antipsychotic. The first-generation antipsychotics, now called typical antipsychotics, are dopamine antagonists that block D2 receptors, and affect the neurotransmission of dopamine. Those brought out later, the second-generation antipsychotics known as atypical antipsychotics, can also have effect on another neurotransmitter, serotonin. Antipsychotics can reduce the symptoms of anxiety within hours of their use but for other symptoms they may take several days or weeks to reach their full effect. They have little effect on negative and cognitive symptoms, which may be helped by additional psychotherapies and medications. There is no single antipsychotic suitable for first-line treatment for everyone, as responses and tolerances vary between people. Stopping medication may be considered after a single psychotic episode where there has been a full recovery with no symptoms for twelve months. Repeated relapses worsen the long-term outlook and the risk of relapse following a second episode is high, and long-term treatment is usually recommended.


title: Schizophrenia

text: About half of those with schizophrenia will respond favourably to antipsychotics, and have a good return of functioning. However, positive symptoms persist in up to a third of people. Following two trials of different antipsychotics over six weeks, that also prove ineffective, they will be classed as having treatment resistant schizophrenia (TRS), and clozapine will be offered. Clozapine is of benefit to around half of this group although it has the potentially serious side effect of agranulocytosis (lowered white blood cell count) in less than 4% of people.


title: Schizophrenia

text: About 30 to 50 percent of people with schizophrenia do not accept that they have an illness or comply with their recommended treatment. For those who are unwilling or unable to take medication regularly, long-acting injections of antipsychotics may be used, which reduce the risk of relapse to a greater degree than oral medications. When used in combination with psychosocial interventions, they may improve long-term adherence to treatment.


title: Schizophrenia

text: Extrapyramidal symptoms, including akathisia, are associated with all commercially available antipsychotic to varying degrees. There is little evidence that second generation antipsychotics have reduced levels of extrapyramidical symptoms compared to typical antipsychotics. Tardive dyskinesia can occur due to long-term use of antipsychotics, developing after months or years of use. The antipsychotic clozapine is also associated with thromboembolism (including pulmonary embolism), myocarditis, and cardiomyopathy.


title: Schizophrenia

text: A number of psychosocial interventions that include several types of psychotherapy may be useful in the treatment of schizophrenia such as: family therapy, group therapy, cognitive remediation therapy (CRT), cognitive behavioral therapy (CBT), and metacognitive training. Skills training, and help with substance use, and weight management – often needed as a side effect of an antipsychotic – are also offered. In the US, interventions for first episode psychosis have been brought together in an overall approach known as coordinated speciality care (CSC) and also includes support for education. In the UK "care across all phases" is a similar approach that covers many of the treatment guidelines recommended. The aim is to reduce the number of relapses and stays in hospital.


title: Schizophrenia

text: Other support services for education, employment, and housing are usually offered. For people with severe schizophrenia, and discharged from a stay in hospital, these services are often brought together in an integrated approach to offer support in the community away from the hospital setting. In addition to medicine management, housing, and finances, assistance is given for more routine matters such as help with shopping and using public transport. This approach is known as assertive community treatment (ACT) and has been shown to achieve positive results in symptoms, social functioning and quality of life. Another more intense approach is known as "intensive care management" (ICM). ICM is a stage further than ACT and emphasises support of high intensity in smaller caseloads, (less than twenty). This approach is to provide long-term care in the community. Studies show that ICM improves many of the relevant outcomes including social functioning.


title: Schizophrenia

text: Some studies have shown little evidence for the effectiveness of CBT in either reducing symptoms or preventing relapse. However, other studies have found that CBT does improve overall psychotic symptoms (when in use with medication) and it has been recommended in Canada, but has been seen to have no effect on social function, relapse, or quality of life. In the UK it is recommended as an add-on therapy in the treatment of schizophrenia. Arts therapies are seen to improve negative symptoms in some people, and are recommended by NICE in the UK. This approach is criticised as having not been well-researched, and arts therapies are not recommended in Australian guidelines for example. Peer support, in which people with personal experience of schizophrenia, provide help to each other, is of unclear benefit.


title: Schizophrenia

text: Exercise including aerobic exercise has been shown to improve positive and negative symptoms, cognition, working memory, and improve quality of life. Exercise has also been shown to increase the volume of the hippocampus in those with schizophrenia. A decrease in hippocampal volume is one of the factors linked to the development of the disease. However, there still remains the problem of increasing motivation for, and maintaining participation in physical activity. Supervised sessions are recommended. In the UK healthy eating advice is offered alongside exercise programs.


title: Schizophrenia

text: An inadequate diet is often found in schizophrenia, and associated vitamin deficiencies including those of folate, and vitamin D are linked to the risk factors for the development of schizophrenia and for early death including heart disease. Those with schizophrenia possibly have the worst diet of all the mental disorders. Lower levels of folate and vitamin D have been noted as significantly lower in first episode psychosis. The use of supplemental folate is recommended. A zinc deficiency has also been noted. Vitamin B is also often deficient and this is linked to worse symptoms. Supplementation with B vitamins has been shown to significantly improve symptoms, and to put in reverse some of the cognitive deficits. It is also suggested that the noted dysfunction in gut microbiota might benefit from the use of probiotics.


title: Schizophrenia

text: Schizophrenia has great human and economic costs. It decreases life expectancy by between 20 and 28 years. This is primarily because of its association with heart disease, diabetes, obesity, poor diet, a sedentary lifestyle, and smoking, with an increased rate of suicide playing a lesser role. Side effects of antipsychotics may also increase the risk.


title: Schizophrenia

text: Almost 40% of those with schizophrenia die from complications of cardiovascular disease which is seen to be increasingly associated. An underlying factor of sudden cardiac death may be Brugada syndrome (BrS) – BrS mutations that overlap with those linked with schizophrenia are the calcium channel mutations. BrS may also be drug-induced from certain antipsychotics and antidepressants. Primary polydipsia, or excessive fluid intake, is relatively common in people with chronic schizophrenia. This may lead to hyponatremia which can be life-threatening. Antipsychotics can lead to a dry mouth, but there are several other factors that may contribute to the disorder; it may reduce life expectancy by 13 per cent. Barriers to improving the mortality rate in schizophrenia are poverty, overlooking the symptoms of other illnesses, stress, stigma, and medication side effects.


title: Schizophrenia

text: Schizophrenia is a major cause of disability. In 2016, it was classed as the 12th most disabling condition. Approximately 75% of people with schizophrenia have ongoing disability with relapses. Some people do recover completely and others function well in society. Most people with schizophrenia live independently with community support. About 85% are unemployed. In people with a first episode of psychosis in schizophrenia a good long-term outcome occurs in 31%, an intermediate outcome in 42% and a poor outcome in 31%. Males are affected more often than females, and have a worse outcome. Studies showing that outcomes for schizophrenia appear better in the developing than the developed world have been questioned. Social problems, such as long-term unemployment, poverty, homelessness, exploitation, stigmatization and victimization are common consequences, and lead to social exclusion.


title: Schizophrenia

text: There is a higher than average suicide rate associated with schizophrenia estimated at 5% to 6%, most often occurring in the period following onset or first hospital admission. Several times more (20 to 40%) attempt suicide at least once. There are a variety of risk factors, including male gender, depression, a high IQ, heavy smoking, and substance use. Repeated relapse is linked to an increased risk of suicidal behavior. The use of clozapine can reduce the risk of suicide, and of aggression.


title: Schizophrenia

text: A strong association between schizophrenia and tobacco smoking has been shown in worldwide studies. Smoking is especially high in those diagnosed with schizophrenia, with estimates ranging from 80 to 90% being regular smokers, as compared to 20% of the general population. Those who smoke tend to smoke heavily, and additionally smoke cigarettes with high nicotine content. Some propose that this is in an effort to improve symptoms. Among people with schizophrenia use of cannabis is also common.


title: Schizophrenia

text: Most people with schizophrenia are not aggressive, and are more likely to be victims of violence rather than perpetrators. People with schizophrenia are commonly exploited and victimized by violent crime as part of a broader dynamic of social exclusion. People diagnosed with schizophrenia are also subject to forced drug injections, seclusion, and restraint at high rates.


title: Schizophrenia

text: The risk of violence by people with schizophrenia is small. There are minor subgroups where the risk is high. This risk is usually associated with a comorbid disorder such as a substance use disorder – in particular alcohol, or with antisocial personality disorder. Substance use disorder is strongly linked, and other risk factors are linked to deficits in cognition and social cognition including facial perception and insight that are in part included in theory of mind impairments. Poor cognitive functioning, decision-making, and facial perception may contribute to making a wrong judgement of a situation that could result in an inappropriate response such as violence. These associated risk factors are also present in antisocial personality disorder which when present as a comorbid disorder greatly increases the risk of violence.


title: Schizophrenia

text: In 2017, the Global Burden of Disease Study estimated there were 1.1 million new cases; in 2022 the World Health Organization (WHO) reported a total of 24 million cases globally. Schizophrenia affects around 0.3–0.7% of people at some point in their life. In areas of conflict this figure can rise to between 4.0 and 6.5%. It occurs 1.4 times more frequently in males than females and typically appears earlier in men.


title: Schizophrenia

text: Worldwide, schizophrenia is the most common psychotic disorder. The frequency of schizophrenia varies across the world, within countries, and at the local and neighborhood level; this variation in prevalence between studies over time, across geographical locations, and by gender is as high as fivefold.


title: Schizophrenia

text: Schizophrenia causes approximately one percent of worldwide disability adjusted life years and resulted in 17,000 deaths in 2015.


title: Schizophrenia

text: In 2000, WHO found the percentage of people affected and the number of new cases that develop each year is roughly similar around the world, with age-standardized prevalence per 100,000 ranging from 343 in Africa to 544 in Japan and Oceania for men, and from 378 in Africa to 527 in Southeastern Europe for women.


title: Schizophrenia

text: Accounts of a schizophrenia-like syndrome are rare in records before the 19th century; the earliest case reports were in 1797 and 1809. "Dementia praecox", meaning premature dementia, was used by German psychiatrist Heinrich Schüle in 1886, and then in 1891 by Arnold Pick in a case report of hebephrenia. In 1893 Emil Kraepelin used the term in making a distinction, known as the Kraepelinian dichotomy, between the two psychoses – dementia praecox, and manic depression (now called bipolar disorder). When it became evident that the disorder was not a degenerative dementia, it was renamed schizophrenia by Eugen Bleuler in 1908.


title: Schizophrenia

text: The word "schizophrenia" translates as 'splitting of the mind' and is Modern Latin from the Greek words "schizein" (σχίζειν, 'to split') and "phrēn", (φρήν, 'mind') Its use was intended to describe the separation of function between personality, thinking, memory, and perception.


title: Schizophrenia

text: In the early 20th century, the psychiatrist Kurt Schneider categorized the psychotic symptoms of schizophrenia into two groups – hallucinations and delusions. The hallucinations were listed as specific to auditory and the delusions included thought disorders. These were seen as important symptoms, termed "first-rank". The most common first-rank symptom was found to belong to thought disorders. In 2013 the first-rank symptoms were excluded from the DSM-5 criteria; while they may not be useful in diagnosing schizophrenia, they can assist in differential diagnosis.


title: Schizophrenia

text: Subtypes of schizophrenia – classified as paranoid, disorganized, catatonic, undifferentiated, and residual – were difficult to distinguish and are no longer recognized as separate conditions by DSM-5 (2013) or ICD-11.


title: Schizophrenia

text: Before the 1960s, nonviolent petty criminals and women were sometimes diagnosed with schizophrenia, categorizing the latter as ill for not performing their duties within patriarchy as wives and mothers. In the mid-to-late 1960s, black men were categorized as "hostile and aggressive" and diagnosed as schizophrenic at much higher rates, their civil rights and Black Power activism labeled as delusions.


title: Schizophrenia

text: In the early 1970s in the US, the diagnostic model for schizophrenia was broad and clinically based using DSM II. Schizophrenia was diagnosed far more in the US than in Europe which used the ICD-9 criteria. The US model was criticised for failing to demarcate clearly those people with a mental illness. In 1980 DSM III was published and showed a shift in focus from the clinically based biopsychosocial model to a reason-based medical model. DSM IV brought an increased focus on an evidence-based medical model.


title: Schizophrenia

text: In the 1930s a number of shock procedures which induced seizures (convulsions) or comas were used to treat schizophrenia. Insulin shock involved injecting large doses of insulin to induce comas, which in turn produced hypoglycemia and convulsions. The use of electricity to induce seizures was in use as electroconvulsive therapy (ECT) by 1938.


title: Schizophrenia

text: Psychosurgery, including the lobotomy and frontal lobotomy – carried out from the 1930s until the 1970s in the United States, and until the 1980s in France – are recognized as a human rights abuse. In the mid-1950s the first typical antipsychotic, chlorpromazine, was introduced, followed in the 1970s by the first atypical antipsychotic, clozapine.


title: Schizophrenia

text: From the 1960s until 1989, psychiatrists in the USSR and Eastern Bloc diagnosed thousands of people with sluggish schizophrenia, without signs of psychosis, based on "the assumption that symptoms would later appear". Now discredited, the diagnosis provided a convenient way to confine political dissidents.


title: Schizophrenia

text: In 2002, the term for schizophrenia in Japan was changed from to to reduce stigma. The new name, also interpreted as "integration disorder", was inspired by the biopsychosocial model. A similar change was made in South Korea in 2012 to attunement disorder.


title: Schizophrenia

text: In the United States, the annual cost of schizophrenia – including direct costs (outpatient, inpatient, drugs, and long-term care) and non-healthcare costs (law enforcement, reduced workplace productivity, and unemployment) – was estimated at $62.7 billion for the year 2002. In the UK the cost in 2016 was put at £11.8 billion per year with a third of that figure directly attributable to the cost of hospital, social care and treatment.


title: Schizophrenia

text: The book "A Beautiful Mind" chronicled the life of John Forbes Nash who had been diagnosed with schizophrenia and won the Nobel Memorial Prize in Economic Sciences. The book was made into a film with the same name; an earlier documentary film was "A Brilliant Madness".


title: Schizophrenia

text: In 1964 a case study of three males diagnosed with schizophrenia who each had the delusional belief that they were Jesus Christ was published as "The Three Christs of Ypsilanti"; a film with the title "Three Christs" was released in 2020.


title: Schizophrenia

text: Media coverage reinforces public perception of an association between schizophrenia and violence; in film, people with schizophrenia are highly likely to be portrayed as a danger to others. In the UK guidelines for reporting conditions and award campaigns have shown a reduction in negative reporting since 2013.


title: Schizophrenia

text: A 2015 Cochrane review found unclear evidence of benefit from brain stimulation techniques to treat the positive symptoms of schizophrenia, in particular auditory verbal hallucinations (AVHs). Most studies focus on transcranial direct-current stimulation (tDCM), and repetitive transcranial magnetic stimulation (rTMS). Techniques based on focused ultrasound for deep brain stimulation could provide insight for the treatment of AVHs.


title: Schizophrenia

text: The study of potential biomarkers that would help in diagnosis and treatment of schizophrenia is an active area of research as of 2020. Possible biomarkers include markers of inflammation, neuroimaging, brain-derived neurotrophic factor (BDNF), and speech analysis. Some markers such as C-reactive protein are useful in detecting levels of inflammation implicated in some psychiatric disorders but they are not disorder-specific. Other inflammatory cytokines are found to be elevated in first episode psychosis and acute relapse that are normalized after treatment with antipsychotics, and these may be considered as state markers. Deficits in sleep spindles in schizophrenia may serve as a marker of an impaired thalamocortical circuit, and a mechanism for memory impairment. MicroRNAs are highly influential in early neuronal development, and their disruption is implicated in several CNS disorders; circulating microRNAs (cimiRNAs) are found in body fluids such as blood and cerebrospinal fluid, and changes in their levels are seen to relate to changes in microRNA levels in specific regions of brain tissue. These studies suggest that cimiRNAs have the potential to be early and accurate biomarkers in a number of disorders including schizophrenia.


title: Rita Ora

text: Rita Sahatçiu Ora (born Rita Sahatçiu; 26 November 1990) is a British singer and songwriter. She rose to prominence in February 2012 when she featured on DJ Fresh's single, "Hot Right Now", which reached number one in the UK. Her debut studio album, "Ora", released in August 2012, debuted at number one in the United Kingdom. The album contained the UK number-one singles, "R.I.P." and "How We Do (Party)". Ora was the artist with the most number-one singles on the UK Singles Chart in 2012, with three singles reaching the top position.


title: Rita Ora

text: Born in Pristina, modern-day Kosovo, Ora was named an Honorary Ambassador of Kosovo in 2015. Ora's second studio album, "Phoenix", was released in November 2018. The lead single, "Your Song", reached the UK top ten, and the subsequent singles, "Anywhere" and "Let You Love Me", reached the top five in the UK. "Let You Love Me" made Ora the first British female solo artist to have thirteen top ten songs in the United Kingdom.


title: Rita Ora

text: Ora was born on 26 November 1990 in Pristina, SFR Yugoslavia (modern-day Kosovo), to Albanian parents. Her mother, Vera (), is a psychiatrist and her father, Besnik Sahatçiu, is a pub owner, having previously studied economics. Ora has an older sister, Elena, and a younger brother, Don. She was born as Rita Sahatçiu (; surname derived from the Turkish word , which means 'watchmaker'), but her parents later added Ora ( means 'time' in Albanian) to the family surname so it could be easily pronounced.


title: Rita Ora

text: Her family left Kosovo for political reasons, because of the persecution of Albanians initiated with the disintegration of Yugoslavia. They relocated to London, England in 1991, when she was a baby. She grew up in Notting Hill, in West London, and attended a performing arts school, Sylvia Young Theatre School.


title: Rita Ora

text: Ora began performing at open mic sessions around London and, occasionally, in her father's pub. In 2008, she auditioned for "" on BBC One to be the British contestant for the Eurovision Song Contest 2009 and qualified, but later withdrew from the competition after a few episodes as she "did not feel ready" and thought "that challenge wasn't for her." Her manager, Sarah Stennett (who also worked with Ellie Goulding, Jessie J and Conor Maynard), later told "HitQuarters" that she reassured Ora that performing in Eurovision would hinder, rather than help her chances to make it as a solo artist.


title: Rita Ora

text: Shortly after, Ora's management got in touch with the American label, Roc Nation, and told them about her. Ora signed a recording deal and a publishing deal with Roc Nation in December 2008, and was one of their first signees. She made a cameo appearance in Jay Z's video for "Young Forever" (2009). After being signed, Ora recorded an album and wanted to release it, but her label advised against it and she started to work on other material for her debut album.


title: Rita Ora

text: Throughout 2011, Ora released covers and videos about working on her debut album on YouTube. The videos caught the attention of DJ Fresh, who at that time was looking for a female vocalist for his song, "Hot Right Now". Ora featured on the single that was released on 12 February 2012, debuting at number one on the UK Singles Chart. During February 2012, Ora was also the opening act at the UK concerts from Drake's Club Paradise Tour.


title: Rita Ora

text: The first UK single from her debut album, "R.I.P." (featuring Tinie Tempah), was released on 6 May 2012. Produced by Chase & Status, the song debuted at the top of the UK Singles Chart, becoming her first solo UK number one. On 12 August, "How We Do (Party)" was released as a single, and it reached number one in the UK and Ireland. It was Ora's second UK number one as a solo artist, and third overall in 2012.


title: Rita Ora

text: Whilst supporting Coldplay on their Mylo Xyloto Tour, she later announced that her debut album would be titled "Ora". The album was released on 27 August 2012 in Europe and Oceania, and debuted at the top of the UK Albums Chart. Ora was nominated for Best New Artist, Push Artist and Best UK/Ireland Act at the 2012 MTV Europe Music Awards. In September 2012, it was announced that Ora would be the opening act on the UK concerts from Usher's Euphoria Tour set to start in January 2013. However, the tour was postponed due to Usher's "professional and personal commitments."


title: Rita Ora

text: "Shine Ya Light", released on 4 November, became Ora's fourth consecutive UK top ten single in 2012, peaking at number ten. On 28 November 2012, Ora performed as a special guest at the concert held in Tirana, Albania for the 100th Anniversary of the Independence of Albania. In January 2013, Ora embarked on her first UK tour, Radioactive Tour, to support her debut album. She was nominated for three awards at the 2013 Brit Awards, including the Brit Award for British Breakthrough Act.


title: Rita Ora

text: In January 2013, Ora revealed that her second album would be clearer and have more direction than the first one. On 26 February 2013, she revealed to "Digital Spy" that her second album shows a different angle to a "party girl." On 24 May 2013, Ora was the headline act on In New Music We Trust stage at BBC Radio 1's Big Weekend. On 28 June 2013, she performed on the Pyramid Stage at Glastonbury.


title: Rita Ora

text: In 2014, she had two top-five UK singles; the song "I Will Never Let You Down" which debuted at number one, and she featured on Iggy Azalea's "Black Widow" which peaked at number four in the UK, and the latter became Ora's first top ten song on the US "Billboard" Hot 100 chart, peaking at number three. On 14 December 2014, Ora performed at the 2014 telecast of "Christmas in Washington", filmed at the National Building Museum. In February 2015, Ora featured on Charli XCX song, "Doing It", which debuted at number eight in the UK. On 22 February 2015, at the 87th Academy Awards, she performed the song "Grateful", which appears in Gina Prince-Bythewood's film, "Beyond the Lights" (2014).


title: Rita Ora

text: In December 2015, Ora filed a lawsuit against Roc Nation, seeking release from the label and citing that the contract she signed in 2008 is "unenforceable", due to California's "seven-year rule." The complaint stated that she's "only been permitted to release one album despite creating multiple additional records for release" and that her relationship with Roc Nation is "irrevocably damaged." In January 2016, Roc Nation filed a counter-lawsuit against Ora for breaking her recording contract, in New York. They reached a settlement in May 2016.


title: Rita Ora

text: In June 2016, it was reported that she signed a new record deal with Atlantic Records. On 3 September 2016, she performed in a concert at the Basilica of St. Paul Outside the Walls, in Rome, at the vigil for Mother Teresa's canonisation, alongside other Albanian artists, accompanied by the Kosovo Philharmonic Orchestra.


title: Rita Ora

text: On 26 May 2017, Ora released her first solo single in almost two years, titled "Your Song", which peaked at number seven in the UK. The song served as the lead single from Ora's second studio album, after previous attempts at her second record were lost in her lawsuit against her former label, Roc Nation. The second single, "Anywhere", became her eleventh top ten song in the UK, peaking at number two. In January 2018, Ora released the song "For You" (with Liam Payne), from the soundtrack of the film "Fifty Shades Freed".


title: Rita Ora

text: On 18 September 2018, Ora revealed the title of her second studio album, "Phoenix", and its release date, 23 November. On 21 September, she released the album's fourth single, "Let You Love Me". The song reached number four in the UK, marking Ora's 13th top-ten song, thus breaking a 30-year-old record for most top ten songs by a British female solo artist (previously jointly held by Shirley Bassey and Petula Clark). On 29 October, she announced tour dates for the album in Europe, Asia and Oceania from 1 March until 29 May 2019.


title: Rita Ora

text: In April 2019, Ora released the song "Carry On" with Norwegian producer Kygo, as a standalone single for "Pokémon: Detective Pikachu", a film in which she also briefly appears. On 31 May, she released the song "Ritual", with Tiësto and Jonas Blue.


title: Rita Ora

text: In September 2019, Ora confirmed to "Marie Claire" that she had begun working on her third studio album. She provided further details regarding her upcoming third studio album with "NME", stating that "people have been coming to studio sessions from all over the world. I've been working on this now for the past two years, on and off. I have plans for this third album to be something I've never done before." On 12 February 2021, Ora released the extended play, "Bang", with Kazakh producer Imanbek.


title: Rita Ora

text: An appearance in an episode of the British drama series, "The Brief", was her first television role, at age 13. Shortly after, she appeared in the British film, "Spivs" (2004). In April 2014, Ora appeared alongside Korean popstar, Hyuna, in an episode of "Funny or Die" called "Girl, You Better Walk." In 2015, she played Christian Grey's sister, Mia, in the film adaptation of the best-selling novel "Fifty Shades of Grey", a role she later reprised in the film's two sequels. Ora originally approached the production hoping to contribute to the film's soundtrack and instead was asked to audition for the role of Mia Grey by the director of the film, Sam Taylor-Johnson. In the 2021 film, "Twist", an adaptation of Charles Dickens' "Oliver Twist", Ora played the Artful Dodger.


title: Rita Ora

text: In February 2022, she was announced to act in the Disney+ prequel an eight-episode limited series to the 2017 film, "Beauty and The Beast", in a role described as a "fugitive with surprising abilities who carries with her a secret that could potentially affect an entire kingdom", but the project has been put on hold indefinitely.


title: Rita Ora

text: In 2010, Ora featured in a commercial for Skullcandy headphones. In 2011, she appeared in Calvin Klein's CK One campaign. In 2013, she was the face of Italian sneaker brand, Superga, and the face of "Material Girl", a clothing line designed by Madonna. In September 2013, cosmetics brand, Rimmel, announced their collaboration with Ora for makeup collections. She was the face of two Donna Karan 2014 collections, Resort collection and Autumn/Winter collection. She was also the face of the label's fragrance, DKNY My NY, inspired by New York City. In March 2014, Ora was one of the cast members of Marks & Spencer's "Leading Ladies" campaign. Later in 2014, she appeared as the face of Roberto Cavalli Autumn/Winter campaign. In 2015, she appeared in Coca-Cola and Samsung Galaxy S6 advertising campaigns. In 2019, she was the face of several German brands; luxury fashion label, Escada, jewellery company, Thomas Sabo, and footwear retailer, Deichmann.


title: Rita Ora

text: In January 2014, Adidas announced a multi-year designer collaboration with Ora for their brand of casual sports clothing, Adidas Originals. Ora designed her own apparel collections for the brand, including footwear and accessories. In 2016, she collaborated with Italian fashion brand, Tezenis, on a capsule lingerie collection. In 2018, Ora co-designed a capsule shoe collection with the Italian footwear designer, Giuseppe Zanotti. After appearing as the face of Escada, Ora co-designed a capsule collection with the brand in 2019.


title: Rita Ora

text: In 2015, she was a coach on the fourth series of "The Voice UK" on BBC One, replacing Kylie Minogue. The same year, it was confirmed that Ora and BBC Radio 1 presenter, Nick Grimshaw, signed as judges for the twelfth series of "The X Factor" on the rival TV network, ITV, after a bidding war between "The X Factor" and "The Voice UK". She hosted the BBC Radio 1's Teen Awards, alongside Grimshaw, several times (from 2013 to 2017).


title: Rita Ora

text: In July 2016, Tyra Banks, the creator of "America's Next Top Model", announced that Ora would replace her as host of the revamped show which aired on VH1. Ora hosted the 2017 MTV Europe Music Awards on 12 November in London, at Wembley Arena. In September 2019, Ora was announced as a judge for the UK version of the music game show, "The Masked Singer", which aired on ITV in January 2020. Ora co-hosted the 2022 MTV Europe Music Awards with Taika Waititi, on 13 November in Düsseldorf, Germany.


title: Rita Ora

text: On 23 March 2013, Ora performed at "Bal de la Rose du Rocher" in Monte Carlo in aid of the Princess Grace Foundation. On 1 June 2013, Ora performed at the "Chime for Change" charity concert at Twickenham Stadium, London, which raised funds and awareness for girls' and women's issues around the world.


title: Rita Ora

text: On 15 November 2014, Ora joined the charity group Band Aid 30 to record a version of the track, "Do They Know It's Christmas?", to raise money for the 2014 Ebola crisis in West Africa. On 9 March 2016, she gave a speech on immigration and the Syrian refugee crisis at the We Day UK event in London, organised by Free the Children.


title: Rita Ora

text: Ora's mother is Catholic and her father is a nominal Muslim. She considers herself spiritual but not religious.


title: Rita Ora

text: Her maternal grandfather, Osman Bajraktari, was the Albanian consul to Russia (then part of the Soviet Union). Ora's paternal grandfather, Besim Sahatçiu, was a film and theatre director.


title: Rita Ora

text: On 10 July 2015, Ora was named an Honorary Ambassador of Kosovo by then-president, Atifete Jahjaga, at the Embassy of Kosovo in London. Ora, who was joined at the ceremony by her parents, and former British Prime Minister and his wife, Tony and Cherie Blair, stated she was "overwhelmed" by the honour.


title: Rita Ora

text: Ora dated Scottish DJ Calvin Harris from 2013 until June 2014. In 2016, Ora began a relationship with American musician Andrew Watt. They were together for two years until September 2018. They got back together in January 2019, but broke up for the second time in October 2019. Since 2021, she has been in a relationship with New Zealand filmmaker Taika Waititi. They reportedly got married in the summer of 2022.


title: Rita Ora

text: In November 2020, Ora broke the COVID-19 restrictions by having her birthday party at a West London restaurant during a period of national lockdown. Ora had recently returned from Egypt and was supposed to be isolating for 14 days as a result. According to the police, Ora's security offered to pay the venue £5,000 to break guidelines and asked for CCTV cameras to be switched off. The restaurant's representative denied that such payment was made. Ora apologised for the breach and was fined £10,000.


title: Sienna Miller

text: Sienna Rosie Diana Miller (born December 28, 1981) is an American-British actress. Born in New York City and raised in London, she began her career as a photography model, appearing in the pages of Italian "Vogue" and for the 2003 Pirelli calendar. Her acting breakthrough came in the 2004 films "Layer Cake" and "Alfie". She subsequently portrayed socialite Edie Sedgwick in "Factory Girl" (2006) and author Caitlin Macnamara in "The Edge of Love" (2008), and was nominated for the 2008 BAFTA Rising Star Award. Her role as The Baroness in "" (2009) was followed by a brief sabbatical from the screen amid increased tabloid scrutiny.


title: Sienna Miller

text: Miller returned to prominence with her role as actress Tippi Hedren in the television film "The Girl" (2012), for which she was nominated for the BAFTA Television Award for Best Actress and the Golden Globe Award for Best Actress – Miniseries or Television Film. Further critical acclaim followed throughout the 2010s, with appearances in the films "Foxcatcher" (2014), "American Sniper" (2014), "Mississippi Grind" (2015), "The Lost City of Z" (2016), "Live by Night" (2016), and "American Woman" (2018), as well as the miniseries "The Loudest Voice" (2019).


title: Sienna Miller

text: Miller was born in New York City, and moved to London with her family when she was 18 months old. She later boarded at all-girls Heathfield School in Ascot, Berkshire. Her mother, Josephine, is a British former model who was born in South Africa to British parents and was a personal assistant to David Bowie and one-time manager of the Lee Strasberg Theatre and Film Institute in NYC.


title: Sienna Miller

text: Miller's screen debut came in the romantic comedy "South Kensington" (2001), opposite Rupert Everett and Elle Macpherson. In 2002, she had supporting roles in "High Speed" and its follow-up "The Ride", and guest-starred in "The American Embassy" and "Bedtime". She had a regular role as the combative yet caring flatmate of an NYPD detective in the television drama series "Keen Eddie" (2003). Although FOX canceled it after only seven episodes, it was Miller's first exposure to American audiences.


title: Sienna Miller

text: With roles in two commercial films and a higher public profile due to her relationship with actor Jude Law, 2004 was a turning point for Miller's career. The crime thriller "Layer Cake", directed by Matthew Vaughn and starring Daniel Craig, featured her as the love interest of a London-based cocaine supplier. "The New York Times" described Miller as "a new It Girl who barely registers on-screen despite wearing little more than lacey filaments that make her look like a gift meant to be unwrapped very quickly". In "Alfie", the remake of Bill Naughton's 1966 film, she played the girlfriend of a cockney limo driver and sex addict (Jude Law). On her new It Girl status, she said at the time: "I'm not very happy about it, to be honest. It makes me uncomfortable because I don't think it's as a result of having a film come out, [but] being scrutinised because of the relationship I'm in".


title: Sienna Miller

text: Miller portrayed a writer of illegal feminist books and the love interest of Giacomo Casanova (Heath Ledger) in the period dramedy "Casanova" (2005). It made a moderate US$37.6 million, and "Entertainment Weekly", in a positive review, wrote: "Ms. Miller has a modern, smart-girl look about her; her Francesca is neither too tough to melt nor too glittering from the Emma Thompson school of smarties". In 2005 she also made her West End debut in a revival of "As You Like It" at the Wyndhams Theatre, where she received lukewarm reviews. Paul Taylor of "The Independent" wrote: "She approaches an emotion with the finesse of someone beating a carpet" and that she "brings to it all the ripe professional stage experience that can be mustered from appearing in three movies".


title: Sienna Miller

text: Miller took on the role of 1960s socialite and Andy Warhol's muse Edie Sedgwick in the biographical drama "Factory Girl" (2006). Johnny Vaughan from "Sun" Online concluded that "[i]t's Sienna Miller's star that shines brightest in this heartbreaking cautionary tale", but Rotten Tomatoes' critical consensus states: "Despite a dedicated performance by Sienna Miller, "Factory Girl" delves only superficially into her character, and ultimately fails to tell a coherent story." In 2007, Miller had a role as the love interest of a young man from a fictional British town, in Matthew Vaughn's adaptation "Stardust", and played a starlet in Steve Buscemi's "Interview", a remake of Dutch filmmaker Theo van Gogh's 2003 movie of the same name. Budgeted at US$65 million, "Stardust" grossed a modest US$137 million worldwide, while critics felt that Buscemi and Miller's "captivating performances" in "Interview" made "a seemingly simple premise gripping and entertaining".


title: Sienna Miller

text: In "The Mysteries of Pittsburgh" (2008), a film adaptation of writer Michael Chabon's novel, Miller played a woman romantically involved with a rebellious bisexual man. It premiered at the Sundance Film Festival and received a limited release. She created a minor stir in Pittsburgh when, in a 2006 interview with "Rolling Stone", she referred to the city as "Shitsburgh", saying, "Can you believe this is my life? Will you pity me when you're back in your funky New York apartment and I'm still in Pittsburgh? I need to get more glamorous films and stop with my indie year." Miller was parodied in Pittsburgh media (including one article that was headlined "Semi-famous actress dumps on the 'Burgh") and criticised for making what was seen as an unnecessarily disparaging remark, given the special treatment the film's cast and crew had received from the visitors' bureau and other city offices. Miller apologised and said her remarks were taken out of context.


title: Sienna Miller

text: In "The Edge of Love," (2008), a British biographical romantic drama, Miller appeared alongside Keira Knightley as Caitlin Macnamara, the wife of Welsh poet Dylan Thomas. Despite a mixed critical reception, "The Hollywood Reporter" critic Ray Bennett wrote that it was a "wonderfully atmospheric tale of love and war", and that "the film belongs to the women, with Knightley going from strength to strength (and showing she can sing!) and Miller again proving that she has everything it takes to be a major movie star." Miller earned a BIFA Award nomination for Best Supporting Actress for her performance. She also voiced a circus fox in the animated film "A Fox's Tale" (2008) and played an undead newlywed in the romantic comedy "Camille".


title: Sienna Miller

text: Miller was cast as The Baroness in the live-action film adaptation of the "G.I. Joe" franchise "" (2009), her first—and to date, only—mainstream Hollywood blockbuster. She auditioned because it did not involve "having a breakdown or [being] addicted to heroin or dying at the end, something that was just maybe really great fun and that people went to see and actually just had a great time seeing." She sprained her wrist after slipping on a rubber bullet while filming a fight scene with Rachel Nichols. "G.I. Joe" was not well received by most critics, but made US$302.5 million worldwide.


title: Sienna Miller

text: She appeared on the UK motorsport show "Top Gear" in 2009 on the segment "star in a reasonably priced car" and set a lap time of 1:49.8, having passed her driving test only five days before.


title: Sienna Miller

text: By this point, her skyrocketing career had been driven off-course by her tabloid notoriety. "The Independent" observed that her professional trajectory reached "its lowest ebb" with "G.I. Joe", an experience that "convinced her she had well and truly lost her way"; while in an interview with UK's "Esquire" magazine, she stated that roles dried up because "people don’t want to see films with people they don’t approve of in them". She opted to take a hiatus from films for the next two years and work in theater instead. She later said, "I was sick of myself, to be honest, or sick of that perception of me. It all felt so f**king dirt".


title: Sienna Miller

text: Miller played the title role in Patrick Marber's 2009 production of "After Miss Julie" on Broadway. She told "The New York Times": "This is what I have always wanted, to be on Broadway. I'm living my dream, and that's all you can ask for. At a certain point, you have to ignore all the rest". On her performance, "The Guardian" stated: "Miller masters it intermittently—an accomplishment, however incomplete." She starred as a former starlet caught up in a love-triangle in Trevor Nunn's 2011 production of "Flare Path" at London's Theatre Royal Haymarket. It drew favourable reviews, with Henry Hitchings of "Evening Standard" writing that Miller "brings to her role just the right mixture of glacial poise and agonised tension". In "The Independent", Paul Taylor said: "Her performance as the conflicted actress-heroine is genuinely heart-tugging in the subtle way it communicates this young woman's struggle between patriotic duty and extra-marital desire".


title: Sienna Miller

text: After her professional slump, Miller experienced what journalists described as a "career revival" She played more complex, dramatic parts in a series of critically acclaimed films. "All the directors speak to each other," she said in an interview. "And once you crack that upper echelon of incredible directors, you've got people rooting for you. People who people listen to. I've never had that before".


title: Sienna Miller

text: In "The Girl" (2012), an HBO and BBC film, Miller portrayed actress Tippi Hedren, the muse of director Alfred Hitchcock. As part of her research, Miller (who was in the early stages of pregnancy) spoke to Hedren several times during filming, and they became friends. Live birds were used for the rerecreation of the attic scene in Hitchcock's "The Birds". Miller told the "Radio Times", "I did go through a bird attack for two hours. It pales in comparison to what [Hedren] was subjected to, but it was pretty horrible. There were men off-camera with boxes of birds, throwing seagulls and pigeons in my face". The film received mixed reviews, but the "Daily Mirror"s Jane Simon wrote: "[G]liding gracefully through it all (and with an impeccable American accent) Sienna Miller brings untouchable beauty and icy glamour, but also captures the extraordinary resilience Hedren must have had to withstand everything Hitchcock threw at her." Writing for "The Telegraph", Clive James said "[a] better choice [to play Hedren] could not have been made than Sienna Miller, who is even lovelier than Hedren was". She garnered nominations for the BAFTA Television Award for Best Actress and the Golden Globe Award for Best Actress – Miniseries or Television Film. In 2012, she also played a socialite in the dramedy "Two Jacks", the hysterical sister of an elementary teacher in the drama "Yellow", and a housewife who aspires to complete in a belly-dance competition in the made-for-television film "Just like a Woman".


title: Sienna Miller

text: In 2014, Miller portrayed Nancy Schultz, the wife of murdered Olympic gold medal-winning wrestler Dave Schultz, in Bennett Miller's "Foxcatcher" as well as Taya Renae Kyle, the wife of United States Navy SEAL sniper Chris Kyle in Clint Eastwood's "American Sniper". While both films were highly acclaimed, "American Sniper" emerged as the highest-grossing war film of all time. In 2015, she took on the roles of a prostitute in the road drama "Mississippi Grind", the former boss of a hard-working small business owner in the comedy "Unfinished Business", a single mother in the dystopian film "High-Rise", and that of a sous-chef in the drama "Burnt", which reunited her with Bradley Cooper. For "High-Rise", she received a BIFA Award nomination for Best Supporting Actress. Miller also took over the role of Sally Bowles in the Broadway revival of "Cabaret" after Emma Stone's scheduled departure from the production and performed for the last six weeks of the show's engagement, between February and March 2015. "New York Daily News" praised her "cocky and steely" performance and felt that her approach to the role "works well in the Kander and Ebb songs "Don't Tell Momma" and "Perfectly Marvelous"." She was selected to be on the jury for the main competition section of the 2015 Cannes Film Festival.


title: Sienna Miller

text: Miller appeared in Paramount Pictures and Plan B Entertainment's adaptation of "The Lost City of Z" (2016), directed by James Gray, portraying Nina Fawcett, the wife of British geographer Percy Fawcett. "The New York Times" found her to be "wonderful" in her role, while "Time" described her as "luminous and astute". In Ben Affleck's period crime drama "Live by Night" (also 2016), Miller played the mistress of a notorious gangster and the love interest of a World War I veteran. In 2017, Miller starred in the drama "The Private Life of a Modern Woman", which was screened out of competition at the 74th Venice International Film Festival, and in a West End production of the Tennessee Williams classic "Cat On A Hot Tin Roof", at the Apollo Theatre.


title: Sienna Miller

text: In 2018, Miller appeared in the war film "The Catcher Was a Spy" as Estella, the girlfriend of Moe Berg, a catcher for the Boston Red Sox who joined the OSS during World War II, as well as the drama "American Woman", in which she portrayed a single mother who is faced with raising her grandson after her daughter goes missing under mysterious circumstances. "American Woman", which gave Miller some of the best reviews of her career, was her first role as the main character not bolstered by any other actors, and marked the first time she was able to delve into a woman character's life in "nuanced ways". Miller remarked: "These opportunities have been few and far between, and that's intrinsic to being a woman in film. I think it's quite rare; not necessarily specific to me, but at 37 years old, I'm thrilled I’ve had this opportunity. I've done good supporting work in fantastic films and had to work very hard to show something in smaller moments. I loved being able to have the space and time to really do everything I want to with a character".


title: Sienna Miller

text: Miller starred as a narcotics detective in the action film "21 Bridges" (2019), alongside Chadwick Boseman. "The Guardian" felt that the actress was "vocally channelling Edie Falco from "The Sopranos"", and with a worldwide gross of US$50 million, the film emerged as a moderate commercial success. She next took on the role of Beth Ailes, the wife of television executive Roger Ailes (played by Russell Crowe), in the miniseries "The Loudest Voice" (also 2019), which aired on Showtime. Miller struggled to find materials on which to base her performance, aside from the script and Gabriel Sherman’s book "The Loudest Voice in the Room". During an interview with "Entertainment Weekly", she said: "There's very little footage of her that I had access to. But there were these two speeches which she gave, which were on YouTube, and another little interview, so I really kind of based my research around that, and relied on the script because there's just not a lot of information on her out there. But the interview and the speeches I found really revealing".


title: Sienna Miller

text: Before her professional acting career, Miller worked as a photography model. She signed with Tandy Anderson of Select Model Management London, and modelled for Coca-Cola, Italian "Vogue", and posed topless in the 2003 Pirelli Calendar. She went on to grace the covers of "Vogue"'s American, British, Australian and Portuguese editions, as well as other international fashion magazines such as "Nylon", "Marie Claire", and "Porter Edit".


title: Sienna Miller

text: Miller signed a two-year contract with Madrid-based denim label Pepe Jeans London. The first ad campaign appeared on magazines in March 2006 and was shot by photographer Mikael Jansson and stylist Karl Templer. In February 2009, Hugo Boss Fragrances announced that she would be the new ambassador for their "BOSS Orange" women's perfume. In March 2016, she announced as the new face of Swedish fashion chain Lindex, starring in the 1970s-inspired Sienna Hearts Lindex spring campaign. Miller appeared as a guest at a Rome retro-styled dinner party in Gucci's Cruise 2020 campaign, which was directed and photographed by American film director Harmony Korine.


title: Sienna Miller

text: In 2007, Miller, along with her sister Savannah, a professional fashion designer, launched a complete fashion label. Called Twenty8Twelve, it gets its name from Miller's date of birth and is financially backed by Pepe Jeans. The sisters remained at the helm of the label until 2012 when they announced they were stepping down as co-creative directors.


title: Sienna Miller

text: Miller is the Global Ambassador for the International Medical Corps. She travelled with them to the Democratic Republic of the Congo in April 2009 and kept a blog about her experiences. She also visited Haiti with the group after the 2010 Haiti earthquake. Miller also worked alongside Global Cool during their 2007 eco-friendly campaign.


title: Sienna Miller

text: Miller is an ambassador for the UK branch of the Starlight Children's Foundation, which works with seriously ill children and their parents. On 1 July 2007, Miller appeared as a speaker at the Concert for Diana held at Wembley Stadium, London to celebrate the life of Princess Diana almost 10 years after her death. Proceeds from the concert went to Diana's charities as well as to charities of which her sons Princes William and Harry are patrons.


title: Sienna Miller

text: Her relationship with – and, for a time, engagement to – actor Jude Law, after they had starred together in the 2004 film "Alfie", brought both her and her style of dress to the media headlines in the mid 2000s. In December 2004, "Vogue" featured Miller on its front cover and described her as "the girl of the year".


title: Sienna Miller

text: Dubbed by some publications as "the new Kate Moss", Miller has been closely associated with the style of fashion that became known as boho chic, and is sometimes credited for bringing it into the mainstream. In advertisements for Chloé in early 2005, for instance, she was shown as if casually shopping, while she told "Vogue" that she had a laid-back approach to grooming, including cutting her own hair. Miller herself has adopted other styles of dress and her shorter, bobbed hairstyle – a feature of bohemian fashion in the quarter century before World War II – helped to define a new trend in 2007.


title: Sienna Miller

text: Throughout the 2000s, Miller gradually became much better known for her tabloid persona and her fashion sense than her professional work. As noted by "The Independent", "she was one of the most famous young actresses of her generation, but still boasted precious little credibility in the industry". She was frequently photographed by paparazzi topless, and occasionally fully nude, at public pools and beaches. Her 2008 affair with married actor Balthazar Getty caused a hit in Miller's popularity. While the North American media labelled Miller a "home-wrecker", in the UK, her apparent enthusiasm for hopping from one relationship to the next earned her the nickname "Serial Miller". Aware of the damage the negative publicity imposed on her career, she said to "GQ Magazine", "I probably seem like not a particularly nice person, not a girl's girl," but she defended her behaviour as part of the normal experience of growing up. "I think if you put a camera in anyone's life and document it daily for six years, from the age of 21 to 27, there are going to be things that aren't always pretty".


title: Sienna Miller

text: Her 2010s career resurgence marked a turnabout in Miller's public image as audiences started to take her seriously as an actress. In an interview with "The Sydney Morning Herald", she stated: "I definitely feel like I'm in a place now where people are more focused on my career than on my private life and clothes, which is refreshing. There's not the same drama around me that there was".


title: Sienna Miller

text: Throughout her career, Miller has appeared in several magazines' lists of the world's most beautiful women. She ranked 48th, 46th, 11th, 27th, and 51st in "Maxim" magazine's Hot 100 Women in 2005, 2006, 2007, 2008, and 2009 respectively. She ranked 86th and 2nd in "Askmen"'s top 99 "most desirable" women lists of 2005 and 2006. She was also 63rd in "FHM" magazine's "100 Sexiest Women in the World" 2006 supplement. From 2004 to 2010, Miller was chosen as one of the "most beautiful famous faces" by The Annual Independent Critics List of the 100 Most Beautiful Famous Faces From Around the World.


title: Sienna Miller

text: On Christmas Day 2004, Miller became engaged to her "Alfie" co-star Jude Law. On 8 July 2005, Law issued a public apology to Miller for having an affair with the nanny of his children. After attempting to salvage their relationship, Miller and Law separated in November 2006. In December 2009, it was reported that Law and Miller had rekindled their relationship after starring in separate shows on Broadway in late 2009. They spent Christmas 2009 in Barbados, along with three of Law's children. They announced they had split again in February 2011.


title: Sienna Miller

text: In 2008, Miller had a highly publicised affair with married actor Balthazar Getty. Miller later sued two British tabloids over the publication of photos showing her and Getty together.


title: Sienna Miller

text: From 2011 to 2015, Miller dated actor Tom Sturridge, with whom she has a daughter, who was born on 7 July 2012.


title: Sienna Miller

text: Following a High Court hearing in May 2011, Sienna Miller was awarded £100,000 in damages from "News of the World" after the newspaper admitted hacking into her phone. Later, as a core participant, she gave evidence to the Leveson Inquiry in November 2011, including the following:


title: Sienna Miller

text: In November 2021, Miller accepted "a major financial settlement" from News Group Newspapers, publishers of "The Sun", over an alleged phone hacking claim. Her lawyers told the court the payout is "tantamount" to an admission of illegal activity by "The Sun". Outside the High Court on 9 December 2021, Miller said about "The Sun" newspaper, "They very nearly ruined my life. I have certainly seen how they have ruined the lives of others."


title: Khloé Kardashian

text: Khloé Alexandra Kardashian (; born June 27, 1984) is an American media personality and socialite. Since 2007, she has starred with her family in the reality television series "Keeping Up with the Kardashians". Its success has led to the creation of spin-offs, including "Kourtney and Khloé Take Miami" (2009–2013) and "Kourtney and Khloé Take The Hamptons" (2014–2015).


title: Khloé Kardashian

text: From September 2009 to October 2016, Kardashian was married to basketball player Lamar Odom, whom she married one month after they first met. They starred in their own reality television series, "Khloé & Lamar" (2011–2012). In 2009, Kardashian participated in the second season of "The Celebrity Apprentice", finishing 10th of 16 candidates by being fired by Donald Trump. In 2012, she co-hosted the second season of the US adaptation of "The X Factor" with actor Mario Lopez.


title: Khloé Kardashian

text: Kardashian is involved in the retail and fashion industries with her sisters Kourtney and Kim. They have launched several clothing collections and fragrances, and additionally released the book "Kardashian Konfidential" in 2010. The Dash boutique employees starred in their own short-lived reality television series, "Dash Dolls" (2015).


title: Khloé Kardashian

text: In 2016, Kardashian hosted her own talk show, "Kocktails with Khloé". She starred and produced health and fitness docu-series "Revenge Body with Khloé Kardashian".


title: Khloé Kardashian

text: Khloé Alexandra Kardashian was born in Los Angeles, California on June 27, 1984 to Kris (née Houghton), a homemaker, and Robert, an attorney. She has two older sisters, Kourtney and Kim, and a younger brother, Rob. Their mother is of Dutch, English, Irish and Scottish ancestry, while their father was a third-generation Armenian American. After her parents divorced in 1991, her mother married 1976 Summer Olympics decathlon winner Caitlyn Jenner (then Bruce) in 1991. Through their marriage, Kardashian gained stepbrothers Burton "Burt", Brandon, and Brody; stepsister Casey; and half-sisters Kendall and Kylie. In 1994, her father garnered public attention as a defense lawyer for football player O. J. Simpson during his murder trial.


title: Khloé Kardashian

text: Kardashian went to Bel Air Prep, Saint Martin of Tours School, Daniel Webster Middle School, A.E. Wright Middle School, and Montclair Prep. As a teenager, she briefly attended Marymount High School, a Roman Catholic all-girls' school in Los Angeles. She left the high school and enrolled in Alexandria Academy, an alternative one-to-one school, after her sisters' graduations, later saying "there was no reason for me to stay" since she "felt like I didn't have any friends." She graduated with honors a year early at age 17. Before her family reality TV show, Kardashian worked as Nicole Richie's assistant.


title: Khloé Kardashian

text: In February 2007, a 2003 sex tape made by sister Kim Kardashian and her former boyfriend Ray J, "Kim Kardashian, Superstar", was leaked, which contributed to the family's rise in popularity. Later that year, Khloé; her mother Kris; her stepparent Caitlyn; her siblings Kourtney, Kim, and Rob; and half-sisters Kendall and Kylie were commissioned to star in the reality television series "Keeping Up with the Kardashians".


title: Khloé Kardashian

text: The series and her sister Kim's popularity led to the Kardashians being able to cash in by endorsing products. These include waist-slimming pants, beauty products and Coca-Cola, for which they are paid (as of 2016) $75,000 per post on Instagram, Facebook and Twitter.


title: Khloé Kardashian

text: The series proved successful for E!, the network on which it is broadcast, and has led to the creations of spin-offs including "Kourtney and Khloé Take Miami" and "Khloé & Lamar".


title: Khloé Kardashian

text: In April 2009, Kardashian and her sister Kourtney announced that they were contracted to star in a spin-off that would follow their move to launch a D-A-S-H store in Miami, Florida. The series, "Kourtney and Khloé Take Miami", debuted on E! on August 16, 2009. Starting May 29, 2009, Kardashian joined Miami Top 40 Mainstream outlet WHYI for a weekly four-hour talk/entertainment program, co-hosted by "106 & Park"s Terrence J. Khloé and her sisters Kim and Kourtney made a cameo appearance in the Season 3 premiere of the series "90210". Kardashian made an appearance in episodes 2, 4, and 8 of "Kourtney and Kim Take New York", which premiered in January 2011. On April 10, 2011, "Khloé & Lamar", Kardashian's own show with her then-husband, Lamar Odom, debuted.


title: Khloé Kardashian

text: Kardashian participated in the second season of "The Celebrity Apprentice", finishing 10th of 16 candidates by being fired by Donald Trump. It was reported she was fired because of her previous arrest for a DUI. In June 2009, Khloé and her sisters teamed up with the Natural Products Association to create a teeth whitening pen called Idol White. Kardashian appeared in one of PETA's "I'd Rather Go Naked Than Wear Fur" campaigns. The three sisters released a jewelry line in March 2010. In the spring of 2010, the sisters released a clothing line for Bebe. Bebe announced they were dropping the line in December 2010. In September 2010, Kardashian and her sisters released another clothing line, K-Dash on QVC. Kardashian and her sisters marketed a fake tan product, released in 2010 and called Kardashian Glamour Tan.


title: Khloé Kardashian

text: The sisters also released a book, "Kardashian Konfidential", in November 2010. In February 2011, Kardashian and her husband released a unisex fragrance called "Unbreakable." In May 2011, Kardashian and her sisters announced the release of their first novel. Prior to publication, the sisters requested help with naming their book. The winner was offered a cameo appearance in the novel. In July 2011, it was announced that the winning title was "Dollhouse". In October 2012, Kardashian and Odom released a second unisex fragrance, "Unbreakable Joy," inspired by the holiday season.


title: Khloé Kardashian

text: Kardashian's radio show, "The Mix Up With Khloé Kardashian Odom", was a "one-hour, commercial-free show where Kardashian will take requests, chat with her celebrity friends, and more during the Mavericks' season while she's in Dallas with her husband Lamar Odom." It aired on January 30, 2012. She later made an appearance on the MTV television series Punk'd with Kelly Osbourne and Miley Cyrus in February 2012. In October 2012, Kardashian and Mario Lopez were confirmed as the co-hosts of the second season of the American version of "The X Factor". It was confirmed on April 22, 2013, that Kardashian will not return to co-host "The X Factor" for its third season. On March 26, 2014, E! announced a "Keeping Up with the Kardashians" spin-off series titled "Kourtney & Khloé Take the Hamptons". "The Hamptons" follows Kourtney, Khloé, and Scott Disick as they relocate to The Hamptons while the girls work on the New York Dash store plus open a pop-up store. In 2015 she published a book titled "Strong Looks Better Naked".


title: Khloé Kardashian

text: In January 2016, Kardashian hosted the "Kocktails with Khloé" pop culture–themed variety talk show, which aired on the FYI cable channel. The show was cancelled after 14 episodes. Kardashian and business woman Emma Grede launched their clothing line Good American in the same year, and made $1 million in sales on the first day. Good American started by selling jeans ranging from size 00 to 24 and has expanded to a variety of clothes including workout clothes, dresses and a maternity collection. Kardashian starred and produced "Revenge Body with Khloé Kardashian", an American reality television series that premiered on the E! cable network, on January 12, 2017. In December 2018, Kardashian became the brand ambassador of Burst Oral Care & performed corn test on the electric toothbrush. On June 14, 2019, Kylie Cosmetics launched their collaboration with Kardashian called Kylie Cosmetics x Koko Kollection. This marked their third collaboration, after previously launched special collection of lip products called Koko Kollection in 2016 and the second part in 2017. In August 2019, Kardashian announced she will become an executive producer for the new season of "Twisted Sisters", an Investigation Discovery show, consisting of ten hour-long episodes following stories of sisters who turned on each other. In November 2019, Kardashian partnered with her sisters Kourtney and Kim to create three new perfumes (one for each sister) for Kim's brand KKW Fragrance. The collection introduces Pink Diamond (Khloé's fragrance), Yellow Diamond (Kourtney's fragrance) and pure Diamond (Kim's fragrance). Each scent is individually inspired by and unique to her, Kim, and Kourtney. In October 2020, it was announced she became the brand ambassador and co-owner of Kiwi collagen supplement company Dose & Co.


title: Khloé Kardashian

text: In September 2021, Khloe Kardashian hosted a tournament for "Candy Crush Saga", marking the game's first tournament. The tournament was held in-app from September 23 until October 7.


title: Khloé Kardashian

text: Kardashian has received criticism and negative comments which were focused on her body since "Keeping Up with the Kardashians" premiered in 2007. She has been compared to her sisters Kourtney and Kim with Kardashian recalling "I didn't really realize that I was 'the fat sister' if you will until I went on TV and the media started saying that about me. I knew I didn't look like my sisters and I didn't have those shapes, but I didn't think that was wrong". Kardashian physique, notably her face, has attracted significant attention from the media and public in recent years. She has received comments from the public regularly saying she looks "unrecognisable". However, Kardashian has denied having surgery, stating that when she lost weight she lost fat in her face and also credits her make-up artist. She has also been open to using photo editing app Facetune, and stated "Facetune is the best thing to bring to the table. It's life-changing" in February 2016.


title: Khloé Kardashian

text: In 2001, Kardashian suffered a traumatic brain injury in a car accident. She went through the windshield and suffered a severe concussion, causing long-term memory loss.


title: Khloé Kardashian

text: Kardashian has migraines, a condition she has had since she was in sixth grade. As an adult, she became a spokesperson for the migraine pharmaceutical Nurtec ODT, which she has said has helped her.


title: Khloé Kardashian

text: On October 28, 2020, Kardashian posted a video on social media, revealing that she was diagnosed with COVID-19. In the video, she said, "I suffer from migraines, but this was the craziest headache".


title: Khloé Kardashian

text: On October 29, 2021, Kardashian announced via Twitter that she and her three-year-old daughter, True, had tested positive for COVID-19. Writing on Twitter, Kardashian said "True and I tested positive for Covid. I've had to cancel several commitments and I'm sorry I won't be able to make those happen. Luckily, I have been vaccinated so all will be ok."


title: Khloé Kardashian

text: In October 2022, Kardashian revealed she had had a "rare" tumour removed from her face, having initially assumed it to be a zit. She had previously had an operation to remove melanoma when she was 19 years old.


title: Khloé Kardashian

text: Kardashian dated basketball player Rashad McCants in 2008. The two broke up after seven months in late January 2009. On September 27, 2009, Kardashian married professional basketball player Lamar Odom, who was a member of the Los Angeles Lakers at the time. The couple were married exactly one month after they met at a party for Odom's teammate Metta World Peace. Kardashian removed her middle name and took her husband's surname, becoming Khloé Kardashian Odom. Kardashian adopted a pet boxer named Bernard "BHops" Hopkins, after Bernard Hopkins, the boxer.


title: Khloé Kardashian

text: On December 13, 2013, after months of speculated separation, Kardashian filed for divorce from Odom and for legal restoration of her last name. Both parties signed divorce papers in July 2015. The divorce had yet to receive final approval from a judge in October 2015, when Odom was hospitalized after being found unconscious in a Nevada brothel. He was in a coma for four days; as he lay in a hospital, Kardashian withdrew her pending divorce petition. In an interview with "People Magazine", Kardashian confirmed that they had not reconciled, but the divorce had been withdrawn so that she could make medical decisions on Odom's behalf. Kardashian and Odom's divorce was finalized in December 2016.


title: Khloé Kardashian

text: In January 2014, she began on-again, off-again relationship with rapper French Montana. They broke up in December that year. Kardashian started dating basketball player James Harden after meeting at brother-in-law Kanye West's Staples Center birthday party in 2015. The two were together for eight months between 2015 and 2016.


title: Khloé Kardashian

text: Kardashian began dating basketball player Tristan Thompson in 2016. Kardashian gave birth to a daughter, True Thompson, on April 12, 2018, amidst controversy after Thompson was found to have cheated on Kardashian during her pregnancy. In February 2019, Kardashian and Thompson split after it was revealed that Thompson had allegedly cheated on Kardashian with her younger half-sister Kylie Jenner's then-best friend Jordyn Woods. In August 2020, they resumed their relationship after quarantining together during the COVID-19 pandemic. In June 2021, they were reported to have broken up again. In July 2022, it was announced that Kardashian and Thompson were expecting a baby boy via surrogacy. In July 2022, their son was born.


title: Khloé Kardashian

text: Kardashian supports the recognition of the Armenian genocide and has visited Tsitsernakaberd, the memorial to the victims in Yerevan, Armenia. In April 2021, Kardashian praised President Joe Biden for officially recognizing the Armenian Genocide, thus becoming the first US president to do so.


title: Khloé Kardashian

text: In October 2020, Kardashian spoke out in support of Republic of Artsakh and Armenians, condemning Azerbaijan's involvement in the 2020 Nagorno-Karabakh conflict. On October 10, 2020, she spoke on the ArmeniaFund fundraising telethon and urged viewers to donate money to help those impacted by the recent war.